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May 22, 2012 News 9 Comments

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5-22-2012 9-56-10 PM

HealthCor, which owns 5% of Allscripts, launches a proxy fight for control of the company by suing Allscripts over its nomination process for board members. HealthCor says the resignation of three of the company’s nine directors last month, all of whom had ties to Eclipsys before Allscripts acquired that company, left the Eclipsys product lines unprotected “from the continuing failures of execution of [Glen] Tullman,” whose ouster it had previously demanded. HealthCor wants the June 15 Allscripts annual meeting postponed to give it time to nominate its own candidates for the three open board seats, saying Allscripts should not have put forth its own slate of prospective new board members without giving shareholders the same opportunity. HealthCor is also criticizing Tullman’s $7.2 million compensation in 2011, saying he makes more than the CEOs of competitors whose stock is going up instead of down.


Reader Comments

5-22-2012 9-57-00 PM

From BoltUpright: “Re: Shantanu Paul. Interesting that he left Allscripts to head up product development at Vitera. He was a major player in the overall integration strategy at Allscripts. Not sure if his departure is motivated by a desire to jump ship because they weren’t listening to him, or if he’s being pushed out as a scapegoat for the integration problems they are having.” Vitera announced Paul’s appointment as SVP of product development here.

5-22-2012 6-56-56 PM

From White Lightning: “Re: Dan Michelson, chief marketing officer of Allscripts. Leaving the company.” Unverified, but a purported internal company e-mail sent my way says he’s leaving to become CEO of a private software company after 12 years with Allscripts. He won’t be replaced, according to the e-mail.

5-22-2012 9-58-40 PM

From Reverse Transcriptionase: “Re: Transcend. The servers of the former Transcend Systems transcription company that Nuance acquired have been down for days.” E-mails forwarded to me refer to a major system issue that was caused by failed storage devices. The last e-mail I saw, from Monday, said that they were still down and were typing and faxing stat reports, preop H&P, and radiology reports. I tried the Transcend Services Web site on Monday evening and it was down, but it’s working now, so I assume the problem has been resolved. Anybody can have systems fail and I give them credit for communicating thoroughly, although I’d be interested to hear what customers did in the interim.

5-22-2012 8-45-49 PM

From Casual Hospital Administrator: “Re: famous highly wired hospital. Patients appear to have been harmed.” The family of a former post-bypass ICU patient of UPMC Shadyside (PA) sues the hospital, claiming the 68-year-old man was somehow not attached to monitors when he died. Documents apparently verify that the patient was not being monitored for a 16-minute period, saying only that “mistakes were made.”

From Don Diego: “Re: HIStalk Advisory Panel. I’m an avid reader and also impressed with the insight, but the post on what Allscripts should do to fix things is absolutely amazing. Way to go, HIStalk.” I appreciate the involvement of the 79 panel members (now 94) who have volunteered to offer their opinions on topics I’ll e-mail them every few weeks. Most of them are CIOs, CMIOs, and practicing doctors, with a few vendor executives added to the mix. They can provide their honest thoughts knowing that even though I won’t identify them in any way, they’re still not potentially untrustworthy anonymous commenters (like Allscripts competitors, for example) since I know who they are. I’ll take suggestions on what I should ask them in the next round of crowdsourcing. In the mean time, I’ll be listing a few companies they mentioned in response to my question about any cool, small companies they’re working with – stay tuned later in the week.

From CDiff: “Re: Chicago CEO pay. The Chicago Tribune set up a Web page so you can do your own sleuthing on any aspect of compensation. Allscripts and Accretive did not bubble up, the the Trib’s lead story was about Debra Cafaro of healthcare real estate investment trust Ventas, who made $18.5 million. As you know, we have no method to compensate you for all you do; you remain the very definition of priceless.” Healthcare well represented on the list: drug maker Abbott ($24 million), supplies vendor Baxter ($14 million), supplies vendor Hospira ($12 million), and drug store operator Walgreen ($12 million) on the first page alone. Glen is on the list at $7.2 million and Mary Tolan of Accretive lags the well-enriched executive pack at $1.6 million.

From Carriage Bolt: “Re: Cerner single revenue cycle product. I’ve heard Adventist Health West is helping them develop a clinic and physician revenue cycle module.” Unverified.


