HIMSS10 – Greenway Medical Technologies

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Eric Fishman, MD and Justin Barnes, Vice President of Marketing, Corporate Development, and Government Affairs for Greenway Medical Technologies have an interesting conversation about Greenway’s position in the Health IT industry. Mr. Barnes provides a unique perspective, as he is involved in several government HIT initiatives.

Dr. Fishman and Mr. Barnes discuss Greenway’s products, such as PrimeSuite, PrimePatient, and PrimeResearch. PrimeResearch allows customers and patients to participate in clinical trials and research with real time data access and polling. Mr. Barnes also talks about several key partnerships that Greenway has made with Microsoft HealthVault and Take Care Clinics (a Walgreens subsidiary). The interview wraps up with Mr. Barnes discussing Greenway’s views on Meaningful Use criteria and the company’s work with the federal Regional Extension Center (REC) program. Greenway is working with RECs to advise them on developing community strategies and achieving sustainable models for EHR deployment.

Category: Featured, HIMSS10, Tradeshows
Date: March 14, 2010
Views:6,414 views

Dr. Eric Fishman: This is Dr. Eric Fishman for EHRtv and today we have the pleasure of speaking with Justin Barnes, Vice President of Marketing, Corporate Development and Government Affairs for Greenway Medical Technology. Justin, thank you for taking your time here at HIMSS10. I understand that in addition to the title I've just given you, you have actually a number of other activities within this industry and let's start with that if we could.

Justin Barnes: Yes, thank you very much Dr. Fishman. I chair the EHR Association within the HIMSS organization and I also sit on numerous boards but the other one that I am here promoting is a new board position with the IHE USA Integrating the Health Care Enterprise.

Dr. Eric Fishman: Let's year we did some interviews with some of your staff at the IHE and I may be wrong but it seems that the IHE is at least twice as large as it was last year at HIMSS.

Justin Barnes: I think it's actually a little bit larger than that but yes, it's grown significantly which is also tremendous for our industry.

Dr. Eric Fishman: I think it is and clearly we're going in that direction. Let's start with Greenway. Greenway has a product, PrimeSuite, it's an integrated single database product of practice management and EHR but I understand that it's even more that. So if you can, very briefly, give us an understanding of the scope and breath of the product line itself.

Justin Barnes: Sure. Greenway's PrimeSuite is a fully integrated EHR practice management and operability solution at its core but then also we have the whole integrated physician's infrastructure around that which also includes PrimeExchange, which is an interoperability engine for all our customers to use. We actually manage all the interfaces for them. We don't expect them to manage those interfaces onsite. Then also, we have a health patient portal called PrimePatient that'll allow the relationship of the physicians and the patients outside the four walls of the practice manage a lot of their scheduling and refill requests and billing. Anything they need in those regards is all taken care of there. Then also another very important aspect is called PrimeResearch which allows our customers to participate in fully integrated clinical trials, clinical research outcomes reporting.

Dr. Eric Fishman: If I may, that was announced exactly one year ago at HIMSS last year.

Justin Barnes: It was.

Dr. Eric Fishman: How's the uptake on that, how's that been going?

Justin Barnes: Tremendous. I think we have almost half of our customers enrolled in PrimeResearch with tremendous interest from them. We see great interest from our customers as well as their patients. I think the other side is getting more companies to understand that we can conduct clinical trials with real-time data from EHRs. Traditionally today, it's done with data that's inter-repository; could be three, six months old or longer but here we can do real-time data access and polling and bring clinical research to practices. Today, only five percent I think of providers participate in clinical research but we're expanding those.

Dr. Eric Fishman: But those who do you can help them?

Justin Barnes: Correct.

Dr. Eric Fishman: I think I may have stopped you in the middle of a long list of features that your product has so if you could continue with that.

