My colleague Dr. Doug Farrago (self-proclaimed “King of Medicine,” who I interviewed back in March) has recently renamed the Placebo Journal Blog to the Authentic Medicine Blog in an attempt to connect readers back to the roots of medicine. The blog is targeted at identifying medico-political barriers in the way of providers actually treating patients.

I have to give him full credit for sharing a recent article from American Medical News that helps explain why it is that no matter how much money the Medicaid stimulus plan pays to providers who adopt certified EHR technology, it will never be enough to reimburse them adequately for what they do. Following the Accountable Care Organization trend, Arkansas is looking to bundle Medicaid pay. Arkansas Medicaid Director Eugene Gessow proposes groups of “partnerships” that would parallel ACOs but will avoid being labeled as such. Seeing how successful Medicare ACOs have been so far, I’m skeptical. And now we’re going to do it with patients that, unlike their 65-and-up counterparts, are in and out of the payer’s coverage?

This type of restructuring may push some providers over the edge. Many providers are reluctant to accept Medicaid due to the increased documentation and regulatory burden compared to other payers. Many of those with Medicaid populations comprising 30% of their panels (20% for pediatrics) saw the opportunity to receive Meaningful Use payments as a way to try to obtain funding they sorely need to continue that mission.

To put this in perspective, I receive $24 per visit for Medicaid for a visit that with private insurance pays out at $65 to $80. Do the math – it’s increasingly difficult to continue to see patients whose reimbursement is less than the cost of doing business, and these tend to be more medically needy patients with significant socioeconomic-related health issues. Mr. Gessow states, “We need to stop paying fees for the process of treatment and instead reward the successful results of that treatment.” In short: we’re going to take the most medically needy patients and make payment for their care outcomes dependent? It certainly sounds that way.

I understand what they’re trying to do. I, too want to see more funding for care teams, social workers, and ancillary staff so they can work with the patients more directly, allowing physicians and other licensed providers to do what we trained to do rather than figuring out transportation issues and prescription vouchers. Those are essential services for many patients, but it doesn’t take an MD to do it.

Arkansas plans to rely heavily on existing EHR and other health IT systems to meet their quality goals. As an “IT guy” watching the havoc caused in the EHR industry by Meaningful Use mandates, I can’t wait for all fifty states to jump on the bandwagon and come up with a patchwork of state-specific mandates that will disrupt development cycles and create make-work upgrades for medical practices and hospitals. Vendors can barely keep up with state requirements as it is. I’m still looking for a vendor who can correctly render every state prescription blank, has state-specific immunization consent forms, and who ships out of the box with state-specific EPSDT forms for Medicaid child well exams.

Trading my “IT guy” hat for my scrub cap, as a physician, I just don’t see it as a reality in a nation where free will and self determination are key social tenets. Ultimately, it doesn’t matter how fabulous your IT platform is, how endearing your health coaches are, or how persuasive your clinicians try to be. If the patient doesn’t want to do what’s recommended, you can’t make them. No amount of clinical decision support or orders tracking can fix that one (although it does help the process of cajoling, bargaining with, and ultimately harassing noncompliant patients).

I’ve been doing quite a lot of travel lately, and have seen some things that as a physician make my hair stand on end. I have no idea how to successfully counsel against behaviors that patients continue to choose regardless of how negatively they may affect their health. Recent favorites:

1. Motorcycle riders without helmets (regardless of the law).
2. Establishments that serve daiquiris through a drive-thru window as long as there is tape over the lid, rendering the container “closed.”
3. Parents at the airport absorbed in their iPhone and iPod universes who ignore their stroller-bound children (folks, have you ever heard of reading a book to your child? It’s recommended by a variety of evidence-based organizations and my state Medicaid program requires me to counsel you on it or I won’t get paid.)
4. My bikini-clad neighbors on the beach, discussing their wrinkle-preventing Botox injections while sunning themselves to a color that I believe Crayola calls “burnt umber” while smoking (some days I really wish I had trained in dermatology).
5. Parent holding an unrestrained infant in the front passenger seat of the car (yes, I know some of us grew up without car seats and lived to tell, but it’s dangerous and illegal in 2011.)
6. Patients who want to talk about whether Kim Kardashian’s alleged gluteal implants would actually show on a radiologic study  (no kidding, I had this question) rather than their diabetes.
7. Patients who can name the starting lineup of the local baseball team, but not their BMI or cholesterol numbers.
8. Folks who take the concept of the “all you can eat” buffet seriously.

