The pMD Blog

Image: Courtesy of The Francis Crick Institute

Here's The Latest in Health Care:


•  The Office of the National Coordinator (ONC) for Health IT recently announced two big changes to the meaningful use certification program. The first gives EHR makers the ability to self-declare compliance. The second provides more discretion around randomized surveillance of certified health IT products. These changes are designed to reduce burden on the health care industry.  Read More

•  For the first time, researchers have been able to modify a key gene in human embryo DNA which gives crucial insight into embryo development. This work may someday lead to new techniques that can help infertile couples have children or treat incurable diseases with embryonic stem cells.  Read More

•  In order to earn a small positive adjustment from Medicare, doctors and practices need to begin collecting data no later than Oct. 2 to fully participate in MIPS, or the Merit-based Incentive Payment System's 90-day reporting period. The government has even made it easier for doctors to avoid a payment penalty based on 2017 reporting by allowing them to pick one measure for one patient, at the very minimum.  Read More

•  After a series of failed Senate votes in July, one repeal-and-replace plan for the Affordable Care Act remains. The proposal turns control of the health care markets over to the states. So, rather than funding Medicaid and subsidies directly, that money goes to the state to develop any health care system it wants.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture software.

Hello again! As promised, I’m back with more simply explained goodies about MIPS scoring for the 2017 performance year. In Part 1 of this series, we discussed the Basics of MIPS Scoring. That post is chock full of great information (if I do say so myself!) so definitely check it out. In today’s post, Part 2, we’ll cover scoring the Quality category. Then, in Part 3, we’ll discuss scoring for the Improvement Activities category. And finally, Part 4 will cover Advancing Care Information scoring, tying it altogether with an overview of the MIPS payment adjustment calculation. But, first, Quality!

The Basics of Scoring the Quality Category

For most of our MIPS Registry participants, the Quality category feels the most comfortable. Many of the principles we came to learn and love in PQRS hold true in MIPS Quality, so it’s less of a puzzle to figure out. But, there are some important differences, and scoring is one of them. Keep in mind that Quality is worth the largest portion - at least 60% - of the overall MIPS Final Score (a calculation I’ll discuss in Part 4), so if you’re aiming for a positive payment adjustment, this category is an important one to pay attention to.  

For the quality category, each reported measure will receive between 3 and 10 points. In order to be considered to receive more than 3 points, a reported measure must:

1) Comprise of at least 20 reported qualifying events;
2) Have a benchmark; and
3) Meet the data completeness standard.*

*For registry, QCDR, and EHR reporting, data completeness means that measures must be reported on at least 50% of the qualifying events for that measure, based on your entire patient population (not just Medicare Part B FFS patients), and must include at least one Medicare Part B FFS patient.

If any of the above features are missing, the measure will receive 3 points. But, if all the above features are established, the measure can receive up to 10 points. To determine whether more points will be awarded, CMS compares your measure’s performance data to a national benchmark. The benchmarks provide a comparison point to determine if your performance was higher than the national average, thus meriting more points.

You’re probably now wondering: where does the national benchmark data come from? Well, for the MIPS 2017 performance year, the benchmarks are based on 2015 PQRS performance data. Each benchmark is broken down into performance deciles, with the worst performance in deciles 3 and below and the best performance in decile 10. Benchmarks also vary from submission mechanism to submission mechanism. So, there is a different benchmark for EHRs, Registries, QCDRs, etc. You can check out the benchmark data that will be used for the 2017 performance year by going to the QPP website’s resource library and downloading the zip file called “2017 Quality Benchmarks.”

So, this is the basic methodology used to score the Quality category. Ultimately, your score depends on the benchmark, but as a rule of thumb, you want to have the highest possible quality performance to maximize points per measure. Also, note that, unlike PQRS where you received an automatic ding if didn’t fully report, with MIPS Quality, if you report less than 6 measures, and you’ll be scored on whatever is submitted, and receive a “0” score for measures that you could have submitted but didn’t. So, your score won’t be high in this scenario, but it’s not an automatic negative. On the other side of the spectrum, if you choose to report more than 6 measures, your outcomes or high priority measure will be scored, and then the measures with the highest points earned will be used in your score. But, note that all measure results submitted will become public information, so consider your quality reporting strategy carefully before submission.

