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HIStalk Interviews Keith Figlioli, SVP Healthcare Informatics, Premier

April 19, 2013 Interviews No Comments

Keith Figlioli is senior vice president of healthcare informatics of Premier of Charlotte, NC.

4-15-2013 7-07-13 PM

Give me some background about yourself and your job.

I’m the senior vice president of healthcare informatics at Premier. Premier, as you probably know, is the largest healthcare performance improvement alliance in the country. We’re this interesting company in that we’re owned by both for-profit and non-profit providers. We’re an extension of their organization to help them with supply chain things, consulting and performance improvement things, and also data things, informatics things.

I’ve been in the technology space for about 20-plus years. I spent the last 10 exclusively in the healthcare IT space and am a veteran of the EMR space as well as the performance improvement space.

 

You’re now on the HIT Standards Committee. Give some background on what that group does, what its composition is, and what agenda items it takes on.

ONC has two different committees. You have the Policy Committee and then you have the Standards Committee.  They are two sets of committee which both report into Farzad. I have yet to join the first committee meeting, but they meet every single month.

The idea and intent is to get a broad-based set of industry stakeholders to provide input into ONC in terms not only policy changes, but also HIT standards changes. The last committee meeting, which you reported on, was talking about the CommonWell Alliance. What does that mean because to some of the work those groups are doing now when you have the private sector playing in going in with what the government is trying to do as well. it’s those types of issues, along with obviously the guidelines and the focus of Meaningful Use.

 

You said in a guest article that EHRs are too siloed and that thinking that HIT starts and stops with EHRs is a great delusion. How do you think that status should change and what role should ONC have in changing it?

That’s actually how I got started in this journey with them. I used to be with Eclipsys, now Allscripts, as you probably know. It’s interesting when you are in that environment you have this view that everything is about EMR. Then you come over to a place like Premier and you broaden your lens and you’re interacting with the C-suite at all these different large IDNs across the country. You obviously get a much broader lens.

I’ve been saying for a while now that we’ve been conditioned that EMR is the panacea. It’s an important transactional system, but it’s one of many in the provider footprint.

What we’re going to see –and you saw a little bit of this noise coming out at HIMSS — is this notion of the post-EHR era. I think you’ve mentioned it and it’s out there as well because when you start thinking about clinical groupware and other groupware and you think about the advent of mHealth and all that stuff, you are starting to see this different burgeoning of set of technologies and toolsets the various stakeholders are going to grab onto here as the industry evolves.

A lot of these core systems and really all the EMRs were architected in the late ‘70s or early ‘80s. A lot has changed. The demands — you look at usability, you look at all the different things that are coming up and bubbling up through Meaningful Use and the adoption of all these systems — maybe they are not set for the demands of the providers’ needs of the future.

 

The irony being that you came from a vendor that sold EHRs and now you serve on a committee for ONC, which basically pays providers to use only EMRs and nothing else. Clearly it’s not just vendors who are pushing EHRs. How do you reconcile all these groups that somehow end up recommending EHRs to the exclusion of everything else?

I think it’s tough. I think to your last question for me — why I wanted to get involved in this — is I could easily be a critic on the sidelines and throw bombs. When Meaningful Use started, one colleague and myself actually owned all the capacity planning for that EMR vendor. Literally we’d come into work and sit with our development group and go, “Oh my gosh, what are we going to do with Meaningful Use, and what do I do with all the other stuff that our customers wanted?”

I’ve had a bird’s eye view on that in terms of really thinking through, “My gosh, look what’s actually going to happen to our development capacity, and is this the right thing that our customers are asking us for?” Then you come over to the Premier side and I get that every day. The interesting thing about my job running the informatics group here is I literally am in a different C-suite discussion every single week, sometimes many. I was in three last week. You start to hear full-time, not only from the CIO’s point of view but the CEO’s point of view, CMIO’s point of view, the CFO’s point of view. You start getting all these different point of view of how technology is really interacting with where they are trying to go and take these systems in the future. It changes your perspective dramatically, at least it has for me.

 

People criticize that EHRs are not innovative and are monolithic, but customers will almost always, when given the choice, buy from their incumbent vendor. How will that market ever take hold if the customers would prefer to buy from the same vendors who are accused of not being innovative?

I use this analogy a lot and I’ve been criticized for using this analogy, but I will use it anyway in this discussion. Come out of healthcare. I had the luxury of doing some work in the travel industry about 15 years ago. You think about the travel industry and you think about the transactional systems in travel. They’re still in use. SABRE is one of them. The advent of the Web came along and we layered SABRE, because if you go and watch that person actually doing that travel booking for you at the gate, you look at that DOS prompt and the F: prompt that the person is doing you’re going, “I don’t even know what she’s doing or he’s doing.”

Then we created the Web. We created the Web front end and put a level of abstraction on top of that transactional system,. That was just a website, so that was USair.com if you will, but we don’t book travel that way.

So we created another level of abstraction. We created Orbitz.com and Expedia. So we aggregated the websites and then … I live in Boston and here in Cambridge they created Kayak, and so they aggregated the aggregators. Now you’re like three levels abstraction up off the transactional system, but you did that because everybody wanted a different view of the information.

I really believe — and I’ve said this many, many times — that the same analogy, because it plays out in any industry, is going to happen in healthcare. We just happen to be in that transactional mode right now. If we get to what ONC says we’re going to get to, 85 percent penetration by the end of the year, that would be great in terms of that core base level. But how do you get to that next point? You’ve got to get people to start thinking about what’s that next level of abstraction tool sets that help them take it to a different place because they have different views of information.

If you have an ADT system that’s driving to a patient list for the day or a rounding list for the day, is that the right thing to do? Or do you need to round up a set of specialists that round up a set of diabetics? That’s not really a registry. It’s really much more of a workflow-based component of how you pull that information together and try to get the outset and the outcomes that you actually want.

 

The travel industry had somewhat of a luxury in that SABRE was a monopoly for the most part, and all they had to do was layer on top of SABRE. You’ve got thousands of EMRs out there. What are you going to layer on top of?

Everyone is different and that’s the complexity here. The next 10 years are going to be the most interesting years in this space, because how this plays out I think is still anybody’s guess. You have all these payers coming in and spending all this money on HIT assets. They run the gamut. You got United that has high acuity solutions — they bought the Picis assets all the way to HIE assets. You’ve got providers standing up population health companies. You’ve got EMR guys trying to build up data warehouse businesses. I think it’s anybody’s guess still how it really plays out.

To your point, because there was no standardization, you have what we have. Another thing I say often is I think we have capitalism running amok in a system that really needs a little bit more standardization. Whether the government can do and pull us out of that is still, I think, TBD.

 

It worked without the government’s involvement for Visa, when they convinced banks it was in their self-interest to connect to a neutral network and exchange information. Is there any potential that that’s the platform that you build on top of?

Yes. I think it’s a great point. Whether it’s something like the Policy or the Standards Committee or ONC or Farzad going, “Hey, this is what we’re going to do. We are going to round everybody up to connect that.” Or it’s something like CommonWell, assuming that everybody belongs and everybody is invited to belong. That’s the thing.

There’s got to be some sort of polarizing collaboration event or set of events that starts that next level. That’s what we’re talking about. That’s really where the next step of innovation is. We’ve done some innovative things in this space, but I don’t think we really have done what we could do potentially.

When you start looking at what’s happening in the portable app area, that’s where interesting things are going on. I’m a runner, so I use one of those applications all the time. I have a Basis watch which tracks my heart rate every single second. That’s real data. I always joke with a lot of our folks “Here is my real EMR — it’s sitting on my wrist.”

 

When you look at groups that had good ideas, like the SMART group, I don’t know that they’ve done a whole lot except to announce that everything should look like an app. Do the EHR vendors need to yield to allow those app vendors to connect, or can those apps be built without EHR vendor cooperation?

That was a big part of our push at Eclipsys right before I left. If you go out into your customer base and you really look at it, if you look at all those great academics that Eclipsys had and still have some but they have lost a few, where was all the innovation coming from? The innovation was coming from people stitching on to that rich documentation and CPOE system all sorts of interesting little things. You can call them apps, you can call then whatever, but that’s where the real innovation was taking place. It wasn’t taking place in the four walls of the development shop at Eclipsys. That was running the core infrastructure. 

That’s why we moved to that Objects Plus open layer that we decided to go do at the time. Then finally as they got into Allscripts, they realized wow, that’s the platform that really we need to think about, and more importantly, compete against folks like Epic and Cerner.

That’s still TBD to play out, but I’m a big believer, as you can tell, in openness. I think whatever you call it, this space to move to the next level has to be open. Even my point about the wristwatch. It’s really interesting and I can analyze it, but unless I pull up the website in my physician’s office, we’re not going to go much farther than because no one is letting these folks in.

 

The only pressure a vendor feels is from customers or shareholders, neither of which has a lot of vested interest. The customers don’t seem to be demanding and maybe can’t even define what openness means. Has there been enough education of customers about what should they be demanding from their vendors to push from inside instead of outside?

I don’t think so. That’s part of the reason I came to Premier, which I would say was like a sideways move outside of the vendor community. When I go talk to my board at Premier, I’m talking to all my members, all my customers. We’re trying to educate them into that path, which is, “This is what you really could do with all this information because we’re such a big data company and we have so much data.” There are different things that we can do there.

As more and more people start pushing on this, the idea that this group and this industry actually start understanding what it could become is going to be very viral and very fast. I think they are going to get to such a tipping point in the next five to seven years that this thing will flip on its head and everybody would be like, “Wow! I can’t believe we got here.” All the people who thought these certain encumbered vendors were locked in for good — I think we’ll see how that plays out.

 

What things excite you in the non-EHR world that could be a vital component?

When you look at KLAS data, it that says that 60 percent of providers are either going to replace an existing data warehouse or build a new one. They might not be building your father’s Oldsmobile data warehouses. They might be building a next generation for that abstraction layer point I was making. That starts giving you an infrastructure if they do it in a certain way, to be able to have openness and to be able to use the data. It’s all about the data. 

The Eclipsys data was funny when some of the burgeoning stuff like Amalga and that stuff was coming out. It was funny to watch that all take hold, because people didn’t know how to react to that. They wanted to have everybody locked into those transactional systems. But the fact is, when you pull back on the transactional systems, you’ve got a GL, you got an MMIS system, you’ve got an EMR, you’ve got 40 other different transactional systems in a provider footprint.

How do you get the information out of that? How do you open it up? Then how do you expose it to a bunch of people to do a lot of things with? If we are going to move to population health, even the big payers don’t have enough money to keep up with the use case demand.

 

How will the EHR vendors react to being forced into a transactional system role? Are they getting blindsided by this, innovating because they have to, or just planning to buy up the competition to make sure nothing is shaken up?

A little bit of all of what you said. You already seeing the movements. You saw Cerner do the wellness move. You’ve seen Cerner start to move on the cloud-based analytics. You’ve seen Epic doing Cogito. They are all seeing this coming — it’s just how do they let it play out? They got to preserve the run rate revenue.

I think the math changes, too. The days of investing $250 million on an EMR are not that long left. There’s going to be a whole different equation for value. 

What I find fascinating about this is that some of the stuff that you’re seeing in population health right now – it’s very nascent and everybody is being dashboarded to death. But the math is so fundamentally different in terms of the dollar signs with that work compared to what the EMR transactions were.

That’s what you saw on ERP, too. If you think back to the SAP and Oracle and PeopleSoft days you had these huge dollar amounts. Then all of a sudden you got a disruptor like Workday come in, and Workday is at a difference price point. It’s an op-ex rather than a capital cost, subscription based, a cloud variant. It’s just different. I think the same thing is going to take hold here.

 

Offering the subscription model didn’t seem to help Eclipsys much. It doesn’t seem that the market cares as much about that as you would think. People are happily writing those hundreds of millions of dollars checks and can’t be dissuaded that that’s a bad idea.

[Laughs] That was a  different set of issues for another time over a drink.

 

What do you think the biggest difficulties are going to be, both for healthcare in general and healthcare IT specifically, in getting people to think in terms of public health rather than episodic care?

These CommonWell folks are onto something. This is not the first time – it just happens to have a lot of press. There were a lot of other variants. There was Intermountain, Geisinger, and a few others trying to do this underneath the covers of something else a while ago. But this idea of privacy and this idea of a national identifier … if you think about the amount of work we’re going to have to do in population health — I know it because we’re doing it right now — to just connect John Smith.

If I take pre-adjudicated claims, I take EMR data, and I take post-adjudicated claims and I want to attach all that to John Smith, we need enormous amount of fuzzy logic work. That is enormous amounts of expense. Where you look at Facebook, you look at a credit card transaction log … if you give me those two feeds, I can probably tell you your health status. But now we’re going to spend all these time arguing about health and healthcare data in a different light, when in actuality, all the other ways that people work in an online medium, they are actually exposing that same information — they just don’t know it.

This is what’s going to be the biggest issue for us to get over that hump, and it may actually delay us by five to seven years longer than what I even originally suggested. Until you get to a generational gap, which is the other side of this privacy debate… if you take a 25-year-old, take somebody from the bridge gap, and then take somebody who’s 50 or 55 — different views on privacy. This idea of data liquidity — the stuff that Todd Park talks about, the stuff that others have talked about in the past — if you want to get to that state, you got to change the public persona of healthcare data. That may be a national identifier. That may be a lot of different things that are sort of being noodled around.

 

There are thousands of times more resources being devoted to trying to comply with screwy government payment policies that are so arcane and illogical that no one can even understand what they mean. If the government is so interested in having everything be transparent and interoperable and easy to understand, shouldn’t they first trash the payment system?

Yes, absolutely, and that’s what they’re doing. If you think about all the government is doing, they’re kind of are, even though we’re all being cynical. They are pushing and pulling right now. They’re pushing you because they’re going to cut you to death. They are going to cut you with all these illogical payment approaches, which are what’s going on, all the way from SGR changes to PQRI.

 

Then they’re pulling you through CMMI in different programs. Whether that’s a test cycle of MSSP, whether that’s a test cycle of a pioneer program, whether that’s a commercial thing that’s doing on the private side, we are actually in this fight right now. The question is, is the government going to have the perseverance to continue to pull people into that mode?

I live in Massachusetts. It’s a nice place to be from a test stage standpoint because we adopted a global budget plus a CPI cap. I think the governor signed it two or three months ago. We’re already playing it out over the cap.

At Premier, we’re a big believer — and I think the members are in this position — that we’re going to be a global payment. It’s just a matter of when. It’s going to be a tough battle in that push and pull sequence until we get there.

 

What is Premier’s position on how healthcare IT is going to evolve?

We’re doubling down heavily. We’ve been in this space for 15 plus years doing informatics all the way back to the days of running tape and taking data out of transactional systems and turning it into information for providers.

Our view is that it’s a critical component of this transition. Having said that, I think the other side for us is just the pure social system changes. The social system change, what we see loud and clear — we run a pretty extensive ACO network and what we see pretty loud and clear — is just what it’s going to take for these members in these organization to transition from the business they’re in today to the business they need to be in tomorrow.

And just a stupid subtle point – it’s not that stupid, but it is subtle — how do you even think about asset allocation? How do you think about building a new cancer tower comparatively to maybe investing in nursing homes or building out your SNFs or your behavioral health footprint?

It’s a really interesting discussion going on right now at the administrative layer of providers. How do you think about this asset allocation? Then, how do you think about the differences of the people you have within that to make this transition?

The ones that we see are the typical ones. The ones that have a health plan understand how to think like a payer as much as like a provider. Kaiser is the blue chip here because they first think like a payer and then they adapt into the provider care footprint. I think a lot of what we see –we’ve got Geisinger as a big member, we’ve got SummaCare and Summa in Ohio is a big member — those folks have big health plan footprints. It’s interesting to watch them as they go into this change.

 

Do you have any concluding thoughts?

It’s interesting to finally talk to you. I think I’ve been following you since you started. I can’t believe it’s been 10 years.

It’s just going to be an interesting time for all of us. Some of the best days are ahead of us. Our ability to attach to a much more open framework and getting people still be able to make a dollar — because I don’t want to push the vendors out of the space – we’ve got to get to a place where people can  interact together and we all can do what we’re here to do, which is fundamentally transform the health of communities. That’s the game here. It’s not maximizing your shareholder.

