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U.S. Supreme Court Will Not Hear Challenge to Affordable Care Act’s Independent Payment Advisory Board at This Time

Goldwater Institute will renew challenge to price-setting board when it makes its first decisions

Washington, D.C.—Today the U.S. Supreme Court announced it would not hear a Goldwater Institute challenge to the Independent Payment Advisory Board created by the Affordable Care Act.

“This case is not dead; we’re simply in a holding pattern,” said Christina Sandefur, a senior attorney at the Goldwater Institute. “We will bring this challenge again once the Independent Payment Advisory Board takes action.”

The Independent Payment Advisory Board is a 15-member board created to set reimbursement rates for Medicare. In reality, it has the power to govern decisions about public and private health care, and to determine which procedures, treatments and drugs will and will not be covered by the government programs that pay for the medical treatment of more than 48 million Americans. IPAB’s decisions automatically become law and cannot be challenged in court. The ACA was written so that the Board cannot be repealed without an unprecedented congressional supermajority, and only during a short window in 2017.

These features are unique to the Independent Payment Advisory Board. Never in American history has another board been created with such broad authority to make law without Congress’s vote or the president’s signature, and that cannot be challenged in court or repealed.

This consolidation of power into one unelected agency was the main aspect of the Goldwater Institute’s challenge. But because the Board has not yet been appointed, or made any decisions, the Ninth Circuit Court of Appeals said the case was not ripe for review at this time.  Today, the Supreme Court did not disturb that ruling.

According to the ACA, as long as IPAB remains unstaffed, the Secretary of Health and Human Services wields the Board’s vast powers alone. And while the Board must act when Medicare costs rise higher than a designated percentage of inflation in a single year, nothing stops it from taking whatever action its members consider to be “related to the Medicare program.”

“We are disappointed we have to wait to bring this challenge before the Court—Americans are subject to IPAB’s limitless decision-making with no recourse,” said Sandefur. “Because the Board is completely insulted from constitutional checks and balances, without Supreme Court action now, it may be too late to decide the case later.”

Congressman Phil Roe (R-TN) has introduced legislation in the U.S. House of Representatives to repeal the Independent Payment Advisory Board. His bill has received dozens of co-sponsors, including several Democrats. Former Congressman Barney Frank (D-NY) has been a vocal critic of the Independent Payment Advisory Board and has also called for its repeal. Twenty-five members of Congress filed an amicus brief asking the Court to hear the Goldwater Institute challenge to IPAB.

Read more about Coons v. Lew here.

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About the Goldwater Institute

The Goldwater Institute drives results by working daily in courts, legislatures and communities to defend and strengthen the freedom guaranteed to all Americans in the constitutions of the United States and all 50 states. With the blessing of its namesake, the Goldwater Institute opened in 1988. Its early years focused on defending liberty in Barry Goldwater’s home state of Arizona. Today, the Goldwater Institute is a national leader for constitutionally limited government respected by the left and right for its adherence to principle and real world impact. No less a liberal icon than the New York Times calls the Goldwater Institute a “watchdog for conservative ideals” that plays an “outsize role” in American political life.

March 30, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Medical Information Records, LLC to Bring Dell Predictive Analytics and Azure Machine Learning to the Operating Room

Combination of AnesthesiaOS™ and Dell Statistica helps anesthesiologists make real-time assessments of patient risk.

HOUSTON, Texas, March 16, 2015 – Medical Information Records (MIR), LLC, a leading provider of medical software technology, today announced its collaboration with Dell Software and Microsoft to deliver real-time predictive analytics capabilities and to learn from each and every point of care experience.

The relationship enables customers to use Dell’s Statistica advanced analytics
platform and Microsoft’s Azure Machine Learning in tandem with MIR’s AnesthesiaOS case management technology, empowering anesthesiologists to better record, track and analyze patient data to make real-time predictions about patient risk factors and take preventative steps in a proactive manner.

“Our vision at Medical Information Records is to advance medicine by creating a smarter workflow for providers,” said Terrence Ray, Chief Executive Officer at MIR. “Our AnesthesiaOSTM platform was already making it easier for anesthesiologists to document procedures and access criticalpatient information directly from the operating room. Now, using that technology in conjunction
with Dell Statistica and Azure Machine Learning, they can go a step further by analyzing that data in real-time to gain insight into a patient’s risk factors and adjust the level of care they provide accordingly”.

MIR’s AnesthesiaOSTM platform is a cloud-based EHR running on Microsoft Azure that enables providers to easily complete an anesthesia record, while Dell’s Statistica advanced analytics software solution combined with Azure Machine Learning delivers a wide range of data mining, predictive analytics and data visualization capabilities. The combined solution enables anesthesiologists to complete an anesthesia record directly in the operating room with AnesthesiaOS and Azure Machine Learning, and then access that information in real-time and run predictive models to calculate patient risk scores and determine the appropriate treatment procedures with Dell Statistica. “The potential to reduce patient risk through the use of predictive analytics is well documented, but remains largely untapped throughout the healthcare industry,” said John K. Thompson, General Manager of Global Advanced Analytics at Dell Software. “We’re excited to be working together with the team at MIR to help doctors and hospitals leverage technology to improve the quality of care and deliver better outcomes for patients.”