Bonus Points Awarded in the Quality Category

Before we move on from Quality scoring, there is one more thing you should know. That is, you can receive bonus points in the quality category for two separate reasons. The first is by reporting additional high priority measures, and the second is by reporting measures via end to end electronic reporting.

Bonus Points Earned by Reporting Additional High Priority Measures

The first way to earn bonus points in the Quality category is to report additional high priority measures. But, there are three nuances to earning these bonus points that you should keep in mind:

1) The total amount of bonus points available is capped at 10% of the total points available to the reporter in the quality category. So, this isn’t a huge bonus, but it’s still a bonus!
2) To receive bonus points, you must submit at least the one required, fully reported, scored outcomes or high priority measure. So, make sure at least your first outcomes or high priority measures has 20 cases reported and 50% of all encounters, plus at least 1 Medicare Part B FFS patient.
3) Bonus measures themselves must have at least 20 cases reported and 50% of all encounters, plus at least 1 Medicare Part B FFS patient.

Assuming the above is considered and satisfied, bonus points are awarded as follows:

- Each additional outcome or patient experience measure = 2 bonus points.
- Each additional high priority measure = 1 bonus point.

Note that if you don’t report six measures, you can still earn bonus points, but only if you’re doing so because of lacking availability of applicable measures. Otherwise, you can earn bonus points on as many high priority measures as you report - both including the initial six, and including any additional measures you report. So, be sure your measure selection strategy includes as many outcomes and high priority measures as possible!

Bonus Points Earned by Reporting Via End to End Reporting

The second way to earn bonus points in the Quality category is to report your measures via end to end electronic reporting. But, again, earning these bonus points has some nuances to keep in mind:

1) The amount of bonus points available is capped at 10% of the total points available to the reporter in the quality category. So, this isn’t a huge bonus either. But, note that each bonus point category is a separate cap, so you can max out both separately.
2) Bonus points can be earned only if reporting via qualified registries, QCDRs, EHRs, or the CMS Web Interface, and when end to end electronic reporting is utilized. Claims reporters won’t qualify for these bonus points.

Keeping these considerations in mind, each measure reported via end to end electronic reporting will receive 1 bonus point.

Once all of that is determined, both types of bonus points are added to the score from the initial measures, and then divided by the total points available to that reporter in the quality category. This number is then multiplied by 60, which is the weight of the quality category in the final score. This is your final score for the Quality category.

 

Image: 2017 MIPS Quality Performance Category Fact Sheet


Yahoo! That’s Everything for Quality!

We made it through Quality scoring! Noice! One last note before we go -  all the information above is most relevant to 2017 performance year registry reporting, and there are some quirks depending on which type of submission mechanism you choose. pMD is a qualified registry, so we focused on that aspect of MIPS Quality scoring. If you have any questions or would like to learn more about our MIPS registry, give us a call! And, of course, to find out more about pMD's suite of products, which includes charge capture, secure messaging, and care coordination software and services, please contact pMD.

References:

Each reported quality measure will receive between 3 and 10 points: “[W]e will provide points for all submitted measures, but only a subset of measures receives points based on performance against a benchmark.” See https://www.federalregister.gov/d/2016-25240/p-3502; see also Table 17 in the Final Rule at https://www.federalregister.gov/d/2016-25240/p-3502 (illustrating that there are two categories for submitted quality measures one category that recieves 3 points and one category that receives between 3 and 10 points).

To receive more than 3 points, the reported quality measure must have a benchmark, have 20 cases, and meet the data completeness standard: See Table 17 in the Final Rule at https://www.federalregister.gov/d/2016-25240/p-3502.

