The pMD Blog

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pMD Blog...

where we cover interesting and relevant news, insights, events, and more related to the health care industry and pMD. Most importantly, this blog is a fun, engaging way to learn about developments in an ever-changing field that is heavily influenced by technology.

Here's The Latest in Health Care:

•  The Department of Health and Human Services (HHS) recently proposed a new rule to improve the interoperability of Electronic Health Information between different health systems. In a recent press release, HHS will require the health care industry to adopt standardized application programming interfaces (APIs) to allow seamless movement of health information from one system to another by 2020. This has been a long-awaited victory for patients, now giving them the accessibility they need to view their medical and insurance records from any device.  Read More

•  In a report published Thursday, the Centers for Disease Control and Prevention highlighted the start of the nation's third opioid epidemic wave with fentanyl at the center of it all. Fentanyl is a powerful synthetic opioid that offers a particularly potent high but can also shut down breathing in under a minute. What's fueling the recent spike in fentanyl deaths? The drug is easy to produce due to its synthetic nature, making it easier for drug dealers to traffic and for users to get a hold of it.  Read More

•  As technology begins to drive the health care industry, providers need to be cautious not to lose the element of humanity in how they deliver care. Telehealth can be a powerful tool to gather data and logic but if handled well, it can also be a compelling model for quality patient care. It's important to think of telehealth as a virtual starting point in providing convenient, transparent, and quality care, remembering to incorporate a personal touch and acknowledging the value of both the provider's and the patient's time.  Read More

•  Artificial Intelligence (A.I.) - a concept that's been sensationalized in Hollywood films and a reality that's slowly starting to make its way into health care. A new breed of artificial intelligence technology is rapidly spreading across the medical field in which systems and devices are able to detect signs of illness and disease in a wide variety of images, such as C.A.T. scans and X-rays. However, scientists warn of a dark side of A.I. where small manipulations can change the behavior of A.I. systems. The biggest concern is of these devices or systems getting into the wrong hands of those who would manipulate A.I. to misdiagnose patients for the purpose of maximizing on insurance reimbursements.  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, secure messaging, clinical communication, MIPS registry, and care navigation software.

As we approach the submission deadline for 2018 MIPS reporting and find ourselves in the second quarter of 2019, it’s important to understand the changes that are in store for this upcoming reporting year. As a qualified MIPS registry, pMD gives customers the tools to submit their 2019 MIPS data to CMS and navigate some of these changes using our robust dashboard. As there are a lot of updates to the MIPS reporting requirements each year, I would like to address a few of the many questions that have recently come up.

Changes to Eligibility

In prior years, the list of clinician type has been fairly short to only include physicians, their mid-level providers, and nurses. Starting in reporting year 2019, there are 6 additional clinician types that are now included in MIPS reporting:

Physical therapists
Occupational therapists
Qualified speech-language pathologists
Qualified audiologists
Clinical psychologists
Registered dietitians or nutrition professionals

Find yourself on this list?  There is no need to panic! You can easily check to see if you are required to report based on your Medicare Part B volume by using the Quality Payment Program’s tool: QPP Participation Status

For the first year since the program began, clinicians who were previously ineligible to report can opt-in beginning Year 3. Physicians interested in this must meet at least one of the following criteria and are an eligible clinician type:

1. Have ≤ $90K in Part B allowed charges for covered professional services
2. Provide care to ≤ 200 Part B-enrolled beneficiaries
3. Provide ≤ 200 covered professional services under the Physician Fee Schedule (PFS)

Interested in opting-in to MIPS this year?  Keep in mind that opting-in may be irreversible, but stay tuned for an announcement from CMS QPP on where and how to opt-in later this year!

Changes to Submission

In previous years, claims-based submission was a viable option for many clinicians and organizations to report.  This year, claims submission is only available to small practices who have less than 15 providers. Larger groups may want to look into submitting through a qualified registry, QCDR, or your EHR. Questions about how to submit through a qualified registry? Give us a call at 800-587-4989 x2 to discuss your reporting options!

