News 2/18/11

From Klinger: “Re: HIMSS. Here’s a link to a HIMSS presentation (PDF) on its policy priorities for 2011.” It says only around 20% of hospitals are at or above Stage 4 in the seven-stage EMR Adoption Model. There’s more stuff on policy that didn’t really interest me too much.

From Allscripts Person: “Re: your ONC poll. This explains the biased results.” Apparently someone from Allscripts sent an e-mail to all employees urging them to vote for Stephanie Reel. From the e-mail included, “To show our support for her, we want you to visit the HIStalk Blog and vote for Stephanie Reel … She is currently in the lead – let’s make make sure she wins!” She’s got 62% of the vote so far. I think she would do a fine job just like she’s done at Hopkins, although all of the ONC-heads so far have been physicians and she isn’t one. She would be good at establishing consensus since she’s responsible for IT throughout Hopkins, not just Johns Hopkins Medicine.

From WildcatWell: “Re: Apple. Does not want to get anywhere near the liability threshold of having the iPad as the hardware interface of choice for true EMR/CPOE encounter usage.”

The VA and DoD are closing in on agreement to use a single electronic medical records platform, according to VA CIO Roger Baker as quoted by the excellent NextGov. The article quotes a source as saying the winner will probably be the VA’s VistA, with the loser being DoD’s AHLTA. That’s a huge decision and a likely windfall for the usual contractors who will have to tweak whichever system wins to appease the pouting loser. The chair of the committee says the departments spent a combined $10 billion to create the two systems, which I’d bet is a low number intended to hide the real cost (especially of AHLTA, which is surely one of the biggest HIT boondoggles in history).

IBM, Nuance, and the University of Maryland School of Medicine are working to turn the Jeopardy-playing IBM Watson computer into a physician’s assistant, analyzing real-time information against the literature and making suggestions. They’re hoping the computer can make sense of the hodgepodge of scanned and discrete data and make it all searchable.

Parrish Medical Center (FL) chooses McKesson’s Horizon Clinicals, HERM, ambulatory EMR, and RelayHealth solutions.

Let’s have a word about our benevolent and fun HIStalkapalooza sponsor, Medicomp Systems. They’ll be talking at HIMSS about Quippe, their just-announced Web-enabled, browser-based, interoperable EMR tool that gives physicians a touch screen interface backed by the MEDCIN Engine for handling the codes needed for compliance and reimbursement. Check out the video above of it running on an iPad and stop by Medicomp’s booth (#2231, I believe) to check it out, meet the party architects, and maybe see some video shot at HIStalkapalooza running from Tuesday on (you never know what people will do after a few IngaTinis). We have quite a few practicing physicians coming to HIStalkapalooza and Medicomp will honor them during that event (hint: make sure to show up). That’s Dave Lareau starting off the video – he’ll be your emcee and will oversee the red carpet interviews. I haven’t told anyone but Inga this, but I had a beauty queen sash made for Dave that says, “I Paid For All of This.”

University of Kansas Hospital (with the illogical abbreviation of KUHA) and CSC announce their development of the CareVeillance clinical surveillance tool, which analyzes data from multiple systems to provide alerts and quality metrics.

Dave Miller, executive director of application systems at the University of Chicago Medical Center, tells me that he has accepted the position of Vice Chancellor for Information Technical Services/CIO at the University of Arkansas for Medical Sciences in Little Rock. 

A report suggests that the HITECH gold rush is hurting the PACS, RIS, and CVIS markets as hospitals divert IT budgets to fund EHRs. It predicts that vendors of those systems will have to discount as they fight a share of a smaller total market, at least through 2013.

On the HIStalk Job Board: Project Manager – Healthcare Implementation, Implementation Consultant, Healthcare Informatics Analyst. On Healthcare IT Jobs: RN Clinical Informatics Transformation, Director Implementations EHR/PM, VP Business Development, Meditech PCM Implementation Analyst.

