From The PACS Designer: “Re: ResMD from Calgary Scientific. ResMD has been mentioned on HIStalk Mobile several times as an up-and-coming mobile solution for referrers only, since FDA approval is still pending for radiology use of the iPhone. Now that ResMD image viewing software has been adapted for the iPhone, referrers can get very good image quality and navigation when viewing images of their patients.”

From Digital Bean Counter: “Re: Alere Health. The EVP/CIO was finally let go. It was a longstanding belief held by many that he was single-handedly responsible for the demise of Alere’s poorly implemented Pega-based clinical health management system.” Unverified – he’s still on their Web page. I couldn’t place the company name, so I Googled to find that it offers online wellness programs, a PHR, and a health portal.

Listening: reader-recommended and Minneapolis-based catchy power pop from Sing It Loud. Sounds kind of Gin Blossomy or Weezerish to me in places, although I could have done without their note-for-note cover of Get Down Tonight. I’ve listened to stuff from the two albums on Rhapsody and I kind of like it – it would make nice driving music. They’re recently defunct, apparently parting ways just three months after releasing a new album. The reader’s family member produced the album and used his Hammond B3 organ on it, which is always a plus.

It’s been a great weekend so far as I write this Saturday evening. I worked ten hours at the hospital Friday, came home and worked another eight hours on HIStalk stuff, including doing a cool interview that I’ll run Monday (although I took a break to escort Mrs. HIStalk to our favorite sexy Asian bistro for some fine pad kee mao), worked on the HIT course I teach, got up way before dawn and worked another several hours on HIStalk, ran eight sweaty miles on the gym’s treadmill while blasting Metallica and REM into my skull and trying to impress the lithe young females running effortlessly just as fast as me while reading their Kindles and chatting on the phone, had some private time with Mrs. HIStalk sitting in front of the fireplace (which might have been triggered by my fighting off leg cramps from my just-finished run since she may have thought that I was performing a mating ritual with all my spastic leg-flexing and prancing around that threatened to topple the Christmas tree), planned our upcoming out-of-the-country beach break, and am now settled in for a few more hours of HIStalk work with college football on. It doesn’t take much to make me happy, which is probably why I rarely think it sucks to be me even when it might.

Athenahealth warns that FY2011 earnings won’t meet expectations, expecting $0.68-$0.78 vs. expectations of $0.85. Shares dropped around 10% on the news, but started a move back up Friday. As the graph above shows, the last trade was at $40.99, vs. a 52-week high of $47.82.

A Huffington Post Investigative Fund article covers the IOM’s just-begun study of the safety of electronic medical records systems. An interesting quote from Peter Pronovost, one of the most influential patient safety experts in the country: “There is a need for the basic science of safety of HIT. There is still a lot of basic knowledge we don’t have.” During the IOM’s two-day meeting last week, Epic’s representative repeated the mantra of boss Carl Dvorak, urging that any recommendations not stifle innovation. Human-computer interface expert Ben Shneiderman said, “Until we have a more public data collection, we will not have quality.” IOM hasn’t posted the minutes from Wednesday’s meeting that I can find. I think the writing is on the wall: FDA’s going to get involved in clinical systems oversight, in the form of a vendor registry and voluntary surveillance program if I had to bet.

HIMSS and RSNA incorporate IHE USA. HIMSS VP Joyce Sensmeier will be its president.

Weird News Andy knows how to repurpose an old joke. Q: How do you get from the pancreas to the uvula? A: Practice, practice, practice. He’s referring to Google’s just-announced Body Browser.

We missed mentioning another sponsor KLAS win. GetWellNetwork was the category leader in Interactive Patient Systems, with a 100% “would buy again” score. It’s amazing to me how many HIStalk sponsors lead their markets, although not as amazing as how many have been successfully acquired in the past couple of years (I’m resisting the urge to claim that as a sponsor benefit).

India is moving to what it calls Telemedicine 2.0, going beyond videoconferencing to live streaming of data and images to mobile phones. A pilot project involves detection of retinopathy in premature babies, offsetting a shortage of specialists.

Thanks to new HIStalk Platinum Sponsor Vocera, providers of instant voice communication systems that enhance staff efficiency and improve patient flow for more than 650 hospitals and 450,000 daily users. It runs on voice-powered communication badges and smart phones, connecting healthcare workers to each other and to alarm and alert systems, and is exclusively endorsed by the American Hospital Association. The company just made some nice acquisitions that bring in products for managing patient hand-offs. The San Jose, CA company announced Q3 numbers that include a 39% year-over-year growth rate, 22 new customers, and 31 new employees. They not only now support HIStalk, they were an original Founding Sponsor of HIStalk Mobile. Thanks to Vocera for their support.

Jack Janoso, originally hired by Sharon Regional Health System (PA) as CIO, is named acting CEO after the incumbent is fired.

My e-mailed copy of December’s Microsoft HUG Connection (which I can’t find online) says that HIMSS is canning its Users Group Alliance Program and turning the Microsoft Health Users Group over to Microsoft. I could never figure out how HIMSS could justify running vendor-specific user groups in the first place, so I can’t say I’m crushed that they’ve flip-flopped. I don’t know what happens to their Cisco group, Community for Connected Health, the only other one. The same, I’d guess.

HIMSS Analytics names Marc Holland as VP of market research. He previously ran System Research Services, an HIT market research and competitive intelligence firm.

About half of provider readers say would be less likely to participate in an HIE if its technology was owned by an insurance company, with most of the other half saying that wouldn’t matter to them. New poll to your right: if some level of FDA oversight of clinical HIT is required, which options do you like? You can choose multiple items and click the Comments link to elaborate.

Nine employees of St. Joseph’s/Candler Health System (GA) are disciplined for uploading a cell phone photo taken of an x-ray of “a male patient’s pelvic region” to Facebook. The hospital says the information wasn’t identifiable, so the employees broke hospital policies but didn’t violate HIPAA. An investigation found that a radiology employee left their workstation logged in while doing a procedure in another room, allowing someone to access the image twice in that time. The hospital fired three employees, disciplined three, and suspended three without pay.

