I’m finally back in my normal routine with the usual rounds of meetings, committees, working groups, conference calls, and Meaningful Use activities that make up the fun-filled CMIO lifestyle. Lots of reader response this week, and that has kept me going through it all. Every time I take vacation, I forget how much one gets punished the week after, so thanks to all of you for keeping me going. Your e-mails have been a true bright spot in an otherwise harried week.

Last week’s piece on physician rating web sites generated several comments. Most of them agreed that the sites don’t have a tremendous amount of worth compared to word of mouth or physician recommendations. Tammi sent her thoughts:

Too bad there isn’t a truly reliable source I would trust. Having been down the roads I have been down, my choice would still be to do my homework and ask around and ask the right folks. And then ask again. It is about more than the physician, too. Who supports them and what is their experience?

Entirely true. There may be a lead physician performing a procedure, or a primary care physician quarterbacking the care, but there’s a whole world of nurses, consulting providers, patient care technicians, case coordinators, therapists, and a host of others involved. Having seen it from both the physician and patient sides, it pays to do your homework.

In response to my comments on physicians and social media, Chris reminds us that it goes both ways:

A lawyer friend of mine passed this along the other day about a judge allowing Facebook posts as evidence in a personal injury case. I wonder how long until we see this same thing in a medically related case?

Based on some of the antics of my employees on Facebook, it’s apparent that people don’t care who is reading or what they are writing. And no, I’m not stalking them. Most of them actually friended me, so it’s not as if they don’t know that I might be reading. I worry for their livers and their brain cells, that’s all I’m saying.

Tremendous feedback on my quest for appropriate cocktail pairings to go with mandatory online training. I can officially confirm that Personal Protective Equipment is much more enjoyable with a drink and some nibbles. Judy encouraged me to not forget Compliance as a potential topic. My recommended pairing for either Compliance or Risk Management training:

Over the next few weeks, I’ll be working on some online modules that are required for specialty board recertification. For those, I have chosen some picks from Caduceus Cellars.  (For those music lovers who like Mr. H’s notes on what he’s listening to, you may be interested to know that Caduceus is project involving Maynard James Keenan, legendary front man for Tool and A Perfect Circle.)

Rock star HIStalkapalooza correspondent Evan Frankel mentions:

I have fallen back in favor of Portugal’s very unique and refreshing green wine ‘vinho verde’ with scholarly research. With an iced glass as its chalice, [it] really does induce people to sit outside, enjoy a sunset and get into really meaningful and enjoyable conversation about the future of healthcare in America.

Evan, do you wear your fabulous jacket when you drink it?

Matthew noted:

One cannot go wrong with Orin Swift’s excellent The Prisoner. Not only is this blend of mostly Zinfandel, Cabernet Sauvignon, and Syrah pleasing to the palate, the label itself perfectly sums up how one feels while attending mandatory training offerings.

Oh yes, I will be using this one. Perhaps some bottles as attendance prizes for Meaningful Use upgrade training? Or for myself, when I’m forced to attend said upgrade training, which although I wrote and approved, I have to attend to verify credit in the online system?

Speaking of verification of attendance, a letter to the editor in American Medical News caught my eye this week. Massachusetts surgeon Jeffrey Kaufman writes about his experience of being required to punch a time clock. Although I’ve not had to actually clock in and out, my employment agreement and pay stubs reflect an “hourly wage” for being a physician. I don’t remember the last time I worked a straight 40-hour week. When I asked about it, I was told that the personnel resource management system (aka software) can’t handle a salaried employee. I’ve been known to mentally divide my salary by actual hours worked. As a Chief Resident, I could have done better on the night shift at Taco Bell.

Last but not least, the perfect wine pairing for a discussion of Meaningful Use. I will definitely be looking for this one the next time I shop for the fruit of the vine. I’ll have to make a point to have some in house prior to the final decisions on Stage 2. Have any other cocktail suggestions? E-mail me.

E-mail Dr. Jayne.

