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Monday Morning Update 3/3/14

March 1, 2014 News 11 Comments

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From Elizabeth: “Re: HIStalk mug. Thanks so much for the HIMSS coverage this year, as always. It was great that you had a booth because I’m pretty sure others would agree that the HIStalk gang are celebrities, albeit anonymous, in this space. I am sending you a little pic of my coveted HIStalk mug in its new home in snowy, cold NY. I think it fits in very well. It was by far my favorite takeaway from the conference, so much so that I wrapped it in a t-shirt from another vendor so it wouldn’t break on the flight home. I am happy to report that it remained safe and intact.” I can’t explain why I like seeing pictures of reader workspaces, but I do.

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From Sipper: “Re: HIStalk mug. Big fan of HIStalk for many years, read it every day, loving my new mug!”

From Posit: “Re: HIMSS thoughts. Educational sessions were strayed, put together in silos, and not given by industry leaders but more by committee members trying to get placed on the HIMSS board. Educational content had nothing new. Hillary was dry, useless, and added nothing to the conversation of healthcare. The CIO Forum was the usual boy’s club, mostly just CIO wannabes as the majority of CIOs were out sunning themselves. The attendance count seemed to include anyone walking in the door. The HIMSS14 handbooks had many typos – sloppy work.”

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From Dr. Info: “Re: HIMSS video. I saw this gem out of the corner of my eye and then had to endure many painful minutes of this insipid self-promotional video before it came around again for a quick photo for your blog. I’m probably the only person who watched the whole thing, including the producers and editors! Maybe they should just change the acronym already.” You would think HIMSS could spell its own name, especially when it was shilling its HIMSS14 TV informercials (“one-third of air time will be dedicated to our sponsors,” which puts even network TV to shame.)

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From Eager Cleaver: “Re: cost of exhibiting at HIMSS. You should get someone with a modest-sized booth to anonymously provide all line-item costs to exhibit. Readers would be shocked.” I did this a few years ago and would be happy to do so again if a company would be willing to share. I would do it for the HIStalk booth, but it was tiny and we did everything on the cheap, so it’s not really representative. Meanwhile, money alone won’t buy you prime hall space, as booth selection is driven by HIMSS points, which is like your grocery store loyalty card with a lot more zeroes. The annual conference brought HIMSS $25 million in revenue, half its total take. Dues made up only 18 percent of its total revenue. According to its 2011 tax forms, Steve Lieber was paid $925K, so he’s surely well over the million-dollar mark by now. Also in the footnotes of the form: HIMSS owns 81 percent of MedTech Publishing (book value $8 million), which means if you get your industry news from Healthcare IT News, mHealth News, or Government Health IT, you’re getting it from the vendor-friendly, HIT-cheerleading HIMSS.

From GreenFlamed: “Re: Dragon Medical Network. v12.50.200.089 is not ready for prime time, especially in Virtual Desktop environments. It takes a crazy amount of support to sustain and keep your end users happy. The new service pack is riddled with bugs and the dictation box transparency feature is broken. We are facing a major Dragon buy-in and adoption crisis currently because it keeps crashing. Are there any other Dragon360 Network users out there using Dragon on a Virtual Desktop environment?”

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Only 20 percent of respondents say their business card titles include a certification. New poll to your right: if you attended the HIMSS conference, how was it overall?

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Some of the classrooms we helped via HIStalk’s donation of proceeds from the big ad at the top of the page to DonorsChoose projects are already benefitting. Mr. Delperdang reports (and sends the photo above left) that his Mississippi high school students are using the inexpensive supplies we donated (remanufactured printer cartridges and a file cabinet, which he calls “a blessing”) to print and file assignments and college applications. Ms. Vega’s Illinois second graders have created a reading station from the set of non-fiction books we purchased, which she says is the most popular learning station in the classroom and that “even my students whom were afraid to speak and share ideas are now sharing their background knowledge with us.” Ms. Opatz’s Utah fourth graders have formed reading groups around the books we purchased for them (photo above right.) We funded a bunch of projects from the ad revenue and will be doing more, so stay tuned.

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Oracle – like its CEO, Larry Ellison – rarely passes on the opportunity to exhibit boorish behavior. The company’s sloppy technical work reportedly assured the failure of Cover Oregon’s health insurance exchange, with the resulting outcry shaming Oracle into making a public promise to fix the problems it caused at no charge beyond the $90 million it was already being paid. The still-dysfunctional site isn’t likely to get better – Oracle has decided without explanation to pull 60 percent of its employees assigned to the project.

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California’s health insurance exchange, fresh off a five-day system outage, says 14,500 people whose applications were partially completed in the days before the unplanned downtime will need to start over.