More WikiLeaks stuff, this time an embassy report on Cuban healthcare. It claims hospitals are infecting patients with Hepatitis C, providers administer chemo and radiation treatments without meds to treat symptoms and side effects, the government jails homosexuals with HIV/AIDS, one doctor works 14-hour days and then hitchhikes home because low salaries preclude buying a car, providers aren’t allowed to access the Internet or attend conferences, rich foreigners get first crack at the best medical facilities, and government officials seek their care from other countries. Most interesting: the government supposedly banned Michael Moore’s movie Sicko, which criticized the US health system and lauded Cuba’s, for fear that Cubans would immediately recognize the movie as bogus since they have no such access to the excellent care the movie claims (Moore made a statement saying the US government made that up to discredit him).

I like to cruise the Web sites of sponsors every couple of months just to see what’s new. Here’s what I found:

• FormFast is offering a January 20 Webinar on lean healthcare strategies, featuring the well-known author of book on that topic.
• I’ve been following the Facebook posts of Cumberland Consulting Group, which instead of being dry and infrequent corporate drivel, are regular, cute profiles of its people and their goings-on.
• Lindsey Jarrell and Colin Konschak of DIVURGENT Healthcare Advisors have their book, Consumer Centric Healthcare: Opportunities and Challenges for Providers, published by ACHE. It’s available for $67.50.
• “Local” consulting form North Highland opened a new office in Jacksonville, FL.
• Orchestrate Healthcare and its partner Vangent won a $3.3 million contract to support a Meaningful Use HIE deployment for the Indian Health Service.
• IntraNexus ran a case study of Oswego Hospital, which uses its Sapphire browser-based hospital information system that includes CPOE, results reporting, a clinical repository, barcoding, documentation, and other applications.
• ZirMed released a free iPad app for its patient kiosk, which lets patients check in at doctors’ offices and send their information to its system. Future plans include real-time insurance verification and handling of co-pays.
• Informatics Corporation of America won the attendee-chosen Best in Show from a field of 38 vendors at a November payer and provider summit.
• Philips has started an Innovations in Radiology group on LinkedIn.
• Stockell Healthcare Systems offers a webcast on its InsightCS revenue cycle system.
• SCI Solutions has a good list of archived webinars, some created by hospitals, including How Can I Make My Customers LOVE Accessing My Hospital and Recipe for Success: How to Sweeten Physician and Patient Relationships.
• Orion Health had several announcements last week: its Rhapsody integration engine was chosen my Genesis Health System, the company was chosen as the primary technical provider for Alaska’s HIE, it announced an enhanced release of Orion Health EHR, and it just released GA of Version 4.1 of its Rhapsody integration engine.
• MedVentive’s founder and CMO Jonathan Niloff did a best practices Webinar called ACOs: Old Concept, New Name – Tales from the Field in late November. It’s available on their site through February.
• maxIT Healthcare has tagline I hadn’t seen, “Meaningful Use Requires Meaningful Assistance”, highlighting its 400 clients and their 350-consultant average experience of 19 years.
• Carefx will be at January’s eHealth Initiative Annual Conference in Washington and the 2011 Military Health System Conference the week after that.
• MyHealth DIRECT is growing and has openings for several client services positions.
• CynergisTek CEO Mac McMillan’s article (warning: PDF), Make Meaningful Sense of Meaningful Use: What to Do Right Now, is featured in the December issue of New Perspectives from the Association of Healthcare Internal Auditors.
• Cyndi Cahill of Vitalize Consulting Solutions was elected to the CHIME Foundation’s board of trustees. The company was just named #4 on KLAS’s list of professional services providers, landing in the top ten for clinical implementation, staff augmentation, and technical services.
• Mary Carr RN of iSirona just ran Part 3 of her series on steps to medical device integration success.
• Sentry Data Systems demonstrated its drug tracking, 340B, and business intelligence solutions at the ASHP Midyear a couple of weeks ago.
• MobileMD’s 4DX HIE scored (warning: PDF) 93.64 on its most recent KLAS report, with an all-green report card and all-green trending.
• AdvancedMD is offering white papers for practices that include Medical Practice Optimization and A Prescription for e-Prescribing: How to Make It Work for Your Practice.
• BridgeHead Software CEO Tony Cotterill was interviewed on the topic of protecting healthcare data, covering archiving, storage management, and data migration.
• Culbert Healthcare Solutions is offering consultant positions.
• Software Testing Solutions offers an analysis of how its solution can help Sunquest LIS users meet CAP requirements.
• Holon exhibited at the ASHP Midyear this month, with one of its offerings being Virtual Central Order Entry Pharmacy, its Web-based solution to distribute order entry workloads using custom rules to allow pharmacists to manage physician orders from any location.
• Virtelligence participated in the HIMSS Southern California meeting this month.
• Renaissance Resource Associates has a number of open consulting positions (Epic, GE, and all major vendor systems).
• EHRScope’s frequent blog postings cover industry news and product information.
• Salar has posted a demo of TeamNotes, its clinical documentation system recently selected by PinnacleHealth (along with its charge capture system).
• PatientKeeper offers a number of archived Webinars, including ones on physician adoption, CPOE, and physician portals.
• We ran an interview with MedAptus CMO David Delaney, MD on the subject of revenue cycle management tools a couple of weeks ago.
• NPC Creative Services highlights some of it public relations and press release work on its site. I believe Inga told me they were instrumental in steering a couple of new sponsors to HIStalk, which I appreciate.
• Keane Optimum has earned Complete EHR certification.
• An Intellect Resources blog entry covers how to choose your professional references.
• Enterprise Software Deployment posts its holiday card online, complete with staff pictures (who doesn’t like looking at people pictures?)
• Diligence Analytics offers its cost-effective, professionally conducted research and analysis services to HIT vendors.
• A2M posted a list of of some of its big-name consulting clients.
• MED3OOO just announced a strategic partnership with Emergency Reporting in which it integrated that company’s Web-based fire/EMS system with MED3OOO’s EMS billing and recovery services.
• Daniela Mahoney RN, president and CEO of Healthcare Innovative Solutions, will present Co-Pilots to your CPOE Success – Clinical and IT Collaboration and other CPOE-related sessions at the Ohio Hospital Association CPOE meeting in Dublin on January 18. She will also present several sessions at the South Carolina Hospital Association’s STEEEP Summit the following week.
• Anson Group posted its well-written review of last month’s mHealth Summit, comparing the rise in mHealth to that of Facebook.
• Capsule is running a “Wish I Had Time To … “ story contest for nurses. The entry deadline is March 31 and the submissions will be published as an interactive storybook on their site. Winners will be chosen by Facebook Likes.

