Volume 3, Issue 7: Industry News


RESTON, Va. & SACRAMENTO, Calif. — (BUSINESS WIRE) — Avizia, powering system-wide telehealth, has announced its partnership with VeeMed, a leading provider of physician services for telehealth. The partnership aligns Avizia’s system-wide telehealth platform with VeeMed’s provider services for high-acuity use cases including neurology, behavioral health and intensive care—offering healthcare organizations flexible options to staff and power high-quality, comprehensive virtual care programs.

Through its collaboration with VeeMed, Avizia is able to offer healthcare organizations the full suite of telehealth tools and resources they need to conduct secure, seamless remote virtual consultations for high-acuity specialties.

“VeeMed shares the Avizia commitment to bringing the best possible telehealth experience to healthcare providers and patients,” says Mike Baird, founder and chief executive officer of Avizia. “VeeMed understands the importance of telehealth in the greater transition toward value-based care. Our partnership will ultimately benefit healthcare organizations eager to launch a system-wide strategy by giving them flexible options to meet the unique needs of their patient populations.”

The combined Avizia/VeeMed solution will boost healthcare organizations’ existing programs. In the case of telestroke, for example, Avizia’s telehealth technology equips VeeMed neurologists with enhanced far-end camera control, PACS image access and the care coordination and collaboration features they need to efficiently and effectively assess and treat stroke patients when time is of the essence.

“A great physician network is strengthened by the technology that powers a health system’s telehealth program,” says Jim Roxburgh, cofounder and COO at VeeMed and former director of the Dignity Health Telemedicine Network. “Our partnership with Avizia allows our teams to successfully launch telestroke programs in less than four weeks, as opposed to months. We are excited to see what the future holds for our relationship.”

Interest in telehealth among healthcare providers is at an all-time high, according to Avizia’s 2017 Closing the Telehealth Gap report. Organizations that use telehealth are largely interested in leveraging the technology to expand access/reach (70 percent) and improve patient outcomes (55 percent). They are especially excited about telehealth’s potential to strengthen their stroke/neurology (72 percent); behavioral health (41 percent); and intensive care (20 percent) programs.

Avizia enables more than 40 unique telemedicine use cases and is the leader in system-wide telehealth. Avizia’s platform can scale from a single program administered by a small healthcare organization to a powerful system-wide virtual care delivery initiative. Avizia’s platform is interoperable with any EHR, allowing for a seamless telehealth experience across all devices and form factors.

Learn more about Avizia’s market-leading telehealth solutions at www.avizia.com.


VeeMed is a global telemedicine company focused on virtual clinical patient healthcare services and advanced telemedicine technology in chronic care, nephrology, pulmonary medicine, neurology and mental healthcare. Visit www.veemed.com.



Avizia partners with providers to deploy and power system-wide telehealth. To do this, Avizia combines a collaborative approach with a market-leading telehealth solutions suite that scales across the continuum of care. Trusted by four of the top five 10 IDNs in the nation and one in four US hospitals, Avizia empowers providers to deliver unparalleled access and clinical excellence to patients. Visit www.avizia.com.


In Response to Public Comments on CMMI, CMS will Consider Direct Provider Contracting Model

By: Rajiv Leventhal, Healthcare Informatics

The Centers for Medicare & Medicaid Services (CMS) has released the comments submitted by healthcare stakeholders in response to the CMS Innovation Center’s new direction request for information (RFI), while also announcing that the agency is considering a direct provider contracting model as a result of the feedback that was received.

For background, Congress created the Center for Medicare and Medicaid Innovation (CMMI) in 2010 to test new approaches and models to pay for and deliver healthcare. In an op-ed in the Wall Street Journal last September, CMS Administrator Seema Verma said the Trump Administration plans to lead CMMI “in a new direction” to give providers more flexibility with new payment models and to increase healthcare competition. Verma said that CMS would be issuing a request for information to collect ideas on the path forward. “We will move away from the assumption that Washington can engineer a more efficient healthcare system from afar—that we should specify the processes healthcare provider are required to follow,” Verma wrote at the time.