When reporting through QCDRs, qualified registries, and EHRs, data completeness means reporting on 50% of all-payer data for that measure, and including at least one Medicare patient: Data completeness will include “all-payer data for the QCDR, qualified registry, and EHR submission mechanisms... In addition, those clinicians who utilize a QCDR, qualified registry, or EHR submission must contain a minimum of one quality measure for at least one Medicare patient.” See https://www.federalregister.gov/d/2016-25240/p-1492.

If any of the reported quality measures are missing the minimum requirements, they will receive 3 points: See Table 17 in the Final Rule at https://www.federalregister.gov/d/2016-25240/p-3502; see also 81 FR 77286, available at https://www.federalregister.gov/d/2016-25240/p-3476.

Comparing reported quality data against the national benchmark determines if a measure will receive more than 3 points: “When a clinician submits measures for the MIPS Quality Performance Category, each measure is assessed against its benchmarks to determine how many points the measure earns.” See Quality Measure Benchmarks Overview pdf, pg. 1, available for download from https://qpp.cms.gov/about/resource-library, in a zip titled “2017 Quality Benchmarks.”; see also 81 FR 77286, available at https://www.federalregister.gov/d/2016-25240/p-3476.  

National benchmark data used for the MIPS 2017 performance year is taken from 2015 PQRS performance data: “These historic benchmarks are based on actual performance data submitted to PQRS in 2015, except for CAHPS.” See Quality Measure Benchmarks Overview pdf, pg. 1, available for download from https://qpp.cms.gov/about/resource-library, in a zip titled “2017 Quality Benchmarks.”

Each benchmark is broken into deciles: “Each benchmark is presented in terms of deciles.” See Quality Measure Benchmarks Overview pdf, pg. 1, available for download from https://qpp.cms.gov/about/resource-library, in a zip titled “2017 Quality Benchmarks.”; see also 81 FR 77286, available at https://www.federalregister.gov/d/2016-25240/p-3476.

There is a different benchmark for each submission mechanism: “Benchmarks are specific to the type of submission mechanism: EHRs, QCDRs/Registries, CAHPS and claims.” See Quality Measure Benchmarks Overview pdf, pg. 1, available for download from https://qpp.cms.gov/about/resource-library, in a zip titled “2017 Quality Benchmarks.”

To maximize your MIPS score, you should fully report at least 6 measures: “[F]or any MIPS eligible clinician who does not report a measure required to satisfy the quality performance category submission criteria, we proposed that the MIPS eligible clinician would receive zero points for that measure. For example, a MIPS eligible clinician who is able to report on six measures, yet reports on four measures, would receive two “zero” scores for the missing measures.” See https://www.federalregister.gov/d/2016-25240/p-3513.

If you choose to report more than 6 quality measures, then the measures with the highest points assigned with be used: “If a MIPS eligible clinician elects to report more than the minimum number of measures to meet the MIPS quality performance category criteria, then we will only include the scores for the measures with the highest number of assigned points, once the first outcome measure is scored, or if an outcome measure is not available, once another high priority measure is scored.” See https://www.federalregister.gov/d/2016-25240/p-3623.

All measure results submitted will become public information: “[W]e are finalizing our proposal to report on Physician Compare the final score for each MIPS eligible clinician, performance of each MIPS eligible clinician for each performance category, and to periodically post aggregate information of such data. Accordingly, we are finalizing § 414.1395(a), which provides that for public reporting of an eligible clinician's MIPS data in that for each program year, we will post on a public Web site, in an easily understandable format, information regarding the performance of MIPS eligible clinicians or groups under the MIPS.” See https://www.federalregister.gov/d/2016-25240/p-4762. See also 81 FR 77394, available at https://www.federalregister.gov/d/2016-25240/p-4767. (“[W]e proposed to make all measures under the MIPS quality performance category (81 FR 28184) available for public reporting on Physician Compare (81 FR 28291). This would include all available measures reported via all available submission methods, and applies to both MIPS eligible clinicians and groups.” Proposed policy finalized at 81 FR 77395, available at https://www.federalregister.gov/d/2016-25240/p-4781).