I know many readers will be bugging out for the holidays this week. My wish for you is joy, peace, and unconditional love. Enjoy the break, then get right back here afterward because HIMSS will be just a few weeks away and it’s going to get crazy around here.

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From Wireless Observer: “Re: InnerWireless. They’ve raised at least $75M in VC cash. Their VCs are just flushing their investment — there is no way they will ever recover what they put in. A transaction amount will never be mentioned because it will be embarrassingly low. This company has been a bit of a financial horror show. Not only did they burn tons of cash, don’t forget that IW bought what was left of Pango Networks (billed as a ‘merger’)and killed that company. And if anyone remembers, they developed the SPOT RTLS solution to the tune of $6-8M and killed that one, too. Not a good track record, to say the least.”

From HIPAA Hound: “Re: Hans Rosling BBC video lecture on the statistics of national wealth and health in the last 200 years. Pretty interesting in a geeky way.” It is pretty cool, not just for the information it conveys about countries advancing in income and health, but in the graphical way the information was presented. It also supports something I find myself saying a lot: public and global health is not all that related to healthcare services delivery. Only in some countries are hospital and insurance considered synonymous with health.

From Orion’s Belt: “Re: JPS. Not only is their new CIO’s background light when it comes to hospitals, they’ve chosen a consulting partner, Accenture, with very limited EMR experience, especially with Epic. I’d keep an eye on them if I were in your business .”

From Laddie: “Re: Texas Health Resources. Dealing with a severe outage of their Epic EMR caused by a Citrix upgrade that coincided with the 09 upgrade.” Verified. CIO Ed Marx says he’d love to blame a vendor, but the buck stops with him and it was a leadership failure in his mind. To Ed’s credit, I’ve heard CIOs say  lot of surprising things, but that’s the first time I’ve heard that. Many of those I’ve known would have been making excuses left and right and looking for an IT director to fire as a sacrificial lamb. I can say from first-hand experience that when you have Citrix problems, things get very exciting – lots of systems go dark since it’s a single point of failure for all the major apps of many hospitals (although it has to be a big failure since it’s not hard to work around a failed server in the Citrix farm).

From CYAO: “Re: University Health Care System (GA). Appointed an ED physician as CMIO to lead their EMR implementation.” Shannon Stinson, MD is named VP/CMIO. The announcement took a little shot at McKesson, which is egressing as Epic is ingressing. Said the CEO, “For many years, University and McKesson successfully partnered on clinical and financial information system projects. However, recent experience with McKesson has not been as successful.” You know the relationship had to have soured if it warranted a CEO dig in a press release.

From The PACS Designer: “Re: Opera 11 browser beta. TPD is experimenting with Opera 11 after being a Firefox advocate for a long time. Some recent Firefox changes result in numerous hiccups that make the Firefox browser less attractive for use.” I like Opera myself, although I rarely use it except when I’m testing some Web change I’ve made to make sure I didn’t screw it up. I use Chrome 90% of the time, with Firefox making up the rest (but it’s noticeably slower). Opera feels very lightweight and fast to me and it just seems smoother (and extra points for working a Spinal Tap reference into the page’s description, shown above from a Google search). I know I’d rather have a root canal than use IE.

I’ll be beaming these instructions to you telepathically when you least expect it, so do these things now and I’ll stop: (a) put your e-mail address in the spam-proof Subscribe to Updates box to your right, ensuring that 6,490 more ambitious souls aren’t the first to know that your company has been sold or your 1998 arrest record has been unsealed and printed verbatim here; (b) check out HIStalk Practice and HIStalk Mobile; (c) Friend (Inga or me) or Like (HIStalk) on Facebook to help that nice Zuckerberg boy dominate the world; (d) show some sponsor love by perusing their ads and clicking reflexively at the many interesting ones so those companies won’t crush my ego by abandoning me; (e) instantly find mentions about a company or person by dropping their name in the search box to your right, which digs through all three sites at your command; and (f) tell your friends and enemies to read HIStalk, but don’t get their hopes up by laying it on too thick. Thanks for reading, commenting, writing, rumor-reporting, and e-mailing. And be nice to Inga since she’s fragile.

The very nice Sunquest folks sent us a copy of a letter from President and CEO Richard Atkin that was e-mailed to customers Thursday afternoon, with the explanation that they know we’ve already written about their new investor (on December 3), but that they can comment now that the deal’s done (I really was touched a little that they remembered us, to be honest, but then again I’m easily won over with flattery). As we wrote earlier, an investor consortium led by Huntsman Gay Global Capital has taken a substantial equity position in Sunquest, but the company will remain independent and Vista Equity Partners, which bought the company from Misys, will continue as the largest single shareholder. The letter says the funds will be used to increase the field sales force, expand the regional consultant program, develop more products, create executive and strategic advisory boards, and possibly acquire other companies. My assessment is this: there’s not much of a safety net given the large amount of debt involved, but if management can use the money wisely and strategically to move to the next level, nobody’s going to worry about it. Like always, strategy and execution (in the form of management) will decide the outcome.

Listening: reader-recommended Dashboard Confessional, an emo band that I’m surprised I haven’t mentioned since I do listen to them occasionally.

