Unlike other sites, I don’t re-run anything that has appear elsewhere. I’m making an exception in this case, however. Brad Dodge at healthcare marketing and PR company Dodge Communications did a fun writeup of the HIMSS exhibit hall that I thought deserved a broader audience. He gave the OK to run it here.

Did You Make the HIMSS Best and Worst List?
By Brad Dodge, Dodge Communications  

One of the most challenging elements of marketing communications is that it can be VERY subjective. When vendors are considering their investment to exhibit at a conference like HIMSS11, how important is it to have a brand new booth? Sure, it’s cool, but also expensive. Does the incremental investment bring in a commensurate number of leads into the booth? And how on earth do you measure that? How about a question like, “Thanks for coming into our booth. Would you have come by if our booth was 20% less cool? 40% less cool?” Didn’t think so.

So, no disrespect intended, let us acknowledge our best and worst of HIMSS awards. Don’t forget, there were more than 1,000 exhibitors, so if you think you were the worst in a category that we awarded to someone else, it’s probably because we didn’t see you. Which is for another conversation altogether on visibility.

WORST IMAGERY: The see-through head with colored veins running down to the spine at Cattails Software. Turns out that the entire brand identity is centered on the see-through head. Maybe it appeals to physicians. Not us.

MOST SURPRISINGLY NICE THEATER AREA: CDW. Very engaging, close to the aisle, nice little talk-show-interview area off to the side and very clean presentation technology.

WORST SIGNAGE: Merge Healthcare. A whole backdrop of patents that the company holds, we guess. They were too small to read, but big enough to look like we were supposed to be able to read them. If we hadn’t asked the guy what they were, we’d have never known. Lost opportunity.

MOST OBVIOUS CASE OF LITTLE-BOOTH-IN-A-BIG-SPACE: Healthwise. Refer back to our comments in the opening paragraph. Our opinion: if you’re going to the black tie event, you gotta spring for the tux.

MOST OVERUSED BRIBERY TOOL: The Apple® iPAD®. We lost count of how many vendors had stacks of them that they’d give/raffle to attendees who’d listen to the pitch. And don’t get us started talking about the misuse of the trademark.

WORST FASHION STATEMENT: As in the shortest skirt. As in who thought that was a good idea? We saw her at the ACS booth. We thought that booth babes had toned it down? Maybe their parent Xerox forced them into it.

WORST FLOOR PLAN FAUX-PAS: HIMSS interoperability showcase was WAYYY at the end of the hall, and it was a really cool exhibit. If you went a little bit past it, you’d be at Cape Canaveral. We think it should be the absolute center of the show floor.

HONORABLE MENTION FOR LONGEST USE OF THE TRUSS BOOTH: We’re sure there were OLDER booths in the hall, but nothing says 1990 like a booth built using trusses. We guess they’re still paying off the loan. Award goes to  ESRI. At least the booth staff wasn’t wearing leg warmers.

MOST OVERUSED ICON: The world. As in global healthcare. Get it? ESRI wins it again. Mainly because we didn’t write down the others.

MOST BLATANT DISREGARD FOR TRADEMARKS: This list is entirely too long to publish. For a taste, go here. What was so surprising is that every one of these companies would go ballistic is their own IP or trademarks were compromised similarly.

BEST GIVEAWAY THAT THE DODGE TEAM WANTED TO WIN: The waverunner at the SCC booth. We’re looking up SCC on Google, and once again are stumped by the acronym that’s shared by a zillion other organizations. Is it Spokane Community College? (first result) Scottsdale Community College? (second result) Seminole State College? (third result, and it’s not even an SCC!) Did you already see our opinions on the strength of acronyms in healthcare brands? So, we had to go to the HIMSS pocket guide to figure out who the winner is. SCC is SCC Soft Computer.

FRESHEST GRAPHICS: IBM. We know it’s a challenge to have noticeable graphics at a behemoth conference like HIMSS. We think IBM did a nice job. Colorful. Different. Link to healthcare.

BEST NOT-FEELING-THE-THEME: Epic. The stacked stone, jewel tones, solid-walled booth is obviously very expensive to build, ship and store. We felt like we were in the past. Does anyone care?

BEST NEW BOOTH DESIGN: We have to say that we liked the way that the long, narrow Moss headers were used in a number of new booths to pull the exhibits together without cramping the space. Allscripts and Ingenix both did a nice job at this.

All in all, we were thrilled to have a dozen of our employees at HIMSS11 meeting with clients, editors and others. We thought it was a great show and look forward to 2012 in Las Vegas.

Dr. Gregg "1 to 3 Docs" Goes to HIMSS (Part 1)

Amidst the ACO, ACA, MU, ONC, and HITECH BS buzz these days, it seems there is also a lot of chatter amongst HIT vendors, HIMSS helpers, and REC-related registrars about how to reach the 1 to 3 provider practices, how to get the bit players biting on the digital bait.

If my numbers are still accurate (I haven’t checked them in a few years,) the majority of healthcare in our country is still being delivered in the small practice and small community hospital setting. As I’ve long ranted, you can’t build a national health information network if over 60% of the network is ignored. Granted, we don’t have the glam and glitter of the giant groups and grandiose medical conglomerates, nor can we write those big, beautiful, multiply-zeroed checks that they can. But, we have one thing they don’t, one thing they need that only we can provide:

Us.

And, “they” need us. And, they’re starting to get that point. And, it’s about to get really interesting here in the trenches.

With that in mind, I thought it might be worthwhile to share a trench-eye view of the world of HIMSS11.

There’s really no other showcase for HIT left now that TEPR is pushing up digital daisies, no place else where you can see, en masse, what might be possible for a practice considering health IT options. And, what makes that sort of sad is the fact that the HIMSS conference doesn’t hold much draw for anyone from a 1-3 provider practice.

First off, HIMSS is an industry show, a vendor’s show. Even its timing during the work week bespeaks this. Unless you have a sugar daddy awaiting in the wings (or, unless you’re a committable geek like me,) you simply cannot justify losing thousands of dollars of income generation for the one or two or three work days that you’d need to sacrifice in order to go. Without a corporate expense account upon which to lean, it’s a bear trying to go to a conference held during work days. Most grunts prefer to save those times off for family vacations, not stuff which is essentially more work.

Secondly, HIMSS isn’t really 1-3 doc friendly. Seminars and educational sessions are targeted toward CIOs, CMIOs, CTOS, CEOs, other “O”s, and informatician-types who have no, or very little, interaction with or awareness of the little "o"s in the 1-3 provider world. I truly doubt many "1-3′ers" who are just considering the whole EHR thing would find much of value at their level during HIMSS. I doubt many of them think about ONC or HITECH unless they have to, which likely isn’t too often. I doubt many of them care a smidge about server-based versus SaaS. They mostly want to know how to do this digital redirection with as little pain as possible and get on about the business of being patient care providers.

Third, as others have opined, walking the HIMSS floor without "VC" stamped on your head or a green "PRESS" banner flying below your HIMSS badge may limit your ability to get a conversation started, at least in some vendors’ booths. I have had the notion that HIMSS exhibit hall exhibits are more designed for inter-exhibitor intercourse than any product promotion to potential end users. (Plus, just a little side note here: I understand how boring it can be in an exhibit booth with no visitors, but if I were a corporate CEO and saw someone representing my company’s interests with as much neglect and disrespect as some I saw on the HIMSS exhibit hall floor, there’d be a post-HIMSS Pink Slip Thursday pending.)

Bitch, moan, bitch, moan. As I said in my last post, I despise non-constructive whining. So, in keeping with that credo, and after a few more observations, I will be offering up some potential remedies next time in “1 to 3 Docs” Goes to HIMSS – Part 2.

From the trenches…

“Not engaging in ignorance is wisdom.” – Bodhidharma

E-mail Gregg.

From the standpoint of a clinician (a.k.a. "doctor"), HIMSS was — and usually is — a great opportunity to get an idea of the underlying forces that are shaping the development of health IT, whether substantive or faddish. However, these forces are all operating on a scale, and in an environment, pretty far removed from where actual healthcare happens, e.g. the doctor-patient relationship.  

To look at it in a more cynical fashion, make no mistake – this is a trade show where vendors of large information systems and hardware attempt to sell them to frequently non-clinical IT personnel. That said, I found many of the booth personnel to be reasonably friendly, but I can’t rule out a bit of selection bias.

At least in name, there were many educational sessions addressing operational and organizational challenges, but many of these ended up just being information-light or thinly disguised case studies of Vendor X’s product that lacked much depth. You’ll have to look elsewhere to learn about process innovation, re-engineering healthcare, etc.

That’s not to say that the conference is bad. Certainly not. You just have to keep in mind what it is and what it isn’t. HIMSS is kind of like Home Depot. It might be a great place to see new tools, but it’s not where you to go to learn how to build a house.  

As a clinician, I came away with an appreciation of a few things. In an effort to chase after the $$$($$$$$) sloshing around healthcare these days, many vendors have created products that clearly demonstrate a lack of understanding about what end users actually want and need.  Of course, given their real target audience, this might not matter to them.  Moreover, for the large subset of back-end systems and products, their application to healthcare is almost an aside. 

(Speaking of asides: yeah, we know you all create value and whatnot, but how are you different and/or better than the other 20 vendors in the exact same space? For that matter, what exactly is it that you do?) 

This shortcoming is often compounded by the fact that decisions regarding clinical systems are often — if not usually — made by non-clinicians looking out for their own interests. They’re not out to screw the clinicians, but if there’s any trade-off between the clinicians and the admin/IT side, we know who will win the tug-of-war.  

HIMSS provides great insight into understanding the what, how, and why of health IT development. Though unintentional, it’s also a good reminder that healthcare is rapidly shifting from small(er) collections of independent providers to large systems with a corresponding shift of decision-making away from the clinicians to a concentrated group of often non-clinical individuals. It’s a real bummer for people like me, but instead of denying reality we might as well learn how to play the game.

HIMSS Recap
By Evan Frankel

HIMSS ’11 is now officially behind me. Originally tasked with reporting on the HIStalkapalooza party, there was a conflict with my desire to punish my liver. Therefore, after a couple of days of recovery, feverish work to network and saunter the exhibit hall, all that is left is a newbie’s recap of the conference.

The last HIMSS I attended was quite some time ago. I was a much different person and the industry was in a much different place. What was once an informational and educational experience to be shared with industry peers and HIT professionals has warped into a testament to the power of marketing dollars and a commitment to further the sales of vaporware and roadmaps.

I thought I was prepared. I believed that my conviction to spend the entirety of each day in the exhibit hall (bless you Exhibitor badge, you keep me from winning prizes, but enable me to loiter whenever I please) was well meaning as I knew that I could easily download and review all sessions at a later time. In hindsight, I wish I wore a pedometer.

Clearly this is a rapidly evolving industry, what just a couple of months ago was a drive to Meaningful Use, federal inducement and incentive, and a push to make digital every last granule of data has altered course to focus on the eternally long list of problems already encountered. It seems like vendors wanted to talk about their few happy clients and wouldn’t admit to any struggles or lessons learned.

I visited, in one way or another, 84% of all of the booths on the floor (yes, that means I am without a voice today and shook almost 850 hands). I asked everything from the most basic question, “What do you do?” to engaging in hour-long conversations about the challenges companies have in retaining talent and clients. I am always impressed to see passion and conviction, it goes without saying that being in love with your company is an engaging trait.

I saw some things that not even ‘brain bleach’ can remove from memory, which is a shame. Not only is the overtly obvious booth-babe phenomenon here to stay, but the desire to at least make them conversant in their employer’s product or mission seems to no longer be even a slight priority. I am not leering at you, I am just floored that you are not able to help me in any way.

Even the most senior of executives were forced into booth duty, which could have been very refreshing, but in certain cases was both scary and cringe-inducing. Case in point: I was told by more than one vendor, in reference to long and close-to-failed EMR implementations, that they are a good thing since the vendor collects pay by the hour. I had another vendor tell me they sell implementation support and training time by the 100-hour block because anything else would nickel-and-dime the customer. When asked about small practices, there is not a per-hour rate (which would help me understand the profit margin on implementations, since the same company was hiring project managers and implementation staff). But at least they were honest, which couldn’t be said for all.

