Application of Information Technology to Improve the Primary Care Experience
Conclusions), I discussed how IT was being deployed to make a visit to a MinuteClinic more convenient for patients and efficient for the NP caregiver. There was nothing earthshaking about the IT from my perspective -- making an on-line appointment, displaying wait time for patents in the waiting area, and news about the availability of a vaccine in short supply on the web. I immediately thought about how Uber and other ride-sharing apps have shaken up the previously stable taxi industry using IT. Many people now prefer Uber over taxis because you can summon a ride from any location in a city, you are messaged with th...
Source: Lab Soft News - December 20, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Delivery Healthcare Information Technology Medical Consumerism Quality of Care Source Type: blogs

New CMS Reimbursement Guidelines: Support for Provider-to-Provider Consults
Here's a link to a high quality webinar fromAmericanWell about telehealth (see:A Guide to Integrating Cross-Continuum Telehealth into your Health System). Starting at about 11:00 minutes in the recording, the discussion turns to new CMS telehealth reimbursement guidelines for FY2019 that include new services such as remote patient monitoring (see:CMS to Reimburse Providers for Remote Patient Monitoring Services). Another new type of service that will be reimbursed isprovider-to-provider consultations (see:CMS wants to expand telehealth coverage. Here's what that means for you). Here's the key passage from this ...
Source: Lab Soft News - December 20, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Lab Industry Trends Lab Information LIS Definitions and Strategy Pathology Informatics Quality of Car Source Type: blogs

A Visit with a MinuteClinic Nurse Practitioner; My Observations and Conclusions
I recently visited a local CVS MinuteClinic for a vaccination. I have previously blogged about MinuteClnics because I believe that they, along with the Walgreens and Walmart clinics, will attract a substantial share of primary care visits in the near future. Here are some of my previous notes about MinuteClinics (see:Details about CVS' MinuteClinic POCT Strategy;CVS Offers Telemedicine Visits for MinuteClinic Patients;The"Proximity Advantage" Enjoyed by Retail, Walk-In Clinics Over Health Systems;Retail Drug Stores Emerging as Healthcare Hubs for First-Tier Primary Care).My first impression during the visit w...
Source: Lab Soft News - December 18, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Information Technology Healthcare Innovations Medical Consumerism Public Health Telemedicine Source Type: blogs

Johns Hopkins Pediatric Hospital in Florida Suffers Soaring Surgical Mortality Rate
The prestigiousJohns Hopkins Health System acquiredAll Children's Hospital in St. Petersburg, Florida, in 2011 (see:All Children's Hospital Joins Johns Hopkins Medicine). This was a non-cash transaction and the first U.S. hospital outside of the Baltimore/Washington, D.C., region to become integrated with JHM. As reported recently, this move has been the source of extreme embarrassment for Johns Hopkins as reported in a recentTampa Bay Times article (see:Top All Children ’s executives resign following Times report on heart surgeries). Below is an excerpt from it:The CEO ofJohns Hopkins All Children ...
Source: Lab Soft News - December 15, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Hospital Executive Management Medical Ethics Medicolegal Issues Public Health Quality of Care Source Type: blogs

Amazon Launches New Medical Record Language Processing Service
One of the most significant factors in extracting information from EHR record is the use ofnatural language processing (NLP) which I have referred to in a number of previous notes (see, for example:EMRs and the Data Entry Paradox; Same Concept Not Applicable in the LIS World;Assessing Drugs Using"Real World Evidence" in Addition to Clinical Trials;AI Allows Computers to"Read" EHR Records and Make Predictions). A recent article discussed why one should"care" about Amazon's new medical language processing service (see:Why Should You Care About Amazon's New Medical Language Pr...
Source: Lab Soft News - December 13, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Computer Security Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Lab Information Lab Regulation Medical Research Medicolegal Issues Predictive Analytics Source Type: blogs

Walmart Shapes Its Own Primary Care, Unbundling Strategy
Walmart is establishing its own version of a primary care, unbundling healthcare strategy (Walmart Care Clinics) that is both similar and different to CVS-Aetna. The details were discussed in a recent article (see:Walmart Health: A Deep Dive into the $WMT Corporate Strategy in Health Care)...[R]eports [have emerged] that Walmart is in merger talks withHumana, a health insurer with a $37B market cap, and looking to buyPillPack, an online pharmacy, for just under $1B [to] make Walmart look more like an integrated health care delivery system with every passing day. On top of Walmart ’s existing health care offerings, ...
Source: Lab Soft News - December 11, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Delivery Healthcare Innovations Healthcare Insurance Medical Consumerism Pharmaceutical Industry Public Health Source Type: blogs

Virtual Scribe Vendors Remotely Generate EHR Notes and Coding
The use of scribes to act as intermediaries between a clinician and a patient is now common practice in outpatient healthcare settings (see, for example: Shift of Hospital EMR Data Entry Tasks from MDs to Scribes;The Emergence of EMR Scribes as a New Category of Hospital Employees;The Explosive Growth of EHR Scribes; Back to the Future). This use of scribes relieves the clinician of the laborious responsibility of entering data into the EHR. The clinician only interacts with the patient and the scribe extracts the necessary and appropriate EHR information from the conversation without any cues from the clinician. Dis...
Source: Lab Soft News - December 6, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) Healthcare Delivery Healthcare Information Technology Healthcare Innovations Quality of Care Source Type: blogs

eConsult System Designed to Optimize Hospital Specialty Referrals
NYC Health& Hospitals system has developed and deployed e-consult software that is both EHR linked and web-based. It has been shown to be a valuable tool for reducing wait time for speciality care appointments and to enable PCPs to improve the quality of care (see:eConsult proves valuable tool for NYC Health+Hospitals in cutting wait times, speeding referrals). Below is an excerpt from it:The [web-based, EHR integrated] eConsult tool allows primary care providers and specialists to communicate more effectively and co-manage patients when appropriate, as well as allowing them to connect patients to specialty care. The s...
Source: Lab Soft News - December 5, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) Healthcare Delivery Healthcare Information Technology Healthcare Innovations Medical Education Source Type: blogs