CMS recently said that the agency received more than 1,000 responses to the RFI from a wide variety of individuals and organizations located across the country, including medical societies and associations, health systems, physician groups, and private businesses. Since the RFI comment period closed last November, CMS has been reviewing the responses, “which provided valuable insight on the potential to improve existing models as well as ideas for transformative new models that aim to empower patients with more choices and better health outcomes,” CMS officials said.

What’s noteworthy in CMS’ announcement is that in response to the comments that were received on the RFI, the agency also said that it would be taking a next step to develop a potential model in direct provider contracting (DPC). According to CMS, “A direct provider contract model would allow providers to take further accountability for the cost and quality of a designated population in order to drive better beneficiary outcomes. Such a model would have the potential to enhance the doctor-patient relationship by eliminating administrative burden for clinicians and providing increased flexibility to provide the high-quality care that is most appropriate for their patients, thus improving quality while reducing expenditures.”

As part of its process to gain further insight from the public in this area and ask more focused questions, CMS is issuing a follow-up RFI on the DPC model through May 25.

In the RFI on the DPC model, CMS said that it is aware of a wide range of payment arrangements that involve aspects of “direct provider contracting,” from the existing ACO (accountable care organization) initiatives and CPC+ Model test to capitation arrangements between primary care providers and commercial insurers or Medicare Advantage plans, to arrangements in the private sector where, for example, patients contract directly with physicians and group practices.

Given this range of activities, the agency wrote, “a DPC model (or models) could be tested in an iterative manner with additional options added over time. For purposes of beginning a DPC model test, CMS could contract directly with participating practices, such as primary care practices or larger multi-specialty groups, to establish the practice as the main source of care for services ranging from solely primary care to a wide range of professional services for beneficiaries that voluntarily elect to enroll with the practice.”

Moreover, regarding the CMMI “new direction RFI,” some stakeholder comments were made public late last year, including from Premier, which said that the center should take to “promote patient-centered care and test market-driven reforms that empower beneficiaries as consumers, provide price transparency, increase choices and competition to drive quality, reduce costs, and improve outcomes.” In it comments, Premier also called for increased participation in Advanced Alternative Payment Models (APMs) under MACRA (the Medicare Access and CHIP Reauthorization Act.

Other comments from the EHR Association called for the harmonization of the technology requirements of new payment models with the requirements related to certified EHR technology (CEHRT) already incorporated into other programs, such as advanced APMs and the Merit-Based Incentive Payment System (MIPS). The American Hospital Association (AHA), meanwhile, specifically mentioned its desire for the timely availability of data, while the American Medical Informatics Association (AMIA) recommended that CMS look for ways to provide “innovation support” to grantees, while also leveraging new models and pilots to further promote and optimize the use of informatics tools and capabilities for improved patient care.

According to CMS officials, in totality, the responses focused on a number of areas related to enhancing quality of care for beneficiaries and decreasing unnecessary cost, such as increased physician accountability for patient outcomes, improved patient choice and transparency, realigned incentives for the benefit of the patient, and a focus on chronically ill patients. In addition to the themes that emerged around the RFI’s guiding principles and eight model focus areas, the comments received in response to the RFI also reflected broad support for reducing burdensome requirements and unnecessary regulations.

CMS said that the agency is sharing the feedback received to promote transparency and facilitate further discussion of how to move the Innovation Center in a new direction. “The RFI was a critical step in the model design process to ensure public input was available to help shape new models. Over the coming year, CMS will use the feedback as it works to develop new models, focusing on the eight focus areas outlined in the RFI,” the agency said. The public comments can be read in full here.

“HHS has made shifting our healthcare system to one that pays for value one of our top four department priorities,” said HHS Secretary Alex Azar. “Using bold, innovative models in Medicare and Medicaid is a key piece of this effort. We value stakeholder input on the new direction for the Innovation Center, and look forward to engaging on especially promising, groundbreaking ideas such as direct provider contracting.” Verma added, “The responses from this RFI will help inform and drive our initiatives to transform the healthcare delivery system with the goal of improving quality of care while reducing unnecessary cost.”

