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News 5/24/13

May 23, 2013 News 18 Comments

Top News

5-23-2013 6-21-30 PM

Secretary of Defense Chuck Hagel tells the DoD that he supports the use of commercial software to replace the department’s AHLTA EHR rather than switching to the VA’s VistA platform as he previously hinted was his preference. The DoD says it has identified 20 commercial software vendors capable of meeting its EHR needs. You’d have to bet on Epic given that it’s outselling everybody in big hospitals, they were allegedly the DoD frontrunner in 2010, and the Wisconsin Congressional delegation was squeezing the federal government to choose Epic awhile back (and not to mention that there are nowhere near 20 serious players to choose from.) On the other hand, DoD loves throwing billions at the fat cat contractors and Epic might not want to work through them.


Reader Comments

From Lil Wayne: “Re: Practice Fusion. Does anyone buy into their claim of having 30 percent of the primary care market? Seems beyond ludicrous.” I’m always curious about their methodology for counting actual users vs. someone who signs up with minimal usage. I would also be interested in seeing audited user statistics. Practice Fusion isn’t in the top five vendors by Meaningful Use attestation as I recall, in the low single digit percentages of all attesting providers.

From Stephanie: “Re: certification. If I already have a certified completed EHR and use another vendor’s patient portal within the HIE, does my patient portal also need to be certified? I’m just placing patient documents out in the portal for patients to view.” I know Frank Poggio will answer if nobody else does.

From Sleepless Fax Server Administrator: “Re: HITECH modifications to HIPAA. Will add risk to faxing or mailing results. There is a 100 percent chance of a violation when a provider changes practices since no healthcare IT system can determine the right address or fax number based on the date the patient was seen – they always use the current information. Even if you solved that problem, how would any system know if the patient followed the provider to the new practice? Also, critical radiology results are required by regulation to be faxed within 24 hours.”

5-23-2013 7-29-45 PM

From Major Tom: “Re: conference. Thought you would enjoy this e-mail.” A promoter pitches their conference as offering “peer-to-beer” knowledge exchange, creating mental images of sullen, bar-perched attendees mumbling into their mugs.

From Non-Sequitur: “Re: RAC recoveries hit $1.37 billion. Forwarding a synopsis from Wolters Kluwer. You are still the brightest spot in many of my mornings!” Thanks, milady, that’s sweet of you to say. The article says RACs collected $1.371 billion in Medicare overpayments and returned $65.4 million in underpayments in the first six months of FY2013 (obviously like with the IRS, your odds of an unexpected refund aren’t so good when the RACs come knocking). The current major issue is documentation for cardiovascular procedures.


HIStalk Announcements and Requests

Listening: Superchunk, possibly the best and most prolific indie band in history. I’ve played all 15 of their albums on Spotify and it’s a stunning body of influential work spanning almost 25 years. A new album will be out in August and a tour follows.


Acquisitions, Funding, Business, and Stock

5-23-2013 11-07-30 AM

Online medical consult provider ConsultingMD secures $10 million in funding from Venrock.

5-23-2013 11-20-36 PM

Quality Systems reports Q4 results: revenue up 2 percent, EPS –$0.07 vs. $0.25, missing on both.

From the Quality Systems earnings call:

  • Poor performance in the company’s Hospital Solutions Division (a $4.2 million loss on $4.5 million revenue) will require investments in development, implementation,and support.
  • Steve Puckett will be moved from Hospital Solutions to CTO and COO/EVP Daniel J. Morefield will take over Hospital Solutions.
  • In a “what were they doing before?” moment, the company said it has “aligned our marketing team with our overall revenue objectives and shift and focus to increasing product demand and lead creation,”
  • To an analyst’s question about implementation margins of zero percent, the CFO’s response was, “There’s a number of factors, but I think hospital certainly is. I think we’ve already been talking about the — some of the challenges that we’ve been — that we’ve had there and that certainly impacted the profitability on that particular revenue category. I think — so it gets a little hard to generalize. On the ambulatory side, we’ve got — but I’ll let you — you ought to know, though, that certainly it’s not something — we are paying attention to it and we do intend to drive higher margin there in that space. We have — we are in some — having some transition in the ambulatory world … the full expectation is, for us, it’s going — going forward is to drive a higher level of profitability on that revenue category.”
  • The company declined to give dates for a SaaS product, saying it will focus on the current product.
  • The company expects a move back to larger EMR vendors as the small ones fail trying to keep up with Meaningful Use and ICD-10.
  • They expect more government programs to follow the DoD’s apparent lead in moving to commercial software, with vendors scrambling to get their GSA status.

Sales

East Lansing Orthopedic Association (MI) selects SRS EHR.

5-23-2013 11-21-55 PM

Conway Medical Center (SC) chooses StrataJazz from Strata Decision Technology for decision support, budgeting, and capital planning.


People

5-23-2013 6-14-27 PM

The New Jersey chapter of Entrepreneurs’ Organization and the Star-Ledger/NJ.com name SRS CEO Evan Steele the winner of the Garden State Entrepreneur Excellence Award in the $10M+ category.

5-23-2013 12-26-07 PM

TeleTracking Technologies hires Nanne Finis (Joint Commission Resources) as VP of consulting services.

5-23-2013 10-16-53 PM

Yousuf Ahmad, who will take over as CEO of Mercy Hospital (OH), is profiled in the local business paper because of an earlier position as CIO of Mercy Health Partners. Interestingly, he attended University of London on a cricket scholarship, graduated at 19, and is ranked among the world’s 400 best Scrabble players.


Announcements and Implementations

Cerner’s PowerChart Touch mobile solution earns a bronze award for Best Clinical Health Care Experience at the 2013 International User Experience Awards.

All of Maine’s 38 acute-care hospitals and 376 ambulatory provider sites have agreed to participate in the state’s HIE, operated by HealthInfoNet.

Holy Family Memorial Health Network (WI), Johnson Memorial Hospital (IN), and United General Hospital (WA) implement Hyland Software’s OnBase enterprise content management platform integrated with their Meditech systems.


Government and Politics

Idaho State University will pay $400,000 to settle alleged HIPAA violations stemming from a breach of unsecured data on 17,500 patients from an ISU family medicine clinic. The university notified HHS of the breach upon realizing that a disabled firewall had left patient data unsecured for at least 10 months.

5-23-2013 10-54-10 AM

HHS reports that 55 percent of all EPs and and 80 percent of eligible hospitals and critical access hospitals have been paid MU incentives through the end of April. HHS had established a goal for 50 percent of EPs and 80 percent of hospitals to have EHRs by the end of 2013.

North Carolina’s state auditor finds that the state’s DHHS hasn’t overseen the implementation of its new $484 million Medicaid claims system properly, making it likely it will not be ready by the scheduled go-live in 40 days. CSC developed the system, which was written in COBOL by programmers from India copying code the company developed for a similar system in New York, and previous audits found poor documentation and unauthorized changes. DHHS allowed CSC to develop the acceptance criteria for its own project. The system was supposed to go live in August 2011 at a cost of $265 million. The state had already cancelled a 2003 contract with ACS saying their system wasn’t working before hiring CSC. Residents of other states are on the hook since the federal government is covering  90 percent of the development costs and at least 50 percent of the ongoing operational costs. Nothing good has ever come from combining state and federal governments, taxpayer money, contractors, and ambitious computer system plans.


Innovation and Research

Intermountain Healthcare announces a system that will track cumulative radiation exposure from higher-dose imaging exams and report it via the EMR.


Other

The County of Monroe Industrial Development Agency (NY) approves $369,359 in tax exemptions for eHealth Technologies, which is building a $4 million, 36,000 square-foot facility and is planning to add 60 jobs over the next three years.

5-23-2013 11-25-09 PM

Via Christi Health (KS) blames lower than anticipated revenues for its decision to lay off up to 400 staff members — about four percent of its workforce — across the state by the end of June.

5-23-2013 11-31-20 PM

Conservative columnist Michelle Malkin, known for writing screamingly partisan books such as Culture of Corruption: Obama and His Team of Tax Cheats, Crooks, and Cronies sets her sights for the second time on Epic’s Judy Faulkner in an article titled “The Obama crony in charge of your medical records.” She also weighs in that HITECH is “government malpractice at work;” calls out Epic and not its competitors for having “enhanced power to consolidate and control Americans’ private health information” (missing the point that only Cerner runs a profitable business unit that sells de-identified data from the hospital systems it hosts); and accuses the President of choosing Faulkner as the vendor representative on the HIT Policy Committee because of partisan politics (“the foxes are guarding the Obamacare henhouse.”) It’s a safe bet due to partisanship on both ends of the political spectrum that anyone who follows her faithfully believes every word, and anyone who doesn’t wouldn’t believe even one.

In Detroit, Henry Ford and Beaumont call off their merger plans, with the unstated sticking points apparently being cultural differences, disagreements over keeping both academic medical centers, and the unwillingness of Beaumont’s independent physicians to work with Henry Ford’s management.  