So, good luck, Arkansas Medicaid providers. I wish you well. Good luck to the IT vendors as you scramble to meet whatever regulations they come up with and to the clients who pay for customization while waiting for the vendors to achieve an aggressive go-live timeline for mid-2012. And finally, good luck to the patients who are unwitting participants in an experiment that wouldn’t pass most Institutional Review Board approval processes.

The only silver lining here is for the hordes of consultants that will descend, trying to figure out ways to secure their piece of the “savings” that Medicaid anticipates.

E-mail Dr. Jayne.

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Google makes it official: the company is shutting down three-year-old Google Health on January 1, 2012. Google predictably did what its know-it-all technology company predecessors have done over the years: dipped an arrogant and half-assed toe into the health IT waters; roused a loud rabble of shrieking fanboy bloggers and reporters (many of them as light on healthcare IT experience as Google) who instantly declared it to be the Second Coming that would make all decades-old boring vendors instantly obsolete or subservient to the Googleplex; and then turned tailed and slunk off at the first sign of lackluster ROI, leaving the few patients and providers who actually cared high and dry except for those same old boring vendors who have stuck it out for decades instead of chasing whatever sector looked juicy at the moment.

Why did Google Health fail? Simple and obvious: consumer demand for personal health records is close to zero, which has always been the case and probably always will be. Convincing patients to take the time and effort to maintain PHRs is as tough a sell as convincing doctors to voluntarily use CPOE, and for the same reasons: those doing the work don’t get much benefit. Patients don’t want to maintain their own records and clinicians aren’t about to trust patient-maintained information for making treatment decisions (not to mention that taxpayer-incented HIEs and Epic’s MyChart are stealing their thunder by not relying on patient-powered sneakernet in the first place). PHRs aren’t fun. They don’t accrue Farmville points, you can’t put pictures of your cat or a funny YouTube video on them, and you don’t get HITECH money for typing in your weight every now and then. The only model Google knows involves near-universal adoption that gets advertisers salivating, not having a tiny contingent of wellness buffs and savvy chronic disease suffers using their free online service. Ultimately, Google’s problem is that an awful lot of Americans care about reality TV and celebrity gossip more than their health. They’re more interested in patch-me-up-doc “healthcare” than I-need-to-make-better-choices “health” that requires proactive electronic tools. The most shocking aspect of Google Health’s announcement in 2008 was either that Google hadn’t figured that out or that they thought they could succeed anyway.

Want to bet that Google will come crawling back to healthcare one of these days when earnings start to slip? That’s what generally happens with those short attention span technology vendors. Like Microsoft before it, Google has gone from a dominant force that can do no wrong to a clearly fallible company that makes a ton of money, but that often is more of a follower than a leader with surprisingly routine and easily predicted product failures. And speaking of Microsoft, I’m not sure whether Google Health’s timely death is good news or bad for HealthVault, a better product, but still facing the same uninterested market even with the loss of its only high-profile competitor (advantage: Dossia?)

It’s OK to include scanned documents in an EMR, say 86% of respondents, while a less-forgiving 14% of purists say no way, electronic doesn’t just mean electronic, it means discrete data only. New poll to your right, in honor of the dearly departed Google Health: do you keep a current and medical reliable electronic Personal Health Record? I asked that same question in 2007, when 88% of the most technologically and medically savvy people in healthcare said they did not (maybe Google should have taken those results as one of those warning cow skulls in the desert).

Suggestion to anyone claiming to be an insightful Epic expert: your credibility will be enhanced if you spell the company’s name right (it is not EPIC).

A company approached me about sponsoring the HIStalk reception at HIMSS next year (I love that I don’t have to troll to get companies interested since I don’t have the time or inclination to do that). I found out from those folks something I hadn’t noticed: HIMSS has completely screwed around with the Las Vegas conference days, with the pre-conference stuff starting on Monday (Saturday is now Monday, in other words) and the sessions run Tuesday through Friday (so everybody will need to bail out for home on Thursday instead of Wednesday). Great – now you can’t do a Saturday night stay when trying to find a cheap flight and we’ll either have to travel with all the other business schmos on Monday or fly out a day early. They’ve moved my cheese and I’m unhappy, but I’ll get over it. So, despite my concluding HISsies slide from Orlando, the reception is probably not going to be Monday night if I decide to do another one. If you’re slotted to present a Friday session, you might want to plan for a roundtable instead of an auditorium.