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April 19, 2013 Interviews No Comments

News 4/19/13

April 18, 2013 News 7 Comments

Top News

4-18-2013 6-10-27 PM

Defense Secretary Chuck Hagel says his office has taken direct control of the DoD-VA EHR integration project as he acknowledges to a House subcommittee that “we’re way behind.” Hagel told the committee that he has personally blocked the DoD’s EHR request for proposal because “I didn’t think we knew what the hell we were doing.” He added, “Until I get some understanding of this and get some control over it, we’re not going to spend any money on it.” Hagel, whose experience includes tours as an infantry squad leader in Vietnam and serving as a VA deputy administrator as its VistA system was being developed, says the DoD will have its marching orders within a month.


Reader Comments

4-18-2013 6-44-17 PM

From Mr. Horizon: “Re: Bayhealth – Kent General Hospital, Dover, DE. Went live on McKesson Expert Orders whole house with physicians with minimal problems this week.”

By Anonymous: “Re: MyChart. I gave it another chance and ordered a prescription refill. This morning, I was thinking I never received order confirmation from Caremark. It was a busy morning, so I didn’t get around to calling my doctor to see what was up. This afternoon, I received my trusty Caremark communication that the week-old order was received today. Who knows when the physician practice checks messages or Rx refill requests coming through MyChart? A bigger question: why the heck are you promoting this to your patients if it essentially has no functionality due to no real implementation and weekly checking of messages and notifications, even if weekly? Score:  MyChart zip, Caremark slam dunk. And Mayo had 5 percent portal engagement with what was hopefully a functional portal.” Anonymous wrote the Readers Write article on her MyChart impressions a couple of weeks ago that generated quite a few comments.

4-18-2013 7-02-08 PM

From Poor Richard: “Re: patient portals. New York is allowing citizens to gauge ‘likeability’ of patient portals by voting. I didn’t recognize many of the vendors on the ballot. Some presentations were very professional while others appeared to have been completed in the basement of a programmer. Some of the presentations I considered unimpressive had massive vote appeal, so of course now I am wondering about voter fraud (especially considering I am not a New York resident and they let me vote!) Personally, I preferred ChARM EHR, not for their goofy upper case/lower case naming, but because they were the only vendor in this entire group who addressed maintaining membership through incentives. In ChARM’s (damn, I hate typing that) model, they included a rewards system for using the portal, which is a feature sorely lacking in every patient portal I have seen.“

4-18-2013 7-29-50 PM

From Dan: “Re: GNU Health. I’ve been involved with installing and supporting cumbersome and incredibly expensive EHRs like Horizon and Epic at hospitals and wondered what options are available for organizations with little funding. This one seems to have potential. I’m interested to hear your thoughts.” It’s free, seems to have several basic modules, and already supports ICD-10. No US customers are listed, which is typical of free EHRs that work well in countries that don’t care about billing and other non-patient related capabilities that are unfortunately very important here. Readers are welcome to jump in.

From Lance: “Re: $1 million ONC EHR vendor tax. I work for a vendor and think that ONC could have spent a lot less to achieve the same MU attestation results. Many of the RECs did not earn their M1 and M2 milestones, simply piggybacking on the EHR vendor’s installed base. Many of our clients that we introduced to RECs said they didn’t add anything and all they needed was the free MU resources we provided.”


HIStalk Announcements and Requests

inga_small Recent highlights from HIStalk Practice include: OIG publishes protocols for providers who wish to voluntarily self-disclose evidence of potential fraud. Jonathan Bush dishes with the Wall Street Journal. Children’s Mercy Hospitals and Clinics in Kansas City offers Wichita allergy patients an option for telehealth visits. Professional organizations give tips for physicians participating in social media. NorthShore University Health System’s ambulatory clinics achieve Stage 7 on the HIMSS Ambulatory EMR Adoption Model. Culbert Healthcare Solutions’ Brad Boyd discusses patient access issues. Finally, 91 percent of readers participating in our recent HIStalk Practice Reader survey say that reading HIStalk Practice has helped them perform their jobs better over the last year. If you have room for self improvement, it’s likely worth your while to mosey over to HIStalk Practice. Thanks for reading.

4-18-2013 7-35-27 PM

Welcome to new HIStalk Platinum Sponsor Predixion Software. The San Juan Capistrano, CA-based company offers self-service predictive analytics that are fully integrated with the Microsoft stack, allowing modelers to work with Predixion’s workbench and modeling tools from within Microsoft Excel. The company’s predictable admissions module scores patients at admission and throughout their stay using a hospital-specific model to predict readmission risk with up to 86 percent accuracy. If you’re curious how that works, read up on Practical Predictive Analytics for Healthcare 101. The company won a Microsoft HUG award last month for the use by one of its major healthcare customers of Predixion Readmission Insight. Thanks to Predixion Software for supporting HIStalk.

Here’s a video interview of Chad Eckes, CIO of Cancer Treatment Centers of America and Predixion advisory board member, talking about predictive analytics.

It’s time for that post-HIMSS planning of which conferences to attend this year. If you have suggestions, let me know. I had a nice invitation to attend TEDMED as the guest of a generous company, but couldn’t make it because of work conflicts at the hospital.


Acquisitions, Funding, Business, and Stock

4-18-2013 8-29-48 PM

Roper Industries, which acquired Sunquest Information Systems in August 2012, will buy New Jersey-based Managed Healthcare Associates for $1 billion in cash. MHA offers alternate site services, software, and analytics.


Sales

CareONE LTACH (NJ) long-term acute care hospital selects NTT DATA’s Optimum EHR.

4-18-2013 4-09-36 PM

University of Colorado Health will incorporate Medseek’s predictive analytics and hospital website solutions into its patient engagement initiatives.

4-18-2013 4-08-20 PM

Australia’s Ballarat Health Services deploys the Rhapsody Integration Engine from Orion Health as its connectivity program for message exchange.


People

4-18-2013 8-31-05 AM

Quest Diagnostics names Jim Davis (GE, InSightec) SVP of diagnostic solutions.

4-18-2013 8-05-01 PM

Long-time friend of HIStalk Justen Deal of Vieu Health is named BlackBerry Business Fan of the Month, dropping a much-appreciated plug by saying in his profile piece, “And in my field, HIStalk is where you go when you really want to know what’s really happening; it’s sometimes a bit irreverent, but it’s always smart, insightful, and to-the-point.”

Andy Flanagan (SAP) is appointed SVP, Health Services Sales & Business Management of Siemens Healthcare.

Beacon Partners appoints Michael Whalen (GE Healthcare)  VP of professional services and promotes Chris Kondrat to VP of business integration.


Announcements and Implementations

The Premier healthcare alliance will offer its members access to Phytel’s population health intelligence suite.

4-18-2013 4-12-04 PM

Massachusetts General Hospital joins the PathCentral Pathology Network, an online information exchange and digital consultation forum that enables physicians to upload digital images for pathologists to review and render diagnoses.

Indiana University Health implements Health Catalyst Late-Binding Data Warehouse in 90 days to create a centralized repository of clinical, financial, and patient satisfaction data.

Lumeris releases its Accountable Primary Care Model called the Nine Cs that addresses reducing costs, improving quality, and improving patient and physician satisfaction.


Government and Politics

A JAMIA article describes interviews with VA leadership on their vision for a next-generation EHR. Identified needs include designing better user interfaces to present decision support messages more effectively, creating smaller applications to allow fine tuning workflows, developing a recommendation engine to guide practice as it learns preferences and presents peer practices, using back-end documentation tools such as natural language processing, creating support for teamwork, developing interoperability with the DoD and other care settings, and improving data governance and stewardship.

4-18-2013 8-19-51 PM

HHS and the FCC name members of the new Food and Drug Administration Safety Innovation Act (FDASIA) Workgroup, which will report to the HIT Policy Committee on improving patient safety and innovation in healthcare IT. The new members are from health systems, technology companies, healthcare software vendors, and venture capital firms. The group’s chair will be David Bates, MD, MsC (above), SVP for quality and safety and chief quality officer of Brigham and Women’s Hospital.


Technology

Experts say new WiFi standards 802.11ac and 802.11ad could drive improved hospital wireless connectivity, such as iPhones supporting EHR lookups at 450 Mbps. 802.11ac will replace 802.11n as the WiFi standard, while the short-range 802.11ad technology can support data rates of up to 7 Gbps in potentially replacing cables for connecting computer peripherals or medical equipment.


Other

EHR adoption in children’s hospitals grew from 21 percent in 2008 to 59 percent in 2011, which was significantly higher than adoption rates for adult hospitals.

The Health Technology Forum Innovation Conference: Platforms for the Underserved will be held Friday, April 19 at the UCSF Mission Bay Conference Center in San Francisco, CA. Speakers include Gavin Newsom (lieutenant governor of California); Justin Graham, MD (CMIO, North Bay Healthcare); Kate Bennett, ND (CMIO, John Muir Health); and Darren Schulte, MD (president, Apixio).

Another health technology accelerator makes its debut as Dallas-based Health Wildcatters offers the usual package of mentoring services and seed money in return for equity.

In Canada, Nova Scotia’s largest health district says its computer systems experienced 1 million security threats in the past year, none of which led to lost data. Most were malware and spyware attacks.

4-18-2013 8-41-31 PM

Aetna CEO Mark Bertolini, speaking at the Stanford Graduate School of Business 2012 Healthcare Innovation Summit on Wednesday, says the insurance company is evolving into a health IT company through its acquisitions that include Medicity, iTriage, and Active Health.

In Canada, Regina General Hospital says 15 patients were mistakenly given clindamycin to treat clindamycin-resistant infections due to an unspecified computer error in creating sensitivity reports.

Former Roxy Music member and music producer Brian Eno designs light and sound installations to create healing environments in two British hospitals.

4-18-2013 8-57-38 PM

AlertWatch, which offers surgical patient monitoring software developed at the University of Michigan’s Venture Accelerator, is profiled in a technology publication. A real-time demo (above) is available online. The company’s patient safety advisor is former astronaut Jim Bagian, MD, who I’ve seen speak – he’s excellent.

4-18-2013 9-04-56 PM

A University of Vermont medical student and a partner are working on software that will allow pharmacies to communicate with patients via simple HIPAA-compliant text messages to help them understand their medications. Luke Neill and Sam Mayer were congratulated by actor Matthew Perry at Clinton Global Initiative University earlier this month.

Weird News Andy wonders how in the world this happens. Workers at a commercial laundry processing a load of linen from Regions Hospital St. Paul, MN are startled when a baby’s body falls out. The hospital apologized, explaining that the stillborn infant’s body had been wrapped in linens in the morgue and was mistaken for laundry.


Sponsor Updates

  • Surgical Information Systems CEO Ed Daihl explains the importance of perioperative analytics and the competitive edge it gives hospitals. The company also announces the winners of its SIS Perioperative Leadership Awards.
  • Awarepoint highlights its first quarter 2013 achievements, which include installation of 4.1 million net new square foot of RTLS coverage across 10 clinical sites, the addition of numerous new clients, and renewed commitments from five organizations.
  • Availity and Greenway Medical Technologies join insurer Florida Blue to enable the sharing of clinical data and patient summaries.
  • Trustwave offers an infographic highlighting the high cost of BYOD.
  • Optum opens a free emotional support line staffed with mental health specialists for those affected by the recent Boston explosions.
  • Lisa Bielamowicz, MD, SVP with The Advisory Board Company, reviews three key elements for successful population health management.
  • iHT2 hosts an April 24 Webinar on healthcare cyber first responders.
  • Medseek announces the winners of its eHealth Excellence Awards during this week’s 2013 Client Congress in Austin.
  • Imprivata hosts an April 23 Webinar on streamlining clinical communication with Imprivata Cortext.
  • Good Morning Texas profiles Key-Whitman Eye Center and how its implementation of RTLS technology from Versus is reducing wait times.
  • CAQH recognizes several organizations that have earned voluntary CAQH CORE Phase I or Phase II Operating Rules certification, including NextGen (NextGen PM), OptumInsight (Optum Netwerkes 2.2.0), and RelayHealth (RelayExchange.)

EPtalk by Dr. Jayne

First of all, I want to send my thoughts and prayers to the people of Boston as well as the marathon participants, their families, and the first responders and health care teams who assisted. One of my shoe-shopping pals was running and I was tracking her as the horrifying event unfolded. This was her first Boston Marathon and she slowed down around mile 17, for which I am grateful. Her previous projected finish time would have put her in the thick of it. Hopefully she (and all the other runners who didn’t finish) can qualify again next year.

A recent study shows that physicians may benefit from seeing cost information when ordering laboratory tests. We see plenty of EHRs with medication formularies, but not too many with lab cost data. In my experience, the Advance Beneficiary Notice functionality of many EHRs is sorely lacking, so maybe this will spur vendors to spend some attention in that area. I’d be interested in not just seeing cost information but seeing data on whether tests are really helpful in diagnosing or confirming a particular condition. Of course order sets are helpful, but this would be a twist on the concept for docs who don’t think order sets apply to them.

Weird news: scientists are looking at how intestinal parasites attach to develop better ways to attach skin grafts. Here’s to the spiny-headed worm as the newest member of the healthcare team.

From Tom T: “Re: your piece about the ACP/FSMB online professionalism policy. You are right on the money again and again. The self-righteousness and patronizing tone of those guys is getting to be nauseating. The latest blow is the decision coming from Walgreens to get involved in chronic illness management. How sad that they have no idea of what we do and how bad that will be for healthcare. I for one will refuse to see patients who are going to Walgreens for anything.”

Thanks for writing. I’m interested to see the details on how Walgreens plans to pull this off, specifically how they plan to communicate with other members of the patient care team. When I’m wearing my PCP hat, I refuse to refer to other physicians that don’t communicate in an adequate or timely fashion, and I won’t hesitate to refer patients away from pharmacies or other businesses that don’t have the patients’ best interests at heart. The best service in my community (which is heavily saturated with all kinds of chain pharmacies) actually comes from a mom-and-pop shop and their prices are competitive.

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I wonder if Inga has a pair of these in her closet? I can’t imagine they’d be comfortable, but they’re certainly unique.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 18, 2013 News 7 Comments

News 4/17/13

April 16, 2013 News 4 Comments

Top News

4-16-2013 9-28-53 PM

4-16-2013 9-34-13 PM

Six Republican senators release a report criticizing the HITECH EMR push, saying EMRs are increasing healthcare spending instead of reducing it and that Medicare doesn’t have a plan to ensure interoperability, increasing the chances that $35 billion in taxpayer money will be wasted. It accuses the administration of using money spent as a benchmark of success rather than specific goals, says that Meaningful Use self-attestation means providers may not be using technology as intended, and accuses CMS and ONC as having lax security policies and procedures that jeopardize the security of patient data. It also concludes that post-HITECH penalties will affect small providers disproportionately and that reporting requirements are creating provider compliance burdens.


Reader Comments

From Katherine the PCP: “Re: athenahealth. I’ve been live for two weeks now as part of a health system rollout and I am happy as a clam. The folks from athena were wonderful and worked very well with Clinovations, who were there for the extra help. Athenahealth is everything I expected and more. I did not have to make even one call to their call center. Happy to be paperless!” This was from long-time HIStalk physician reader who I know, so this was not a questionable anonymous comment.


HIStalk Announcements and Requests

4-16-2013 6-51-38 PM

An international HIStalk sighting: an unidentified reader sent over this photo wearing an “I Could Be Mr. H” beauty queen sash taken in London. We’ll be getting more photos from other cities as the sash’s owner enjoys global travel, I’m told. If you’re heading to interesting places this summer, snap your own picture featuring a recognizable location and something HIStalk related (an iPad image of the web page, a printed logo, etc.) and I’ll run it here.

4-16-2013 8-15-22 PM

Welcome to new HIStalk Platinum Sponsor Care Team Connect. The Chicago-area company was launched in 2008 to help chronically ill patients receive better and less expensive care, offering a technology platform that coordinates care among hospitals, community providers, and patients and their families. CTC Gateway is a Web-based platform that makes it easier to distribute patient data to support shared risk payment models via payment reconciliation, file management, attribution list delivery, outcomes reporting, population stratification, and communication and transparent reporting among provider partners. CTC Navigator provides a rules-engine driven checklist process to ensure that target patient populations receive the right care with efficient use of resources. Clients include Integrated Health Partners, Vanguard Health Systems, Ellis Medicine, and MemorialCare Health System, along with its integration into the Michigan Health Information Network to provide real-time updates and alerts for 25,000 patients. Thanks to Care Team Connect for supporting HIStalk.