I did find a partner in crime on Tuesday. Armed with the exact same questions for the exact same vendor, we were able to get completely different answers to the same question. “Can I run this in my data center?” shouldn’t elicit both a Yes and a No. But I guess we could chalk that up to, “it’s all customizable”, which may be the mantra that I take to every meeting I ever attend. It sure beats committing to one answer or solution, I suppose.

To the gentleman who stood next to me at the Google booth and asked the employee what “this Google thing does”, as if he had never heard of them, thank you for being the funniest guy in the room. But it also made me sad, as their answer wasn’t, “Oh, we are here to take over the world, at least all of it that isn’t Europe.” That would’ve been super cool and probably more honest.

The best attraction that a booth could present, in my novice opinion, is the soft, ultra-plushy carpet. I have no idea if that was an up-sell from the convention center or not, but after logging 5+ miles each day on the concrete covered by a millimeter of carpet, a soft booth floor was welcome respite.

I tried to muster the energy to engage all of the hired booth talent as possible. I watched a man duct-tape his eyes shut and guess the serial numbers on a dollar bill. There is a lot of talent in that trick, but was it worth losing most of an eyebrow?

I saw comedy, three-card monte, and a bunch of artistic impressionism. Then I got tired of standing at the NHINDirect/Connect/Interoperability showcase and went back to the booths.

I don’t want to come off as angry, jaded, or a naysayer that we are getting further from solving most of our healthcare woes than we were before. However, if another person tells me all about the value they create with their solution without understanding the basic premise of entropy in the universe, I may beg HIMSS to administer an IQ test as part of registration. As a quick lesson, in order to create value, you must eliminate something, and I highly doubt it is your profit margin, so riddle me this — where did you get that value?

The booth demo on a large scale is a brilliant concept; it is akin to auditing a college course. You can come and go as you please and no one grades you on paying attention. In fact, if we were to require an assessment at the end of every 10 people or larger group demo, I would wager less than 1/3 could even get the product name right. Luckily next year is in Vegas, as I hope to actually find some action on these wagers (but I have a feeling I won’t be allowed back).

Speaking of Vegas, HIMSS executives predict a sharp increase in attendance in response to the location. I hope they market this correctly, as they should expect more registrants, not attendees. Vegas has a wonderful way to make you forget why you are there.

I will need to check, but I believe HIMSS will continue to be the same weekend as the “Great American Race”, which would have been a nice thing to know before I booked my travel plans. Not only would I have trekked to Daytona to see what the hubbub is about, but I am sure I could have had some easy pickings on making analogous the driving fast cars in circles to the current state of the HIT industry. Spinning tires until they explode? Banged-up, dented, smoking heaps of metal? That it takes 16 people to change a tire and fill a tank of gas? 100,000 people half-drunk standing in their own sweat? This is almost too easy.

Undeniably, HIMSS ’11 will be considered a success: record attendance, millions of dollars poured into the local taxi and livery economy, a significant dry-cleaning bill upon return for all those in attendance, and a chance for the industry to look inward and see how far we have come and have to go to increase adoption of tools that will improve patient care and health insurance company dividends.

For this naïve newbie to the industry, it was an overwhelming and underwhelming experience. I guess I ended up being whelmed in the end. There is so much noise, so much fear-mongering, so much confusion surrounding just about everything, that is no wonder we are going to Vegas next. For practices and hospitals making any technology decision these days, it is practically a crap-shoot. I would put my chips on another year of consolidation amongst vendors and a mix of success and horror stories from the institutions that adopt more technology.

In the end, it is what it is, no more or no less.

Pictures of HIStalkapaloozans
By David Polivka, Developer, Medicomp 

Pictures of HIStalkapaloozans
By Anthony Istrico

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From Terry: “Re: Oracle. We talked to an Oracle contact at HIMSS and their HIE vendor partner will be…Orion.” Unverified. 

From BurnedOutFromHIMSS: “Re: Tom Niehaus, president of CTG Healthcare. Just heard he’s joining Encore Health Resources. That’s a big blow to CTG and a great catch by Encore. I think very highly of him and he’ll be a good fit for the culture Ivo and Dana have built.” Verified by Ivo. Tom will be executive VP of business development reporting to Dana Sellers at Encore. Ivo says he’s known him for a couple of decades, thinks he’s one of the most effective executives in the industry, and says he has the integrity and character to fit well into Encore’s culture.

From McLean: “Re: McKesson. Rumors about that they will open source their platform and focus on solutions and services. Given the lack of market expansion they have experienced, this may be a sound decision, making them the Red Hat of IT as a compelling alternative to overpriced offerings from other vendors.” Unverified.

From Marlow Gates: “Re: Certify Data Systems. CEO is Mark Willard, a Brit. Last year he supposedly bagged some huge hospital systems with a system that doesn’t make the usual suspect list of HIE solutions because it doesn’t have a portal. They seem to be flying under the radar for as long as possible. They have some sort of arrangement with Cerner, but are doing direct deals as well. The management team is long on technical skills with not a lot of long time HIS regulars.” Inside Healthcare IT e-mailed to say they’ve written a couple of articles about the company, including one in the current issue that they’ll make available to the reader who asked about the company (assuming it wasn’t a company plant looking for PR).

From All Hat No Cattle: “Re: Cignet HIPAA penalty. Not a rumor, but a shocker.” The Office of Civil Rights fines Cignet Health (MD) $4.3 million for HIPAA violations, the first-ever civil penalty levied against a covered entity. The Cignet idiots not only refused to give 41 patients copies of their medical records over a one-year period, they then ignored OCR’s subpoena while making no effort to resolve the patient complaints. Cignet operates four clinics in southern Maryland and insurance operations in the UK, Nigeria, and Ghana. The Web site is pretty seedy-looking, I’d say, and includes a prominent link to franchising information, bragging that, “With Cignet health plan and Cignet discount card, Centers are sure to have a good percentage of cash paying, insurance claim free patients.” I can see the attraction of cash customers — some online sources say that Cignet was the subject of a Maryland Insurance Commissioner’s cease-and-desist order for selling phony insurance. Owner Dan Austin’s medical license had been revoked in 2000 after conviction of mail and loan fraud — I found the above in Maryland court records. He was running a student loan scam.

From Bob: “Re: HIMSS writeups. I certainly appreciate your writing up what you think are the most important, interesting, and amusing aspects of HIMSS. Indeed, I felt (almost) like I was there and didn’t really miss anything (of importance) … well, except for the Blue Cat babes, perhaps ” It’s funny about the conference … you know going in that you’ll miss 90% of it, so you try to pick and choose wisely. That means you could randomly pick 10 attendees and none of them were probably in the same educational sessions, attending the same parties, or picking up the same valuable nuggets. Maybe that’s my niche for next year – debriefing a bunch of people on what they saw that was important just to get a collective opinion. Every year I feel like an outsider who missed the good stuff and I bet I’m not the only one.

From Kyoto: “Re: Allscripts good and bad news. The integration work is not only on the mark, but far exceeded client expectations during previews. Gomez came up with a new approach that allows seamless integration, going well beyond the usual tired approach. It’s also making its numbers. On the other hand, Enterprise EHR clients continue to complain about product quality and sales leadership is leaving. Lack of SCM sales is causing fear in its ability to expand in the community space, part of its key Connected Community strategy.” Unverified.

From InteropNotSilos: “Re: HHS Secretary Sebelius. After all the hot air at HIMSS, she goes home to see the Lewis and Clark Information Exchange, the only one operational in Missouri or Kansas.”

Listening: Pepper, Hawaii-based reggae/funk, sometimes reminiscent of Red Hot Chili Peppers.

These poll results don’t mean much since Allscripts encouraged its employees to vote for Stephanie Reel, but if you throw her out, it’s a pretty close race between John Halamka and Bill Bria. New poll to your right: if you went to the HIMSS conference, how was the quality of the educational sessions?

Jobs on the job board: VP Sales Central Region, Senior Software Engineer, Project Manager – Healthcare Implementation. On Healthcare IT Jobs: Senior Software Engineer, Senior Systems Analyst – Financial Systems, Project Manager.

Welcome to new HIStalk Gold Sponsor TeleTracking of Pittsburgh, PA, celebrating its 20th anniversary this month. The company focuses on patient flow automation, offering a variety of products for bed tracking, transport tracking, patient milestone tracking through procedure areas like OR and cath lab, the NaviCare OR perioperative solution, a work order management system, and the RadarFind RTLS for asset tracking. Conclusion: TeleTracking is all about squeezing out inefficiency, adding as much as 20% more capacity and collecting a wealth of operational data for making decisions. It’s the #1 KLAS-rated patient flow system and is used by 92% of US News and World Report’s Best Hospitals. Thanks to TeleTracking for supporting HIStalk.

Here’s a TeleTracking video I found on YouTube for my fellow visual learners.

Revenue cycle vendor MedAssets turned in Q4 numbers Friday: revenue up 17% to $106.9 million, EPS -$0.87 vs $0.17, wildly missing expectations of $0.22. Its 2011 forecast also missed expectations. Shares were punished, dropping 34% of their value by Friday’s market close.

In thinking about the lack of wellness emphasis at HIMSS, I thought a model I’ve used myself that works: RealAge. I took its test once, got hooked on the idea of getting a “you’re this old based on life expectancy” number, and started following some of its suggestions for changes to diet, exercise, and stress. I get an occasional e-mail recommending some course of action or product. Best of all, there’s a great business model since it sells advertising (it’s owned by Hearst). I know it’s ad-based, but I still find the information useful. Any wellness technology will need to be this user friendly to succeed, and may also need to blend social networking into its capabilities (which RealAge doesn’t really do as far as I know).

UNC Health Care (NC) chooses IBM for its private HIE. It’s funny how the definition of HIE has changed – now it takes one for UNC’s own doctors to share information with each other. Next thing you know it will take an HIE to send physician orders to departments. I guess choosing a single system was out of the question. 

MED3OOO had an iPad drawing Wednesday of HIMSS for HIStalk readers only. Congratulations to the winner, Susan Murray, director of application services for HCA. Nice! I have to say I’m liking mine quite a bit, too, although I’m just getting started with it. I have the iPad for a nice-sized screen and keyboard and then my iPod Touch that allows accessing everything from a tiny footprint, so I almost don’t need a desktop any more.

Inga found this HIMSS presentation disturbing. Wonder what was going through the minds of the Lawson suits when they green-lighted it?

Our shoe judge Lindsay has a day job with RelayHealth when she’s not evaluating footwear, but she obviously keeps her HIStalktapalooza responsibilities on her mind even there, showing the burdens of office inherent in wearing the Official Shoe Diva sash.

Tiny Schoolcraft Memorial Hospital (MI) will lay off 13 FTEs, a sizeable chunk of the 25-bed hospital’s 250-employee workforce. The reason: Medicaid reimbursement isn’t going up and they have to pay for an EMR upgrade. Says the CEO, “With this somewhat gloomy forecast, the hospital must continue to implement, at significant capital cost, an improvement to our Electronic Medical Record system, meeting additional criteria set by federal law … We qualify for EMR funding both for the hospital EMR and our Rural Clinic once we meet all of the (HHS) ‘meaningful use’ standards. We expect to meet the requirements with a 90-day qualifying period in both the hospital and the clinic by the end of the year. We hope to get most of our costs covered by the funding. Unfortunately, you must spend the money and meet the requirements before you get reimbursed. If the standard in not met by 2015, Medicare will reduce your payments.”

System integrators try to appease open source advocates who blame those companies for ignoring the British government’s call for more open source applications. The companies say it’s not their fault that the government signs enterprise software license agreements and lets vendor alliances dictate software stacks that exclude open source components. Examples given all pertain to healthcare: the Department of Health’s enterprise agreement with Microsoft and NPfIT’s Cerner contract that required the Oracle database, IBM hardware, and IBM’s WebSphere application server. One company’s rep threw out the FUD that open source software shouldn’t be used for anything mission critical, but the government said that talk needed to stop considering that the London Stock Exchange runs on open source software.