If you report less than 6 measures, you’ll be scored on whatever is submitted, and receive zero points for any measure that could have been reported but was not: “Previously in PQRS, EPs had to meet all the criteria or be subject to a negative payment adjustment. However, we proposed that MIPS eligible clinicians receive credit for measures that they report, regardless of whether or not the MIPS eligible clinician meets the quality performance category submission criteria.” See https://www.federalregister.gov/d/2016-25240/p-3513; “After consideration of the comments, we are finalizing at § 414.1380(b)(1)(vi) that MIPS eligible clinicians who fail to report a measure that is required to satisfy the quality performance category submission criteria will receive zero points for that measure.” See also https://www.federalregister.gov/d/2016-25240/p-3524.  

You can receive bonus points in the quality category, but these bonus points are capped at 10%: [W]e are increasing the cap for high priority measures from 5 percent to 10 percent of the denominator (total possible points the MIPS eligible clinician could receive in the quality performance category)  of the quality performance category for the first 2 years.” See https://www.federalregister.gov/d/2016-25240/p-3561/.

To receive bonus points, the reporter must submit at least one scored high priority measure: “The MIPS eligible clinician can receive bonus points on all high priority measures submitted, after the first required high priority measure submitted, assuming these measures meet the minimum case size and data completeness requirements...” See https://www.federalregister.gov/d/2016-25240/p-3550; see also 81 FR 77292 https://www.federalregister.gov/d/2016-25240/p-3529 (“We noted that a MIPS eligible clinician who submits a high priority measure but had a performance rate of 0 percent would not receive any bonus points. MIPS eligible clinicians would only receive bonus points if the performance rate is greater than zero.”)

If you do not submit 6 measures, due to lacking availability of measures, you can still receive bonus points: “The MIPS eligible clinician can receive bonus points on all high priority measures submitted, after the first required high priority measure submitted, assuming these measures meet the minimum case size and data completeness requirements even if the MIPS eligible clinician did not report all 6 required measures due to lack of available measures.” See https://www.federalregister.gov/d/2016-25240/p-3550.

Measures that receive bonus points must be reported with at least 20 instances, and meet the data completeness standard, which for registries is 50% of all encounters reported, with 1 Medicare Part B FFS patient included:  “Bonus points are also available for measures that are not scored (not included in the top 6 measures for the quality performance category score) as long as the measure has the required case minimum and data completeness.” See https://www.federalregister.gov/d/2016-25240/p-3529.

Bonus points will be awarded on all reported measures that hit the 20 case minimum and the data completeness standard - both including the original 6 reported and any additional measures reported: “Bonus points are also available for measures that are not scored (not included in the top 6 measures for the quality performance category score) as long as the measure has the required case minimum and data completeness.” See https://www.federalregister.gov/d/2016-25240/p-3529.

Each outcome or patient experience measure reported in addition to the required high priority measure will receive 2 bonus points: “[W]e are finalizing at § 414.1380(b)(1)(xiii) our proposal to award 2 bonus points for each outcome or patient experience measure ... that is reported in addition to the 1 high priority measure that is already required to be reported under the quality performance category submission criteria.” See https://www.federalregister.gov/d/2016-25240/p-3553.

Each high priority measure reported in addition to the required high priority measure will receive 1 bonus point: “[W]e are finalizing at § 414.1380(b)(1)(xiii) our proposal to award ... 1 bonus point for each other high priority measure that is reported in addition to the 1 high priority measure that is already required to be reported under the quality performance category submission criteria.” See https://www.federalregister.gov/d/2016-25240/p-3553.

The cap for bonus points earned via end to end electronic reporting is 10%: “[W]e are increasing the cap for using CEHRT for end-to-end reporting from 5 percent to 10 percent of the denominator of the quality performance category (total possible points for the quality performance category) for the first 2 years.” See https://www.federalregister.gov/d/2016-25240/p-3598.