All you need to know about the inevitable demise of most HIEs once the government grant trough has been lapped dry is contained in this story. The squabbling CEOs of two Kansas HIEs  force the state’s lame duck HIE regulatory body to pass a resolution preventing them from trying to charge each other connection fees. KHIN and LACIE are required to connect their networks by July, but KHIN demanded that LACIE pay it a fee. The date has been moved back to December, and meanwhile the regulatory board – KHIE – will turn over its responsibilities to the state’s Department of Health and Environment on July 1 in a cost-cutting move. The dialog from the May 9 meeting:

[KHIN CEO] "If we give that data to another (network) they will have a competitive advantage, if we give it to them for free. We know that LACIE knows this — they’ve been out talking to providers all across the state of Kansas saying ‘If you join LACIE you can join at a lower fee, and you’ll get all of KHIN’s data for free.”

[LACIE CEO] That’s untrue, Laura. That’s absolutely untrue and we’ve told you it’s untrue. I’m sorry, Mr. Chair but that is an absolute lie.”

A University of Florida study finds that ED employees spend 12 minutes per hour on Facebook, and strangely enough their usage increases with ED patient volume and severity. On the other hand, it was a one-hospital study covering a 15-day period in late 2009 covering mostly the time between Christmas and New Year’s, so the method isn’t convincing.

A Pennsylvania judge orders the hiring of a forensic examiner to review the Facebook page of a woman who claims she slipped and fell due to a puddle of liquid on the floor of Lancaster Regional Medical Center. The woman claims she suffered serious injuries and can’t afford the surgery; the hospital found Facebook pictures and videos from up to 17 days after the accident after showing her frolicking in the snow.


Sponsor Updates

  • Greenway Medical announces the availability of its PrimeMOBILE mobile access solution for Windows 8.
  • Biilian’s HealthDATA posts a list of the 10 hospitals claiming the most in outpatient charges, according to expense report data published by CMS.
  • Liaison Healthcare launches Healthcare Terminology Manager and Healthcare Terminology Translation to facilitate the management of diverse controlled medical vocabularies for simplified data exchange.
  • Park Place International will market Interbit Data’s disaster recovery and business continuance software solutions to its customers implementing Meditech.
  • Levi, Ray & Shoup introduces MFPsecure, a line of hardware and software aimed at the pull printing and secure document delivery markets.
  • Ping Identity announces details of the workshops at its Cloud Identity Summit 2013, which takes place July 8-12 in Napa, CA.
  • The Boston Globe names Keane, Inc., now part of NTT Data, to its Globe 100 Hall of Fame in recognition of the company’s 25 years as a top-performing company in Massachusetts.
  • Visage Imaging releases Visage Ease version 1.3.0, which gives authorized healthcare providers mobile access to imaging results on iOS devices.
  • Care Team Connect hosts a July 10 Webinar on readmission prevention.
  • EClinicalWorks CEO Girish Kumar Navani discusses the company’s latest projects and offers his perspective on where healthcare is headed and IT’s role in healthcare transformation.  
  • Greenway Medical customer Texas Orthopedics shares how its use of PrimeMOBILE has improved patient care and increased efficiency, productivity, and profitability.
  • INHS highlights the SHMC Pediatric Oncology clinic and its use of online status boards to cut patient wait times.
  • Encore Health Resources posts a YouTube video featuring CEO Dana Sellers participating in a discussion on EHRs and analytics.
  • Emdeon CEO George Lazenby shares his secrets to innovation and growth.

EPtalk by Dr. Jayne

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From Anotherdrgregg: “Re: your recent piece on gimmicks. Preparing for our EMR, we looked at all our diets, some 30 in all, including the oddly named ‘anti-atherogenic diet.’ We reduced the number of diets to four, not including bariatric diets. The reasoning was that if you could hold it down, you were probably going to be discharged home. Administration nodded sagely, then went ahead with diet on demand complete with special breakfasts and a chef in a toque. Now they want to know why utilization is not high.” Any reader who can use the word “toque” gets my vote. He went on to list other frivolous hospital expenditures: flat screen TVs, real oak moldings on the doors, and carpets so thick that you can’t roll a gurney on them. He closed with this thought: “The finest hospital I ever worked at had painted cinderblock walls. it was a forward operating base.”

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Hard to believe it’s almost June. In CMS terms, that means barely more than a month before Eligible Hospitals in the first year of Meaningful Use run out of time to begin the reporting period for Fiscal Year 2013. If you don’t start your reporting period by July 3, you’re out of luck as the federal fiscal year ends September 30.

Reuters Health reports that many health Web sites are too complicated and full of jargon, leading to confusion for patients. Instead of the fourth to sixth grade reading level recommended by the American Medical Association and the Department of Health and Human Services, the average reading level of online materials studied ranged from high school to college. Reviewers also found information that was oversimplified to the point of inaccuracy and large numbers of clichés at some specialty sites.

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Scientists have often debated whether white coats and neckties spread germs. Unfortunately for fashionistas like Inga, handbags are now under scrutiny. Twenty percent of handbags studied had levels of bacteria high enough to cross-contaminate other surfaces. I wonder if the findings would also apply to brief cases or laptop bags?


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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May 23, 2013 News 18 Comments

Morning Headlines 5/17/13

May 16, 2013 Headlines No Comments

HHS Secretary Sebelius announces Senate confirmation of Marilyn Tavenner

The US Senate today confirmed Marilyn Tavenner as the new CMS administrator, making her the first to be confirmed to the position in over nine years.

Hospital can’t afford EMR contract, Assembly rejects funding request

City assemblymen from Juneau, AK rejects an $8.5 million budget request to pay for an already-signed Cerner contract for Bartlett Regional Hospital, saying that they were never consulted on the contract prior to its signing and that the $1.15 million in annual maintenance fees is more than they are willing to pay.

Health Care Innovation Awards Round Two

CMS announces Round Two of the Health Care Innovation Awards which authorizes up to $1 billion in awards to help fund innovative projects that will help deliver better care at a lower cost.

Marin General Hospital nurses warn that new computer system is causing errors, call for time out

Unionized nurses at Marin General Hospital are asking administrators to put its Paragon CPOE implementation on hold until glitches can be ironed out, claiming, "Orders are being inadvertently passed to the wrong patients. People have gotten meds when they’ve been allergic to them. This is dangerous.”

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May 16, 2013 Headlines No Comments

News 5/17/13

May 16, 2013 News 12 Comments

Top News

The House Appropriations Committee approves $344 million in development funds for an integrated EHR for the VA and DoD, but mandates that no funds be expended on any EHR unless it is an open architecture system that serves both agencies.


Reader Comments

5-16-2013 8-31-28 PM

From Stifler’s Mom: “Re: Marin General Hospital. Nurses warn that the new computer system is causing errors.” A dozen unionized Marin General nurses attend the healthcare district’s board meeting to ask hospital administration to put the McKesson Paragon implementation on hold, claiming orders are being entered on the wrong patients, patients have been given meds to which they are allergic, and discharges and surgical prep are taking two hours.

From Carolyn: “Re: first HIStalk Webinar with HTTS. Will the recording be made available for those of us who could not attend the live session?” The recorded Webinar, “Vendor Software Training: What Providers Should Demand” is available for anyone to view here and a PDF of the slides is here. Everyone who registered will get an e-mail with these links, along with those to the HTTS-developed forms mentioned in the presentation (the Software Vendor Training Checklist and Sample Evaluation Form.)

5-16-2013 7-50-36 PM

From Horizon Consultant: “Re: Bayhealth – Milford Memorial Hospital. Went live on Horizon Expert Orders full house with physicians this week, with few problems.”

From Acorn: “Re: Maine Medical problems. Their Epic project is over budget by some unidentified amount, but will be high 8-9 digits, more than member hospital boards signed up for. Rollouts that were expected to conclude in 2013 are on hold until Maine Medical Center is stabilized – 2015 maybe? MaineHealth’s mouthpiece said training was not an issue, but I respectfully disagree. Insufficient engagement at all levels and all phases has been at the root of problems.”


HIStalk Announcements and Requests

inga_small This week’s highlights from HIStalk Practice include: the AMA looks at how patient-physician communication is affected by the use of computers in the exam room. INTEGRIS Health (OK) contracts with athenahealth for athenacollector and other products. Doctor office visits fell in 2012 while patients’ out-of-pocket costs jumped 30 percent. Primary care providers beat specialists in generating money for hospitals. The AMA does not recommend jumping directly from ICD-9 to ICD-11.  Make the world a happier place (at least my world) and sign up for e-mail updates when you check out the HIStalk Practice news. Thanks for reading.

5-16-2013 7-24-53 PM

Nuance CMIO Nick Terheyden tweets out another fun photo as he carries the HIStalk logo on his travels, this time with HIMSS President and CEO Steve Lieber from the stage of the Arkansas HIMSS Chapter meeting. Take along a printed logo or your iPad and snap and e-mail a photo from somewhere fun and I’ll run it here. We’ve seen photos from London and Dubai previously, so it’s your turn.

I’m behind on almost everything, so be patient if you are expecting something from me. I was so exhausted Wednesday night after work that I literally fell asleep in the middle of typing HIStalk, so I’m struggling to keep up.