To view the original article, click here.

Mosquitoes That Carry Zika Could Bring Deadlier Yellow Fever This Year

By: Larry Barzewski, Sun Sentinel

The Zika scare of 2016 could morph into a yellow fever panic this year if South Florida residents let down their guard when it comes to protecting themselves from disease-carrying mosquitoes.

There hasn’t been a yellow fever outbreak in the United States in more than 100 years, but state health officials are concerned that a large outbreak in Brazil — and other outbreaks in South and Central America — could lead to infected travelers bringing the disease to South Florida, which has the right mosquitoes and climate for it to spread.

The disease is deadlier than the Zika virus. Zika raised alarms because many infected pregnant women gave birth to infants having microcephaly, a condition that causes abnormally small heads and developmental defects. Yellow fever can kill. Brazil reported 1,131 cases and 338 deaths attributable to yellow fever between July and March.

Most people infected with yellow fever will get symptoms so minor they won’t realize they have been infected. Even for those who do notice, the symptoms such as fever, chills and headaches don’t make it stand out from many other illnesses.

But for about 15 percent of the infected, the initial symptoms pass and then come back with a vengeance within a day, causing internal bleeding and jaundice — the yellowing of the skin that gives the fever its name — the failure of the liver and other organs. Of those, up to half die, usually within a week or two.

Reducing the threat

The Centers for Disease Control in March warned travelers not to go to yellow fever hotspots in Brazil unless they were vaccinated.

South Florida officials are hopeful that the stepped-up mosquito control efforts already underway here to curb Zika will help contain any potential yellow fever outbreak. Yellow fever and Zika are carried by the same Aedes aegypti mosquito, which can also transmit dengue and chikungunya.

“If yellow fever is introduced into South Florida, and I suppose it will be, you’re not going to see the same explosive outbreak we did with Zika,” said Justin Stoler, an assistant professor of geography at the University of Miami who has done global health research with a focus on mosquito-borne illnesses. “There hasn’t been prior exposure, but we’ve kept mosquito populations down, which is a good thing.”

Broward County began its first truck spraying of the year April 30 to kill infant mosquitoes that are expected to multiply as the region’s heavy rains increase, said Anh Ton, who oversees Broward’s mosquito control efforts.

South Florida’s rainy season runs from May 15 to Oct. 15, according to the National Weather Service. The truck spraying is designed to kill mosquito larva in standing water, as opposed to aerial spraying that targets adult mosquitoes.

The Aedes aegypti doesn’t travel far from where it is bred. The mosquito, one of more than 40 types in South Florida, gravitates to urban areas and can breed in as little as a bottle cap full of standing water. It bites during the daytime and not just at dusk and dawn, officials said.

Yellow fever and Zika

Yellow fever is a rare disease in the United States, with only one reported case between 2004 and 2016, according to the Centers for Disease Control.

Devastating outbreaks killed thousands in Philadelphia in 1793, in Memphis, Tenn., in 1878 and in New Orleans throughout the 19th century, among other places.

It wasn’t until 1900 that the Yellow Fever Commission formed by the U.S. military proved that the disease was spread by mosquitoes, which led to practices such as fumigation and the covering of open water cisterns where the mosquitoes bred. The last U.S. outbreak occurred in New Orleans in 1905.

Zika wasn’t on anyone’s radar when it struck. The CDC didn’t track Zika cases until the virus exploded on the scene in 2016. Infections spiked in Miami-Dade’s Wynwood neighborhood, which caused the CDC to issue a travel warning for a U.S. city for the first time ever.

Most of the reported Zika cases came from travel abroad, especially in Brazil where there was a massive outbreak, but local transmissions also surfaced in 2016: 287 cases in Miami-Dade, five in Palm Beach and one in Broward, according to the state health department.

The Zika virus is still out there. Although there is no vaccine for Zika, the number of cases has reduced dramatically in the past two years as South Florida counties increased mosquito-control efforts and more people were protected because of previous exposure to the virus.