The cap for end to end electronic reporting is distinct from the cap for reporting additional high priority measures: “MIPS eligible clinicians will be eligible for both the CEHRT bonus option and the high priority bonus option with separate bonus caps for each option.” See https://www.federalregister.gov/d/2016-25240/p-3598.

You can only earn the end to end electronic reporting bonus if reporting via qualified registries, QCDRs, EHRs, or the CMS Web Interface, and end to end electronic reporting is utilized: “We are finalizing that the CEHRT bonus would be available to all submission mechanisms except claims submissions. Specifically, MIPS eligible clinicians who report via qualified registries, QCDRs, EHR submission mechanisms, and CMS Web Interface in a manner that meets the end-to-end reporting requirements may receive one bonus point for each reported measure with a cap as described.” See https://www.federalregister.gov/d/2016-25240/p-3599.  

Each measure reported via end to end electronic reporting will receive 1 bonus point: 77298 “After consideration of the comments, we are finalizing at § 414.1380(b)(1)(xiv) one bonus point is available for each measure submitted with end-to-end electronic reporting for a quality measure under certain criteria described in this section.” See https://www.federalregister.gov/d/2016-25240/p-3598.  

To calculate the quality category final score, bonus points are added to the score of the initial measures, divided by the total possible points, and then that number is multiplied by 60: “We will sum the points assigned for the measures required by the quality performance category criteria plus the bonus points and divide by the weighted sum of total possible points. The quality performance category score cannot exceed the total possible points for the quality performance category.” See https://www.federalregister.gov/d/2016-25240/p-3623; see also 81 FR 77276-7, available at https://www.federalregister.gov/d/2016-25240/p-3375.; see also 81 FR 7300-1, available at https://www.federalregister.gov/d/2016-25240/p-3631 (examples of scoring calculation).

The weighting for the Quality category is 60%: “Therefore, we are finalizing at § 414.1330(b) for MIPS payment years 2019... 60 percent … of the MIPS final score will be based on performance on the quality performance category.” See https://www.federalregister.gov/d/2016-25240/p-1164.

Image: Eric Thayer for The New York Times

Here's The Latest in Health Care:


•  Sixteen people have died and 421 sickened in San Diego County between last November through September as a result of a Hepatitis A outbreak. About 65% of the infections occurred among the homeless or illicit drug user population. Hepatitis A is typically spread by ingestion of contaminated food or water and in rare cases, transmitted person-to-person through fecal-oral route.  Read More

•  Two neighborhoods in Houston have reported contaminated floodwaters containing bacteria and toxins that sicken people. The results of the testing found that the water contained Escherichia coli at a level more than four times the amount that is considered safe. Residents must take precautions to return safely to their homes.  Read More

•  A new bipartisan bill would build telehealth coverage into Medicare Advantage plans. This bill would encourage the use of telehealth technology to improve health care for seniors, particularly for those in rural parts of the country.  Read More

•  Eight elderly residents of the Rehabilitation Center at Hollywood Hills in Hollywood, Florida, died after a transformer that drove its air conditioning unit broke down, leaving residents vulnerable to the unforgiving heat and humidity. Health officials suspended the nursing home indefinitely and have moved 158 residents from the center to nearby facilities.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture software.

The switch from traditional fee-for-service to the new, value-based care model has been slowly taking shape in health care, leaving practices to figure out how to stay ahead of the changes without taking significant hits to their practice. Specialized care involves referrals from different providers and transitions of care between facilities, which can create gaps in the patient’s care. The average patient over 65 years old sees more than 28 providers! So how will practices successfully coordinate care as patients move between multiple care settings and providers in this new world of reimbursement?

I’ll give you a hint: it doesn’t start with EHRs. EHRs were not designed for care teams to manage patients across multiple transitions of care and enhance the provider-patient relationship. And many EHRs are still resistant to work with external systems, not to mention that about one-fifth of practices are still using paper records. Practices that do have EHRs still revert to paper-based systems when they see patients outside the four walls of their clinic. Whether a physician is rounding at the hospital with a paper printout, or a nurse navigator is using a paper report to track patients, paper isn’t doing the caregiver or the patient any favors. Health information that can save a patient from duplicate procedures, improve the quality of care, or even save a patient’s life, is spread out across different pieces of paper.

