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News 11/15/13

November 14, 2013 News 7 Comments

Top News

11-14-2013 11-32-20 PM

Moses Cone Memorial Hospital (NC) sees its credit rating downgraded from stable to negative after spending $90 million to implement Epic, with plans to spend another $40 million and to add another 90 employees to support it over the next three years.


Reader Comments

From Head Scratcher: “That Allscripts announcement about implementing Sunrise at two newly acquired Montefiore hospitals comes just days after Montefiore announces the signing with Epic. Interestingly, Jack Wolf is not leading the Epic install.” Unverified.


HIStalk Announcements and Requests

inga_small Are you current with all the latest HIStalk Practice news? Some highlights from the last week include: “better-performing” practices use patient-satisfaction surveys to evaluate and improve practice operations. Doctors blame EMRs for slowing them down and reducing productive face-time with patients. Emdeon reports a Q3 loss of $16.2 million and a nine percent increase in revenues. Practices charge for online access to patient portals. Dr. Jayne’s personal physician shares impressions from NextGen’s User Group Meeting, including a review of the NextGen Patient Portal solution. Thanks for reading.

On the Jobs Page: Director of Business Development, Solution Sales Executive, Sales Excellence Manager.


Acquisitions, Funding, Business, and Stock

RightCare Solutions, a provider of decision support and transition of care technology developed by a University of Pennsylvania Nursing professor, raises $5 million in a Series B funding round.

11-14-2013 10-45-11 AM

Healthcare messaging company docBeat secures $1.1 million in a pre-Series A round.


Sales

Signal Health (WA) selects HealthUnity’s HIE, analytics, and PHR platform.

11-14-2013 11-36-12 PM

Albert Einstein Medical Center (PA) will integrate MedCurrent’s OrderRight radiology decision support system Cerner Millennium.

Wentworth-Douglass Hospital (NH) selects PatientKeeper Charge Capture and PatientKeeper Sign-Out solutions for its hospitalists and intensivists.


People

11-14-2013 4-04-26 PM

The Care Continuum Alliance appoints ICA CEO Gary Zegiestowsky to its board.

11-14-2013 10-47-47 PM

An internal McKesson email indicates that Kevin Torgersen, president of Imaging & Workflow Solutions, resigned this week for personal reasons. IWS will be reorganized under the acute care product line and several personnel changes were announced to employees.

11-14-2013 10-52-53 PM

Kevin Brown (athenahealth) is named VP of West Coast sales for CareCloud.


Announcements and Implementations

Accenture and The Phoenix Partnership deliver the first phase of an EHR across nine NHS systems in Southern England.

11-14-2013 11-26-55 AM

Virtual Radiology releases its free Radiology Patient Care benchmarking metrics.

Orion Health launches Rhapsody 5.5.

pMD announces ICD-10 Converter, which automates ICD-9 to ICD-10 conversion.


Government and Politics

11-14-2013 12-44-49 PM

CMS releases the Virtual Research Data Center, a data sharing tool that provides researchers access to Medicare and Medicaid data from their own workstations for performance analysis and data manipulation.

The Obama administration won’t require insurance companies to upgrade existing individual plans to meet ACA requirements for 2014 as long as the insurers notify consumers what ACA protections their plans don’t include and of the additional options available through insurance exchanges. The announcement comes a day after CMS revealed that 106,185 individuals had selected plans in the first period of open enrollment, only 26,794 of them through the federal exchange.


Technology

11-14-2013 1-00-29 PM

inga_small Even if I talked on the phone more I don’t think I would be an early adopter of this technology. Google files a patent for an electronic skin tattoo that sticks to your neck and serves as a hands-free microphone for your cellphone. The tattoo could also carry a lie detector that would detect skin response caused by nervousness. To be clear, I was a “no” before the lie detector part was mentioned.


Other

In Oregon, a university-based pediatric intensivist remotely diagnoses a baby’s life-threatening bacterial infection using a telemedicine workstation controlling a robot-like device. The mother says the telemedicine technology “is the greatest thing ever invented” and does not think her daughter would be alive without it.

11-14-2013 10-39-54 AM

A KLAS report finds that no single vendor leads in the population health management tools market, though early leaders are emerging based on their portfolio breadth, experience, and ability to deliver. Those vendors include The Advisory Board Company, Conifer Health, Explorys, Healthagen, Optum:Humedica, i2i Systems, McKesson, Optum: Care Suite & Impact, Phytel, Premier, and Wellcentive.

Three US organizations win the 2013 Malcolm Baldrige National Quality Award, including Baylor Regional Medical Center at Plano (TX) and Sutter Davis Hospital (CA).

Steven Brady, SVP for administration at SUNY Upstate Medical University, resigns after the university discovers that he received outside income without permission from its affiliate MedBest Medical Management, which has a $22 million contract with the university to implement a PM/EMR system.


