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(SPONSORED) Mobile devices are an important part of the modern health landscape, but the industry needs to go further than that.

Privia Health will expand its work with athenahealth to ratchet up its focus on population health, the accountable care organization announced on Wednesday. Arlington, Virginia-based Privia Health will fully integrate athenahealth’s population health offering into its existing framework of athenaOne services for all 1,200 of its multi-specialty independent providers across five states and Washington, D.C. [Also: Jonathan Bush performs CPR on San Francisco sidewalk] Athenahealth will assign evidence-based health risk statuses to patients. The goal is to enhance patient engagement, and provide insight to better direct and align clinical protocols and team-based capabilities – all in an effort to provide value-based care. Privia Health CEO Jeff Butler credits athenahealth with helping the medical group become one of the top ACOs in the country, with care models and incentives fully-aligned around driving value into the system. In 2014, the first year Privia assumed shared-risk in the Centers for Medicare and Medicaid Services Shared Savings ACO model, Privia saved Medicare nearly $5.7 million and received half of that back in an incentive payment, according to CMS data. Privia Health has worked with athenahealth since 2014 to support clinical integration and connectivity between its medical groups and clinically integrated networks. Privia and athenahealth have already integrated athenahealth’s platform with Privia’s proprietary population health workflow systems and technology, bringing automation and scale to Privia’s programs that are focused on improving outcomes and reducing healthcare spending. Twitter: @HealthITNews

Steve Sisko, aka @Shimcode on Twitter, did not originally embark down the path toward healthcare IT. His primary career choice, rather, was in the field of aviation technology.

After facing an unacceptable 70 percent patient matching rate, the San Diego Health Connect health information exchange said it has turned its performance around using identity validation technology to better match patients and in the process clean up its master patient index. Its current patient matching rate is 98 percent. "To a certain degree, we caused the problem ourselves," said Dan Chavez, executive director of San Diego Health Connect. "We use very strict matching criteria. Not every HIE uses the strict matching criteria we do. We require a 100 percent match on six variables to automatically match patients. Other HIEs make the governance decision not to match on such strict criteria. If you loosen the rules in probabilistic and deterministic matching, you can have a higher rate. We want the machine to do as much as possible, but we don’t make it easy because we want the faith and trust that what comes out of the HIE is 100 percent correct." [Also: 'New value propositions' emerge for HIE.] At the 70 percent matching level, San Diego Health Connect had a backlog of requests that had to be manually reviewed. For example, Dan Chavez and Daniel Chavez and Daniel J. Chavez could all be the same person, with different records at different facilities in the San Diego area. Further, when consumers get married or divorced and change names, multiple different records may exist. "There are more than a few Chavez's in San Diego, as you might expect, so my name might go into the exception queue — and I’ve received care at Sharp and Scripps, and maybe my records do not match," he said. "Prior to using Verato, someone from the Sharp medical records department and someone from the Scripps medical records department would have to get together through an e-mail or phone call. If I had additionally been to UCSD, or if someone fat-fingered my Social Security number, the exception would pop up yet again for me, and UCSD would have to get online with Sharps and Scripps. So you see the magnitude of the problem." The exceptions queue grew so large and the backlog so long that medical records departments in the community said this HIE thing was killing them. [Also: New HIE, vendor members for CommonWell.] Verato's Carbon is a cloud-based identity data management system, what the company claims to be the most complete and accurate database of U.S. identities. "We source billions of records including credit agency and telecommunications provider data, along with government and legal data; and we use proprietary technology to produce our view of individual identities," said Joaquim Neto, senior solutions architect at Verato. San Diego Health Connect, for instance, automatically ran its exception queue against the Carbon database and quickly matched 80 percent of the exceptions to their correct records, Chavez said. "Then, with a little bit of examination, we could much more easily deal with the additional 20 percent — associating pediatric patients with parent addresses," Chavez cited as an example. "One of the challenges of patient ID in pediatrics is naming conventions. With the interactions with Carbon, we then could go back to the community and say, 'We all are doing some things incorrectly.' It gave us some guidelines in community-wide naming conventions, so we could go back to participants in the HIE and say, 'If it’s a hyphenated last name, let's place the second name in this field and the first name in that field.'" Improving the patient matching rate earned San Diego Health Connect a higher degree of confidence in the information coming out of the health information exchange among healthcare organizations in San Diego and Imperial County, Chavez said. "People know if the HIE is delivering information for Dan Chavez that there is a 98 percent-plus chance that we in fact have the right Dan Chavez," he said. "That confidence was not there before." [Like Healthcare IT News on Facebook] The HIE declined to share the cost of using the Carbon system from Verato, but the vendor said the ticket could be between $250,000 to $500,000 a year for an organization the size of San Diego Health Connect. "The soft return on investment is the confidence in the HIE as we deal with the medical records in the entire community of 3.2 million people; these providers know when they get patient information from SDHC, it is correct," Chavez said. "The hard ROI comes in no need for medical records departments to call up anyone to check exceptions. They do not have to challenge the data or make 3-5 phone calls to reconcile. Those phone calls at a minimum of 5 minutes a head are expensive." Twitter: @SiwickiHealthIT