“Even the best anesthesiologists can be better with enhanced access to data and insights, “said Joseph Sirosh, Corporate Vice President of Machine Learning at Microsoft. “The ability to access and analyze patient demographics, vital signs, past medical histories and other critical information in real-time to determine the expected clinical impact is a potential game changer for anesthesiologists, and we’re proud to be partnering with the MIR team to help make it possible.”
In 2014, Medical Information Records was selected as the overall winner of the Dell Healthcare Pitch Days competition, which featured nearly 30 companies offering innovative solutions designed to change the way healthcare is delivered.

About AnesthesiaOS™
AnesthesiaOSTM is truly the future of AIMS as it transcends how electronic health records (EHRs) are viewed today. AnesthesiaOS is a cloud-based modular EHR that will allow any provider to easily complete an anesthesia record while focusing on the quality of patient care and not merely documentation.

AnesthesiaOS is designed to enhance the point of care, not control it.  Developed
by an anesthesiologist for use by hospitals, surgery centers, and individual providers, it can be utilized to perform operating room cases via a web portal, personal computer or tablet device and provides EHR enhancements that center around the patient care experience while maintaining documentation and compliance requirements without additional or adverse changes to the
provider’s workflow.

March 27, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Logicalis US: Image Management is One of Healthcare CIOs’ Toughest Tasks

Solution Provider IDs Five Core Components in an Effective Enterprise Imaging Strategy

NEW YORK, March 24, 2015 – Gathering, storing, accessing, and analyzing a rapidly expanding volume of patient images is one of the most complex IT tasks in today’s healthcare environments. These images tell a patient’s clinical life story, and with the recent proliferation of affordable digital technologies such as point-of-care ultrasounds, digital cameras and medical/surgical scopes, images in varying formats are being produced in record numbers by a variety of service lines outside of radiology – including surgical services, dermatology and pathology.  According to Logicalis US, an international IT solutions and managed services provider (www.us.logicalis.com), the key to managing these images is to develop a comprehensive enterprise imaging strategy that addresses five core components and to do so, in a standardized, vendor neutral way.

“Developing a thorough enterprise imaging strategy is quickly becoming one of the most important things a hospital CIO can do,” says Kim Garriott, Principal Consultant, Healthcare Strategies, Logicalis Healthcare Solutions.  “Medical imaging is so much more than just capturing and storing X-rays and ultrasounds; it’s a multi-modal discipline that gathers images from a variety of sources and makes them readily available to clinicians through the patient’s electronic medical record (EMR) regardless of the underlying technology used to obtain them. Imaging gives clinicians information they need to enhance patient outcomes, and having that technology available, from a business perspective, can result in increased reimbursements from insurance and Medicare.  Beyond the obvious quality of care issues, hospitals that aren’t taking the steps necessary to move their imaging management practices to the next level risk regulatory infringements and compromised data security making the development of an enterprise imaging strategy one of the most important tasks in healthcare IT.”

Healthcare Imaging’s Five Core Components
Logicalis Healthcare Solutions’ imaging experts have identified five core components that, when properly addressed within the healthcare system’s enterprise imaging strategy, will result in improved coordination of care, increased satisfaction among clinicians, improved patient engagement, streamlined operational costs, and stronger regulatory compliance:

  1. Acquisition: Healthcare IT pros must discover the technologies and clinical workflows used to acquire medical images across as many as 40 service lines before developing their EMR optimization plans.
  2. Storage: Keeping medical images on hand involves more than just storing them; it also requires an in-depth disaster recovery plan and whole-system monitoring to ensure those images are both available and secure 24×7.
  3. Access: Until now, physicians have accessed medical images in a variety of cumbersome ways ranging from portals to unsecure CDs and other portable media delivered directly by the patient into the doctor’s hands.  What doctors want – and are beginning to expect – is to have the patient’s entire medical image library available through their EMR and accessible for viewing regardless of device or source of acquisition.
  4. Sharing: The ultimate goal is for a variety of clinicians to be able to collaborate, securely sharing a patient’s images both within the same healthcare provider and between providers regardless of where those images reside.
  5. Analytics: Clinicians also need to be able to analyze medical images and the associated meta-data in a thoughtful, patient-centric way that leads them to new diagnoses and treatment plans that can benefit both the individual patient as well as a larger patient population as a whole.

Want to Learn More?

About Logicalis
Logicalis is an international IT solutions and managed services provider with a breadth of knowledge and expertise in communications and collaboration, data center and cloud services, and managed services.