Sponsor Updates

  • Gartner positions CommVault in the leaders quadrant of its Magic Quadrant for Enterprise Information Archiving.
  • Kareo launches Kareo Marketplace, a solution center to help private practices identify cloud-based applications and services to optimize their operations.
  • VMware announces it will provide HIPAA business associate agreements to its customers.
  • Visage Imaging will demonstrate new features for its Visage 7 Enterprise Imaging platform at RSNA December 1-5 in Chicago.
  • The ICA-powered Kansas HIN reaches the connectivity milestone of providing access to more than one million patients.
  • Great River Health Systems (IA) shares how Encore Health Resources provided contract review and pre-implementation assistance while transitioning to Cerner.
  • EDCO Health Information Solutions recommends three point-of-care record scanning articles.
  • ICSA Labs offers five tips for keeping enterprises safe from mobile app threats.
  • Wolters Kluwer Health is providing a free emergency resources portal to Philippine hospitals and healthcare institutions in support of typhoon disaster relief efforts.
  • HIStalk sponsors named to Deloitte’s Technology Fast 500 list for 2013  include AirWatch, Awarepoint, Kareo, InstaMed, Etransmedia Technology, Allscripts, Liaison Technologies, SRSsoft, Greenway Healthcare, Halfpenny Technologies, Imprivata, Valence Health, Vocera Communications, and VMware.
  • Impact Advisors principal Laura Kreofsky discusses MU audits at next week’s Oregon & SW Washington Healthcare, Privacy & Security Forum.
  • Elsevier launches Elsevier Adaptive Learning study solution for improved learning and memory retention for healthcare professionals.

EPtalk by Dr. Jayne

I’ve been digging through provider quality reports this week and it’s so tiresome. I have to know which physicians are in jeopardy of missing their bonus targets so that when they call screaming at me that the reports are wrong, I can be prepared. It’s surprising how badly some of them are doing. They receive a package of reports monthly so that they can see where they are, and our chief medical officer works with those that are underperforming to institute changes in the practice to try to increase their success. There’s only one month left in the year, however, and unless providers are only under their targets by a fraction of a percent (or see small numbers of patients), it’s not likely that they can turn things around now.

What kills me is that some of the measures they fail to hit seem to be no-brainers. Our EHR has tons of prompts to make sure that certain services are done – both passive alerts (icons, exclamation points) and “in your face” type modal window popups that they cannot get past without acknowledging. We have standing orders available that providers can print, sign, and institute in their offices (and in the EHR) so that their clinical staff can administer vaccines without individual patient orders. We have signage available reminding diabetic patients to remove their shoes and socks so the providers can examine their feet. Inevitably, though, providers miss the mark.

Sometimes I really wish I had gotten a psychology degree instead of a chemistry one – it would have been much more useful in figuring out what makes my colleagues tick. Why wouldn’t you want certain services to be on autopilot? Why would you want to have to give individual verbal orders (or heaven forbid ,enter them into the EHR yourself) for flu shots or tetanus shots? And what makes some providers very eager to get on board with these kinds of clinical protocols when others dig in their heels? If I could crack this code I could retire early.

Maybe it’s being afraid of “cookbook medicine” or just not wanting to be told what to do by others. In some cases, it’s being in denial of the clinical evidence that shows that standing orders prevent disease and disability. Maybe it’s just feeling beaten down by what the healthcare system has become. Another one of my friends just made the decision to leave clinical medicine – she finished her MBA and is off to work for one of the major health IT vendors.

I’m looking forward to 2014 as a chance to reset. Those providers that missed the mark can start over. We only have to attest for 90 days instead of the full year, so that will reduce some stress, although our impending EHR upgrade and some other payer initiatives are adding to the overall tension. I suspect that CMIOs at other hospitals and health systems are feeling the same kind of pressure, but there is not a lot we can do about it since the forces are largely external.

For me, it’s back to the quality reports. But first, another NextGen User Group special report from our roving reporter. Inga shared comments from my personal physician about the NextGen User Group this week in Las Vegas. Here’s her second installment:

NextGen UGM Update

The customer appreciation parties thrown by vendors on Monday were a lot of fun. My favorite was IMO’s elegant cocktail party held in a suite with a balcony overlooking the strip. They had Monday Night Football showing on the balcony’s big screen TV (that’s the way to live!) and an excellent wine assortment, although rumor was the MGM wouldn’t let them serve reds due to the all-white décor of the suite. The buzz on the street was that Navicure’s party was best and had nearly 1,000 attendee at the Hard Rock. I’m just a little PCP, though, so didn’t score an invite.