Justin Barnes: I think the most important is that we bring this entire fully integrated solution to physician practices. We focus on the one doctor group all the way up to the 100 doctor group. We bring this entire suite to them so they can really choose how they want to install, what they want to install, obviously starting off with a fully integrated EHR practice management interoperability solution, but then expanding out to the whole patient portal and then obviously bringing out the whole clinical research in behind it when they're ready to do that. I think this kind of breath and depth for a practice really will help the transformation process of health care as we roll this out across the country.

Dr. Eric Fishman: It's a powerful suite. Now you mentioned PrimePatient which I guess I could call a patient portal. You also have a relationship that's been announced with Microsoft HealthVault. If you could briefly discuss those two methods of getting patient information outside of the office and the ability to schedule patients and prescription refills and things of that nature.

Justin Barnes: We have actually a demonstration that just happened today, an interoperability demonstration at Microsoft's booth, announcing our partnership and also putting our partnership into facilitation which I think is very important. A lot of people talk about interoperability and talk about how they're going to do it. Well, that's something Greenway does a little bit differently. We don't talk about it a little bit, we actually implement it and do it. That's what we showed here with great success today and really it's another avenue for patients to access their medical information and manage it. Then they can share what components of the medical record that they want to with whomever else they want to within HealthVault's community and probably far beyond that. We can transfer that information using standards based interoperability either the CCD, the Continuity of Care Document or even the CCR, Continuity of Care Record and that's obviously one of the topics that we're managing even on Capitol Hill. Should we go with one standard, the CCD as a single document or should we start off with two. We can do two but it'd probably be better if we stuck with one.

Dr. Eric Fishman: We'll get to Capitol Hill in a few minutes. I've heard some fascinating things and I know that's where you spend a lot of your time. You've also recently announced a partnership with Take Care Health. If you could discuss that for a few moments.

Justin Barnes: Yes. Take Care is a Walgreens subsidiary and they have roughly 380 worksite clinics across the country in some very large Fortune 100 companies. Really, they offer a primary and acute center model for companies that have greater than 1,000 employees. They really use the fully integrated EHR model to increase access to patient health information and produce the quality outcomes and reporting that they want to do as part of their model to be successful. When they walk into a clinic, Take Care can usually see a 10 percent reduction in health care costs. Nationally, we see 10-17 percent increases across the country but when Take Care can go into a practice, they can usually show at least a 10 percent reduction in health care costs fairly quickly. So this integrated EHR interoperability model that they're deploying can really bring to bear those results even quicker. We're very excited about this opportunity to work with them.

Dr. Eric Fishman: Justin, thank you. Four syllables I've heard more than any others this last few days is meaningful use. I'm sure that Greenway has done a lot to assist physicians and ensure that they'll be able to be shown as meaningful users. If you could address that.

Justin Barnes: Meaningful use is certainly a very popular term here at HIMSS' annual conference but meaningful use in Greenway we've had probably for many, many years. Hopefully, most leaders within the industry have gone that direction long before the federal government got involved. Over 90 percent of our customers meaningful use their product today at the point of care with their patients. It's something we've been very focused on. We took at lot of that experience and expertise to Capitol Hill even we were creating the R language and wanted to make sure that we had the proper incentives and that we aligned meaningful use to a way it can be successfully deployed across the country.

The incentives are going to be very important but also we're creating our comments now on how to kind of perfect meaningful use. I think it's very important that we stay focused on criteria that we know will still incentivize physicians to want to adopt technology. We don't want to have over burdensome criteria coming out, certainly in stage one, because you want to bring a few hundred thousand care providers into adoption technology. We start off at a good enough level that we can bring them into this.

Dr. Eric Fishman: Thank you. You're well-positioned to understand that the final rulings will be substantially different than the interim ruling that was suggested and put out December 30. Do you anticipate there'll be many changes?