Acquisitions, Funding, Business, and Stock

4-16-2013 9-00-49 PM

Baltimore-based care coordination platform vendor Ankota raises $2 million to increase headcount. The CTO is a former GE Healthcare CIO and the chief medical office is a Hopkins population health specialist.

4-16-2013 9-24-32 PM

CrowdMed, which uses the wisdom of crowds (“Medical Detectives”) to help patients determine their diagnosis, raises $1.1 million in funding.


Sales

Fulton County Hospital (AR) selects Healthland Centriq EHR for its 25-bed critical access facility.

INTEGRIS Health (OK) signs with TeraMedica for its Evercore Clinical Enterprise Suite.

The iHealthTrust HIE (TX) selects iMedicor to provide secure communication services via the iMedicor SocialHIE platform.

Blue Shield of California hires Kony Solutions to develop mobile apps on the KonyOne platform. Meanwhile, Kony is considering an IPO later this year.


People

4-16-2013 3-50-19 PM

Amy Garcia (American Nurses Association) joins Cerner Clairvia as chief nursing officer for the company’s workforce and capacity management business unit.

4-16-2013 6-23-59 PM

Healthcare VC firm Aberdare Ventures hires Mohit Kaushal (West Health) as a partner.

4-16-2013 2-48-32 PM

AliveCor, the developer of a mobile-based ECG monitor for the iPhone, names Daniel J. Sullivan (SuperDimension, Inc.) president and CEO.

4-16-2013 8-32-21 PM

James Muir is promoted to VP of revenue cycle management sales at NextGen.

4-16-2013 7-59-29 PM

Harvard Vanguard internist Alan Brush, MD, who joined the organization in 1975 and has headed its internal medicine EMR design committee since 2000, wins the Harvard Vanguard Lifetime Achievement Award.

Lester Wold, MD (Mayo Clinic) joins VitalHealth Software as CMO.

Health Evolution Partners appoints Kevin McNamara (McNamara Family Ventures) as an operating partner.

DataMotion, a health information service provider, hires Andrew Nieto (Allscripts) to oversee the company’s DataMotion Direct secure e-mail service.


Announcements and Implementations

Pioneer Community Hospital (GA) implements McKesson EMR as part of the $27 million EHR initiative of Pioneer Health Services.

Saint Joseph Hospital (IL) uses polling software and interactive keypads as part of its EMR training program, embedding questions for audience feedback into its PowerPoint presentations.

The Cherry County Hospital (NE) goes live this month on Meditech’s nursing and therapy documentation and will implement CPOE and eMAR in June.

Mount Sinai announces the go-live of Epic at Mount Sinai Queens, which marks the second major phase of the health system’s $120 million rollout.

4-16-2013 10-49-13 PM

Rogue Regional Medical Center (OR) went live on Epic last last week, while Providence Medical Center (OR) makes the switch April 27.

Home health services provider AccentCare begins a phased implementation of the Homecare Homebase solution.

GE Healthcare announces several new customer-focused initiatives including recognition of facilities using GE HIT products to boost productivity in significant ways; road shows featuring Centricity Imaging Solutions; and, an expanded channel partner program to support ambulatory practices.

Palomar Health (CA) pilots a clinical messaging infrastructure to enable secure HIE using the Direct Project’s secure messaging protocols and the HPDPlus specifications for online physician directories.

CajunCodeFest 2.0 will be held April 24-26 at University of Louisiana at Lafayette, with teams of self-organization participants building healthcare prototypes over a 27-hour period in competing for a $25,000 grand prize. Social activities include a crawfish boil, a Cajun band, and the concurrent Festival International de Louisiane.

GetWellNetwork’s GetConnected 2013 meeting is underway in San Diego, with more than 500 patient engagement leaders in attendance.


Government and Politics

4-16-2013 3-23-17 PM

Not surprisingly, the HIMSS EHR Association issues a statement indicating it does not support the EHR user fee included in the President’s proposed 2014 budget.


Innovation and Research

A study published in JAMA Internal Medicine finds that physicians ordered 8.6 percent fewer tests when shown test costs during order entry. Cost per patient day fell 9.6 percent.


Other

4-16-2013 10-52-40 PM

Life post-Allscripts for Glen Tullman includes building a $5 million glassblowing studio for his son, serving as executive chairman for a chain of tea cafes, running his solar panel business, operating a healthcare app venture capital fund, and starting a company that sells tablet PCs to Chicago schools. Some quotes about his Allscripts experience:

I would have moved faster in integrating Eclipsys. And I would have pushed more aggressively into interoperability, connectivity and care-coordination areas … I think it was the right time to go off and focus on what I do best, which is the innovation part of building great new companies. That’s my interest. It’s hard to do that in a multibillion-dollar, publicly traded company focused on quarter-to-quarter earnings.

4-16-2013 10-51-19 PM

Detroit Medical Center (MI) will lay off 300 employees, or 2 percent of its workforce, in response to the sequester-driven 2 percent Medicare payment reduction. It will also cut executive salaries.

4-16-2013 8-56-03 PM

Cerner gets a National Enquirer mention for providing key evidence in the prosecution of Charles Cullen, the Somerset Medical Center (NJ) who killed at least 40 and possibly as many as 400 patients by drug injection. A fellow nurse who was familiar with Cerner worked with investigators to determine that Cullen was looking up patients not under his care to target them for murder, leading to his arrest. Cullen’s story is described in a new book, The Good Nurse: A True Story of Medicine, Madness and Murder.

4-16-2013 9-10-46 PM

GigaOM profiles California-based MDRevolution, a cardiologist-founded technology-heavy medical practice that combines cardiology, nutrition, and genetics to create affordable, customized healthcare. Patients use fitness trackers, app-enabled monitoring devices, and genetic assessment tools. The practice accepts insurance and charges an extra $25-$75 per month for access. The founder says its self-developed patient engagement software will drive the discovery of new treatment insights. The practice uses physicians minimally as managers rather than clinicians and says new locations may eliminate physicians entirely and replace them with nurse practitioners.

4-16-2013 9-14-19 PM

In England, a hospital physician is profiled for running a series of NHS Hack Days where volunteers (“Geeks Who Love the NHS”) work on disruptive digital health projects.

Also in England, an IT trade group says NHS’s information architecture encourages siloing and urges it to move toward open standards and the approaches that worked for e-commerce providers. The Department of Health has asked the trade group to make recommendations for achieving a paperless NHS.

A New York Times article profiles tele-ICU systems such as the Philips eICU, concluding that vendor-support studies show dramatic benefits, but other studies find little difference in outcomes. Several hospitals that launched remote ICU monitoring services with extensive publicity have since pulled the plug, including New York-Presbyterian, Kaleida, and at least three other hospital systems that installed systems in 2004 and 2005. Kaleida said the tele-ICU was a nice marketing tool, but they saw no significant improvement in mortality and complication rates and decided to redeploy the personnel back to the bedside.


Sponsor Updates

  • Captain Stephen Harden, chairman and CEO of LifeWings Partners, shares how aviation uses technology to avoid fatal errors at this week’s Surgical Information Systems National Conference in Atlanta.
  • Illene Moore, MD of Dearborn Advisors lists the traps to avoid when optimizing EHR use.
  • SuccessEHS integrates its EHR/PM solution with four Welch Allyn medical diagnostic devices.
  • Sunquest Information Systems President Richard Atkin keynotes at the MedTech Nordic Investing & Partnering 2013 event September 3 in Helsinki, Finland. SIS CTO Eric Nilson posts the second of his three-part series on quality reporting for anesthesia.
  • Brian Hodges, Informatica’s SVP of worldwide professional services, discusses risk-sharing and its impact on buying decisions.
  • Kennedy Consulting Research & Advisory includes Aspen Advisors, Beacon Partners, Cumberland Consulting, Deloitte, GE Healthcare, and Impact Advisors in a report on firms in the healthcare payer, provider, and government consulting sectors.
  • The Advisory Board Company, Heritage Provider Network, and the Bipartisan Policy Center launch the Care Transformation Prize Series, a national contest to encourage healthcare organizations to identify roadblocks to implementing new care models.
  • Truven Health Analytics announces its report on the 15 top health systems, which were selected based on highest survival rates and fewest complications.
  • QlikView offers a series of BI technology summits in several cities in coming months.
  • EDCO Health Information Solutions and HealthPort collaborate to provide improved and expedited management of PHI.
  • MedHOK’s 360Measures V 2.55 earns P4P software certification based on testing on the Integrated Healthcare Association’s California P4P measures, NCQA, and HEDIS.
  • The Indianapolis Star names First Databank as a Top Workplace in 2013 based on employee feedback.
  • GE Healthcare hosts its 2013 Centricity Live USER Conference this week in Washington, DC and announces GE Chairman and CEO Jeff Immelt as one of the keynote speakers.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 16, 2013 News 4 Comments

Morning Headlines 4/16/13

April 15, 2013 Headlines No Comments

Fulton County Hospital Selects Healthland EHR Technology to Improve Patient Care and Increase Productivity

Fulton County Hospital, a 25-bed critical access hospital located in Salem, AR, has selected Healthland’s Centriq EHR.

athenanet, athenahealth’s suite of cloud-based services for health care providers, certified for Cerner interoperability

athenahealth has received "gold status" interoperability certification from Cerner after passing performance tests that measure athena’s ability to exchange clinical data using Cerner’s architecture and communication protocols.

E-Prescribing Market By Hardware, Software, Services, End-Users, Products & Deployment – Global Forecasts To 2017

The e-prescribing market is forecast to realize sustained 26 percent annual growth over the next five years to become a $794 million market by 2017.

When Your M.D. Is an Algorithm

The Wall Street Journal covers big data algorithms designed to help curb prescription drug abuse.

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April 15, 2013 Headlines No Comments

Morning Headlines 4/12/13

April 11, 2013 Headlines 8 Comments

New ONC fee proposal scares health IT sector

ONC releases its budget plan for 2014, which includes a 28 percent increase in funding and a proposal to introduce a new fee structure for EHR vendors.

athenahealth Inc. vs CareCloud Corporation

athenahealth files a patent infringement lawsuit against competitor CareCloud, citing a 13-year-old practice management patent.

Statistical blunders blamed for death rate scare at Leeds heart unit

In England, The Leeds Teaching Hospitals suspend all children’s heart surgeries after skewed EHR data erroneously spikes mortality rates.

Cerner Hits 52-Week High

Shares of Cerner hit a new 52-week high at $95.54,  a 40 percent increase since its 52-week low on October 23, 2012.

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April 11, 2013 Headlines 8 Comments

News 4/12/13

April 11, 2013 News 9 Comments

Top News

4-11-2013 7-09-59 PM

ONC’s proposed 2014 budget calls for $78 million in spending, up from $61 million in 2013. Staffing will increase from 89 to 109 FTEs. Also in the budget is $1 million in user fees that would be paid by EHR vendors.


Reader Comments

From The PACS Designer: “Re: MyChart. It’s nice to see that TPD’s post on MyChart signup generated a Readers Write from Anonymous along with a large number of reader comments. TPD’s view is MyChart is a good start for an online medical record, but much more needs to be done to add to maximum value for each patient using this option. For MyChart to be used, the patient must request a printed copy of the provider’s existing record. At the very end of the printed record you’ll find a unique starting code, which you will enter once you logon to MyChart. As for lab results, you’ll only get those on your record that the provider has interface installed for those other lab systems. What’s likeable is each medication listed on your record has a link to the National Institutes of Health’s NIH MedlinePlus site, which gives you access to the prescriptions purpose and side effects along with much more information you can’t find on your pharmacist’s prescription fact sheet.”



HIStalk Announcements and Requests

inga125

Inga is taking the day off, so I’m sure we all wish her well in whatever interesting activities she has arranged. She mentioned earlier that her sixth anniversary with HIStalk is this week, so perhaps she is celebrating. Here’s to her.

We will be presenting some Webinars shortly and I need three hospital CIOs to provide presenter feedback for the first one. Real-time viewing isn’t required since we will have a recorded practice run of the Webinar to review. It will probably run around 40 minutes. Let me know if you can help. I’ll send an Amazon gift card as my thanks.

On the Jobs Board: Solution Sales Executive, Senior Program Manager, Senior Client Representative.

4-11-2013 8-10-22 PM

Welcome to new HIStalk Platinum Sponsor QPID Health Record Intelligence. QPID (Queriable Patient Inference Dossier) aggregates EHR data to support real-time clinician-directed queries, analytics, and reporting capabilities at the point of care. Fast queries are supported by caching and indexing the patient record, with structured and unstructured information parsed and tagged. Any number of rule sets (apps) can be used, with examples that include an EHR search portal, an ED patient summary dashboard, a GI conscious sedation intake system, coding optimization, bronchitis screening, OR diabetes alert, and automated determination of smoking status. I interviewed President and CEO Michael Doyle on the day of the company’s February 14 launch. Thanks to QPID for supporting HIStalk.


Acquisitions, Funding, Business, and Stock

4-11-2013 9-27-35 PM

Cerner shares hit a 52-week high Thursday, closing at $95.54, up 30 percent in the past year. Above is the one-year share price chart of CERN (blue) vs. the Nasdaq (red).

Athenahealth files a patent infringement lawsuit against PM/EHR competitor CareCloud, claiming that the company violated athenahealth’s 2001 patent for claims processing rules. Several former employees of athenahealth now work for CareCloud. Athenahealth declined to comment on the lawsuit, but CareCloud CEO Albert Santalo provided us with this statement:“ To the best of our knowledge Carecloud is not infringing on Athenahealth’s 13-year-old outdated method and we won’t be making any additional comment at this time.”


Sales

Piedmont Healthcare (GA) will deploy Perceptive Software solutions to integrate data directly into its Epic EHR throughout five hospitals and 45 physician offices.

4-11-2013 9-30-25 PM

Hennepin County Medical Center (MN) continues its population health drive for HIV care with Forward Health Group’s PopulationManager.


People

4-11-2013 9-05-22 PM

Chris Coburn, executive director at Cleveland Clinic Innovations, will leave that organization to take an unnamed position with Partners HealthCare.

Michael Thompson (Mindray) joins Medstreaming as COO.


Announcements and Implementations

Vocera ships its 500,000th communication badge.

4-11-2013 7-57-27 PM

Tennessee-based Parental Health, which offers a care management platform for seniors, will raise $3 million via a Series B fundraising round, with the proceeds going toward the addition of up to 12 full-time employees in sales and marketing.

The Bipartisan Policy Center’s Health Innovation Initiative, Heritage Provider Network, and The Advisory Board company will hold an April 16 discussion on the the use of data by providers, health plans, and states to address healthcare challenges. A big data challenge will be announced. Speakers include Janet Marchibroda (BPC); Senator Bill Frist, MD; Aneesh Chopra (The Advisory Board Company); Karen Ignani (AHIP); and James Weinstein, MD (Dartmouth-Hitchcock Health System). The event will be streamed live.

Intuit Health announces that the seven millionth patient has registered for its health portal.

4-11-2013 8-43-18 PM

Practice Fusion launches Patient Fusion, which allows patients to schedule online appointments via the Web with any of the free EHR company’s 27,000 physician users and access their health records online. Mobile versions will follow.

Impact Advisors expands its mergers and acquisitions services for the healthcare IT market.

MMRGlobal files a patent infringement complaint against Quest Diagnostics and its Gazelle personal health records system.

4-11-2013 9-33-36 PM

Western Maryland Health System expands its use of Versus RTLS to include a mobile, location-aware call button for caregivers.


Government and Politics

ONC announces internally the hiring of Joe Bormel, MD, MPH (QuadraMed) as Director of Health Outcomes. He will focus on usability, clinical decision, support, and Meaningful Use and certification policy. We reported his hiring as a rumor as ONC medical officer on Tuesday, but did not list his title (“medical officer” in ONC is any physician employee). Bormel will report to Chief Medical Officer Jacob Reider, MD.