Individuals, groups, and virtual groups can begin to use multiple submission mechanisms for Year 3 reporting so you are no longer locked in to using just one mechanism or vendor. This change should make it easier for clinicians and health care organizations to leverage the tools they already have to submit different sections of reporting. The QPP has increased their capabilities, allowing the review of multiple submissions, selecting only the highest scores to keep as the final one for determination. In fact, they list out that “if the same measure is submitted via multiple collection types, the one with the greatest number of measure achievement points will be selected for scoring.“

Changes to Scoring

One of the more notable changes to Year 3 is the change to the final score breakdown. The contribution to the final score for the Quality category decreases to 45% and increases to 15% for the Cost category. There are no changes to the contributions of Promoting Interoperability or Improvement Activities categories.

Another change to the Quality category is that the small practice bonus for groups with less than 15 clinicians is awarded to the Quality section so long as there is at least 1 quality measure reported. This differs from Year 2 which awarded the 5 points to the final score total.

Changes to Payment Adjustments

As the QPP rolls out the MIPS program in stages, we will see increased difficulty in obtaining a positive payment adjustment. The first year of MIPS offered a “Test” submission in which by submitting any data, clinicians can easily avoid any penalties.  Last year, clinicians just had to score 15 points to avoid the penalty and be eligible for a positive payment adjustment. Beginning in calendar year 2019 (MIPS Year 3), the performance threshold had been increased to 30 points. Clinicians scoring under 30 points for their MIPS Final Score are subject to a negative payment adjustment. For groups trying to obtain the Exceptional Performance bonus, that threshold was also increased to 75 points.

Speaking of payment adjustments, the maximums have been increased for them as well.  Clinicians who fail to sufficiently report MIPS are subject to a penalty of up to -7% payment adjustment on Medicare Part B FFS payments. On the flip side, the maximum bonus can be up to a positive 7% payment adjustment - however, to keep budget neutrality, it will depend on overall submission performance and will be scaled and distributed appropriately.

A full list of changes to the Year 3 Final Rule and the most up-to-date information can be found on the QPP website.

Questions on your 2019 reporting options?  Feel free to take a look at what we offer for MIPS reporting here, or give us a call at 800-587-4989 x2!

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.

Here's The Latest in Health Care:

•  Hate exercising? Well, new research shows that exercise can lower blood pressure and reduce body fat as effectively as many common prescription drugs. While there's still a need for long-lasting studies that directly compare different drugs and various workout types, you might want to reconsider skipping out on gym time or that weekend hike!  Read More

•  If a new government-run Medicare public option were to be rolled out, more than 36 million people would likely leave private coverage. What would that mean for U.S. hospitals? It would mean a nearly 10% cut in the cost of providing care, threatening the ability of providers and clinicians to meet the needs of their patients.  Read More

•  As data analytics become increasingly important to the success of health care organizations, proper implementation of analytics technology is critical in maintaining that success. Some implementation best practices include defining outcomes that will be key to the success of the organization, starting with applications that can show an immediate impact by freeing up time and cost, and making sure technology vendors and CIOs work closely with clinical sponsors and management on all new initiatives.  Read More

•  Controlling anger as a parent can often times prove challenging. And teaching your little ones to control their own anger is a lesson in itself. One anthropologist spent more than 30 years studying Inuit adults' extraordinary ability to control their anger and instill this in their children.  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, secure messaging, clinical communication, MIPS registry, and care navigation software.

Last year we were excited to announce the launch of our free Secure Messaging product, which is now enabling thousands of health care providers across the United States to communicate in a way that’s convenient and secure. As that offering has gained adoption, we’ve been actively soliciting feedback from our user base in order to understand how we can continue to make the product better for them. One of our biggest takeaways has been that, while secure text messaging has indeed addressed a major pain point, there are additional scenarios where a richer form of communication would be helpful.

That’s why we’re excited to announce the upcoming release of secure video calling capability.  This new feature will enable providers to utilize pMD to quickly get a second opinion from another clinician, connect with a nurse at a remote clinic, or even chat directly with a patient who may not be able to leave his or her home. Best of all, video calling will be built in to our free Secure Messaging product.

