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News 5/24/13

May 23, 2013 News 18 Comments

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5-23-2013 6-21-30 PM

Secretary of Defense Chuck Hagel tells the DoD that he supports the use of commercial software to replace the department’s AHLTA EHR rather than switching to the VA’s VistA platform as he previously hinted was his preference. The DoD says it has identified 20 commercial software vendors capable of meeting its EHR needs. You’d have to bet on Epic given that it’s outselling everybody in big hospitals, they were allegedly the DoD frontrunner in 2010, and the Wisconsin Congressional delegation was squeezing the federal government to choose Epic awhile back (and not to mention that there are nowhere near 20 serious players to choose from.) On the other hand, DoD loves throwing billions at the fat cat contractors and Epic might not want to work through them.


Reader Comments

From Lil Wayne: “Re: Practice Fusion. Does anyone buy into their claim of having 30 percent of the primary care market? Seems beyond ludicrous.” I’m always curious about their methodology for counting actual users vs. someone who signs up with minimal usage. I would also be interested in seeing audited user statistics. Practice Fusion isn’t in the top five vendors by Meaningful Use attestation as I recall, in the low single digit percentages of all attesting providers.

From Stephanie: “Re: certification. If I already have a certified completed EHR and use another vendor’s patient portal within the HIE, does my patient portal also need to be certified? I’m just placing patient documents out in the portal for patients to view.” I know Frank Poggio will answer if nobody else does.

From Sleepless Fax Server Administrator: “Re: HITECH modifications to HIPAA. Will add risk to faxing or mailing results. There is a 100 percent chance of a violation when a provider changes practices since no healthcare IT system can determine the right address or fax number based on the date the patient was seen – they always use the current information. Even if you solved that problem, how would any system know if the patient followed the provider to the new practice? Also, critical radiology results are required by regulation to be faxed within 24 hours.”

5-23-2013 7-29-45 PM

From Major Tom: “Re: conference. Thought you would enjoy this e-mail.” A promoter pitches their conference as offering “peer-to-beer” knowledge exchange, creating mental images of sullen, bar-perched attendees mumbling into their mugs.

From Non-Sequitur: “Re: RAC recoveries hit $1.37 billion. Forwarding a synopsis from Wolters Kluwer. You are still the brightest spot in many of my mornings!” Thanks, milady, that’s sweet of you to say. The article says RACs collected $1.371 billion in Medicare overpayments and returned $65.4 million in underpayments in the first six months of FY2013 (obviously like with the IRS, your odds of an unexpected refund aren’t so good when the RACs come knocking). The current major issue is documentation for cardiovascular procedures.


HIStalk Announcements and Requests

Listening: Superchunk, possibly the best and most prolific indie band in history. I’ve played all 15 of their albums on Spotify and it’s a stunning body of influential work spanning almost 25 years. A new album will be out in August and a tour follows.


Acquisitions, Funding, Business, and Stock

5-23-2013 11-07-30 AM

Online medical consult provider ConsultingMD secures $10 million in funding from Venrock.

5-23-2013 11-20-36 PM

Quality Systems reports Q4 results: revenue up 2 percent, EPS –$0.07 vs. $0.25, missing on both.

From the Quality Systems earnings call:

  • Poor performance in the company’s Hospital Solutions Division (a $4.2 million loss on $4.5 million revenue) will require investments in development, implementation,and support.
  • Steve Puckett will be moved from Hospital Solutions to CTO and COO/EVP Daniel J. Morefield will take over Hospital Solutions.
  • In a “what were they doing before?” moment, the company said it has “aligned our marketing team with our overall revenue objectives and shift and focus to increasing product demand and lead creation,”
  • To an analyst’s question about implementation margins of zero percent, the CFO’s response was, “There’s a number of factors, but I think hospital certainly is. I think we’ve already been talking about the — some of the challenges that we’ve been — that we’ve had there and that certainly impacted the profitability on that particular revenue category. I think — so it gets a little hard to generalize. On the ambulatory side, we’ve got — but I’ll let you — you ought to know, though, that certainly it’s not something — we are paying attention to it and we do intend to drive higher margin there in that space. We have — we are in some — having some transition in the ambulatory world … the full expectation is, for us, it’s going — going forward is to drive a higher level of profitability on that revenue category.”
  • The company declined to give dates for a SaaS product, saying it will focus on the current product.
  • The company expects a move back to larger EMR vendors as the small ones fail trying to keep up with Meaningful Use and ICD-10.
  • They expect more government programs to follow the DoD’s apparent lead in moving to commercial software, with vendors scrambling to get their GSA status.

