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November 12, 2013 News 21 Comments

Top News

11-12-2013 5-49-15 PM

AMIA announces in an email to members that Kevin Fickenscher, MD will step down as president and CEO on November 30, 2013 to return to industry. He took the position for 20 months ago. The search for his replacement will start immediately.


Reader Comments

11-12-2013 7-57-05 PM

From Pitiful: “Re: U. Arizona Health System. More than 9,500 glitches in its Epic EHR, claims to have solved more than 6,000. The health system is financially precarious.” Unverified. They were scheduled to go live November 1.


Acquisitions, Funding, Business, and Stock

11-12-2013 3-22-35 PM

Vocera reports Q3 results: revenue flat, adjusted EPS -$0.02 vs. $0.13, missing earnings estimates.

11-12-2013 3-26-09 PM

Alan Dabbiere, chairman of mobile device technology vendor AirWatch, expresses an interest in acquiring BlackBerry’s services division and integrating the Blackberry server technology into its device management technology to provide corporate customers a single dashboard for all devices.

Long-term care EHR provider PointClickCare acquires Meal Metrics, the developers of a web-based nutritional management solution.

11-12-2013 7-45-41 PM

AuthentiDate announces a $2.46 million private placement from unnamed investors. The company offers telehealth, referral management, and discharge management solutions, with the VA as a notable customer.


Sales

11-12-2013 1-42-31 PM

Star Valley Medical Center (WY) selects Access E-forms on Demand to eliminate paper forms.

11-12-2013 1-40-41 PM

ValleyCare Health System (CA) will implement CareInSync’s Carebook mobile communication platform for care team coordination.

The 11-provider Ocean Eye Institute (NJ) selects SRS EHR.

11-12-2013 1-38-41 PM

Denver Health (CO) selects Besler’s BVerified Screening and Verification solution.

The Nevada HIE will deploy the Orion Health HIE.

Montefiore Health System will upgrade its newly acquired hospitals in New Rochelle and Mount Vernon to Allscripts Sunrise, including EHR, Analytics, Radiology, and Laboratory and implement the FollowMyHealth patient engagement platform.

SummaCare (OH) selects Wolters Kluwer Health’s Health Language to convert ICD-9 codes and DRGs to ICD-10.


People

11-12-2013 1-55-25 PM

PaySpan names Cheryl King (First Data) CFO.

11-12-2013 1-50-27 PM

Candace Smith (Medline Industries) joins Voalte as CNO.

11-12-2013 3-53-30 PM

The VA appoints Arthur L. Gonzalez (TISTA Science and Technology Corp.) deputy CIO for service, delivery, and engineering.

11-12-2013 4-02-05 PM

Direct Recruiters, Inc. promotes Dan Charney to president.

11-12-2013 6-50-31 PM

Scotland-based Craneware appoints Colleen Blye (Catholic Health Systems of Long Island) to its board.


Announcements and Implementations

Nextgen introduces NextGen Share, an interoperability solution based on the Mirth HIE platform that facilitates clinical data exchange and referrals from within the NextGen EHR.

11-12-2013 1-56-46 PM

CSI Healthcare IT completes a Cerner activation at the University of Tennessee Medical Center.

Merge Healthcare will exit the consumer medical information kiosk business, which reportedly accounted for $10 million of the company’s $250 million in sales last year. Merge, which spent $2.8 million on 500 of the kiosks last year with an ultimately failed plan to roll them out throughout Chicago, said technology upgrades were too expensive and it agreed to get out of the business following a patent infringement lawsuit. The kiosks made up one of 11 deals between Merge and companies owned by its chairman and largest shareholder, Michael Ferro, who stepped down in August 2013.

Westmed Medical Group (NY) reports that its ACO program with UnitedHealthcare and Optum improved nine of 10 health quality metrics, increased patient satisfaction, and reduced costs since its establishment in mid-2012.

DrFirst launches the Patient Advisor Report Card, a medication adherence alert system that provides a physician with medication adherence rates for each patient.

NextGen announces NextPen Voice, a pen that accepts either voice or written input depending on user preferences and activities. It uses digital pen technology from Sweden-based Anoto, which announced three weeks ago that it couldn’t survive another 12 months without issuing new stock rights.

Four large Boston-area organizations – Dana-Farber, Brigham and Women’s, Boston Children’s Hospital, and Broad Institute – form the Joint Center for Cancer Precision Medicine, which will study the genetic characteristics of tumors to choose the best chemotherapy drug treatments for individual patients.