On the Jobs Board: Clinical Analyst, Marketing Communication Specialist. Sponsors post their jobs for free.

5-16-2013 8-04-07 PM

Welcome to new HIStalk Platinum Sponsor, HCS (Health Care Software, Inc.) of Wall, NJ. Everybody likes stable vendors who aren’t just dabbling temporarily in healthcare, and HCS has been doing provider-only healthcare IT since 1969 (!!) The company’s INTERACTANT platform, an integrated suite of clinical and financial applications (revenue cycle, financials, EMR, mobile, and analysis) is meeting and exceeding the needs of all kinds of provider organizations (inpatient, outpatient, long term acute care, behavioral, and rehab). Check out their white papers (the best title: “Meaningful Use: Why Should Ineligible Providers Still Care?”) and case studies.  Thanks to HCS for supporting HIStalk.


Acquisitions, Funding, Business, and Stock

The AMA reports a four percent decline in 2012 revenues from 2011, largely due to an 86 percent drop in advertising revenues and lower sales for printed coding books.  Membership was up over three percent, but net  operating profit fell 33 percent.


Sales

Port Huron Hospital (MI) signs a three-year contract with CareTech Solutions to use the iDoc Archive solution for storage of patient data as the hospital transitions to a new EHR.

Wilson Memorial Hospital (OH) chooses Access to integrate electronic patient signatures into Meditech and register patients electronically during downtime.

5-16-2013 10-13-57 PM

Trinitas Regional Medical Center (NJ) selects Dell’s Unified Clinical Archive solution to manage its clinical image archive.

The VA extends its contract with Authentidate for its Electronic House Call vital signs monitoring device and service and for the Interactive Voice Response System for remote patient monitoring.


People

5-16-2013 12-40-55 PM

MedeAnalytics names Andrew Hurd (Epocrates/Carefx) CEO, taking over for Mike Gallagher who will serve as executive chairman.

5-16-2013 6-17-47 PM

Jerry Baker (Halfpenny Technologies) joins HIT Application Solutions as president and CEO.

5-16-2013 6-18-54 PM

URAC appoints Kylanne Green (Inova Health System) president and CEO.

Streamline Health Solutions promotes Nicholas Meeks from VP of financial planning to SVP/CFO, taking over for the resigning Steve Murdock. Carolyn Zelnio (Aderant) also joins the company as VP/chief accounting officer.


Announcements and Implementations

5-16-2013 7-17-41 PM

HealthTech, parent company of HMS, MEDHOST, and Patient Logic, held a ribbon-cutting ceremony this past Wednesday to celebrate the opening of its new, larger headquarters in Franklin, TN. Participating were Allen Borden (assistant commissioner, Tennessee Department of Economic and Community Development); Rogers Anderson (Williamson County mayor); Ken Moore, MD (City of Franklin mayor); Matt Largen (president and CEO, Williamson County Chamber of Commerce); Bill Anderson (president and CEO, HealthTech); Steve Starkey (president, HMS); and Craig Herrod (president, MEDHOST).

Encore Health Resources launches its health analytics consulting practice, which follows the company’s preference of "Smart Skinny Data” (using information from specific sources to focus on specific analysis needed) over “Big Data.” The practice will offer analytics strategy, tools selection, implementation, performance improvement, and data governance help.

5-16-2013 10-16-04 PM

New York eHealth Collaborative issues an RFP to develop a statewide health portal, just after declaring Mana Health’s design to be the winner earlier this week.

5-16-2013 8-52-13 PM

Patient Updater releases a new version of its HIPAA-compliant messaging platform that allows hospitals to keep the families of surgery patients informed.


Government and Politics

The Senate confirms Marilyn Tavenner as CMS administrator, making her the first CMS leader to be confirmed in over nine years.

CMS will spend up to $1 billion for the second round of the Health Care Innovation Awards to promote projects that test new payment models in support of better care and lower costs.

5-16-2013 8-21-37 PM

Eleven top government officials will speak at the 2013 Health Privacy Summit, June 5-6 in Washington, DC, including Todd Park (White House), Joy Pritts (ONC), Leon Rodriguez (OCR/HHS), and David Muntz (ONC).


Innovation and Research

5-16-2013 9-07-42 PM

Massachusetts Governor Deval Patrick visits a digital health summit in Ireland to discuss collaboration between startup companies in their respective areas.

5-16-2013 9-11-20 PM

The wireless pill reminder bottle from AdhereTech wins the Healthcare Innovation World Cup.


Other

5-16-2013 11-23-15 AM

CareTech Solutions takes the top spot in a KLAS survey on IT outsourcing. Though many providers are pulling back on extensive IT outsourcing (EITO) in favor of partial IT outsourcing (PITO), EITO remains the most popular option for smaller hospitals.

5-16-2013 8-42-58 PM

The city government of Juneau, AK, which owns 57-bed Bartlett Regional Hospital, votes down an $8.5 million appropriation for a Cerner implementation the hospital has already signed for. The hospital CEO says the contract was signed before Quorum Health Resources left as facility managers and he’s not comfortable with the $1.155 million in annual maintenance costs on the $7.37 million capital purchase (15.7 percent per year). The hospital is hoping its contract has enough out clauses to convince Cerner to allow it to walk away as it seeks a less expensive system.

5-16-2013 12-09-29 PM

The deadline to submit proposals for educational content for HIMSS14 is June 3, or about 7 1/2 months before the actual conference. Interestingly, HIMSS suggests that proposed topics be “timely.” Interested speakers should consult their crystal balls before applying.

The federal government charges 89 people — including about 22 doctors, nurses, and other medical professionals in eight cities — with Medicare fraud schemes that totaled $223 million in false billings.

5-16-2013 9-30-15 PM

A New York medical practice exposes the personal information of thousands of its patients when a clerk mistakenly attaches an Excel worksheet to an e-mail being sent to 200 patients.

Weird News Andy offers a pithy headline for this story, “Time to eat cookies whilst on the rack,” but you’ll have to think to get it. British researchers find that body mass index (BMI) is a poorer predictor of life expectancy than the ratio of waist size to height. People with a ratio of 0.8, which would be 56-inch waist for a 5’10” man or woman, lived 17 years less on average, while keeping the ratio at 0.5 or less (a 35-inch waist in this example) was associated with reduced incidence of stroke, heart disease, and diabetes. The ratio works on children as young as five, the researchers say.


Sponsor Updates

 

  • OB leaders at MedStar Franklin Square Medical Center (MD) describe PeriGen’s EHR, surveillance, and decision support system that supports healthier babies and mothers on “Today in America.”
  • T-System posts a video explaining how its system benefits ED patients and clinicians.
  • e-MDs will offer analytics and dashboards to its customers via an agreement with dashboardMD.
  • ReadyDock adds Complete Tablet Solutions as a reseller of its tablet management products.
  • This week’s 2013 Truven Health Advantage Conference in Scottsdale, AZ featured keynote addresses by Gov. Howard Dean, MD; Sen. Bill Frist, MD; and David Newman, MD.
  • Prognosis Health Information Systems discusses key considerations when changing EHRs. 
  • SuccessEHS hosts a CEU-approved Webinar May 29 on ICD-10 changeover planning.
  • The Boise Metro Chamber of Commerce recognizes Heathwise with its Healthcare Industry Excellence Award.
  • Kareo posts a Webinar on the ins and outs of Stage 2 MU.
  • Verisk Health hosts a May 29 Webinar featuring Bob Kay, senior data analyst with New Hampshire’s Granite Healthcare Network, who will discuss analytics for ACOs.
  • Craneware offers Webinars May 22 and May 30 on best practices for improving financial performance.
  • ChartWise Medical Systems CEO Jon Elion, MD discusses ethical practices in clinical documentation improvement on May 21 during the ACDIS Conference in Nashville.
  • MedAssets customer Oconee Medical Center will share how it used the company’s technology and services to improve point-of-service collections at this week’s NAHAM conference in Atlanta.
  • Finalists for Impact awards from the Technology Association of Georgia Southeastern Software Association include Billian’s HealthDATA (emerging mega trend and technology solutions provider) , McKesson (technology solutions provider), and NextGen (independent software vendor).


EPtalk by Dr. Jayne

From Big G: “Re: sick or not sick. I have a story to mirror yours. There I was, a medical student rotating at a large, urban children’s hospital’s ER. I was getting my duties from the charge nurse (‘Don’t touch anything.’) Without breaking stride, looking out at the vast, screaming waiting room, surely my vision of Hell, she pointed to one kid, and said, ‘He’s next.’ 30 years on, that display of sick/not sick sticks with me. Meningitis. Thanks for sharing. We’ve all had those semi-scary moments where we’re amazed by someone’s psychic abilities. Thank goodness for seasoned warriors in the trenches.”

During a recent “listening session” with CMS officials, the AMA offered testimony on the issue of cloned documentation. Comments on usability and reconsideration of Stage 2 MU were also hot topics in the discussion.

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What is it with endorsements on LinkedIn lately? In recent weeks I’ve been “endorsed” for skill sets that I don’t remotely possess. If nothing else, it’s good for some entertainment, and some of it makes me sound just the slightest bit cool.