Florida recorded 1,469 Zika cases in 2016, with 298 infected locally. The state numbers dropped to 265 cases in 2017, with only two locally transmitted. There have only been 30 cases and no local transmissions so far this year.

Travel hub in South Florida

South Florida is susceptible to such diseases not only because of its climate and mosquitoes, but because it is a major hub attracting visitors from throughout the Americas for education, tourism, business and commerce, said Bindu S. Mayi, an associate professor of microbiology at Nova Southeastern University.

That’s why a World Health Organization report in April identified Miami as one of the global cities susceptible to the spread of yellow fever because the United States doesn’t require people arriving from abroad to be vaccinated against the disease. Infected travelers arriving in South Florida could be bitten by mosquitoes here, which could then spread the disease through bites to other people.

“It was inevitable we would get these diseases,” Mayi said. “It’s remarkable how well we responded.”

The proliferation of a disease can be worse if it is new to an area, because there is no natural immunity, she said.

“These flare-ups happen, especially when you have a large chunk of population that has never seen this virus,” Mayi said. “There is nothing initially stopping the body from hosting the virus.”

Most people in the U.S. haven’t been vaccinated for yellow fever because it is so uncommon. With the recent Brazil outbreak and efforts there to vaccinate large portions of the population, the available supply in the U.S. is limited and the sole U.S. manufacturer doesn’t expect to have more available until the end of the year.

The vaccine is being recommended for people traveling to areas known to have yellow fever. It is not recommended for everyone. The vaccine could cause worse problems for infants under nine months old, adults older than 60 and people with compromised immune systems.

A factor that could limit South Florida’s exposure to yellow fever from travelers is the size of the outbreak in Brazil. The number of cases there in recent years has been a few thousand, while Zika infected hundreds of thousands there. That means there’s a much smaller pool of people with the potential for bringing the virus to the U.S., said Larry Bush, an affiliate professor of clinical biomedical sciences at Florida Atlantic University.

Dr. Lyle Petersen, the CDC’s director of diseases transmitted through insect bites, also said there was low risk of a yellow fever outbreak in Florida.

“We learned with Zika, thousands of people came to the United States with Zika virus which is carried by the same mosquito — the Aedes aegypti mosquito — and only saw very limited transmission down in parts of southern Texas and in the Miami area,” Petersen said in a March teleconference.

That’s still not a guarantee against the disease.

“The fact that the [Aedes aegypti] mosquito is widespread in the country, all you need is a person infected with the virus to be the source of the virus,” Bush said. “Mosquito control and mosquito bite prevention with repellent is really crucial. We can’t overdo it.”

What is yellow fever?


Most people infected with yellow fever virus have no illness or only mild illness.

Symptoms, which usually take three to six days to appear, include the sudden onset of fever, chills, a severe headache, back pain, general body aches, nausea, vomiting, fatigue and weakness.

About 15 percent of cases are more severe. After a brief remission of up to a day, these individuals can experience high fevers, jaundice, internal bleeding and eventually shock and multiple organ failure.


There is no specific treatment. Rest, fluids and use of pain relievers and other medications to reduce fever may relieve some symptoms. Hospitalization is recommended to provide supportive care and observation.

Certain medications should be avoided. Those include aspirin and nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen, which could increase risk of bleeding.

Patients should avoid mosquito exposure for up to five days after the onset of fever to avoid spreading the disease to uninfected mosquitoes.

To view the original article, click here.


U.S. Providers Fix Complications from Medical Tourism Procedures

By: HealthDay News

Cosmetic surgery procedures done in developing countries can carry substantial risks of complications that U.S. providers and payers must handle, according to a study published in the April issue of Plastic and Reconstructive Surgery.

To view the original article in its entirety, click here.


Telehealth Closes Patient Care Access Gaps in Rural Mississippi

By: Sarah Heath

PatientEngagementHIT.com – Across the country, telehealth technology is helping to close care gaps in areas where healthcare consumers otherwise would face considerable patient care access challenges.

To view the original article in its entirety, click here.


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