I am absolutely loving Vince Ciotti’s HIStory series. He’s getting lots of e-mails and kudos, even from 20-something HIT sprouts who understand the “doomed to repeat history” thing and figure they can learn from the pioneer diaries. Vince recently had calls from Jim Pesce (McAuto) and Mike Kaufman, who are following his series and contributed to the installment above (I’m really impressed with Mike’s history since I didn’t realize his deep roots when he and I have exchanged e-mails over the years).  E-mail Vince if you have some history inside your head or on paper that would round out his recollections. The industry goes back to the late 1960s (Meditech was formed in 1969), so with 40-plus years having gone by, it’s time to document some of this stuff.

Speaking of Mike Kaufman, in Googling to see what he’s up to, I see that he, along with fellow former Eclipsys SVP Hans Boerma MD and money guy Frank Panaccio formed KBT Partners, which offers advisory services to healthcare IT and related companies.

I’m also quite enjoying the work of Micky Tripathi in his monthly Pretzel Logic column on HIStalk Practice. His writing is fluid and personal (not to mention entertaining) and he’s obviously an expert in all things EMR (fortunately, since he’s the president and CEO of the Massachusetts eHealth Collaborative). I just posted his Quality Measures Conundrum piece and it should be required reading for anybody who cares about EMRs or Meaningful Use.

My Time Capsule editorial this week from 2006: Medical Equipment Sales Boom While Health IT Struggles. A snip: “The takeaway message is that, science aside, doctors and hospitals will utilize the hell out of something when they’re paid to do so (equipment, drugs, supplies, and for-profit referral centers). While it’s nice if patient care is improved, it’s only mandatory that it not be worsened.”

A Harvard Business Review working paper covers why creative tension among company executives can be a good thing. One of its examples is Misys CEO Mike Lawrie, who in 2008 insisted that the company’s open source division not be rolled into Allscripts but rather allowed to compete with it for resources, which supposedly benefited both groups.

Speaking of Misys, the company offering to buy it is revealed as Fidelity National Information Services, a Jacksonville, FL-based bank technology firm that has a healthcare division (benefit administration, PHR, consumer health portal, ID cards, lockbox, revenue cycle).

Weird News Andy revives this story: mourners filing past the coffin at a Russian woman’s funeral are startled when she raises up and begins screaming, not nearly as dead as the local hospital had said. The funeral-goers’ time wasn’t wasted, however: the woman had a heart attack from all the commotion and died minutes later in the same hospital.

A survey finds that no surveyed physicians in the UK, New Zealand, Canada, and Sweden said they practice defensive medicine, compared to the 92% in the US who admit to letting fear of lawsuits drive their medical decisions.

CapSite releases the Lite version of its database, strictly for providers and hospitals. The Web-based tool provides access to thousands of contracts and proposals from peer institutions, complete with pricing and T&C covering 800 vendors in HIT, imaging, medical devices, and services. It’s free for 30 days and the company is signing me up to check it out, so I’ll be interested to snoop around since I love looking at contracts.

Athenahealth buys Point Lookout Resort and Conference Center, 396-acre, $7.7 million property near its Belfast, Maine operations center, which it will use for client and employee training. The facility overlooks Penobscot Bay and has 106 cottages, a bowling alley, and a beach. I’m thinking we need an HIT geek summer camp, complete with marshmallow roasts, snipe hunts, and furtive ukelele-inspired groping around the campfire.

OptumInsight (formerly Ingenix) is awarded a patent for its LifeCode natural language processing technology, which can extract content and context from electronic medical records. That technology runs the company’s computer-assisted coding applications,  which the company says can ease the transition to ICD-10.

I’m pleased with this find since I’m thrifty (cheap, some might say, including someone with whom I share a bed). I take low-dose lisinopril for blood pressure (my BP is only 115/55, but my doc likes me to take it for some reason). I thought Walgreens offered $4 generics, but they don’t any more, so they charged me $10 for 30 tablets. I looked for alternatives and found that not only does Walmart offer a long list of maintenance meds for $10 for a 90-day supply, but mail delivery to your door is free. That is Walgreens Strike 2, the first being that they charge almost $50 for a vial of Canine HIStalk’s insulin while Walmart sells their custom-relabeled Novo Nordisk insulin for only $24.88. We may have a healthcare crisis in this country, but it would be a heck of a lot worse without Walmart (at least now that they offer health insurance to more of their employees).