E-Consult Software Evolving for the Optimization of Hospital Specialty Referrals
NYC Health& Hospitals system has developed and deployed an e-consult program that is both EHR linked and web-based. It has proved to be a very valuable tool that has cut wait time for speciality care appointments and improved the performance of PCPs in the health system (see:eConsult proves valuable tool for NYC Health+Hospitals in cutting wait times, speeding referrals). Below is an excerpt from it:The [web-based, EHR integrated] eConsult tool allows primary care providers and specialists to communicate more effectively and co-manage patients when appropriate, as well as allowing them to connect patients to specialty ...
Source: Lab Soft News - December 5, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) Healthcare Delivery Healthcare Information Technology Healthcare Innovations Source Type: blogs

Blurring of Definition of Big Medicine; Corporatization of Healthcare
Eight years ago I posted a note referring to an article in theNew York Times (see:More Doctors Giving Up Private Practices) about the emergence of"Big Medicine" (see:Physician Private Practice Declines; the Last Barrier to Emergence of"Big Medicine"). In that note, Big Medicine was defined as being composed of the following organizations: (1)Big Pharma, (2)Big Payers (i.e., the U.S. government and large insurance companies); and (3)Big Providers (i.e., large consolidated regional health systems). A related concept now occurring in Big Medicine is its corporatization. As a result, physicians workin...
Source: Lab Soft News - December 3, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Insurance Pharmaceutical Industry Quality of Care Source Type: blogs

Roche Diagnostics Shows Keen Interest in Diagnostic Management Teams
I was slightly taken aback by a recent email blast I received fromRoche Diagnostics with links to a current and planned complementary articles about Diagnostic Management Teams (DMTs) (see:DMT series). I have posted a number of blog notes in the past about DMTs (see, for example:First Diagnostic Management Team Conference Scheduled for Next February;Deploying a DMT at the Front-End of Lab Orders for a Complex Patient). The concept of the DMT was pioneered by Dr. Mike Laposata in 1984 as a means to assist clinicians in the ordering and interpretation of coagulation tests about which he was a national expert. In the in...
Source: Lab Soft News - November 30, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Blood banking Clinical Lab Industry News Clinical Lab Testing Cost of Healthcare Genomic Testing Healthcare Innovations Lab Industry Trends Lab Processes and Procedures Pathology Informatics Source Type: blogs

OptumHealth, One of the Largest Employer of MDs, Pursues Telemedicine
For readers ofLab Soft News that may be unaware of this,OptumHealth, a unit of UnitedHealth Group, is the one of the largest employers of physicians in the U.S. (see:With 8k more physicians than Kaiser, Optum is'scaring the crap out of hospitals'; UnitedHealth Group Soon to Be Largest Employer of Doctors in the US). Here's a quote from this first article:Since its acquisition of 250 Las Vegas-area physicians in 2008, UnitedHealth Group has steadily expanded its physician workforce to shield itself from competitors and hospitals....To date, the health insurance giant's physician arm, OptumCare, e...
Source: Lab Soft News - November 29, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Information Technology Healthcare Innovations Telemedicine Source Type: blogs

Some Ideas Governing Patient Data Stewardship by Hospitals
A recent kerfuffle atMemorial Sloan Kettering Cancer Center launched a discussion about whether MSK acted judiciously by providing a for-profit, startup company exclusive access to its hospital surgical pathology imaging data as well as associated textual records (see:Controversy at MSK Cancer Center Regarding the Pathology Archive and Database;Controversy Surrounding Memorial Sloan Kettering Cancer Center and Paige.AI Highlights Risks of Data Sharing and Monetization in Anatomic Pathology). The larger issue here is who"owns" or"controls" hospital data. These questions were addressed in a recent a...
Source: Lab Soft News - November 28, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Information Technology Lab Information Lab Regulation Lab Standards Medical Consumerism Medical Ethics Medicolegal Issues Source Type: blogs

Upcoming Free Webinar Focusing on Diagnostic Management Teams (DMTs)
TheAssociation for Pathology Informatics (API) andSunquest Information Systems will present the next free webinar in the 2018-2019 series on Thursday, November 29, at 1:00 ET. Dr. Michael Laposata, M.D., will deliver the lecture on the following topic:Obstacles to Widespread Implementation of Diagnostic Management Team Services. This current series of webinars focuses on the challenges to pathology informatics arising in large health systems. Dr. Laposata originated the idea of DMTs decades ago in order to help break down the wall between the test ordering physicians and lab professionals with specialized expertise i...
Source: Lab Soft News - November 26, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Healthcare Delivery Healthcare Innovations Lab Processes and Procedures Quality of Care Source Type: blogs

Three Examples of Predictive Analytics in Clinical Practice
I have posted previous notes about predictive analytics, particularly with regard to their use in the clinical labs (see, for example:Successfully Screening for Lung Cancer Based on Predictive Analytics;Diagnostic and Predictive Analytics and Their Possible Link to the Future of the LIS). However, of at least of equal importance, will be the use of predictive analytics in hospitals to improve clinical care and reduce costs. Such projects are even more important in an era of value based case with emphasis on efficiency and effectiveness. I therefore thought that it would be useful to provide some example of projects i...
Source: Lab Soft News - November 23, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Business Healthcare Delivery Healthcare Innovations Medical Research Predictive Analytics Quality of Care Source Type: blogs