Cielo MedSolutions’ Company Blog

A Medical Home in Action

2010-01-25T17:19:00.000-05:00

If you are looking for some great examples of a high-performing patient-centered medical home implementation, the University of Michigan Health System Department of Family Medicine has published a few slide shows and articles on their implementation and their outcomes to-date. I mentioned one of these pieces in a prior blog post, but we get so many requests for examples I wanted to share it again, along with a new piece. Lots of great detail in both of them.

Article: Patient-Centered Medical Home

Slide Show: From Philosophy to Reality: Making our House a Home

Dave Morin
CEO and Co-Founder
Cielo MedSolutions LLC

PQRI Registry Submission is Working!

2010-01-06T14:30:00.002-05:00

We've now talked to many of the providers for whom, on their behalf, we submitted quality data to PQRI (via Cielo Clinic). All of the providers we have spoken with have received their reimbursement! Reimbursements have ranged from hundreds of dollars to thousands of dollars, but since it is a formula on allowed charges, of course the amounts will vary.

We've also received comments from people that have previously done the very-manual claims submission process for PQRI that registry submission is the "only way to go". Remember, just by using our product in the normal course of care delivery, we are taking care of capturing the data needed for reporting and, at the appropriate time, doing the data uploads. That's pretty simple and that's how it should be.

Dave Morin
CEO and Co-Founder
Cielo MedSolutions

Cielo's Partnership with DrFirst

2009-12-04T09:09:00.002-05:00

This is exciting. Through our partnership with DrFirst, our customers will be able to e-prescribe right from Cielo Clinic. Here's an example of what that means at the point-of-care:

Dr. Smith is seeing Pam Doe. Using Cielo Clinic on his laptop, he notices a reminder to prescribe a statin. So, on Pam's Cielo Clinic encounter form, he clicks on the eRx button. This automatically logs him into DrFirst, takes him to Pam Doe's eRx record in DrFirst and updates the eRx record with any changes (like an address change).

Dr. Smith prescribes the statin through DrFirst. He then goes back to Cielo Clinic, where that new prescribed drug is now on Pam's active medication list.

What didn't he do?

He didn't have to jump out of Cielo Clinic, log into Dr. First and find Pam Doe. He also didn't have to update DrFirst with any record changes and he didn't have to update Pam's medication list in Cielo Clinic.

For a busy doc seeing 30-40 patients a day, this is a significant time savings!

We really think this sort of integration is important. Just a simple interface won't do - that doesn't make your job easier at the point-of-care. A subtle but important difference that Cielo MedSolutions understands.

Dave Morin
CEO and Co-Founder
Cielo MedSolutions

Health Center Data Warehouses

2009-10-03T11:48:00.002-04:00

Nice piece published by the George Washington University School of Public Health and Health Services on data warehouses and quality improvement - "Health Center Data Warehouses: Opportunities and Challenges for Quality Improvement". The Michigan Primary Care Association is truly a leader in this concept and this paper highlights the pitfalls and promise of using a data warehouse for QI, a must-read if you considering this.

Dave Morin
Cielo MedSolutions

MyCareTeam

2009-09-17T04:00:00.000-04:00

To expand the reach of our registry into all areas of clinical care, I'm pleased to announce our latest partnership with MyCareTeam.

MyCareTeam is a Massachusetts-based company that has a wonderful, proven diabetes management product. Their product, MCT-Diabetes, allows patients to download data from their home glucose monitoring device into their web-based diabetes management tool. This web-based management tool then helps patients monitor their glucose, look at trends and build up a health record. This health record can be shared with care providers or uploaded to Google Health.

Our partnership will allow MCT-Diabetes to download this information right into a patient record in Cielo Clinic. So, a diabetic patient monitoring their glucose could, through MCT-Diabetes, send their information to their provider and this information would be seamlessly inserted into the patient's Cielo Clinic electronic health record. Our population management tools and decision support engine can then make use of this data to help with management. Great stuff for a Medical Home.