Care coordination tools are emerging to fill these transitional gaps in the patient’s care and prevent avoidable readmissions. pMD’s care coordination tool allows caregivers to manage their patients in a more effective way to improve health outcomes, especially for patients with chronic conditions and who are part of a bundled payment or other risk sharing program. Caregivers can record progress notes, manage care plans, add personalized information about their patients, and run robust reports to get ahead of diseases before they require expensive treatments. pMD also connects the care team to the local medical community by allowing caregivers to invite others to the secure texting platform and create an easy-to-access, secure network.

The value-based care model is opening up new opportunities for creative solutions to improve quality of care and reduce health care costs, and pMD is happily taking on the challenge.

If you have any questions or would like to find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, and care coordination software and services, please contact pMD.

Image: Jim Bourg/Reuters

Here's The Latest in Health Care:


•  Pfizer is under fire this week by the Food and Drug Administration for failing to properly investigate malfunctioning reports surrounding their EpiPens. Patients have died when the device failed to work. The company reportedly received numerous complaints about problems with the activating device, yet did not conduct a proper investigation.  Read More

•  The American Medical Association (AMA) is calling on congress to come up with alternatives to the reversal of the Deferred Action for Childhood Association (DACA) that will not hinder the health care workforce. On Tuesday, the president announced the decision to end DACA, which protects about 800,000 immigrants, in six months. The AMA is concerned that this reversal could impact patients and the nation's health care system by affecting the health care and tech workforce.  Read More

•  For parents who oppose vaccinations, or anti-vaxxers as they're often known, the personal belief exemption is not recognized in some states. In California, Mississippi, and West Virginia - states that only allow exemptions based on medical concerns - a growing number of families are seeking medical exemptions to get around new state laws requiring vaccinations regardless of religious beliefs.  Read More

•  In a recent health poll, participants divulged their motivations to discontinue taking a prescribed drug. Many reported bad side effects and others responded that cost is a factor. It's important to speak with your health care provider prior to stopping a drug that's been prescribed.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture software.

There’s very little I like more than learning new things, a chance to socialize, and (most importantly) free food. If that statement resonates with you, then I highly suggest you attend the next conference in your area!

We, at pMD, are avid conference goers and truly appreciate the value that they bring. Conferences have a multitude of benefits for both the attendees and the exhibitors.  They are more than just a gathering of doctors, administrators, CFOs, or staff. They are a place to share all that is new and exciting in the field.

I’ve attended two conferences so far this year: GI Roundtable in Forth Worth, Texas and GI Outlook in Hollywood, California. Why they keep sending me to gastroenterology conferences, I can’t tell you but I sure do know more about colonoscopies than I ever thought I’d need to know! I’ve found that conferences provide a higher ROI than some of the more traditional marketing methods because there is tremendous value in meeting face-to-face.

Benefits of conferences are twofold for us at pMD. As well as being able to meet with current pMD customers in attendance, we also get the opportunity to market our product to potential customers. Let’s talk through both of these in a little more detail.

If you’ve read any of our previous posts about pMD traveling, such as travel by the numbers or travel tips, you know that pMDers have no problem jet-setting around the country for our customers. What’s even better is having our customers come to us! That’s what conferences are like. We typically have more than a handful of pMD users attending every conference. We have pMD customers in 35 different states, which means that there’s a 70% chance that we’ll have a resident customer at a conference in any given state. I like our odds. Conferences are a great opportunity for us to get valuable customer feedback, all in one place, and all in a day or two! Talk about efficiency.

