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April 18, 2013 News 7 Comments

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4-18-2013 6-10-27 PM

Defense Secretary Chuck Hagel says his office has taken direct control of the DoD-VA EHR integration project as he acknowledges to a House subcommittee that “we’re way behind.” Hagel told the committee that he has personally blocked the DoD’s EHR request for proposal because “I didn’t think we knew what the hell we were doing.” He added, “Until I get some understanding of this and get some control over it, we’re not going to spend any money on it.” Hagel, whose experience includes tours as an infantry squad leader in Vietnam and serving as a VA deputy administrator as its VistA system was being developed, says the DoD will have its marching orders within a month.


Reader Comments

4-18-2013 6-44-17 PM

From Mr. Horizon: “Re: Bayhealth – Kent General Hospital, Dover, DE. Went live on McKesson Expert Orders whole house with physicians with minimal problems this week.”

By Anonymous: “Re: MyChart. I gave it another chance and ordered a prescription refill. This morning, I was thinking I never received order confirmation from Caremark. It was a busy morning, so I didn’t get around to calling my doctor to see what was up. This afternoon, I received my trusty Caremark communication that the week-old order was received today. Who knows when the physician practice checks messages or Rx refill requests coming through MyChart? A bigger question: why the heck are you promoting this to your patients if it essentially has no functionality due to no real implementation and weekly checking of messages and notifications, even if weekly? Score:  MyChart zip, Caremark slam dunk. And Mayo had 5 percent portal engagement with what was hopefully a functional portal.” Anonymous wrote the Readers Write article on her MyChart impressions a couple of weeks ago that generated quite a few comments.

4-18-2013 7-02-08 PM

From Poor Richard: “Re: patient portals. New York is allowing citizens to gauge ‘likeability’ of patient portals by voting. I didn’t recognize many of the vendors on the ballot. Some presentations were very professional while others appeared to have been completed in the basement of a programmer. Some of the presentations I considered unimpressive had massive vote appeal, so of course now I am wondering about voter fraud (especially considering I am not a New York resident and they let me vote!) Personally, I preferred ChARM EHR, not for their goofy upper case/lower case naming, but because they were the only vendor in this entire group who addressed maintaining membership through incentives. In ChARM’s (damn, I hate typing that) model, they included a rewards system for using the portal, which is a feature sorely lacking in every patient portal I have seen.“

4-18-2013 7-29-50 PM

From Dan: “Re: GNU Health. I’ve been involved with installing and supporting cumbersome and incredibly expensive EHRs like Horizon and Epic at hospitals and wondered what options are available for organizations with little funding. This one seems to have potential. I’m interested to hear your thoughts.” It’s free, seems to have several basic modules, and already supports ICD-10. No US customers are listed, which is typical of free EHRs that work well in countries that don’t care about billing and other non-patient related capabilities that are unfortunately very important here. Readers are welcome to jump in.

From Lance: “Re: $1 million ONC EHR vendor tax. I work for a vendor and think that ONC could have spent a lot less to achieve the same MU attestation results. Many of the RECs did not earn their M1 and M2 milestones, simply piggybacking on the EHR vendor’s installed base. Many of our clients that we introduced to RECs said they didn’t add anything and all they needed was the free MU resources we provided.”


HIStalk Announcements and Requests

inga_small Recent highlights from HIStalk Practice include: OIG publishes protocols for providers who wish to voluntarily self-disclose evidence of potential fraud. Jonathan Bush dishes with the Wall Street Journal. Children’s Mercy Hospitals and Clinics in Kansas City offers Wichita allergy patients an option for telehealth visits. Professional organizations give tips for physicians participating in social media. NorthShore University Health System’s ambulatory clinics achieve Stage 7 on the HIMSS Ambulatory EMR Adoption Model. Culbert Healthcare Solutions’ Brad Boyd discusses patient access issues. Finally, 91 percent of readers participating in our recent HIStalk Practice Reader survey say that reading HIStalk Practice has helped them perform their jobs better over the last year. If you have room for self improvement, it’s likely worth your while to mosey over to HIStalk Practice. Thanks for reading.

4-18-2013 7-35-27 PM

Welcome to new HIStalk Platinum Sponsor Predixion Software. The San Juan Capistrano, CA-based company offers self-service predictive analytics that are fully integrated with the Microsoft stack, allowing modelers to work with Predixion’s workbench and modeling tools from within Microsoft Excel. The company’s predictable admissions module scores patients at admission and throughout their stay using a hospital-specific model to predict readmission risk with up to 86 percent accuracy. If you’re curious how that works, read up on Practical Predictive Analytics for Healthcare 101. The company won a Microsoft HUG award last month for the use by one of its major healthcare customers of Predixion Readmission Insight. Thanks to Predixion Software for supporting HIStalk.