Thanks to Healthwise, a new HIStalk Platinum Sponsor. The Boise, ID company offers consumer-friendly patient education content for care managers and health coaches; an EMR-integrated patient education solution that helps meet Meaningful Use requirements; and health information content that integrates with personal health records, call center applications, portals, Web sites, and wellness applications. The content library is extensive: a health encyclopedia, decision aids, virtual coaching, medical illustrations, calculators, and slideshows. Mobile access content and tools are coming soon. Founder, chairman, and CEO Don Kemper and SVP Molly Mettler created the concept of “information therapy” in their 2002 book. The company offers a white paper called Getting Patients to Meaningful Use: Using the HL7 Infobutton Standard for Information Prescriptions. I have to say I’m impressed that the 36-year-old company’s mission is simple (empower people to care for themselves, give them a way to ask for help when they need it, and let them decline care they don’t need), that its executives are recognized public health experts, and that it’s a non-profit (!!) I forgot to look them up at HIMSS, so I might have to add Don Kemper to my interview list to learn more. Thanks to Healthwise for supporting HIStalk.

The folks at HealthHarbor e-mailed to say that HIStalk is their favorite industry blog and they recommended that their readers follow our daily HIMSS reports, so here’s a link back to their HIMSS writeup from a price transparency standpoing, just for being nice.

GE Healthcare and Capsule sign a deal to link GEHC’s Carescape patient monitors to Capsule’s Enterprise Device Connectivity Solution and Mobile Vitals plus.

This week’s company-wide e-mail from Kaiser’s George Halvorson focuses on HIMSS, mentioning that 35 of the 55 Stage 7 hospitals are Kaiser’s. He also mentioned a global HIT strategy document the company presented at the Davos World Economic Forum in Switzerland last month. The link provided was invalid, but I Googled and found what I assume is that PDF document here.

Ohio State University Medical Center’s CITIH (Center for IT Innovations in Healthcare) will convene its one-day HIT summit, Bridging Health IT Innovation, on April 18.

GE Healthcare announces iPad/iPhone access for Centricity Advance and Centricity Practice Solution.

A 27-year-old doctor in China using the alias Snooky is fired for comments she made about patients on a microblogging site, including, “The blood pressure of one patient has been dropping, and it seems that I might have to get up at midnight to dispose of the corpse. It’s not easy for me to keep my bed warm in such cold weather, so please don’t die until I get off work.”

Mass General will pay HHS $1 million to settle a HIPAA case in which a billing manager taking paper HIV/AIDS records home accidentally left them on the subway.

KLAS says 35% of ambulatory EMR users are replacing their systems. Most often considered to buy are Allscripts, Epic, and NextGen.

Imprivata announces vmWare View authentication and single sign-on agreements with Teradici and Dell. It also announces OneSign Anywhere for mobile devices as well as integration of its OneSign single sign-on and authentication platform with EpicCare.

Oracle announces Health Sciences Information Manager, an HIE solution that includes record location, information security, auditing, and NHIN Connect integration.

E-mail me.

2011 HISsies Winners

Smartest vendor strategic move
Allscripts buys Eclipsys

Stupidest vendor strategic move
McKesson’s Horizon Enterprise Revenue Management struggles

Best healthcare IT vendor
Epic

Worst healthcare IT vendor
GE Healthcare

Most fun healthcare IT vendor
athenahealth

Best leader of a vendor or consulting firm
Judy Faulkner, Epic

Best provider user of healthcare IT
Kaiser Permanente

Most promising technology development
Tablet (including iPad)

Most overrated technology
Cloud computing

Biggest HIT-related news story of the year
Meaningful Use

Most overused buzzword
Meaningful Use

”When ____ talks, people listen”
David Blumenthal, ONC

Most effective CIO in a healthcare provider organization
Ed Marx, Texas Health Resources

Most effective medical/clinical informatics professional
Martin Harris, Cleveland Clinic

HIS industry figure with whom you’d most like to have a few beers
Judy Faulkner, Epic

HIS industry figure in whose face you’d most like to throw a pie
Neal Patterson, Cerner

HIStalk Healthcare IT Lifetime Achievement Award
John Glaser, Siemens

HIStalk Healthcare IT Industry Figure of the Year
David Blumenthal, ONC

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From Just Saying: “Re: your Soarian demo. While pithy, this post would have been more honest if it had said, ‘I fell prey to the seductions of the attractive women and bright lights at the Siemens booth and I am so ashamed.’ Wouldn’t it have been just as valid to say ‘good to see Siemens playing offense again…Glaser seems to be making an impact already?’” Actually I wasn’t paying attention to the women or the lights – I was dragging along tired at the end of the day Wednesday and the rep stuck some 3D glasses out and promised the video would last only five minutes, just long enough for me to rest on what looked like comfortable benches (but weren’t). I didn’t find the video effective, but maybe some did. Actually, I already had an improving opinion of Soarian and the video didn’t really change it either way, but I was too tired and fidgety to want to sit through a demo, which was my real intention several times I passed the Siemens booth way down on the end (but somehow I never actually did it). I want Soarian to do well – we could use a respectably performing system that isn’t 30 years old. John Glaser did a little speech at the end of the video. He dropped by HIStalkapalooza, having warned me in advance that he wouldn’t be able to make it in time to accept his Lifetime Achievement Award in person before the band went on.

Just to show there’s no hard feelings, here’s a good consumer-oriented Soarian video from Yakima Valley Memorial Hospital that I found on YouTube. It’s more interesting than the 3D one if you ask me.

From LaVerne: “Re: Siemens. HHS lists Siemens as a certified vendor, but why do they list Enterprise Document Management as required additional software? How does that apply to Meaningful Use? MS4 is certified but does not require any document management product. Perceptive, Hyland, and other vendors don’t even modularly certify their DM products, so that might lead to the conclusion that Siemens has the only certified DM solution. Are they being intentionally mendacious or am I missing something?”

From Dolphins Fan: “Re: vendor attention. Once again, you guys did an awesome job of covering HIMSS — thanks! I can relate to your stories of being ignored by product vendors. I can think of several (Azzly and Phreesia immediately come to mind, but there were several others) where I felt if my nametag didn’t have ‘VC’ on it, I wasn’t worth talking to. As someone who provides significant guidance on many clients’ purchase decisions, it makes me wonder if these firms are actually driven by serving customers or just by scoring funding and being acquired.” I feel guilty going public with stories of unresponsive booth reps, but I’d want to know if I was the vendor. You get the feeling that nobody from management is overseeing, or if so, they aren’t very good managers (and in fact, some of the worst offenders were clearly the suits more interested in holding court with cronies than working prospects). Even Dr. Jayne’s CMIO badge couldn’t stir some of them. Let us read from the Book of Glengarry Glen Ross: “You got leads. Mitch and Murray paid good money. Get their names to sell them. You can’t close the leads you’re given, you can’t close %#*@, you ARE %#*@. Hit the bricks, pal, and beat it, ’cause you are going OUT … A guy don’t walk on the lot lest he wants to buy. They’re sitting out there waiting to give you their money. Are you gonna take it? Are you man enough to take it? What’s the problem, pal? … Always Be Closing.”

From Rodrigo Barnes: “Re: Certify Data Systems. Why don’t we hear more about them?” Never heard of them, sorry. I checked their management team and never heard of any of them, either. That doesn’t mean they aren’t good at whatever connectivity stuff they do, but maybe not so good at getting their story out.

From Northeastern CIO: “Re: HIStalkapalooza. Thanks to you, Inga, Dr. Jayne, and of course, Medicomp, for the wonderful HIStalkapalooza party. I enjoyed it, got to speak with several interesting folks, had fun watching the awards, and appreciated the food. You ordered great weather too, making it all the more difficult to return to the cold. As others continually state, you do great work and I appreciate being part of your expanding circle of colleagues.” Thanks! I bet lots of folks are missing the weather and the non-monochromatic Florida landscape.

From JL, MD: “Re: Microsoft. Go to silverlight.interknowlogy.com to view two videos that are part of the 2011 HIMSS Microsoft HSG presentations from today that demonstrate form-factor convergence for Surface, Windows 7, Windows 7 tablet, Windows Mobile for healthcare information display for patients and providers. A second video demonstrates the ability for a Windows 7 PC enabled with USB KINECT and custom healthcare gestures can display healthcare image data, and do 3D manipulation of coronary image data using gestures via KINECT without XBox 360.” I wish they hadn’t been so Microsofty in posting the videos in the annoying Silverlight format that takes a long time to load and requires a huge plug-in if you don’t already have it (I don’t mind it for apps, but it seems like overkill for a video). Had they done like every other vendor in the world and posted it on YouTube, I could have run it right here. Ever seen a Silverlight video go viral? Uh, no, and that’s why. So anyway, the videos are pretty cool. I saw a Surface at RelayHealth’s booth, but nobody seemed to be doing much with it. I have a feeling the other form factors are getting completely buried by the iPad with little hope of catching up, but I don’t claim to be an expert. Example: I saw dozens or hundreds of vendors raffling off iPads to hundreds of anxiously awaiting HIMSS attendees. I saw one giving away a KINECT and nobody offering the others.

Inga, Dr. Jayne, and I are home now. I won’t speak for the ladies, but I’m pretty beat since last night’s long post took me until midnight to finish and I was back up at 3:30 a.m. to get ready for the trip home. Maybe HIMSS is a fun week for some, but I’ve worked constantly since it started and slept little, including leaving HIStalkapalooza right after the band started so I could write that night’s recap. On the other hand, Mrs. HIStalk was waiting with open arms when I got home today and I’m calling it an early night tonight, so I expect conditions to improve steadily, at least until the pre-dawn commute to the hospital Friday morning. We’ll just clean up some loose ends tonight and I’ll be back in the usual swing Saturday for the Monday Morning Update.

And just to be clear, although nobody has complained: we write up what we think are the important, interesting, and amusing aspects of HIMSS. We don’t do it to make those who couldn’t attend feel left out – we do it so they’ll feel like they were there and didn’t really miss anything. I’m sensitive to reading about someone else’s good time, but it’s not that great a time when you’re taking notes all day and spending hours writing them up at night.

OK, was I the only one to do this (multiple times, in fact?) I was ambling along the exhibit hall aisle and rounded a corner a bit too sharply, stepping my inside foot into inches-deep swanky booth carpet and nearly falling over from the immediate, one-sided deceleration. Or this, a couple of times: I impulsively grabbed a freshly baked chocolate chip cookie from a booth and chomped down, but was horrified to get napalm-hot melted chocolate chips all over my teeth and fingers with no easy way to clean it off.

Since Medicomp was so gracious to sponsor HIStalkapalooza, I’ll give them a little more exposure with this video shot from the show floor as users went through brief Quippe training to earn their iPad (I’m in one snippet, I noticed). I think I recognize a couple of the docs who went on camera.

Here’s Vince Ciotti, debriefing after his industry history presentation Wednesday afternoon. I had joked that he should wear a Mike Brady costume to his presentation and sent him the link — darned if he didn’t do it. If he had some mascara, he’d look like Alice Cooper in his 70s heyday.

E-mail me.

HERtalk by Inga 

From Gossip Girl: “Re: Epic. A CIO to me explained Judy’s strategy. Epic is cutting the price on a lot of deals, especially the more prestigious health systems. If Epic has a couple of years that aren’t profitable, she can afford it and she doesn’t have investors to answer to. She realizes that these health systems make big HIT decisions only once every 10 or 15 years, so Epic needs to get in there now and hope that over time the health systems will keep buying more product. Meanwhile, the second-tier health systems see Epic getting all the wins and decide they need to get Epic, too. And those guys aren’t getting as sweet a deal as the top tier.”

From EMR vendor: “Re: HIStalk luncheon. Thank you for the great lunch today. I met some great people at my table and will have a follow up meeting with one of them.” Mr. H and I were thrilled to hear it provided a good networking opportunity. I mentioned in an earlier post that several competitors happened to sit at the same table and I and wondered how often folks like Girish Navani, Michael Sterns, and Evan Steele have lunched together. A reader suggested I’d be surprised how often it likely happens, since those folks collaborate as members of the EHR Association. For the record, two of these three told me they had never met the others before then.