Logicalis employs over 3,800 people worldwide, including highly trained service specialists who design, specify, deploy and manage complex IT infrastructures to meet the needs of almost 6,000 corporate and public sector customers.  To achieve this, Logicalis maintains strong partnerships with technology leaders such as Cisco, HP, IBM, CA Technologies, EMC, NetApp, Microsoft, VMware and ServiceNow.

The Logicalis Group has annualized revenues of $1.6 billion from operations in Europe, North America, Latin America and Asia Pacific and is one of the leading IT and communications solution integrators specializing in the areas of advanced technologies and services.

The Logicalis Group is a division of Datatec Limited, listed on the Johannesburg and London AIM Stock Exchanges, with revenues of approximately $6 billion.

March 24, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

TransUnion Survey: Nearly Seven in 10 Patients Would Avoid Healthcare Providers That Undergo a Data Breach

Chicago, March 24, 2015A new survey from TransUnion Healthcare found that more than half of recent hospital patients are willing to switch healthcare providers if their current provider undergoes a data breach. Nearly seven in 10 respondents (65%) would avoid healthcare providers that experience a data breach.

Older and younger consumer groups responded differently to data breaches. While 73% of recent patients ages 18 to 34 said they were likely to switch healthcare providers, older consumers were less willing. Nearly two-thirds (64%) of patients older than 55 were not likely to consider switching healthcare providers following a data breach.

“Older consumers may have long-standing loyalties to their current doctors, making them less likely to seek a new healthcare provider following a data breach,” said Gerry McCarthy, president of TransUnion Healthcare. “However, younger patients are far more likely to at least consider moving to a new provider if there is a data breach. With more than 80 million millennials recently entering the healthcare market, providers that are not armed with the proper tools to protect and recover from data breaches run the risk of losing potentially long-term customers.”

Other survey insights on consumers’ expectations following a data breach include:

·         Nearly half of consumers (46%) expect a response or notification within one day of the breach.

·         31% of consumers expect to receive a response or notification within one to three days.

·         Seven in 10 (72%) consumers expect providers to offer at least one year of free credit monitoring after a breach.

·         Nearly six in 10 (59%) consumers expect a dedicated phone hotline for questions.

·         More than half of consumers (55%) expect a dedicated website with additional details.

“The hours and days immediately following a data breach are crucial for consumers’ perceptions of a healthcare provider,” said McCarthy. “With the right tools, hospitals and providers can quickly notify consumers of a breach, and change consumer sentiments toward their brand.”

For more information about data breach services, visit TransUnion Healthcare.
About the Survey
The online survey included responses from 1,228 U.S. consumers who have received medical care at a doctor’s office, clinic or hospital in the past two years. The survey was conducted in February 2014.

About TransUnion Healthcare
TransUnion Healthcare, a wholly owned subsidiary of credit and information management company TransUnion, empowers providers with Intelligence in an Instant® by providing data and analytics at the point of need.  TransUnion offers a series of data solutions designed to provide greater ease of use, accuracy and transparency in the revenue cycle process thereby assisting providers in lowering their uncompensated care.  www.transunionhealthcare.com

About TransUnion
Information is a powerful thing. At TransUnion, we realize that. We are dedicated to finding innovative ways information can be used to help individuals make better and smarter decisions. We help uncover unique stories, trends and insights behind each data point, using historical information as well as alternative data sources. This allows a variety of markets and businesses to better manage risk and consumers to better manage their credit, personal information and identity. Today, TransUnion reaches consumers and businesses in more than 30 countries around the world on five continents. Through the power of information, TransUnion is working to build stronger economies and families and safer communities worldwide.

I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

HHS announces proposed rules to support the path to nationwide interoperability

Electronic Health Record Incentive Programs and 2015 Edition Health IT Certification Criteria rules proposed

The U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) today announced the release of the Stage 3 notice of proposed rulemaking for the Medicare and Medicaid Electronic Health Records (EHRs) Incentive Programs and 2015 Edition Health IT Certification Criteria to improve the way electronic health information is shared and ultimately improve the way care is delivered and experienced. Together, these proposed rules will give providers additional flexibility, make the program simpler, and drive interoperability among electronic health records, and increase the focus on patient outcomes to improve care.

The proposed rules are one part of a larger effort across HHS to deliver better care, spend health dollars more wisely, and have healthier people and communities by working in three core areas: to improve the way providers are paid; improve the way care is delivered; and improve the way information is shared. Together, these improvements can support better care and lower costs in the health care system.

“The flow of information is fundamental to achieving a health system that delivers better care, smarter spending, and healthier people. The steps we are taking today will help to create more transparency on cost and quality information, bring electronic health information to inform care and decision making, and support population health,” said HHS Secretary Sylvia M. Burwell.