We know that often, vendors dangle new features behind a paywall, or an upgrade requirement, rather than shipping them directly to their customers. However, our philosophy at pMD has always been, first and foremost, to help clinicians provide better patient care.  The cutting edge design agency, Chagency, sums up this approach well in a recent blog post, suggesting, “Help [your users] grow so you can grow together.” To accomplish this, we push down as much value into our free offering as we possibly can, knowing that the more people who benefit from pMD, the bigger the impact we’re able to have on health care in this country.

We’re extremely excited about this upcoming enhancement to pMD’s product suite. We look forward to continuing to gather feedback from our customers as they leverage this new tool to improve their care delivery. Most importantly, we’re not done innovating. In fact, we’re just at the beginning of a compelling roadmap of new features to empower richer communications in health care.


Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.

Here's The Latest in Health Care:

•  In a recent statement by the Food and Drug Administration, the agency reported that several makeup products from Claire's stores, a common sight in many malls across the U.S., tested positive for asbestos. Asbestos is a mineral that has been linked to deadly cancers. Claire's has removed the three products that tested positive from stores, which includes eye shadows, compact powder, and contour powder.  Read More

•  The joint health care venture between Amazon, Berkshire Hathaway, and JPMorgan Chase will officially be called Haven. The aim of the company is to bring together the three companies to create better patient outcomes, greater satisfaction, and lower costs for U.S. employees and their families.  Read More

•  Eating grapefruit or drinking grapefruit juice can have dangerous and even life-threatening effects while taking certain drugs. Grapefruit juice is known to interfere with absorption of some drugs. Additional drugs affected by grapefruit are some AIDS medications, certain birth control pills, antihistamines, some blood pressure drugs, and more.  Read More

•  Health care professionals are urging the Centers for Disease Control and Prevention (CDC) to clarify its opioid guideline pertaining specifically to the matters of opioid taper and discontinuation. Experts say the CDC's opioid guideline is being misapplied and is hurting chronic pain patients, even driving some to suicide.  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, secure messaging, clinical communication, MIPS registry, and care navigation software.

Here's The Latest in Health Care:

•  How well do you know this week's health care news? Take the weekly health quiz to find out!  Read More

•  While data sharing and interoperability are making headway, providers are still facing a learning curve in using this outside, less-structured contextual data, such as notes and lab reports. The information that's being shared isn't always usable from one organization to the next.  Read More

•  Since last March, Apple rolled out a feature in its Health app that allows users to store their medical records. But can Apple live up to its privacy values? Medical records stored in the app could list information that most users would not want their employers, advertisers, or insurance companies to see.  Read More

•  A bill introduced last week would require health care and social services employers to implement workplace violence prevention plans that would be enforceable by the Occupational Safety and Health Administration (OSHA). Hospitals would be required to meet design standards to improve safety for their health care workers.  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, secure messaging, clinical communication, MIPS registry, and care navigation software.

College career fairs can be exhausting and are probably the last thing you feel like attending as a college student. It takes away from valuable free time, you have to change into something other than sweatpants, and then have to spend time awkwardly interacting with people you don’t know. Now that I'm the one representing my organization at college career fairs, I've gained a whole new perspective. Career fairs are incredibly important to both the employers and the schools putting them on, and to make the most of these events, the planning starts long before the fair itself.

What recruiters wish you knew about career fairs

They want to hire you! Employers have skin in the game. They have chosen to spend valuable office time or time away from their families to travel, often overnight, to get to know YOU, so they want to make it worth their while. There are many reasons why recruiters choose a specific school from which to recruit. The school might have a top program in the field from which they're looking to hire or the company has a top executive that’s an alumnus or alumna. Regardless of the reason, companies who attend are looking to hire.

Employers plan too! Preparation starts 6 months in advance because space is limited for these fairs and registration isn’t free. They spend time designing an eye-catching booth and customizing fun swag and informational materials in order to make the best impression. Most of these materials contain useful information about the company, career opportunities, and how to apply. Let’s face it, who doesn’t like free stuff? Take what we brought, review those materials, and let us know if you like it!

Come early and don’t linger. The best time to attend a career fair is at the beginning of the event. Recruiters speak to many students, so get in there, shoot your elevator pitch, ask your questions, and hit the next booth on your list before a line starts to form in front of you. As the day progresses, recruiters start to lose their voices and energy levels begin to wane, so it’s always good to make your impression as early into the event as possible.