Cincinnati, Ohio-based Mercy Health has saved more than $42 million on drugs since 2010 by building a formulary within its electronic health record platform. The move, according Wayne Bohenek, vice president of care transformation at Mercy Health, makes it easier for the system’s network of providers to order medications that are on its list and compliant with Mercy’s pharmaceutical contracts. The 23-hospital system went live with its Epic EHR in 2010. It took Mercy Health’s pharmacy and therapeutics committee three years to create the formulary -- a comprehensive list of medicines that Mercy Health would prescribe, said Bohenek. The committee, composed of prescribers from all specialties, evaluated the cost-effectiveness, side effects, comparable efficacy, indications and available literature for medications in 100 classes. [Also: Managed care pharmacies reap benefits of EHRs] Mercy places drugs in one of four categories: on the formulary and available from order sets; on the formulary but not available from order sets; restricted to a specific disease state or provider type; and neither on the formulary nor in order sets. These categories correspond to Mercy’s “bullseye” -- a visual representation of each medication class that committee members use to review their decisions.  For drugs that are neither on the formulary nor in order sets, Mercy built more than 800 therapeutic interchanges. When providers order a non-formulary medication, the system suggests formulary alternatives. If providers don’t choose an alternative, they document a reason. Mercy reports on the data to identify providers who routinely order non-formulary medications. “We generate reports on non-formulary drugs -- how many times they were ordered, and what the cost savings would be if we were to use a formulary drug instead,” Bohenek said. “We can provide that report by region and provider and have discussions with providers who are using non-formulary drugs. The reports show providers how much non-formulary drugs are costing the region.” “We’re pretty prescriptive about it,” said Susan Mashni, chief pharmacy officer at Mercy Health. “An extensive drug monograph is completed for each class of medications.” So far, Bohenek and Mashni said providers have been receptive tot eh workflow. “I think most prescribers see the reality of how much drugs cost and what the impact of prescribing them is,” Mashni said. “As long as it’s just an educational discussion, they’re very responsive to the concept that you’re going to improve patient compliance if you don’t give them the most expensive drug out there.” Mercy Health now has an average formulary compliance of more than 98 percent. [Like Healthcare IT News on Facebook] The formulary management is most effective with a single EHR across the health system because it enables the health system to make modifications as their contracts change and to monitor compliance.   The move to Epic – and the health system board’s insistence that 85 percent of content be standardized – provided the impetus Mercy needed to adopt a formulary. Prior to rolling out Epic, Mercy employed a mix of technology, primarily from McKesson and Meditech  – and paper. Twitter: @HealthITNews

(SPONSORED) Telehealth technologies are on the rise. For hospitals and providers, telehealth enables more frequent connections with existing patients, and the ability to reach new patients in new markets. Here are the top ten questions providers ask when considering telehealth.

Since his days as executive editor at WIRED magazine, which he led to a dozen National Magazine Awards in as many years, science journalist Thomas Goetz has been driven by a key question: "How are industries tipping in the face of information technology?"