From Greg Wilson: “Re: thanks. Just a quick note to convey my thanks. We had a lot of fun as a group and I had a lot of fun being a part of it. Very sincerely, thank you for the opportunity to be part of the ceremonies. It means a great deal to us.” Greg (regional sales VP for Salar) was the official HIStalk King and Queen judge and did an excellent job. I am not sure if we have complete video of his presentation, so you will have to trust me that it was wickedly funny. He gets bonus points for wearing his HIStalk Booth Babe sash in their booth for the rest of the show.

From Broke But Connected: “Re: exhibit hall Internet. Yes, it costs $1,500/day. We thought it was outrageous. I guess they figure whatever the traffic will bear! Do you think HIMSS gets a kickback on it???” Someone is clearly making serious money.

From Loyal Fan: “Re: HIStalkapalooza. It was great, but I think the music was a little too loud and it was too dark. The conference provides a great opportunity for people who haven’t seen each other in awhile to connect. They can listen to loud music at home.” That is great input. I’m sure that over the next few weeks Mr. H will continue to reflect on things and start thinking about next year.

Allscripts definitely had one of the most hopping booths. I liked its layout because it had a theater right in front and was quite open throughout. I hear Allscripts had over 1,000 people at their event at the Hard Rock Live (I had an invite, but missed it.) They also made a few product announcements, but they haven’t surfaced in my overflowing inbox yet.

I have concluded that I greatly favor the booths that are wide open with the product demo and people at the edges, as opposed to those that you have to enter in order to check out what they are offering. For example,the configuration of the booths for McKesson and Siemens (and to some extent NextGen) were a little intimidating. I almost felt I needed an invitation before walking in.

I thought Ingenix had a huge booth. Turns out it wasn’t quite as huge as I thought. They were right next to another vendor with the same red color scheme, so it appeared the two were one. Ingenix was featuring its various acquisitions and I just thought the vendor next to them was just another new division. Funny.

Orlando traffic, at least around the convention center, is insane. Fortunately my hotel was relatively close and I walked the 15-20 minutes most of the time. Wednesday I was weary and decided to ride the bus. Long story short, I got on the wrong bus and it took me 40 minutes to get back. After dropping off my things, I decided to take a cab back over to the Peabody. There was a limo in front and the guy said he had to drop a group off at the next hotel over and then would take me. So I shared the limo with artists who were performing for NextGen (they told me they practiced a lot). While it was fun chatting with them, that limo ride ended up taking at least 20 minutes because of the traffic. Sheesh.

JB walks the red carpet. Check out the gorgeous dress.

JB announcing the HISsies. Look at the size of the crowd.

I asked quite a few people what the “buzz” was. I think there is generally an agreement that we are past the Meaningful Use frenzy in terms of aligning with vendors. At this point, most people are either committed or at least pretty far down the line in the EHR selection process. Now people are looking a little more into the future and trying to figure out what tools they need for likely Stage 2 and 3 requirements (the HIE booths were busy) and for establishing ACOs. Meanwhile, everyone knows they must cut costs and improve care, and there are literally hundreds of niche vendors offering everything from tracking systems, infrastructure alternatives, and RCM add-on utilities. Obviously Meaningful Use and ICD-10 will remain the priorities for the next few years, but I think health systems are going to become increasingly interested in finding these more peripheral products, if they indeed offer a meaningful ROI or transform care. And likely the McKessons and Ingenixes will look to buy many of these smaller companies so they can sell more into their existing base. I wonder if over the next few years the number of individual HIMSS exhibitors actually declines.

I am now home and thanking my lucky stars that I don’t travel for a living. The Orlando airport was a zoo and it took me almost 30 minutes to go through security. While sitting at my gate, a couple guys (clearly vendors) were remarking that it looks like the economy has finally turned around, based on the heavy interest they saw this week. Maybe, maybe not, but that’s a pleasant thought to end the week.

 E-mail Inga.

Overheard HIStalkapalooza Comments
By Evan Frankel,  MD-IT (roving reporter wearing a memorable jacket)

Jonathan Bush:  “You can only interview me if you buy me a cigar. It is principled.”

DrLyle: “I can’t believe that people aren’t asking more questions. For smart people, they accept way too much.”

Dr. Gregg Alexander: “I have heard about college savings funds for children. I don’t have one.”

Dr. Christ Pavlatos: “The shiny and flashing buttons are lovely. As a trained medical doctor, a seizure episode could result from focusing too much on the flashing lights. I would think that the person that causes the seizure is required to resuscitate them — it’s only fair. The buttons are all conveniently located in the cardiopulmonary level, which is easy to focus too much eye attention on.”

Bill Fera, Ernst & Young: “Are you an HIStalker?”
Evan: “I am here, aren’t I?”
Bill: “Are you Mr H?”
Evan: “Nope, I am just a schmuck in a velvet jacket.”
Bill: “That you are. Baba Booey.”

Louann Whittenburg, Medicomp: “I love your coat. Is that velvet?”
Evan: “It is.”
Louann: “We are going to have fun tonight. I am very excited for people to get inside and start to drink, dance, and have a good time.”
Evan: "Me, too."
Louann: "I think your coat is awesome. It is perfect for this party."

Jonathan Bush: “I gotta be honest, I don’t actually read HIStalk. I have other people read it and I say, ‘What did it say?’ and then I am like, ‘Oh.’”

Jonathan Bush: “I did not know that Mr H takes the quotes verbatim from our conversations, and so I say all kinds of shit and I am expecting a lot of conversation back and forth between our PR guy and Mr H. on what he’ll actually  put up there. I mean, shame on me. It has happened more than once.”

Jonathan Bush: “We can’t predict anything. We don’t even know what Stage 2 Meaningful Use looks like. Do you think the ‘e’ at the end of Crowne makes it fancy?”

DrLyle: “I went to Washington and started asking them the tough questions. They don’t want to hear it. There is no easy answer to hard problems sometimes.”

Jonathan Bush: “I wouldn’t do anything that is resident on one device, iPad or otherwise. Make millions of little apps. The biggest growth prospect in healthcare is the little app. We want to drive business through our ecosystem where you do the R&D. You make hundreds of them and the one people all really like is the one that pays for all of the rest. Even if we grew our R&D department 30% each year we wouldn’t be able build all of the apps you can. Be agile, get them out there, get in front of the doctor. You just got the first interview on the athenahealth ecosystem. You kids take this stuff and go and make apps and make money. I don’t care. I can’t make it all and everyone else sucks. Figure out the APIs and then go build something cool.”

Dr. Amanda Heidemann: “It is great to see all these well-dressed people out for the night. I think it is hysterical how many people follow the blog and wanted to come to this party. Did you stop on the red carpet? I was so nervous. Can you go get me another glass of wine?”

Mrs. John (Denise) Glaser: “I think he (John) takes in all in stride. I mean, he is here. I actually believe John has a lot of respect for Jonathan Bush. It looks like you all are having a lot of fun. I like your jacket a lot.”

Jasmine Gee, athenahealth: “I am having a blast tonight. I think this is the most fun you can have at a conference. Why aren’t you dancing?”

Ash Gupta and Jonathan Baran of Healthfinch: “I am very happy to meet you, this is a real honor.” (they were talking about meeting Jonathan Bush and interrupting my private cigar and beer time with him. I wish they had said that about me.)

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From JJ Canuck: “Re: Oracle. I was visiting the Oracle booth (was trying to figure out their integration engine story … which is ‘coming out.’) The sales guy said they will announce a ‘big deal’ in the next week or so about a partnership with a ‘big vendor’ that will provide badly needed HIE capabilities and some other vague set of features. When I asked if it was Cerner, he just smiled, giving me the indication that I had made a good guess. Sore feet and off to Universal for the last wonkfest. Maybe I’ll throw-up that $9 bean burrito I had at lunch on the roller coaster with Neal Patterson sitting behind me. Daydreamin’.” You remind me that I forgot to complain about predatory convention center food pricing: a soda out of the machine was $3.25, a chicken salad sandwich was $9, and a banana was $3. That last one’s especially maddening since I buy a big bunch of them at Sam’s for half that amount.

From Jay: “Re: best marketing tee shirt ever. From backup vendor Mozy’s booth at HIMSS.” It’s a bit of a stretch, but almost funny. I tried their service a few months back and it was a pig on my PC, so I removed it and went with SugarSync.

From Andrea: “Re: HIStalk. LOVE LOVE HIStalk, you, and Inga. How would a small biz like us (VAR) compete with the big bad vendors unless we had inside dirt on them? Keep up the fantastic work and have fun at HIMSS!” Thanks — we love you right back.

From Fred: “Re: Meditech. Announced on Saturday that they would be getting modular or near modular certification for their HIS software. They reported that it just required some paperwork and would be completed soon.” I’ll mark this as Unverified since I was given related information off the record a couple of weeks ago.

From Leotards: “Re: Noteworthy. That’s a snarky comment made by an underperforming mid-level manager or sales rep no longer with CompuGroup Medical, I presume. Rick Mullins is gone; there’s been quite the shakeup of the existing C-suite amongst all the companies CompuGroup Medical US is merging into a single entity. Supernumerary chiefs of all stripes are being relieved of their individual fiefdoms as NoteWorthy,Healthport, Visionary HealthWare and Antek HealthWare are all subsumed by CompuGroup. Sweeping positive changes have been instituted, our flagship products are being strengthened and developed, and all this accomplished without sending out huge swaths of pink slips as sometimes happens with these acquisitions. I’m just a field rep in the trenches, but I’m quite pleased to now be part of CompuGroup Medical.” Unverified.

From J.B.: “Re: Meditech. The Meditech/LSS deal is finalized. They still haven’t straightened out any arrangements of staff, but LSS is still going to be called LSS.  It is now a ‘wholly owned subsidiary’ of Meditech.” Verified – Meditech has posted the news on their site.

From Dichotomy: “Re: HIStalkapalooza and sponsor lunch. You have to repeat these in Las Vegas! It was really great meeting together.” We’ll see how it goes, but I would definitely like to do both again. It was really nice (but nerve-wracking, especially for Inga) to briefly say hello to our sponsors and for me to be flanked by those lovely and whip-smart (but suddenly mute) ladies. Since I almost never see actual HIStalk readers in person, I asked for a show of hands of how many people felt they knew Inga, Dr. Jayne, and me personally even though we haven’t met. A surprising number of hands (a majority, I’d say, maybe more than that) went up. That was gratifying since we definitely feel connected to our readers and sponsors whether we’ve met them or not. I’m glad that comes across.

From Tech Doc: “Re: innovation. Saw Napochi at HIT X.0 Geeks Got Talent on Monday. Showed a 3D body module of their EMR used to map IVs and such which integrates with their flowsheet and physician note. Didn’t find a booth, but their website has a video of them demoing a touchscreen whiteboard replacement. Pretty neat stuff.”

From Kate the Sponsor: “Re: HIStalk. I just wanted to say thank you for the wonderful events at HIMSS! I really appreciate what you both do. HIStalkapalooza was a blast, loved the venue. I got there a little late, however, and missed the awards – are you going to post the full awards section on the site? I did see the highlights in the video Inga posted which were great. I’m sorry I missed the hilarious red carpet commentators — I felt like I was watching E! I also really enjoyed the sponsor lunch yesterday. It was great to break bread with fellow HIStalk fans and sponsors, but really the true highlight was having the three of you make an appearance. And, Inga, the handwritten thank you notes were so sweet. That must have really tired your hand out to write all those yourself, but the personal touch was really special. Thanks again for all you do for the industry, looking forward to next year!” Thanks for those nice words. I’ll get the HISsies list up when I get back to the comfort of a full-sized keyboard and dual monitors since there’s a lot of typing involved. I hope the lunch attendees whose notes were written by me (Inga and I split them) could read them since my handwriting is pretty bad. I said there that we are proud to be amateurish and my handwriting is a testimonial to sincerity backed by a total lack of polish.