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The National Committee for Quality Assurance (NCQA) publishes the names of 112 people newly certified as Patient Centered Medical Home experts. Those certification is aimed to help providers assess the quality of those offering to assist practices through the PCMH process. I hope they were all aware that their e-mail and snail mail addresses were going to be published to the world.

Speaking of certifications, I’m interested to hear who plans to sit for the American Board of Preventive Medicine subspecialty board exam in clinical informatics. The online application for initial certification is live and late fees apply to any application submitted after June 1. The exam is already fairly pricey and the Board will offer a non-fellowship pathway for the first few years. It will be interesting to see how presence or absence of certification impacts the job market for physician informaticists. Have you registered? What did you think? E-mail me.

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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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May 16, 2013 News 12 Comments

News 5/15/13

May 14, 2013 News 1 Comment

Top News

5-14-2013 10-26-43 PM

Compuware subsidiary Covisint, whose healthcare business offers an HIE platform, files for a $100 million IPO.


Reader Comments

From Olga: “Re: identifying patients by driver’s in Texas. I think it’s a bit naïve to think that one can simply attach a card swipe solution to a provider’s registration system and everything will be good to go. Card swiping is only the first step of the registration process. The data captured from the card still need to be bounced up against the provider’s EMPI so that this service can determine if this is a new registration or if that individual already exists within the patient index that matches the demographic details on the ID card. The card swipe is really only part of the solution. It doesn’t solve issues around identity theft. That can be addressed only through two-factor authentication, maybe through the use of biometric devices like fingerprint or palm vein scans. I commend Texas with a step in the right direction, but this shouldn’t be classified as, ‘Whew! Solved that problem!’” I agree – lots of people get services under false pretenses by presenting someone else’s insurance card, and the link needs to be made to the hospital’s records in the absence of a national patient identifier. The only sensible solution would be that identifier plus biometrics, but you couldn’t get elected dogcatcher having your political opponent pounce on that perfectly sensible and fraud-detecting idea as government meddling.
5-14-2013 10-28-27 PM

From Passionate Radiologist: “Re: American College of Radiology. Launches Imaging 3.0 – Beyond Image Interpretation to keep rads in the forefront of patient care.” Imagine 3.0 is described as, “It includes a set of technology tools that equip 21st-century radiologists to ensure their key role in evolving health care delivery and payment models—and quality patient care. Imaging 3.0 is a call to action to all radiologists to take a leadership role in shaping America’s future health care system.” I would be interested in the opinions of radiologists about this initiative.

5-14-2013 10-30-31 PM

From KJ!: “Re: eHealth in Canada. Interesting article about funding cuts.” The federal government says Canada Health Infoway won’t be shut down despite the surprise decision not to give it new funding in 2013. The organization has already earmarked the $900 million it has received, the last of which was in 2010. The government says it needs to cut back on spending.

5-14-2013 9-49-11 PM

From Dr. Gregg: “Re: athenahealth. Have you guys seen CodeView?” I hadn’t seen it. Athenahealth’s CodeView is a billing code lookup that shows average reimbursement per per procedure for all insurance types as pulled from the company’s network.


HIStalk Announcements and Requests

5-14-2013 10-32-23 PM

Thanks to everyone involved in today’s first-ever HIStalk Webinar. We had good attendance and a nicely done presentation by Lorre and Shauna from Health Technology Training Solutions. Thanks to our moderator Jim and the CIOs who pre-screened the run-through with me and provided feedback that the presenters then incorporated into the final version. That’s how we’ll run Webinars going forward.


Acquisitions, Funding, Business, and Stock

Printing management system vendor Levi Ray & Shoup will acquire Capella Technologies, which offers products for HP printers.


Sales

5-14-2013 1-29-05 PM

Ephraim McDowell Health (KY) expands its contract with HealthCare Anytime to include its entire patient portal suite.

5-14-2013 2-48-59 PM

Northeast Georgia Health System selects Isabel Healthcare to provide diagnosis decision support and patient engagement tools.

The Department of Defense will implement Mediware’s blood donor and transfusion software validation services in partnership with Planned Systems International.

5-14-2013 2-55-21 PM

Continuum HealthPartners (NY) selects Wellsoft’s EDIS for its four NYC-area EDs.

5-14-2013 2-58-47 PM

Griffin Hospital (CT) will implement Vree Health’s TransitionAdvantage service to help patients adhere to the hospital’s recommended post-discharge care plans and reduce preventable 30-day patient readmissions.

5-13-2013 4-42-17 PM

Texas State University selects eClinicalWorks EHR and Patient Portal and the Health & Online Wellness PHR smartphone app for its student health service.

5-14-2013 3-02-15 PM

Hartford HealthCare Corporation (CT) will implement the AccessAnyWay content management enterprise solution from Streamline Health Solutions.

Lehigh Valley Health Network (PA), White Plains Hospital (NY), and Laurens County Health Care System (SC) select the Good to Go discharge communication solution from ExperiaHealth, a subsidiary of Vocera Communications.

5-14-2013 3-03-31 PM

Bay Area Hospital (OR) will use Besler Consulting’s BVerified Screening and Verification solution to address CMS sanctions screening requirements.

Hanover Hospital (PA) choose Capsule’s DataCaptor for medical device integration with Meditech.


People

5-14-2013 3-14-41 PM

nTelagent names Lloyd Baker (Passport Health) regional VP of sales.

5-14-2013 6-34-58 PM

BizTimes Milwaukee names API Healthcare President and CEO J. P. Fingado winner of its 2013 Bravo! Entrepreneur Award.

5-14-2013 3-18-59 PM

Polycom CEO Andrew M. Miller joins Informatica’s board.

5-14-2013 6-36-08 PM

Telehealth provider Teladoc names Henry DePhillips, MD (Audax Health) CMO.

5-14-2013 3-28-01 PM

Convergent Revenue Cycle Management, Inc. appoints Greg Rassier (Rassier Consulting/Conifer Health Solutions) COO.

5-14-2013 8-56-50 PM

Intellect Resources names Dan Stoke (Allscripts) VP of client sales and service.

SeniorCare, a provider of analytics-driven prospective care solutions, appoints Joell Keim (Outcomes Health information Systems) president.

HealthMEDX hires Craig Frazier (Intuitive Medical Software/McKesson) as COO.

Matt Ebaugh (Kaiser Permanente) is named VP/CIO of Kings Daughters Health System (KY).


Announcements and Implementations

Strategic Health Intelligence of Pensacola and Atlantic Coast HIE of Miramar become the first providers to exchange patient information with the Florida HIE Patient Look-up Service developed by Harris Corporation.

NextGen Healthcare will integrate PDR Network’s drug information technology with the NextGen Ambulatory EHR platform.

5-14-2013 3-20-20 PM

St. Francis Memorial Hospital (NE) goes live on McKesson Paragon June 17.

LDM Group will provide its healthcare messaging solutions PhysicianCare and ScriptGuide to providers through DrFirst’s Rcopia e-prescribing solution and Patient Advisor patient education solution.

Community Memorial Health System (CA) begins deployment of PatientKeeper CPOE for more than 500 physicians.

Healthwise will offer National eHealth Collaborative’s Consumer eHealth Readiness Tool to its clients.

Mountain States Health Alliance reports significant improvements in glycemic control within 60 days of implementing Glytec’s inpatient glucose control platform Glucommander.

5-14-2013 10-12-43 PM

Athenahealth completes its $168.5 million purchase of the 760,000 square foot Arsenal on the Charles complex in Watertown, MA from Harvard University, in which the company’s headquarters has been located since 2005.


Government and Politics

Proposed legislation in Texas would allow licensed healthcare providers to collect or verify patient information with a swipe of a patient’s driver’s license.


Innovation and Research

An project seeking crowdfunding via Indigogo is a placebo mobile app, which is a lot more interesting and scientific than the title would suggest.


Technology

Student journalists from Virginia Commonwealth University  interview Colin Banas, MD, CMIO of VCU Medical Center (VA). He talks up the hospital’s PatientKeeper system, which they are running with Cerner.


Other

5-14-2013 10-34-31 PM

MaineHealth President and CEO Jim Donovan tells patients of its St. Andrews Hospital that the hospital’s future direction wasn’t set by the decision to replace Meditech with Epic.

New York eHealth Collaborative names the winners of its Design Challenge for the Patient Portal for New Yorkers. Mana Health took first place.

In a Techonomy guest article, Jonathan Bush of athenahealth says VC funding of healthcare IT companies is “tragic” if you exclude HITECH, with the reason being (a) healthcare is not a shopper’s market; (b) the federal government stifles innovation and instead rewards risk aversion that he calls “the scenario of maximum regret” – audit, lawsuit, and death; (c) doctors are paid for volume instead of service, quality, and competitive pricing. His solutions aren’t nearly as decisive, but he naturally likes his own company’s innovation program.

An Arizona nurse sues her former physician business partner for blocking her access to their clinic’s computer systems, which she says prevented her from treating her patients.