Sales

East Lansing Orthopedic Association (MI) selects SRS EHR.

5-23-2013 11-21-55 PM

Conway Medical Center (SC) chooses StrataJazz from Strata Decision Technology for decision support, budgeting, and capital planning.


People

5-23-2013 6-14-27 PM

The New Jersey chapter of Entrepreneurs’ Organization and the Star-Ledger/NJ.com name SRS CEO Evan Steele the winner of the Garden State Entrepreneur Excellence Award in the $10M+ category.

5-23-2013 12-26-07 PM

TeleTracking Technologies hires Nanne Finis (Joint Commission Resources) as VP of consulting services.

5-23-2013 10-16-53 PM

Yousuf Ahmad, who will take over as CEO of Mercy Hospital (OH), is profiled in the local business paper because of an earlier position as CIO of Mercy Health Partners. Interestingly, he attended University of London on a cricket scholarship, graduated at 19, and is ranked among the world’s 400 best Scrabble players.


Announcements and Implementations

Cerner’s PowerChart Touch mobile solution earns a bronze award for Best Clinical Health Care Experience at the 2013 International User Experience Awards.

All of Maine’s 38 acute-care hospitals and 376 ambulatory provider sites have agreed to participate in the state’s HIE, operated by HealthInfoNet.

Holy Family Memorial Health Network (WI), Johnson Memorial Hospital (IN), and United General Hospital (WA) implement Hyland Software’s OnBase enterprise content management platform integrated with their Meditech systems.


Government and Politics

Idaho State University will pay $400,000 to settle alleged HIPAA violations stemming from a breach of unsecured data on 17,500 patients from an ISU family medicine clinic. The university notified HHS of the breach upon realizing that a disabled firewall had left patient data unsecured for at least 10 months.

5-23-2013 10-54-10 AM

HHS reports that 55 percent of all EPs and and 80 percent of eligible hospitals and critical access hospitals have been paid MU incentives through the end of April. HHS had established a goal for 50 percent of EPs and 80 percent of hospitals to have EHRs by the end of 2013.

North Carolina’s state auditor finds that the state’s DHHS hasn’t overseen the implementation of its new $484 million Medicaid claims system properly, making it likely it will not be ready by the scheduled go-live in 40 days. CSC developed the system, which was written in COBOL by programmers from India copying code the company developed for a similar system in New York, and previous audits found poor documentation and unauthorized changes. DHHS allowed CSC to develop the acceptance criteria for its own project. The system was supposed to go live in August 2011 at a cost of $265 million. The state had already cancelled a 2003 contract with ACS saying their system wasn’t working before hiring CSC. Residents of other states are on the hook since the federal government is covering  90 percent of the development costs and at least 50 percent of the ongoing operational costs. Nothing good has ever come from combining state and federal governments, taxpayer money, contractors, and ambitious computer system plans.


Innovation and Research

Intermountain Healthcare announces a system that will track cumulative radiation exposure from higher-dose imaging exams and report it via the EMR.


Other

The County of Monroe Industrial Development Agency (NY) approves $369,359 in tax exemptions for eHealth Technologies, which is building a $4 million, 36,000 square-foot facility and is planning to add 60 jobs over the next three years.

5-23-2013 11-25-09 PM

Via Christi Health (KS) blames lower than anticipated revenues for its decision to lay off up to 400 staff members — about four percent of its workforce — across the state by the end of June.

5-23-2013 11-31-20 PM

Conservative columnist Michelle Malkin, known for writing screamingly partisan books such as Culture of Corruption: Obama and His Team of Tax Cheats, Crooks, and Cronies sets her sights for the second time on Epic’s Judy Faulkner in an article titled “The Obama crony in charge of your medical records.” She also weighs in that HITECH is “government malpractice at work;” calls out Epic and not its competitors for having “enhanced power to consolidate and control Americans’ private health information” (missing the point that only Cerner runs a profitable business unit that sells de-identified data from the hospital systems it hosts); and accuses the President of choosing Faulkner as the vendor representative on the HIT Policy Committee because of partisan politics (“the foxes are guarding the Obamacare henhouse.”) It’s a safe bet due to partisanship on both ends of the political spectrum that anyone who follows her faithfully believes every word, and anyone who doesn’t wouldn’t believe even one.