From Suzanne: “Re: HIStalk. No doubt you are inundated with work, e-mails and miles and miles of walking this week, but I just wanted to send you a quick note to thank you for a great lunch today (and great party last night). We are thrilled to be new HIStalk sponsors – and not just because of free food and drinks! As a small, newcomer vendor in a tiny 10×10 booth at the far end of the hall and among the ocean of booths at HIMSS, it has quite literally been amazing how many people have come up to us, saying they have specifically sought us out.  When we ask how they have heard about us, many have said through HIStalk. I was a little skeptical of advertising on HIStalk at first, thinking that the majority of readers may be vendor types, but that is clearly not the case.” Thanks – you are too sweet. We won’t recommend a product we haven’t used ourselves, but we will get readers the information they need to allow them to qualify their own interest. I’m happy we can do that since it benefits both vendor and prospect. According to the survey I just finished, 83.4% of HIStalk readers say they have a higher level of interest in companies we’ve written about. That’s flat out amazing and we don’t take that responsibility lightly.

For me and many/most attendees, the HIMSS conference is over. Maybe you’ll see Michael J. Fox flying into MCO as you are flying out since he gets to speak to the few folks sticking around for Thursday sessions.

Tomorrow is traveling home day, and while I’ve really enjoyed being here, I’ll be even happier to get back to my familiar routine, PC, and wife. A ton of people were sitting in the grassy area outside the Lobby C area of the convention center this afternoon. It looked like a capitalist Woodstock as attendees in suits sprawled awkwardly in the grass (I saw one guy fully face down on the lawn, suit and all, reading a book). I bet most of the impromptu sunbathers were heading back to snow and gloom and figured they’d better get sun now or else wait a couple of months for it to find its way back to them. 

The weather was good today — it’s a perfect and breezy 78 as I write this close to sundown and kids are having a ball in the pool right outside my window. Walking back to my hotel, I could smell wood smoke from a steakhouse, blooming flowers, and a little tang of ocean salt in the air. For most folks going home, they’re going to be smelling smoke from the fireplace, flower-scented air fresheners in closed and airless rooms, and salt from the treated roadways. No wonder people like to vacation here, even though Orlando is culturally bankrupt, jammed with traffic, and filled with people who’ve lived her for decades and yet won’t quit calling New York and Ohio “home.” Those are issues that only the locals care about.

I’m behind on e-mails from the traveling, the conference, and our events, so bear with me as I try to catch up this weekend. I think people sometimes forget that it’s just me on the other end and I’m working a lot of hours.

Here’s the bad news for all you folks (including me) who are proudly taking new iPads home won as prizes this week: the iPad 2 comes out next week, so that new one you bagged this week is already obsolete even before you even get to strut it in front of your admiring families. Doh!

I got some e-mails from execs of some of the vendors I mentioned yesterday as ignoring my “I’d like a demo” booth body language to give them a second chance. I did so today, with mostly the same results. I should mention, however, that my title and hospital name on my badge wouldn’t necessarily make me a likely candidate, although the small font size makes it unlikely that they ignored me for that reason. Today was the last exhibit day and nobody was paying much attention to those of us still roaming the exhibits late into the afternoon. Mostly I saw reps talking on the phone or sitting together in their couch / table areas making dinner plans or cursing as they spoke animatedly among themselves (I’ve noted that young, male sales reps seem to curse a lot in each other’s company – it’s like using profane emoticons).

And speaking of that, I also do not identify myself to vendors, even those I exchange e-mails with or those who tell me to ask for the CEO or other executive personally. I’m a mystery shopper – I want to be treated exactly the same as anybody else (or as me in my day job role).

Our King and Queen judge Greg Wilson from Salar got this picture today with John Templin and his long string of badge ribbons. I’m not sure Greg knows the history – John does this every year, usually as he’s trying to raise money for the HIMSS Foundation. You saw him on stage this morning as the keynote started.

A CapSite survey finds that 23% of hospitals plan to use consulting help to get their clinical systems up and running.

Franciscan Alliance will roll out Epic at its 13 hospitals and 165 practices. The cost: more than $100 million over the next two years.

UK Healthcare will implement Allscripts EHR/PM and integrate it with a new version of its Sunrise inpatient EHR.

Jordan Hospital (MA) lays off four managers (IT, quality, pharmacy, and diagnostic services) and VP/CIO Dennis Fonseca.

New PatientKeeper CPOE customer: Madison Memorial Hospital (ID). Going live on the same product: Ashe Memorial Hospital (NC).

CollaborativeCARE Conference signs a deal to bring in HIMSS to run a one-day education program during its first conference this coming November.

Wednesday Keynotes – Kathleen Sebelius (HHS secretary) and David Blumenthal (national coordinator)

• I don’t know if I’ll ever get used to Steve Lieber’s spiked-up hair, which I noted as he read a suck-up HIMSS proclamation honoring Kathleen Sebelius for taking money away from taxpayers and giving it to much richer vendors and doctors.
• It’s a given: everyone in politics and government will always publicly praise their wise, hard-working, and selfless bosses (Sebelius-Obama, Blumenthal-Sebelius).
• Sebelius said that of 231 vendors of certified products, 2/3 of them have fewer than 50 employees, and “any one of them could be the next Google or Microsoft.” Really? With 230 competitors and few takers for most of them until the Cash for Clunkers EMR program came along? Maybe she meant the next Google Health or Microsoft HealthVault.
• She talked about the country’s health. I’d still argue that EMRs just make the treatment episodes arguably more efficient. It’s what people do when they’re not sitting in front of a provider that’s expensive. Someone should create a business model for wellness and population health. She didn’t mention any of those things.
• She said you can’t just advocate the technology – you must advocate an improved healthcare system.
• She lauded Blumenthal’s “doctor perspective” (he supposedly still sees the occasional patient, although he’s had muckety-muck Harvard jobs for so long it would be interesting to see how many and how well).
• Blumenthal was a pretty good speaker, just a bit quiet and monotonic and very careful with his words (I actually liked his style). He said he was naïve about what could be accomplished at last year’s HIMSS conference.
• He said 21,300 providers have signed up as Meaningful Users and $20 million has been paid out under Medicaid. The Medicare payments will start in May.
• He said the timetable for Stage 2 will be challenging, but reasonable and achievable.
• He cited 62 Regional Extension Centers enrolling 6,000 providers each week.
• He said that colleges have trained 3,400 people in HIT and the goal is 10,000 per year.
• “HIE is a team sport that requires local coaches.”
• He said the system was deficient in quality measures, population health, clinical decision support, and interoperability.

Exhibit Hall and Session Notes

• A reader asked me to check out Lawson. They were pitching ACO support, Cloverleaf, scheduling, HR management, and ERP. Their booth was pretty dead, but it was a bit early. They had coffee and popcorn. The booth looked nice (curvy yellow sofas and quiet demo areas) and the wall posters made it clear they have a lot of products. I can’t say I had a reaction either way.
• Another reader asked me to stop by Candelis Astra, which offers some kind of workflow cloud solution stuff for radiology and images. That’s all I know because of the five reps in the booth, two were on their phones and the other three were sitting around a table deep in their own conversation. One did pop around the corner and ask if I wanted a demo, but I was committed to walking away at that point. Still, they did ask, so I give them credit for that – I was just being stubborn.
• I dropped by Clairvia and still didn’t get much attention, but the over-the-shoulder demo I watched looked really strong and a big competitor admitted that when it comes to clinical scheduling and acuity, Clairvia is better. It’s a slick-looking product.
• I talked to one vendor’s rent-a-booth-babe. She says she likes HIMSS because it’s conservative. I asked what that meant and her answer was basically that this week’s vendor-employer didn’t make her come in nearly naked. Apparently vendors often do.
• The OnBase magic guy is the best ever. Not only is he funny and really good at riffing (“Step closer, the trolley is coming … I just saved  your life, dude”), he even knew a lot of product stuff, like when someone from HP was there and he knew details of OnBase’s partnership with them. I keep thinking maybe he’s an employee who just happens to know magic, but if so, he’s darned good.
• NCR had their HIStalk sign out. I played with their wayfinding kiosk and it was cool. The rep played me perfectly, letting me poke around while offering just enough conversation to make me feel engaged
• A reader asked me to find out what Epic’s Canto runs on. It’s iPad-only, the rep told me. I have to say those Epic kids are really pleasant and helpful.
• I like the big sign on Healthland’s booth: “We’re not for everyone – bringing a certified EHR to rural hospitals.” Bravo – how many companies would just leave it wide open in the hopes that Cleveland Clinic or someone like them might get fooled into buying it? I admire helping prospects qualify themselves. Well done.
• Orchestrate had their HIStalk sign out – thanks! I saw President Charlie Cook there.
• I looked over someone’s shoulder at Shareable Ink and it seemed pretty cool, but I didn’t really get to see any of the form-filling part, just the end result.
• A reader (or maybe it was the vendor – I forget) asked me to drop by Proxense, which does proximity-based security, I think. I’m guessing because the rep said hello and nothing else, so I did the same. I checked out their Web site and it’s not very well designed (note the hover text  over the Sales menu item that says “some sort of tagline about sales.”) and makes it hard to figure out what they do. They’re probably engineers from the looks of things.
• I stopped by HT Systems/PatientSecure several times and was anxious to see their palm biometrics in action, but that didn’t happen. There was some other company’s business development guy hogging their time (talking rather than listening). I think I would have saved that conversation for non-exhibit hours if I were him and if I were the company, I’d have some video or something since it’s a highly visual product and a conversation-starter (or so I assume, not having seen it). I’m pretty sure it’s cool.
• I watched a theatre presentation of Nuance’s new Healthcare Development Platform. It sounded interesting: products connect via HTTPS to Nuance to run speech recognition (support provided for iPad/iPhone/iPod Touch OS, Windows Mobile, and any browser). Five lines of code turns a text box into a speech recognition field that then runs its Clinical Language Understanding to extract structured data and map it. They’re offering a free 90-day developer’s license when it goes out of beta in March or April.
• The only good educational session I attended during the entire conference was today, a really good one on medication barcoding. It’s what you always hope for but rarely get at HIMSS – one guy describing in super-concentrated form all the problems his hospital solved when rolling out medication barcoding. I’ve never seen a session that was so meaty, full of real-life pearls, and pleasant to watch. The pocket guide says only Session 165, Still. Whoever Still is, kudos. No self-indulgent posturing, no fluff, no teasing in the hopes you’ll hire him or his company to finish the story – just really good experience shared. People actually clapped and meant it and the audience questions, instead of the usual droning pontificating, were insightful and on point. My faith in humanity was restored.
• A reader asked me to check out Success EHS, a Birmingham-based PM/EMR vendor. Like almost all Southern vendors, they were very nice and friendly. The product didn’t look all that much different than other EMRs, but it does run the MEDCIN engine and it had a cool Meaningful Use dashboard that shows real-time stats on how individual docs or groups are doing in hitting their numbers. Most impressive is that they charged nothing for that module or any of their Meaningful Use upgrades. I mentioned that I’d won an iPad and the young lady rushed off to give me a super-nice case for it, saying, “I bet you didn’t win one of these.”
• I dropped by former sponsor Apelon thinking I could find a few nuggets to mention just to be nice, but they didn’t have much to say.
• A pretty cool guy from Software AG skillfully pulled me from flowing exhibit traffic to chat. They’re the company giving away the electric guitar that Inga was bragging on playing. They have a rules-based SOA integration platform that can monitor streams of data and do trending and alerting. It’s a platform aimed at vendors and technically astute hospitals and I didn’t understand all of it, but they gave me a couple of cool books that I’m going to read: Process Intelligence for Dummies and SOA Adoption for Dummies.
• Siemens roped me into a five-minute 3D demo of Soarian that was a complete waste of time (and maybe not even a demo since I don’t recall seeing actual screens). The glasses were kind of cool, but the only 3D effects were some lists and video clips that looked like they were floating and the guy narrating live was a bit too over the top for me. It also seemed to be of the “we suck less than before” variety, proudly listing #2 in one category, “improving” in another, etc. I would have worked harder on the message and less on the medium.
• The best thing I saw all conference was Medicomp’s Quippe (pronounced “quip”, by the way), which I checked out only because Inga, Dr. Gregg, and Dr. Jayne were all raving about it and I figured I was the guy to neutralize the Kool-Aid (or IngaTinis) they’d obviously been given. Didn’t happen: it was way cooler than they said. It’s really iPad optimized, allowing dragging templates over to the work space, supporting insertion of pictures with a variety of annotation tools, and some proprietary gestures that are really cool. For example: drag on a vital signs table, write 101.5 with your fingertip on any blank part of the screen, draw a little L over the temperature field, and your 101.5 is instantly converted to text and dropped into the box (or you can use the on-screen keyboard if you’d rather). I don’t know much about ambulatory systems, but what impressed me most is that when you choose a given symptom, tabs open up unobtrusively that show previous encounters for that patient in which those same symptoms were reported. It’s just a very dynamic, fluid app that really wouldn’t work as well on a non-tablet platform. I’ll not call it a “game changer” since my cohorts have overused that phrase when referring to it, but I’ll call it as ingenious and as physician-friendly as anything I’ve ever seen. I saw another vendor’s implementation of the current MEDCIN engine and it was nice, but not in the same league (that vendor confided that they can’t wait to get their hands on Quippe to add it to their product).