Weird News Andy hopes his turn signals were working. A man accidentally amputates his arm while cleaning equipment, then puts it in the car and drives nine miles to the hospital, where he parks calmly in the parking lot, walks in, places the arm on the receptionist’s desk, and asks to have it reattached.

St. Luke’s Hospital (AZ) finds a 19-year-old student passed out in a wheelchair in its ED lobby, left there by his friends after 20 shots of tequila with a 0.47 percent blood alcohol level and a Post-It note stuck to him explaining that he had been involved in a drinking contest.


Sponsor Updates

  • Ping Identity CEO Andre Durand discusses how creating the right circumstances can lead to “eureka moments.”
  • Informatica introduces Informatica Cloud Summer 2013, the latest release of its integration and data management software which delivers native SAP connectivity, process automation, and MDM advances.
  • Caradigm signs an OEM agreement for BIO-key International’s fingerprint biometric technology for identity and access management.
  • McKesson expands its McKesson Gives Back Program nationwide and will provide up to 100 selected physicians with the McKesson Practice Choice EHR/PM program.
  • Impact Advisors principal Laura Kreofsky predicts that most organizations will experience Meaningful Use fatigue by 2015.
  • Winthrop Resources will participate in the International MUSE 2013 event May 28-31 in National Harbor, MD.
  • NTT Data will participate in the Open Data Center Alliance’s Forecast 2013 event in San Francisco June 17-18.
  • MedAssets calls for exhibitors for the 2013 Technology & Innovation Forum October 1 in Orlando. Deadline for submissions is June 3.
  • Bruce Eckert, national practice director for Beacon Partners, discusses habits of meaningful EHR users at the Arkansas HIMSS conference May 16.
  • Vitera Healthcare Solutions sponsored this week’s MediFuture 2023 that promoted disruptive innovation in healthcare in the Tampa Bay region.
  • Beacon Partners releases a white paper on the seven steps to know and do now to reach Meaningful Use Stage 2.
  • Intelligent InSites offers a white paper with tips for enterprise RTLS success and hosts a May 23 Webinar on the operational aspects of an intelligent hospital. 

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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May 14, 2013 News 1 Comment

News 5/8/13

May 7, 2013 News 8 Comments

Top News

5-7-2013 10-43-55 PM

McKesson reports Q4 results: revenue down 3.4 percent, adjusted EPS $1.45 vs. $2.09, missing expectations on both. In the earnings call, John Hammergren mentions that the company will exit its international technology and hospital automation business. I don’t know which product lines hospital automation includes, for instance whether that means the medication packaging and distribution systems business (ROBOT-Rx, AcuDose-RX, etc.) Technology solutions revenues were up 3 percent, but profit was down 16 percent, “well below our expectations.”


Reader Comments

From The PACS Designer: “Re: Windows 8. The unfriendly start menu for Windows 8 has Microsoft scrambling to fix the problem.” The company admits that its flagship product has a steep learning curve as it forced users to use its touchscreen-friendly tile-based graphical system instead of giving them the familiar Start button.

From Kaye: “Re: HIStalk sponsorship. This remains the best value we get for the money in advertising!” Thanks – that’s a nice comment and we appreciate it, especially coming from a company that has sponsored multiple HIStalk sites since 2009.

5-7-2013 10-45-46 PM

From Anesthesiologist: “Re: Google Glass. How can I partner with companies to develop applications that might be useful in the perioperative setting?” If you’re interested in working with this doc, e-mail me and I’ll forward to him.

From Arcane: “Re: Epic implementation. Do you know of a source for rollout and post-live support staffing numbers?” I have many readers and consulting firms that have implemented Epic, so please add a comment with your thoughts.


Acquisitions, Funding, Business, and Stock

5-7-2013 10-46-35 PM

Greenway reports Q3 results: revenue up 3 percent, adjusted EPS $0.01 vs. $0.08, beating earnings estimates of –$0.02  but falling well short of revenue expectations. The company blames a faster-than-expected shift to subscription-based pricing. Shares are near their 52-week low. President and CEO Tee Green also said in the earnings call that with HITECH in the rear-view mirror, buyer fatigue has set in over the past several quarters. Training revenue was also impacted, he said, by customers choosing train-the-trainer and pushing training back to after the quarter’s close.  He also said that Greenway’s participation in CommonWell hasn’t resulted in any sales (without expressing puzzlement at the analyst who apparently thought it might) but said more companies are signing on.

5-7-2013 10-47-20 PM

InstaMed raises $3.5 million in an internal round of funding.

5-7-2013 10-48-05 PM

Healthcare transaction processing firm MediSwipe signs a term sheet with a Chicago-based PE fund to receive up to $600,000 over the next nine months.

5-7-2013 10-48-35 PM

Vocera Communications reports Q1 numbers: revenue down 3.1 percent, EPS –$0.14 vs. -$0.08. CEO and Chairman Bob Zollars says the company saw an increase in new customer signings but did not complete several significant hospital deals.

Siemens Healthcare posts a 4.9 percent increase in Q1 profits, although revenues fell 2 percent.

5-7-2013 10-50-27 PM

Qualcomm Life acquires HealthyCircles, a startup that supports the secure sharing of patient data.

WebMD CEO Cavan Redmond, who has been on the job less than a year, will leave the company, along with CFO Anthony Vuolo.

Perceptive Software blames recent acquisitions for its decision to lay off about 40 employees, or three percent of its workforce.


Sales

5-7-2013 10-51-42 PM

Massachusetts General Hospital selects eHealth Connect Referral Portal from eHealth Technologies to support two-way communication between the hospital and its referring doctors.

East Kent Hospitals University NHS Foundation Trust chooses Harris Corporation’s Clinical Integration Platform to integrate data from six clinical systems across five sites. East Kent will also use Imprivata’s OneSign single sign- on technology.

Upper Peninsula Home Health, Hospice and Private Duty (MI) will implement the Procura for Hospice solution.

SCL Health System (CO) selects Leap-10 from Wolters Kluwer Health to streamline its conversion to ICD-10.

Amarillo Legacy Medical ACO (TX) selects eClinicalWorks Care Coordination Medical Record to advance its ACO objectives and coordinate care among its 100+ provider members.

Physical Rehabilitation Network will deploy NextGen Healthcare’s EHR, PM, PatientPortal, and NextPen products across its 100+ locations and use NextGenRCM Services for revenue cycle management.

Virtual Radiologic signs a five-year deal with Visage Imaging to implement Visage 7 Enterprise Imaging Platform for its 400 radiologists in a read-anywhere environment.


People

5-7-2013 10-38-08 AM

Ernst & Young names Intellect Resources President and CEO Tiffany Crenshaw a finalist for Entrepreneur of the Year 2013 in the Southeast region.

5-7-2013 11-09-04 AM

Former Cerner VP Ian Chuang, MD joins Netsmart Technology as CMO/VP of healthcare informatics.

5-7-2013 11-14-09 AM

Former National Coordinator Robert M. Kolodner, MD joins telehealth provider ViTel Net as VP/CMO.

5-7-2013 2-26-52 PM

Care Team Connect names Richard Popiel, MD (Regence BCBS) to its board.

5-7-2013 3-32-46 PM

Healthcare software solution provider MedicaSoft, LLC appoints Mike O’Neill (VA Center for Innovation) CEO.

5-7-2013 7-29-50 PM

Beebe Medical Center (DE) names Michael J. Maksymow, Jr. (Continuum Health Alliance) VP/CIO.

5-7-2013 10-27-30 PM 5-7-2013 10-28-38 PM

QPID hires Gary Zakon (ModelLogic) as VP of engineering and Caroline Smyth (Smyth Consulting) as VP of sales.

5-7-2013 8-31-06 PM 5-7-2013 8-31-57 PM

Eric J. Topol, MD is named editor-in-chief of Medscape. What’s most interesting to me is that his ongoing full-time employer Scripps Clinic apparently Photoshopped his black suit jacket to look like a white lab coat in the pictures above from their site.


Announcements and Implementations

Access is named as a Meditech Collaborative Solutions vendor, offering Meditech customers an integrated solution to capture and upload electronic signatures and data collected from clinical systems and medical devices.

5-7-2013 10-53-44 PM

Johns Hopkins Medicine integrates Epic with Hyland Software’s OnBase enterprise content management solution in its ambulatory and inpatient departments.

Philips launches Healthcare Transformation Services, a global business unit to provide consulting services to hospitals and health systems.

Trustwave introduces a mobile security practice to help enterprises with their BYOD strategies.

HCA MidAmerica Division equips seven hospitals and multiple physician offices in its Midwest region with Accelarad’s medical imaging solution.

Lifespan (RI) completes its rollout of the the TeamNotes electronic documentation system from Salar.

5-7-2013 8-07-30 PM

PerfectServe launches DocLink, a secure communications network for physician-to-physician communication.


Government and Politics

5-7-2013 10-21-35 AM

ONC publishes a governance framework for trusted health information exchange to help HIEs and other healthcare organizations understand ONC’s priorities and how to align with “national priorities.”