Government and Politics

inga_small The Wall Street Journal reports that fewer than 50,000 people signed up for health insurance through Healthcare.gov during October. Despite my “success” about 10 days ago signing up for insurance, my application now appears to be in limbo. After two support chat sessions, two support phone calls, and an email exchange with my selected insurance carrier, I’ve been advised that the normal 48 hour “acceptance” process has been delayed. I’m trying to remain optimistic that the new plan will be in place in time for me to cancel my current plan so I won’t be stuck paying for two plans come January.

CMS tells industry stakeholders it might reconsider performing external, end-to-end ICD-10 testing with physician offices following recent problems with its Healthcare.gov site. CMS said previously it would not offer external testing and that it was confident with its current internal testing.

11-12-2013 6-23-55 PM

Former National Coordinator David Blumenthal, MD, now president of The Commonwealth Fund, says President Obama’s call for federal government IT procurement reform after the contractor-assisted bungling of Healthcare.gov is necessary because “the federal process is clearly broken.” He says of his experience at ONC:

Our staff would decide what services we needed, write a request for proposals (RFP), and send it off to a totally independent contracting office. That office could be within the Department of Health and Human Services (DHHS), but if the DHHS office was too busy, the RFP could go almost anywhere: the Department of the Interior, the Department of Housing and Urban Development, the Department of Education — whatever contracting office had time to process the work. Officials extensively trained in the details of federal procurement, but lacking familiarity with our programs or field of work, would put the RFP out to bid. An expert panel–over which we had minimal control — would evaluate the responses. Months later, the contracting office would present us with the signed contract. The winner was usually picked from a group of companies with considerable experience working the federal procurement process. If we weren’t happy with the firm, or with their later performance, there was virtually nothing we could do about it. Getting out of this shotgun marriage meant months of litigation, during which the funds would be frozen and the work itself would grind to a halt.

11-12-2013 8-07-25 PM

News I missed from several weeks ago, if it was announced:  CMS awards several companies an $800 million contract to support the Measure and Instrument Development and Support program for healthcare quality measures as part of HITECH.

11-12-2013 8-08-44 PM

It’s not just the federal insurance exchange website that’s having problems. Users report that the Massachusetts Health Connector site won’t accept hyphenated names and requires proof of incarceration for non-prisoners. The spokesperson gave the same response as those for Healthcare.gov – sorry for the problems, we’re fixing them, but in the mean time, pick up the phone or mail a paper form.


Innovation and Research

11-12-2013 8-09-30 PM

The New York Digital Health Accelerator celebrates its first year and the recent success of two graduates of its nine-month mentorship program: Avado (patient relationship management tools, acquired by WebMD) and Cureatr (secure physician messaging, obtained $5.7 million in funding).


Other

11-12-2013 4-34-12 PM

inga_small If you are like me, you may be a little flash-mobbed out. However, this video of a woman dancing with the OR staff minutes before undergoing a double mastectomy brought tears to my eyes. Got to love the doctors, nurses, and techs who busted some moves with Deborah Cohan, an OB/GYN and mom of two who I wouldn’t mind having as a BFF.

Patient Privacy Rights launches a “Save Health Privacy” campaign on crowdfunding site Indiegogo, hoping to raise $10,000 to purchase privacy-friendly technology and to create a privacy education app. Donate $500 and you’ll get a dinner with PPR Founder Deborah Peel, MD.

11-12-2013 6-31-54 PM

The National Patient Safety Foundation releases an online, self-paced course titled “Health Information Technology through the Lens of Patient Safety,” targeting physicians, pharmacists, nurses, and quality professionals who are involved with both IT strategy and patient safety. Topics include organizational culture, transparency, patient engagement, integration of care, and human factors engineering. The course costs $30 and CE credits are provided. McKesson provided an educational grant to make the course possible. I’ll most likely take the course myself and report back.

A Pittsburgh internist sues a local medical billing company after its systems fail with no usable backup. The doctor concludes, “It is all in the cloud, and if the cloud disappears someday, we are all in trouble.”

11-12-2013 8-02-34 PM

Weird News Andy notes the story of an ABC reporter who got her first-ever mammogram on live national TV to call attention raise awareness for Breast Cancer Awareness Month, only to have the test reveal that she has cancer. Amy Robach, 40, will have a double mastectomy performed this week. WNA observes that under new guidelines, she would not have been a mammogram candidate until she turned 50, assuming she had lived that long without treatment.