The VA requests $3.7 billion for its 2014 IT budget, a 10 percent increase. It includes $252 million for projects related to the VA-DoD shared EHR.


Technology

4-11-2013 9-35-42 PM

Athenahealth will provide third-party developer access to its physician network by rolling out an programmer API, allowing creation of an ecosystem of apps that can use its anonymized medical histories, appointments, and billing information through its More Disruption Please program. 


Other

In the UK, a hospital suspends its children’s heart surgery program because of high mortality rates, only to find that poorly produced data that had been fed to its new computer system had produced a false alarm.

Weird News Andy calls this “clear thinking for fatheads.” Stanford researchers develop a method of rendering harvested brain tissue transparent by removing the fat in its cells, allowing them to view structures down to the individual cell and molecule level.


Sponsor Updates

4-11-2013 7-46-51 PM

  • Good Samaritan Hospital chooses Access and Perceptive Software to create electronic forms on demand.
  • Vicki Lucas, RNC, PhD, chief nursing officer of PeriGen, covered strategies to increase OB revenue at the World Congress Leadership Summit on The Business of Women’s Health Washington, DC on April 10.
  • UMC Health System (TX) goes live on Cerner CPOE with the assistance of HCI Group.
  • GetWellNetwork will serve as a patient engagement sponsor for The Academy Huron Institute’s 2013 program “Developing Innovative Value-Based Delivery and Payment Models.”
  • T-System signs an exclusive agreement with X32 Healthcare to offer Lean methodology for analytics and services with the ED.
  • Hurley Medical Center (MI) selects Ciber to implement its Infor Healthcare Suite.
  • Michele Hilton, GM of medical billing services for ADP AdvancedMD shares the top five challenges for hospitals to get paid.
  • Merge adds endpoint and adjudication management to its eClinical OS platform for end-to-end study support in a single platform.
  • Aprima Medical Software partners with ClearDATA for cloud hosting of its EHR/PM/RCM software and services.
  • e-MDs announces the free Kansas City User Group roadshow on May 2.
  • MedAssets honors veterans and humanitarians during the 2013 MedAssets Healthcare Business Summit in Las Vegas.
  • DrFirst receives the Surescripts 2012 White Coat of Quality Award for the third consecutive year.
  • Ingenious Med reaches the milestone of 25,000 charge capture users.
  • Levi, Ray & Shoup hosts a webinar April 16 and 18 on improving performance in an SAP environment.
  • CTO Charles Halfpenny of Halfpenny Technologies will present a master level session at the 18th Annual Executive War College on the value of lab data to health plans.
  • Walsh College (MI) renews its IT outsourcing contract with CareTech Solutions.
  • Confirmit awards McKesson its third ACE Award.
  • Beacon Partners is hosting a webinar April 19 focusing on five key issues between Stage 1 and Stage 2 of Meaningful Use.
  • HealthCare Anytime CEO Brady Klick served on a patient engagement panel at an April 11 program sponsored by the Northern California HIMSS chapter.
  • Orion Health celebrates its 20-year anniversary, having surpassed $100 million in annual revenue, raised headcount my three to more than 750, and implement its solutions in more than 30 countries.

EPtalk by Dr. Jayne

Red Raider Alert: Texas Tech University Health Sciences Center notifies patients of an information breach as a result of a billing error. Apparently patient statements were mailed to the wrong addresses.

Mr. H posted a reader question about job recommendations for new graduates to better understand the HIT environment. Depending on your degree and experience, I’d consider looking for a position as an implementation specialist for a hospital, health system, or large medical group. It’s a great way to learn what the industry looks like outside of the vendor space and once you’ve done a couple tours of duty with complicated practices or hospital departments, you’ll be extremely valuable in the job market. At least in my area, teams are often composed of people that are new to healthcare – one is managed by an engineer and includes not only healthcare veterans, but also a minister and several former retirees.

A recent article in American Medical News notes that volume, not quality, still determines most doctor pay. I would love to see payment reform that rewards not only quality, but customer service, personality, and the time spent with patients. Despite the hard edge sometimes portrayed in my writing, when it comes to actual patient care I tend to be much more empathetic than my peers. When I was in community practice, my patients appreciated my listening skills as well as my ability to partner with them and negotiate long-term outcomes rather than simply lecture. Why shouldn’t I be paid more for that level of service? You want to see true physician engagement? Figure out a way to pay primary care physicians so that they can afford to see 20-25 patients a day rather than 30-35. And figure out a fair way to measure Meaningful Use that isn’t “all or nothing.”

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Physician social media site Doximity gets my jeer of the week for its unreadable e-mail. It was so bad that I almost outed myself trying to screen shot it – the white rectangle is covering the black-on-black “insert recipient name here” field that I didn’t see until I pasted it over to send to Mr. H. Seriously, folks, do you really think anyone can read black on black or dark gray on black?

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Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 11, 2013 News 9 Comments

Chatting with John Gomez 4/10/13

April 10, 2013 Interviews 25 Comments

John Gomez is CEO of JGo Labs.


What’s the big news these days?

It’s over. Epic wins. Not sure that is big news, more like the Emperor’s New Clothes from childhood. Everyone kind of knows they won, but no one wants to point it out.

Why do you think Epic has won?

As the data rolls in, some qualified and some conjecture, the one thing that seems to remain consistent is that Epic is the big winner when it comes to the EMR market. This may seem rather obvious, but for some reason we keep hearing how there is still tremendous opportunity in the EMR market.

I am not sure where that huge opportunity lies or what market is being referenced by the Epic competitors, but from what I see, if we are discussing the hospital market, then Epic has won the lion’s share. Congratulations go to Judy and team. Job well done.

I am often asked by analysts if Epic is the big winner, who is the runner up? My vote would be Cerner. I actually am rather impressed by the company’s turnaround, KLAS scores, and general ability to deliver a quality product at a competitive price point with solid periphery services.

That brings us to the rest of the pack — Allscripts, GE, McKesson, and the niche players trying to carve out a place among the smaller hospitals that haven’t made an EMR partner choice. Mind you that even in the small hospital market of 50 to 150 beds, Epic is making inroads, with CPSI doing a great job of gaining ground. There are some other players, but in my eyes, these are the companies to watch.

What happens now?

Mind you I am often wrong about these things, but there are basically two things that will happen. The first is that we will see continued focus by hospitals to optimize their financials for the new world order. Secondly, we will see a resetting of the landscape.

 

Where do you think the market is in terms of our maturity?

If we went back to the 80s and 90s, we would find ourselves surrounded by plethora of word processing and spreadsheet offerings. Anyone remember WordPerfect, Multimate, Wang, and Write? How about Quattro Pro and QuickCalc? Today the office productivity market is owned by Microsoft, with some pressure from Google and Open Office, but nothing even remotely close to threatening Microsoft Office’s market share. We have seen the same thing occur with databases (Access, dBase, Clipper, Sybase, IBM-DBM, Gupta) and even accounting packages (JD Edwards, AccPac, etc.) I suspect we are in the early stages of consolidation where we will see some of the EMR market begin to shift and clients moving over time to the market leaders.

 

Why don’t you think that hospitals will move now instead of saying with their incumbent EHR vendor?

The thing to understand about this market is that for all intents and purposes, it is a very conservative market. I suspect that hospitals don’t just jump ship overnight because there is vast fear of the unknown. By that, I mean there is just enough FUD — fear, uncertainty and doubt — that hospitals stay put. 

I do believe that if there was a very prescriptive means of migrating, hospitals would move, but today there is no clear methodology that shows a hospital exactly how to move, the risks, the plan. and how to be successful in that migration. If someone brought to market a clear migration methodology that was highly prescriptive, I suspect they would be very successful and hospitals would certainly make the move.

 

We hear a lot about cloud computing, open platforms, and SaaS. Will they allow new companies to emerge and challenge the current market leaders?

I hear that a lot. I have investors who try to convince me that an EMR that is cloud based or has a great new user interface or some new single platform solution is going to make everyone suddenly abandon their EMR of choice and jump ship. I just don’t see that happening.

This market is very loyal and is not enticed by the great new shiny object. Clients in this market move because a vendor just cannot keep its promises and does not follow through. This market is not driven by small savings in costs or the promises of being open. I do think being open is important, but I don’t know of any hospital that is going to move because there is suddenly a new platform.

 

Many people say Epic is closed.

That is pretty funny. Since leaving Allscripts, I have had the chance to really get to know Epic. I have found that Epic is actually very open and has a flexible platform. They have programs to work with third parties and there are many, many third parties that integrate with Epic.

Much of what you hear about Epic is myth. Much of it is created by their competitors, which is rather telling if your only way to combat Epic is to spread myth.

 

Give me an example of Epic’s openness.

Actually I can give a bunch of them. For one, they were one of the first vendors to integrate with the DoD and VA seamlessly. That is significant because most of the HIE standards in the country are based on the DoD/VA work. Epic is the leader in this space and what’s more, they use this to help all of their clients exchange data. I don’t know if they did this by design or by accident, but either way the outcome is brilliant.

In terms of third-party integration, they seem to be very open to that in my eyes. A good friend of mine, Matt Sappern the CEO of Perigen, reached out to Epic and asked about how they might be able to integrate. Epic was responsive, and in a few short weeks they had an agreement in place. Perigen, to the best of my knowledge, is now extremely excited and an Epic supporter.

Contrast that to some of the other vendors, even ones with app stores, and you find that it is extremely difficult to put a deal in place and takes weeks and weeks if not months. Epic suddenly starts looking like the nicest company on the planet to work with.

 

How will the market change?

Over the past several years, what we have seen is inorganic growth in the market. Companies, especially the EMR vendors, really needed to just do what the government required, deliver on their promises, and follow through to be assured of growth. Not to minimize it, but that is what Epic did and does and what Cerner did and does. The companies that had failed leadership, lost their way, or focused on financials rather then quality … well, they kind of didn’t enjoy that growth.

As things settle down, we are going to see a shift from inorganic growth to organic growth. Organic growth is where you must rely on your own innovation and understanding of the market to gain share or preserve share. You need to figure it out and no one, not the Government or anyone else, is going to provide you a checklist, like Meaningful Use.

That shift from inorganic to organic will reset the market. It means everyone — Epic, Cerner, McKesson, Allscripts — all have a chance now to either win or lose. The key will be figuring out what they need to do to take advantage of this reset. It will be easiest for those who own the most market share, but it is not guaranteed. Just because you won the EMR battle doesn’t mean you won the war.

 

Where do you see the opportunities?

I think that in terms of opportunity there are two categories. The first being add-on opportunities and the second being apple seed opportunities. Add-on are those opportunities where a vendor can bring to market new offerings that they bolt on or integrate with their EMR. The second and most critical to long-term success are apple seed opportunities. These are new offerings that provide new market growth, for example, entering adjacent markets or inventing entirely new products.

 

Simplify that statement.

I would steal a line from my friend Matt that I mentioned earlier. The go-forward victors will be “those companies that can help hospitals make money or avoid penalties.” I think that regardless of whether we are talking about add-on or apple seed opportunities, the net net is that the clients in this market are going to need to really to focus on optimizing operations. That will drive much of the investment they make in the coming three to five years.

 

What does Allscripts have to do fix itself?

That answer would make an interview in and of itself. In hopes of not boring your readers, I will keep it short.

The bottom line is that they need to decide what they are. Are they a software company or sales company? To date, they have operated as a sales company. Even when I was there I fought that persona and always felt it was one of the biggest issues we had. They have a long way to go to become a software company.

I also think they need to figure out who is really conducting the orchestra. They have lots of people suited up for opening night, but in my eyes it seems there is no conductor. I am sure they are working hard to get things right, but just seems like they need to get one person who can articulate end to end how it all works, when and how it is all going to come together, and where it is going in the future. In a manner that is clear, market relevant, and based on facts.

I still have a huge soft spot for my former team members and feel bad for them. They have been working day-in and day-out on something they truly believe in, yet time and time again the leadership of the company has let them down.

When I talk to analysts, they focus on 5-10 percent growth models. All they care about is how the company just grows 5-10 percent. This is one case where Wall Street is just as guilty in holding this company back by forcing them to focus on financials rather then building a great set of solutions. 

Going private isn’t the answer. That is just leadership weakness looking for a scapegoat. Cerner turned themselves around a few years ago, as did many other public companies.

The market is going to reset. It is all a matter of if this company takes advantage of that. So far I just don’t see much difference today than anything the previous seven or eight CEOs have done or tried.

 

What are the biggest market fallacies or myths?

I covered one, that Epic isn’t open. Some of the others are related to what I consider emerging trends. I think there are a lot of buzzwords being thrown around that, as they often do sound great but aren’t actually more than buzz.

Things like population management, clinical trials integration, and outcomes management are catchy, but when you get past all the buzz, they seem to be solutions looking for problems. I would really caution vendors and providers to think very carefully before investing in these areas. I would especially advise providers to see if they can’t solve these issues with the tools they have, inexpensively, before they pull the trigger and buy more technology.

Lastly, I am thinking mobility. Provider mobility, except in some limited areas like wound care for instance, just isn’t there yet and is not going to be the big paradigm shift. It will happen, but probably not as fast as the buzz indicates. I do think on the patient side mobility is huge and growing rapidly with great returns.

 

What would be some strategies you would recommend hospitals consider over the next few years?

I think that first and foremost, forego best of breed for tight integration. Features can be evolved and hospitals can easily push a vendor to fix the gaps.

On the other hand, integration — regardless of Meaningful Use 3 — is really really hard to get right. Despite vendor best intentions, it’s not going to happen overnight. In the future, I suspect you can live with a small feature gap, but as you need to rely more and more on a holistic view of the patient, you will find that integration is mission critical.

I would also tell hospitals that they need to stop paying premiums for software. This industry is one of the few left where you have pricing models that really make no sense. How does bed count or total caregivers change the value of the software? It doesn’t.

If you want to find an easy means to optimize costs, push vendors to realign their prices and charge intelligently. I think it is cool that market economics allow for $20M software deals, but going forward, clients need to set ceilings and really question the pricing.

Hospitals also need to truly examine the value of the shiny object. Do they need that population management thing? Are they really going to need to integrate with clinical trials? Do they need a huge data warehouse? Maybe, but chances are most hospitals do not. Question the shiny object and invest in practical solutions that drive real revenue and reduce exposure to penalties.

I would tell them to reconsider their departmental systems. I think there are really great new offerings out there that can help drive down costs, improve throughput, and make a difference to the bottom line of the hospital. I also would tell them to look into outsourcing things like their pharmacy and ICU. For smaller hospitals, this can be a serious way to reduce costs, improve quality of service, and drive margin improvement.

I would suggest they consider embracing self-care systems and introduce more case management that is subsidized by their majority payor. That is a little harder to explain here, but basically it is about reducing admissions for non-critical patients and still generating revenue.

Lastly, I would tell them to work really hard at being a business. I know that isn’t politically correct, but I think that focusing on being a business actually would improve revenue, which is ultimately required to make investments in improving patient care.

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April 10, 2013 Interviews 25 Comments

News 4/10/13

April 9, 2013 News 14 Comments

Top News

4-9-2013 10-40-32 AM

The HHS inspector general and CMS propose rules that would update and extend existing safe harbor exceptions and allow hospitals to continue subsidizing EMRs for affiliated physicians.


Reader Comments

From Wildcat Well: “Re: HIE. ONC announces an interest in a nationwide interoperable HIE. Is this not the same initiative as the CommonWell Health Alliance pilot? CommonWell will be a 501(C)(6), but regardless. Looks like a race of private vs. the government. Thoughts?”  

4-9-2013 7-33-51 PM

From Shodan the Barbarian MD: "Re: Shodan search engine. Guess you could easily find the IP address of a monitor, anesthesia machine, ventilator, or IV pump and change the settings. Scary with the virtually non-existent security of these devices.” A CNN article covers the Shodan search engine, a Google-like service that finds any device connected to the Internet such printers, webcams, routers, servers, security cameras, and even medical equipment. Many of those devices have no security protection at all, and many more have the manufacturer’s original password or an easily guessed replacement like “password1” or “1234”. An independent security consultant was able to run a car wash, turn off the cooling system of a hockey rink in Denmark, and access the control system of a French hydroelectric plant.