Additionally, another added benefit of attending or sponsoring a conference is exposure. As an exhibitor, you bring a fancy tablecloth, a showy backdrop, and maybe some branded hand sanitizer, candy, and pens. You sponsor the ads in the syllabus, pay for the best booth placement possible, and cross your fingers that it all pays off! Well, we would like to extend a warm thank you to our aforementioned customers for making our jobs as exhibitors just a tad bit easier. Nothing markets better than word of mouth, so the best possible thing we could ask for at a conference is that our customers speak highly of our product. With over 700 reviews on pMD to date, it’s no wonder we’ve had an influx of referrals coming toward our booth! We love spreading the word to potential customers about how great pMD is and conferences are a wonderful opportunity to do just that.

Conferences are an invaluable resource to companies. pMD takes pride in owning a product that people are happy to talk about and there’s no better place to share our product than among health care professionals that could benefit from its usage!

If you have any questions or would like to find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, and care coordination software and services, please contact pMD.


Here's The Latest in Health Care:


•  In the wake of Hurricane Harvey, Houston health systems were able to access medical records thanks to a robust IT infrastructure, EHR adoption and HIE agreements. These health systems set up makeshift virtual clinics in evacuation centers across Houston, allowing providers to connect to medical records, order medications and input patient data.  Read More

•  Specialists oversee the care of the most costly and sickest patients in the nation and therefore are increasingly responsible for driving the value-based care model. Some suggested strategies to deliver more effective care and consumer engagement, which may become requirements in the future, include having specialty practices invest in insight platforms and advanced analytics. These technologies are not yet widely adopted in health care but are important in the future success of delivering value-based care.  Read More

•  Medicare patients beware: you can be hospitalized for several days, can undergo exams and tests, and can receive medications without ever officially being admitted to the hospital. What does that mean for you as a patient? This technically means you're "under observation" and considered an outpatient versus an inpatient, which may deny coverage for subsequent nursing home care.  Read More

•  The Food and Drug Administration (FDA) announced on Wednesday its first approval of a cell-based gene therapy in the U.S. The treatment, known as CAR-T cell therapy, will involve removing immune system T cells from each patient and genetically modifying the cells in the lab to attack and kill leukemia cells.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture software.

Product feedback connects us directly to our customers and helps us to develop products which best serve their needs. Product feedback also provides valuable insight into our customers’ current pain points as well as their vision for the future. This feedback helps pMD to continue to expand our product while also aligning closely with the goals of our customers. Below are a few key ways in which pMD works to ensure that product feedback is collected, prioritized, and action is taken!

Promote a culture where employees are customer-facing and always listening for feedback:

Here at pMD, we love to visit our customers. In a recent blog post by my colleague Chris, he discussed some of the great benefits experienced by visiting our customers on site. At pMD, every team member is always open and eager to hear customer feedback. We enjoy traveling to visit our customers because this allows us to meet face-to-face, discuss our product, and learn new ways in which we can help. Each team member is trained on the 5 Whys methodology of gathering product feedback. This practice helps us to understand the root of the customer’s request and what product gaps or desired product enhancements the feedback is reflecting.

Organize product feedback thoughtfully and strategically:

We love to use our own software internally as this allows us to test first-hand how the product is performing. As you might now be guessing, we also use pMD to track and organize our product feedback. Each piece of feedback is carefully analyzed and assessed. Once the feedback is fully vetted, we document and categorize the feedback based on helpful criteria. For example, we tag each feedback request based on categories such as “Product Feature” and "Project Size”. This allows us to easily report all of the feedback we receive and detect certain trends and patterns.

Act on product feedback and close the feedback loop accordingly:

When a customer takes the time to share their valuable feedback, we want to be sure that action is taken. As described above, we document product feedback in a way that allows us to easily analyze patterns as well as pinpoint specific requests. With this data, we are then able to take meaningful action. Based on product feedback, we often pivot our product roadmap or perhaps add a new feature to the list of enhancements we want to build.