Ivo, Dana, and the Encore Health Resources crew are famous for throwing relaxing, no-pressure, open-ended social events (“Pub Nights”) at HIMSS, where the game plan is basically: (a) anyone who feels like it just shows up and eats and drinks for as long as they want to hang around, and (b) Ivo pays. Our pal Amy says you are all invited, every night at 9:00 from Saturday through Wednesday except Monday, at the bar at Tommy Bahama’s. It’s right up the street from the convention center and hotels at Pointe Orlando, the same complex as BB King’s (swanky in a tropical way). Encore isn’t exhibiting at HIMSS, but I’m sure they wouldn’t mind talking shop with prospects, old friends, and potential consultants about their offerings (IT planning, EHR implementation and optimization, analytics, and project management). I’m planning to be there at least one night.

More HIMSS fun: if you’re staying in a hotel on or near International Drive north of the convention center, be on the lookout Monday and Tuesday morning for a limo with my smoking doc logo on both sides. It will be cruising the circuit between the convention center and Sand Lake Road, offering rides to the convention center to anyone who flags it down. I thought that would be a nice gesture to the folks staying in the less expensive hotels up the street who don’t have the luxury of the short stroll over from the Rosen or Peabody (not to mention that it’s good HIStalk PR to have the logo riding around in plain sight). Take advantage of it so I’ll feel like I got my money’s worth. I’m not sure of the color, but it’s a 10-passenger stretch and I doubt there will be many of those on I-Drive early in the morning.

Merge Healthcare announces Q4 numbers: revenue up 139%, EPS $0.10 vs. –$0.03. I interviewed new CEO Jeff Surges a couple of weeks ago.

Welcome to new HIStalk Gold Sponsor CCT Solutions, Ltd. of New York, NY (and London). This is an interesting business: the company provides software training for big clinical system rollouts like CPOE, clin doc, bar coding, etc. They can provide a large number of instructors plus 24×7 on-site go-live support, which hospitals are rarely staffed up to effectively do themselves. They’ve handled some impressive volumes, training 16,000 employees of Continuum Health Partners and proving up to 500 support staff. Some of their other clients include Beth Israel Medical Center, Broward Health, and Albert Einstein Health Network. They’ll be at HIMSS and would be happy to chat. Thanks to CCT Solutions for supporting HIStalk.

I got an e-mail from Grady Memorial Hospital (GA) SVP/CIO Deborah Cancilla, asking for a “retraction of the information posted” in my mention that the hospital was laying off EMR contractors to address a budget shortfall. I replied that I really couldn’t retract anything since all I did was link to AJC, which quoted CEO Michael Young directly (“Part of the staffing cuts will likely include temporary and contract workers who were brought in to set up the hospital’s new electronic medical record system, Young said”) but I would update my post with whichever of the three possibilities she would verify as the problem: (a) the paper misquoted Mr. Young; (b) Grady changed their mind on the “likely” cuts; or (c) Mr. Young’s statement was incorrect. Michael Young e-mailed me that he misspoke – the cuts won’t affect the contract workers. Deborah also wanted to clarify that the $40 million cost for Epic is the five-year budget. I appreciate the updates.

Thanks to new HIStalk Platinum Sponsor InSite One, now a Dell company. InSite One focuses on cloud-based digital medical data management solutions: data archiving, disaster recovery, and digital health data exchange. The company’s cloud-based, intelligent vendor-neutral archive and its disaster recovery services are offered from within Dell’s Unified Clinical Archive solution, which allows clinicians to share patient information regardless of the PACS, modality, or application that created it. I interviewed Mitchell Goldburgh, who talked about infrastructure simplification, the company’s one-time fee per image that allows customers to stay current on technology without spending capital or managing infrastructure, and the 3.6 billion objects and 54 million studies they are managing in a single archive. I learned a lot from that interview. Thanks to InSite One for supporting HIStalk.

Telemedicine systems vendor New Mexico Software will offer second opinion teleradiology services directly to consumer, charging the customer’s credit card to have one of its remote radiologists review their digital images.

FDA relaxes its pre-market review standards for low-risk medical devices, such as hardware that stores glucose meter readings or that sends lab results to nursing stations.