The Meaningful Use Stage 3 proposed rule issued by CMS specifies new criteria that eligible professionals, eligible hospitals, and critical access hospitals must meet to qualify for Medicaid EHR incentive payments. The rule also proposes criteria that providers must meet to avoid Medicare payment adjustments (Medicaid has no payment adjustments) based on program performance beginning in payment year 2018. The rule give more flexibility and simplifies requirements for providers by focusing on advanced use of electronic health records and eliminating requirements that are no longer relevant.

The 2015 Edition Health IT Certification Criteria proposed rule aligns with the path toward interoperability – the secure, efficient, and effective sharing and use of health information –identified in ONC’s draft shared Nationwide Interoperability Roadmap. The proposed rule builds on past editions of adopted health IT certification criteria, and includes new and updated IT functionality and provisions that support the EHR Incentive Programs care improvement, cost reduction, and patient safety across the health system.

“This Stage 3 proposed rule does three things: it helps simplify the meaningful use program, advances the use of health IT toward our vision for improving health delivery, and further aligns the program with other quality and value programs,” said Dr. Patrick Conway, M.D., M.Sc., CMS acting principal deputy administrator and chief medical officer. “And, in an effort to make reporting easier for health care providers, we will be proposing a new meaningful use reporting deadline soon.”

“ONC’s proposed rule will be an integral component in the shared nationwide effort to achieve an interoperable health system,” said Karen DeSalvo, M.D., M.P.H, M.Sc., national coordinator for health IT. “The certification criteria we have proposed in the 2015 Edition will help achieve that vision through provisions that consider the range of health IT users and uses across the care continuum, including those focused on interoperable standards, data portability, improved transparency, privacy and security capabilities, and increased oversight through ONC’s Health IT Certification Program.”

Under the Health Information Technology for Economic and Clinical Health Act, doctors, health care professionals and hospitals, including critical access hospitals, can qualify for Medicare and Medicaid incentive payments when they adopt and meaningfully use health IT technology certified by ONC. Since the programs began in 2011, more than 433,000 eligible professionals and eligible hospitals have received an incentive payment representing about 60 percent of eligible professionals in either the Medicare or Medicaid programs and about 95 percent of eligible hospitals.

The Stage 3 proposed rule’s scope is generally limited to the requirements and criteria for meaningful use in 2017 and subsequent years. CMS is considering additional changes to meaningful use beginning in 2015 through separate rulemaking. Read more about this announcement on Dr. Conway’s blog.

The Stage 3 proposed rule may be viewed at here and the comment period ends on May 29, 2015. The 2015 Edition proposed rule may be viewed at here and the comment period ends on May 29, 2015. The Draft 2015 Edition Certification Test Procedures may be viewed at HealthIT.gov, and the comment period ends on June 30, 2015.

More information on meaningful use can be found on the CMS EHR Incentive Programs website at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html.

More information on ONC’s editions of certification criteria can be found at http://www.healthit.gov/policy-researchers-implementers/standards-and-certification-regulations.

March 20, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

$8 Billion Annual Savings Opportunity for U.S. Healthcare With Adoption of Electronic Business Transactions

2014 CAQH Index Shows Progress, Gaps in Switch from Manual to Electronic

WASHINGTON, DC – Mar. 17, 2015 – U.S. healthcare could save $8 billion annually by transitioning six routine business transactions from manual to electronic, according to the newly published 2014 CAQH Index™. The CAQH Index tracks progress from manual (e.g., via phone, fax or mail) to industry standardized (HIPAA) electronic administrative transactions between health plans and healthcare providers. This annual report, the second from CAQH, details adoption rates and potential savings.

“Hospitals should be focusing on patients, not paperwork. By expanding automated electronic communications between providers and health plans, we can reduce health care costs, ease administrative burdens, and ensure that key stakeholders in our health care system communicate with each other more effectively,” says Joel Perlman, Executive Vice President, Finance, and Chief Financial Officer, Montefiore Medical Center.

Based on data from 2013, the 2014 CAQH Index represents a collaboration between healthcare providers and health plans. Data submitted includes administrative transactions and cost estimates for analysis. The report reflects data from participating health plans representing 112 million enrollees – almost 45 percent of the privately insured U.S. population – on more than four billion transactions. In addition, a range of healthcare facilities and provider practices participated in a data collection process conducted on behalf of CAQH by Milliman, Inc.

Both this and the prior year’s CAQH Index studied six transactions — claim submission, eligibility and benefit verification, prior authorization, claim status inquiries, claim payment, and remittance advice transactions. This enabled year-over-year comparisons between health plans providing data counts for both reports. CAQH also measured two transactions for the first time: claims attachments and prior authorization attachments.

While overall adoption rates of fully electronic transactions (those automated for both health plans and healthcare providers) rose only slightly during this period, the volume of fully electronic transactions grew by double-digit rates for eligibility and benefit verifications, claim status inquiries and claim payments.

