Med-ed company Pri-Med is buying Amazing Charts, a provider of electronic health records, a tie-up the firms say will enable them to deliver customized education to physicians and then assess the patient-level impact.
Amazing Charts, which provides EHRs to about 5,600 mostly small medical practices, will become an independent operating subsidiary of Pri-Med. It was founded in 2001 by family physician Dr. Jonathan Bertman. Bertman will continue to serve as president, and Kathleen Repoli as SVP. Other terms of the deal were not disclosed.
Healthcare providers who use EHRs have risen to about 50%, according to one study, thanks to meaningful use incentives and other factors. These doctors get messaging like drug alerts, boxed warnings and clinical trial availability delivered to their screen. Pri-Med and Amazing Charts want to add customized med ed to that list.
“Not only do we need knowledge at the point of care. We need to know where the knowledge gaps are,” said Bertman, adding that he was looking for a strategic partner with the wherewithal to enable the firm's roughly 7,000 users to improve care. “Now my own software can tell me personally, in my own practice, what do I need to do to improve.”
Pri-Med can then, in theory, deliver its med-ed activities where and when decision support is needed. “Our goal is to really give some prescriptive-type tools to clinicians and patients at the point of care, augmented by what we already do—great live and online education,” said Dr. Marc Mosier, chief medical officer, Pri-Med.
For example, Mosier said, “If I see there are deficits in the diabetes belt [the area of the country most at risk for the blood sugar disease], and we create education in live or online format directed to health disparities and cultural competence to manage cardio-metabolic risk, what better way to assess whether we're having an impact than through the clinicians we engage.”
The tool may also align with the need to improve reimbursement. “Where things are going is we're going to be compensated base on how we improve outcomes with patients,” said Bertman, referring to incentives in the Affordable Care Act that reward clinicians for moving toward qualitative vs. quantitative measures of care.
Mosier said not many of the other roughly 180 EHRs are exploiting the synergies between CME and EHR. “Some offer a type of minimalist searchable database [for professional education].”
Indeed, said Dr. Steven Waldren, who serves as director of the Center for Health IT at the American Academy of Family Physicians (AAFP), in an e-mail, “This is not common. There is some CME linkage to EHRs, I think, but I have not heard of analysis of the data to suggest specific education. This is one of the future goals of the CDR [clinical data repository] we have been working towards.”
So too for assessing outcomes. Up until now, the gold standard for conducting needs assessment and measuring outcomes has been chart-level reviews. However, “getting doctors to participate in these studies is particularly difficult…and very, very expensive,” said John Mooney, founder and CEO of Pri-Med. “We've tried as an organization…to do chart-level reviews using independent companies out there, and it's easier said than done.”
If Pri-Med can use Amazing Charts as a med-ed platform to determine whether its education changed behavior at the clinical level, as measured by improved patient outcomes, this type of linkage could become a mainstay to improving patient care.
Noted AAFP's Waldren, “There are some significant data issues that must be solved to allow this to succeed, especially at any scale,” but he termed the goal “realistic.”
“We have great EHRs, but the jury is out on whether they improve outcomes,” said Bertman. “Everyone—the government and tax payers—are assuming they do, but to improve it in a study, that data hasn't happened yet. It's still up in the air. We can generate data that it does, or doesn't.”