Atlanta-based startup Digital Assent, which developed the PatientPad ad-powered patient check-in tool for practices, raises $7.5 million in a Series B funding round. The founders came from Sythis, which developed an interactive selling solution that licensed its technology for PatientPad.

Sad: a hospital-based physician finds that someone is checking out porn and Googling phrases such as “rat poison symptoms in humans” on his office computer. It turns out to be the hospital’s night shift security guard, who has since confessed to trying to kill his family by poisoning them and who is now charged with beating his pregnant wife, his father-in-law, and his five-year-old daughter to death with a baseball bat and then burning down his house.

Cleveland’s MetroHealth System, getting heat from the county council about no-bid consulting contracts and excessive spending, takes positive action: it hires a $300 per hour PR company (without bidding, I assume) to help its executives practice for their appearance in front of the investigating committee.

Another Weird News Andy story that has me in stitches is this story, which he entitles Four Inches? Just a Flesh Wound. An 11-year-old girl trimming her horse’s mane opens up a 10 cm gash in her chest when the horse bolts. Her mother calls emergency response for an ambulance, only to be told to clean the wound, apply pressure, give aspirin, and then drive to the nearest hospital within eight hours or so. The hospital’s first question when she arrived: “Why didn’t you call an ambulance?”

E-mail Mr. H.

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An HIT Moment with ... is a quick interview with someone we find interesting. Donald W. Kemper is founder and CEO of Healthwise of Boise, ID.

Describe Healthwise, its incorporation as a non-profit, and how it is similar or not similar to the typical healthcare content vendor.

I see Healthwise as a not-for-profit force for good. Our mission is to help people make better health decisions. It is that mission that drives us both to serve and to lead our clients and partners.

With each advance in technology, our mission challenges us to find new ways to help people do more for themselves, to help them ask for the care they need, and to help them say no to care that is not right for them. And, by the way, to accomplish all that, we develop really great content.

We’ve had this same mission since our founding in 1975. Our mission never changes, but how we implement it changes every day as new technology, new partners, and new policies open new opportunities. After each user session with Healthwise content, we count a “mission point.” We track those user sessions on a mission point counter in our lobby. On June 8, our counter hit our one billionth mission point. That was very cool, but each mission point is a cause for celebration.

How else are we different as a non-profit? Well, we can’t be bought and there is no need to worry about quarterly shareholder reports. Our total focus can be on doing the right thing and helping our partners to be successful.

What are the company’ s offerings and how they co-exist with healthcare IT?

Health IT has enabled Healthwise to innovate in a hundred ways — all for the benefit of the patient. In the old days, we used books and workshops to educate, motivate, and inspire people. Through HIT, we can do it even better, in a more personalized way, and for millions more people than before. Consider the following information services offered with the consumer’s best interest in mind:

• EMR Solutions. Doctors are busy, and with Meaningful Use, they have even more on their plates than ever. Our EMR Module makes it easy to deliver patient education from the EMR desktop, optimized to provider workflow. Patient instructions in English, Spanish, and other languages to support refugee populations.
• PHR Solution. Patients need help understanding the medical data now accessible to them electronically under Meaningful Use. Our Knowledgebase connects the patient’s medical data to plain language information on lab results, medications, problem lists, and patient self-management tools.
• Virtual Coaching Conversations (Shelly Visits). Imagine a private coaching session with a health educator to help you understand your condition and develop an action plan for self-management. Next, imagine the same session with a virtual coach named Shelly who can visit you anywhere, anytime, and as often as you like. Shelly Visits use motivational interviewing, cognitive behavioral therapy, and other proven techniques along with voice and graphics to mimic (and sometimes improve upon) a one-to-one coaching session with a health educator or coach, but without the hourly rate of the professional. So far, we have 15 different Shelly Visits across key wellness and chronic condition issues. You should ask for an appointment with Shelly.
• Decision Points. These interactive patient decision aids walk a person through a six-step process for evaluating what is known about treatment options against his or her values, preferences, and desires. Do I need this test? Should I take this medication? Is this surgery right for me? With a summary from a Healthwise Decision Point, a patient is well prepared to work with his or her doctor to make the right treatment choice.
• Care Management Solution. Our newest solution helps care coordinators to easily prescribe and deliver patient-specific self-management guides and decision support tools and to report back the patient’s use of those tools. The “report back” feature allows the patient’s voice to be better heard in shared decision making and care plan creation. It also provides a foundation for patient accountability within an accountable care partnership.
• Learn to Earn. The self-management courses take people through short, engaging health information tracks, like getting started and prioritizing weight management and goal setting and managing diabetes through lifestyle changes. Learn To Earn measures and reports the patient’s progress and completion back to HIT systems so the care team can understand patient activity or easily connect the learning to an incentives program.