Average adoption rates of fully electronic transactions varied widely, from a high of 92 percent for claim submission to a low of 7 percent for prior authorization. About half of all claim payments and remittance advice transactions remain manual. Health plans continued to process about 1 billion transactions manually, and healthcare providers handled over 2.4 billion.

The potential for significant cost savings is due to the large volume of transactions, as well as the dramatic cost difference between manual and electronic transactions. For health plans, costs for each manual transaction averaged $2 for the six transactions studied, while electronic transaction costs ranged from only 5 to 10 cents. Healthcare providers’ estimated costs averaged more than $5 for manual versus $1.60 per electronic transaction.

“The CAQH Index shows that additional progress to realize the full potential of electronic transactions requires an ongoing commitment by all healthcare stakeholders, including health plans, providers, vendors and government,” says Robin Thomashauer, Executive Director, CAQH. “Findings can inform industry initiatives such as CAQH CORE and CAQH Solutions that support the move towards greater use of electronic transactions.”

Health plans and providers can estimate their potential cost savings by using an interactive savings calculator available at www.caqh.org. The complete 2014 CAQH Index report and highlights are also available for download.

The 2015 CAQH Index is underway, and is seeking additional participants. Health plans and providers that participate will receive a confidential, independent assessment of how they compare to their industry peers.

About the CAQH Index Advisory Council
The CAQH Index Advisory Council helps guide the measurement strategy and establish data submission specifications for the CAQH Index. The Council is composed of experts in claim-related transactions and business processes. Members are listed in the 2014 CAQH Index report.

About CAQH®
CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of business processes, delivering value to providers, patients and health plans. Visit www.caqh.org and follow us on Twitter: @caqh and LinkedIn.

2014 CAQH Index™ Highlights

  • Health plans representing 112 million enrollees – approximately 45 percent of the commercially covered population in 2013 – contributed data for the 2014 Index. The responding health plans provided data on more than 4 billion transactions, including 1.4 billion claims submitted.
  • For the six main categories of claim-related transactions studied, adoption rates of fully electronic standardized transactions (automated for both health plans and healthcare providers) varied from over 90 percent to less than 10 percent. For fully electronic (HIPAA standardized) transactions, adoption rates in 2013 were: claim submission (92%), eligibility and benefit verification (69%), prior authorization (7%), claim status inquiries (54%), claim payment (58%), and remittance advice (47%). Based on data from health plans responding in both years, adoption rates of fully electronic transactions rose slightly between 2012 and 2013.
  • In 2013, the volume of fully electronic standardized transactions grew by double-digit rates on a year-over-year basis for eligibility and benefit verifications (+14%), claim status inquiries (+23%), and claim payments (+14%). The largest declines in the volume of manual transactions were for claim submission (-15%), claim payments (-15%), and remittance advice (-16%).
  • Nearly 8 billion transactions were performed electronically by commercial health plans and about 6.5 billion were handled electronically by healthcare providers. Despite the increase in electronic transactions, approximately 1 billion transactions were handled manually (telephone, fax, mail etc.) by health plans in 2013, and there were over 2.4 billion transactions handled manually by healthcare providers. These counts are based on an extrapolation from the plans reporting for the 2014 Index (112 million enrollees) to the whole commercially covered population (approximately 245 million enrollees).
  • The range of adoption of fully electronic standardized transactions varied widely among responding health plans. The rate of adoption for electronic claim submission had the narrowest range, from a high of 97 percent to a low of 81 percent. The transaction with the largest range of adoption rates of fully electronic transactions among health plans was claim status inquiries, from a high of 97 percent down to zero percent (i.e., no adoption).
  • In 2013, a large share of claim payments and their corresponding remittance advice statements continued to be handled by paper checks and mail. Among all responding health plans, only 58 percent of claim payments were made electronically, and the remaining 42 percent were paid by check. Approximately half of remittance advice transactions were made electronically, with roughly equal percentages transmitted by HIPAA standardized electronic transactions (47 percent) and by mail (45 percent), and about 8 percent made via web portals.
  • For health plans, costs for manual transactions averaged approximately $2 per transaction for the six main transaction categories studied; costs of electronic transactions ranged from about 5 to 10 cents per transaction. Healthcare providers’ estimated costs per transaction averaged more than $5 for manual transactions and approximately $1.60 for each electronic transaction.
  • In total, completing the transition from manual to electronic processes for the six main transactions studied could save health plans and healthcare providers approximately $8 billion annually. In addition, the 2014 Index studied claim attachments and prior authorization attachments for the first time, virtually all of which were handled manually. If those attachments were instead processed electronically, additional savings for both health plans and healthcare providers would be possible. The transaction type estimated to have the highest potential savings is eligibility and benefit verification ($4 billion).
March 18, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Community Health Network Partners with Kyruus to Improve Patient Access

Integrated health system chooses the leader in patient access solutions to provide best-in-class patient experience

Boston, MA, March 18, 2015 – Kyruus, a leading provider of Patient Access and Referral Management Solutions, announced today that Community Health Network  has selected its ProviderMatch suite of products to help optimize the experience of patients cared for at the Indiana-based health system. The $1.5 billion provider network is a recognized leader in integrated health services and provides care in more than 200 sites across Indianapolis. Community will utilize Kyruus to streamline its provider data and enable real-time, data-driven matching of patients to the right providers within its network.