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From Brass Tacks: “Re: Danbury Hospital. They fired the CFO over this.” Former Danbury CFO William Roe is sentenced to 33 months in federal prison for embezzling $200,000 from Danbury Hospital (CT) and former employee St. Rita’s Medical Center (OH) by approving invoice payments to a fake software consulting company he had set up. Roe, who made $594K in 2009, blamed poor judgment and begged for a light sentence. The judge, unimpressed by his two court order violations, said, “Your primary concern is for yourself and your family, who have already benefited from the funds you’ve stolen.”

A New York Times article on usability of clinical systems highlights the usual arguments: usability experts say there’s no question that today’s systems are measurably poorly designed to the detriment of clinician users and patients, while vendors strongly resist the imposition of usability standards or mandatory usability testing.

Most poll respondents say the person running the company that employs them is honest and honorable. New poll to your right: should the federal government measure and report the usability of clinical systems?

Essentia Health (ND) goes live on Epic’s EHR July 31th.

Gartner positions mobile application development platform provider Kony in the “Visionaries” quadrant of the Magic Quadrant for mobile consumer application platforms.

David Roberts, HIMSS’s VP of government relations, says it is unlikely that Congress would vote to eliminate future funding for EHR Meaningful Use incentives, despite the current current stalemate in federal budget negotiations. To eliminate the incentives, Congress would need to specifically vote to narrow the scope of the program or eliminate the program entirely. Roberts believes that legislation lacks adequate support to be passed in either houses of Congress.

The weekly e-mails of Kaiser Chairman and CEO George Halvorson are often HIT-related, with this week’s no different. Kaiser researchers have published autism-related studies made possible by its extensive patient data warehouse. They found that pregnant woman who used certain drugs greatly increased the odds of having an autistic baby, but vaccines were not among those drugs. They also found that children are dying of whooping cough because they aren’t being given pertussis vaccine.

Here’s the latest installment of HIStory from Vince Ciotti, this time covering vendors of minicomputer systems.

Greenway Medical Technologies files registration to raise up to $100 million in an IPO. Underwriters include Morgan Securities, Morgan Stanley, William Blair, Piper Jaffray, and Raymond James.

Caristix is offering a free beta program for software that helps hospital integration analysts identify and document custom HL7 interface segments and values.

Indian River Medical Center (FL) hires as its first CIO Bill Neil, formerly IT director at Presbyterian Healthcare Services (NM).

Scripps Health (CA) chooses Meddius to provide Integration as a Service, replacing its Sybase integration engine.

Yale New Haven licenses the Rothman Index, which uses real-time clinical systems information to generate a patient score that helps clinicians identify patients whose condition is deteriorating.

UPMC’s living donor kidney transplant program was shut down in May because up to six transplant team members failed to notice a Cerner EMR lab result alert indicating that a donor had undiagnosed hepatitis C. Her kidney was transplanted into a patient who did not have the disease, resulting in the temporary shutdown of the program. The surgeon who did most of the procedures was removed from his position, joining his equally high profile colleague who was fired in an earlier UPMC transplant scandal. A highly regarded transplant nurse was suspended for two weeks. Outside experts blamed generally poor EMR design, saying that UPMC administrators had a “knee-jerk reaction” in removing the surgeon, who had been under pressure to increase procedure volume, instead of examining the system that allowed the error to occur.

Seven former nurses from Valley Regional Medical Center (TX) sue the hospital, alleging they were fired in retaliation for making good faith reports of unsafe patient conditions. The nurses were terminated for "insubordination" after opposing assignments they claimed endangered critically ill patients. One nurse explained the situation as follows:

"It’s about standing up for your patient. We got into this profession to advocate for our patients… Patients who can’t speak up for themselves… And that’s what we’re trying to do here."

EHRs provide more comprehensive information on health services received than do Medicaid, according to a study published in the Annals of Family Medicine.

Mayo Clinic announces it is close to completing the development of tools that can identify and sort digital health information from any EMR, regardless of file format and data organization. Mayo’s project is funded by the HHS through its $60 million Strategic Health IT Advanced Research Projects (SHARP) program.

Next month CMS will roll out a pilot program for the electronic transmission of documents to support claims. Designated “health care handles” will serve as intermediaries between CMS and providers.