Define information therapy and its value in improving population health in an environment calling for better outcomes and lower cost.

Information therapy is the prescription of the right information to the right person at the right time. Often that means that the clinician who has just made a new diagnosis, ordered a new test, or prescribed a new medication can semi-automatically (i.e. one-click action) prescribe care self-management tools and document it in the EMR. Information therapy brings health education into the workflow of the clinician.

Do the Meaningful Use requirements place enough emphasis on patient-facing applications and readily available information? What would you have like to seen them include?

Meaningful Use requirements have made patient information prescriptions a “must have” rather than a “nice to have.” That is a major advance. Patients have already begun to enjoy the Meaningful Use-delivered benefits of patient-specific educational resources, discharge instructions, and the recognition of advance directives.

The two big items next on the Meaningful Use agenda for patients would be patient access to care plans and the requirement that a patient response to an information prescription be included in the clinical record.

Is the uptake of consumer-facing technologies such as social networking, search engines, and online health support encouraging for what you’re trying to accomplish?

It all helps with our basic mission. People need three kinds of input in their quest to manage health problems. Yes, they need plain language, easy-to-understand, evidence-based information on their condition and their treatment options. That is what we strive to provide.

Next, they need a strong relationship with a primary care provider who knows them well and can help to guide them through the options.

And finally, they need to hear from people “just like them” who have been through the same decisions and faced the same options.

Each piece helps, but no single source will lead to the best outcomes.

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I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).

I wrote this piece in April 2006.

Medical Equipment Sales Boom While Health IT Struggles
By Mr. HIStalk

GE Healthcare just announced quarterly profits of nearly half a billion dollars. While much of that came from diagnostic equipment sales, it’s still worthy of reflection — whether you helped boost the company’s bottom line through your purchases or whether you have to compete against them.

An interesting phenomenon occurs on the non-IT side of healthcare technology. Vendors of diagnostic imaging equipment and Star Wars-like treatment gadgetry use a little bit of science and a lot of scientifically-designed propaganda to create demand for the latest Gamma this, 64-slice that. Customers plant public relations articles in the local newspaper, bragging on their new toy with a subtle message: “Our competitors are cold-hearted cheapskates for not shelling out for the cool patient care stuff like we do for you.”

What’s the downside?

1. In many cases, the equipment has no proven benefit for patients. Seeing an image more clearly doesn’t necessarily mean anyone gets better faster.
2. Supply creates its own demand, ensuring that all those new private office MRI machines are humming from constant use on patients who didn’t need it until Doc got his first invoice.
3. More billions in costs are piled onto a poorly performing healthcare system.

So how can GE, Siemens, Philips, and other conglomerate vendors make so much money on this stuff and still not necessarily make much of a dent in healthcare IT? More specifically and paradoxically, why are customers so willing to spend millions on a given company’s non-IT technologies while fighting tooth and nail to avoid using that same vendor’s IT products?

The most obvious reason is that providers can make money by running expensive tests, particularly when coached by vendor reimbursement experts who can influence the companies who write the checks (and who eventually increase premiums in response). The patient’s not paying anyway, so everybody’s happy, at least until the next round of healthcare and insurance cost increases.

The science behind this equipment is often no better than the shaky anecdotal suppositions about CPOE or ambulatory electronic medical records. Still, it creates its own demand, mostly because customers have a financial incentive to fit it into their practice, while those other IT technologies are largely ignored and unsuccessful because they require extra work for no extra payment.

The takeaway message is that, science aside, doctors and hospitals will utilize the hell out of something when they’re paid to do so (equipment, drugs, supplies, and for-profit referral centers). While it’s nice if patient care is improved, it’s only mandatory that it not be worsened.

Few health IT technologies have ever caught on that didn’t benefit users directly. The stuff being touted today (RHIOs, CPOE, clinical decision support) doesn’t, so it wallows around with unenthusiastic little pockets of interest here and there. The cheerleaders keep complaining about low adoption and the need for someone else to pay for it.