“A core aspect of our vision at Community  is to provide an exceptional experience to every patient that seeks care here,” said Julie O’Toole, vice president of patient experience at Community Health Network. “Kyruus’s ability to simultaneously enrich and simplify the way we connect patients with our providers enhances our ability to deliver on this promise.”

The ProviderMatch deployment will allow Community’s  referral specialists and care managers to access a “single source of truth” for its providers, enabling quick and accurate matching of patients to network providers based on their specific clinical and operational needs. Community  will also leverage the same data and search technology to power its online physician finder tool at ecommunity.com.

“Optimizing patient experience begins at the first point of contact. We have a responsibility to make sure that patients get referred to the right provider the first time so that care is delivered efficiently and at the highest quality standards,” said Dr. Graham Gardner, co-founder and CEO of Kyruus. “We are proud to partner with organizations like Community Health Network that share this vision and look forward to helping serve their patients.”

About Community Health Network

Ranked among the nation’s most integrated healthcare systems, Community Health Network is Central Indiana’s leader in providing convenient access to exceptional healthcare services, where and when patients need them—in hospitals, health pavilions and doctor’s offices, as well as workplaces, schools and homes.  As a non-profit health system with over 200 sites of care and affiliates throughout Central Indiana, Community’s full continuum of care integrates hundreds of physicians, specialty and acute care hospitals, surgery centers, home care services, MedChecks, behavioral health and employer health services.  To learn more, visit eCommunity.com or call 800-777-7775.

About Kyruus

Kyruus is a leading provider of enterprise software solutions that enable hospitals and health systems to optimize the patient experience across all channels of patient access. Leveraging a proprietary Big Data approach, our technologies integrate and enrich information about provider expertise, demographics, and scheduling logic for real-time referrals and supply-demand matching throughout the health system. ProviderMatch ensures that patients are matched with the right providers, at the right time, in a manner that maximizes provider efficiency and care coordination. To find out why a Better Match Means Better Care, please visithttp://www.kyruus.com.

I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

HITRUST to Improve Patient Privacy with New Framework for De-Identification of Health Information

De-Id Framework to Simplify and Standardize Key Process of De-Identification of Healthcare Data

FRISCO, Texas–The Health Information Trust Alliance (HITRUST) announced today the new HITRUST De-Identification Framework, developed to improve patient privacy, enhance innovation and streamline the appropriate use of healthcare data. The framework meets the need of healthcare organizations for greater guidance and consistency in the de-identification and use of de-identified healthcare data, while simplifying and streamlining the process. De-identification is a key method for protecting privacy by preventing a patient’s identity from being connected with health information and is a core component of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.

“HITRUST believes clearer guidelines in the form of standards for the uses of de-identified data and managing associated risks are needed”

The HITRUST De-Identification Framework is fully aligned and mapped to the HITRUST Common Security Framework (CSF), the most comprehensive and widely adopted information security and privacy framework for the healthcare industry. The CSF is used by hospitals, health plans and other healthcare organizations as a certifiable, scalable and efficient approach to regulatory compliance and risk management. Now in its seventh major release, HITRUST continues to innovate and enhance the CSF ensuring it meets the ongoing needs of the healthcare industry.

Currently, many healthcare organizations remain uncertain about the de-identification process and the use of de-identified data. The new HITRUST De-Identification Framework offers standards and controls, consistent with HIPAA, to enhance the understanding of de-identification, clarify what qualifies as de-identified data, and to promote the use of de-identified data – leading to better healthcare for all.

HITRUST will hold a webinar on March 24th to brief the industry on this development and simultaneously release a draft of the new framework for an open comment period of 30 days.

“HITRUST believes clearer guidelines in the form of standards for the uses of de-identified data and managing associated risks are needed,” said Daniel Nutkis, CEO, HITRUST. He added, “Since the de-identification process needs to take into consideration the environmental safeguards in place housing the de-identified data, the HITRUST CSF was the logical vehicle to align it with.”

In addition to the new framework, HITRUST is providing resources, such as methodologies and white papers, for organizations to develop and assess their programs, as well as subject matter experts on topics such as the risks of re-identification.