HIStalk Announcements and Requests

Here’s a tip for companies who go to the trouble to issue press releases about their new hires. Include a link to a hi-res photo and insist that the person create a LinkedIn profile that includes a head shot (and not a thumbnail-sized one – a professionally made full-size headshot since LinkedIn automatically creates the thumbnail). You would be surprised at how many press releases I get about folks who have no apparent photographic presence on the Web, or who use a blurry, small, or amateurish snapshot as their LinkedIn photo. I’m less likely to run those announcements. Another gripe is PR companies that e-mail me a press release that hasn’t been posted anywhere else (including the company’s own site), so I don’t have anything to link to. Or, that send Word documents instead of pasting the text into the body of the e-mail or attaching a PDF – I practice safe text, meaning I’m not opening your Word doc unless I know where it’s been.


Acquisitions, Funding, Business, and Stock

5-22-2012 8-05-21 PM

Apple’s iPad in Business page features HCA’s use of AirStrip, Epocrates, PatientKeeper, Heart Pro, and other apps I didn’t recognize.

5-22-2012 8-07-49 PM

Here are iPad screen shots of Nova’s $17.99 Heart Pro, developed with Stanford University School of Medicine as a patient teaching tool. Very cool.


Sales

Iowa Primary Care Association selects Ignis Systems to integrate lab orders and results for 15 community health centers running Centricity EMR.

5-22-2012 10-03-14 PM

San Jacinto Methodist Hospital (TX) chooses PerfectServe for clinical communications.


People

5-22-2012 5-49-27 PM

Former Optum/Axolotl VP Anand Shroff joins Health Fidelity, Inc. as chief technology and product officer.

5-22-2012 6-34-28 PM

Nate Ungerott joins Health Care DataWorks as VP of sales. He was previously with Accuvant.

5-22-2012 9-36-17 PM

Investor Sue Siegel is named CEO of GE’s healthyimagination, which is spending billions on healthcare innovation and bringing healthcare IT to rural and underserved areas. She replaces Mike Barber, who has moved to VP/GM of molecular imaging at GE Healthcare.

Teresa Jamison is named VP of customer operations of SciQuest. She was previously with Allscripts.


Announcements and Implementations

Oregon’s statewide HIE implements Harris Corporation’s CareAccord platform and Direct Secure Messaging system.

Anthem Healthcare Intelligence, a provider of healthcare BI solutions and services,  rebrands as Agilum Healthcare Intelligence.

The 319-bed Cooper Green Mercy Hospital (AL) implements Medsphere’s OpenVista EHR and Stockell Healthcare’s Insight CS financial and accounting solution, replacing Meditech. The hospital says it will receive considerably more HITECH money than its five-year costs.

CBORD will offer Horizon Software International’s point-of-sale system that allows cafeterias to handle meal plans, payroll deduction, and gift cards to provide “the best total return on investment for healthcare food service operations.” Pretty cool, but I wish hospitals cared enough about their cafeterias to stop outsourcing them to companies like Aramark or Sodexo, who are given free rein to coldly enforce margin-preserving policies that would drive a real restaurant out of business within days: pre-portioned freezer-to-grease prisoner food from Sysco (the potato peeler has left the building), wildly overpriced drinks with no free refills, and weighing plates so that a modest portion of waterlogged spaghetti with canned sauce ends up costing $8. Nobody cooks, everybody scowls defiantly (especially the cashiers), and they all clear out by mid-evening, leaving the captive audience of off-hours employees and visitors with only the vending machines as a shining example of wellness. The best, cheapest, and most nutritional food that’s anywhere close is usually the hot dog cart out front or the caterers who bring in real food for the executive meetings.


Government and Politics

5-22-2012 8-57-01 PM

The VA refines its VistA strategy at the Open Source Think Tank, planning to spend up to $5 billion to tap the open source community and the private sector to advance VistA. Among its significant challenges is the Military Health System, which likes the fat cat contractor approach that turned its own AHLTA EMR into a $10 billion flop. The generals claim they’re leading the military-industrial complex charge, trying hard to win some EMR hearts and minds. In the mean time, the VA and DoD announce that they won’t roll out their integrated EHR until 2017. The excellent NextGov got a copy of the presentation outlining the problems. The only sure thing is that it will be late, over budget, and politicized.


Innovation and Research

A Brigham and Women’s study finds that doctors who dictate their notes instead of using templates or typing free text have lower quality of care, as evidenced by standard quality measures. The authors postulate that doctors who use a keyboard instead of a microphone pay more attention to on-screen discrete data elements and clinical decision support messages.