Dave Morin
CEO and Co-Founder
Cielo MedSolutions

Getting it Right

2009-09-16T14:46:00.002-04:00

Kudos to Joe Fortuna, chairman-elect of the healthcare division of the American Society of Quality, for speaking to the 21st Century Health Care Caucus of the U.S. House of Representatives on technolgy implementation in health care. Click for article

Joe stressed the importance of getting the business processes of a practice organized prior to implementing a new technology and ensuring the culture of the practice is ready for the new technology tool. I couldn't agree more. My 20+ years of experience in technology implementations has proven to me, over and over again, that a successful technology implementation is as much about the technology as it is about the organization's ability to adopt it -meaning it has clear definition about what it wants to accomplish, it's processes are streamlined (automating lousy processes only makes the lousiness go faster) and the people using the technology are engaged, ready to take advantage of the technology tool and willing to put in the effort to make it work.

Dave Morin
CEO and Co-Founder
Cielo MedSolutions

They briefed the caucus on the importance of proper preparation to ensure successful implementation of healthcare IT and emphasized the need to optimize the business processes and culture of provider organizations before deploying new information technologies.

Cielo’s HITECH Act Update, August 30, 2009

2009-08-30T16:28:00.003-04:00

Cielo MedSolutions now provides periodic email updates on the implementation of this Act and its impact on an ambulatory care practice. Below is our first update. If you'd like to be on the email list, simply let us know at info@cielomedsolutions.com.

Of course, the usual disclaimers are in place: this is a rapidly changing landscape as no final decisions have been made on the HITECH Act and views expressed in this document are only opinions.

SNOMED-CT is the Problem and Procedure Vocabulary

From the HIT Policy Committee, August 14, 2009, Report From Clinical Operations Workgroup update slides:

“Primary vocabulary standards:
· Clinical problems and procedures: SNOMED CT
· Drugs: RxNorm
· Ingredient allergies: UNII
· Lab tests: LOINC
· Units of measure: UCUM
· Administrative terminology: CAQH CORE and HIPAA”

From the HIT Policy Committee, August 14, 2009, Clinical Quality Workgroup: Progress Report update slides:

"· Multiple versions of measures to provide options
o 2011 – ICD 9 or SNOMED CT
o 2013 – ICD10 or SNOMED CT
o 2015 – SNOMED CT
· Can use internal codes using SNOMED CT expertise to map to SNOMED CT
· EHR certification should require problem list”

Views: it looks as though problem lists will ultimately need to be built with SNOMED CT versus ICD9 or ICD10 and the open question is the year it needs to be done. This could be a significant issue for systems that do not have a clinical thesaurus that can cross-reference problem terms across different vocabularies (in other words, a system needs to be able to know how an ICD9 or ICD10 code maps to a SNOMED code). In addition, registry and EMR systems that only utilize billing files for problem documentation may struggle with using an alternative coding system (problems will still come in from billing files only in ICD9). Because Cielo uses a clinical thesaurus (the ENCODE table mapped to ICD9, ICD10 and ICPC) and one of Cielo’s Medical Advisory Board members is leading a committee to map ICPC to SNOMED, this will not be an issue for Cielo Clinic.

Registries called out as key to ARRA

From the National Committee on Vital and Health Statistics Report of Hearing on “Meaningful Use” of Health Information Technology, April 28-29, 2009:

"Testifiers reported that the ability to get data out of EHRs easily – both for reporting and for creating panels of patients, is difficult with today’s EHRs. However, it was noted that in addition to embedding registry functionality in an EHR, such functionality (and others) may better be delivered through applications and services that are not part of a single all-encompassing application, such as population or disease registries."

Views: This testimony from industry leaders reinforces the growing sentiment that registry solutions are a very viable solution for meaningful use.