5-7-2013 10-54-20 AM

CHIME recommends in a letter to six Republican senators a one-year extension for Stage 2 MU before progressing to Stage 3. CHIME contends the extra year will give providers the opportunity to maximize their EHR technology to achieve the benefits of Stage 1 and 2 and give vendors time to “prepare, develop and deliver needed technology to correspond with Stage 3.”

5-7-2013 9-10-19 PM

Deputy National Coordinator Judy Murphy, RN kicks off National Nurses Week with a blog post on the role of nurses in healthcare IT and an invitation for nurses to share their stories.


Innovation and Research

5-7-2013 8-55-50 PM

UCSF creates the Center for Digital Health Information. It will be led by UCSF Medical Center CMIO Michael Blum, MD, who will assume the newly created position of associate vice chancellor for informatics and who will continue to lead its Epic implementation (physician leaders of the project are pictured above, with Blum on the left). Current projects include a team-based communications platform, an open source diabetes management system, a Web-based collaboration tool for virtual tumor boards, and a social media-based cardiovascular study.

Kaiser Permanente Center for Total Health will hold a Google Glass event in Washington, DC the evening of June 18.

5-7-2013 10-17-39 PM

South Carolina-based Iron Yard launches the Digital Health Program accelerator and incubator in the Spartanburg area.


Technology

Bloomberg TV covers the technology used by Palomar Medical Center (CA) and the "hospital of the future.” Palomar Health Chief Innovation Officer Orlando Portale is featured.


Other

An Imprivata-sponsored study finds that clinicians waste 45 minutes per day in using inefficient communication systems such as pagers.

Hospital IT leaders are focused on accommodating greater mobile and wireless connectivity to their networks and with ensuring the security of patient data in BYOD environments, according to a HIMSS Analytics study.

5-7-2013 8-13-09 PM

A Raleigh, NC clinic warns patients that it was scammed by a company that claimed it would digitize the practice’s old X-rays, but instead harvested their silver content and then destroyed the films.

5-7-2013 10-56-14 PM

University of Rochester Medical Center warns 537 patients that their PHI may have been compromised when a resident lost a USB drive containing quality improvement information. The hospital thinks it went to the laundry and was destroyed.

John Halamka reports on new Meditech 6.1 development after mixed response to Version 6: a cloud-hosted system based on standards, Web-centric and mobile-enabled, with both inpatient and outpatient capabilities, complete with analytics, a PHR, and care management tools. He says it will ship in 2014.

5-7-2013 9-01-55 PM

Drug chain CVS shuts down its drug company-sponsored refill reminder program because of limitations imposed by the new HIPAA Omnibus Rule on using patient information for marketing.

Weird News Andy refers to this story as “brain drain.” A man who thought his year-round runny nose was caused by allergies finds that it’s actually brain fluid leaking from a tiny hole. It’s been fixed and he’s fine. WNA also likes this story, in which researchers claim to have found the cause of graying hair (hydrogen peroxide buildup in the hair follicle) and a cure for both gray hair and vitiligo (a proprietary treatment involving a UV-activated enzyme).


Sponsor Updates

5-7-2013 10-36-38 PM

 

  • API Healthcare and The DAISY Foundation offer The Nurses Week Story Contest, with submissions from nurses due May 12.
  • McKesson releases version 13.0 of its Homecare solution.
  • Orion posts a video featuring Orion clients that have solved interoperability challenges.
  • More than 200 hospitals using CareWorks content management system from CareTech Solutions have received 32 Website awards in the past year.
  • Truven Health Analytics finds that healthcare spending is 20 percent higher for public sector employees than for the private employee population.
  • Passport Health Communications names Texas Health Resources, Trinity Medical Center (AL), and Kadlec Regional Medical Center (VA) winners of its Leaders at the Forefront of the Healthcare Experience contest for best healthcare access management practices.
  • Gwinnett Medical Center (GA) discusses how using RelayHealth services helped the hospital remove patient billing obstacles.
  • iHT2 hosts a May 29 Webinar on security, privacy, and compliance risks in a post-reform era.
  • Greenway Medical President and CEO Tee Green discusses the compatibility of innovation and other topics with PGA tour partner Jason Dufner.
  • Red Herring names Kony Solutions a finalist for its Top 100 North America award, which honors the year’s most promising private technology ventures.
  • EBSCO announces its intent to collaborate with the American College of Physicians to give ACP access to its DynaMed evidence-based clinical summary resources and literature surveillance.
  • Gartner names Health Catalyst to its list of Cool Vendors in Healthcare Providers 2013 and profiles Shareable Ink in its update on 2011 winners.
  • Greenway Medical releases agenda details for its PrimeLEADER 2013 user conference in Washington, DC August 22-25.
  • CommVault launches a customer education services program that includes customized user training and access to online training courses for its Simpana software.
  • ADP launches a Website to help clients and other employers plan for and comply with the Affordable Care Act.
  • Nuance names seven healthcare organizations winners of its Voice of the Customer award for improving quality of care, reducing costs, and accelerating EMR adoption using speech recognition and clinical language technology.
  • CCHIT extends EHR Module certification to the latest version of the Medseek Empower patient portal.
  • TELUS Health and McGill University enter a three-year joint venture to conduct research on how best to use technology to improve health and healthcare delivery for Canadians.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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May 7, 2013 News 8 Comments

Morning Headlines 5/6/13

May 5, 2013 Headlines 1 Comment

Two Cerner live sites go to tender

In England, two NHS hospitals release an RFP seeking a replacement for their Cerner systems.

AMA says EHRs create ‘appalling Catch-22′ for docs

Steven Stack, MD, chair of the AMA board of trustees. spoke at a CMS listening session on billing and coding within an EHR system. He questioned the government’s mandating the use of EHRs while simultaneously orchestrating a witch hunt over cut-and-paste fraud accusations associated with physician documentation. Sack points to the generic, nearly uniform output of EHR documentation systems for causing a false perception fraud.

TriZetto Corporation Announces Reorganization of Leadership Team

TriZetto announces an executive reorganization as CEO Trace Devanny departs immediately leaving an empty seat that will be temporarily filled by TriZetto board member Vicky Gregg. An executive search is underway for a permanent replacement for Devanny. Jude Dieterman, formerly EVP and COO, has been promoted to the newly created role of president.

Govt moves to roll out ambitious e-health plan

The health department in India has issued an RFP for its recently announced e-health plan, which calls for each citizen to have a health card to hold demographic data and an integrated EHR that will automate hospital processes and bring all information into a centralized state health information system.

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May 5, 2013 Headlines 1 Comment

Monday Morning Update 5/6/13

May 5, 2013 News 16 Comments

5-4-2013 3-43-24 PM

From MaineMan: “Re: MaineHealth / Maine Medical Center. Names interim CIO.” According to the March 25 employee newsletter, Andy Crowder (JC Solutions Group and Florida Hospital before that) is serving as interim CIO.

From The PACS Designer: “R: Intel’s Haswell. We are about to enter a much faster PC user experience with architecture from Intel called Haswell. One of the key features is Haswell provides is a nine-hour battery life through the use of more efficient chips. You can expect to see Haswell powered PC’s in the fourth quarter.” The article says the chip may revive the rapidly dying PC business by making them more competitive with tablets. Of course, that’s what Intel said about the Ultrabook, which hasn’t made Intel-powered laptops a bit more attractive vs. a Macbook Air or an iPad.

5-4-2013 2-00-21 PM

Three-quarters of respondents don’t think it makes sense for innovation conferences to exclude hospitals and physicians under the assumption that they helped cause the problems that seen to require more innovative approaches. New poll to your right: several hospitals have reported financial losses that occurred as they were implementing an EHR. Who is to blame?

Thanks to the following sponsors, new and renewing, that have recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.

5-5-2013 9-32-33 AM
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5-5-2013 9-30-42 AM

Two NHS trusts running NPfIT’s Cerner implementation issue tenders for replacement systems.

5-4-2013 2-51-08 PM

Centegra (IL) will go live on McKesson Paragon on May 6.

Some quotes from Jonathan Bush during the athenahealth earnings call Friday:

  • The company that started as an ill-fated birthing clinic and used to hold all-hands meetings from the tailgate of the Jeep Wagoneer is entering the big show. We have done well at the land war that is selling back office services doctor-to-doctor and hospital-to-hospital, but for the first time, we have a crack at the hearts and minds campaign.
  • Take athenaCoordinator. It is a really easy way for any health caregiver to connect to every other one without the complexity of an organ transplant. It is a two-week sales cycle and a two-hour implementation process.
  • We’ve already just announced today Epocrates EDU, which is a whole version of Epocrates to help educators, medical schools, the texting that we are going to be rolling out, secure HIPAA-compliant, patient-related texting between doctors. We’ll be able to attach links to athenaClinicals next year so that doctors who aren’t clients of athenaClinicals will be able to take a quick look at a patient face sheet in athenaClinicals.
  • I think we are seeing — particularly the folks who got pregnant with Epic, sort of they’re going to this sort of desperate burn-bright tactics. We heard where Yale-New Haven has told all the doctors that have privileges that they will either this piece of shit Epic that none of them want or do you have their privileges revoked. So there’s that kind of tactic going on. "Oh, we can’t interface." I’m like, "What you mean? Epic interfaces all the time. They actually do it really well." … The folks that have gone off and laid down more money than they have on Epic have, in the back of their mind, that they are going to make a real impact on referral patterns by getting doctors on to Epic that don’t want to be on it. And it’s — really, Epic is the only one. Cerner builds interfaces, no problem.