In Detroit, Henry Ford and Beaumont call off their merger plans, with the unstated sticking points apparently being cultural differences, disagreements over keeping both academic medical centers, and the unwillingness of Beaumont’s independent physicians to work with Henry Ford’s management.  

All you need to know about the inevitable demise of most HIEs once the government grant trough has been lapped dry is contained in this story. The squabbling CEOs of two Kansas HIEs  force the state’s lame duck HIE regulatory body to pass a resolution preventing them from trying to charge each other connection fees. KHIN and LACIE are required to connect their networks by July, but KHIN demanded that LACIE pay it a fee. The date has been moved back to December, and meanwhile the regulatory board – KHIE – will turn over its responsibilities to the state’s Department of Health and Environment on July 1 in a cost-cutting move. The dialog from the May 9 meeting:

[KHIN CEO] "If we give that data to another (network) they will have a competitive advantage, if we give it to them for free. We know that LACIE knows this — they’ve been out talking to providers all across the state of Kansas saying ‘If you join LACIE you can join at a lower fee, and you’ll get all of KHIN’s data for free.”

[LACIE CEO] That’s untrue, Laura. That’s absolutely untrue and we’ve told you it’s untrue. I’m sorry, Mr. Chair but that is an absolute lie.”

A University of Florida study finds that ED employees spend 12 minutes per hour on Facebook, and strangely enough their usage increases with ED patient volume and severity. On the other hand, it was a one-hospital study covering a 15-day period in late 2009 covering mostly the time between Christmas and New Year’s, so the method isn’t convincing.

A Pennsylvania judge orders the hiring of a forensic examiner to review the Facebook page of a woman who claims she slipped and fell due to a puddle of liquid on the floor of Lancaster Regional Medical Center. The woman claims she suffered serious injuries and can’t afford the surgery; the hospital found Facebook pictures and videos from up to 17 days after the accident after showing her frolicking in the snow.


Sponsor Updates

  • Greenway Medical announces the availability of its PrimeMOBILE mobile access solution for Windows 8.
  • Biilian’s HealthDATA posts a list of the 10 hospitals claiming the most in outpatient charges, according to expense report data published by CMS.
  • Liaison Healthcare launches Healthcare Terminology Manager and Healthcare Terminology Translation to facilitate the management of diverse controlled medical vocabularies for simplified data exchange.
  • Park Place International will market Interbit Data’s disaster recovery and business continuance software solutions to its customers implementing Meditech.
  • Levi, Ray & Shoup introduces MFPsecure, a line of hardware and software aimed at the pull printing and secure document delivery markets.
  • Ping Identity announces details of the workshops at its Cloud Identity Summit 2013, which takes place July 8-12 in Napa, CA.
  • The Boston Globe names Keane, Inc., now part of NTT Data, to its Globe 100 Hall of Fame in recognition of the company’s 25 years as a top-performing company in Massachusetts.
  • Visage Imaging releases Visage Ease version 1.3.0, which gives authorized healthcare providers mobile access to imaging results on iOS devices.
  • Care Team Connect hosts a July 10 Webinar on readmission prevention.
  • EClinicalWorks CEO Girish Kumar Navani discusses the company’s latest projects and offers his perspective on where healthcare is headed and IT’s role in healthcare transformation.  
  • Greenway Medical customer Texas Orthopedics shares how its use of PrimeMOBILE has improved patient care and increased efficiency, productivity, and profitability.
  • INHS highlights the SHMC Pediatric Oncology clinic and its use of online status boards to cut patient wait times.
  • Encore Health Resources posts a YouTube video featuring CEO Dana Sellers participating in a discussion on EHRs and analytics.
  • Emdeon CEO George Lazenby shares his secrets to innovation and growth.