4-9-2013 7-43-59 PM

From Bob Loblow: “Re: QuadraMed. CMIO Joe Bormel, MD has left after 10 years and is now with ONC.” His LinkedIn profile still shows him as an independent consultant, having left QuadraMed in January 2013. Update: readers confirmed that Joe started as ONC’s medical officer on Monday, April 8.

From JM: “Re: healthcare IT resources. What would you recommend a recent graduate do to better understand the HIT environment? Are there specific resources, entry-level positions, or education to seek out?” This question comes up every few months and I always invite readers to provide advice.

From Marie: “Re: at-risk contracts. I am doing research for a master’s program. We hear about at-risk contracts between payers and providers, but why haven’t we seen a similar movement between HIT vendors and providers? Why aren’t providers demanding that vendors go at risk for the cost and quality results they promise? Why aren’t vendors offering it to create competitive advantage?” I can only say that you’d be crazy as a vendor to make a hospital your partner knowing they don’t have the focus and capability to deliver the 80 percent of an HIT project’s value that comes from how a system is used rather than the system itself. That would be like a hammer manufacturer going at risk that you’ll build something nice with their product and pay them if so. I’ve had experience writing at-risk contracts as a customer and either party could get royally screwed just because some idealistic metric (readmissions, medication errors, cost per case, etc.) went up or down over several years because of factors entirely unrelated to the new system. Perhaps you could look at more specific measures such as orders originating from an order set, accepted clinical warnings, or decreased turnaround time, but it’s hard to assign a dollar value to those. But I’ll let readers chime in and help Marie with her project.


HIStalk Announcements and Requests

inga_small This week marks my sixth anniversary at HIStalk. Happily I still think it’s the best job in HIT. In fact, every once in awhile I have to pinch myself to make sure I am not dreaming and that I am not about to wake up in the middle of the night to catch a 6:00 a.m. flight for an EHR demo to a bunch of doctors and their transcriptionists(!) Thanks Mr. H for keeping it fun.

4-9-2013 7-45-43 PM

Welcome to new HIStalk Platinum Sponsor Xerox, and specifically its Healthcare Solutions business. The company’s provider offerings include system selection and implementation (Meaningful Use, EHR, ERP, revenue cycle, ICD-10), optimization (technology and infrastructure, extended business office, collections, compliance), and analytics (clinical surveillance, decision support, care management, case management, and benchmarking). The company has been serving providers for 25 years, has 1,500 hospital clients, works in 31 states, and does work for 19 of the top 20 health plans. Some of the major vendors supported are Epic, Cerner, GEHC, Siemens, Meditech, McKesson, Allscripts, Infor Lawson, and Kronos. Thanks to Xerox for supporting HIStalk.

Here’s a video I found on YouTube that provides an overview of Xerox in healthcare.


Acquisitions, Funding, Business, and Stock

A Wisconsin newspaper’s article called “Life After Epic: From Epic ‘Grad’ to Entrepreneur” covers companies started by still-young former Epic employees, some of them working from a railroad car converted to co-working space. A local entrepreneur networking group estimates that 50 former Epic employees are working startups in the Madison area, most of them not healthcare related. A new entrepreneur says Epic’s one-year non-compete clause provides a good time to start a company.

4-9-2013 10-32-34 PM

Allscripts CEO Paul Black was paid $9 million in his first 12 days on the job, according to the Chicago business paper. Most of that was in stock and bonuses. Glen Tullman, his fired predecessor, made $7.1 million in 2012.

4-9-2013 10-33-14 PM

iMDsoft opens a new office in Dusseldorf, Germany that will provide around-the-clock support to its customers in Germany, Austria, and Switzerland.


Sales

Presence Health (IL) will deploy the Medseek Predict CRM solution.

Mississippi Medicaid selects the MedeAnalytics Accountable Care Solution to warehouse claims and clinical data collected from various HIEs.

4-9-2013 10-34-01 PM

The Ocean Beach Hospital (WA) board of commissions approves the purchase of Healthland’s EHR.

Planned Systems International and its partner Mediware win a $5 million DoD contract to provide validation services for the Enterprise Blood Management System.


People

4-9-2013 6-04-33 PM

Versus promotes Kevin Jackson to VP of technology.

4-9-2013 6-11-33 PM

Terry McGeeney, MD (TransforMED) joins healthcare consulting firm BDC Advisors.

4-9-2013 6-10-41 PM

MedeAnalytics hires Ping Zhang (Epocrates) SVP of product innovation and CTO.

4-9-2013 9-39-25 PM

Paula Sanders is promoted to chair of Post & Schell’s national Health Care Practice Group of 30 attorneys, representing clients on health facility regulation including RAC audits, HIPAA, and fraud and abuse.


Announcements and Implementations

The Joint Commission issues a Sentinel Event Alert after 80 deaths between 2009-2012 are found to be related to medical device alarm fatigue.

Massachusetts General Hospital and American Well announce a telehealth pilot program that will initially focus on child and adolescent psychiatry, heart failure, and neurology.

Christus Health Systems and Legacy Community become the first providers in Houston to share patient data via the Medicity-powered Greater Houston Healthconnect HIE.

4-9-2013 1-50-38 PM

Western Maryland Health System implements the Visibility Staff Assist solution from Versus Technology.

The local paper profiles St. Luke’s Regional Medical Center (IA) and its recent transition to EHR. The paper notes that, “The Affordable Care Act, commonly called Obamacare, requires health care providers to move to electronic medical records by 2014” and that, “Epic is not interoperable with hospitals and clinics that use other forms of electronic medical record.”

CIC Advisory announces a Meaningful Use Stage 2 benchmarking tool that includes on-site interviews and reviews followed by a detailed scorecard for a flat fee of $2,500.

4-9-2013 6-53-07 PM

Technology recruiter Greythorn offers its first Healthcare IT Market Report. It covers salaries, benefits, consulting , bonuses, and part-time employment.

Spain’s first telemedicine service launches as La Palma and Tenerife Islands offer virtual consultations via Cisco HealthPresence.

MMRGlobal launches a service that will allow providers to offer and bill for telemedicine services via its personal health records system. It has also adding a genomics module. Both will integrate with the 4medica EHR beginning April 15.


Government and Politics

4-9-2013 10-38-15 PM

Nextgov reports a rumor that the DoD may be ditching its plans to upgrade its AHLTA EHR system and instead reconsider using the VA’s VistA, with two potential reasons cited by sources: (a) the rise of former VA deputy director Chuck Hagel to Secretary of Defense; and (b) the satirical comments on incompatible DoD-VA EHRs by Jon Stewart in his March 27 “Daily Show,” in which he blamed the DoD for stubbornly following its expensive AHTLA agenda to avoid giving up ground to the VA.


Technology

4-9-2013 10-39-35 PM

Johns Hopkins surgeon and patient safety expert Martin Makary, MD, MPH says in a JAMA editorial that hospitals should use the video equipment they already have in the OR to record every procedure to support quality improvement efforts. Patients overwhelmingly support having their procedures recorded, surveys have found, and the recordings could be used for training and for inclusion in the EHR to support less-detailed operative notes.

4-9-2013 7-18-09 PM

The Apache Software Foundation moves the Apache cTAKES  project to a Top-Level Project. The open source NLP system, originally developed by a Mayo Clinic team, extracts information from free-text EMR documentation.

Google announces that its Google Fiber gigabit-speed Internet service, originally rolled out in Kansas City with 100 times normal broadband speed, will be live in Austin, TX by the middle of next year.


Other

4-9-2013 11-22-30 AM

The big data revolution could reduce healthcare spending by an estimated $300 to $450 billion according to a McKinsey & Company report.

Paul Black blogs about his first 100 days as CEO of Allscripts and reflects on emerging themes, including the need to work closely with customers and patients to transform the industry; the need for population health management across venues for care; and the importance of coordination care tools.

The Wall Street Journal looks at the use of cloud-based storage for medical images, noting that more than half of the country’s health systems are expected to embrace cloud-based image storage over the next three years.

GE Healthcare, which cut 10 percent of its South Burlington, VT staff last year, lists 120,000 square feet of its office building there for lease. The company has 436 employees occupying 142,000 square feet.

4-9-2013 6-24-06 PM

Here’s the latest cartoon from Imprivata.

4-9-2013 8-20-57 PM

The New York Times covers “a parallel world of pseudo-academia” in which conferences and journals with prestigious-sounding names offer presenters and authors resume-padding exposure in return for cash. It says that universities need to be careful in reviewing resumes and predicts that people will be misled by poorly research publications that appear in credible-sounding online-only journals. A research librarian estimates that 4,000 “predatory open-access journals” are being published because it is “easy money, very little work, a low barrier to start-up.” One physician sent two articles in response to an e-mail from The Journal of Clinical Case Reports and was billed $2,900, with the journal running his articles even after he requested they be withdrawn. A Duke University School of Medicine professor agreed to serve on the board of one such publication and was surprised it solicited him to recruit authors and publish his own papers; when he asked to be removed from the board, the journal just left his name on its masthead anyway.

4-9-2013 8-25-10 PM

Jamie Stockton of Wells Fargo Securities provides updated MU attestation information for hospitals. Leading in EP attestations were Epic, Allscripts, eClinicalWorks, NextGen, GE Healthcare, McKesson, Cerner, Practice Fusion, Greenway, and athenahealth, which
as the top 10 vendors accounted for two-thirds of all attesting EPs.

4-9-2013 7-40-24 PM

Weird News Andy uncovers this case of texting while flying: the National Transportation Safety Board finds that a contributing factor in a 2011 medical helicopter accident was the pilot’s texting before and during the flight. The helicopter crashed into a field after running out of fuel, with NTSB’s conclusion being that the distracted pilot thought he had more fuel than was actually available. The pilot, a flight nurse, a paramedic, and a patient were killed in the crash. The pilot had sent or received 240 text messages during his shift the day the helicopter crashed, including seven during the flight itself as he made arrangements to have dinner with a co-worker.


Sponsor Updates

  • Billian’s HealthDATA offers a white paper on the top integrated marketing priorities in the age of healthcare reform.
  • AT&T generated $5.6 billion in revenue in 2012 from healthcare industry businesses implementing one of the company’s cloud and mobility-based solutions.
  • AirStrip ONE beats 15 competitors in a mobile health app contest. 
  • Brad Levin, GM of Visage Imaging, will participate in a SIIM 2013 session titled “Who do you turn to for help in developing solutions?” in the Dallas area June 6-9.
  • Wellsoft will participate in the 2013 Emergency Medicine Update and the e-Health 2013 conferences in Canada during the month of May.
  • Emdeon highlights the benefits of e-prescribing and discusses why providers need to embrace the technology.
  • Merge Healthcare and Integrated Data Storage will create a hosted private cloud offering for the Merge Honeycomb platform.
  • Cassie Sturdevant, a senior recruiter with Impact Advisors, joins a panel of other healthcare recruiting experts to discuss the healthcare job market.
  • Surgical Information Systems CTO Eric Nilsson shares his impressions on interoperability and the Intelligent Hospital Pavilion at last month’s HIMSS conference.
  • HealthEdge partners with CTG Health Solutions to deliver integration services for customers using the HealthRules Answers BI suite.
  • Cornerstone Advisors Group launches its new website.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 9, 2013 News 14 Comments

Monday Morning Update 4/8/13

April 6, 2013 News 11 Comments

From Antares: “Re: HIStalk. Ever since my very first week at Epic, HIStalk has been part of my morning information breakfast :)  I think you guys provide a forum that is critical to identifying cutting edge news, trends, and opinions.” Antares is the the co-founder and president of a new consulting firm. Nice comment — thanks.

4-6-2013 6-52-41 AM

A somewhat surprising one-third of respondents expect to leave their employer within the next year. New poll to your right, inspired by a reader’s comment: CommonWell Health Alliance is touting interoperability among its members. What grade would you give those members that offer hospital systems (McKesson, Cerner, and Allscripts) for the level of integration among their own hospital modules?

On the Jobs Board: Senior Program Manager – Caradigm Intelligence Platform, Solution Sales Executive, Senior Director Clinical Product Management.

4-6-2013 8-50-58 AM

McKesson Chairman, President, and CEO John Hammergren, along with the other longest-serving member of HP’s board, will resign after being pushed out by shareholders angry over a series of  botched HP acquisitions approved under their watch. Hammergren’s re-election was opposed by 46 percent of shareholder votes. HP Chairman Ray Lane will also step down, although he will remain on the board.

4-6-2013 9-30-51 AM

In the UK, the Cambridge University and Papworth NHS trust hospitals sign a contract to implement Epic and become the company’s first UK reference sites. The 10-year, $250 million contract goes to HP Enterprise Services to manage the eHospital project. Go-live is planned for October 2014. Epic beat Allscripts and Cerner last year because of Epic’s standardized and successful implementation methodology, although the trusts acknowledge that the always-tricky localization of the US product is something they will be watching closely.

Franciscan St. Elizabeth Health (IN) goes live over the weekend with Epic in its three hospitals, part of Franciscan Alliance’s $100 million project.

Wake Forest Baptist Medical Center (NC) admits that some of the $50 million it lost in the half of its fiscal year was caused by its implementation of Epic. The hospital spent $13.3 million on Epic of an unannounced total project cost, but also cited an additional $8 million of expense due to “greater-than-anticipated impact on volumes and productivity” and another $27 million in lost margin because of productivity losses during implementation. OR cases were reduced 4.1 percent, with the time required for Epic training being one of the factors listed. Moody’s, the hospital’s bond rating agency, downgraded the hospital’s debt to A1 in March because of “the unexpected decline in financial performance through the first half of fiscal 2013, largely due to the installation of a new information technology platform (Epic).” The hospital’s CFO issued a statement to the ratings downgrade saying that Moody’s has an overall negative outlook for non-for-profit health systems, but acknowledged the financial hit that its Epic implementation has caused.

In Canada, a high-profile doctor decides to leave the province because quality is declining, wait times are increasing, and Newfoundland and Labrador are among few provinces that does not provide an EMR, which she says is “vitally important.” The doctor has taken a hospital job.

Axial Exchange launches the Patient Engagement Index, which grades hospitals on their deployment of personal health technologies, social media usage, and patient satisfaction results from CMS’s HCAHPS survey.

CEOs surveyed by Gartner name 21 organizations as the most admired for using IT as a competitive advantage, among them Cleveland Clinic, HCA, Intermountain Healthcare, Kaiser Permanente, and Mayo Clinic. The most important indicator, the CEOs said, is providing customer-facing IT.

Philadelphia-based healthcare accelerator DreamIt Health announces its inaugural class of 10 companies that will start four-month boot camp on Monday. They are:

  • AirCare (telenursing and readmission prevention)
  • Biomeme (infectious disease diagnosis and tracking)
  • Fitly (game-based child obesity motivation)
  • Grand Round Table (matching EMR information against other cases for diagnosis)
  • Medlio (virtual health insurance card)
  • OnShift (clinician communication)
  • Osmosis (mobile clinician learning)
  • MemberRx (drug selection based on EMR information)
  • SpeSo Health (online second opinions for diagnosis)
  • Stat (patient transport)

4-6-2013 10-23-18 AM

Another health accelerator launches, with Louisville, KY-based XLerateHealth opening for business and offering a 10-week mentoring program. Applications for the August class will be accepted through May 17.

PDR Network will present the third annual PharmEHR Summit on Wednesday, April 17 in Philadelphia. The invitation-only meeting of leaders from pharma and EHR vendors will feature panels on EHR leadership, patient engagement, the Wall Street view of the EHR industry, an FDA presentation on EHRs, and several other sessions.

A New Jersey court rules that Warren Hospital can subpoena the records of Internet service providers in trying to identify unknown hackers who accessed the hospital’s e-mail system and sent defamatory messages to all employees in 2010.

4-6-2013 10-34-46 AM

Maryland’s Health Services Cost Review Commission will decide this week whether to allow the CRISP HIE  to use its confidential patient-level data to support CRISP’s population health management functions.

In Tanzania, the text messaging service of Parents Love Me, a national healthy pregnancy and safe motherhood program, reaches 100,000 subscribers in 15 weeks, with 4 million text messages delivered since it was launched in late November 2012.