Here’s a video interview of Chad Eckes, CIO of Cancer Treatment Centers of America and Predixion advisory board member, talking about predictive analytics.

It’s time for that post-HIMSS planning of which conferences to attend this year. If you have suggestions, let me know. I had a nice invitation to attend TEDMED as the guest of a generous company, but couldn’t make it because of work conflicts at the hospital.


Acquisitions, Funding, Business, and Stock

4-18-2013 8-29-48 PM

Roper Industries, which acquired Sunquest Information Systems in August 2012, will buy New Jersey-based Managed Healthcare Associates for $1 billion in cash. MHA offers alternate site services, software, and analytics.


Sales

CareONE LTACH (NJ) long-term acute care hospital selects NTT DATA’s Optimum EHR.

4-18-2013 4-09-36 PM

University of Colorado Health will incorporate Medseek’s predictive analytics and hospital website solutions into its patient engagement initiatives.

4-18-2013 4-08-20 PM

Australia’s Ballarat Health Services deploys the Rhapsody Integration Engine from Orion Health as its connectivity program for message exchange.


People

4-18-2013 8-31-05 AM

Quest Diagnostics names Jim Davis (GE, InSightec) SVP of diagnostic solutions.

4-18-2013 8-05-01 PM

Long-time friend of HIStalk Justen Deal of Vieu Health is named BlackBerry Business Fan of the Month, dropping a much-appreciated plug by saying in his profile piece, “And in my field, HIStalk is where you go when you really want to know what’s really happening; it’s sometimes a bit irreverent, but it’s always smart, insightful, and to-the-point.”

Andy Flanagan (SAP) is appointed SVP, Health Services Sales & Business Management of Siemens Healthcare.

Beacon Partners appoints Michael Whalen (GE Healthcare)  VP of professional services and promotes Chris Kondrat to VP of business integration.


Announcements and Implementations

The Premier healthcare alliance will offer its members access to Phytel’s population health intelligence suite.

4-18-2013 4-12-04 PM

Massachusetts General Hospital joins the PathCentral Pathology Network, an online information exchange and digital consultation forum that enables physicians to upload digital images for pathologists to review and render diagnoses.

Indiana University Health implements Health Catalyst Late-Binding Data Warehouse in 90 days to create a centralized repository of clinical, financial, and patient satisfaction data.

Lumeris releases its Accountable Primary Care Model called the Nine Cs that addresses reducing costs, improving quality, and improving patient and physician satisfaction.


Government and Politics

A JAMIA article describes interviews with VA leadership on their vision for a next-generation EHR. Identified needs include designing better user interfaces to present decision support messages more effectively, creating smaller applications to allow fine tuning workflows, developing a recommendation engine to guide practice as it learns preferences and presents peer practices, using back-end documentation tools such as natural language processing, creating support for teamwork, developing interoperability with the DoD and other care settings, and improving data governance and stewardship.

4-18-2013 8-19-51 PM

HHS and the FCC name members of the new Food and Drug Administration Safety Innovation Act (FDASIA) Workgroup, which will report to the HIT Policy Committee on improving patient safety and innovation in healthcare IT. The new members are from health systems, technology companies, healthcare software vendors, and venture capital firms. The group’s chair will be David Bates, MD, MsC (above), SVP for quality and safety and chief quality officer of Brigham and Women’s Hospital.


Technology

Experts say new WiFi standards 802.11ac and 802.11ad could drive improved hospital wireless connectivity, such as iPhones supporting EHR lookups at 450 Mbps. 802.11ac will replace 802.11n as the WiFi standard, while the short-range 802.11ad technology can support data rates of up to 7 Gbps in potentially replacing cables for connecting computer peripherals or medical equipment.


Other

EHR adoption in children’s hospitals grew from 21 percent in 2008 to 59 percent in 2011, which was significantly higher than adoption rates for adult hospitals.

The Health Technology Forum Innovation Conference: Platforms for the Underserved will be held Friday, April 19 at the UCSF Mission Bay Conference Center in San Francisco, CA. Speakers include Gavin Newsom (lieutenant governor of California); Justin Graham, MD (CMIO, North Bay Healthcare); Kate Bennett, ND (CMIO, John Muir Health); and Darren Schulte, MD (president, Apixio).

Another health technology accelerator makes its debut as Dallas-based Health Wildcatters offers the usual package of mentoring services and seed money in return for equity.

In Canada, Nova Scotia’s largest health district says its computer systems experienced 1 million security threats in the past year, none of which led to lost data. Most were malware and spyware attacks.