A healthcare startup made a wild pitch to Cara Waller, CEO of the Newport Orthopedic Institute in Newport Beach. The company said it could get patients more engaged by "automating" physician empathy. It "almost made me nauseous," she said. How can you automate something as deeply personal as empathy? But Waller needed help. Her physicians, who perform as many as 500 surgeries a year, manage large numbers of patients at various stages of treatment and recovery. They needed a better way to communicate with patients and track their progress. [Also: Patient-physician emails improve care quality] The California startup, HealthLoop, told Waller its messaging technology would improve their satisfaction and help keep them out of the hospital. High satisfaction scores and low readmission rates mean higher reimbursements from Medicare, so Waller was intrigued. So far, she's been surprised at patients' enthusiasm for the personalized -- but automated -- daily emails they receive from their doctor. "There's a limited number of resources in health care. If you do 500 joint replacements in a year, how do you follow up all of those patients every day?" Waller said. The technology "allows you to direct your energy to people who need the handholding." "Automating empathy" is a new healthcare buzzword for helping doctors stay in touch with patients before and after medical procedures -- cheaply and with minimal effort from already overextended physicians. It may sound like an oxymoron, but it's a powerful draw for hospitals and other health care providers scrambling to adjust to sweeping changes in how they're paid for the care they provide. Whether the emails actually trigger an empathetic connection or not, the idea of tailoring regular electronic communications to patients counts as an innovation in health care with potential to save money and improve quality. [Also: Healthcare security: Adapt or die] Startups like HealthLoop are promising that their technologies will help patients stick to their treatment and recovery regimens, avoid a repeat hospital stay, and be more satisfied with their care. Similar companies in the " patient engagement " industry include Wellframe, Curaspan, and Infield Health. HealthLoop's technology is being tested at reputable medical centers including the Cleveland Clinic, Kaiser Permanente-Southern California, the University of California, San Francisco, and the Newport Orthopedic Institute in Orange County, company officials said. Doctors can send daily emails with information timed to milestones in surgery prep and recovery and ask patients or caregivers for feedback on specific issues patients may face during recovery. The doctors may write their own email scripts, as Newport Orthopedics' physicians did, or use the company's suggested content. An online dashboard helps doctors and administrators keep track of which patients are doing well and who might need more follow-up care. Patients can also communicate with office staff about medications and office visits. Their responses to daily emails can trigger a call from the doctor's office. A patient might see this message: "How are you? Let me know so I can make sure you're okay. I have four questions for you today." Such a call may have been a lifesaver for David Larson, a Huntington Beach retiree. After Larson responded "yes" to an email that asked if he had calf pain after knee surgery, he got a call from his doctor's office telling him to come in immediately. An ultrasound confirmed he had a blood clot that could have landed him back in the hospital -- or threatened his life. With treatment, the blood clot dissolved and he resumed recovery. "There were times when it was like, 'Oh brother, they're contacting me again,' but none of this would have been caught if it wasn't for the email," said Larson, 66. "So it was more than worth it to me. Now I'm back to walking the dog, surfing, riding a bike." How to keep patients like Larson from hospital readmission because of avoidable complications after a hospital stay has long been one of health care's most vexing and expensive challenges. Almost one of every five Medicare patients discharged from a hospital -- approximately 2.6 million seniors -- must be readmitted within 30 days, at an annual cost of more than $26 billion, according to the Centers for Medicare and Medicaid Services. For decades, hospitals had no financial incentive to keep patients out of the hospital after they were discharged. But under the Affordable Care Act, financial penalties were established for hospitals with readmission rates higher than the national average for certain conditions. Also under the ACA, hospitals are financially rewarded for high scores on patient satisfaction scores and good performance on other quality measures set by CMS. Doctors' groups increasingly are affected financially by this sea change, either because they are part-owners in a hospital, as Newport Orthopedics is with Hoag Hospital in Newport Beach, or because they participate in other risk-sharing financial partnerships with hospitals. With that kind of money at stake, hospitals and other health care providers may be willing to pay for programs like HealthLoop, if the tryouts prove successful. And you could see your own relationship with your physician change as a result, whether you're on Medicare or not: HealthLoop is aimed at all patients, whatever the payment source. Some experts worry that health care providers will come to rely too heavily on electronic communication as a cheap substitute for the hard work of improving the doctor-patient relationship and the quality of care that patients get. "Automating personalized messages isn't a terrible thing; we all get some of that in our everyday lives," said Michael Millenson, a health industry consultant. "The real question is whether this kind of automated messaging is in conjunction with a cultural change in how doctors think about their patients or not." Health care providers have long experimented with ways to prevent complications that can land a patient back in the hospital, with varying success, said Kristin Carman, vice president of health policy research at the American Institutes for Research. Robo-calls reminding you to take your medicine, for example, don't seem to be very effective. And the new technologies don't always address demographic, cultural and language barriers that can prevent patients from communicating with their doctors. For now, HealthLoop is only available in English. Dr. Jordan Shlain, a San Francisco internist, said he founded HealthLoop because he wanted a simple way to keep track of his patients' progress after a hospital visit or procedure. "Every human has the same kind of trajectory of concerns and anxieties with regard to medical situations," Shlain said. [Like Healthcare IT News on Facebook] HealthLoop, based in Mountain View, offers "a digital extension of the doctor," he said. "You know your doctor can't email you every day; you know your doctor usually will not call you. Now you're in a world where your doctor says I'd like to use this system to stay in touch with you and guide you through your recovery." Dr. Thomas Vail, professor and chairman of the department of orthopedic surgery at the University of California-San Francisco would agree -- up to a point. With his UCSF colleagues, Vail is testing HealthLoop's system with his patients, and the university will be evaluating whether patients who use it have fewer adverse events than their peers. UCSF helped create some of the language for the automated emails and has a financial relationship with the company, said Dr. Aenor Sawyer, who directs UCSF's Skeletal Health Service and is a leader at the university's Center for Digital Health Innovation. While Vail thinks HealthLoop is potentially promising, he's cautious about its role in his practice. "I don't think it substitutes for face-to-face communication," Vail said, "but it does help us collectively to not overlook something that might be important." This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation. Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation. Twitter: @HealthITNews