Modular Approach Available through EHR-M

From the HIT Policy Committee Review of Initial Recommendations by the Certification and Adoption Workgroup, Paul Egerman and Marc Probst, Intermountain Healthcare, August 14, 2009:

“Recommendation 4 – Flexible Software Sources - provide for certification of components so EHRs can be purchased from multiple sources”

Views: a registry can be certified via EHR-M. You will be able to assemble best of breed components from a variety of vendors to meet meaningful use. You will probably find this can be done at a total price-point lower than a monolith EMR. Cielo is assembling the best-of-breed products that, together, will be pre-interfaced and meet meaningful use.

Submissions Will be Electronic

“CMS noted that only measures that "can be submitted electronically" will be allowed.”

Source: CMS Sheds Light on Meaningful Use, HDM Breaking News, August 14, 2009

Views: electronic submission is good. We predict the constructs in place for registry reporting on PQRI will be used for meaningful use submissions. Therefore, a system already doing PQRI uploads, like Cielo Clinic, should have an advantage.

Dave Morin
CEO and Co-Founder
Cielo MedSolutions LLC

Success!

2009-07-06T10:21:00.010-04:00

The success of a health care software product can be measured in many ways. As such, I'd like to point out two new stories that tell not only how our customers are using our product, but also reflect the ability of Cielo Clinic to impact care in very different care settings.

One

Jean Malouin MD, Assistant Chair, The University of Michigan Health System Department of Family Medicine, recently presented at the Blue Cross Blue Shield of Michigan Physicians Group Incentive Program Quarterly Meeting on the University's implementation of a Patient-Centered Medical Home (PCMH). In the presentation, she shares their PCMH implementation experiences and illustrates their population management strategies. This, of course, includes many references to their use of Cielo Clinic. I urge you to take a look, it's great educational material on how to implement a medical home and how Cielo can help. Click here to view the presentation from the the Blue Cross Blue Shield of Michigan web site, or click here to download them from this blog entry - /PGIP062009houseahome.pdf

Two

The Joy-Southfield Community Development Corporation runs a free clinic in the City of Detroit staffed by a wonderful group of people truly dedicated to better health care and community activism in the City. Check out their web site to learn more and if you can, please support them!

The free clinic uses Cielo Clinic to manage their patients' screening, prevention and chronic disease management needs. Recently, they completed a study on blood pressure control, hypertension management education and diagnostic profiling among African American women (the full study is described in the link below). Since installing Cielo Clinic (less than a year ago), they've posted some very impressive gains in care quality and the study tells the story! Blood pressure control among hypertensive patients is at 60% (the national goal is 50%). Hypertension management education access increased 143%. Patients with no lab profile is less than 5%. Great numbers, especially with a clinic staffed with volunteers. Much of this success is attributed to Cielo Clinic.

Click here to see their June 2009 Revitalizer Newsletter, which includes an article on the study - /JoySouthfieldRevitalizerJune2009.pdf

Summary

Our customer base consists of free clinics, federally qualified health centers, solo practitioners, group practices, rural providers, integrated health systems and academic health centers. In short, our product is being successfully in almost every conceivable care setting. There's lots of talk these days about usability testing for EHRs, I think the stories above and the breadth of our customer base reinforce what we hear over and over, Cielo fits into virtually any workflow, is simple to use, and drives results.

Dave Morin
CEO and Co-Founder
Cielo MedSolutions LLC

Initial Lessons on Practice Transformation

2009-05-12T16:51:00.000-04:00

I haven't seen this covered in any of the daily health care newsletters I receive, but I certainly think it warrants great attention.

"Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home" is a paper published in the May/June 2009 edition of the Annals of Family Medicine. In it, the authors summarize the findings of the American Academy of Family Physicians' National Demonstration Project where a model of the patient-centered medical home was tested in 36 family practices across the US.

For anyone working toward or contemplating a Medical Home model, you really need to pay attention to the outlined Initial Lessons Learned and Practice Recommendations.

In summary, it shows that moving to a medical home is not easy, in fact, it's really hard to do. And it takes a huge commitment.

Regarding technology, there's a great quote in the paper "For example, it is possible and sometimes preferable to implement e-prescribing, local hospital system connections, evidence at the point-of-care, disease registries and interactive patient Web portals without an EMR." 1

In other words, Cielo Clinic with e-prescribing may be what you need for a medical home.