KLAS just published its Top 20 Best in KLAS awards. I’ll probably dig deeper into it later, but here’s what has struck me so far:

• Epic was named as the highest scoring vendor overall, with Hayes Management Consulting taking the top spot among professional services firms.
• If you’re a single-vendor shop, the highest ranking software suite by far was Epic, but McKesson took two of the top four spots (Paragon and Horizon). Most surprisingly to me, Siemens Soarian came in #3.
• I always like to look at Worst in KLAS, the bottom-ranked products in the hospital application categories: GE Centricity (hospital EMR), CGI Sovera (document management and imaging), Emergisoft (ED), McKesson Pathways (scheduling), GE Centricity (lab), Cerner ProVision (PACS), McKesson STAR (patient accounting and patient management), Mediware WORx (pharmacy), Sunquest (radiology), and McKesson Horizon (surgery management).
• Some products did very well in one of KLAS’s subcategories, which means they can’t win an award, but some of them did earn a 100% “Would Buy Again” customer rating, which is to me the most useful measure of all.

RelayHealth’s RelayClinical EHR earns ambulatory EHR certification from Drummond Group, giving the company a trifecta of offerings (EHR, HIE, and PHRs).

Former Eclipsys CEO Andy Eckert is named CEO of CRC Health Corporation, which offers behavioral care services.

Xconomy Boston gives a status update of the integration of the former Sentillion into Microsoft. It’s still a work in progress and a lot of it is hush-hush, but former Sentillion CEO Rob Seliger has been promoted to GM of product management for all of the Healthcare Solutions Group, which includes HealthVault and Amalga, and references were made about new products yet to be announced.

I’ll take Things in Common for $200, Weird News Andy. And the Jeopardy answer is: blood pressure, surgeons’ egos, reimbursements, and meth users from the ceiling. The question: what are things that fall in the ED? A man shows up at a Louisville hospital’s emergency department with what he says are alcohol burns, but the woman who gave him a ride says his car-based meth lab had exploded. The police come, the man tries to climb into the ceiling to drop down into another room to escape, but he misjudges and crashes to the hallway floor. The police spokesperson’s assessment was cynically dry: “I would say it’s unusual for anybody that’s in the hospital to try and escape through the ceiling tiles.”

The VCs behind MedPage Today (which has an interest in the KevinMD site) sell out to Everyday Health, which runs ad-supported health and lifestyle sites that include that of Jillian Michaels.

Jobs on the sponsor-only Jobs Page: Application Consultant, West Coast (Nuance), Software/Implementation Engineer (MobileMD), Eclipsys Activation Consultant (Enterprise Software Deployment). On Healthcare IT Jobs: Client Manager, Soarian Clinicals Consultants, Dragon Trainer/Systems Analyst, McKesson Paragon Consultants.

Cerner founders Neal Patterson and Cliff Illig are sued for $3 million by their golf course partners, who claim the guys stiffed them on payments due.

I’ve said nice things about Nextgov, but this won’t be one of them. What were they thinking when they wrote the Wednesday story above? David Brailer quit as national coordinator nearly five years ago, in April 2006. David Blumenthal has been in that position since March 2009, but Rob Kolodner held the job between the Daves. Not to mention that its CMS, not ONC, that will “hand out” HITECH money (oh, if it were only that simple). When I saw the clumsily breezy headline, I thought that Health Evolution Partners was cutting Brailer’s pay and I wondered how (and why) Nextgov sleuthed that out.

A British hospital opens a communications room for hearing-impaired patients that offers assistive devices for hearing aid wearers and Webcam access to a sign language interpreter.

The board of 136-bed Rice Memorial Hospital (MN) approves $4.7 million to purchase a clinical information system. Its preferred vendor is Epic, which would make this one of the smallest Epic implementations ever, I would guess (assuming Judy goes for the deal). Now this is interesting since Epic contractually gags its customers from divulging what they paid, so you never see a price breakout: Epic was the cheapest of the five vendor proposals, with the cost detailed as $1.2 million for the license fee, $100K for hardware, $800K for implementation, and $2.6 million for five years’ of maintenance.

I was digging through the statement (warning: PDF) made this week by the FDA’s Jeffrey Shuren at the IOM’s Committee on Patient Safety and HIT meeting. Tidbits: (a) he implies that EHRs are medical devices for which FDA has elected not to enforce existing requirements, but FDA is interested in IOM’s opinion on whether it should start regulating them; (b) he suggests that clinical decision support will be a targeted area; (c) FDA believes interoperability should be standardized; (d) systems should be monitored with real-time surveillance. He points out that FDA oversight can take several forms: requiring manufacturers to register, running a voluntary post-market surveillance program, requiring manufacturers to follow ISO-like quality management programs, or require vendors to submit information before putting their products on the market.

Oracle announces Cloud Office 1.0, a Google-like suite of Microsoft Office-compatible word processing, spreadsheet, and presentation apps. That’s probably not the best news Microsoft has heard lately.

Former Allscripts EVP Mark Karch is named EVP of Apparture Inc., which offers Web-based marketing solutions for healthcare companies.

Strange: a woman in Australia reports to police that her iPhone has been stolen from her purse while she’s visiting a hospital. They track it down using its GPS-like application and call in a police helicopter to swoop down on the thief, a 16-year-old boy riding a stolen bike.

E-mail me.

HERtalk by Inga

From Eel Shoes: “Re: non-HIT matters. At this time of year, i don’t think we are hearing enough eel stories. I wondered if Inga had tried the soft but durable eel skin shoes?” I was quite amused by the reader that posted this comment, as well as the follow-up eel conversations. I am not an eel expert, though I once had a soft and durable pair of brown eel-skin pumps that have since been donated to Goodwill. As of late, my shoe fancy has been leaning towards new boots. Here is the pair I’d love to see under the Christmas tree (size 8, if anyone has Santa connections).