Sponsor Updates

  • Salar sponsors the Student Design Challenge: Reinventing Clinical Documentation at next week’s AMIA 2013 Annual Symposium in Washington, DC.
  • Amcom Software hosts its annual user conference, Connect 13, this week in San Diego.
  • NextGen Healthcare is hosting 5,000 attendees this week at its user group meeting in Las Vegas. Dr. Jayne’s personal physician offers her impressions of the conference on HIStalk Practice.
  • Hyland Software and Bottomline Technologies will integrate their mobile data capture and ECM technologies.
  • Elsevier adds new content types and an enhanced mobile app to Mosby’s Nursing Consult .
  • Kootenai Health (ID) estimates that its implementation of the Summit Interoperability Platform saved the organization $50,000 to $75,000 in 2012 through the elimination of duplicate interface purchases and maintenance costs and the reallocation of hospital IT staff.
  • ChartMaxx hosts webinars November 13 and 21 discussing ways to provide high quality care while cutting costs and improving revenue cycle.
  • LDM Group sponsors the iPatientCare National User Conference November 15-17.
  • Strata Decision Technology hosts a November 18 webinar on high performance decision support operations.
  • Market research firm Harvey Spencer Associates ranks Nuance Communications the world’s leading scanning and capture software vendor based on market share.

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 "21 comments" on this Article:

  1. Re: WNA’s statement that “under new guidelines, she would not have been a mammogram candidate until she turned 50”. Makes you realize many of the new guidelines are all about saving money for the masses, not saving individual lives. I’ve started demanding tests when I want them, on my own nickel (dollars) if necessary. Paid off, as have discovered (and subsequently been cured of) a dangerous disease that I wouldn’t have known about for another ten years.

  2. Inga,
    Thanks for sharing this:
    If you are like me, you may be a little flash-mobbed out. However, this video of a woman dancing with the OR staff minutes before undergoing a double mastectomy brought tears to my eyes. Got to love the doctors, nurses, and techs who busted some moves with Deborah Cohan, an OB/GYN and mom of two who I wouldn’t mind having as a BFF.

    These ladies not only have moves like Jagger, they make me so proud! Best piece I’ve seen in a long time, and I send my thoughts, prayers and well wishes to Ms. Cohan. I doubt she’ll have a long recovery with those moves! 🙂

  3. From Pitiful: “Re: U. Arizona Health System. More than 9,500 glitches in its Epic EHR, claims to have solved more than 6,000. The health system is financially precarious.” Unverified. They were scheduled to go live November 1.

    The U-A system went live on November 1st. I’m guessing these are 9,500 help desk tickets, of which I’m sure there are many multiples and some that aren’t actual “glitches” but just people not using the system.

  4. Re: U. Arizona. It seems very hyperbolic to declare a health system financially precarious 12 days after go live.

  5. I agree, not 9500 glitches, but very likely items on an issues list. This includes bugs, items not working as expected, things that aren’t clear, enhancement requests, etc. Either way, items that are interfering with workflow, successful use and adoption. Similar Epic Go Live I was close to similarly had literally thousands of unique issues on the issues list after a couple of weeks. This is not unique to Epic, the other vendors have similar results.

    As part of this industry, these results make me ashamed to admit it. Is this really the best we have to offer?
    We can do better, but as an industry we have to demand it. Instead, we accept this mediocrity and call it the best.

    I respect the counterpoints to the OP hyperbole, but let’s assume this was exaggerated 4-fold, 2125 issues is still pitiful and simply not good enough by any standard.

  6. Re: University of Arizona…

    9,000 glitches? That sounds like an issues list, and as such, 8,500 of those are probably forgotten passwords, concerns about the color of buttons etc.

  7. While I appreciate the comment of WNA and Mak, I disagree with the implication. The stories about this reporter do not reveal when she last saw her Gyn or if she regularly did breast self exam? Money should be spent on ensuring women understand the importance of BSE — a more reliable method of discovering breast cancer.

  8. Over 9,000 open tickets for a 500 bed/1100 provider system is high, however, like many other posters have already indicated, the vast majority of these tickets are minor configuration issues, personal preference items, etc… and many are likely to be duplicates. This is not unique to healthcare but simply part and parcel of any enterprise software go-live. Additionally, the vast majority of tickets are more related to the implementation of the software (and the training of it) than the actual software itself.