4-18-2013 8-41-31 PM

Aetna CEO Mark Bertolini, speaking at the Stanford Graduate School of Business 2012 Healthcare Innovation Summit on Wednesday, says the insurance company is evolving into a health IT company through its acquisitions that include Medicity, iTriage, and Active Health.

In Canada, Regina General Hospital says 15 patients were mistakenly given clindamycin to treat clindamycin-resistant infections due to an unspecified computer error in creating sensitivity reports.

Former Roxy Music member and music producer Brian Eno designs light and sound installations to create healing environments in two British hospitals.

4-18-2013 8-57-38 PM

AlertWatch, which offers surgical patient monitoring software developed at the University of Michigan’s Venture Accelerator, is profiled in a technology publication. A real-time demo (above) is available online. The company’s patient safety advisor is former astronaut Jim Bagian, MD, who I’ve seen speak – he’s excellent.

4-18-2013 9-04-56 PM

A University of Vermont medical student and a partner are working on software that will allow pharmacies to communicate with patients via simple HIPAA-compliant text messages to help them understand their medications. Luke Neill and Sam Mayer were congratulated by actor Matthew Perry at Clinton Global Initiative University earlier this month.

Weird News Andy wonders how in the world this happens. Workers at a commercial laundry processing a load of linen from Regions Hospital St. Paul, MN are startled when a baby’s body falls out. The hospital apologized, explaining that the stillborn infant’s body had been wrapped in linens in the morgue and was mistaken for laundry.


Sponsor Updates

  • Surgical Information Systems CEO Ed Daihl explains the importance of perioperative analytics and the competitive edge it gives hospitals. The company also announces the winners of its SIS Perioperative Leadership Awards.
  • Awarepoint highlights its first quarter 2013 achievements, which include installation of 4.1 million net new square foot of RTLS coverage across 10 clinical sites, the addition of numerous new clients, and renewed commitments from five organizations.
  • Availity and Greenway Medical Technologies join insurer Florida Blue to enable the sharing of clinical data and patient summaries.
  • Trustwave offers an infographic highlighting the high cost of BYOD.
  • Optum opens a free emotional support line staffed with mental health specialists for those affected by the recent Boston explosions.
  • Lisa Bielamowicz, MD, SVP with The Advisory Board Company, reviews three key elements for successful population health management.
  • iHT2 hosts an April 24 Webinar on healthcare cyber first responders.
  • Medseek announces the winners of its eHealth Excellence Awards during this week’s 2013 Client Congress in Austin.
  • Imprivata hosts an April 23 Webinar on streamlining clinical communication with Imprivata Cortext.
  • Good Morning Texas profiles Key-Whitman Eye Center and how its implementation of RTLS technology from Versus is reducing wait times.
  • CAQH recognizes several organizations that have earned voluntary CAQH CORE Phase I or Phase II Operating Rules certification, including NextGen (NextGen PM), OptumInsight (Optum Netwerkes 2.2.0), and RelayHealth (RelayExchange.)

EPtalk by Dr. Jayne

First of all, I want to send my thoughts and prayers to the people of Boston as well as the marathon participants, their families, and the first responders and health care teams who assisted. One of my shoe-shopping pals was running and I was tracking her as the horrifying event unfolded. This was her first Boston Marathon and she slowed down around mile 17, for which I am grateful. Her previous projected finish time would have put her in the thick of it. Hopefully she (and all the other runners who didn’t finish) can qualify again next year.

A recent study shows that physicians may benefit from seeing cost information when ordering laboratory tests. We see plenty of EHRs with medication formularies, but not too many with lab cost data. In my experience, the Advance Beneficiary Notice functionality of many EHRs is sorely lacking, so maybe this will spur vendors to spend some attention in that area. I’d be interested in not just seeing cost information but seeing data on whether tests are really helpful in diagnosing or confirming a particular condition. Of course order sets are helpful, but this would be a twist on the concept for docs who don’t think order sets apply to them.

Weird news: scientists are looking at how intestinal parasites attach to develop better ways to attach skin grafts. Here’s to the spiny-headed worm as the newest member of the healthcare team.

From Tom T: “Re: your piece about the ACP/FSMB online professionalism policy. You are right on the money again and again. The self-righteousness and patronizing tone of those guys is getting to be nauseating. The latest blow is the decision coming from Walgreens to get involved in chronic illness management. How sad that they have no idea of what we do and how bad that will be for healthcare. I for one will refuse to see patients who are going to Walgreens for anything.”