Cleveland Clinic will implement 3M’s Codefinder Computer-Assisted Edition software for inpatient and outpatient coding.

athenahealth expands its board with the appointment of its former COO, David E. Robinson. Before joining athenahealth, he was an EVP of SunGard Data Systems.

MedSynergies appoints former Dell/Perot exec James Dye as SVP of client management. MedSynergies also names Brid Kealey as SVP of human resources and Chris Walker VP of performance and change management.

Ephrata Community Hospital (PA) begins implementation of its Meditech EMR and expects to complete the first stage of the transition in early 2011.

Tool maker Stanley Black & Decker will pay $61.2 million cash for mobile workstation and asset tracking provider InfoLogix. InfoLogix will become part of Stanley’s Healthcare Solutions business, which Stanley is seeking to expand.

Hospital billing company and Tenet subsidiary Confer Health Solutions will close two of its seven offices as it tries to improve efficiencies. Conifer will close offices in Anaheim and Alhambra and consolidate its California work in its remaining Anaheim office. Closures will affect all 100 Modesto employees.

Colorado Regional Extension Center (CO-REC) announces its approved list of 14 EHR products.

Atlantic Health (NJ) forms an ACO that  encompasses a seven-county area. The health system has already aligned with more than 300 participating physicians.

The price tag for OSU Medical Center’s Epic EMR: $100 million over the next five years. Once implemented, Ohio State doctors and hospitals have the potential to earn $25 million in ARRA money.

Kaiser Permanente promotes CIO Philip Fasano to EVP and CIO. CEO George Halvorson says the promotion reflects the “magnitude of Phil’s impact and contribution to our organization.”

UC Davis concludes that EMRs impact physician specialties differently (duh). The initial implementation of EMRs decreased physician productivity 25 to 33%. Over time, internal medicine providers adjusted to the new technology and slightly increased their productivity, but pediatricians and family practice doctors did not recover to their original productivity levels. The conclusion: there is a  “mismatch between technology design and the work-flow requirements and health administration expectations” for different specialties.

Sponsor Updates

• API Healthcare introduces the Electronic Employee Record, designed for healthcare organizations to store and maintain employee information, track trends, and create forecasts.
• Wills Eye Health System (PA) contracts with NextGen for its EHR and PM products.
• Children’s Hospital Central California subscribes to CapSite to improve its capital expenditure process.
• Wellsoft signs a two-year extension contract with Premier, allowing Wellsoft to remain the sole contracted supplier of EDIS for Premier’s member hospitals.
• St. Tammany Parish Hospital (LA) selects RelayHealth as its partner to build its community-wide HIE.
• HIStalk sponsors placing in the KLAS top ten of all vendors are 3M, Philips, Picis, Sunquest, McKesson, and Merge Healthcare.
• Sponsors in the professional services top ten in KLAS are Hayes Management Consulting, Vitalize Consulting Solutions, Ingenix, and McKesson.
• Sponsor products earning a Best in KLAS title in their segment are eClinicalWorks EMR (ambulatory EMR 26-100 physicians), Greenway Medical PrimeSuite Chart (ambulatory EMR 6-25 physicians), e-MDs Chart (ambulatory EMR 2-5 physicians), McKesson Paragon (community HIS), Allscripts Sunrise EPSi Decision Support (business decision support), Wellsoft EDIS (ED), McKesson Pathways Financial Management, Materials, and HR Manager (financial/ERP), McKesson Horizon Practice Plus (practice management 26-100 physicians), Greenway Medical PrimeSuite Practice (practice management 6-25 physicians), e-MDs Bill (practice management 2-5 physicians), and Nuance eScription (speech recognition).
• Sponsors named Best in KLAS in the professional services category are Navicure (claims and clearinghouse services)and CareTech Solutions (IT outsourcing – extensive).
• Precyse Solutions ranked #2 in KLAS’s transcription provider category, but outscored everyone in report quality.
• UPDATE: we missed one! MedPlus’s ChartMaxx took Best in KLAS in the document imaging and management category, winning the #1 spot seven times since 2002. MedPlus has 140 implementations and 415,000 users.

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Submit your article of up to 500 words in length, subject to editing for clarity and brevity (please note: I run only original articles that have not appeared on any Web site or in any publication and I can’t use anything that looks like a commercial pitch). I’ll use a phony name for you unless you tell me otherwise. Thanks for sharing!

The Elephant in the Room
By Dana Sellers

I spend most of my time with provider organizations. Recently, though, I spent a day with a company that focuses on payers. As we discussed the many challenges our industry faces in today’s tough economic and regulatory climate, it hit me that we appeared to be coming at the problem from different angles.

One side of the room talked about patients, clinical data, and quality measures. The other side talked about members, population management, and risk reduction. It reminded me of the old story about the blind men who touch the same elephant, but describe it very differently. We were all talking about the same elephant, but we saw it and described it in our own terms.

There’s one thing both providers and payers have in common, though. Everyone’s trying to figure out how to play in a changing world that’s moving toward pay-for-performance, value-based purchasing, and ACOs. Providers are jockeying for position — buying physician practices, networking with community docs, and starting to think a lot more like payers.

Provider CIOs, who are just fully realizing how hard it is to capture the discrete data needed for the first 15 quality measures within their own walls, are facing the challenge of aggregating discrete clinical data over extended provider communities that include a hodgepodge of physician practices, specialty clinics, long-term care facilities, and home care settings.

Key payers are jockeying for position, too. Last week Aetna bought Medicity. Earlier this year, Ingenix, a subsidiary of UnitedHealth Group, purchased Axolotl and Picis. It makes sense that payers want into the HIE world. They need a way to gather clinical data, but more importantly, they want a framework that will allow them to influence the behavior of care providers to drive best practices back out to the point of care. These moves may really complicate things from a provider’s perspective, though.

How all of this will play out isn’t clear by any means, but there are a few things I’d be willing to bet on.