Strange: a city-employed nurse is fired for inappropriately accessing the electronic medical records of hospital patients. She says the real issue is her part-time job as a psychic, where she told patients they were about to experience heart attacks and claimed to be speaking to deceased co-workers from beyond the grave.

Contacts

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

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Top News

Nuance Communications acquires transcription services provider Webmedx. Both companies offer outsourced transcription services with speech recognition capabilities and offer NLP technology to extract information and convert it into discrete data. It’s been a busy week for the transcription services and speech technology segment: earlier this week, MedQuist announced plans to acquire M*Modal for $130 million.

Allscripts adds four senior execs to its leadership team including Cliff Meltzer as EVP of solutions development, Steve Shute as EVP of sales, Jackie Studer as SVP and general counsel, and John Guevara as CIO. Meltzer is an Apple, Cisco, IBM, and CA Technologies veteran and replaces the now retired John Gomez. Long-time IBM-er Shute replaces Jeff Surges, the current CEO of Merge Healthcare. Studer (GE Healthcare) takes over for Kent Alexander, and Guevara (Microsoft, Intermec, Siemens) is Allscripts’ first CIO.  Allscripts also announced the department of COO Eileen McPartland, who is leaving to become CEO of a private company outside of the healthcare industry.

From Charlie Brown “Re: Worried. Hey Inga. No push e-mail this AM for HIStalk and no new postings since yesterday. Did HIStalk break?” Thanks for your concern, Chuck, but nothing is broken (well, nothing that I know about, anyway.) Alas, Mr. H didn’t set up anything in advance for posting Wednesday, so we went a rare mid-week day with no Readers’ Write or interview. Mr. H promised me he’d eventually return from vacation, so look for an in-box full of HIStalk blasts next week.

From Boozers “Re: 2010 market share. Wow. Look at how Epic is hurting McKesson.” This table from KLAS shows Epic won 75 deals last year in the 200+ bed hospital market and had no legacy losses. The next best performer was Cerner, with 14 wins and six legacy losses. At the bottom: McKesson Horizon with four wins and 24 legacy losses. Ouch.

From Court Jester “Re: From the floor at AMDIS. Lots of interesting discussions and speakers and talk around the evolution of technology adoption by physicians. The hottest topics center around  CPOE and clinical documentation and the need for good workflow and ease of use.” AMDIS’s 20th Annual Physician-Computer Connection Symposium is wrapping up Friday in Ojai, CA. I must admit that if I were Court Jester I would be hanging by the Ojai Resort’s gorgeous pool rather than in the back of one of a meeting room.

This week on HIStalk Practice: Dr. Gregg dialogs with Stupid Simple and S&M. Sermo intros Sermo Mobile and iConsult. A whopping 76% of physicians with smart devices utilize iPhones. Physicians increased their ability to generate registries after implementing EHRs. Telepsychiatry is not catching on as fast as other telemedicine services. If you sign up for the HIStalk Practice e-mail updates, the budget crisis might be resolved and the US women might crush Japan. With stakes like that, how can you not sign up? And thanks for reading.

drchrono closes $675,000 in its first round of institutional financing. Investors include several VC firms, plus Gmail creator and FriendFeed cofounder Paul Buchheit and Google’s principal engineer Matt Cutts. drchono offers a free EHR for the iPad.

Nevada Rural Hospital Partners, a 14-hospital alliance, partners with Anthelio (formerly PHNS) to provide business office solutions and coding services to member hospitals.

Progress Software appoints Philip M. Pead to its board of directors. Pead is the current chairman of the board for Allscripts and the former president and CEO of Eclipsys.

Dominick Bizzarro, the CEO of the Healthcare Information Xchange of New York, resigns to join InterSystems as business manager for the HealthShare HIE platform.

Nevada-based HealthInsight launches its HIE using Axolotl’s platform. Providers will begin sharing patient information in September.

Cheboygan Memorial Hospital (MI) outsources its IT operations to Phoenix Health Systems, who will implement Meditech’s EHR and provide IT leadership and service desk support.