An editorial by the CIO of a hospital in Spain urges NHS to continue its quest to go paperless. He says his own all-digital Cerner hospital viewed technology as the essential tool for improving quality and affordability of care. His tips: create the culture for change, get clinicians involved so they can understand the patient benefits, keep it simple, and focus on how training is delivered. His hospital freed up 8,000 physician and nurse hours annually and reduced length of stay by 10 percent.

This story amused Inga, who added a WNA-like title of, “Maybe she was planning to claim a charitable donation.” An Oregon woman is indicted for dumping the clothes of her deceased 89-year-old mother in a Goodwill store dumpster and also including her mother’s body.

More from Vince this week on the HIS-tory of Meditech.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 6, 2013 News 11 Comments

Morning Headlines 4/5/13

April 4, 2013 Headlines 1 Comment

Policy Committee ponders CommonWell influence

Farzad Mostashari, MD, and Judy Faulkner discuss the ramifications CommonWell will have on interoperability during this weeks ONC HIE workgroup.

Baylor Quality Alliance Selects Greenway for Participation in EHR Program

Greenway announces a partnership with Baylor Health Care System to provide ambulatory EHR’s for its cmomunity physicians.

HIMSS Analytics Honors Florida Hospital Carrollwood with Stage 7 Award

120-bed Florida Hospital Carrollwood, an Aventist Health System facility and Cerner shop, is awarded HIMSS Stage 7. 

EHR Adoption Encouraged by State Meaningful Use Acceleration Challenge 2.0

ONC has renewed the state Meaningful Use accleration challenge with new benchmark goals for the 2013 year.

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April 4, 2013 Headlines 1 Comment

HIStalk Interviews Mitch Morris, MD, Principal, Deloitte Consulting LLP

April 1, 2013 Interviews No Comments

Mitchell Morris, MD is a principal with Deloitte Consulting LLP.

3-31-2013 11-21-45 AM

Tell me about yourself and the company.

I am a partner at Deloitte. I lead our health information technology practice.

My background is a little unusual. l started as a physician and was in academic practice for nearly two decades at MD Anderson Cancer Center. I  got very interested around problems of quality and efficiency in healthcare, as so many of us do, and what technology tools can be brought to bear to solve those problems.

I complained a lot, got put on a committee, kept complaining, and I was chairing the committee. Eventually they said, “Well, if you think you’re so smart, here’s a budget, you do it.” Over a period of years, I ended up being the chief information officer at MD Anderson, a post I held for about six years. I left for consulting in 2001. I have been with Deloitte for going on seven years now.

 

Most of us in hospitals think about Deloitte working with providers, but you have responsibility over pharma and medical devices as well. Do you a lot of issues that overlap with what we traditionally think of as healthcare IT?

Yes. It’s a fascinating time. One of the things about being at Deloitte, the nature of our company gives us exposure to some of the areas of convergence that are happening.

Some great examples are large health plans acquiring medical practices and even hospitals with an eye towards payment reform and accountable care. We’re seeing tremendous convergence there. We’re seeing a great level of interest in life sciences companies – pharma, biotech, devices — in better understanding and integrating with what goes on in the provider world. Their business models are driving them towards closer integration and accountable care is even a part of that. 

An interesting phenomenon to watch is academic clients — academic health centers and universities, who in a sense can be viewed as small biotech companies on their own as they have a research agenda — are also linking up the combination of genomic and phenotypic information from electronic health records with what goes on in the laboratory. 

It’s a pretty exciting time when you look at all of the different pieces that are in the mix. The driver of health reform making everyone go into a frenzy has created a lot of activity. It’s fun to get creative and innovative around it, but then it’s all sometimes a little frightening as to where we’re all headed and how much control we have over it. But it’s been a good time from that point of view to be a healthcare consultant.

 

Every kind of company is positioning themselves for whatever they think the healthcare system will look like. The roles are becoming blurred about who’s the provider and who’s the payer. Do you think all this is going to benefit patients?

That’s a great question and I don’t think there’s an easy answer. Certainly the current healthcare system is too fragmented, broken, and too expensive, so we needed to change. What I wonder about is how much pain we’re going to go through during the change process and how quickly we will get to something that actually does help patients.

I think at the end it will help patients and consumers. Part of it also is your perspective. In the US, we tend to have a perspective of healthcare from the point of view of the individual. What’s going to happen to me or my loved one and what can I access for them? Most other countries have the perspective of the population. I’ve got a bucket of money. I have a population I need to serve. How can I do the most good with the bucket of money I have? 

As we transition as a country from a very individual view of healthcare — that we do everything for everyone — to a more population-based view of population health management, another common term along with accountable care, there’s definitely some pain that we will go through and some careful examination of our values as consumers and providers of healthcare as to what we think is most important. I’s a not easy decision ahead of us on that score, I don’t think.

 

Most of the science of public health was developed in this country, yet most of it gets exported to other countries whose citizens accept that concept better than ours. Is there a movement that suggests we will begin to behave more like a public health organization?

There are signs that Health and Human Services is directing funding to that end. I think the different iterations of value-based care, whether it’s accountable care organizations or other forms of value-based payment systems, are a step in that direction. The formation of the PCORI and their funding and pushing clinical effectiveness studies and the regulatory pieces that are coming out for pharma and for healthcare providers around clinical effectiveness are pushing us in the right direction. We make decisions and consumers make decisions not based on what they saw on the television commercial for that new drug, but rather let’s look at some data and see not just from a Phase III clinical trial but actually out in the market, what’s the most effective way to spend our healthcare dollar to be most helpful?

The pace sometimes seems fast to us, but I think it’s proceeding fairly slowly. I think an open question is this. We get to 2014 and as the health insurance exchanges kick in and more people have access to care, there will be further pressure on reimbursement. The whole sequestration issue in Washington right now is having a big impact on that as well with a 2 percent Medicare cut.

I think those things are going to be drivers in the marketplace to accelerate the adoption of some these other approaches to reimbursement and care in general. It has a potential to move faster than it is, but one thing I’ve been guilty of in the past is thinking things will happen faster than they will. I wouldn’t be surprised if change continues to be at a relatively slow pace and maybe that’s a good thing.

 

Are we putting too much faith in both the motivation and the ability of providers to use business intelligence and analytics to improve outcomes and reduce costs?

You probably went to HIMSS and a lot of your readers did. I think at least half the industrial exhibits there had the word “analytics” on the booth somewhere. There’s certainly a great deal of interest, but also a fair amount of hype.

The question will be when provider organizations in particular have to continue their march towards Meaningful Use, they have to deal with ICD-10, they have to deal with shrinking reimbursements and their cost-reduction initiatives –are they going to be willing to spend on things that are not required to do? If they do spend something, will it be a minimalist approach or a more comprehensive approach towards analytics?

Trying to run a healthcare organization today without good at analytics is like flying a plane blind. But I haven’t seen a huge change in organizations’ willingness to significantly invest in this.

The good news is with all the competition that’s out there creating solutions, that’s driving prices of solutions around analytics down. You don’t have to spend millions of dollars. There are out-of-the-box things that can help you, for example, analyze your revenue cycle or analyze readmissions or fill in the blank of what your current problem is. 

To  do a comprehensive approach to solve the analytics problem at an organizational level requires some investment, careful thought, and careful adjustments of governance and organizational structure to make it work. I think we’re ways away, but as measured by the interest at HIMSS, it seems like a lot of people are talking about it, that’s for sure.

 

Do you expect to see any new government involvement with healthcare IT issues, for example usability or FDA regulation?

As we take each federal agency, I think FDA has a strategy that they are enacting at a careful pace that will include a greater degree of regulation and oversight and a broadening of what they provide oversight for. I think in terms of what comes out of ONC and the rest of Health and Human Services, it’s hard to guess what kinds of things will come out from them. I think they pretty much have a full plate right now, but I wouldn’t want to speak for what their intentions are. Deloitte does a lot of work for those organizations, so I feel it will be improper for me to speculate.

 

What’s your overall thought on Meaningful Use as a program?

It certainly stimulated a lot of spending and a lot of progress. It’s far from being perfect, but I think overall it has driven a lot of benefit and organizations that had been taking a wait-and-see or very slow approach to the adoption of electronic health records –and certainly in the case of medical practices — it’s really accelerating things. 

The challenge that we have as an industry is not just getting in a system and checking the boxes on the Meaningful Use attestation document, but being able to really say as a group medical practice or as a hospital system, we’re driving benefits around quality and efficiency by using a system that we didn’t we have before.

While there are examples of electronic health records achieving benefits, there are also examples where it didn’t work out so well. It’s frustrating for me personally that as an industry, we haven’t done a better job of showing a broad and widespread benefit. We shouldn’t even be asking this question, and debating is kind of shameful in a way. 

The good news is most organizations I’m working with and our teams at Deloitte are working with are showing really great progress. It’s happening at a much faster pace because of the federal funding compared to prior to that. The maturity of the software also has a lot to do with it today, too.

 

Other than the minimal requirements for Meaningful Use, are providers showing an interest in technologies that engage and motivate consumers or patients directly?

I think that’s emerging. In terms of working directly with consumers, some of the healthcare organizations — and I’ll include health plans in this — that are a little more on innovator side are really looking at solutions that involve mobile technologies that go into the home or to the workplace and help with wellness and chronic disease management. There’s plenty of examples of where those things have been successfully implemented. 

As we get towards more mature versions of accountable care, linking together all the providers in a consumer’s ecosystem that they deal with and allowing things to happen at home or retail settings is a tremendous advance. A lot of that is technology enabled. You can’t do it without technology.

We’re still at the early stages of developing transactional systems that advance the agenda around population health management. We’ve got some pretty good back-end analytics stuff that we’re capable of doing today. We still have a way to go on on the transactional side. 

Part of it is that interoperability is still off in the future somewhere. Every community has a bunch of different systems that they have to put together, so that that makes it challenging. But there are some interesting emerging technologies from several software vendors that, as they mature, are going to bear some fruit.

 

What healthcare IT changes do you predict over a three- to five-year timeline?

It’s always difficult to predict disruptive things that might come along. Barring that, I look at what our clients are really challenged with. Managing and reducing cost is a huge issue, not just of IT, but overall. Being able to manage IT spend, looking and doing that through selective sourcing, making sure the organization is firing on all cylinders, being able to support analytics for your organization to reduce cost, making sure the revenue cycle systems are firing on all cylinders. Those things are going to be tremendously important.

We see the healthcare industry consolidating. At Deloitte, we have very large merger and acquisition practice. They’re tremendously busy, and we are doing a lot of post-merger integration. When all of the consolidation occurred in the 1990s, very often there wasn’t consolidation of IT and supply chain and HR, etc. Now because of the cost drivers, as we are seeing medical groups consolidate, hospitals consolidate, health plans consolidate, they are all trying to figure out, how do we get IT to be a key enabler of the efficiencies that we expect to gain from the merger or the acquisition? We’ll see a lot of that.

Preparing for value-based payments through accountable care and all the analytics need to support that we’ve already touched on. Convergence with the health plans and life sciences will be another significant driver. What’s going to wind down a little bit as this big round of primary implementations gets finished for Meaningful Use around clinical systems, that work will diminish, although there’s still a lot of optimization work that can be done out there. “I installed Epic, Cerner, fill-in-the-blank system, but to really get the benefit I expected, I need to spend more time looking at workflow and efficiency and quality and decision support. I think that’s work that I will spend time on.”

ICD-10 is going to wind down. I think mobility is going to crank up. The whole layer of coordinating care at the population level rather than at the facility level will create some opportunities for existing software companies, there will probably be some new entrants into the market who are able to beyond what an HIE does, really coordinate the care and the workflow beyond the walls of an organization. There’s multiple pieces of the provider supply chain taking care of people out there.That will be a really interesting one to watch.

At the Deloitte Center for Health Solutions, we recently released some work by Dr. Harry Greenspun that interviewed some CIOs of large systems and what they’re thinking. Some of the things I’m saying are reflected in that, and as well as some of challenge, which is juggling so many different priorities. I think one of the challenges our CIOs and healthcare today face, if you ask them what’s their number one priority, they’ll list 10 things because they’ve got so many things they have to do. That competing set of priorities that are all number one gets reflected in everything that we’re doing in the industry, and everybody who works in it is a reflection of all those things that are going on in healthcare. Those things are fun, but also a headache at the same time.

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News 3/29/13

March 28, 2013 News 7 Comments

Top News

3-28-2013 10-09-06 PM

Caradigm will integrate Orion’s HIE solution with its Caradigm Intelligence Platform (CIP, formerly Amalga) and resell the Orion product. Orion will resell and provide services for CIP and Caradigm’s identity and access management solutions in New Zealand, Australia, and certain Asian countries. Orion will also develop decision support, population health, and quality improvement for CIP and promote CIP to its HIE prospects and customers. Caradigm has also decided not to commercialize the Qualibria knowledge solution product and will instead incorporate it into CIP, which will result in elimination and reassignment of an unspecified number of employee positions in product planning and engineering operations. The Salt Lake City newspaper says 70 percent of the company’s Utah employees, about 40 to 50 people, were laid off Wednesday.


Reader Comments

3-28-2013 10-10-32 PM

From Jasmine Gee: “Re: athenahealth’s attestation numbers. To answer readers’ doubts about how many of our Medicare Part B physicians using athenaClinicals are participating in MU, the answer is about 70 percent. That’s over 5,000 total Medicare Part B physicians. The remaining 30 percent are Medicare Part B physicians who bill so few Medicare claims that their incentive check would be tiny, so they’ve declined to pursue Medicare MU. Remember: the maximum Medicare MU incentive payment is 75 percent of billed Part B charges for the program year, with a cap based on when you start.” Jasmine is the product marketing director for athenaclinicals and was responding to recent comments from readers questioning the legitimacy of athenahealth’s claim that 96 percent of its participating providers have successfully attested for MU.

3-28-2013 10-11-45 PM

From ForEclipsii: “Re: delayed go-live at the new Royal Adelaide Hospital in Australia. I believe that the application in question is actually the brand-new Sunrise Financial Manager which rolled out a few months ago. People working on it were told to drop everything and work on a version for Australia.” Unverified, but that makes sense based on the newspaper article, the mention of billing issues, and the earlier Allscripts contract.


HIStalk Announcements and Requests

inga_small We opened a HIStalk Practice reader survey, which is different than the HIStalk survey we ran a couple of weeks ago. If you are a HIStalk Practice reader (and you should be!) please take 60 seconds to give us your input. Thanks.

inga_small Some of the HIStalk Practice goodies from the last week include: hospital-owned physician practices in Kentucky are losing as much as $100,000 per year per doctor. The Wall Street Journal examines patient-physician e-mail communications. The NCQA extends its PCMH recognition program to specialty physicians. The average turnover for physicians in 2012 was 6.8 percent, compared to 11.5 percent for PAs and NPs. Michael Brozino, CEO of simplifyMD, discusses his company, its technology, and the state of the EMR industry. DrFirst President G. Cameron Deemer shares insights on e-prescribing, EMR vendor consolidation, and the impact of government incentive programs. Take a moment and click on an ad or two – one of our sponsors may have a product or service that makes your life better. Thanks for reading.

On the Jobs Board: Senior Director Clinical Project Management, Product Manager, VP of Sales and Channel Development.

I’m looking for someone who can help produce Webinars and perhaps do some other paid part-time work. Industry experience would be nice but probably isn’t essential, although excellent writing, speaking, marketing, and organizational skills are. E-mail me.


Acquisitions, Funding, Business, and Stock

3-28-2013 7-47-11 PM

ReadyDock will receive $150,000 in pre-seed funding from Connecticut Innovations to continue development and marketing of its devices for disinfecting, charging,and storing computer tablets.

3-28-2013 9-08-33 PM

Bankrupt Raleigh, NC-based EMR vendor E-Cast, which had annual revenue of $4 million as late as 2006, is winding down after the business is sold to Global Record Systems LLC for $100,000.


Sales

3-28-2013 10-14-59 PM

Safeway will roll out the SoloHealth Station kiosk to 700 of its stores, giving customers access to free health screenings and personalized assessments.

Kettering Health Network extends its relationship with MedAssets for its revenue cycle management and workflow services.

Philips earns a fourth-year option worth $77 million to provide patient monitoring systems and training to the Department of Defense.