1. The 15 quality measures in Stage 1 are just the tip of the iceberg. Over the next five years, reimbursement will be increasingly based on data that must be captured, aggregated, and reported electronically, rather than through abstracting.
2. Physicians are key. To enhance the health of a population in a substantial way, you need to be able to connect with community-based care providers, manage handoffs, and influence decisions at the point of care. Whether it’s through acquisition or networking, healthcare organizations need to include physicians in their IT strategies.
3. The lines are blurring. Providers are starting to look and talk a lot more like payers, and payers are starting to move into areas long thought to be the domain of providers. We’ll see providers assuming risk and managing populations of members. Interesting alliances and new business models will emerge, and CIOs will need new information systems to support this new world.
4. Data will be the new gold in whatever finally emerges out of healthcare reform. Not just clinical data or financial data, but both combined … and lots of it. Payers have known this for years, and have invested heavily in systems to capture and report on member data. The organizations that come out on top will be the ones that figure out how to capture data, how to aggregate it, and how to apply the insights they derive from it to bring about real changes in quality. This doesn’t happen overnight. CIOs who don’t take the time to develop an analytics strategy will struggle to keep up.

So maybe at the end of the day, it doesn’t matter so much that we all have the same pachyderm perspective … as long as we can get it to do the heavy lifting.

Dana Sellers is CEO of Encore Health Resources of Houston, TX.

I Have an ONC-Certified EHR and Vendor Meaningful Use Guarantee, Why Do I Need Anything Else?
By James O’Connor

Software is a tool. An ONC-certified EHR captures and reports data, but an EHR system cannot characterize the gaps in your workflow and processes, initiate change within your practice, or foster teamwork to meet a common goal. These activities can be supported by a good software tool, but cannot be enacted by one. Here’s an illustration.

Recording demographics is a core requirement. To an EHR vendor, "readiness" means there is a form somewhere in the system that collects the information and there is a report that calculates the ratio.

To a medical practice, "readiness" means something else entirely. Certainly demographics are being recorded to some extent now, but one of the Meaningful Use requirements is to record a patient’s preferred language. To comply, practices must update forms (if patients still register on paper) and train staff to ask established patients the question (to fill in the gaps).

There is no partial payment for partial compliance. If the ratio doesn’t hit the minimum 50%, there will be no incentive payment. There are a number of requirements that depend on staff, not clinicians, to fulfill. These must be understood and incorporated into the workflow.

It is no great secret that Meaningful Use (at least Phase I) is not rocket science. The steps to prepare do require organization and a certain depth of knowledge. A small- to medium-sized practice willing to dedicate a competent individual to undertake this task can reasonably expect the person to succeed. 

It might take a little longer. There may be a few bumps in the road dealing with the HIPAA security assessment. There could be some resistance to change if the individual selected to head the effort has a "regular" job that does not ordinarily have the power to influence senior members. But surely it can be done.

On the other hand, there are benefits to bringing in an outsider: no subtraction from practice productivity, no power struggles, no learning curve, greater objectivity, expertise with security assessments. Also, you can fire a bad consultant, but dealing with a staff member who isn’t performing can be touchy.

Regardless of the path chosen, be sure to read the EHR vendors’ guarantees closely. They generally offer to credit the monthly usage or maintenance fees for a limited period of time if the practice doesn’t receive the incentive payment. Practically speaking, how will that work? 

The incentive is paid to individuals, but fees are typically paid by the practice. Does that mean if one physician does not qualify, then there are no fees for the entire practice that month? Does it mean that a portion of the fee will be credited?When you really think about it, what is a monthly maintenance fee compared to $44,000? 

Yes, you need an ONC-certified EHR system, but don’t depend on an EHR vendor’s guarantee to get you ready.

James O’Connor, MD is CEO of MDcohort of Ashburn, VA.

Electronic Medical Records, HITECH, and Your Health Information: Does Bureaucracy Inhibit Innovation?
By Doug Wallace

In case you have not heard, the economic stimulus program that passed in 2009 includes a little something called the Healthcare Information Technology for Economic and Clinical Health (HITECH) act, funded in excess of 20 billion dollars.

Your doctor is now required to computerize your personal health records. All of them. Boom!

Gone will be your current paper medical charts. But where will they go? Scanned and computerized for easy access and review. And why?

The current administration has claimed that, “To improve the quality of our healthcare while lowering its costs, we will make the immediate investments necessary to ensure that all of America’s medical records are computerized”.

While productivity and efficiency is a necessary goal, who is to decide how to accomplish such an initiative?

Much as the Transportation and Security Administration (TSA) claims that upon purchasing a ticket for air travel, you may well than “give up a lot of rights”. Will this hold true for your medical information?

In the move to enforce compliance of HITECH and physician adoption of electronic medical records, some immediate barriers to this initiative have become evident. Among them: doctors are not moving as fast as the money is flowing; the healthcare market already is positioned to deliver on what HITECH demands; any “preferred EMR systems” in good favor of Health Information Exchanges (HIEs) would hinder free market choices.

Is it fair to use regulation as a way to bypass legislation? Or just let bureaucrats decide? The US healthcare system is approximately 2.5 TRILLION dollars, or 18% of the GDP. Should measures such as our personal medical information be placed on a relative fast track whose journey has just begun, for an outcome that is uncertain?

Doug Wallace is executive VP, business development solutions for My EMR Choice of Doylestown, PA.

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From Nasty Parts: “Re: InnerWireless. Their VC backers want their money. Look for it to be acquired soon.” Unverified. The Richardson, TX company offers wireless infrastructure. It struck me as odd that its board of directors has four members, all of them money guys from different VC companies.

From THRGuy: “Re: JPS Health Network, Fort Worth. The interim CIO, has been named CIO. So a complex hospital implementing a complex EMR hires a CIO who has never had that job before?” I thought maybe he’d been there a long time, but it’s just been a year. His LinkedIn profile indicates no college degree, either. But it’s the same argument that college football teams go through: do you pay huge dollars to bring in a big-name ringer who could fail or bail, or do you figure your chances are about as good going with a known quantity who seems capable? Especially when a successful EMR implementation shouldn’t be under the CIO’s control in the first place. I will say from the cheap seats it does seem like a puzzling choice, but I have to assume they have the knowledge and incentive to pick the best candidate. And like coaches, CIOs are replaceable if things don’t work out, even when it’s not their fault. UPDATE: Joe Venturelli e-mailed to say that he obtained a bachelor’s degree in design from School of Visual Arts, which I see he’s updated on his LinkedIn profile. He also notes that he was CIO for NewHope Bariatrics. Thanks for the update.