Technology

Bloomberg profiles Jintronix, a company I’ve mentioned that’s building technology around Microsoft Kinect that helps home rehab patients do their exercises correctly.

Mentioned in the above article is potential Kinect competitor Leap, a $70 iPod-size Minority Report-type pre-order USB peripheral that the company says will be 200 times more accurate than “a game system that roughly maps your hand movements,” able to distinguish individual fingers and track movements down to 1/100th of a millimeter. Assuming it’s not bogus, which seems to be a topic of discussion.


Other

5-22-2012 5-54-49 PM

In the UK, NHS announces an initiative to provide patients with online access to their medical records by 2015.

Bond ratings firm Fitch Ratings surveys its client hospitals about capital spending and finds that they consider IT investments to be the most important, ranking much higher than capital spending to increase capacity and align with physicians. The company was surprised to find that hospitals don’t expect the Patient Protection and Affordable Care Act to have significant influence on their capital spending plans regardless of the Supreme Court’s ruling.

Boston Children’s Hospital announces that an employee at a conference in Buenos Aires, Argentina lost an unencrypted laptop containing information on over 2,000 patients as an e-mail attachment. Somehow until trying to track this down I didn’t realize that Boston Children’s Hospital is one facility of Children’s Hospital Boston (if I’m correctly deciphering the seemingly contradictory logos and names on their site).

One of those lame problem-solver type news crews investigates a woman’s 10-hour ED wait, quoting the ED doc’s two mitigating issues: a new EMR system (Cerner from Trinity Health, I believe) and the need to treat sicker patients first.

5-22-2012 8-17-10 PM

HIStalk reader Alexander Scarlat MD’s book, Electronic Health Record: A Systems Analysis of the Medications Domain, is now available on Amazon. This is not one of those easy-to-skim books that seem to get published without any real purpose – it is hardcore into the medication domain (prescribing, drug concepts, dispensing, MAR, user interface, etc.) Alex was kind enough to send me an autographed copy since I reviewed a pre-press chapter and provided a quote for the back cover:

… encompasses high-value, high-volume therapeutic transactions of indescribable complexity that touch nearly every licensed professional in a hospital, enrobing drug ordering, dispensing, and administration in sophisticated layers of clinical decision support, caregiver work lists, and back-end charging and continuum of care functions. I am pleased that the topic merits its own formal review and analysis in Dr. Scarlat’s book. I found the user interface chapter immediately useful – in fact, I’m hoping the vendors of my own hospital’s systems take its recommendations to heart.

Weird News Andy is all up in our grill with this story, which he subtitles, “A Brush with Death.” Doctors investigating a man’s suspected appendicitis instead find that his intestine is pierced by a nail-like object later identified to be a bristle from his metal grill cleaning brush, which had become embedded in the steak he ate.


Sponsor Updates

  • Greenway Medical and NextGen will participate in a patient data exchange demonstration during the ONC’s 2012 Direct Demonstration Showcase in Washington, DC May 31.
  • Healthcare Informatics releases its annual list of top 100 vendors based on revenues from HIT products and services. HIStalk sponsors earning a spot of the list include: 3M Health Information Systems, API Healthcare, Allscripts, Beacon Partners, Capario, CareTech Solutions, Cumberland Consulting Group, eClinicalWorks, GE Healthcare, Greenway Medical, Health Data Specialists, HealthStream, Iatric Systems, Impact Advisors, Lawson Software, maxIT Healthcare, MED3OOO, MEDSEEK, McKesson, MedAssets, Merge Healthcare, NTT Data (formerly Keane), NextGen, Nuance, Optum, Orion Health, Passport Health Communications, SCI Solutions, Sunquest Information Systems, Surgical Information Systems, T-System, TELUS Health Solutions, TeleTracking Technologies, The Advisory Board Company, Vitera Healthcare Solutions, Vocera Communications, and ZirMed.
  • ICA and AlliedHIE launch a national health information exchange to identify technology and communications issues within healthcare organizations.
  • Michael O’Neil, founder and CEO of GetWellNetwork, gave a patient engagement presentation at Cleveland Clinic’s Patient Experience Summit on Tuesday.
  • Hayes Management Consulting reports that eight of the top ten US hospitals listed on US News and World Report’s Honor Roll use MDaudit.
  • The hospital authority for Memorial Hospital and Manor (GA) approves a consulting engagement with Vitalize Consulting for the implementation and training of hospital’s eMAR/BMV project.