Cielo is a big proponent of the medical home model and our software supports what it requires. But, I also believe that the items in this paper regarding the transformation process are what's most important to consider if you are taking this journey.

I urge you to read this paper, it's in the Annals of Family Medicine, Vol 7, No 3, May/June 2009.

1 Annals of Family Medicine 7:254-260 (2009)

Dave Morin
CEO and Co-Founder
Cielo MedSolutions LLC

Great Story on the Impact of Billing Data

2009-04-13T13:22:00.000-04:00

A must-read by e-Patient Dave and his experience downloading his medical data from his hospital into Google Health.

http://e-patients.net/archives/2009/04/imagine-if-someone-had-been-managing-your-data-and-then-you-looked.html

And people still want to use billing data in their patient registry?

Dave Morin
CEO and Co-Founder
Cielo MedSolutions

A Physician Group Focused on Quality

2009-04-07T09:00:00.000-04:00

Working and partnering with great physician groups is really important to Cielo MedSolutions.

Here’s a quick intro to our latest group:

Mercy~Physician Community PHO is a group of 31 primary care providers based in Port Huron, Michigan (a town about an hour north of Detroit). The PHO is led by Marianna Webb, their Executive Director and features a strong support team.

The PHO recently went through an extensive review of technology options and vendors to support their quality initiatives; specifically, Improving Performance in Practice (IPIP) and Physician Group Incentive Program (PGIP), a BlueCross BlueShield of Michigan pay-for-performance program. After that review, they selected Cielo Clinic as their clinical quality management system (registry, clinical decision support and population management).

The PHO will be using the product to track ALL chronic diseases, not just what’s required for their pay-for-performance programs, and utilizing centralized reporting to be proactive about screening, prevention and chronic disease management surveillance.

Interfaces are being put in place with their various other health information technology solutions. They have decided to adopt a train-the-trainer model and will have a PHO staff member training the practices on using the product. And, they will be measuring the impact Cielo Clinic is having on care quality.

Mercy~Physician Community PHO is doing all the right things to ensure success with our product. It’s wonderful to work with a group such as theirs that views quality improvement the way we do.

Dave Morin
CEO and Co-Founder
Cielo MedSolutions LLC

Feedback on Data Integrity Issues

2009-03-29T15:43:00.000-04:00

It seems as if the interest level has risen rapidly on our argument that there are many shortcomings when using billing data and ICD9 for a quality improvement program. I've been involved in numerous discussions about this over the last month and they are, in general, in-line with our thoughts at Cielo; billing data and ICD9 are plain insufficient! Usually, the discussion is with a person that has already undertaken a quality improvement program and found this out after trying to work with their billing data.

To study this further, we are working with a few providers and comparing their billing files to their Cielo Clinic database to look at how a patient's diagnoses align in these two datasets. While I can't release our findings just yet, suffice to say the results of this work are eye-opening. Look for more to come from us on this topic.

FYI - I'd also recommend reading a very good article in the February 2009 article of Healthcare Informatics that discusses this topic.-

Dave Morin
CEO
Cielo MedSolutions LLC

Shortcomings of ICD9 and Billing Data for Clinical Quality Management Systems

2009-02-22T20:10:00.000-05:00

We were recently asked to summarize our thoughts on the shortcomings of ICD9 and billing data when used for diagnoses in clinical quality management systems. I thought I'd share our summary….

Specificity - ICD9, for many diagnoses, does not provide the required level of specificity required for evidence-based care guidelines. An example is asthma. ICD9 cannot differentiate between persistent asthma and intermittent asthma, an important distinction.

Scope – literature has documented that ICD9 can accurately represent approximately 50% of the conditions a primary care provider will encounter. When a condition cannot be properly documented, a provider must choose the “best fit”. This can be a major problem for clinical research and also affects the use of this data for care guidelines.