Justin Barnes: Well, the way the regulation process works is they kind of put everything out there because you really can't add to any regulation after it's been proposed. You only can take away. So they kind of put everything out there including the kitchen sink. Now, they'll probably go back and say there's 25 criteria for meaningful use. As a knowledgeable professional, we might see that come down to maybe 17 or 20 or so for stage one. If it's not going to be stage one, they may roll it to stage 2 which I think is a wise thing.

Dr. Eric Fishman: Thank you. Do you think criteria such as 80 percent of your prescription being done electronically issues of that nature will stay?

Justin Barnes: The 80 percent is for orders and I do think that that number will probably be reduced maybe closer to 50 or 60 percent and I do see the e-prescribing number of 75 percent that may come down a little bit. That started off at 100 percent so even for them to come down to75 percent is already a reduction from what the initial strategy at a CMS was. I don't see that number coming down too greatly, maybe down to 60 percent but maybe not.

Dr. Eric Fishman: Now, when you talk about meaningful use, that leads directly into the REC's, the regional extension centers. Does Greenway have a strategy to address that new body?

Justin Barnes: New modality of transferring health information inside of communities. Yes, we most certainly do and we work with RECs in a couple different capacities. We advise several RECs on how to put together community strategies because at the end of the day, they have to prove meaningful use inside their community to continue on their grants and then hopefully achieve sustainable models for deployment of EHRs. So we've helped in them in overall adoption models, on sustainability models and then obviously when necessary. Usually in all these communities, we also will be providing solutions, along with other great EHRs that are out there, so we can have true interoperability across their community which is critically important. Also, we're looking to work with other leaders that are committed to interoperability because at the end of the day, it's having a solution that can be meaningful used but also sharing information with other interoperable systems.

Dr. Eric Fishman: Exactly correct. Justin, let's go back to Washington now for a few minutes. Not only are they dealing with health information technology and meaningful use, there's a two trillion dollars health care industry. Any comments you'd care to share on that?

Justin Barnes: I think that we've certainly been through a roller coaster over the last several months and I do believe that we're going to move forward with some language. I think most importantly, we actually just got off some phone calls last night working on the whole Senate 21 percent fix. We got a 30 day patch through. I think that's tremendous. It's also another track to ensure that we work on the SGR, the Sustained Growth Rate formula to fix that long term.

Most importantly, health IT is a foundation for any type of health care reform. I think we've already seen that with this $60 billion dollar investment out of Washington, so very pleased with health IT being a foundation for any type of health care reform. I do see components that will be built on quality, reduction in fraud, waste and abuse which will help pay for a lot of these changes coming down. I think that's critically important. I think tort reform is very important as we move and look to take away some of the high cost, the hundreds of millions of dollars created by defensive medicine. I do think that.

Dr. Eric Fishman: Is this the year for tort reform do you think?

Justin Barnes: I think it's certainly the year to move that conversation down the path significantly. Hopefully, it will be part of any health care reform. It has to be, in my opinion, a part of any substantial health care reform language but so does ensuring access and ensuring coverage. Who provides that coverage is certainly up for debate but I certainly think we have some great models that are already out there that we can build on.

I think the public sector has their components that we need to make sure that we solidify but also have to make sure we have to pay for all this. This is where health IT and the reduction of fraud, waste and abuse comes into play. We can take a few hundred billion dollars a year out of the health care system just in fraud, waste and abuse and turn that over to help paying for access and coverage and incentivizing health IT adoption more across the country. Even with the $60 billion dollars are first put into health care IT adoption, we still have a lot more to go in that regard. This is not going to get 6-700,000 physicians and 1.5 million care providers up in EHRs. This is a start. We have a long way to go but I think we've got a good start.

Dr. Eric Fishman: Justin, a pleasure.

Justin Barnes: True pleasure. Thank you very much.

Dr. Eric Fishman: This is Dr. Eric Fishman for EHRtv. We’ve been speaking with Justin Barnes, Vice-President of Marketing, Corporate Development and Government Affairs for Greenway Medical Technologies. Thank you.

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