I’m not sure whether I’ll do a Sunday update from Orlando as a substitute for the Monday Morning Update. I’m sure I’ll run something, provided my hotel’s Internet connectivity is better than the last HIMSS in Orlando, where I had to sit around with the convention center cleaning people until late to latch onto the free WiFi to write HIStalk once it became clear that my hotel’s connectivity was worthless. Safe travels to everyone. If you’re staying home and your bosses are allegedly working hard at HIMSS, feel free to goof off next week. We’ll have lots of updates from Inga, Dr. Jayne, Dr. Gregg, and me.

E-mail me.

HERtalk by Inga

From Henrietta Winston: “Re: HIStalkapalooza. Tell Inga my most special shoes are placed out by my suitcase – ready to be packed. Unfortunately, my footwear is not as snazzy as as hers ): but I will wear jewelry that will make her claws come out!” Thanks for sending Mr. H this warning so he can hold me back, just in case. I failed to mention this before, but bling is absolutely encouraged to finish off your outfit Monday night!

Another day, another data breach. Charleston Area Medical Center warns of a “security incident” affecting 3,655 patients. Apparently a hospital-generated spreadsheet containing names, birth dates, addresses, and Social Security numbers popped up when a patient’s brother-in-law was searching for her address. The hospital says the data was viewable for four months and the site was viewed 94 times before it was shut down. Most hits came from authorized personnel, but one came from India, another from Germany, and a third from a private proxy service designed to anonymously download information from a Web site.

Strong Q4 numbers from athenahealth: revenues of $69.4 million compared to $54.4 last year, an increase of 27%. GAAP net income for the quarter was $7.3 million ($.21/share) and non-GAAP adjusted net income was $98.8 million ($.28/share). Analysts expected earnings of $.20/share and revenues of $67.60 million. athenahealth also mentions that as of December 31st it had 3,348 active providers using athenaClinicals, including 2,383 physicians, compared to 1,471 providers and 920 physicians at the end of 2009.

No surprise here:  achieving Meaningful Use is the top budget priority this year for 75% of hospitals. Over half say physician adoption of EMRs is the biggest obstacle for achieving that goal. The same Imprivata survey found that physicians are using more mobile devices and about half of hospitals either use or plan to deploy virtual desktop infrastructure.

HITArkansas narrows its list of supported EHR vendors to 12 finalists, including Allscripts, eClinicalWorks, e-MDs, Ingenix, McKesson, and Sage. The REC is now working with the vendors to establish pre-negotiated and vetted contracts based on a negotiated base price.

Two thousand clinicians and staff at Genesis Healthcare (OH) are using BIO-key fingerprint biometrics to establish identity in Genesis’s Epic software for meds administration. Genesis will also deploy fingerprint biometric user logon with Vergence, the SSO solution from Sentillion.

Intermountain Healthcare (UT) opens its Homer Warner Center for Informatics Research, which is dedicated to optimizing the use of information in health and biomedicine. The center employs about 60 people, but Intermountain CIO Marc Probst says they could add a couple hundred more over the next decade.

As others have  mentioned, my inbox is overflowing with pre-HIMSS press releases. I’ve said this before, but it bears repeating: your company needs to work on its marketing pitch if takes a reasonably smart person (like me) multiple reads to figure out what exactly the company is trying to sell. KISS, as it were.

Ingenious Med introduces an iPhone/iTouch/iPad app that gives users access to the Ingenious Med charge and data capture platform.

I believe this would qualify for a bad day at the office. An ER patient uses a doctor’s stethoscope in an attempt to strangle his doctor. Apparently the patient became combative during his exam, and when the doctor tried to use the stethoscope, the patient attempted to wrap it around the doctor’s neck. Felony assault charges are pending.

I spent about an hour today attempting to map out my HIMSS game plan. I am sure that I am overly ambitious and I’ll run out of time and energy long before I’ve seen it all. I’m wondering if I will really make that 7:00 a.m. breakfast (what was I thinking?) and even an 8:30 start time Tuesday sounds torturous (post-HIStalkapalooza and all). Then there are the 900+ exhibitors to check out. And of course I’ll need to make time for a few HIStalk updates so readers at home can live vicariously through my adventures. I’m exhausted just contemplating it all.