Accuracy – the needs of documentation for reimbursement leads to incorrect problem documentation. A common example is the need to document a diagnosis of asthma for a patient presenting with wheezing. If the patient is ultimately not asthmatic (which is usually the case), there is no way to “go back” and change their diagnosis on the billing data record. Therefore, when that billing data file is used in a registry, it inaccurately represents the asthmatic patient population. This inaccuracy can exceed 50%.

Completeness - Billing data does not document lifestyle issues like smoking and cannot capture clinical modifiers such as family history and risk factors. These elements are important for care guidelines and can be important data elements for clinical research.

We believe that these shortcomings are solved through the use of ICPC, the International Classification of Primary Care and through the use of clinician-verified diagnoses. A few prior blog entries talk about this and we'll be talking a fair bit more about it in the months ahead.

Dave Morin
CEO and Co-Founder
Cielo MedSolutions LLC

The Road Traveled to PQRI Reporting

2009-01-15T21:18:00.000-05:00

I'm going to go out on a limb here and comment on a request we hear often:

"can we just use your registry to upload to CMS to get our PQRI money?"

Answer: yes, you can.

But, think about this. If you do the minimum 30 chart pulls, abstract the data, key it in and upload it, you're probably looking at about a $1,000 expense. And, I haven't budgeted for the software yet.

The average reimbursement from PQRI is $600.

Your and your staff's time is VERY expensive, and valuable.

Is this really the way you want to invest your time and money?

Now, if you use a clinical quality management system to manage all your patients for all their needs, you not only get PQRI $$s, you get the value of any other pay-for-performance program, you build the base for your patient-centered medical home, and you prepare yourself for any other quality program that comes in the future. Your patients are better cared for, your practice is operating more efficiently and you may just be generating more revenue in your practice as you keep your patients up to date on their screening, prevention and chronic disease management needs.

Shortcuts sound great, but they unfortunately don't work. And, in this case, I think they actually cost you more than doing things the right way.

Dave Morin
CEO and Co-Founder
Cielo MedSolutions LLC

400% License Growth

2009-01-03T21:14:00.000-05:00

Happy New Year! I’m happy to report that we had a 400% growth in Cielo Clinic software licenses in 2008. In 2009, we will process our 1,000,000th patient encounter with our system.

This is great testimonial to the power of Cielo Clinic.

Dave Morin
CEO and Co-Founder
Cielo MedSolutions

What Diseases do you Support?

2008-12-23T21:09:00.000-05:00

A question we get asked a lot is "what diseases do you support?". The answer is : virtually all. This is the beauty of a table-driven rules engine (our rules engine is the technology that manages all the clinical guidelines you follow. Based on a patient's information, it generates reminders for their due services). All you do is fill out a web form; put in the diagnoses, co-morbid diagnoses or clinical indicators you want to build the guideline rule around and, voila, the guideline is in your system, ready to use. You can set a whole host of other attributes around the guideline, but again, you are just filling out a form. No programmer necessary!

Any disease management system that requires a programmer to "create the rule" is one that won't scale and will require dollars for support of that programmer each time a change is needed. "Next-generation" disease management systems are built with table-driven rules engines.

Dave Morin
CEO and Co-Founder
Cielo MedSolutions

Personal Health Records and Actionable Data

2008-12-04T21:03:00.000-05:00

Just read the executive summary of a great paper on the personal health record (iPHR) market written by Chilmark Research entitled "iPHR Market Report, Analysis and Trends of Internet-based Personal Health Records' Market". On page 1-13, the author notes that "iPHRs that serve simply as an online filing system for medical records will become irrelevant"1 and "adoption and ultimately ROI of iPHR solutions will be highly dependent on the ability of a given solution to deliver actionable information to the consumer promoting changes in behavior(s) that reduce health risk(s)."2

This fits nicely with our beliefs; a passive system that simply collects information is of limited use in healthcare. Technology must support the ability to drive positive change in the quality of care provided and must provide actionable data to help drive this change. Whether its in a clinical quality management system like Cielo Clinic or in a personal health record solution, this is a key attribute.