EPtalk by Dr. Jayne

clip_image004  5-23-2013 6-46-11 PM

From Anotherdrgregg: “Re: your recent piece on gimmicks. Preparing for our EMR, we looked at all our diets, some 30 in all, including the oddly named ‘anti-atherogenic diet.’ We reduced the number of diets to four, not including bariatric diets. The reasoning was that if you could hold it down, you were probably going to be discharged home. Administration nodded sagely, then went ahead with diet on demand complete with special breakfasts and a chef in a toque. Now they want to know why utilization is not high.” Any reader who can use the word “toque” gets my vote. He went on to list other frivolous hospital expenditures: flat screen TVs, real oak moldings on the doors, and carpets so thick that you can’t roll a gurney on them. He closed with this thought: “The finest hospital I ever worked at had painted cinderblock walls. it was a forward operating base.”

clip_image002

Hard to believe it’s almost June. In CMS terms, that means barely more than a month before Eligible Hospitals in the first year of Meaningful Use run out of time to begin the reporting period for Fiscal Year 2013. If you don’t start your reporting period by July 3, you’re out of luck as the federal fiscal year ends September 30.

Reuters Health reports that many health Web sites are too complicated and full of jargon, leading to confusion for patients. Instead of the fourth to sixth grade reading level recommended by the American Medical Association and the Department of Health and Human Services, the average reading level of online materials studied ranged from high school to college. Reviewers also found information that was oversimplified to the point of inaccuracy and large numbers of clichés at some specialty sites.

clip_image006

Scientists have often debated whether white coats and neckties spread germs. Unfortunately for fashionistas like Inga, handbags are now under scrutiny. Twenty percent of handbags studied had levels of bacteria high enough to cross-contaminate other surfaces. I wonder if the findings would also apply to brief cases or laptop bags?


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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18 Responses to “News 5/24/13”

  1. 1
    Art_Vandelay Says:

    Does anyone know how the Epic implementation with the Coast Guard is doing?

  2. 2
    Arkansas Dave Says:

    I’m a conservative Republican, and I find Malkin as misguided as her worst critics do, especially when it comes to healthcare. She clearly doesn’t do her homework or research, and her sensationalist claims are only made to draw attention to herself and promote her books. If you watch her on TV (which I routinely mute) it doesn’t take a rocket scientist to see that she is just another narcissistic journalist who can’t get a real job. Unfortunately, those exist on both sides of the political fence.

  3. 3
    Private Citizen Says:

    I heard a rumor that it was 2 years behind schedule with SAIC (the prime contractor) with the Coast Guard and Epic pointing fingers regarding blame. Would be interested in hearing from someone working on this project

  4. 4
    Dr. Gregg Says:

    Ack! “Anotherdrgregg”?? We’re replicating via 3D printers!

    Great illustrative point re: the confusion around what drives patient satisfaction (i.e., Press Ganey scores) and what the patient/provider dyad actually need for optimized outcomes (i.e., what yields truly satisfied patients.) Similar to the misunderstanding around what patient engagement means as shown in the Reuters Health report (i.e., having a website – or apps, patient portals, etc. – isn’t engaging if the content they contain isn’t “engagement-worthy.”)

    OK, no more “i.e.”s or drgreggs… for now.

  5. 5
    MU Nerd Says:

    For Stephanie, per the Meaningful Use final rule, EPs and EHs must use a certified EHR for the measures of providing patients with timely online access and patients view, download, or transmit. If you’re using a separate patient portal that isn’t linked to your EHR, the portal must receive certification to the applicable standards in the certification rule. There’s already one PHR on the certification list for the 2014 criteria from Get Real Health. I would expect that other PHR products will follow suite.

  6. 6
    Grizzled Veteran Says:

    Lil Wayne,

    Practice Fusion’s website indicates they have 150,000 medical professionals, but in their latest press release they say 150,000 users. Not sure how “medical professional” is defined but since: (1) their revenue model is based upon advertising (2)advertising fees are based upon number of EYES viewing an ad (3) it takes about 5 minutes to sign up and download the software….then my thoughts are that they count anyone that has downloaded the software as a user, this would pump up the number of EYES they say they have that can view ads. I’m just sayin’

  7. 7
    FLPoggio Says:

    Re: “If I already have a certified completed EHR and use another vendor’s patient portal within the HIE, does my patient portal also need to be certified? I’m just placing patient documents out in the portal for patients to view”

    If only there were a simple ‘yes/no” answer. But as with all government regs, it depends…

    For example, if the portal is used to track or create data for attestation, like percent of patients accessing the portal as required in Stage 2 (170.314(e)(1), then it should be certified.

