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Monday Morning Update 6/2/14

May 31, 2014 News 12 Comments

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From Anonymous Tipster: “Re: ONC reorganization. Looks like the current leadership is basically staying in place. Flattening of the structure and some folks got big promotions. Rearranging deck chairs on the Titanic?” An internal email to ONC staffers from Karen DeSalvo announces that the following will serve as ONC’s leadership team along with Deputy National Coordinator Jacob Reider, MD:

  • Office of Care Transformation: Kelly Cronin
  • Office of the Chief Privacy Officer: Joy Pritts
  • Office of the Chief Operating Officer: Lisa Lewis
  • Office of the Chief Scientist: Doug Fridsma, MD, PhD
  • Office of Clinical Quality and Safety: Judy Murphy, RN
  • Office of Planning, Evaluation, and Analysis: Seth Pazinski
  • Office of Policy: Jodi Daniel
  • Office of Programs: Kim Lynch
  • Office of Public Affairs and Communications: Nora Super
  • Office of Standards and Technology: Steve Posnack

It’s not uncommon for a new leader of an organization to restructure the org chart, so I don’t read too much into that. I do wonder with provider pushback on the fading Meaningful Use program whether ONC will retain its influence and keep all its people busy. Government agencies never just go away on their own – they always find ways to survive and try to keep their funding. ONC is part of HHS, which is swollen with so much bureaucracy that nobody’s going to notice ONC’s little corner of it, but other than cheerleading for EMRs, RECs, HIEs, and other big ideas whose funding (and thus interest) has expired, what will ONC’s couple of hundred employees work on?

Reader Comments


From Anonymous Tipster: “Re: VA. My prediction: The VA and DoD will eventually decide to use a commercial vendor for a combined EHR (with a multi-billion dollar price tag) and Epic will ultimately win the bid. With the forgone conclusion of the Shinseki resignation now a reality, I am wondering if there are any implications for the VistA EHR system used by the VA. While the VA OIG report points to serious problems with the scheduling system, at last year’s summit of the Open Source Electronic Health Record Alliance (OSEHRA), Stephen W. Warren, executive in charge for information and technology at the VA, bragged about the scheduling system. The whistleblower in the case is pointing out some of these technology deficiencies and it seems that VistA could wind up being a tech fall guy for some of the VA’s problem. The VA inspector general has reported that an audit by an outside accounting firm revealed continuing problems protecting mission critical systems. Many of these problems rise from the fact that VA hasn’t instituted security standards on all its servers and systems. Remember back in 2009 when the VA canceled its patient scheduling system — dubbed the Replacement Scheduling Application Development Program — after spending $167 million over eight years and failing to deliver a usable product.” I agree that the VA scandal will blacken VistA’s eye along with the VA’s ability to run big software projects since people are starting to notice the VA’s scheduling history. On the other hand, DoD is a black hole of wasted taxpayer dollars. I think it’s safe to say that giving either agency a bunch of money for software in any form is likely to result in the usual budget overruns, missed dates, internal mismanagement, and a poor ROI when considering veteran/service member outcomes. Epic might be a safer choice, but those ever-present beltway bandits will figure out a way to make it less functional and more expensive. Regard Shinseki, I doubt he had any personal knowledge of the scheduling issues despite ample OIG warnings (which could also be said of the President) but clearly political pressure meant he had to go.

From The PACS Designer: “Re: Windows 8.1 for free. Microsoft has announced that it will offer tablet producers Windows 8.1 with Bing for free to ensure that it’s the platform sold to new customers. With Windows 9 coming next year, they’ll be able to get their next OS on these recently purchased tablets with an upgrade offer.” I would much rather get Android for free than Windows 8.1.

HIStalk Announcements and Requests


Respondents were split on whether the Meaningful Use slowdown is good or bad. New poll to your right: how do you see Meditech’s competitive position compared to a year ago?

Announcements and Implementations


Jamestown Regional Medical Center (ND) goes live with Epic, spending $1.2 million to replace HMS.

Government and Politics


The State of Maryland says it will fund development of a replacement health insurance exchange using $40-50 million in leftover funds and Medicaid funding without tapping into federal money. The state will pay Deloitte to customize Connecticut’s exchange for its use. Maryland fired contractor Noridian Healthcare Solutions in February after the $170 million Maryland Health Connection failed immediately on its October 1 go-live. Some state legislators wonder why it doesn’t just use Healthcare.gov, with one saying, “What still is amazing to me is why they don’t go to the federal exchange, which is free and works. You still have to spend $40 to $50 million. It is still money they are spending on something they don’t have to.”

Oregon Governor John Kitzhaber says the state will sue Oracle, hoping to recover the $134 million it paid the company to develop the failed Cover Oregon health insurance exchange.


UPMC finally admits that that all of its 62,000 employees could be at risk for identity theft rather than the 27,000 it announced in April as unknown hackers breached its payroll system and used IDs to file 800 fraudulent tax returns.

A Kansas urologist who is also the president-elect of the Kansas Medical Society says his practice’s biggest problem is electronic medical records. “Now, we’re basically key-punch operators, transcriptionists having to input the data ourselves.  Voice-recognition software and some of those things help, but it has essentially tripled the time to complete a medical record. How do you accomplish that when we are already working 12 to 14 hours a day?” He says EMRs will shake out within 10 years, but doctors are quitting over them now.


Hurley Medical Center (MI) accidentally discloses the Social Security numbers of several employees when someone accidentally attaches an employee worksheet to a mass email about insurance.

Weird News Andy notes that Illinois closed three mental health facilities in 2012, but left behind heavy equipment, a medical specimen, and boxes of paper personnel and medical records.

Sponsor Updates

  • The Advisory Board Company will participate in several events at Health Datapalooza. VP Piper Su will moderate a panel on “Creating Wellness Outside the Clinic.” Jay Nagy, associate principal of corporate strategy, will participate in a panel discussion on “Integration of Patient Generated Data into HCP Clinical Workflow to Achieve Improved Outcomes.” Jonah Czerwinski , managing director of strategic planning, will serve on a panel discussion, “Creating a Sustainable Future for Healthcare.”
  • Validic  will exhibit at Health Datapalooza and will announce new device integration partners.
  • Michael Simon, principal data scientist at Arcadia Healthcare Solutions, provides a recap of eHealth Initiative National Forum on Data and Analytics.


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

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12 Responses to “Monday Morning Update 6/2/14”

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  1. 12
    Seriously? Says:

    I agree with El Jefe, the root of this issue is not technology and assuming so would miss the point entirely. Using technology to address the problem of scheduling is a safe bet, whether it is Cerner or Epic, but I am mostly concerned that the scheduling debaucle is just the tip of the ice berg for an organization that appears to be operating outside the context of what is reasonably considered safe or even legal. Seriously?

  2. 11
    Demo Chic Says:

    @Jan Martinez: From the ambulatory standpoint, practices that already had robust interoperable EHRs benefitted from HITECH. In my organization, Stage 1 was a slam dunk as was most of Stage 2. It helped us recoup money spent years ago, although there have been a few hiccups along the way and a bit of extra work. I’ve also seen practices who hadn’t done EHR due to cost have a decent benefit, especially if they played the game under Medicaid rules, but only if they chose a good product and had strong skills to standardize and create efficiencies along the way.

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