    Before any conclusions can be made, other than the open ticket rate does seem high by comparison, it would be necessary to know the breakdown of severity 1/2/3 issues in this pool. Serious items such as incorrect order sets, missing billing codes, errors in the master facility list, etc… are not a result of problems in the software but rather, missed implementation items, and likely would be present whether the EHR was Epic, Cerner or any other full replacement.

    An EHR implementation is a complicated endeavor. We make it more so when we attempt to recreate 15+ years of tinkering with a legacy system in a 18-24 deployment of a new system and do so in an environment where decisions are made by committee. The best implementations are realistic about how much change the organization can take and where they actually overfund areas like training or order set creation in order to help manage that change. No one likes model systems out of the box; unfortunately, very few are willing to accept the fact that it will take many more millions to customize the system to your needs.

    I agree, we can do better.

  9. Sounds like a lost end user submitted that comment. Who else uses the word “glitches”?!

    Change “health system is financially precarious” to “health system, like every other one, has end users slow to grasp new EMR workflows”.

  10. Having been through a large Epic go-live earlier this year, 9,500 after two weeks doesn’t sound bad at all. As others have pointed out, these are probably reported issues rather than glitches and many are likely duplicates, training issues, security issues, or enhancement requests. We found that only after going live did staff truly understand what their workflows should be, often different from the information they provided to our team during discovery and build.

    On another note, there seems to be some alarmist post about “another disastrous Epic go-live” at least weekly. Getting kind of old, no?

  11. Financially precarious sometimes means that customer ignored guidance on revenue dip after go-live and didn’t make reserves.

  12. I seek volunteers from this health IT community to be passengers on a new experimental aircraft from Acme Aircraft Company The aircraft avionics and software have been specially exempted from FAA validation and safety testing, to promote innovation.

    However the vendor of the aircraft says they’ve tested the aircraft thoroughly.

    In the first flight tests there were about 10,000 “issues”, most were minor, but not all were.

    Do I have volunteers?

  13. Good job! Under 10,000 issues within a couple weeks of an Epic go live. Probably a typical number for a single hospital Epic install the last year or two. You don’t get much vendor guidance beyond a new college grad or two with no healthcare experience other than childhood trips to the pediatrician.

  14. The original poster was obviously some sort of concern troller… For crying out loud, I just implemented a 2 department surgical scheduling optimization in an organization that has been live on an EMR for a decade and we logged 150 ‘issues.’

    I am constantly frustrated by analogies to other industries… particularly sick and tired of the comparisons to airline safety. Healthcare IT implementation issues are rarely really ‘technology’ related… typically they are related to chaotic workflows that the EMR uncovers.

    The bottom line is that taking care of a homeless patient recovering from sepsis is simply different than landing a 737.

  15. Yes HuskyDoc, there’s nothing to be learned from the decades of experience in risk assessment and mitigation in other industries and settings. Let’s re-invent it for health IT. Or better yet ignore the issue.

    The best approach is to implement the technology, uncover chaotic workflows and deal with them on an ad-hoc basis in an operational setting (i.e. with patients).

  16. Re: “I am constantly frustrated by analogies to other industries”

    The ones you should be frustrated about are analogies to health IT and banking, and other mercantile, management and manufacturing computing sectors. “If banking is computerized, how hard could medicine be?”

    On the other hand, safety issues in medicine are much like safety issues in transport – where even minor “glitches” from informational error and related factors can cascade into disaster How would I know? I was medical programs and safety manager for the third largest public transit authority (at the time) in the U.S., SEPTA.

    In fact I personally observed a minor health/employee compuetr records screwup cause a train wreck. Literally. Many deaths and injuries,

  17. Husky doc said “…typically they are related to chaotic workflows that the EMR uncovers…” Huh? Here’s the truth: The EMR generally does not ‘uncover’ chaotic workflow — EMRs generally CAUSE chaotic workflow. This truth can be found in informatics 101.

  18. I would not want to go on your experimental jet no more than I want my family’s care directed by an EHR with CPOE that has thousands of issues, glitches, defects, or flaws.

    I want the doctors to be concentrating on the patient and not distracted by the dysfunction HIT systems that impede their care of patients.

    Get these devices approved as being safe, effective, and usable. So there.

    The end

  19. David Blumenthal, MD: “the federal process is clearly broken.” He says of his experience at ONC

    Now they tell us! This after they have been trying to inject more and more government into healthcare.







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