A bipartisan group of Congressmen introduces a bill that would amend the EHR incentive program to benefit multi-campus hospitals. The legislation would give each hospital campus the opportunity to earn Meaningful Use incentives.

The US Patent and Trademark Office awards Epic Systems a patent for “a system and method for providing decision support to appointment schedulers in the healthcare setting.”

Directors of the Kingsport, TN-based RHIO CareSpark vote to cease operations this fall, citing an unsuccessful effort “to transition from a grant and contract based nonprofit organization to a user subscription and revenue sustained entity.” CareSpark was formed in 2005 after receiving $600,000 in funding from the Foundation for eHealth Initiatives and local partners.

• Greenway Medical and PGA Tour Golf Pro Jason Dufner debut their new partnership at the British Open. Note the Greenway logo on Dufner’s jacket.
• The Drummond Group awards SRS EHR ONC-ATCB certification as a complete EHR.
• GE Healthcare releases a new white paper discussing the annual cost of healthcare-associated infections in terms of dollars and lives. GE Healthcare also announces the formation of MIND, a coalition to help physicians detect, diagnose, and manage neurodegenerative diseases.
• The Entrepreneurs EDGE awards Lexicomp, a Wolters Kluwer Health subsidiary, its fourth Crain’s Leading EDGE award for creating economic value in Northeast Ohio.
• Blanton Godfrey, Ph.D. and board chairman of the Institute for Healthcare Improvement will be the featured speaker at TeleTracking Technologies annual client conference in San Diego in October.
• Sage awards Peter Christensen Health Center (WI) its Healthcare Best Practices award at the Sage Summit conference in Washington DC.
• Practice Fusion announces Practice Fusion Connect 2011, a free EMR event for its 100,000+ clients, November 11th in San Francisco.
• AirStrip Technologies expands its leadership team, promoting Bruce Brandes from chief sales officer to EVP and chief strategy officer. Also, AirStrip was named InformationWeek magazine’s Most Transformative Healthcare Application at this week’s Healthcare Leadership Forum in NYC.
• Emmi Solutions selects Health Language, Inc. to enhance the usability of its patient engagement programs.
• North Highland announces an expansion into Japan through a partnership with GENEX.
• Iatric Systems earns ONC-ATCB certification for three more products. Iatric is also hosting a slew of free Webinars over the next three months, covering a variety of clinical and technical topics.
• Precyse hires Kristen Saponaro as VP of marketing. Saponaro was the principal of Saponaro Communications, LLC, the consulting firm that supported Precyse in its recent rebranding efforts. Precyse was also recently awarded a medical transcription services contract with Community Medical Center (PA).
• Anson General Hospital (TX) leverages its ChartAccess EHR from Prognosis to successfully attest for Meaningful Use.
• NextGen execs Charles Jarvis and Tony Landauer are scheduled panelists at next month’s CompTIA Breakaway 2011 in Washington, DC.
• Allscripts provides its preliminary Q2 financial numbers, which include expected bookings of about $240 million and profits and revenue above analysts’ expectations.

It’s been difficult to get back to the routine with me returning from the beach and Mr. H vacationing, but the lovely Inga has been doing a fantastic job holding down the HIStalk fort. Although I’m still somewhat achy from the gut-busting laughter that accompanied Dr. Gregg’s recent comments on the EHR selection process, I didn’t want to miss the opportunity to share some newsy tidbits and random thoughts.

HHS releases a proposal to revise HIPAA and harmonize it with HITECH provisions. The AMA states: “The proposed rule seemingly goes beyond what is required by laws and would pose significant burdens on physicians if finalized.” The comment period ends on August 1, so let your voice be heard.

The Sage Summit is being held this week at the Gaylord National Hotel and Convention Center in Washington DC. Partner Days are July 10-15 and Customer Days are July 12-15. I understand the Wednesday evening event was “Night at the Museum” at Smithsonian Air and Space. Anyone attending? Let us know what you are seeing and hearing.