5-4-2013 3-19-19 PM

TriZetto announces that CEO Trace Devanny will leave the company immediately after two years on the job “to pursue other opportunities” as a search is undertaken for his replacement. EVP/COO Jude Dieterman is promoted to president, a newly created role. Board member Vicky Gregg will assume the role of non-executive chair.

Intermountain Healthcare is working with Blue Cirrus Consulting to develop a homegrown tele-ICU solution.

UCSF lauches MeForYou.org at the OME Precision Medicine Summit. The precision medicine project will link people with genetically similar others via their genomic information, environmental factors, and their EHR information to help guide clinicians. They differentiate it from personalized medicine in that in precision medicine, the information used goes beyond genomic data and scientists can tap into that information directly to guide research and treatment.

5-4-2013 4-41-19 PM

Team Break Fix won the $25,000 grand prize at the Cajun Codefest 2.0 in Lafayette, LA last week.

Weird News Andy says this gives heart attacks the finger. The EndoPat test predicts heart problems by checking blood flow in the fingers.

Vince has a Part 3 installment on GE Healthcare in this week’s HIS-tory.


Sponsor Updates

  • Cynthia Davis, RN, co-founder and principal of CIC Advisory, is named Entrepreneur Woman of the Year by the St. Petersburg (FL) Area Chamber of Commerce Women’s Leadership Council.
  • Allscripts posts the agenda for its ACE conference, to be held August 20-23 in Chicago.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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May 5, 2013 News 16 Comments

News 5/3/13

May 2, 2013 News 2 Comments

Top News

5-2-2013 10-44-47 PM

A selectman and software developer from Edgecomb, ME blames MaineHealth’s decision to close a local ER on the health system’s $150 million Epic implementation. The selectman’s letter to the editor to the local newspaper notes that MaineHealth has charged “millions of dollars” to member hospitals, but has had “a real failure in its implementation,” resulting in unplanned operational costs with minimal benefit to the state. Meanwhile, in a memo to employees last week, Maine Medical Center’s CEO listed several causes for its $13.4 million loss in the first half of the fiscal year, including “unintended financial consequences” of its Epic rollout as well as incorrect charging. The organization has placed further Epic implementations on hold as teams from Epic and the hospital try to fix problems.


HIStalk Announcements and Requests

inga_small A few HIStalk Practice highlights from the last week: patients say the most bothersome aspect of doctor visits is unclear or incomplete explanations of problems. Health Texas Provider Network partners with MediMobile for its mobile charge capture solution. The number of physician office jobs for billers and medical record clerks has declined sharply over the last two years. Epocrates is the most popular mobile app among US physician app users. Athenahealth names St. Boniface Haiti Foundation the winner of its 2013 Vision Award. Physicians are generally making more money this year than last, but are also spending more time on paperwork. Most news items on HIStalk Practice are not mentioned HIStalk, so peruse HIStalk Practice regularly to stay current on the ambulatory HIT world. Thanks for reading.

On the sponsor-only Jobs Page: Regional Sales Director, Senior Director of Business Development, Senior Manager Engineering Development, Open Positions in Development.


Acquisitions, Funding, Business, and Stock

5-2-2013 10-45-35 PM

Merge Healthcare reports Q1 results: revenue up 4.3 percent, EPS –$0.07 vs. –$0.02, missing earnings estimates.

5-2-2013 10-46-12 PM

API Healthcare announces the signing of over 25 contracts in Q1 and bookings that were 25 percent higher than the same period in  2012.

5-2-2013 10-48-26 PM

MedAssets announces Q1 numbers: revenue up 15.3 percent, adjusted EPS $0.41 vs. $0.24, beating expectations on both.

5-2-2013 10-49-46 PM

Athenahealth announces Q1 results: revenue up 30 percent, adjusted EPS $0.38 vs. $0.17, beating on both but adjusting fiscal year EPS guidance to below consensus.


Sales

5-2-2013 10-51-29 PM

University of Nevada School of Medicine chooses GE Healthcare’s Centricity Business, Centricity Practice Solution, and Centricity PACS-IW.

Filmore County Hospital (NE) selects NextGen Healthcare’s Inpatient Clinicals and Inpatient Financials.

Baylor Quality Alliance (TX) chooses Humedica MinedShare from Optum to analyze administrative and clinical data from payers, various EHRs, and the Baylor Health Care System HIE.

Louisiana Specialty Hospital will implement ONE-Electronic Health Record from RazorInsights. 

5-3-2013 7-08-25 AM

MD Anderson Cancer Center (TX) chooses Epic as its vendor of choice, according to an internal memo forwarded by a reader. Other readers had reported that same rumor late last week, saying that Epic had beaten Cerner as VOC.


People

5-2-2013 6-25-04 PM

UNC Health Care (NC) interim CIO Tracy Parham, RN is named permanent CIO, where she will lead its Epic project.

5-2-2013 6-47-56 PM

Parallon Business Solutions names John Guevara (Allscripts ) as CIO.

5-2-2013 7-14-00 PM

Patient Privacy Rights names Adrian Gropper, MD (HealthURL Consulting) as CTO.

5-2-2013 7-48-03 PM

Stephen Collins (Allscripts) is named president of Austin-based behavioral charting system vendor ChartAssist.

5-2-2013 8-07-48 PM

The Advisory Board Company CEO Robert Musslewhite is named by Washingtonian as one of its 100 Tech Titans and is also profiled in a feature in The New York Times.

Galen Healthcare Solutions appoints Joel Splan (Northwestern Memorial Healthcare) as CEO.


Announcements and Implementations

Rockdale Medical Center (GA) implements Nuance’s PowerScribe 360 voice recognition software for the dictation of imaging reports.

5-2-2013 8-53-10 AM

PointClear will move its corporate headquarters from Huntsville, AL to Dunwoody, GA.

5-2-2013 11-02-55 AM

McKesson recognizes Peninsula Regional Medical Center (MD) as the 2013 winner of its Distinguished Achievement Award for Clinical Excellence for effectively using McKesson technology along with Modified Early Warning Scores to proactively identify patients at risk for a code blue.

Aprima Medical Software will interface its EHR/PM system with the Homecare Homebase platform.

LHP Hospital Group implements McKesson’s Paragon HIS at Portneuf Medical Center (ID), Seton Medical Center Harker Heights (TX), and Texas Health Presbyterian Hospital WNJ (TX).

Elsevier launches its third annual “Superheroes of Nursing” contest and is accepting nominations for applicants in the categories of Achiever, Protector, Educator, Validator, and Connector.

SCI Solutions adds text appointment reminders to its Schedule Maximizer scheduling solution.

Modern Healthcare has corrected its article about the State of West Virginia’s payments to Medsphere for implementing OpenVista. The originally reported figure was $8.4 million per year, but that was actually the total amount spent since the contract was signed in 2005. Current payments are just under $1 million per year.

5-2-2013 10-54-20 PM

Mount Sinai Medical Center (NY) announces that it has enrolled 25,000 patients in its BioMe program, which links DNA samples to its Epic EMR information to support targeted medical care and to provide de-identified data for research. 

First Databank announces ICD-10 for Saudi Arabia at the HIMSS Middle East conference.


Government and Politics

5-2-2013 6-30-10 PM

HHS names Lyfechannel the winner of its healthfinder.gov Mobile App Challenge for its myfamily app, which helps individuals manage their family’s health through customized prevention information for each family member.

Healthcare modeling and analytics company Archimedes collaborates with CMS to give users easier access to public payer claims data.

5-2-2013 3-29-16 PM

CMS announces that hospitals and EPs have been paid $13.7 billion through the end of March, with $8.5 billion going to 8,558 hospitals and $5.2 billion to 255,722 EPs.

FDA launches the redesigned FDA Patient Network, which will educate patients and their advocates about FDA and will invite them to attend and present at FDA meetings.

Farzad Mostashari was a panelist in a discussion of technology in healthcare put on by Politico last week. The 77-minute video is of very high quality and it’s an interesting mix of people and topics.

5-2-2013 11-08-05 PM

CMS gets criticism for removing information on hospital-acquired conditions from its Hospital Compare site. CMS says the information is flawed and is redundant, but patient groups say CMS is buckling to the complaints of low-performing, high-profile hospitals.


Innovation and Research

Vanderbilt University launches the Health App Challenge to transform clinical summaries into a more patient-friendly form. Entries are due August 1, with the winner receiving $10,000 and up to five finalists being awarded $2,000 or more each.