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The General Accounting Office reviews the progress of the VA and Department of Defense in deciding to pursue their independent EHR plans and make them interoperable. They aren’t impressed: GAO says those organizations don’t have proof that it will be cheaper to run their separate systems than to create a single one. It also points out that despite the VA’s plan to pilot its system by September 2014 and the DoD’s intention to take its system live by the end of FY2016, neither have said what their systems will consist of, when they will be finished, or what they will cost. The report also says the VA and DoD are still fighting over control, with the federally mandated Interagency Program Office (IPO) having no power over funding and staffing. Both the VA and DoD, strangely enough, agreed with GAO’s recommendations that they perform a cost analysis, justify choosing the more expensive choice if that’s the case, create interoperability plans, and strengthen the control of IPO.

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McKesson, bowing to shareholder pressure, reduces the pension of Chairman, President, and CEO John Hammergren from $159 million to $114 million, although one analyst says the company’s executive pension plan is still “the richest in corporate America.” Perhaps an earlier announcement of his forced impoverishment would have allowed him to escape the indignity of winning his second consecutive HISsie award last week for “Industry Figure In Whose Face You’d Most Like to Throw a Pie.”

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It occurred to me while Mark Bertolini was delivering the HIMSS conference’s opening keynote address, his Aetna employees were setting up the company’s booth in the exhibit hall. Somehow that seems wrong. If it weren’t for HIMSS trying desperately (and unsuccessfully) to get people to stick around later into the week, they would have put the second consecutive keynoting Clinton (Chelsea next year?) in that spot as they have done with politicians in the past.

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People have asked what my favorite conference giveaway was. I’ll go with the iPhone 5 cover from zCover. I wasn’t initially impressed because they had a tableful of them and they were packaged in plastic bags, to the point I was about to just toss it in the trash when I got home. It’s a really nice case that fits the phone perfectly (including little covers for each port) and a clip-on back that ties the package together. It has its own buttons that cover the ringer volume and home buttons that make them easier and more satisfying to use. I’m really glad I picked it up – it has replaced my rubber bumper cover.

It’s hardly news since Intermountain Healthcare announced that it was choosing Cerner as a partner last fall partly because it wasn’t confident about hitting Meaningful Use dates, but CIO Marc Probst says Intermountain will forego incentives and accept penalties for not being ready for MU2 in 2014.

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Streamline Health Solutions promotes Richard Nelli to COO.

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Greenway acquires PeopleLynk, which sends patient relationship messages based on EHR events.

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Infor signs a letter of intent to acquire assets of GRASP Systems, including patient acuity, workload management, and patient assignment systems.

Ingenious Med launches its patient encounter platform One by Ingenious Med (IM1), providing care coordination and patient management to acute and sub-acute spaces.

Strata Decision Technology announces sales of its StrataJazz financial platform to Yale New Haven Health System (CT), Northwestern Medical Center (VT), and Southern Illinois Healthcare (IL).  

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ONC and ANA will present a free one-day summit for nurses on March 21 at The Baltimore Washington Medical Center in Glen Burnie, MD. The agenda includes a keynote by Deputy National Coordinator Judy Murphy, a panel discussion about using health IT to exchange information, afternoon breakout sessions, and a town hall discussion. I recommend as a counterpoint to all of that healthy discussion a side trip to my favorite place in Glen Burnie, Ann’s Dari-Creme.

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In Canada, New Brunswick doctors question their medical society for striking a deal that allows only one EHR – the one sold by a for-profit company co-owned by the medical society — to access the province’s databases. Only 240 of 950 eligible physicians have signed up ahead of the March 31 deadline to earn a 50 percent government subsidy, with only 34 of those actually using the mandatory Velante software. Doctors question whether the medical society’s motivation is business success rather than patients, while the province’s health minister says it may have to take over the system if too few doctors sign up. A similar situation exists in Nova Scotia, where the province gave Nightingale exclusive rights to provide a subsidized EHR that connects to the government’s information.

The VA creates a development portal that explains how to create mobile apps for its use.

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CareSync wins the most promising startup contest at the HIMSS conference.

”How the Medical Establishment Got the Treasury’s Keys,” an interesting article by economics professor Uwe Reinhardt, recounts irrational and naturally inflationary creation of Medicare in the 1960s as flawed grand plan to reduce poverty:

To help implement that vision, these proponents reluctantly paid the price the providers of health care extracted in return for accepting the legislation: Congress surrendered to the providers the keys to the United States Treasury, full well knowing that this social contract could have only a short shelf life. One would assume that physicians and hospital leaders knew that as well. In other words, the proponents of Medicare who signed on to the deal were anything but stupid. When confronted by the health care sector with a harsh trade-off between their cherished vision for health care, on the one hand, and a sensible payment policy, on the other, they let their vision override economically sound payment policy. Millions upon millions of America’s senior citizens are indebted to them for a program that remains highly popular to this day.

Weird News Andy wonders, “Does the noise in my head bother you?” in reading of a British tourist hearing scratching noises inside her head that turned out to be a happy family of eight flesh-eating maggots. WNA also likes this story, in which stethoscopes were found to carry more bacteria (especially MRSA) than anything other than the fingertips of doctors. It’s probably not realistic that doctors who can’t be convinced to wash their hands would sterilize their stethoscopes. 