If providers were paid to reduce utilization and improve outcomes, advanced IT support would be demanded, not refused. Until then, the conglomerate vendors will thrive on the medical equipment side and struggle on the IT side unless someone bribes customers to get on board.

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Top News

McKesson signs a definitive agreement to acquire Portico Systems, a supplier of provider management tools for health plans, for a reported $90 million in cash.

Reader Comments

From Polymorph: “Re: ambulatory rumors. TactusMD just pulled out of their Meaningful Use / EncounterPro offer. EncounterPro has pulled their open source project and also brought in a new management team.” Unverified. These aren’t companies I follow, so I have nothing to add.

From Bull City: “Re: Duke going Epic. According to job listings on their HR site, Duke is replacing McKesson Horizon with Epic. MCK loses a showcase site and development partner, Epic steals yet another high-profile client.” Even non-psychics could have seen that coming since Duke has Epic ambulatory underway and hospitals rarely stop there.

From David: “Re: home brewery. I saw this article and thought maybe you had some extra time aside from HIStalk and the hospital.” It’s a fun article, but it’s not about me. The high-end home brewery of Tim Artz, a director of Agfa HealthCare’s government health IT and imaging business, is featured (he gets extra points for having a homemade meat smoker, whose product surely goes nicely with his beer).

From Joey Cheesesteak: “Re: Investors Business Daily article. One of my daily reads (along with HIStalk). Their daily 10 Secrets to Success section is highly recommended.” IBD characterizes Cerner shares as slow but steady. I used to subscribe, but finally figured there was no way my casual reading was going to pit me favorably against professional money managers in the zero-sum game of buying stocks. I put my little stash in a wrap account, where it has outperformed my returns and given me someone to blame other than me when it doesn’t. However, I just now remember meeting with some investment guy at Cerner’s user group in Orlando years ago and he kept pressuring me to name one healthcare stock to buy. I told him Cerner. I’m sure he’s taking all the credit.  

From MT Hammer: “Re: Webmedx. Acquired by Nuance, as told to employees in a conference call Tuesday. Webmedx was the #3 player in the MT field behind Nuance and CBay/MedQuist.” Unverified. Webmedx was the #1 KLAS transcription services vendor for 2009 and 2010 and offers natural language processing solutions for clinical documentation.

HIStalk Announcements and Requests

If you still aren’t tuned in to HIStalk Practice, here are some of the goodies you missed over the last week: Henry Schein MicroMD GM Keith Slater shares insights on why physicians should or should not implement EHRs. A whole lot of physician practices are not ready for the 5010 transaction set. Healthcare insurers mess up one out of every five claims processed, costing $17 billion in administrative costs — wow. Don Michaels, PhD of Hayes Management Consulting and the Harvard School of Public Health takes about full plates and the ICD-10 500-pound gorilla. Forbes uncovers Practice Fusion’s vision for making money. The cloud looks pretty good in terms of security breaches. While catching up on the latest HIStalk Practice news, help us keep our supporters happy and our servers humming by touring the offerings of our sponsors.

On the Jobs Board: Solutions Executive, Systems Engineer, Technical Marketing Engineer. On Healthcare IT Jobs: CEO & President, Clinical Application Analyst, Manager of Data Governance, Horizon Implementation Consultant.

Listening: new from Montreal power poppers Simple Plan, cheery, loud summer music mostly about girls, such as You Suck at Love. It’s like sangria on a hot day: fizzy, sweet, unchallenging, and likely to lock in memories of what you were doing during those ephemeral days when you were enjoying it constantly. They’re big supporters of charitable causes.

Your HIStalk punch list: (a) sign up for the e-mail updates if you haven’t already, joining a highly selective group of 7,414 subscribers who have Pavlovian reactions of various types when I ring their inbox bell; (b) engage Inga, Dr. Jayne, and me in social intercourse by making our electronic acquaintance on Facebook or LinkedIn (Dann’s LinkedIn HIStalk Fan Club is up to 1,666 members, universally cute and smart from what I can see); (c) vanquish your predilection for passivity and send me news, rumors, photos, guest articles, or sentimental yearnings; (d) love my sponsors at least a little for their brave support of what may be the most amateurish and off-the-wall site in the button-down world of HIT (You Suck at Love? Really?), appreciate their ads by clicking forcefully, check out the Resource Center, and trust that despite the inevitable role conflicts between you as a prospect and they as a vendor, you at least have HIStalk in common and therefore share an appreciation of the offbeat.