By the way, I downloaded HIMSS11 mobile app for my iPhone and it’s pretty handy. The best part is the ability to search for the room number of individual sessions as well as exhibitor booth numbers. Far better than carrying a paper schedule – or asking for help.

See you in Orlando!

E-mail Inga.

Sponsor Updates by DigitalBeanCounter

• Mediserve client Burke Rehabilitation Hospital (NY) becomes the first post-acute care hospital in the country to achieve HIMSS Stage 6 certification.
• MedCentral Health System (OH) selects MobileMD to provide health information exchange to its medical community using the 4DX HIE product.
• McKesson awards Peninsula Regional Medical Center (MD) its 2011 Distinguished Achievement Award for Clinical Excellence based on its use of Horizon Clinicals to drive improvements in care. Peninsula decreased its sepsis-related mortalities 37% since October 2009 and attributes its use of technology and process change for saving 77 lives.
• MEDSEEK announces an 833% growth in sales in 2010. MEDSEEK also introduces ecoSmartTM, a targeted marketing solution with predictive modeling capabilities to customize a patient’s online experience based on user behavior.
• ICA releases a series of white papers offering guidance on health information exchanges, including issues on interoperability, technology, Meaningful Use, and privacy.
• Ashe Memorial Hospital (NC) deploys PatientKeeper CPOE and PatientKeeper Physician Portal. The hospital will next implement PatientKeeper NoteWriter.
• Beth Israel Deaconess Physician Organization contracts with Ingenix for its Impact Suite of software. The Impact solution will provide analytics to measure clinical performance and reduce variations in care.
• Picis announces its Perioperative and Critical Care solutions version 8.3, which includes automated medication interaction checks, a content library, and a quality reporting portal.
• InSite One completes integration testing at the IHE North American Connectathon and the InDex technology passed testing for conformance to the IHE technical frameworks. You can experience more of InSite One’s technology at the HIMSS Interoperability showcase.
• Enovate announces its e900 series of wall arms that allow clinicians to maintain eye contact with patients while working on the keyboard.
• New Brunswick’s Stan Cassidy Centre chooses Orion Health Patient Portal.
• EDIMS says it experienced a successful 2010, which included  a sale to Saint Barnabas Health Care Systems, New Jersey’s largest healthcare system. EDIMS also signed a unique agreement with Clara Maass Medical  Center (NJ) to provide onsite medical services at Red Bull Arena.
• Greenway Medical collaborates with HP to offer practices EHR solutions running PrimeSUITE 2011 EHR and HP hardware. Also, Greenway client Children’s Clinic of Muskogee (OK) is the first pediatric practice in the country to qualify for Meaningful Use funds. The clinic’s four providers are set to receive an $85,000 check, which will be handed out at the HIMSS conference.
• Orchestrate Healthcare will give away a free Apple MacBook Air at HIMSS. Booth 6151.
• Philips introduces a Philips Recorder for iPhones and iPads, which turns the device into a wireless dictation dictation recorder and works with the SpeechExec Enterprise suite.
• Shared Health and Health Language partner to use HLI’s Language Engine in Shared Health’s web-based applications and products. In case you missed it, Mr. H interviewed George Schwend of Health Language here.
• UNC Hospitals chooses Carefx’s Fusionfx Physician Insight Plus performance improvement dashboards.
• John Muir Health (JMH) and MuirLab contract for AT&T’s HIE solution, Healthcare Community Online.
• Speaking of AT&T, its partnership with Vitality to make Vitality Glowcaps (mentioned in a previous HIStalk) wins the 2011 Global Mobile Award.
• AHA Solutions announces an alliance with HIT research and advisory firm CapSite, which offers hospital executives due diligence and RFP information from hundreds of vendors.

EPtalk by Dr. Jayne

The pre-HIMSS mailings have finally tapered off, but I did receive two fairly funny “personalized” emails this week. The first was from a vendor whom I’ve repeatedly told that I am not interested in meeting with, addressed to me but sent to my brand new administrative assistant, who dutifully replied on my behalf, not realizing this was bulk mail and that if they really had a relationship with me and had left me a voice mail as they stated in the e-mail, that they wouldn’t now be spamming her.