Recruiters care about you and will review your resume if you thoughtfully present it to them. Take advantage of this, it’s not every day you have industry professionals giving you useful feedback to enhance your resume.

How to make the most out of this experience

Dress for success. First impressions are important and they start the moment you walk up to a recruiter. Coming from the gym or an all-night cram session might not give off the impression that you’re interested in looking for a professional career. Shower, brush that hair, and dress in business casual attire if you feel like a suit just isn’t your jam.

Personalize your outreach. If you made a connection with a recruiter, find out how you can contact them and send a thank you email. Don’t take it the wrong way if they don’t give you their business card (recruiters get hundreds of emails after a career fair and don’t always remember to give out their cards) but you can send a thank you note and express your interest either on your application cover letter or as a note to the company’s “careers” email address. Reference the recruiter’s name and how they impacted you.

Do your research beforehand. Remember that recruiters will speak to hundreds, sometimes thousands, of candidates throughout the year. How will you stand out? Colleges tend to send a list of employers to students prior to the fair. Check out the company’s website and peruse their open positions. You’ll have a much more meaningful conversation if you are referencing a specific opportunity.

Hone your elevator pitch. You have a small amount of time to relay who you are and why you should be considered. Create a clear and concise pitch that summarizes these points in 60 seconds or less. Some questions you might be asked: What is your major? When do you graduate? What are you looking for? What is something we wouldn’t know about you from looking at your resume?

Go into a career event with the mentality that this is a networking opportunity that may even get you a job! This won't be the last time in your professional career that you are in a loud room, surrounded by people you don’t know, and asked to sell yourself in 60 seconds or less. Use this time to practice your networking skills!

Apply through the company website even if you handed your resume to a recruiter. Recruiters will take your resume and plan to reach out to you when they get back to their office if they are interested. Don’t leave your career to chance! If you are truly interested in the opportunity, err on the safe side and submit your resume through their website.

You don’t have to have everything figured out yet. After all, it’s a college career fair and the first step towards taking on the real world. Take advantage of the experience you gain at these fairs so that when you are ready to take that next step, you know what you want and can confidently launch your career in a role with a company you love. I look forward to seeing you at the next one soon!

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.

Here's The Latest in Health Care:

•  People are often faced with such a rigid sense of self that when presented with a new concept about ourselves, our first reaction is typically to reject it. We immediately defend ourselves and keep our concepts intact. But maybe if we turned to the example of the locust, we might get a lesson in adaptability and embracing a more flexible self image. Locusts actually start out as shy, anti-social grasshoppers that, under the right circumstances, morph into the swarming, social, and aggressive locusts we read about in Biblical verses. Researchers say that if you are struggling in one role in life, it helps to have multiple views of yourself, much like the grasshopper and the locust.  Read More

•  On Thursday, a team of scientists reported that they have in effect doubled the genetic alphabet. As we understand DNA today, it's spelled out with four letters, or bases, A, C, G, and T. This team of scientists have built DNA with eight bases - four natural, four unnatural, and has named it the Hachimoji DNA. This new system could have many applications, including a far more durable way to store digital data that could last for centuries.  Read More

•  In a recent survey, a vast majority of respondents said that they would like the ability to communicate with their loved ones' care teams via text messaging. Only about 10 percent of patients prefer to receive provider communication through patient portals. With so many technologies to choose from, health care teams should consider vendors who can meet consumer preferences for communicating via text messaging.  Read More

•  Facebook is accused of exposing users' sensitive health data, according to a complaint filed with the Federal Trade Commission (FTC). The complaint, made public this week, claims that Facebook failed to protect the sensitive health information users uploaded to its 'Groups' product and exposed that information to the public. The complaint also argued that Facebook's privacy policies are not clear and users aren't informed of how their health data will be used.  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, secure messaging, clinical communication, MIPS registry, and care navigation software.