Doctor on Demand has expanded its telemedicine platform to include board-certified psychiatrists, the company announced on Tuesday. In December 2014, Doctor on Demand began offering mental health services with the addition of psychologists to its provider network. Extending the network to include psychiatrists will complete the mental health cycle, from therapy to medicine, officials said. "Mental health is a vital area, where there may be the most need for telemedicine," said Donovan Wong, MD, medical director of behavioral health at Doctor on Demand. [Also: Telehealth's biggest roadblock: physician reimbursement] "There's really a lack of access to care," he said. "Rural areas have the worst access, but even in big cities, like Los Angeles, the wait time is up to five weeks or more for 80 percent of the population. That's really our mission: increasing high quality care. With mental health, that's really what we'd like to do." Doctor on Demand's telemedicine platform connects patients with care providers. It started in 2012, with board-certified physicians, later expanding to offer consults with lactation consultants and psychologists. More than 300 mental health professionals can be found on the network in 27 states, including licensed psychologists and board-certified psychiatrists. The company plans to expand the services nationwide by mid-year. Currently, many patients pay out-of-pocket, but Wong said Doctor on Demand hopes to change that in the near future. The platform has partnered with dozens of employers and health plans, such as United Healthcare, providing 45 million Americans access. Last month, the company announced it signed its 400th corporate customer. “Many Americans don’t have access to mental health treatment, and for those that do, long wait times, distance, cost and stigma are still barriers to getting care.” Wong said in a statement. "These are all challenges telemedicine can address." [Like Healthcare IT News on Facebook] A 2013 National Survey on Drug Use and Health estimated one in five adults aged 18 or older had a mental illness, but only 45 percent of these affected parties received treatment. Furthermore, 55 percent of the nation's 3,100 counties have no practicing mental health workers and the average wait time to see a psychiatrist is two months in some cities and eight months in rural counties. "Too many people don’t know where to turn for mental health care, so they get overpriced care, the wrong care, or no care at all," said Adam Jackson, co-founder and CEO of Doctor on Demand, in a statement. "By adding psychiatrists, we're striving to meet our mission of increasing access to high-quality care.” Twitter: @JessiefDavis

Hillary Clinton won a slim victory over Bernie Sanders in the Iowa caucus on Monday while Tea Party Republican Ted Cruz upset boisterous billionaire Donald Trump to win the bulk of his party's delegates. Either way, the results were a bit of a surprise as both parties' frontrunners seemed much more vulnerable than thought. As American voters are weighing the differing proposals and positions of the top candidates this primary season, we thought we'd ask our audience of healthcare insiders who they think would be the best to lead the country from strictly a healthcare policy position. [Also: Candidates differ on healthcare as Iowa caucus begins.] Most Republicans are pitching different models to replace President Obama's signature Affordable Care Act. On the other hand, Clinton wants to strengthen it while self-proclaimed Socialist Bernie Sanders is fighting for a single-payer system. Answer the informal poll below to tell us where you stand. Twitter: @HenryPowderly