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I noticed this display appear on Day 2, near the escalators where you enter the conference center. Only in Las Vegas can you get walk-in IV hydration and a B12 shot. It’s a cash practice with no insurance billed, so of course they can do whatever they want. One young IT guy I overheard in a session said he took advantage of it after a night of too much fun. He mentioned that the nurse who administered his IV normally works in a pediatric ER and loves working the “spa” because the patients have big veins.

There were many good educational sessions on ICD-10, Meaningful Use Stage 2, and how to improve revenue cycle and clinical documentation. A fair amount of continuing medical education credit was offered as well. The MGM did a great job with logistics for 5,000 people. This was my first User Group and the build-up to the Tuesday client event was huge. They always keep the entertainment a secret and past musical acts have included Sammy Hagar, Styx, Foreigner, Huey Lewis and some other well-known groups. The first act turned out to be the Brian Setzer Orchestra, which would have been good if the acoustics weren’t so distorted. The second was Big and Rich, which provoked a mass exodus. I was among the scattering crowd so I can’t report after that. Wednesday was a little more low-key with only two education sessions and I suspect many people left early to avoid the chaos that is the Las Vegas airport.

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I forgot to send this picture earlier in the week, you have to love an airport with a liquor store in baggage claim. I relaxed on the plane on the way home reading the Twitter feed for the event and some of my favorite tweets were:

  • Either I’m in ICD-10 hell or they have the heat on in room 309

Followed by:

  • Do you know the ICD-10 code for burning up like you are Lucifer’s step sister?

And then:

  • Depends on whether burning is via a coal- or wood-fired oven, nuclear meltdown, etc. Please consult CMS GEM mappings.

You have to make fun of ICD-10 or you’d cry, so I found it particularly funny.

All in all it was a successful meeting. I got some CME, heard some great speakers, and learned some things that should make my EHR documentation quicker and easier. I’ll definitely be back next year!

I’m glad she got to go and I was able to live vicariously through her – I’ve only been to my own vendor’s meeting. I’d love to see how the grass looks on the other side of the fence. Maybe that’s an idea – we could auction off a chance to have Dr. Jayne attend and review your user group meeting (under an assumed name, of course). Proceeds could go to charity. What do you think? Email me.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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7 Responses to “News 11/15/13”

  1. 1
    David Says:

    RE: Moses Cone Memorial Hospital

    Another hospital going over budget in implementing Epic and then realizing the much higher cost of ongoing maintenance sees its credit rating downgraded.

    Do any CFOs out there know the percentage of hospitals which move to Epic and see their credit ratings downgraded?

  2. 2
    SpoonEHR Says:

    The article about Moses Cone says that the Epic implementation “eliminated hundreds of jobs.” No details on how this works, but it sure sounds bad. And then, in the HISTalk commentary, we read that their credit rating is down partly because they plan to spend money creating 90 new jobs; apparently jobs aimed at supporting technology are bad. But these other, lost jobs were good. Seems contradictory somehow…

  3. 3
    IDontBelieveAnythingIReadAnymore Says:

    The article about Moses Cone *does not* say that the Epic implementation eliminated hundreds of job – in fact it said they added 90 job for Epic. Why is it so hard for almost anyone that comments or reports to get the details correct these days?

  4. 4
    Basic Science Says:

    So, the Medicare and Medicaid cuts didn’t really have anything to do with this?

    A 2% cut on even half of $1B in revenue is huge for all systems right now. No matter what EHR they are installing.

    Yes they spent money to install Epic, but they likely also banked some hefty Stimulus payments to offset that expense. Those are serious dollars.

    I think what’s going on here is that in tough times, people try to convince their bond rating agencies that what ever is happening is associated with a one time event (like an install or an acquisition) so they bring it up in hopes to convince rating agencies it’s a blip. Doesn’t sound like they are blaming their EHR for this.

  5. 5
    72andSunny Says:

    Hey, IDontBelieve …, click on the actual link in the Moses Cone blurb above. It takes you to an article that says the hospital eliminated hundreds of jobs. It positions that statement immediately after one about implementing Epic. One can infer. And the actual article linked to makes no mention of adding 90 jobs related to the Epic deployment. SpoonEHR will graciously accept your apology now.

  6. 6
    Not a Fan of Bob Says:

    Actually. The article DOES say Moses Cone eliminated Hundreds of Jobs. Read the actual article. Fact: nearly all Epic sites go over budget. And eliminate jobs, often the CIO who selected Epic.

  7. 7
    Sam Lawrence Says:

    For those that don’t follow the news in NC (besides Epic issues of course), everyone is struggling because the state rejected expansion. Volumes are down and unreimbursed care is through the roof. Even an expenditure of half that amount is going to hurt. Or maybe I’m just tired of the sensationalist stories that basically suggest an EMR implementation from any vendor is the sole cause of financial instability. Companies all over the world make investments and post losses every day. Perhaps everyone is just up in arms because they’ve finally discovered that healthcare is a business like any other.

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