The IOM’s Committee on Patient Safety and Health Information Technology, which is conducting a year-long study on the safety of HIT, held its first meeting Tuesday, continuing through Wednesday. Tuesday’s presenters: Gail Warden (University of Michigan), David Blumenthal (ONCHIT, which is paying for the study), Peter Pronovost (Johns Hopkins), Lawrence Shulman (Dana-Farber), Rainu Kaushal (Cornell), Dean Sitting (University of Texas Health Science Center at Houston), Sumit Rana (Epic), Madhu Reddy (Penn State), Ben Schneiderman (University of Maryland), and folks from NQF, Geisinger, AHRQ, FDA, CMMS, and CCHIT. I’m not exactly sure why Epic had someone presenting (or CCHIT, for that matter – what about the other EHR certification bodies?) The key agenda item was the last one in Tuesday’s session – what is the government’s role in overseeing HIT safety?

David Blumenthal will deliver a keynote address at the eHealth Initiative’s annual conference in Washington, DC on January 19-20. He speaks at a lot of events, but I don’t ever see anything quotable, so I assume he sticks to the standard EMR stump speech.

Weird News Andy is intrigued that patients in England are raising huge amounts of money for US cancer treatments after being told by NHS that nothing can be done and being offered no financial help, only to find that the same treatment is actually being delivered in England as part of clinical trials. Some parents claim their kids were turned down for the trials because those running them didn’t want make their study look bad.

Cathy Bruno, CIO of Eastern Maine Healthcare, wins the CIO of the Year award from the New England HIMSS chapter.

Cerner opens an employee health and wellness center this week for Deffenbaugh Industries, a Kansas City trash company. I noticed that Liking Deffenbaugh on Facebook puts you in the running for a Stinky the Garbage Truck toy, just in case you haven’t chosen a Christmas gift yet for that special someone.

Federal CTO Aneesh Chopra, speaking at a Brookings Institute forum on Internet policy, talks up the healthcare data sharing platform Direct Project as an example of the government’s role as a convener to facilitate innovation.

The Tampa VA hospital launches a $3 million Smart Home project to rehabilitate veterans with traumatic brain injury. Apartments are set up to keep patients re-learn activities and to monitor their movement using a real-time location system.

Healthcare IT vendor Cegedim clarifies news reports suggesting that up to 4,000 French pharmacies rigged its software to underreport taxes due using a secret code, with authorities estimating revenue loss of up to $534 million over three years. The company says it highly doubts that the one known tax fraud case translates into 25% of all pharmacies in France, also pointing out that the change is traceable if they tried anything sneaky.

Massena Memorial Hospital (NY) gets a local newspaper mention for its use of Meditech’s bedside medication barcoding system.

A study published in Archives of Internal Medicine finds that patients who receive care from multiple hospitals and EDs have more medical errors, treatment delays, and duplicate testing, with the conclusion being that data-sharing technology might pay its way by improving that situation. At least what the (free) abstract says about the (not free) article. Sometimes I wonder why you still have to pay for medical journal articles in an age where publishing costs are close to nil, especially since much of the heavy lifting is done by unpaid peer reviewers anyway.

iSoft sells its financial management software group, trying to pay down debt and focus on its core clinical systems business.

The government of Ontario seizes Hôtel-Dieu Grace Hospital due to high executive turnover and a wrongful termination lawsuit. The hospital was under review for a series of pathology and surgery errors.

E-mail me.

HERtalk by Inga

CHRISTUS Health plans a seven-state rollout of Medicity’s ProAccess Community and MediTrust Cloud Services, plus ambulatory order initiation, physician referral, and CCD exchange. They were already using Medicity’s Novo Grid technology.

Now on iTunes: Dragon Medical Mobile Recorder from Nuance Communications. The app allows users to dictate at the point of care via iPhones, which is then delivered to the eScription and Dictaphone Enterprise Speech platforms or to Nuance’s outsourced transcription services.

Moses Cone Health System (NC) implements Proficient Health’s Proficient Orders to streamline communication with local physicians and facilitate future participation in the North Carolina HIE.

Discovery Health Records Solutions completes a $2 million equity offering with the backing of Silverhawk Capital Partners.

CCHIT names three new members to its board of trustees and 11 commissioners to start terms on January 1.

Elliot Health System (NH) implements EMC and VMware solutions to virtualize and consolidate its IT infrastructure. EHS says the VMware vSphere platform eliminated the need to purchase 130 physical servers and resulted in a 50% reduction in data center power usage. EHS, which runs Epic EMR and McKesson financials, next plans to deploy a private cloud to deliver EMR services to physician practices.

MedVirginia announces that it’s the first community HIE to connect with the VA’s and DoD’s Virtual Lifetime Electronic Record (VLER). MedVirginia is leveraging its existing open source CONNECT gateway to the NHIN to enable clinical information exchange based on the CCD C32 format.

Surprising: almost 90% of providers are actively planning or piloting a PHR solution, according to a new KLAS report. Providers are trying to decide whether to partner with their EHR or HIE vendors or choose a free-standing, no-cost solution. Many providers are interested in free options because they can brand them as their own. Microsoft is the most-considered PHR vendor, followed closely by Epic and Google.

Also new from KLAS: satisfaction scores for ambulatory clearinghouses. Navicure, ZirMed, EDI Gateway, and Capario earn the top scores while Emdeon’s indirect product was noted as “most improved.” KLAS also points out that providers are willing to pay higher fees for more functionality if it can make practices significantly more efficient and shorten A/R cycles.