The HITRUST De-Identification Framework includes the following key components:

  • Use Cases: Defines the multiple levels of anonymization and recommends specific use cases for each variant, such as end-to-end testing of automated clinical workflows and data mining for clinical research.
  • Criteria: Defines criteria for evaluating de-identification methodologies, estimating re-identification likelihood and criteria for certifying expertise in these methodologies.
  • Technical Controls Framework: Standards for mitigating the risks associated with the use, storage and maintenance of a data. The controls will create a baseline security framework for de-identified data and will include controls to mitigate re-identification risks.
  • HITRUST CSF Mappings: Mappings to the HITRUST CSF as it relates to de-identified data.

“These criteria create a clear framework for healthcare organizations that can be used to implement and evaluate a de-identification program. Organizations aligning to these guidelines are better able to protect patient privacy. At the same time, de-identification helps make the healthcare system work better for everyone by paving the way for innovation and increased public health benefits. We envision CSF Assessors will also assess against the framework,” said Kimberly Gray, Chief Privacy Officer – Global, IMS Health.

“With this comprehensive De-ID framework tied to the CSF, we can increase the adoption of best practices for de-identification, and allow more responsible protection and sharing of health information,” said Khaled El Emam, CEO, Privacy Analytics. “The framework is based on methods that are currently used in the field and have been shown to be robust and ensure high data quality.”

“De-identification is an increasingly important and challenging element in the evolution of health care, in the United States and globally. Because of the important societal benefits of appropriate de-identification, the HITRUST effort is an essential step forward in building an effective and consistent framework for these practices,” said Kirk Nahra, ESQ, Partner, Wiley Rein LLP.

To register for the HITRUST De-Identification Framework webinar visit: https://hitrustalliance.net/de-identification/

About HITRUST

Founded in 2007, the Health Information Trust Alliance (HITRUST) was born out of the belief that information protection should be a core pillar of, rather than an obstacle to, the broad adoption of health information systems and exchanges. HITRUST – in collaboration with public and private healthcare technology, privacy and information security leaders – has championed programs instrumental in safeguarding health information systems and exchanges while ensuring consumer confidence in their use.

HITRUST programs include the establishment of a common risk and compliance management framework (CSF); an assessment and assurance methodology; educational and career development; advocacy and awareness; and a federally recognized cyber Information Sharing and Analysis Organization (ISAO) and supporting initiatives. Over 84 percent of hospitals and health plans, as well as many other healthcare organizations and business associates, use the CSF, making it the most widely adopted security framework in the industry. For more information, visit www.HITRUSTalliance.net.

March 12, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Pittsburgh Trauma Surgeons Use Google Glass for On-the-Spot Info

Monroeville, PA – Surgeons at the Forbes Hospital Trauma Center, part of the Allegheny Health Network, are exploring an innovative use of Google Glass technology, along with new software called Visual Info Zonal Reminder (VIZR), to assist in the care of critically injured patients.

Introduced in 2013, Google Glass is a wearable technology with an optical head-mounted display that provides information in a smartphone-like hands-free format. Wearers communicate with the Internet via natural language voice commands.

Forbes’ trauma surgeons are among the first in the country to investigate use of the technology in the patient care setting. The initial application of Google Glass at Forbes will be the integration of prompts during trauma patient resuscitation based on checklists similar to those used in the aviation industry.

“With this new technology, surgeons will have hands-free, immediate access to critical information, checklists and reminders specific to injury categories that will greatly assist in our efforts to provide effective, timely care that saves lives,” said Christoph R. Kaufmann, MD, Trauma Medical Director, Forbes Hospital.

VIZR is being used exclusively at Forbes Hospital. The software features information on a wide range of traumatic injuries. For example, if a pregnant patient with injuries to the abdomen is in transport to the emergency department, the surgeon can voice command a checklist with crucial questions to ask the EMS upon arrival or even prior to arrival.

Once a patient program is initiated, a timer begins that provides important prompts and reminders to the trauma team every few minutes.

“This technology will also be useful during mass casualty events” Dr. Kaufmann said. The technology is meant to augment the surgical team’s skills and training, to serve as a time-saving resource, not replace the surgeon’s knowledge of what to do in a traumatic event.

The software was adapted from military-style checklists for triaging wounded in the battlefield to keep on track while caring for single or multiple patients with life-threatening injuries Google Glass also has promise as a tool to assist in the training of emergency and trauma specialists.

The Google Glass technology being used at Forbes has been modified so it does not record photos or videos in the hospital setting, ensuring that patient privacy is not compromised.

March 4, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Annual DataMotion Survey Reveals Shortfalls in Healthcare Security & Compliance Policy and Major Mobile Vulnerabilities

Email and File Transfer Poll Exposes Widespread Risks Still Taken By Employees;

Lack of Encryption for Email and Mobile Devices; Growth in Policy Development Undermined by Implementation Failure

FLORHAM PARK, N.J. – March 4, 2015 DataMotion™, an experienced email encryption and health information service provider (HISP), today announced results of its third annual survey on corporate email and file transfer habits, revealing significant security risks. While companies in all industries increasingly have put security and compliance policies in place – nearly 90 percent of all respondents affirming that in 2014 (compared to 81 percent in 2013) – the growth is largely from healthcare entities. More than 97 percent from the industry report their organizations as having policies in place, compared to 90.4 percent in 2013. However, challenges remain for healthcare when it comes to implementing these, ranging from low employee comprehension to policy violations. Additionally, a lack of encryption, risks in mobile device usage and low awareness of Direct Secure Messaging (Direct) pose serious issues for the highly regulated industry.