Product feedback is also a very beneficial tool for our development team as we define the scope of any new feature. We never want to build a feature based on our assumptions. It is much more valuable to receive direct customer feedback throughout each stage of the feature development lifecycle to ensure we are on the right track. Customer feedback is a critical part of our agile workflow and our customers’ input is fundamental to our success as we develop new features and product enhancements. Additionally, as a final step to this feedback loop, we then communicate these new features out to our customers to ensure that the developed feature is meeting expectations.

We hear you:

Your product feedback is vital in helping us to move our products forward and build the best possible solutions. Product feedback is essential in driving what features we develop, when we develop them, and how they are developed. We document and curate this feedback in a way that is thoughtful, organized, and allows us to define patterns, trends, and also any urgent bugs which might need to be addressed. With this, we are able to maintain a product roadmap that ensures our customers’ needs and goals are our top priority. We are incredibly grateful for all of your amazing feedback. Please continue to share your ideas with us. You are the essential piece to making pMD the amazing product it is!

If you have any questions or would like to find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, and care coordination software and services, please contact pMD.

Image: Scott Olson/Getty Images

Here's The Latest in Health Care:


•  A new technique called "genome cloaking" allows researchers to access specific gene mutations while still keeping the patient's private genetic information protected. Researchers from Stanford University developed this method, which uses cryptography to hide genetic information, to protect patients' privacy while doctors perform genetic analyses.  Read More

•  While wearables remain a popular tech purchase, actual ongoing user engagement and evidence proving the health benefits still continues to be a challenge. Researchers are still trying to find ways to integrate wearables into health care, specifically with patient care.  Read More

•  Johnson & Johnson paid $417 million in damages to Eva Echeverria of East Lost Angeles, who developed ovarian cancer after using the company's baby powder product for decades. Numerous studies have linked talcum powder use with ovarian cancer but the findings have not been consistent. This may be the largest award so far among lawsuits tying ovarian cancer to talcum powder.  Read More

•  Didn't heed the protective eye-cover warnings during Monday's Great American Eclipse? Chances are, your quick glances may not have caused permanent, long-term damage to your eyes. However, it takes at least 12 hours before knowing if anything has happened. If your vision seems blurry or you're seeing spots, make an appointment with your optometrist to further assess any damage to your eyes.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture software.

At pMD, the role of an Account Executive (AE) is very exciting! If you’ve kept up with our blog, or have interacted with our team members, you know that travel is essential to our company. We are rarely ever confined to a cubicle. Often, you can find our team scattered across the U.S. and at times attending several meetings in different cities and different time zones within a 24-hour period! While a lot of this travel is focused on our current customers, there is a large need for us to travel to prospective customers as well.

pMD AEs take a different approach to sales. We spend a great deal of time understanding the prospective customer’s current workflow and assessing whether any one of our suite of products would be a good fit for them. At pMD, you learn to ask a lot of questions and the logic behind that is intentional. Our product is by no means one-size-fits-all and is all very customizable. For example, a cardiology group in Southern California may use our Charge Capture product very differently than another cardiology group in Northern California. So, asking a multitude of questions is imperative to learning more about your potential customer and how pMD can be customized for them.

Since 1998, our team has prioritized travel and has witnessed the positive impact first-hand. A solid face-to-face meeting is invaluable when comparing to a 30-minute phone conversation. I’ve personally experienced the benefits of in-person meetings and can attest that traveling to prospective customers helps to build trust, inspire positive conversations, and ultimately build strong(er) relationships. While you’re on the road, it’s important that you’re maximizing that face-to-face time.

Traveling should never feel like a burden. At times, it can be exhausting and time-consuming but only if you allow it to be. Here are some helpful tips and tricks to make your future travel escapades more comfortable, more efficient, and ultimately more rewarding!


I’ve personally found that these tips promote a more efficient way to travel, which saves you time and keeps you sane! What can you do with more time? It provides you the opportunity to visit more prospective customers and spend quality time listening to their needs. If you build a relationship and develop trust with prospective customers early on, they will ideally become happy, new customers! Happy, new customers translate to a happy pMD team! If you have any questions or would like to find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, and care coordination software and services, please contact pMD.