Community Memorial Health System (CA) chooses Wolters Kluwer Health’s ProVation Order Sets as its electronic order set solution.

The executive director of the 10-county Rochester RHIO says all 15 hospitals in its region are connected, as well as labs, elder care agencies, and health insurance companies. In addition, over 360,000 patients have signed consent forms to allow their doctors’ offices see their records online.

Salinas Valley Memorial Hospital (CA) sends a company-wide memo announcing that between 100 and 120 employees will lose their jobs by the end of the year as the hospital tries to trim operating costs. Affected workers include 40 nurses, unit assistants, clerical workers, housekeepers, and nutrition workers. The hospital has already eliminated 205 employees since July. I am pondering the exact wording on that memo. Perhaps, “Merry Christmas! You are Fired!”

MMRGlobal names Sunil Singhil EVP and adds two new members to its board of advisors. Singhil is a co-founder of  Nihilent Technology and its former COO. Joining the board are Qualcomm VP Michael J. Finley and Spalding Surgical Center CEO John R. Seitz.

A Michigan pilot dupes the AMA, hospitals, and specialty colleges into believing that he is a physician. Apparently William Hamman attended medical school, but dropped out. At some point over the last 20 years he tweaked his resume to include a medical degree from the University of Wisconsin-Madison. He had spoken at meetings and universities since 1992 and for five years served as the co-director of Western Michigan University’s Center of Excellence for Simulation Research. He joined William Beaumont Hospital (MI) in 2009 as an educator and researcher. A routine background check by Beaumont eventually uncovered Hamman’s lack of credentials and he resigned. Nice job of vetting over the first 20 years.

Emergisoft partners with Crystal Cruises to implement EmergisoftMaritime, the first EHR designed specifically for cruise ship healthcare. I believe I must do a site visit in order to provide readers with a full product evaluation.

Sponsor Updates

• SCI Solutions wins an eHealthcare Leadership Gold Award recognizing its outstanding healthcare Web portals.
• CDW Healthcare signs up to be a channel partner for Greenway Medical Technologies, offering Greenway’s PrimeSUITE.
• Lower Bucks Hospital (PA) selects Wellsoft EDIS.
• Mindray signs a deal to become the sole distributor of iMDsoft’s MetaVision in China and will also make it available to customers in 10 other countries.
• Hopkins County Memorial Hospital (TX) chooses the Access Intelligent Forms Suite for printing barcoded and data-populated forms on demand.
• The Alaska eHealth Network picks Orion Health to provide its HIE solution in a hosted SaaS mode.
• Lisa McVey, VP and CIO for McKesson Provider Technology and RelayHealth’s provider and consumer business units, wins a Women in Technology award in the enterprise business category.

E-mail Inga, MD, PhD, FACP, CPA

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The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Fit to Lead

What to do? Our flight left Jackson Hole way behind schedule. Sitting next to me was a colleague from our cross-town rival. We both grew anxious about the possibility of missing our connecting flight out of Chicago. We landed late.

Within 20 minutes, we had to traverse O’Hare to catch the commuter to Hopkins. Conference fatigue might have been a factor, but before we exited the jet bridge, evidence suggested that we were not going to make it to the departure gate. At least not together.

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New Year’s is fast approaching. This is a traditional time for reflecting on the past and setting a vision for the future. Crafting plans. I do this annual exercise for myself, my career, and with my family.

Need a new challenge?

Consider making 2011 the year of managing energy and getting fit. If you can’t do this for yourself, then do it for others. The people and communities you serve and influence deserve the best you can give (not to mention your family).

Energy is our most critical resource, yet most of us fail to manage it effectively. Year after year, leaders are asked to do more with less, be more productive, and remain fully engaged. If our bodies are not trained to handle the stress load, then the demands on our energy will exceed our capacity. This state of poor health results in lower productivity, disengagement, unfulfilling relationships, and compromised leadership.

I want to live a satisfying life. But am I willing to do what it takes to get there? Are the benefits worth my effort, my sacrifice? According to my wife’s trainer, “You’re never too old to see changes.”

The resources are out there, so ignorance is no excuse. I like the American Heart Association model, and I urge everyone to take their short The Simple 7 assessments. I was shocked to learn that less than 1% of the US population meets The Simple 7 criteria. Retired Generals and Admirals recently sounded another alarm bell this year with their treatise on Too Fat to Fight.

Casual observation suggests that healthcare leaders are not immune. How can we get to accountable care without first living it ourselves?

Ample evidence shows positive correlations between fitness and energy levels and performance and life satisfaction. The Human Performance Institute offers a course for the corporate athlete, which I recommend. In their holistic approach, which encompasses the physical, emotional, mental, and spiritual aspects of life, the Institute reported the following results amongst graduates:

• 75% report they are more engaged with life
• 62% report they are more engaged with their family
• 65% report they are more engaged in taking care of their health
• 48% report improvement in self-confidence
• 57% report they are more productive at work
• 42% report they get better sleep
• 61% report they are more likely to take positive action to make changes in their lives

Being fit provides other benefits. I worked for an organization that gave health insurance discounts based on compliance with one or more of their five measures of health. I worked to meet each criterion, and my health insurance costs were zero!

If I want to keep up with my wife, I’ve gotta be fit. She reminds me that someday we will have grandchildren, and she wants to be able to run and play with them. Heck no, I’m not going to be left to sit on the playground bench. At family reunions, my nephews love to play soccer and touch football, and I’m determined not to be outdone…by too large of a margin, anyway. I have significant interests outside of work, and I know I could not perform any of them well let alone attempt them without adequate energy management.

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I had a choice to make that day in O’Hare. Stay with my colleague and watch our flight depart without us or leave him behind. I decided that making it home to spend time with my family was more important than time with a rival. I moved along and made the flight just as they were closing the door.

Yes, that is a silly story, but how many connections do we miss in life because a lack of energy? We’ve all missed personal and professional flights — and regretted it.

New Year’s is upon us, so make a resolution: 2011 — The Year of the Fit Leader.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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