At pMD, we have a foundation that has been built from over 20 years of experience working with employees with various backgrounds and working with customers from varying specialties and experiences. Throughout our 20 years in the industry, we’ve established a structure to ensure that our process to obtain new customers and keep existing ones happy is standardized, effective, and as efficient as it can be. Even after 20 years, we continue to stay open to learning new and better ways to improve our already proven process. This leads me to the question: what happens when an idea or plan doesn’t go the way you expect? Does it mean you’re set up for failure? No. In fact, sometimes when things don’t as planned, it might actually be for the better. So make lemonade with those lemons.

Recently, I was involved in an implementation that didn’t go as I had originally planned and it turned out to be one of the best implementations I had ever been a part of. One of our customers had been using pMD for a number of years for one of their many specialties. And for the past two years, we have been trying to expand our usage to other specialties within this large organization. As a team, we discussed what additionally we could provide to the already existing specialty to ensure their continued success with pMD, providing more leverage to expand to their other groups. We set out a plan to do some heavy customer outreach and made sure we spoke with not only the administration but, more importantly, with the providers themselves to get their feedback on how pMD was working for them so far. After all, they’re the ones who would know best on how the system is working. Through close account management, we were able to implement new, robust features to the existing group and get our foot in the door to finally expand to a new group.

Why was this implementation then so special? It started at the top. Leadership was heavily involved in the vetting and implementation of pMD. We followed our best practice of learning about the group and their workflow as well as speaking with and presenting to leadership and their physician champions. We were on the right path to go live with this new specialty group by the end of October. They expressed interest in wanting to do a trial run with a smaller subset of physicians and provide feedback before going live for the entire group. This process lasted 1-2 weeks before getting the green light to go live with the entire group. We also received feedback and made the appropriate adjustments with the idea that we were still on track to implement the new group by the end of October. However, when we discussed the go-live date, the group wasn’t comfortable to move forward with that timeframe because of scheduling conflicts and additional questions they had about the system. While it was a frustrating time for our team, we eventually came to implement the new group officially in December (over a month after the initial target date of October 2018). Surprisingly, after all the prior obstacles, the implementation went about as smoothly as any implementation I had ever been a part of.

A smooth implementation isn’t a result of magic. Leadership with this group took those extra weeks to very clearly communicate to their providers and staff as to why they were making the transition to pMD. When we came on-site the first week of December, we weren’t met with surprised looks or confused faces. Everyone we worked with was prepared and understood the ‘why’ behind the process. In the span of four days, our team was able to successfully get over 30 providers using pMD without a hitch.

It takes strong leadership and clear communication for new ideas to mature and to be adopted. Much like this implementation, pMD does the same. When our strategy doesn’t always necessarily go as planned, we adapt, we communicate the ‘how’ and ‘why’, and then we move forward with those changes. This implementation was also a great example of how pMD continues to grow its brand, starting from a long-time customer and expanding into its surrounding community. Since the implementation, we’ve added several more providers and expanded the use of a new product, pMD® Clinical Communication™, within this organization. So when things don’t go as planned, remember that better results might even come out of it.

Find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, clinical communication, and care navigation software and services, please contact pMD.

Here's The Latest in Health Care:

•  A recent report published that artificial intelligence is being used to automatically diagnose common childhood conditions after processing the patient's symptoms, history, lab results, and other clinical data. Millions of Americans each year are misdiagnosed as a result of physician bias or overlooked alternatives. The hope is that someday this highly accurate system may assist doctors in diagnosing more complex or rare conditions.  Read More

•  Health care executives agree that some of the top challenges the industry is currently facing includes declining reimbursements and the patient experience, in addition to maintaining and upgrading IT and cybersecurity. Executives also identified that some of the key initiatives to reducing costs and improving the patient experience are to enable interoperability and increase data visibility across the enterprise.  Read More

•  Before you go squashing the next scurrying cockroach you see, consider the fact that insects actually have antimicrobial-producing microorganisms that could one day help cure diseases. As more and more infections become resistant to antibiotics, scientists are turning to insects and the bacteria living inside them as a source for new antibiotics in a time when demand is high but pipeline for new drugs is dwindling.  Read More

•  The Department of Health and Human Services Office for Civil Rights reported 10 settled cases and one judgement totaling $28.7 million in 2018 in response to HIPAA violations. It is 22% higher than what was reported in 2016 and a record year for settlements.  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, secure messaging, clinical communication, MIPS registry, and care navigation software.