    On the other hand if the portal is not used for this, or does not reformat/add/change/ data and is not used for attestation in any way, then certification may not be necessary. Yet, if the portal passes data to an interface engine, and the engine is used to place data in a quality measures tool, then you are better off getting both certified.

    But here’s the real Catch 22. Under Stage 2 all provider systems (whether used for MU or not) must meet HIPAA compliance. And under HIPAA they must meet Privacy and Security requirements. And a good way for a vendor to ‘prove’ HIPAA compliance is to pass the ONC privacy and security test criteria. So it behooves a vendor to get certified whether or not the system will be used for attestation. In effect, as of this past January, the new HIPAA rules have mandated certification.

    Net-net is you might be able to ‘slide-by’ on this if you get MU audited (although there are no published MU audit procedures as pointed out by Mr. H in his interview!) – so better to be safe than sorry…

    More at: http://histalk2.com/2013/03/20/readers-write-vendors-welcome-to-the-world-of-hipaa/

  8. 8
    I_hate_faxes! Says:

    Faxes – Ugh. We hired a firm to evaluate compliance within our practice (23 docs). The consultant had seizure when they saw our workflow with faxes. They wrote up four pages of what would be HIPAA violations! They turned us on to “Informedika” which was free. We paid a lot for this consulting insight but I will post it for free…….just don’t say you got it from me.

  9. 9
    Johnny Paycheck Says:

    Stephanie,
    If you are using a Patient Portal that is outside of your certified EMR, then yes, the Patient Portal must also be certified as an EHR module.

  10. 10
    seagirl Says:

    I want that handbag!

  11. 11
    Skeptic Says:

    PracticeFusion statements…if you check the web traffic metrics on http://www.alexa.com/siteinfo/practicefusion.com#
    then the mean time of users on their website is 8-9 minutes.
    Since their EHR is web based only, then either their users interact with their EHR for only 8-9 minutes on average since they are so fast (!) or they have only one-two patients in their practice…

    Joke aside, I think the truth is that most of their alleged “users” check it once out of curiosity and never return.
    This aligns with the low attestation numbers HIStalk mentioned above.

  12. 12
    Counting Says:

    It’s sad to see that the VA &DoD are considering buying an off-the-shelf system. Vista and AHLTA have traditionally been 2 of the more cutting edge systems out there. IMHO, Vista is still the best hospital EHR out there, and beats the heck out of Epic as a useful system, despite its flaws and limitations. I’d like to see the VA & DoD reconsider the approach to the iEHR, in part because they have the best shot at building the next-generation system that will get us closer to where we actually want to be as an industry. If Hagel gives up and buys an off-the-shelf EHR, especially Epic, it will basically put a nail in the coffin for acute-setting EHR innovation for decades to come.

  13. 13
    Cybernonymous Says:

    RE: Michelle Malkin.

    Republicans, Democrats, Socialists, etc. all part of the Global Political Borg; Resistance is futile.

  14. 14
    Also Ex-Epic Says:

    @Counting
    I have no exposure to AHLTA or VistA but if, as you say, VistA is really the best hospital EHR around, I wish the government would offer a commercial version of it for sale (or spin the developers off as a private enterprise tasked with the duty of meeting VA needs as well as those of any non-government customers).

  15. 15
    Word Nerd Says:

    The government isn’t supposed to be in the business of selling stuff or playing favorites among companies. (Note the operative phrase “supposed to” before responding and revealing your political persuasion.) There are, however, a few companies that sell VistA outside the VA, starting with Medsphere and DSS.

  16. 16
    Fax_Nightmare Says:

    We found out some of our faxes actually went to the wrong facility. We did not even know they were going to the wrong fax until two months later. We are also going to informedika.

  17. 17
    Jayne Histalk MD Says:

    Seagirl – it’s the “Diana” handbag by Lana Marks. Way out of my price range unfortunately but a girl can dream.

  18. 18
    ML Says:

    @Also Ex-Epic: VistA is open source and free for anyone to use.

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