3-28-2013 10-16-16 PM

Lahey Health (NH) announces officially that it has signed with Epic, which will apparently replace Allscripts in both its hospitals and practices.


People

3-28-2013 6-40-34 PM

MEDHOST hires Barbara Bryan (Bryan Advisory Group/Eclipsys) as VP of consulting.

3-28-2013 11-34-52 AM

David Joyner (Blue Shield of California) joins Hill Physicians Group (CA) as COO, replacing the recently promoted CEO Darryl Cardoza.

3-28-2013 7-21-23 PM

Mobile Heartbeat names Jamie Brasseal (Dell Healthcare and Life Sciences) as VP of its western region.


Announcements and Implementations

Drchrono will incorporate digitized patient education material developed by Mayo Clinic into its EHR.

Five healthcare organizations will participate in the pilot phase of Tennessee’s Health eShare Direct Project, spearheaded by the Tennessee REC.

3-28-2013 10-17-51 PM

Children’s Hospital at London Health Sciences Centre in Ontario implements Upopolis, a social networking tool for children receiving care in hospitals that is powered by TELUS Health.

Vibra Healthcare completes the first phase of deployment of PatientKeeper NoteWriter electronic documentation software across four of its long term acute care hospitals.

Cerner will integrate print spooling software from Plus Technologies into Millennium to streamline print operations.

ACS MediHealth will work with Troy Group to develop prescription printing solutions for Meditech.


Government and Politics

3-28-2013 12-17-15 PM

ONC announces Planning Room, a Website launched in collaboration with Cornell University to allow public input on the federal HIT strategic plan.

Two North Carolina state senators introduce a bill that would require hospitals to post on the state’s HIE their pricing for common procedures and their typical reimbursements from health plans.


Other

3-28-2013 10-19-06 PM

An NPR article covers the massive increase in the number of Americans who are receiving government disability payments for often questionable reasons such as unverifiable back pain or mental illness, with 14 million citizens now being mailed a monthly federal check without even being counted among the unemployed. The article concludes that disability “has become a de facto welfare program for people without a lot of education or job skills,” with fewer than 1 percent of recipients from early 2011 having returned to the workforce.

3-28-2013 10-20-04 PM

CNN profiles St. Louis-based Advanced ICU Care, which offers tele-ICU services.

A Reuters article finds that Wolters Kluwer is able to make good profits in healthcare because its medical references are moving from printed to electronic form, with 100 medical journals offered as iPad apps. The company says demand is increasing because apps allow teaching procedures by video, which also allows the company to sell more targeted advertising.

Studies published in JAMA find that not only has a mandatory reduction in medical resident working hours failed to improve their depression rates or sleep patterns, it has also been associated with an increase of medical errors of up to 20 percent. One possible explanation is the unintended consequence of hospitals expecting their residents get the same work done in less time.

In Canada, an Alberta ED doctor is suspended for looking up the electronic medical records of patients she wasn’t treating. She was caught when a patient asked for a copy of his access log and found that nine doctors, none of whom were treating him, had looked at his files. The hospital determined that the ED doctor was using workstations that her colleagues had left logged on.

The New York Times says radiology residents are beginning to realize that the heyday of big money for minimal work is over due to Medicare cuts, technology-driven competition, teleradiology, and demands to move public money from specialties to primary care. Financially motivated medical students pursing the high-paying, procedure-based ROAD specialties (radiology, ophthalmology, anesthesiology, and dermatology) are all seeing average incomes dropping steeply with the exception of the less Medicare-dependent dermatology.

inga_small The NHS pays for a woman’s $7,260 breast implant operation after convincing doctors that her 32A chest size had put her in a state of emotional distress that could be alleviated only by an upgrade to 36DDs. The mother of two now intends to leave her children with her parents, move to London, and pursue a modeling career. She referred to TV star Katie Price in her statement: “I want the world to see the new me and want money and fame just like Katie. I can’t thank the NHS enough for giving them to me.” I can’t claim emotional distress, but perhaps I should consider moving to the UK so I could be a more successful anonymous blogger.

Weird News Andy says “some might call it murder.” A doctor in Brazil is charged with seven murders and is suspected of hundreds more as a hospital’s ICU team routinely freed up beds by administering muscle relaxants to patients and then turning off their oxygen supply. Prosecutors released the doctor’s wiretapped telephone conversations that included, “"I want to clear the intensive care unit. It’s making me itch. Unfortunately, our mission is to be go-betweens on the springboard to the next life.” WNA is also curious who approved a patient’s breast enlargement procedure when 1,200 people have starved to death in NHS hospitals “because nurses are to busy to feed patients.”

3-28-2013 8-28-32 PM

It’s like the postmortem version of fake Facebook friends: a UK company offers rent-a-mourners to families who want the funerals of their loved ones to be better attended or to “increase perceived popularity.” Actors, who are billed at $68 for a two-hour funeral or wake, are briefed about the deceased and trained to chat convincingly with real family and friends.


Sponsor Updates

  • Minnesota Public Radio profiles Intelligent Insites and how its real-time operational intelligence software will be used in 152 VA hospitals.
  • Regions Hospital (MN) reports that its use of Besler Consulting’s BVerified Transfer DRG and IME tools have resulted in significant revenue recoveries.
  • The LDM Group discusses the rapid growth rate of e-prescribing across healthcare.
  • API Healthcare’s President and CEO J.P. Fingado shares tips on increasing operational effectiveness with the healthcare workforce information exchange in an April 2 Webinar. 
  • The Albuquerque Journal spotlights Seamless Medical Systems and its SNAP iPad app for capturing patient data.
  • Eric Venn-Watson MD, AirStrip’s VP of clinical transformation, discusses how private healthcare could benefit from the US military’s cutting-edge health technologies.
  • Gary Palgon, VP of healthcare solutions for Liaison Healthcare Informatics, discusses how data integration can help organizations reduce readmission rates.
  • eClinicalWorks opens a website for its 2013 National Users Conference in San Antonio October 11-14.
  • Frost & Sullivan publishes a white paper on the impact of ClinicalKey, Elsevier’s clinical insight engine.
  • Impact Advisors Principal Laura Kreofsky discusses the privacy and security risks of social medicine and Senior Advisor Ryan Ulteg offers insight into the financial implications of ICD-10 implementations for physicians.
  • ADP AdvancedMD launches a website that provides a timeline for practices as they prepare for the ICD-10 transition.
  • Access chooses CoSentry as its cloud and data center services provider.

EPtalk  by Dr. Jayne

I didn’t have a lot of time to search for newsy tidbits this week because I was heads-down in CMS FAQs. As usual with government programs, now that money is flowing, audits have been introduced to try to recoup any inappropriate payments. My hospital is very concerned by the answers to the “Will there be audits” question, so I thought I’d share the highlights:

  • Yes, there will be audits.
  • You will need to have scads of documentation and it needs to be retained for six years.
  • Contractors will be involved in auditing. If you already have post-traumatic stress disorder from heavy-handed RAC audits, I feel for you. They’re leaving the door wide open for abuse: “The level of the audit review may depend on a number of factors, and it is not possible to include an all-inclusive list of supporting documents.”
  • Audit requests will come via e-mail from a CMS address. The e-mail used when registering for the EHR Incentive Program will be used for the initial request. If you put your physician’s e-mail address in the box, make sure she or he knows to be on the lookout for this and check your spam filters. Further communication will be through a secure communication process.
  • You need to maintain documentation that supports the values you used for CQMs and payment calculations.
  • Individual patient records may be requested for review.
  • On-site reviews at the practice or hospital, including a demonstration of the EHR system, may be requested. For those of you gaming the system by turning on features just for your attestation period, this could come back at you unless you can re-create exactly the way you were configured at the time of attestation.
  • Separate audit processes apply for Medicaid.

One of my CMIO colleagues received a hospital request in the fall. It was a spreadsheet that seemed pretty simple, but ended up requiring a ridiculous amount of data. She shared it with me confidentially. I loved the request that the reports include the EHR vendor’s logo to “prove” that it came from the EHR. If people are going to be fraudulent, I think they would be smart enough to dummy that up.

Despite clearly worded responses, the auditors didn’t understand the hospital’s answers or the math behind the calculations. They rejected spreadsheet data and insisted on screenshots from the application, or alternatively screenshots that showed a user exporting the data to spreadsheet. Again, do they not think screenshots are easy to fake? Maybe the hospital needs to film the user running the report and post it on YouTube for the auditor’s viewing pleasure.

From her recount, the auditors had all the power, and even having the vendor step in to provide supporting documentation didn’t help. MU is all or none – if there is a single discrepancy, you have to return all the money. It’s the equivalent taking a class and being expected to score 100 percent on every quiz, paper, and exam, including the final.

I hope CMS understands a simple principle about perfection that we learned in medical school — it doesn’t matter if all the lab numbers look great but the patient is dead.

Print


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 28, 2013 News 7 Comments

News 3/22/13

March 21, 2013 News 5 Comments

Top News

3-21-2013 8-44-57 PM

Athenahealth announces a partnership with mHealth app vendor iTriage to connect the app’s consumer users with providers in athenahealth’s network.


Reader Comments

3-21-2013 8-49-22 PM

From HITcontractor: “Re: ProMedica Health. Halts install of McKesson Horizon Emergency care in its facilities, reverts to its previous vendor Picis due to failed adoption and hesitation by providers.” Unverified.  

From Interested: “Re: Northwest Community Hospital in Arlington Heights, IL. Chatter is they’re going up on Epic, although the chatter doesn’t include which consulting firm has been awarded the contract.” Unverified.

From FormerMCKIC: “Re: McKesson. Ending contracts with all non-essential Horizon Clinicals contractors including IC and project managers, CPM. Their contracts will end 3/31/13.” Unverified, but reported by multiple readers.

inga_small From Proudly Pink: “Re: Voalte pink pants. What’s with people hatin’ on our pink pants? Here’s our response to the pink pants bashing.”  Dodge Communications awarded Voalte the winners of the Most Unfortunate Booth Attire award in its annual list of the HIMSS exhibit hall’s best and worst. Apparently the Voalte crowd love their pink pants, which employees must earn the right to wear.

3-21-2013 7-09-09 PM

From Boutros Ghali: “Re:  HIMMS. It’s just embarrassing.” Indeed it is. This e-mail blast from a healthcare marketing company VP is filled with misspellings, punctuation errors, and odd wording. I can’t imagine recipients rushing to turn their brand identity over to this company. I’ll be charitable in omitting the individual and company names, but I’ll hold on to this e-mail in case they annoy me in the future.


HIStalk Announcements

3-21-2013 4-00-21 PM

inga_small Some highlights from HIStalk Practice this week include: Practice Wise CEO Julie McGovern offers some thoughts on electronic file management and protecting PHI. CMS says that between five and 10 percent of EPs attesting for MU will be selected for prepayment audits. Hospitals continue to consider practice acquisitions. Physicians with e-prescribing tools are more likely to prescribe less expensive drugs. Thanks for reading!

On the Jobs Page: VP of Sales and Channel Development, Healthcare Technology Project Manager, C-Level Healthcare Technology Sales Executive.


Here are the last of the HIStalkapalooza photos from Medicomp.

3-21-2013 6-58-21 PM

Seth Halvorson accepting the HIStalk Lifetime Achievement Award on behalf of his father, George C. Halvorson of Kaiser Permanente.

3-21-2013 6-59-57 PM

CIO Unplugged Ed Marx and friends.

3-21-2013 7-01-03 PM

Team Orion.

3-21-2013 7-03-49 PM

Team Vitera.

3-21-2013 7-05-39 PM

Bowling tournament winners.

3-21-2013 7-01-46 PM

Jonathan Bush of athenahealth and James Aita of Medicomp.

3-21-2013 7-02-57 PM

Medicomp calls this the “Where is Mr. H?” picture.

3-21-2013 7-04-43 PM

Medicomp CEO Dave Lareau (in the “I Could be Mr. H” sash) and friends.


Acquisitions, Funding, Business, and Stock

3-21-2013 8-07-03 PM

EHR data search technology startup QPID raises $4 million in its initial financing round from investors Matrix Partners, Partners Innovation Fund, Massachusetts General Physicians Organization, and Cardinal Partners.

3-21-2013 8-08-06 PM

South Carolina-based Benefitfocus, which offers employee self-service benefits enrollment systems, plans to file an IPO later this year.


Sales

3-21-2013 8-51-12 PM

New York-Presbyterian Hospital selects the PatientTouch point-of-care mobile platform from PatientSafe Solutions.

India-based outsourcer Wipro wins a $200 million infrastructure maintenance outsourcing contract from Catholic Health Initiatives.


People

3-21-2013 6-17-14 PM

Sara Teppema (Society of Actuaries) joins Valence Health as director of actuarial services.

3-21-2013 6-19-07 PM

Virginia Hospital Center appoints Russell McWey, MD, the hospital’s chief of medical imaging, to VP/CIO.

3-21-2013 7-15-53 PM

Peter Henderson (PatientKeeper) is named COO of social wellness platform ShapeUp.

3-21-2013 7-18-25 PM

Steve Everest (Prognosis HIS) is named CIO of Oklahoma Surgical Hospital (OK).


Announcements and Implementations

3-21-2013 3-11-01 PM

Overlake Medical Center (WA) migrates various HIS systems to Epic with integration assistance from Summit Healthcare.

3-21-2013 3-31-25 PM

Baptist Health Richmond (KY) says that the Accelero Connect integration platform from Accent on Integration has allowed the hospital to integrate its Philips IntelliVue patient monitors and Meditech HIS, resulting in streamlined clinician workflow and a reduced risk of documentation errors.

3-21-2013 3-32-50 PM

Lehigh Valley Health Network (PA) goes live with iMDsoft’s MetaVision in its PICU.

McKesson launches two free mobile apps for the iPad and iPhone. Lytec Mobile is for use with the Lytec 2013 practice management system, while Medisoft Mobile is available for Medisoft V18.

Meditech certifies NetApp FAS storage for its systems.

PatientKeeper adds infusion billing workflow co-developed with Partners HealthCare to its charge capture solution.

Xerox announces a cloud-based Mobile Device Management service.


Government and Politics

Representatives Sam Graves (R-MO) and Adam Schiff (D-CA) reintroduce the Medicare Audit Improvement Act, which would limit the number of document requests during Medicare audits to two percent of a hospital’s claims, with a maximum of 500 per 45 days.

I wouldn’t want his job. National Coordinator Farzad Mostashari, facing Congressional hearings on mHealth, is asked by Congressman Michael Burgess, MD (R-TX), “Hospital systems in the same city that have the same operating system aren’t talking to each other. You’re the head, why don’t you fix that? Why don’t you just make that happen?”


Technology

The US Patent Office issues EarlySense a patent for the respiratory trend analysis component of its patient safety monitoring system.


Other

3-21-2013 8-52-56 PM

The cash-strapped city of Pittsburgh files suit against the $10 billion in revenue UPMC, demanding payment of six years of payroll taxes and elimination of UPMC’s tax-exempt status. The mayor says UPMC donates less than 2 percent of its revenue to charity care, pays several executives annual salaries of more than $1 million, and has closed hospitals in poor areas while opening them in more affluent ones, all while avoiding $20 million in annual tax payments that it would otherwise owe the city.

The Institute for Health Technology Transformation outlines strategies for health organizations that are implementing big data solutions, including ways to use data to improve patient care and the types of data that can be analyzed for healthcare purposes.

Improved medical device interoperability could save the healthcare industry $30 billion a year and improve patient care and safety, according to analysis presented to a House subcommittee by West Health Institute.

3-21-2013 8-54-48 PM

In the UK, Leeds Hospital halts its $2.5 million speech recognition and digital dictation rollout due to “performance problems” that one official says was “very much affecting patient care and safety and putting patients at risk.”

Also in the UK, two NHS trusts, one of them a Cerner Millennium user, issue a tender worth up to $53 million for a shared inpatient EHR system.

Patient Privacy Rights Founder Deborah Peel, MD calls a new CVS employee policy that charges employees who decline obesity checks $50 per month “incredibly coercive and invasive.” CVS covers the cost of an assessment of height, weight, body fat, blood pressure, and serum glucose and lipid levels, but also reserves the right to send the results to a health management firm even though CVS management won’t have access to the results directly. Peel says a lack of chain of custody requirements means that CVS could review the information and use it to make personnel decisions.