A recent survey shows consumers have a higher opinion of facilities using the word “Hospital” as opposed to those who have gone to the ritzier-sounding “Medical Center.” Respondents felt Hospitals provided better care and were more cutting edge. What’s in a name? It reminds me of when a previous employer named their brand new facility the “Cancer Center of Excellence.” Not only was it just tacky, but as far as Centers of Excellence go, it was a new service line that hadn’t gone anywhere near proving itself through outcomes or peer recognition. Personally, I’d like to see a survey on “Information Technology” vs. “Information Services” vs. “Information Systems” departments. A rose by any other name…

For those of you who have been eagerly awaiting implementation of new DEA rules for e-prescribing controlled substances, you’ll probably have to wait on your medical marijuana scripts. The DEA has stated that cannabis “has no accepted medical use and should remain classified as a highly dangerous drug.” Advocates can now appeal to federal courts after a nine year delay. DEA Administrator Michele Leonhart states that “the known risks of marijuana use have not been shown to be outweighed by specific benefits in well-controlled trials that scientifically evaluate safety and efficacy.” How hard do you think it would be to enroll patients in THAT study?

Thanks to Mustang Sally, who sent an article on physicians who use Twitter anonymously. It has some interesting examples, but closes with a mention of the American Medical Association’s ethics policy on social media, which warns that “actions online and content posted… can undermine public trust in the medical profession.” I don’t agree with physicians griping about patients on Facebook or Twitter, but you can imagine that I do see a benefit in anonymity. The full text of the Policy, approved in 2010, can be found here.

Interesting piece from the Kaiser Family Foundation: “Why It’s Okay that EHR Adoption Will Fall Behind 2011 Goals.” The authors cite “cleaning house” as a cause, meaning “older, costly, and difficult-to-implement legacy EHRs will be replaced by less expensive, more agile systems that have been developed specifically for meaningful use and are deliverable in the cloud as Software-as-a-Service.”

I’m off to sample my employer’s mandatory online training offerings, which apparently I must complete or I won’t get paid. After a week of fuzzy umbrella drinks, I’ve decided that Workplace Harassment, Personal Protective Equipment, and Privacy 101 go best with a nice Cab from Joseph Phelps. Have any other suggestions for excellent educational wine pairings? E-mail me.

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

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The Government Accountability Office reports that the federal government’s systems for analyzing Medicare and Medicaid data for possible fraud are inadequate and underuse, making it difficult to detect the $60 to $90 billion in fraudulent claims paid out each year. The GAO also notes that:

• CMS spent $150 million on new systems that went live in 2009, yet crucial pieces are missing.
• The current systems don’t include Medicaid data and CMS’s plans to share Medicare and Medicaid data with states and implement new software have been delayed.
• Of the 639 analysts who are suppose to use the system, only 41 have been trained so far.

CMS’s top anti-fraud administrator was scheduled to testify for a Senate subcommittee Tuesday to discuss the findings.

From Bamma Bubba “Re: UCLA HIPAA violation settlement. Hospital snoops will never stop – it’s a people problem, not an IT problem. Could be a way to increase federal revenue, but then hospitals just pass the costs on to patient and insurers.” Yep, even though our mothers told us to mind our own beeswax, humans are generally just plain nosy. And at HIStalk we also like to make fun of people that can’t spell HIPAA.

Mr. H is still vacationing for a few more days. Either Mrs. H has banned him from the computer or he is in the Land of Bad Internet (I’m betting the latter) because I’ve hardly heard a peep from him in two days. Until his return, feel free to send any hot news my way. Or, if you don’t have hot news, just drop me an e-mail for the heck of it.

When Sidra Medical and Research Center (Qatar) opens in 2012, it  plans to run the Cerner Millennium platform and be the first fully digitized medical facility in the country.

Mediware hires Michael Anania as VP and GM of the company’s Blood Center Technologies product group. Anania’s previous employers include Roche Diagnostics and Baxter Healthcare.

MGMA names Susan Turney, MD its president and CEO, succeeding the retiring William F. Jessee, MD. Turney, who is an internist, has served as CEO of the Wisconsin Medical Society since 2004 and founded and chaired the Wisconsin Statewide HIE.

Apollo Health Street beefs up its sales force with the addition of four regional VPs: Ken Bartlett (SSI, McKesson), Dan Contilli (Healthation, SunGard), Troy McCormick (Invikktus, Emdeon) and David Richards (Dell Services, EPBS-Internedix.)