Acquisitions, Funding, Business, and Stock

Healthport merges with Universata, a provider of release of information services.

Shares in Philips take a hit after the Dutch consumer electronics giant warns of lower sales right before the quarter’s end. The company says it will cut costs and restructure.

CSC gets European Commission approval to acquire iSoft, although shareholder approval is still required.

People

Guillermo Moreno, formerly of Diebold and past president of the South Florida chapter of HIMSS, joins staffing firm Experis as VP of its healthcare practice.

Navicure names Craig Potts as EVP of sales. He was previously with Fiserv.

Christine Connelly, the high-powered CIO of England’s Department of Health, will leave her position at the end of the month. She says organization management is being restructured and she has decided not to pursue one of the remaining executive positions.

Announcements and Implementations

Omnicell’s new G4 medication dispensing system earns ONC-ATCB certification as a Modular EHR.

Baptist Health System (AL) and Henry Ford Health System (MI) will pilot a new cloud-based imaging management system from AT&T that provides quick access to images from any system and provides secure image access to referring physicians and facilities.

Mercy Medical Center-Sioux City (IA) makes the local paper for its new Web-based system that allows patients to pre-register, pay bills, and print a medication card.

Government and Politics

ONC announces that it has made its healthcare IT teaching curriculum available to the public at no charge, including higher education institutions in the US and elsewhere. The material was developed with a $10 million ONC grant. Content covers work redesign, technical support, networking, usability, and project management. It also includes modules with hands-on lab assignments that use the free VistA for Education EHR. The links sent to me didn’t work, but check ONC’s site.

The US Supreme Court strikes down a Vermont statute that prohibits the selling of prescription data to drug companies (usually via third-party vendors such as IMS Health) so they can develop customized sales pitches for doctors. The court found that Vermont had a vested interested in prohibiting prescription drug marketing as a form of censorship since it is a purchaser of generic drugs, not to mention that the advertising lobby argued that drug marketing is free speech. IMS wet its corporate pants at the news, vowing to gear up its hugely profitable business in the interest of public health and healthcare reform.

Innovation and Research

The Children’s Boston/Harvard Medical School SMART Platform Apps Challenge chooses the Meducation app by Polyglot System as the winner of its $5,000 innovation prize, which focused on add-on EMR applications. Meducation will be added to the SMART App Store that launches next year, modeled after its Apple counterpart. Meducation pulls medication lists from the patient record, then allows printing simplified instructions in several languages. It was developed under an NIH grant for underserved populations.

Two UCSF medical students create MediBabble, a free  app that lets caregivers play pre-recorded patient history questions in various languages to patients who don’t speak English. It asks questions that require only yes-no answers or pointing to a body part.

Technology

Microsoft’s Craig Mundie pitches the company’s Kinect motion-based game controller at the Pacific Healthcare Summit, citing its potential use in avatar-based group therapy sessions for mental health patients and as a way for doctors to interact with medical records systems using voice and gestures. I didn’t see a video, but above is one from Wake Forest Baptist (NC) showing the use of Kinect to manipulate medical images.

Other

A 21-year-old con man poses as a doctor at OHSU Hospital (OR), providing medical advice to a patient from the hospital’s coffee shop while wearing a fake hospital badge and uniform. He also claimed to be a software developer at Microsoft.

PatientSecure is getting publicity like I’ve never seen from its little press release about NYU Langone Medical Center going live on its palm scanning system for verifying patient identity. Above is a lengthy evening news piece from ABC’s New York affiliate.

Aspirus Wausau Hospital (WI) loses phone service and network connectivity for several hours on Wednesday when a maintenance worker accidentally triggers a fire suppression system, requiring ambulances to be diverted and some appointments to be rescheduled.

Weird News Andy can’t decide if this is real or The Onion. A UK hospital, claiming it’s too broke to install a nurse call system in the wing for elderly patients, hands out tambourines instead. It even provides a backup system: maracas. A relative said, “These people are pensioners – not members of the Monkees or Mick Jagger,” apparently missing the fact that the once-youthful rockers she mentioned are pensioners themselves – Davy Jones is 65, Peter Tork is 69, Mick Jagger is 67, and Keith Richards has to be at least 185.

WNA also weighs in on this gut-wrenching invention: a self-propelled endoscopy device called The Mermaid, a tadpole-like, joystick-controlled camera that can swim the entire length of the GI tract in a few hours, starting from either end.