3-21-2013 9-00-01 PM

A Russian gynecologist and former City of Moscow chief obstetrician who declares, “I am a doctor first” becomes a billionaire after shares in his Cyprus-based women and children’s healthcare services company rise more than 40 percent in five months. His company, which offers the only alternative to state-run maternity hospitals,  charges $10,000 per delivery, more than the annual salary of the average Russian.

inga_small Eye yi yi. A Texas woman uses her fingers to dig the eyeball out of another woman’s eye socket. The two were fighting when one of the women grabbed the other’s eye and “dug her fingers up there.” The victim was taken to the hospital and the eyeball was re-inserted. The gouger, who suffered a couple of broken fingernails, was arrested and charged with aggravated assault.



Sponsor Updates

  • Health Catalyst Chairman David Burton, MD discusses how value-based purchasing is driving demand for data warehousing solutions.
  • The Institute of Customer Service names Bottomline Technologies the winner of its Customer Service Leadership award. 
  • CareTech Solutions donates $550 to The American Red Cross, Habitat for Humanity, and The American Cancer Society as part of its HIMSS booth activity.
  • CSI Healthcare IT spotlights Jan Turner, VP of professional services.
  • Aprima releases a case study on the practice of Lauranne Harris, MD, which converted from Allscripts MyWay to Aprima in four days.
  • Harris VP of Government Health Solutions Don Mestas discusses the federal procurement process and how his company supports the government with its healthcare offerings.
  • iSirona names UC Irvine Health (CA) the winner of its 2012 Innovator of the Year Award for leveraging connectivity technology to improve hospital processes and patient care.
  • Surgical Information Systems CEO Ed Daihl recaps the HIMSS conference and discusses how intelligent integration can drive financial results.
  • Michael Nutter, director of firm culture and associate satisfaction for Impact Advisors, offers advice on how to tell if employees are really happy.


EPtalk by Dr. Jayne

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Glassdoor names its highest-rated CEOs, quite a few of them running companies many of us interact with regularly.

The AMA sounds the alert on a “demoralized health care work force” citing a “toxic blend” of forces including verbal abuse, physical assault, and a drive to provide more care in less time with fewer resources.

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From Iconic Reader: “Re: icons. Our ED recently deployed visual indicators for suicide risk based on our screening questions. Is it me, or is that a sad-appearing basset hound? It reminds me of something I’ve seen in my kids’ Webkinz account.” Personally I find those icons a little bit disturbing, but I’m sure coming up with an icon that’s politically correct was a challenge.

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CMS launches a new eHealth website. Hot topics on the site’s blog include Administrative Simplification, Privacy and Security, and Aligning Quality Measurement at CMS.

Millions of Americans admit to reading or sending texts while driving in percentages higher than those found in European countries. Cell phone use while driving was also significantly higher in the US. As someone who has almost met her maker several times recently due to distracted drivers, I implore you to hang up and drive.

Physicians with e-prescribing systems have a greater awareness of prescription costs, according to a recent survey. This led to drug choices with lower costs or better insurance coverage among the endocrinologists and primary care physicians who participated.

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From History Fan: “Re: shoes. I was on spring break in Chicago and saw these shoes on display. Of course, I thought immediately of Jayne and Inga! Be grateful you don’t have bound feet.” I definitely enjoyed the pictures. My personal favorite is the classic red pump.

From Heavyweight: “Re: wheelchairs. With all the attention on high-tech doctor’s offices, it’s remarkable that some are missing some low-tech solutions.” The Boston Globe reports on practices that turned away wheelchair-using patients due to lack of powered exam tables or other strategies to transfer and position patients.

Print


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 21, 2013 News 5 Comments

Morning Headlines 3/20/13

March 19, 2013 Headlines No Comments

Boulder Community Hospital computer system crash frustrates patients

Boulder Community Hospital’s Meditech system has been down since last Tuesday and is not expected to return to a fully operational state until this Friday. No official word on what caused the outage or what is delaying the return to service. All users across the facility are on paper.

Health System Implements new Electronic Medical Records on March 18th

111-bed Beloit Memorial Hospital goes live on Cerner this week.

Lifespan Takes Major Step to Transform Health Care Delivery

Five-hospital system Lifespan, Rhode Island’s largest health care system, selects Epic to bring all of its facilities onto a single system. Implementation will start this spring, conclude in 2015, and cost $90 million.

KLAS Diagnoses EMR Usability Concerns

KLAS releases a report on acute EMR usability, measuring specific Meaningful Use related functions such as CPOE, problem list, and physician documentation. No vendor excelled, but Cerner and Epic fared best.

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March 19, 2013 Headlines No Comments

News 3/20/13

March 19, 2013 News 8 Comments

Top News

3-19-2013 7-54-09 PM

Cerner acquires Labotix Automation Inc., which offers specimen handling and transport systems for clinical labs.


Reader Comments

From Katie: “Re: market research companies. We as a vendor are interested in gathering information from our target audience of hospital CIOs and HIM leadership. Do you have any suggestions of anyone with market research expertise and connections in these areas?” I always prefer to open these questions up to readers so I don’t miss anybody. Leave a comment or e-mail me and I will forward to Katie.

3-19-2013 6-56-19 PM

From Shannon Vogel: “Re: EHR incentive payments as taxable income. I thought the IRS guidance may be of interest to your readers.” Thanks to Shannon, who is HIT director of the Texas Medical Association, for providing this information for those docs who are probably less than elated to see 1099s in the mail for their Meaningful Use payouts:

EHR Incentive Payments are Taxable Income

Physicians should have received an IRS Form 1099 from the Centers for Medicare & Medicaid Services for the incentive payments. The forms had to be postmarked by Jan. 31 and were mailed to  addresses on file with Medicare. If you did not receive your Form 1099, you may request a duplicate copy by calling (888) 734-6433, which will take you through a series of prompts (1-1-1-1-2). You will be asked for your National Provider Identifier.   Physicians in the Medicaid EHR incentive program should have received a Form 1099 from their state Medicaid office.  The Internal Revenue Service issued guidance on the EHR incentive payments that may help in tax preparation, especially if payments were assigned to your group or hospital. 

3-19-2013 6-53-55 PM

From Don: “Re: San Diego. Here’s hoping we can bring HIMSS back to San Diego where it belongs! Once the pompous mayor here concedes defeat of his push to renegotiate the hotel room tax, construction can begin. Maybe see you all back in The Gaslamp District in 2016 or 2017. Bring your finest shoe-wear and cut some rug at the grand ball room at The Hotel del Coronado.” San Diego gets the green light for a $520 million expansion of its convention center, which will take about three years. Now it’s up to HIMSS. San Diego, Seattle, and San Francisco are my favorite cities of those I’ve visited because they are on the water, have interesting terrain, enjoy mostly pleasant weather, and are walkable.


HIStalk Announcements and Requests

It’s last call to fill out my quick reader survey. I do it just once a year right after the HIMSS conference. Pretty much every change you’ve seen over my 10 years (hopefully more good than bad) came from survey comments. Inga gets nervous this time of year because after I’ve digested the hundreds of responses, I make our to-do list.


Acquisitions, Funding, Business, and Stock

3-19-2013 7-55-29 PM

Sutherland Global Services completes its acquisition of Apollo Health Street, the technology subsidiary of India-based hospital operator Apollo Hospitals Group.

3-19-2013 7-56-15 PM

Emdeon reports Q4 revenues of $300.7 million, up six percent from a year ago, and a net loss of $10 million vs. $70 million.

3-19-2013 7-57-08 PM

Tenet subsidiary Conifer Health Solutions, which offers revenue cycle solutions, breaks ground on its new headquarters construction in Frisco, TX. The company acquired Dell’s revenue cycle business in November 2012, increasing the annual patient revenue it manages to $21 billion.


Sales

Maricopa Integrated Health System (AZ) selects HP Data Protector and HP StoreOnce for data protection and disaster recovery.

3-19-2013 7-58-42 PM

Providence Health & Service will deploy Health Catalyst’s data warehouse and analytic accelerators across its 32-hospital system.

Canopy Partners (NC) chooses the MModal Catalyst for Radiology platform for reporting and analytics.


People

3-19-2013 6-02-02 PM

PatientSafe Solutions names Tim Needham (Rubbermaid Health) VP of its western region.

3-19-2013 6-03-15 PM

Long-term care provider CenterLight Health System (NY) hires William C. Pelzar (Health Dialog) as its first CIO.

3-19-2013 7-21-03 PM

Anita Samarth, Clinovations president and co-founder, is named by the Washington Business Journals as one of the top 25 Minority Business Leaders of 2013.


Announcements and Implementations

Delaware HIN and Kansas HIN validate interoperability by exchange of patient records via Direct messaging using solutions from the Allied HIE Company and ICA’s Direct Messaging and Exchange products.

Beth Israel Deaconess Medical Center (MA) deploys CommVault Simpana for data backup and security.

3-19-2013 6-05-33 PM

Beloit Health System (WI) goes live this week on Cerner.

Clinithink releases an online version of CliX, its natural language processing engine.

3-19-2013 6-29-49 PM

Lifespan (RI) announces its plans to redesign its delivery model that includes implementing Epic at a cost of $90 million.

AHIMA calls for nominations for its Grace Award that recognizes outstanding achievement in health information management. Evaluation criteria include how organizations contribute to a patient-centered model of care, advance the use of electronic health records, and integrate HIM throughout the workplace.


Government and Politics

3-19-2013 3-10-14 PM

ONC launches Web pages to support its goal of having 1,000 critical access and rural hospitals achieve MU by the end of 2014.


Technology

Healthcare IT research funded by AHRQ has helped Partners in Health and the Regenstrief Institute develop an open EMR that supports healthcare initiatives in developing countries.

Seven Tennessee school systems receive $3 million in HRSA grants to implement telemedicine programs so that school nurses can connect with doctors to diagnose student problems, but the Franklin County school board delays its approval to start the program, citing liability concerns.


Other

3-19-2013 3-26-11 PM

Boulder Community Hospital (CO) reports that its Meditech system has been down since last week and is not expected to be operational until the end of this week. Officials say the hospital has “detailed plans” for going back to manual operations. The outage has caused delays in scheduling non-critical diagnostic tests and distributing routine test results, but essential services are still being provided. The hospital offered no explanation of the problem. An anonymous physician said the backup response is “not an organized plan,” while a patient told the local newspaper, “If they can’t keep their computer system running, how can we trust them to perform surgery?”

3-19-2013 3-31-57 PM

A KLAS report finds that no acute care EMR vendor excels at usability, though Epic and Cerner are best poised to support deep clinical usage. Providers assume the bulk of responsibility for making EMRs usable and 86 percent say that configuring their EMR solution required moderate to extensive effort. Stage 2 MU, with its increased requirements for physician documentation, medication reconciliation, and problem lists, will magnify current EMR challenges.

EMR vendor Lawrence Melrose Medical Record, Inc. notifies the New Hampshire Attorney General’s office of a data breach that has potentially compromised the PHI of two state residents.

3-19-2013 3-51-36 PM

A small study of healthcare professionals finds that 75 percent of organizations are 25 percent or less complete with the ICD-10 transition process. Coding education and implementation are the biggest conversion gaps. Almost half the respondents express some concern about being ready in time to meet the October 1, 2014 deadline.

3-19-2013 6-19-47 PM

Weird News Andy finds this “more than an inkling.” Electronic sensors printed directly on the skin, aka “electronic tattoos,” can monitor health signs such as temperature and hydration status. One potential medical use would be to stream surgical wound information wirelessly to providers.

Strange: a nurse from India working in an Australian hospital just a month after finishing nursing school is fired and banned from practice after giving a 79-year-old patient the contents of a bottle marked as containing heart pills that actually held liquid detergent the patient had been using to clean his dentures. The nurse, who argued that he followed four of five medication administration rules, was ordered by the nursing board to take an English competency test, which he failed in six attempts.


Sponsor Updates

  • Glenn Focht, MD of Boston Children’s Hospital spoke at a private reception during the AMGA conference in Orlando hosted by Ingenious Med.
  • An EDCO Health Information Solutions Webinar profiles two McKesson Patient Folder facilities that enhanced their scanning processes using EDCO technology.
  • Industrial Alliance Insurance and Financial Services signs an agreement with TELUS Health to allow certain healthcare providers to use TELUS Health’s eClaims Web portal service.
  • ThedaCare (WI) selects Wolters Kluwer ProVation MD Cardiology for its catheterization labs at Appleton Medical Center and Theda Clark Medical Center.
  • Ping Identity opens registration for its Cloud Identity Summit 2013 July 8-12 in Napa, CA.
  • Emdeon releases details on its upcoming Webinars.
  • Prognosis offers a four-part series on strategies for MU success.
  • Hayes Management Consulting commemorates its 20th anniversary with an updated website.
  • Nuesoft hosts a March 27 Webinar on best practices for medical billing.
  • Jason Fortin, a senior advisor with Impact Advisors, discusses the need for smaller practices to select an EHR vendor that is capable of achieving Stage 2 MU certification.
  • The Tampa Bay Business Journal names MedHOK the winner of its 2013 BizTech Innovation of the Year Award.
  • Surgical Information Systems CTO Eric Nilsson offers a primer on how to set up a clinical quality reporting program.  
  • Merge Healthcare announces that more than 650 orthopedic surgeons at over 50 practices already have or are in the process of implementing Merge OrthoPACS.
  • ChartWise:CDI posts its 2013 conference schedule.
  • SiliconMesa partners with DrFirst to provide Rcopia e-prescribing functionality to customers running the SiliconMesa EHR and PM system.
  • Craneware announces its support of the Alzheimer’s Association and Alzheimer Scotland as part of its 2013 Craneware Cares corporate responsibility program.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 19, 2013 News 8 Comments

Morning Headlines 3/19/13

March 18, 2013 Headlines 3 Comments

Cerner Has Acquired Labotix Automation Inc.

Cerner announces the acquisition of Labotix Automation Inc., a lab automation solutions vendor for the clinical labs. Financial details of the deal were not disclosed.

EHR vendor to report HIPAA breach

Lawrence Melrose Medical Electronic Record Inc., in Melrose, Mass. will notify the Office for Civil Rights of a data breach after an employee improperly accessed patients’ electronic medical records.

AHCJ unveils hospitalinspections.org

The Association of Health Care Journalists today launches a website to provide a free, searchable database of federal inspection reports for hospitals around the nation following the digital release of the reports by CMS. The Joint Commission has been petitioned to follow suit, but has so far rejected requests for this information, saying disclosure would compromise its efforts to improve hospital quality.

athenahealth Delivers 96 Percent Meaningful Use Attestation Rate Among Participating Providers

athenahealth announces that 96 percent of the company’s participating providers successfully attested for 2012 Medicare Meaningful Use Stage 1, Year 1, more than double the industry average.

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March 18, 2013 Headlines 3 Comments

Morning Headlines 3/18/13

March 17, 2013 Headlines No Comments

House Republicans Question FDA on Mobile Medical Software: Taxes

FDA representatives will appear on Capitol Hill this week to answer for a delay in publishing a regulatory policy for mobile health apps. Additionally, House members want to know if the FDA plans to regulate smartphones as medical devices as has recently been speculated since they would be running FDA regulated health apps.

HIMSS13 with Dodge Communications: Our team picks the best and worst in the exhibit hall

Dodge Communications publishes its best and worst of HIMSS13. Voalte takes worst dressed, Cerner takes best in show. Alere, Caradigm, Greenway, Onyx, McKesson, SCI, and InterSystems also get mentions.

Class Calls IRS Rude, Crude and Abusive

A class action lawsuit filed against the IRS accuses agents of unlawfully seizing more than 60 million medical records from a HIPAA-covered entity in southern California following a raid in March 2011. The suit seeks $25,000 per violation. Agents are also accused of unlawfully seizing and searching employee cell phones without regard to privacy rights, ordering pizza and soda, and using the facility’s multimedia system to watch the NCAA tournament.

Making "Meaningful Use" of HHS Data

Social Health Insights publishes a visualization of Meaningful Use attestation data in what it calls its first of many data mash-ups to come.

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March 17, 2013 Headlines No Comments

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