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

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Currently there are "9 comments" on this Article:

  1. If there is a better example of government ridiculousness than that VA/DOD presentation, I’d like to see it. The military needs to get out of the healthcare business and stick to wars. Our veterans and tax payers deserve better than that horse manure.

    Instead of going all in on one solution, why wouldn’t they trial different vendors in different areas. It certainly couldn’t be more expensive. The VA gets a facility to implement their stuff, Cerner gives it a try in a another, let Epic take a stab at a region, eClinicalWorks, Allscripts, etc. Too bad the best won’t win due to politics, but at least we’d have progress.

  2. http://histalk2.com/2011/12/27/news-122811/

    You covered one documented EMR outage in December, 2011. Therer were others of similar duration that occurred earlier in the month.

    This has relevance since the outage you reported occurred less than a week after the “off monitor in the ICU” death. The issue must be raised as to whether there was an EMR outage at the time this critically ill post-op ICU patient was neglected. You must know all too well of the scurrying and anxiety that occurs on the wards and ICU when the screens go blank and all records vanish at once without warning.

    It begs the question for a requirement that all EMR outages be reported for official and public use, just as what happens in the airline industry with departure delays, for example.

    Thank you for your consideration of this.

  3. The HCI top 100 doesn’t list Practice Fusion. Their website says they have 150,000 users, they couldn’t be exaggerating, could they ? Hmmmmmmm.

  4. Quoting from the documentation method study abstract:

    “In multivariable modeling adjusted for clustering by patient and physician, quality of care appeared significantly worse for dictators than for physicians using the other two documentation styles on three of 15 measures (antiplatelet medication, tobacco use documentation, and diabetic eye exam); better for structured documenters for three measures (blood pressure documentation, body mass index documentation, and diabetic foot exam); and better for free text documenters on one measure (influenza vaccination). There was no measure for which dictators had higher quality of care than physicians using the other two documentation styles.”

    I’m struggling to decipher this. If quality of care is worse for dictation “on three of 15 measures,” does that mean it was BETTER or THE SAME on 12 of 15 measures? If that’s the case, then the conclusion that “quality of care is worse with dictation” is inaccurate, to say the least. And the statement, “There was no measure for which dictators had higher quality of care than physicians using the other two documentation styles,” what exactly does that mean?

    [From Mr H] I would take that to mean that outcomes were similar for all three documentation methods, which is what you might expect, except that dictators (odd word) did worse in three of the measures and did better in none. Those three measures aren’t a big difference, but may be significant because they are the only difference. I’m also not clear (having read only the abstract) whether the “quality of care” refers to actually meeting the quality standards, or whether the study only looked at what was or wasn’t documented regardless of whether it was actually performed. I don’t know that I’d call those “outcomes” in either case, just quality metrics.

  5. Hey, Historian, do you really mean that *all* EHR outages should be reported?

    – What’s an outage? Is it at a specific workstation or an entire system? If it’s somewhere in between, where?

    – Does a podiatrist’s EHR need to be reported? How about a family practice? How about a pathologist? How high down the acute/deadly visit chain do we go?

    – How long does an EHR have to be “down” for it to be reportable? 30 seconds? 10 minutes?

    – Does the entire EHR have to be down to be reported or just part? Which parts? What if the third-party embedded eRX is down, but the rest is OK? What if it’s just, say, the ARRA mandated WWW-based patient educational handouts?

    – What happens if someone doesn’t report? Who owns this data? Where does it go?

    I could go on. I’m not suggesting that we shouldn’t be looking for a relationship between our dependence on EHRs and clinical quality (below the threshold of death), but that’s a broaaaad brushstroke you paint.

  6. “The only sure thing is that it will be late, over budget, and politicized.”

    Oh, dear. Non-federal EHR implementations are never later, over budget and politicized. Had we only known.

  7. Well, to speak of outages, I work in intensive care. When you lose all records of patients at once, a fear takes over. I find it abhorrent to have to wait and hope nothing bad happens during the delays. I am not surprised that patient care disasters occur when every one runs around like how do they say in America, like chicken with head cut off.I hhave witnessed them but an afraid to say much for retaliation takes over by those saaying patient care was not affected. I hope you are out there listening.

  8. Thanks for the input, that clears things up a bit, but not much. I also think you’ve hit the nail on the head with the observation regarding the so-called “outcomes,” as it’s not clear whether they measured anything other than whether or not something was documented. Certainly proper documentation is an important part of quality outcomes, but that’s certainly not the only factor influencing “quality of care.”







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