Thanks for writing. I’m interested to see the details on how Walgreens plans to pull this off, specifically how they plan to communicate with other members of the patient care team. When I’m wearing my PCP hat, I refuse to refer to other physicians that don’t communicate in an adequate or timely fashion, and I won’t hesitate to refer patients away from pharmacies or other businesses that don’t have the patients’ best interests at heart. The best service in my community (which is heavily saturated with all kinds of chain pharmacies) actually comes from a mom-and-pop shop and their prices are competitive.

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I wonder if Inga has a pair of these in her closet? I can’t imagine they’d be comfortable, but they’re certainly unique.


Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.

More news: HIStalk Practice, HIStalk Connect.

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Currently there are "7 comments" on this Article:

  1. Re: “Anonymous” bashing of MyChart

    Enough already.

    Those of us who have implemented and use MyChart very clearly understand that your issue is with your provider organization not the technology platform.

    Your refill request was almost certainly sent to a designated pool of your doctor’s office staff the instant you hit “send.” The lag in processing of the request has nothing to do with the software.

    There is obviously some sort of axe to grind here based on the unwillingness or inability to distinguish between the tool and its implementation.

    If you want to keep score, make sure you are fairly assigning the points…

  2. OK – you’ve gotta be kidding me. $37,000,000,000 spent under ARRA for “meaningful use,” and the government wants more money by taxing the VENDORS! If you’re that bad, GET OUT of the business. Its flat out shameful. America, wake up. That’s 37 Billion with a B.
    * RECs were a joke.
    * Fraud on medicaid practices needing to present only a receipt to get their check has got to be everywhere. Except, its not really fraud because after all, all they had to do was present a receipt to get their money – no usage attestation required for the big, first year check.
    * Physician productivity has plummeted and morale is at an all time low.
    * Basically ZERO interoperability
    * Over 500 “certified” products with 80+ % having fewer than 10 customers (ugh). How will they pay for the massive upgrades necessary for Phase II. Will physicians even bother to sign up for phase II?
    * On the hospital side, the “BEST” vendor is one built on a MUMPS database.

    And this is what you want to support with a new TAX

    This is going to be a HUGE wash-out. Physicians, once bitten twice shy, will be reluctant to sign up a second time around and probably won’t be able to afford it. So – now they’ll be “penalized,” if they can make that stick – which they won’t because the SGR is nearly always kicked down the road but if they do will lower already low reimbursements. Lower reimbursements will cause more doctors to leave and create more physician shortages as Obamacare adds 30 Million patients into the mix and physician needs will be at an all time high.

    On another note – Kudo’s to Hagel. I have a lot of respect for him stopping the stupidity train and saying what he said about the EHR initiative at the VA / DoD. We need more rationalism like his.

    NO VENDOR TAX. If your budget and a $37 BILLION spiff to your customers can’t make it work – you need to find something more productive to do with your time and our money.

  3. Agree with the MyChart comment above. If you want to make it useful, tell us what system you use and make them defend themselves. What that system could say is that they didn’t have time and Epic insists they implement it so it’s very bare bones. But mostly, this has nothing to do with MyChart.

    I agree that MyChart could offer so much more, and in the future I think it will, but don’t pretend that what is there isn’t helpful or doesn’t work.

    My own experience is that my provider, which is a very well established and fairly good MyChart provider, doesn’t deal with some things like appointment scheduling very well either. But, it actually affects them more than it does me. For example, by not being able to schedule a phone visit, I schedule an unneeded office visit because I don’t want to hold to schedule with the scheduling center and my physician’s office is close, so it’s not a hassle to me. I know I’m wasting resources, but that’s the age old dilemma, right? I’m not paying, thus I don’t care.

  4. It’s a bit ironic that the Epic apologists would jump on a bad MyChart implementation, given that Epic has spent the last decade selling the “superior software” story to replace other vendor’s “bad implementations”.

  5. @LFI Masuka…totally agree…Truthfully, are there anything else besides “Epic Apologists?”…….Epic should thank the good Lord every day for that corporate welfare program called Meaningful Use….it is the fuel behind the greatest Jedi Mind trick ever played…….

  6. FDASIA Committee: “HHS and the FCC name members of the new Food and Drug Administration Safety Innovation Act (FDASIA) Workgroup, which will report to the HIT Policy Committee on improving patient safety and innovation in healthcare IT.”

    Same old! same old!

    How can anything innovative and safe come out of this committee when the members are the usual cast of characters?

    The incestuous nature of this HIT Committee will result in reaffirmation of the same flawed policies that have ignored the adverse events and so called “glitches” in these systems that endanger patients (and kill?) daily.

    Shame on the HHS and Secretary Sebelius along with @farzad_ONC and J. Shuren, MD JD of FDA for their mindless selection of the FDASIA Committee.







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