Sponsor Updates

• MedAptus will demonstrate its Intelligent Charge Capture technology at next week’s HMFA ANI conference in Orlando.
• Also participating in HFMA ANI: EDIMS.
• MED3OOO’s InteGreat EHR passes all required elements in the CCHIT 2011 Ambulatory, Child Health, and Security test scripts and is now a Pre-Market Conditionally CCHIT Certified 2011 Ambulatory EHR additionally certified for Child Health.
• Encore Health Resources is named one of Best Places to Work in Healthcare.
• Besler Consulting will feature its BVerified-Revenue Integrity Auditor at HFMA ANI next week. It allows hospitals to quickly act on revenue enhancement and compliance opportunities.
• Capario achieves full accreditation with the Healthcare Network Accreditation Program (HNAP) from the Electronic Healthcare Network Accreditation Commission (EHNAC).
• Catholic Health Initiatives (CHI) is featured as a case study in “getting staffing right” in the new issue of HFMA’s Leadership. Its eight-hospital pilot of Clairvia’s CVM tracks patient progress through the hospital and tracks progress and expected length of stay against CMS benchmarks, suggesting optimal staffing levels and skill mix along the way.
• Concerro offers a complimentary Webcast that covers Joint Commission Emergency Management Standards.
• KLAS ranks Encore Health Resources in second place (missing first by 0.2 points) in advanced health information technology services.
• EnovateIT’s Fred Calero wins Michigan’s Entrepreneur of the Year.
• Health Language, Inc. unveiled the latest release of its LEAP I-10 at last week’s AHIP’s Institute 2011 Conference in San Francisco.
• Sage Healthcare adds nine new clients for its cloud-based Sage Intergy On-Demand PM/EHR.
• Healthwise offers a white paper on Getting Patients to Meaningful Use.
• GetWellNetwork releases a list of winners of its third annual Interactive Patient Care awards. Top honors went to The Indiana Heart Hospital for using GetWellNetwork’s Heart Failure Care Plan to reduce readmission rates and help cardiac patients manage their condition.
• T-System promotes Bill Hall to VP of solution development, Scott Martin to manager of solution management, and Hank Hikspoors to director of new product development.

EPtalk by Dr. Jayne

A networking site for physicians has been launched by Doximity. Unlike my recent trip to the CMS Web site, a visit to Doximity found that my correct and updated practice address was already on file. Advertising the ability to not only connect colleagues but to allow “HIPAA secure messages,” Doximity is supported on iPhone, iPad, Android, and PC platforms. CEO Jeff Tangney co-founded Epocrates. I’m not sure what advantages it has over other networking platforms just yet, but I’m going to keep my eye on it.

Those of us that work in the primary care trenches have seen a variety of body piercings, some of which have gone awry. Researchers  at the Northwestern University School of Medicine have been using a technology developed at the Georgia Institute of Technology that allows patients with spinal cord injuries to steer wheelchairs using a magnetic tongue stud. The magnet sends signals to a headset, which then transmits to an iPod that controls the wheelchair. Although glue was originally used to hold the magnet in place, trials found that a tongue piercing was more reliable.

Life in the fast lane, literally: personalized medical monitoring devices are one of the coolest and least-discussed types of health information technology. This year I’ve been following IndyCar driver Charlie Kimball, who has Type I diabetes. Kimball wears a continuous blood glucose monitor that feeds to a gauge on the dash right next to other traditional race car data points. He finished 13th in this year’s Indianapolis 500.

News of the Obvious

Surprise, surprise: a Harvard study demonstrates that watching TV, snacking on chips, and staying up too late can cause weight gain. Researchers looked at over 120,000 Americans over a 20-year period and found an average weight gain of three to four pounds per four years. I wonder what the results would look like if it was repeated on IT department staffers, EHR and CPOE implementation teams, and Meaningful Use consultants during the last two years?

More non-surprises, as shared by Bama Bubba: Sleep Deprivation in Medical Caregivers Has Deadly Results.  Extended hospital shifts increase the risk of patient safety compromise as well as vehicular accidents. Having had a close encounter with a rural route mailbox after being up all night, I know this to be true. Starting next month, incoming first-year resident physicians will be limited to 16-hour shifts rather than the current 30-hour cap. Having trained “back in the day” when there were no work hour limits, I see this is a positive step towards a more humane training program, but the jury is still out on what impact the work hour limits may have on resident learning.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

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