E-mail me.

HERtalk by Inga

From The HIStalk Queen: “Re: HIStalk queen contest. My name is Janet Skinner from Skinner and Associates Executive Search and thank you! I won the HIStalk Queen contest and I wanted to thank you very much for the nice IPod Touch prize! Wanted to thank Dave Lareau and Medicomp for a fantastic party! Fun idea to include the shoe contest (what woman doesn’t love shoes?!) and the IngaTinis were fantastic, as you warned they would be. I must have had more than one if I pulled off winning the queen contest, but I think the group I was sitting with had a few too many IngaTinis of their own and their loud cheering tipped the scales in my favor. Would love to see the Histalkapolooza an annual event, great fun… and again, thanks so much for inviting us!” Hard to believe this was our fourth HIStalk party (though the first HIStalkapalooza).

Bill Fera, MD, of E and Y was our HIStalk King.

From Your Fan: “Re: Red Carpet Gals. The red carpet greeters are my CEO Jennifer Lyle and account manager Kara Heward of Software Testing Solutions. As a matter of fact, Jennifer won the Inga Loves My Shoes sash last year and still proudly displays it in her office. They had a fantastic time with the HIStalk readers who were great sports and the Medicomp men in the tuxes would have made Stacy & Clinton proud! We’re glad you had a great time and can’t wait to join you next year.”

The only way our shoe judge Lindsey of RelayHealth could have been more cute here was if she’d had more sleep Monday night and if you could have seen her gorgeous shoes.

Kronos: seriously, at least 100 people were in line trying to win one of the five iPads. I feel badly that I won one seeing how many people would have liked to win.

I shared a cab with the NextGen artist guys!

Assessments for the day:

• BlueCat: girls in cat woman suits. Really? I suppose they really looked fabulous and I am only jealous that I can’t pull it off like they could.
• David Blumenthal: watching paint dry probably could have been more exciting than listening to him as a keynote speaker.
• Meanwhile, Katherine Sebelius (who I swear was wearing the same suit as she does in all her head shots) was explaining to HIT professionals what healthcare reform and ARRA meant. Really? The place was packed and some folks had to watch on closed-circuit TV from the hallway.
• Thank you MEDecision for the Starbucks coffee. It was worth the 20-minute wait in line just to overhear Practice Fusion CMIO Robert brag that the company now has 70,000 users.
• The OnBase heckler was pretty good. He called out the “lady in pink” to come over and hear his deal. Very fun.
• IDS: good job and giving me the one-minute pitch you do.
• Pulse guy (who just started shaving last week): ask who your audience is before you start explaining why buying an EMR today is important. Most of us already are pretty familiar with Meaningful Use.
• From one very smart CEO: I figured out how much it cost us per hour to have people here and it is about $7,000. They better be standing on the corner of the booths trying to sell and not checking messages on their smart phones. Good advice that a lot of vendors should have heeded, including some that I kind of wanted to check out. Like CattailsMD, Azzly (the second time I came around), Wavelink, and a dozens of others.
• Thank you, Sage guy, for showing Health Unity. Yes, I noticed you looking at my shoes because you suspected I might be Inga. Integration is not all there yet (those blue screen errors are a dead giveaway) but the embedded integration will be cool.
• George at Sophos: I couldn’t pronounce your sexy Greek last name, but you were adorable.
• I loved the fondue at EDS. Wish more exhibitors (like Meaningful Use Monitor) had bottled water.
• Ingenious Medical: nothing like having a cute girl wearing high heeled blacked boots to bring in the crowd. Definitely not practical for a three-day show, but who the heck cares?

So much more to say, but Mr. H is ready to post. I will do my best to read my cryptic notes and share more tomorrow.

E-mail Inga.

EPtalk by Dr. Jayne

And now the end of HIMSS11 is upon us. I was surprised to see the exhibit hall as full as it was today. Usually by this point, folks are losing stamina, but at least around the noon hour there was still a veritable sea of navy blazers. I did see several ladies sporting running shoes with their suits, and although I stuck it out in the comfy yet stylish heels, I was a bit jealous.

I also saw quite a few people sporting the bright yellow clog slippers given out by ChipSoft. I stopped by to try to get a pair to mail to Inga as a gag gift, but was turned away empty-handed by the less-than-pleasant rep.

Several of you e-mailed over the past couple of days with thoughts on booths I should visit. I’m sorry I couldn’t get to them all. I gave preference to those that had a hook for why physicians would benefit from their products vs. those that just said, “Hey Jayne will you make an appointment with us?” It’s hard to make appointments when one is anonymous.

I ran into an old friend of mine, Vendor Boy, and asked him, as a veteran, what was the best thing he saw at the show. First place: the Epic booth. Second place: the kilt girls.

I agree with what Mr. H said yesterday. Many of the reps seemed tired and/or bored and some didn’t seem to care whether I was interested in talking about their products or not. I would have thought that with the badge scanners and RFID tracking there should have been some kind of “CMIO with purchasing and decision-making authority” alert like a Bat-Signal in the sky that could have shocked them back into action, but alas, several flat-lined. However, there were notable exceptions:

• OnBase, which does document management. With their sports bar theme, they were happy to tell me about their solutions. Our friendly bartender/rep was happy to show an iPad app that I didn’t see yesterday, which allowed quick on-screen approval of documents including annotation.
• Sage, which had a better showing today than when I tried to visit on Monday to see their new HIE solution.
• NCR, which was giving away autographed copies of the Newt Gingrich book Paper Kills 2.0 as a special HIStalk reader perk.
• Up to Date, which tried valiantly to entertain me while I waited to talk to a specific rep who I heard had a great story to tell, although I got pulled away and never did get to meet him.

I visited the 3M booth several times to try to find out about the new mobile app they told Mr. H they were launching. The people I talked to didn’t seem to know what I was talking about, but they did tell me about their coding support product that uses natural language processing to trigger patient care alerts from dictated text in EHR. Since I’ve seen a lot of care coordinators being let go recently (which seems short-sighted with Accountable Care breathing down our necks) that might be handy, but if that was supposed to be the mobile app, I’m not sure how mobile it was.

Personally I haven’t had good luck with the voice recognition software for mobile devices and most of our hospitals still use traditional dictation systems, so it’s not like the doctors are dictating daily notes directly into the system as they round.

TeraMedica had the guys in the colonial outfits with the tri-corner hats again today. Not sure how that plays with data migration, but they looked like they were having a better time than the ones who were in the booth on Monday.

I gave them a couple of days to spiff up, but Alcatel-Lucent still hadn’t ironed the white coats of the faux clinicians gracing their booth.

Emdeon awarded the iPad from their HIStalk reader-only drawing. The winner was very excited and even sent me a photo of the cute gift bag they packed it in. I’m always happy when someone goes beyond the expected, and delivering to the winner in style is much appreciated.

Props to the Hilton who accommodated my late check-out request and even smiled while doing it, allowing me to spend precious minutes poolside before I head back to the sleet and freezing rain that is surely covering my car. Maybe they could drive me home in this.

That’s a wrap for HIMSS11. See you next year in Vegas, baby!

E-mail Dr. Jayne.

Dr. Gregg Goes to HIMSS
By Gregg Alexander

“It’s late and I have a huge headache (no, I don’t drink, so it’s not a HIStalkapalooza leftover,) so I hope my observations come through better than they feel through the throbbing behind my eyeballs.”

OK, that’s how my post for Monday night would have started if I had not somehow hit “Minimize” instead of “Send.” I awoke Tuesday morning wondering why my post was absent and found that the headache cloud had somehow short-circuited me more than I knew.

So now it’s about 1:00 AM on Wednesday morning and I have just gotten back to snow-covered Ohio (I have a practice to run) and out of my HIMSS suit. I see Mr. H, Inga, and Doc Jayne have already posted for the night while I was traveling, so I’ve again missed out. (Sigh.)

So, this’ll be a mishmash of Monday/Tuesday and since I’m not, as I’ve said, a real reporter, I hope you’ll forgive my mark-missing tardiness.

MONDAY

HIStalkapalooza was a ball! Mr. H and Medicomp built upon the great groundwork laid last year by Ivo Nelson and Encore with the friendly venue, excellent food, free drinks, and a rockin’ venue. The red carpet entry, the HIStalk limo rolling up and down, and the Batman-sign-esque HIStalk light on the wall across from BB King’s set a superb tone for J. Bush, Dave Lareau, John Glaser, and the Insomniacs to rock the house all the way out. (Seriously, the red carpet entry and the gorgeous and funny red carpet interviewer ladies would have made even Billy Bush proud.)

The HIMSS opening session left me sort of … well, I actually left it, so I suppose that tells you how much I felt I was gaining. The typical HIMSS HIT rock show multimedia wasn’t enough to make the retread of “look how much we’re doing for the world of healthcare” seem worth enduring … again.

The 1,000-plus exhibitors made it appear that the economic downturn is over, at least in the HIMSS-associated halls. Exhibits stretched for what seems like a mile and from floor to ceiling. In fact, with so many vendors flying banners, signs, and rotating “come-see-mes” from the exhibit hall rafters, they all sort of drown each other out and it makes it seem like less of a good idea. I mean, if it doesn’t help people see where you are from across the vast exhibit hall stretches, is it still a helpful way finder device?

I got to enjoy many great conversations with tons of vendors and noticed one really impressive thing throughout: not once, not one single time did any one of them mention Meaningful Use during any of the conversations. It is possible my ears have started to become numb to it, but I’m pretty sure none brought it up. Not exactly sure what that implies, but I did enjoy the respite.

Loved the MED3000 demo of their incorporation of Medicomp’s Quippe tool. Providers – if you haven’t seen it, you should absolutely make the effort to check it out at either MED3000, Pulse, or especially the Medicomp booth where you might actually have a chance to walk away with a free version of it on a free iPad. I think it is perhaps the first, honest-to-goodness game changer (I see where Inga used this same term in her Tuesday night post) in the world of HIT to come down the pike since Larry Weed. Indeed, Dr. Jay Andres at MED3000 told me every single provider he’d shown it to had all made the exact same queries after seeing it: 1) How soon can I get it? and 2) Is it really as easy as it looks here?

RemitDATA has become a big HIMSS sponsor and has a pretty cool offering (at a GREAT price point) to help docs evaluate the financial side of their practices. Sort of athenaCollector-ish, but from multiple data capture sources.

Thomson Reuters is working on some great stuff for health education (and more) and also has some of the nicest people!

Soapware’s Randall Oates has a great new approach to the medical scribe concept: the Medical Coordinator. The MC sits in another room and listens in to a patient-provider visit, capturing the data and coordinating associated care management issues. No in-the-room intrusion and the provider can focus 100% of the patient. Now, that’s attractive … I am going to look deeper into this one.

athenahealth always has such a fun crew at their booth. Jonathan Bush was holding court (I got an short audience) in the central couch pit. It was just too much fun watching the procession of folks flowing in and out and the antics of the inimitable JB.

I’ve more, but my head has gone from throb to cannon fire…more HIMSS views tomorrow.