1, 2 Chilmark Research, "iPHR Market Report, Analysis and Trends of Internet-based Personal Health Records' Market", May 2008, pg. 1-13

Dave Morin
CEO and Co-Founder
Cielo MedSolutions

International Classification of Primary Care

2008-11-24T15:17:00.000-05:00

If you've spoken to us in the past, you know we are ardent supporters of a classification system called the International Classification of Primary Care (ICPC). This system, we believe, does a much better job of documenting problems and reasons for encounter in primary care than ICD-9. It also provides an ability to create episode-of-care documentation.

Why would you use it? Well, for one, it will generate a more accurate problem list and allow you to be more effective in care delivery. Second, this accuracy will help you with pay-for-performance programs as we have found a more accurate problem list leads to better documentation and hence better pay-for-performance reporting. Third, accurate problem lists are the cornerstone of a patient-centered medical home and an ICD-9 problem list based on billing data is not an accurate problem list. Fourth, it provides a unique view into symptoms and problems - as documented here in "Characterizing Breast Symptoms in Family Practice".1

1 Eberl, Margaret M., Phillips, Robert L., Jr, Lamberts, Henk, Okkes, Inge, Mahoney, Martin C.Characterizing Breast Symptoms in Family PracticeAnn Fam Med 2008 6: 528-533

Dave Morin

CEO and Co-Founder

Cielo MedSolutions LLC

Use Cielo Clinic's Functionality Directly in an EMR or Physician Portal

2008-11-12T07:00:00.000-05:00

Today we announced something that we think is quite unique.

Many providers tell us that their electronic medical record system (EMR) or physician portal doesn't provide the chronic disease management functionality of Cielo Clinic and ask if we could "embed" Cielo Clinic into their existing technology solution to make it even more powerful.

Well, now we can! Cielo Clinic now provides an embeddable web service. For you non-techies, here's what this means:

Cielo Clinic's clinical decision support functionality can be integrated directly into another health IT application. (In other words, Cielo Clinic can run inside another application). This allows you to get evidence-based guideline clinical care reminders right inside your electronic medical record or physicial portal system. No need to utilize two separate applications to get care reminders!

We've already begun work with our first EMR vendor that wants to integrate our technology and have many more we are talking with. This is pretty unique stuff and we think it is important.

As we've said in the past, our goal is to make technology fit into your workflow and this certainly helps in that regard.

If you'd like to talk about how this can integrate into your EMR or physician portal, just give us a call or e-mail!

Dave Morin
CEO
Cielo MedSolutions LLC

2008-10-23T15:02:00.000-04:00

In case you missed it, please take a look at our letter to our colleagues:

Dear Colleagues,

The last few months have been quite busy here at Cielo MedSolutions. We continue to build a dynamic company that provides the very best technology solutions that are cost-effective, easy to implement, drive improvement and fit the needs of ambulatory care providers nationwide.
In parallel with growing our customer base by 450 percent this year, we've also achieved the following notable milestones:

Cielo Clinic Endorsed by TransforMED - Cielo MedSolutions and TransforMED are now Preferred Business Affiliates. TransforMED -a subsidiary of the American Academy of Family Physicians (AAFP)- provides support to primary care physicians and health systems that want to transform their practices into Patient-Centered Medical Homes. Cielo MedSolutions' customers will have access to TransforMED's practice transformation services, and TransforMED will encourage the use of Cielo Clinic's integrated patient registry, clinical decision support and population management tools by practices implementing a Patient-Centered Medical Home.
Cielo Selected for PQRI Reporting to CMS - Cielo Clinic has been designated by the Centers for Medicare and Medicaid Services (CMS) as qualified to submit quality data on behalf of eligible professionals for 2008 PQRI reporting. Providers can now directly upload their quality data to CMS for PQRI reporting using Cielo Clinic.
Cielo Awarded a National Cancer Institute Grant - We have been awarded a grant by the National Cancer Institute to study and design a next-generation chronic disease management system. This solidifies our research and development into the future needs of ambulatory care providers.
Cielo Studying LEAN Principles - Through our partner, Altarum Institute, we are studying and documenting the benefits of LEAN principles in relation to the use of Cielo Clinic. This work is being done at a customer site and the knowledge gleaned from it will translate into additional benefits for all Cielo Clinic users.
Cielo Participating in Innovation Study with Community Health Centers - Our hosting partner, the Michigan Primary Care Association, has been awarded a grant by HRSA to study innovation in the Community Health Center market. Four CHCs will be provided Cielo Clinic with tablet PCs and wireless networks to study disease management through the use of technology.
Cielo Success Story Published Online - One of the latest success stories on Cielo Clinic is featured in the Agency for Healthcare Research and Quality's Health Care Innovations Exchange (see http://cts.vresp.com/c/?CieloMedSolutions/6d4251a388/deec28db9b/0e2d81dc0c, keyword "cielo"), an online database of innovations that improve the delivery of care to patients. In this story, you will see how the University of Michigan Health System, Department of Family Medicine, managed thirteen quality measures to high levels of compliance using the product.
Cielo Drives Dramatically Higher Disease Screening Rates - The September 2008 issue of Medical Care, the journal of the American Public Health Association, includes a paper detailing a grant-funded study of using Cielo Clinic to improve colorectal cancer screening rates in twelve practices throughout the state of Michigan. Average screening rates at the beginning of the study were at 41.7 percent. By the end of the study, that rate had jumped to 66.5 percent.
Cielo Supporting Free Clinics - In support of our community, we are engaging with free clinics in the metro-Detroit area to improve care delivery to disparate populations and build a registry of clinical information on the uninsured.

In addition to the above achievements, we've also added a host of new functionality and a wealth of additional third-party interfaces to our software-as-a-service product offering. Much of this new functionality is a direct result of our customers' requests. And, we have an aggressive product roadmap and a new group pricing model, both of which we'd be happy to share with you.
Organizations work with us at Cielo MedSolutions not only for of our great technology, but also because of our dedication and our support for the overall success of their quality improvement initiatives. We continue to enhance our solutions by bringing together other technology partners, consultants and best practices to create turnkey solutions for successful pay-for-performance programs, patient-centered medical homes, quality improvement initiatives and clinical integration efforts.

Thank you for being a colleague of Cielo MedSolutions. Please stay tuned as we continue to build a dynamic company focused on the needs of ambulatory care providers. If you haven't had a chance to see Cielo Clinic in the last few months, I urge you to take a fresh look. Simply contact Mike Kleczka at 734-827-1000 x1 or mkleczka@cielomedsolutions.com.

Sincerely,

David J. Morin
CEO
Cielo MedSolutions LLC

It's all about the team!

2008-09-24T08:50:00.000-04:00

Those of you who have followed Cielo know our emphasis on not just providing excellent software to support primary care but also our deep belief that quality care is a team sport. That's why I'm so excited about our new partnership with TransforMED.

TransforMED (www.transformed.com) is a company that is linked closely to the American Academy of Family Physicians (AAFP) and efforts on the part of the specialty of Family Medicine to reform primary care practice along a team-based model of care. TransforMED began its work with a 2 year National Demonstration Project (NDP) during which it worked closely with practices across the country in an effort to both assist them in practice transformation, but to also learn from them what works. This work reaffirmed much of what is in the literature about primary care practices being complex systems, and needing a team approach. TransforMED is taking the lessons learned from the NDP to practices that are seeking to implement the Patient Centered Medical Home model endorsed by AAFP and other primary care specialty organizations.

Cielo's new business partnership with TransforMED affirms the common goals of our organizations to transform primary care practice around a new model of care with technology that is designed to support that new model.

Donald E. Nease, Jr, MD
Chief Medical Officer
Cielo MedSolutions, LLC

Patient-Centered Medical Home and the AAFP Scientific Assembly

2008-09-22T10:14:00.000-04:00

For me, a very solid theme emerged from the American Academy of Family Physicians (AAFP) Scientific Assembly. (Background: our team attended the Assembly, had a booth at the show and the management team had meetings with various industry leaders and Academy executives).