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Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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Currently there are "11 comments" on this Article:

  1. First, thank you for the wonderful HIMSS coverage.

    Re: Intermountain MU deadline miss

    Is there any evidence that any of the Meaningful Use requirements have any meaningful clinical benefits, ie , meaningfully improving outcomes, or meaningfully reducing costs?

    Are the only present benefits that the government leaders live under the illusion that because doctors are using the computers and software paid for by the largesse of the Congress at taxpayers’ expense, that care has improved?

    I am surprised that you did not cover the Medical Economics cover page story on the EHR survey.

    Just wondering, and will love to hear what your readers think.

  2. I think everyone knows that the MU is about financing HIT into an industry that was behind the times. There have been numerous articles that have said that not much improvement has been gained just because of IT. On a note about Intermountain, if they take the penalty hit, how do they propose to make up the dollars that they will use. Remember they did this with GE years back, and does anyone recall any outcomes of that lavish investment?

  3. I wonder if CMS will consider installing Cerner on an unrealistic timeframe a “hardship” worthy of “flexibility” given that Marc P. is on the committees which decide MU in the first place.

    If the guys on the committee can’t make MU, isn’t that a clear enough signal that MU is off the rails for us to rally and stop this train of unfunded mandates?

    From CMS:
    CMS Administrator Marilyn Tavenner, speaking at the HIMSS 2014 conference in Orlando Thursday morning, announced that CMS has decided to permit flexibility on how hardship exemptions will be granted for meeting 2014 Meaningful Use Stage 2 attestation deadlines.

    From Intermountain’s original press release:

    We will begin implementing the Cerner system in the first quarter of 2014, completing the implementation across all hospitals and clinics by the end of 2015.

    This is an aggressive timeline but leaders from Intermountain and Cerner are committed to making this a success. Cerner will relocate 25 executives and highly skilled technical staff to Salt Lake City as part of their commitment to making this a smooth transition from HELP, HELP2, and the ECIS Desktop.

    https://intermountainphysician.org/ehr/Pages/strategy.aspx

  4. Is Cerner off their committed timeframe already?

    The SEC papers a while back said Cerner expected to collect 50,000,000.00 from Intermountain each year. Seems like a lot of cash. How much of that was Intermountain going to fund with MU dollars that will now become penalties?

    Was Cerner getting a percent of MU dollars if they activated in time?

  5. Meaningful Use exists primarily to prevent us doctors from buying software, collecting our incentive, and, inevitably, refusing to use it. I’m not sure it was ever about improving care.

    As a pediatrician, I find much of MU meaningless (I particularly enjoyed building the stroke decision support into our children’s hospital system, and asking our pulmonologists to ask kids about smoking). But as MU matures, it pushes us to do things we should do that would take us 20 years to get around to doing. A lot of it does seem to be getting crazier. But I’m trying to focus on the good parts–the things I want for myself as a patient. That approach makes it easier to feel good about the parts that make less sense to me.

  6. How about a way for your fans to purchase a mug with proceeds to HisTalk’s favorite charity? Working for a vendor, this would look awesome in my cube, in meetings, in the break room!!

  7. GreenFlamed: There are specific instructions and implementation steps to deploy in a Virtual Desktop environment. It’s somewhat unfair to put out a “blanket statement” that Dragon V12.5 is not ready for prime time, as there are many, many satisfied customers using Dragon successfully in this environment. Hopefully you will contact Nuance and work in a positive and constructive manner to address your issues.

  8. This sounds silly, but If Intermountain does not attest, and then has penalties in 2016, and then has contracts that are dependent % of medicare …. would those contracts then be further reduced by computing at the penalized medicare rate? or am I missing something?

  9. The iOS at Nant is Vaporware, we don’t even know how we are going to integrate it, and our sales strategy and leadership is clueless. We are looking at totally different buyers in organizations. No one is going to replace their EMR to get GLO-caps and device integration.

  10. @SpoonEHR: My daughter [ Missf(n) – grade 7 ] just told me a very interesting story about how one of her classmates told her his friend uses an inhaler for “something like asthma” from smoking cigarettes. Maybe her classmate is fibbing / bragging / trying to be cool, but I bet you’d be surprised….







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Reader Comments

  • Sam Lawrence: Integrity is out the window these days. No one has held Waltman accountable. No one is complaing to Cerner and they su...
  • Sly Cerner: He was at AbleVets for a split second. Hardly any credible length of time that would make this hire look any less shady....
  • HIT Girl: Color me impressed, in any case. If I have more than two drinks on a Saturday night I'm struggling to get off my couch ...
  • Informatics RN: He did not move to Cerner from the VA--that was a former position before moving to AbleVets....
  • AynRandWasDumb: We'll see whether this marriage remains intact. Who knows how forthcoming he was about his escapades with escorts. That ...

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