PointClear Solutions, a provider of HIT product development services, names Rodney Hamilton, MD, CMIO and managing director of its product strategy practice. Hamilton most recently was chief strategy officer for Vanguard Health Systems; he also spent time as a physician liaison with McKesson.

Predixion Software collaborates with the development team of Clinical Looking Glass to create a predictive model for reducing patient re-admissions. Clinical Looking Glass is a decision support tool that was developed at Montefiore Medical Center (NY).

Chelsea Community Hospital (MI) goes live next weekend on its $12 million EMR system. Chelsea is part of Trinity Health so I am assuming it’s a Cerner implementation.

The Indiana HIE reports that 70 distinct hospitals, long-term health facilities, and health systems were connected to the exchange as of the end of 2010. For the full year, IHIE delivered 3.3 billion pieces of clinical information, which is about 1.1 billion more than 2009’s totals.

Arizona, Connecticut, Rhode Island, and West Virginia have now launched their Medicaid EHR incentive programs, bringing the total number of live state programs to 21. Only 14 of those states states have issued incentive checks.

Cerner is sponsoring a 10-week weight-loss competition aimed at helping Kansas City residents drop a combined 100,000 pounds. The KC Slimdown Challenge is expected to involve about 20,000 people. For the calculator-challenged, that’s about five pounds a person.

Corepoint Health is the top-rated vendor in KLAS’s just-released interface engine report. Corepoint has the largest presence of any vendor in smaller healthcare facilities but very few clients in facilities over 500 beds. InterSystems was ranked a close second, though almost all InterSystems Ensemble customers are in 500+ bed facilities.

• Cumberland Consulting Groups promotes Erik Howell to principal. Howell has managed multiple HIT projects for Cumberland since joining the company in 2004.
• Surgical Information Systems is hosting a July 13th webinar on how social media affects healthcare.
• PatientKeeper’s 2011 User Group Conference is scheduled for September 18-21 in Denver.
• Lori Prestesater, RelayHealth’s VP of strategy and business development, will be discussing ACOs and Meaningful Use as a panelist at the Institute for HIT’s summit July 26-27 in Denver.  Also at the summit: Software Testing Service CEO Jennifer Lyle, who will join a panel discussion on strategies to achieve Meaningful Use.
• URAC awards accreditation to MEDecision’s Alineo health utilization management platform.
• Cancer Treatment of America  selects CareTech Solutions’ Service Desk to provide 24x7x365 IT support for its national network of  centers.
• Concerro is offering a July 23rd webcast on nursing documentation and reimbursements. Coding expert Glenn Krauss will lead the discussion.
• Karen Knect of Encore Health Resources will overview e-Measures during a online session July 13th.
• The Los Angeles County Department of Health will implement Wellsoft Emergency Department Information Systems at its Los Angeles County and USC Medical Center hospitals.
• Vocera Communications names John McMullen to its board of directors. McMullen is a SVP and treasurer at HP and will serve as chairman of the audit committee.
• GE Healthcare launches its fully integrated EMR/PM system, Centricity Practice Solution 10.
• CynergisTek CEO Mac McMillan will be a panelist for the launch of Clearwater Compliance’s HIPAA-HITECH Blue Ribbon panel July 14th.

Contacts

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

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MedQuist Holdings announced the signing of a definitive agreement to acquire M*Modal and its Speech Understanding technology for total consideration of $130 million, which includes $77.2 million in cash and 4.1 million shares of common stock.

Former Misys CEO Vern Davenport was appointed chairman and CEO of the new entity. He will replace Peter Masanotti as CEO and Bob Aquilina as chairman. Aquilina will continue to serve on MedQuist’s board. and Masanotti will remain a consultant to MedQuist through the end of September.

MedQuist has already been using M*Modal’s technology for its medical transcription business. The company intends to enhance further the integration of M*Modal’s front-end speech recognition technology with MedQuist’s clinical documentation platform.

M*Modal has a current annualized revenue run rate of $24 million, about $7 million of which came from MedQuist.

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