For primary care medicine, it's all about the Patient-Centered Medical Home. We engaged in more discussions on that topic with providers and practice staff than any other topic, by far.

I stopped by the TransforMED booth (TransforMED is a subsidiary of the AAFP and helps practices transform into Medical Homes) and heard from the TransforMED team that on the first day of the show alone they had more people stop by than during entire previous trade shows!

From the providers and practice staff that stopped by the Cielo booth - trepidation, excitement, confusion and a TON of questions. There is a lot of hope and a lot of valid concerns.

There is no doubt in my mind that this will be the topic of the upcoming year. That being said, I certainly see the need for leadership and education on the topic. There are large looming concerns (reimbursement is at the top) and they need to be addressed and managed now.

From a technology perspective, Cielo will deliver that leadership. We have very strong ideas that come from years of research completed by our Medical and Health Care Industry Advisory Boards and our own backgrounds in technology. Some of them are quite different (maybe a tad controversial) than what you are probably hearing, but they have been proven and they need to be talked about. Choosing the right underlying technology for a Medical Home is a critical decision. There are non-obvious issues that need to be understood.

Sadly, I can't even begin to count the number of providers that stopped by, told us their EMR can't support many of the elements of the Home and asked how we can help (we work alongside EMR and enhance it).

I/we would really welcome the opportunity to talk to you, either face-to-face, over a webinar or as a speaker at your next gathering, about our thoughts on technology for the Medical Home.

Dave Morin
CEO
Cielo MedSolutions

Cielo Clinic Qualified Registry for 2008 PQRI Reporting

2008-09-11T14:06:00.000-04:00

We are now officially qualified to submit quality data to CMS on behalf of eligible professionals for 2008 PQRI reporting. Our product, Cielo Clinic, went through two rounds of review by CMS and successfully submitted data during this review.

So, what does that mean for you?

Any Cielo Clinic customer may be able to submit data to the PQRI program for the year 2008.
Cielo Clinic customers need not use extra billing codes to capture the information required by PQRI, in fact, there is no additional data to collect outside of the normal information captured by our registry.
Cielo will work with customers to select the correct measures for submission.

There is much more to talk about regarding measures and reporting periods. Give us a call, we are happy to tell you much more about the program and how you can get started. This is a wonderful opportunity to take advantage of this pay-for-reporting program.

Chris King
Cielo MedSolutions

Computerized reminder system drove up colon cancer screening rates, U-M study found

2008-09-07T15:08:00.000-04:00

For those looking to adopt a clinical quality management system or registry, a new must read is available in Medical Care, September 2008 - "Impact of a Generalizable Reminder System on Colorectal Cancer Screening in Diverse Primary Care Practices: A Report From the Prompting and Reminding at Encounters for Prevention Project" (Medical Care. 46(9) Supplement 1:S68-S73, September 2008. Subscription required for fulltext).

This study, funded by the National Cancer Institute and Agency for Healthcare Research and Quality, implemented Clinfotracker (the technology on which Cielo Clinic is based) in 12 diverse practices in Michigan to drive improvement in colorectal cancer screening rates. An average 9% increase was achieved in just 9 months.

This paper studies the ability of a reminder system to improve care delivery and also reviews the ability of practices to adopt clinical technology. I think the second part of this study is just as important as the first part!

Dave Morin
CEO
Cielo MedSolutions

A Data Model for Quality Improvement

2008-08-26T17:40:00.000-04:00

If you are evaluating or researching the technology underpinnings of a medical home, you should take a look at wonderful piece (available on the internet) called "Health IT to Support the Patient-Centered Medical Home" authored by Michael Klinkman and Robert Phillips. This slide show accompanied recent testimony they gave to the National Committee on Vital and Health Statistics.

It's probably different than many of the other presentations you've seen on this topic, but what they have to say is very powerful.

Dave Morin
CEO
Cielo MedSolutions

Disclosure: Michael Klinkman is on the Medical Advisory Board of Cielo MedSolutions.