DataMotion polled more than 780 IT and business decision-makers across the U.S. and Canada. In particular, the survey focused on individuals who routinely work with sensitive data and compliance regulations in a variety of industries including healthcare, financial services, education and government.

More than 300 respondents were from healthcare. Key insights/comparisons on the industry include:

  • Security & Compliance Policy: Gains Undermined by Implementation Failure

o    36 percent of healthcare respondents said within their entity, security and compliance policies are at most only moderately enforced.

o    81 percent of all respondents said employees/co-workers either occasionally or routinely violate these policies. While healthcare fared better, nearly 73 percent admitted the same.

o    Key to making policies work is ensuring employee comprehension. When asked if they thought employees fully understood these types of policies, more than a third in healthcare said no, just a slight improvement over those from other industries.

o    When asked about common reasons why policies are violated, 52.7 percent from healthcare said it was because employees were not aware of the policy or that they were in violation. Another 29.1 percent said employees didn’t understand policies. Most troubling,18.2 percent said policies were intentionally violated by employees to get their job done.

o    These healthcare findings raise a “red flag” whereas key to passing an HHS/OCR HIPAA audit is demonstrating implementation of policies.

  • Lack of Email Encryption, Mobile Dangers and the Direct Problem

o    Nearly a third of respondents across other industries reported they don’t have the capability to encrypt email. Healthcare posted only a slightly lower response; nearly a quarter of respondents saying the same.

o    80.8 percent of healthcare respondents affirmed they’re permitted to use mobile devices for email. Yet, of those that permit email on a mobile device and have encryption at their organization, 31.3% cannot send and receive encrypted email from their mobile client.

o    Direct – the secure, email-like protocol developed for healthcare – garnered news coverage throughout 2014. Nearly 42 percent of healthcare respondents said they’re unaware of Direct. And of those who are aware of Direct, 42 percent say their organization is not using the alternative to email encryption.

o    The widespread use of mobile devices in healthcare, coupled with a lack of encryption, creates a “perfect storm” for exposing sensitive data.

  • Business Associates and the Long Tail of HIPAA/HITECH

o    Almost 70 percent of respondents whose organizations have a business relationship with a healthcare entity process their protected health information (PHI). Yet, 28 percent said they were either not a Business Associate (BA) or were unsure if they were.

o    Of those processing a healthcare entity’s PHI, 40.5 percent had either not been asked to sign a Business Associate Agreement or were unsure if they had.

o    HIPAA regulations redefined BAs to include downstream entities. Many not previously impacted by HIPAA/HITECH now fall under its long tail. The above numbers show a lack of awareness, placing BAs and the healthcare entities they represent at risk for non-compliance.

“Though the survey shows year-over-year growth in the number of companies putting security and compliance measures in place, the widespread security risks occurring are of great concern,” said Bob Janacek, chief technology officer at DataMotion. “Particularly at a time when organizations have experienced serious data breaches, it’s essential for companies to have strong policies and ensure employees fully understand and follow these. While healthcare has made gains in policy development, it’s all for naught if implementation fails, especially in such a highly regulated industry.”

“These measures should be across the board, as the data shows a gaping hole in security when it comes to mobile devices – with many companies permitting their use but not taking into account their lack of email encryption capabilities,” added Janacek. “Hopefully, this data will provide organizations with a better understanding of what steps need to be taken to ensure security and compliance.”

To view the healthcare survey report, click here or visit: http://www.datamotion.com/get-datamotion-2014-survey-report-healthcare-secure-email-file-transfer-practices/.

For survey results across all industries, click here or visit: http://www.datamotion.com/get-datamotion-2014-survey-report-secure-email-file-transfer-corporate-practices/.

About DataMotion

Since 1999, DataMotion™ SaaS technology has enabled organizations of all sizes to reduce the cost and complexity of delivering electronic information to employees, customers and partners in a secure and compliant way. Ideal for highly regulated industries, the DataMotion SecureMail portfolio offers easy-to-use encryption solutions for email, file transfer, forms processing and customer-initiated contact. In the healthcare sector, DataMotion is an accredited HISP (health information service provider) of Direct Secure Messaging. TheDataMotion Direct service enables efficient interoperability and sharing of patient data across the continuum of care. DataMotion is privately held and based in Florham Park, N.J. For the latest news and updates, visit www.datamotion.com, follow DataMotion on LinkedIn or Twitter® @datamotion.

I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.