The second one was from a voice recognition vendor with minimal proofreading skills, apparently missing the fact that EHR had been changed to HER before bulking it out. I hope their product has better translation abilities, but we shall see.

The first reader has responded to my challenge to create a funny Xtranormal clip about implementing technology in the healthcare realm. Love it!

Friday is the last day for the RelayHealth Facebook contest. I’m delighted to see wine and chocolates making the list, as my Valentine’s Day was a little lacking in both and I’m looking forward to making it up. RelayHealth published pictures of the gift bags for participants on their site – tres cute – so vote for your favorites (although they didn’t post my shameless attempt at entering myself, I’ll be sending an anonymous helper to try to score a gift bag, so be on the lookout). If you’re stumped for something to suggest, drop me an e-mail.

I’m off to pack my suitcase and wondering if I can meet the fashion bar that Inga has certainly raised, but wanted to share some recent reader questions before I head to warmer climates:

Dear Dr. Jayne,

What’s up with all these CMIOs who haven’t seen a patient in years, walking around in white coats with stethoscopes for necklaces? Just curious.

Dean

Dear Dean,

This just may be one of the greatest mysteries in health care. One thought is that these physicians are locked in an internal struggle between losing their clinical identity and realizing that they have become far too fluent in Administralian. Maybe this is their way of subconsciously saying, “Hey, don’t forget me, I really still am one of you!” I can sympathize with them when they have to walk through the hospital and see their colleagues on rounds being “real” doctors, although that doesn’t justify the behavior.

Unfortunately, this condition has another insidious manifestation. This is where doctors insist on wearing the white coat out of the clinical office for no reason whatsoever. I can understand if you have an administrative meeting and have to run from rounding or seeing patients to another on-campus building, but that doesn’t explain why one of my colleagues insists on wearing the white coat to administrative meetings at our building, which is a six-mile drive from the nearest patient care facility.

Personally, I think it’s just a bit pretentious. And kind of gross — let’s carry all the germs from the clinical space into the administrative space. (Although, I guess that’s a good cautionary tale for my staffers who don’t want to get a flu vaccine because they don’t work in direct patient care – reminding them that they have to work with these chaps when they visit the IT shop).

I think the worst version of this condition is shown in those poor souls who wear scrubs (complete with surgical shoe covers) outside the hospital. Really, you couldn’t take two seconds to take the booties off? Or you’re willing to bring the contamination of the outside world back into the operating theater? Is it really that critical to let the world know you work in an operating room?

If any of my other CMIO readers have theories, I’d love to hear them.

Dr. Jayne

Dear Dr. Jayne,

Thanks for your comments on doctors using the computer in the exam room. My doctor has been using a computer for years. It is attached to a wall mount right inside the exam room door. He stands up to type on it while he is talking to me. He looks at me, answers questions, then looks down to look over the record or type in information. Why is this so foreign to people? We work every day with people who are putting information into computers, from airlines to the pharmacy. I’m glad he can look to see how I’ve improved my weight, HDL, etc. over the years without bringing in a five-inch paper record (which they never did before anyway, just why you were there today).

Betsy

Dear Betsy,

Thanks for your note. I agree with you, but it still seems to be a big deal for some people. I always enjoy when patients tell me they’re glad that we have the computer or comment on a way it’s made a difference in their health care. I think it makes it more real to be able to show patients graphs of their blood pressure, weight, lab results, etc. I’ve also used it to launch videos on patient care sites to teach patients how to do certain exercises I’m recommending, or to research bits of info patients say they saw on a Web site.

It’s funny how accepting this has evolved over time. When I started my first “paperless practice,” our health system newsletter ran an article about the transition and what made us different. The CMO of my hospital made a big deal of editing out the comment where I said I used the Internet to research health concerns while in the room with the patient. He thought it made me sound like I didn’t have all the answers and that patients wouldn’t trust a doctor that had to look things up.

Fast forward a decade and now we have savvy, empowered patients that understand that we can’t know everything and expect us to not only be using the technology to find the most up to date information, but pushing it out to them via secure portals.

Dr. Jayne

Have a question about medical informatics, electronic medical records, or whether doctors would want their kids going to med school? E-mail Dr. Jayne.