TUESDAY

Despite his humble protestations, Mr. H did a FANTASTIC job with the oratory when he, Inga, and Dr. Jayne made their first ever live-and-in-person show at the HIStalk sponsors’ lunch Tuesday and Maggiano’s. Inga’s boots were incredible and you could even see her just beaming, even through the surgical mask. They say they were Nervous Nellies, but they must cover well because it didn’t show. There was an absolutely incredible turnout with an amazing assortment of vendor bigwigs from all about the HIT world. A few glitches with food service aside, I think they did a knockout job. Mr. H and Inga even hand-wrote personal messages on thank you cards to each of the attendees and I overheard many comments on how nice or how funny the remarks were. All I can say is if you were invited and didn’t make it by, you missed out.

I had a sit-down with Dana Sellers of Encore. She is just as delightful to talk with as Ivo. I love their corporate philosophy and, especially, their slogan of “100% Referenceability.” Make your clients happy – all of them, all of the time. High standards, but their growth and abilities to attract and keep quality IT folks in the current market when those peeps are getting hard to find seems to add validity to their approach.

GE Centricity Advance is now shooting for docs in my neck of the woods (small practices). They seem to have learned some good stuff since I last looked at Centricity and their Mobile version, which is coming in Q2, appears to build even further upon those lessons. (Honestly, I never liked the look of Centricity, but the new Advance and Mobile stuff … much better.)

The trick shots on the pool table at the Iatric booth were very cool.

Ingenix says they’re now looking to thicken the relationships that have spread out so much in their recent buying frenzy. The buying may continue (as it will across the whole HIT market, eh?) but they want those thin ties to strengthen as they work to establish more “integrationability” (my word) across their many arms. Expect some rebranding soon. I like their stated open-to-sharing mindset.

Thomson Reuters has some really cool clinical decision support tools out or coming for physicians, pharmacies, infection control, pediatrics, and more which all benefit from the “same source of truth.” (I like that line.)

MEDHOST touchscreen tools and floor plans for EDs are not in my every day realm, but I really liked how they look and feel.

The Man & Machine waterproof keyboards and mice demo with waterfalls running over these tools was simple, slick, and effective. Contagion control is as, if not more, vital than data capture, I would wager to say.

Onyx and Stinger Medical had some really cool-looking carts and display tools for hospitals that just looked smart.

I felt like Maxwell Smart in the Unity Medical “cone of silence.” I want one.

Lastly, I noted how irritated I kept feeling as I tried to take in as much as I could in my limited window of time at HIMSS. Then, a quick calculation helped me realize it was a “setup for failure” kind of event. With somewhere around 1,000 vendors, if you only spent one minute with each, it’d still take over 16.6 hours to see all there was to see. And, that doesn’t even include the Interoperability Showcase, the education sessions, assorted keynotes, or bathroom breaks.

What a show.

E-mail Gregg.

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From Another CIO: “Re: VIP lines. My title is CIO, but it isn’t worth the ink to print it if all of our staff aren’t working together to accomplish everything that needs to get done.  To this end, I am literally embarrassed to hear about a ‘VIP Line’ at the HIMSS conference and wouldn’t be caught dead in one.” I’m sure HIMSS rationalizes its VIP treatment of CIOs by citing the vendor bucks chipped in to provide them with closed-session speakers, food, break rooms, and other perks. It also used to bug me that there was always an area where vendors could book time with HIMSS-pimped CIOs if they were willing to pay the CIOs cash for a ‘briefing’ (i.e., I’ll pay you to listen to my sales pitch). I suppose their other excuse is that it’s even worse than that at CHIME but  nobody’s complaining because non-CIOs aren’t invited there. Some hospitals have strict policies against executives accepting vendor gifts (“touch that vendor demo bagel and you’re fired”) but the rules doesn’t seem to extend off campus.

From All Hat No Cattle: “Re: Marc Overhage of Regenstrief. Resigning and going to Siemens. We received the announcement earlier this week and had an emergency medical informatics faculty meeting yesterday. Bill Tierney is taking much more of a leadership position initially and the search committee for the next leader of Regenstrief Medical Informatics has been formed.  He is fast tracking this search and we still hope that the next Chair of my department will also be a high level medical informatician.” Apparently verified, at least according to people who said they saw Marc wearing a Siemens badge at HIMSS.

From Florida Flash: “Re: Noteworthy Medical Systems. Continues cratering. Rick Mullins is now the former president and CEO. I guess the bright idea of getting rid of all the sales force, using a lead gen company, and then hiring salespeople back to work the leads didn’t work too well.” Unverified. Rick Mullins is still listed on the executive roster. I should have asked the folks in the CompuGROUP booth today when I was checking them out since they own the company.

From Digger: “Re: ONC. It was asked in the physician symposium what would happen if docs just sit on the EMR sideline until penalties kick in, and then either retire or stop seeing Medicare patients. ONC gave a politician’s non-answer.” It’s a fair question – there is a built-in assumption that doctors will voluntarily give up money rather than opting out of Medicare or hanging up their stethoscope. I overheard someone’s recommendation about shifting value of EMRs back toward the provider and away from the insurance companies: charge patients a $5 per visit surcharge and build a marketing plan around explaining to patients why that’s a good value. I also had another reaction: if doctors had any kind of pricing power, maybe the EMR burden would be lessened since they could charge more to cover their lost productivity. I still like the model of paying them to contribute their data for others to use, which would provide incentive for them to choose whatever product best meets their needs and implement it in a way that optimizes those contributions of patient information. If you were paid X dollars for a contributed H&P or other data set, Uncle wouldn’t need to be in the EMR bribes business.

From Zensocrates: “Re: Allscripts. Encouraging votes for Stephanie Reel is funny given JHM is negotiating with Epic to replace SunriseXA.” Unverified, but commonly known, I think.

From InfoNurse: “Re: HIMSS. Is that Elvis! No, that’s Neal Patterson! By golly, he’s coming to HIMSS11 on Wednesday. Just a walk-through after the lovers’ quarrel and breakup with HIMSS in San Diego. Must be coming to get the pie.” Cerner was a little shifty in mentioning a HIMSS booth number, but it was actually in the IHE section and not a real Cerner booth on the regular exhibit floor. Someone told me Cerner has a room in the convention center, though. I think I knew that vendors can book rooms out of the public eye to entertain right in the convention center. Speaking of The Pie, Neal did win again and I need to post the other HISsie winners, but I may do that when I get back home where I’ve got a more comfortable keyboard.

From Jay: “Re: AHDI/CDIA. CEO Peter Preziosi resigns.” They say they’ll miss him “sorely” and the announcement is gushy in general, so it sounds like it was his choice. The former Medical Transcription Industry Association just rechristened itself as the Clinical Documentation Industry Association.

From Mobile CMIO: “Re: Epic Canto. I have a working sample of the iPad app. Even though it is version 1.0, it is fast, great interface, and embedded dictation tool. I expect this to be quickly and enthusiastically adopted by our medical staff when we go live.” I mentioned Canto yesterday when I saw a poster for it on the outside wall of Epic’s booth.

The big acquisition announcement of the conference so far: Harris Corporation will buy identity management and integration vendor Carefx for $155 million. Obviously Harris wants more of the healthcare IT market than just its government and military business. The deal must have been struck awhile back since the Carefx booth had printed Harris information today that wasn’t an obvious last-minute add on.

Our other rumor was correct: TriZetto will acquire revenue cycle management vendor Gateway EDI.

One more acquisition: Scottish charge master vendor Craneware buys ClaimTrust for $20 million. The Tennessee company offers revenue cycle and auditing solutions, allowing Craneware to inflate its tagline to “automated revenue integrity solutions.” According to the ClaimTrust site, hospital revenue cycle consultant Joe Ferro and his programmer wife started the company in 1998. A nice exit for them.

HIMSS released its online survey results today. The Meaningful Use chase continues to draw a disproportionate share of hospital attention despite possibly more financially critical projects such as ICD-10 and preparing for healthcare reform.

We had a little lunch today for our sponsors, with Inga, Dr. Jayne, and me appearing in disguise for anonymity purposes (lab coats, surgical caps and masks, and reflector thingies). Thanks to Dr. Gregg for coordinating and Ed Marx for delivering a speech before we slipped in, did our thing, and headed out (I don’t know what he talked about, but I’m confident it was excellent). I can’t say we deliver an inspiring or polished performance for several reasons: (a) we have never appeared as ourselves in person and we were quite nervous about that, especially Inga, who Dr. Jayne and I thought sure was going to throw up on the sidewalk on the way in; (b) I had just met Dr. Jayne for the first time in the car (I like her – a little bit sassy and brash in a doctorly way); (c) we weren’t really sure what we should talk about; and (d) we’re writers, not talkers, so our oratorical skills are modest at best and Inga and Jayne declined to say anything at all once we got in the room (thanks a lot, gals). It was great to see everybody, though, and we really appreciate the support and the chance to say so in person. It would have been really cool to hang out for awhile, but we’re paranoid about anonymity since we’d rather not become unexpectedly unemployed. Inga wore the fab boots that I got her for Christmas and pics of those are going viral, she says. On the way in, some guy did a double take while checking our getup and asked if there was anything he should know. I told him we had the outbreak nearly under control.

Thanks to Dr. Gregg for choosing BB King’s for HIStalkapalooza way back in the fall and working up the menus and details. I liked the scale of the venue and the acoustics were good. Above is a red carpet picture from reader Rick. Below are some reader pictures – thanks for those.

If you’re at HIMSS, here’s my recommendation of a cheap, fun local place to eat that’s an easy walk up the street just past Pointe Orlando (one of my pals urged me to share it with you after I took him there even though he was paying and trying to steer me to high-end places). I’ve eaten at Miller’s Ale House probably 40 times over the years and it’s always good. The beer selection and prices are amazing, the waitresses are cute and fun, and you’d be hard pressed to find a better entrée than the $12.50 Bahamian dolphin baked in a foil pouch with garlic, wine, Tabasco, and vegetables. The blackened grouper sandwich is good, too. Start off with the excellent conch chowder and you’ll feel like a Florida native. I’d invite you to eat with me there except my doctor disguise wasn’t all that comfortable.

AT&T’s ForHealth division announces new products and pilots: a smart phone interface for its Healthcare Community Online portal, telepresence, and mHealth Manager.

Passport Health Communications announces a partnership with Bayfront Medical Center (FL) to beta test its precertification / prior authorization product, OrderRite.

I forgot to mention this the other day with all the HIMSS crush: athenahealth names former AMICAS CEO Stephen Kahane, MD, MS as president of the company’s Enterprise Services Group.

Merge Healthcare CEO Jeff Surges brings over some of his former Allscripts colleagues: Steve Brewer as EVP of solutions and Steve Martin as SVP of sales (please hold the arrow-through-the-head jokes since I’m sure he’s heard them many times).

McKesson announces its $1.5 million funding for six mobile health projects related to diabetes. The next grant cycle starts in April.

The folks behind the Extormity EHR and SEEDIE certification parodies come out of the closet: it’s NoMoreClipboard.com.

Allscripts announces its version of the Apps Store and demonstrates “native” integration between Sunrise and its Enterprise and Professional EHRs. I don’t know what “native” means when you have products developed by different companies whose only commonality is current ownership, but I’ll assume it just means you don’t need an integration engine or middleware. I heard a couple of times today that they’re doing a really good job, although whether it will be enough to fight the Epic juggernaut is anybody’s guess (actually, I’ll guess no since it’s late in the game, but kudos for going after them).

Cedars-Sinai picks Encore Health Resources to help with the next stages of  its EHR implementation.

Keane Healthcare Solutions Division announces a mobile client for its Optimum system.

Ross Martin provides this picture of the next challenge for IBM’s Watson, accompanying his funny writeup. “They also believe there is a place for synthetic vocals in pop music today. Andy Aaron, who lead’s Watson’s speech team, says, ‘We’ve hired will.i.am as a consultant to figure out how he makes his voice do that cool, computery voice thing and mimic that.’ Apparently, IBMers have not discovered Anteres Auto-Tune.”

GetWellNetwork announces GA of GetWell@Home, which allows discharged patients to use care plans, teaching tools, and personal health information created for them in the hospital.

From an athenahealth-Sermo survey of physicians about EMRs: three-fourths say they’re good for patient care and two-thirds say they’re worth the money, but 60% say EMRs slow them down. Still, 95% of those docs surveyed will seek Meaningful Use money. Other concerns involve the future of small practices, the impact on patient care of the Affordable Care Act, and the quality of medicine in general down the road.

Drummond Group announces its certification program for hospital EHRs that cover multiple or self-developed applications. The whole “complete EHR” Meaningful Use issue came up in the X.0 session I attended today, where vendors either don’t seek modular certification or decline to sell their offerings piecemeal, making it unclear whether a provider using or owning only specific modules can still claim to be using a certified EHR. ONC really needs to clarify this since it’s a mess and integrated systems vendors have little incentive to clean it up.

Palomar Pomerado Health announces Medical Information Anytime Anywhere (I’ll give them one-time dispensation for making Anytime one word when it should be two). Vendors already offer their own iPhone and iPad apps, but the hospital’s product works can assemble a single view of information from multiple systems (vendors don’t offer that, of course). Cisco covered half of the $250K cost of developing the prototype, but it will take lots more cash to turn it into a stable, off-the-shelf product (which is the hurdle that 95% of hospital-developed apps can’t clear).

Voalté hires former Ritz Carlton quality director Gigi Gray as user experience manager.

Exhibit Hall and Session Notes

• CCT, which offers training contracting services with emphasis on clinical systems, is holding mock training classes on the hour in booth # 5769.
• NCR announces new versions of its portal and kiosk products.
• The X.0 people seemed crestfallen that their beloved Twitter feed was down, forcing people to actually ask their questions instead of Tweeting them.
• Someone’s session talked about cost savings from IT, leading me to ask myself this: cost savings to whom? If you cut costs, you’ll just increase insurance company profits in most cases. They don’t often reduce rates even when their costs goes down. And second, hospitals are so inefficient that they never reduce rates when their costs go down, either. Even if technology allows cost savings, who gets the money?
• In a session on mHealth, one thing was clear: much of the variation in cost and outcomes is because patients are non-compliant. I was thinking that perhaps that’s why our outcomes and costs are so bad compared to those of other countries – our people are fatter, less motivated, more likely to be stressed in their quest for consumer bliss, and often unwilling to make even modest effort to improve their own health. That’s not something that providers can influence very much.
• I checked out a couple of products in the New/Emerging Technology part of the exhibit hall. Oddly enough, people from these startups seemed mostly uninterested in connecting with people looking at their offerings and neither of them offered me a demo despite not having much else to demand their attention. Expert-24 had Virtual Expert, a decision tree generator that looked a good deal like Visio and can supposedly be used by non-programmers to build simple applications that collect information or step through decision support steps. Canadian vendor MedConnex had a simple EMR. I would have had more to share if they had shown more interest.
• I said yesterday that ESD was the most creative vendor given their tiny space, and that’s not even counting the ultra-cool sign I saw in their booth today that I missed then. It said, “Big brother is not watching you,” explaining that you could visit them without being tracked because they opted out of the idiotic HIMSS vendor technology to track attendees with RFID like stray cattle in the exhibit hall. Kudos to them.
• Clairvia didn’t offer a demo of their scheduling and acuity apps despite broad hints from me that I was interested and a conversation of several minutes in which I asked about it, but I can say it looked very cool on the screen I saw.
• I will say that in general, booth people seemed out of energy today. Many of them were fiddling with their phones, talking to each other instead of paying attention to passers-by, or just sitting and staring at the floor. Maybe vendors should send in a fresh team on Tuesdays since many of them were letting prospects walk away without getting any recognition. I keep thinking about the cost of buying a booth just to give reps a place to sit, chat with each other, or talk on the telephone.
• I got a nice pitch from Healthcare Innovative Solutions, which provides consulting services specific to CPOE and EHR. They have a a good story.
• A company called ESET was giving out personal one-year licenses for the company’s antivirus product. I’ve never heard of them, but they say they’re replacing McAfee and the big boys pretty often because their product is more lightweight and doesn’t download huge updates, with their average update being only 18K in size. I’m going to install the license they gave me on my PC at home. I wish I could replace the one at work since when it cranks up once a day, it sucks the life out of my laptop for a couple of hours, not good news when there’s a technical or clinical emergency to deal with.
• Blue Cat Networks had a couple of girls in sequiny, skin-tight costumes that could have passed for spray paint. Just saying. Like many of the pretty females working booths, they were a bit cold, which I guess is the result of being leered at all day.
• Prognosis also didn’t offer a demo or pay much attention despite my broad hints of interest, but the product looked good on the screen shots.
• The folks at C3 Partners explained their Meaningful Use Monitor, a tracking tool to document MU status, ready to submit (after Stage 1, which does not require anything more than attestation, apparently).
• Google had a crappy little booth with – no lie – black and white photocopied sheets about Google Health that had been cut in half. They had a total of four PCs for demoing, which was three more than they needed at that point in time.
• Stoltenberg Consulting was offering free chair massages, which I could definitely have used if they had picked up on my obvious interest (clearly I get miffed when I’m ignored, but at least unlike the average attendee, I can call them out publicly on behalf of all of us).
• MediQuant had an excellent magician with some fun product pitch mixed into his patter. Definitely worth checking out. The guy will read your nametag clear across the aisle and call you by name to get you drawn into his tricks. You won’t mind.
• SSI was the company from Inga’s picture that had females wearing evening gowns.
• Someone asked me what I thought the big theme is this year. I don’t think there is one. iPads are cool, but not all that different, ICD-10 and tools to migrate to it are obviously on everybody’s radar. Other than that, nothing would distinguish this year’s conference from the last two or three. Everybody’s talking innovation, but I don’t see much if it out on the show floor. You tell me – what’s the coolest thing you’ve seen?

I have no further HIStalk responsibilities and I’m not leaving until Thursday morning, so let me know if you’ve seen something I should check out.

E-mail me.

HERtalk by Inga

Yes folks, that is my brand new iPad. I was one of Medicomp’s lucky winners. And yes, Medicomp was our amazing HIStalkapalooza sponsor and they also made me the proud owner of a cool toy. Regardless, their new Quippe is a serious game changer. I looked at the technology that is embedded into MED3OOO’s Integreat product and was amazed. Today I saw Medicomp demonstrate it further and I am convinced that every EMR vendor needs to check out this technology. I haven’t seen any product with anything similar and I am convinced that it’s the way of the future. I realize that I am such raving without giving details, but I will have to go back to that another time.

So this is going to be a totally rambling post, so hold on for the ride.

HIStalkapalooza: OMG I had an amazingly fun time. I must ask Mr. H who the red carpet gals were, but they were gorgeous and hysterically funny. Check out the YouTube video and see for yourself. Many folks came dressed to the nines, including our Inga Loves My Shoes winners and all the finalists for HIStalk King and Queen. If you were a winner, send me a note so I can mention your name. Our judges Lindsey and Greg were the most adorable and funny things. If Lindsey hadn’t been a judge, her pink stilettos would have surely won.

Ingatinis: I had one in the SIS booth yesterday as well as one at BB King’s. The original won over the newbie, though that didn’t stop me from drinking them at BB King’s.

Mr. H, Dr. Jayne, and I treated our sponsors to lunch today. We made a brief appearance and Mr. H said a few words. I rarely get anxious or nervous, but I was a wreck this morning. Thanks to the 100 or so that showed up and showed us the love. One of the sponsors told me that his table included someone from eClinicalWorks, Allscripts, Greenway, and e-MDs, and the NextGen guy came over to say howdy. How often do guys like that break bread together? I wish I could have heard what was being said.

HIMSS isn’t over yet, but already the conference has hit a record number. 30,947 so far, compared to an estimated 27,800 last year in Atlanta.

There are over 1,000 exhibitors, which means it is virtually impossible to check them all out. However, I asked my new BFF Dr. Jayne to join me for a peek at a few EMRs. For whatever reason, we had difficulty getting anyone to show us stuff, usually because people were too busy. We tried to look at Azzly, which I had seen in MGMA in October. It’s brand new and is having its first practice go-live in a couple months. It is cloud-based, so our demo was over the Internet. Apparently the Internet connection was horrible and thus it was impossible to get a feel for the product. Azzly does not offer a local version as a compliment to its hosted version. It’s a little scary to think of all the potential problems of having an Internet-based only product, though everyone is going that direction.

Another vendor said he had to pay $1,500 a day for high-speed Internet access in the booth. I think I heard him right. Could that number be correct?

Dr. Jayne and I also tried to check out Practice Fusion. Apparently they had similar Internet issues and were only providing demos on one small screen. The cute young guy working the booth told me that only about four of their clients go for the ad-free version of their product. When I interviewed Practice Fusion CEO Ryan Howard a couple of months ago, he wouldn’t share that number, by the way.

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Software AG is raffling a hot-looking Fender electric guitar. I gave it a test drive and totally impressed the booth staff.

I did a quick walk through the Interoperability section. There was apparently a speaker at the little theater in there and the crowd was  20 people deep. If you look really hard, you can see a speck that looks like David Blumenthal.

Speaking of Blumenthal, am I the only person who has noticed that SRSsoft’s Evan Steele could be Blumenthal’s better-looking brother?

Second best “trinket” after the iPad: a stainless steel coffee traveler cup from MedAssurant.

Cute fedora hats at FormFast, I think. They are apparently giving them away. I am not sure what it all means, but they also have a pseudo-juggle thing going on in their booth with lots of foliage adornment.

So much more to say, but I scored an invite to one of the big parties, and well, what’s a girl to do?

E-mail Inga.

EPtalk by Dr. Jayne

The highlight of today was stopping by the HIStalk sponsor lunch with Mr. H and Inga.  I felt like a rock star arriving in the HIStalk limo, but the looks on the faces of other patrons at Pointe Orlando at seeing the three of us in our white coats and surgical caps was priceless. We appreciate your sponsorship and thanks to all of you for welcoming me as the newest member of the HIStalk family.

The best thing I saw in the exhibit hall today was Medicomp’s Quippe offering, which they were demoing on the iPad.  Using the MEDCIN Engine as its backbone, it allows for creation of dynamic templates for documenting patient care, allowing physicians to customize while still mapping to recognized findings behind the scenes so that it all works for coding, compliance, and interoperability. You can see it at work also at the MED3000 booth as they have integrated it into their product.  As many vendors move to map to SNOMED and other standards, this approach is one that should be given serious thought.

And as more and more physicians express a desire to have templates that build the note on the screen, this type of functionality should be easier and easier to integrate into existing products.  Of course, some docs still aren’t going to like it, and there will be the ever-present debate over whether findings should be documented in clinical terms vs. patient terms.

I’d be interested to see what physician readers think about this idea – knowing that patients are going to have more and more direct access to their charts, are you changing the way you document? This is a fundamental issue that all of us are grappling with. How are you handling it?  Since Medicomp also gave iPads loaded with Quippe to the physicians attending HIStalkapalooza, let us know how you like it after you have a chance to try it. Drop me a note and I’ll write it up.

Thumbs down to the food court today, when the machines ran out of Diet Pepsi.  Sounds like quite a few of us are trying to avoid the extra sugar that comes with the caffeine that keeps us going.  Even for those who choose the full-sugar versions, at least we’re burning some calories with the trek through the convention center.

I’m still tuckered out from HIStalkapalooza. It was nice to see so many “real” physicians in attendance and I enjoyed talking with some of you. I also enjoyed talking with those of you who are suits – it was nice to share war stories and make some new connections. 

The awards ceremony was priceless and this being my first HIStalk party, I’m glad my expectations were exceeded. Looking forward to many more to come!

Tonight I swung by the Compuware bash at Cuba Libre with my wingman. Great atmosphere (a little heavy on the cigars, though) and reasonably good Mojitos. Enjoyed the heavy dance beat and the excellent people-watching as the night wore on.

Tomorrow’s my last day at HIMSS11, so if there’s something you think should be on my "must see" list, e-mail me.

E-mail Dr. Jayne.

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