Technology

5-2-2013 9-43-07 PM

Former Google Health product manager Missy Krasner, now involved in startups and an advisor to Box, says Google Health was a good idea in theory, but “It was a very bumpy user experience for even the most super-charged, IT savvy consumer.” She says Box will take over where Google Health left off for storing personal health records that it supports HIPAA requirements. She concludes, “So here is my hope for the future. If most EHRs can currently export a Continuity of Care Document (CCD) via the Clinical Document Architecture (CDA), why couldn’t Box grab that clinical care summary format and stylize it in a way that made sense to other doctors or patients via its documenting previewing technology? This would help the interoperability and file transfer juggernaut get a whole lot easier.”

FastCompany profiles companies started by founders who were frustrated with existing products, among them Amazing Charts.


Other

5-2-2013 9-48-14 AM

KLAS reports on the post-acute care market, which is critical for managing outcomes and costs. HealthMEDX was named the top performer among long-term care vendors with 100 percent of its customers saying the company keeps its promises and that they would buy HealthMEDX Vision again.

Weird News Andy summarizes this article as “coming clean.” Piedmont Healthcare (GA) admits that for two years it improperly cleaned colonoscopy requirement at one of its ambulatory surgery centers, requiring it to notify 456 patients that they should be tested for hepatitis and HIV. Employees cleaned the equipment with soap, but missed the disinfectant step.


Sponsor Updates

  • T-System posts a photo gallery from its linkED 2013 Emergency Care Conference held in Dallas April 22-25.
  • Emdat posts a case study from Illinois Bone and Joint Institute, which reduced documentation costs by 50 percent by implementing Emdat’s transcription software and the company’s mobile documentation tool.
  • The Nashville Business Journal names Passport CEO Scott MacKenzie one of the most influential business executives in Middle Tennessee.
  • First Databank hosts a May 14 Webinar on the use of RxNorm within information exchange and clinical quality measures.
  • Kareo offers a May 16 Webinar that considers five activities to prevent a government audit.
  • Executives from Yale-New Haven Health System, Hartford HealthCare, and North Shore-LIJ Health System will share strategies to reduce readmissions at the iHT2 Summit in New York City on September 17-18.
  • Porter Research posts a presentation that provides insight into the trends, challenges, and benefits of engaging consumers in every stage of healthcare.
  • Capsule Tech will exhibit at the annual MUSE conference May 28-31 in Washington, DC.
  • Truven Health Analytics receives a five-year accreditation from the National Institute for Health and Care Excellence for its Micromedex Medication Management solution.
  • The National Committee for Quality Assurance certifies Verisk Health’s Quality Intelligence solution to support quality reporting for commercial and Medicare Advantage populations in the California P4P program.
  • As part of this week’s Medical Library Association Annual Meeting and Exhibition in Boston, Elsevier pledges to donate $1 to One Laptop Per Child for every ClinicalKey search made at Elsevier’s booth.
  • Allscripts releases details on its annual ACE client conference in Chicago August 21-23.
  • Liaison Healthcare launches its EHR Partner Program, which give participants access to orders and results connectivity to over 100 major lab and radiology service providers.

EPtalk by Dr. Jayne

HIMSS opens the call for proposals for the 2014 conference in Orlando with 24 topic categories. If you’re like many of us in the non-profit trenches, being selected as a presenter may be the only way to go to a meeting, so good luck!

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The hot topic in the physician lounge this week was HR 1701, the “Cutting Costly Codes Act of 2013.” Introduced by Representative Poe of Texas last week, it aims to block ICD-10 implementation. What surprises me most was the number of physicians who think the mere introduction of a bill will support their lack of preparation for ICD-10. News flash – if you haven’t started preparing, you’re already behind, and I certainly wouldn’t wait around to see if this becomes law before I get started.

It’s not health IT, but it’s my favorite story this week: “untethered microgrippers.” Engineers at Johns Hopkins are working on miniature devices to retrieve biopsy specimens. Although they’re not quite ready for human testing, they look cool and are promising as a mechanism to take multiple biopsies in hard-to-reach areas.

I almost missed this little tidbit in the Federal Register that would allow use of eight CMS record systems for emergency preparedness. The change would allow CMS to disclose individually identifiable records to “public health authorities and entities acting under a delegation of authority of a public health authority” for the purpose of providing health assistance in an emergency or disaster.

CMS issues a Call for Measures for potential Quality Reporting System items to be used in future rule-making years. CMS is focusing on measures that cover clinical outcomes, patient-reported outcomes, care coordination, safety, appropriateness, efficiency, patient experience, and patient engagement. Submissions must have strong scientific evidence, so I guess my “number of patients seen on time because they weren’t yakking on their phone when I entered the room” measure won’t make the cut.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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May 2, 2013 News 2 Comments

Morning Headlines 5/2/13

May 1, 2013 Headlines 1 Comment

Trinity Health, Catholic Health East complete merger deal 

Trinity Health Systems and Catholic Health East have completed a merger that will make the new 79-hospital organization the second largest not-for-profit system in the country. Interim CEO Judith Persichilli recently said that the new organization will choose which EHR can best support their needs. Trinity uses Cerner, while Catholic Health East runs Meditech.

Project seeking ways to detect diabetes

New York University, NYU Langone Medical Center, and Blue Cross will collaborate on a project to develop machine-learning algorithms to identify cases of undiagnosed diabetes and to predict pre-diabetes.

The Defense-VA-Vendor Conference Nobody Wants You To Know About

The VA and DoD are holding a joint conference with EHR vendors to discuss the stalled iEHR project. The meeting will feature high-ranking speakers from both departments as well as representation from any vendor that expresses an interest in attending. The press has been explicitly prohibited from attending.

Finalists Announced!

The New York eHealth Collaborative’s Patient Portal For New Yorkers project announces nine finalists in its search for a statewide integrated patient portal. The finalists were selected by public voting and will pitch their products to a live audience and a panel of judges.

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May 1, 2013 Headlines 1 Comment

Readers Write: Are Hospital EHR Vendors Primarily Software or Services Companies?

Are Hospital EHR Vendors Primarily Software or Services Companies?
By Kyle Samani

Hospital EHR vendors are not primarily software companies with professional services divisions. They are primarily professional service companies with software divisions.

Although the core value of hospital EHR companies is the software they develop, the bulk of the value they provide is in training, data conversion, setup, logistics, and support. These services are built on top of the software that they support, but are collectively more valuable than the software itself.

I’ve seen the challenge of deploying an EHR in a hospital first hand. Most of the challenges are with the people, not the software. Hospital EHR vendors derive most of their value for their professional services.

Hospital EHR vendors employ more services staff than software staff. At least 60 percent of the employees at the major hospital EHR vendors are in deployment and support services, not software design, development, testing, or administrative functions. Employees, especially road warriors, are expensive. The more employees involved in a given division, the more expensive and valuable that division is.

But perhaps even more important than sheer costs, healthcare IT staff need to receive sophisticated training in hospital workflows and software systems. Before the HITECH Act, there weren’t enough people with healthcare IT skills to deploy the entire country in five or six years. Many argue that there still aren’t enough people. The EHR vendors had to develop large-scale internal training programs to teach all of these people how to set up, train, deploy, and support hospitals. This is one of the greatest sources of value that the big EHR vendors have generated: an educated healthcare IT workforce. The scale and scope at which they’ve done that has been remarkable.

Epic employs 6,400 people and Cerner 11,900. I would estimate that at least 60 percent of those – or 11,000 people in just these two companies – work in training, deployment, and support roles. These companies and many others have developed phenomenally large internal training programs for their employees, who are usually fresh college graduates.

To provide a sense of scale, the University of Texas at Austin — one of the largest universities in the country by enrollment (60,000+ students) and located in a major US technology center — boasts that it has graduated a grand total of 333 people in its 9-10-week-long healthcare IT program since its inception a few years ago. Vendors are educating the workforce, not the educational system.

Training and conversion costs usually prevent hospitals from switching EHRs. These costs are multi-dimensional, spanning financial cost, employee personal costs, and opportunity cost of working through other initiatives such as Meaningful Use 2 and ICD-10.

As an employee at a smaller hospital EHR vendor, I’ve experienced this phenomenon. We are trying to spearhead the replacement market for hospitals that are dissatisfied with their legacy EHRs. Most of them love our product and are even willing to pay, but aren’t willing to change systems because the non-financial costs of change are too great for the organization.

Because the costs of switching are high, the cost of choosing the wrong EHR the first time is even higher. Most large software projects that fail do so because of the people, processes, and cultures, not because the software isn’t capable. In that sense, the services surrounding the software implementation are even more important than the software itself. The majority of the value that the vendors provide is in services, not software.

Looking at hospital EHR vendors as service companies can help understand management decisions that may not have made sense when looking at them as software companies. Decisions are made based on training and deployment realities, not software limitations. This analytical framework can also help explain vendor practices and methodologies (especially hiring), release cycles, growth rates, stability, and many other operating metrics.

Kyle Samani is inpatient deployment manager at VersaSuite of Austin, TX.

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May 1, 2013 Readers Write 2 Comments

News 5/1/13

April 30, 2013 News 4 Comments

Top News

4-30-2013 7-09-06 PM

Greenway Medical announces that it will swing to a loss for the current fiscal year because of declining sales and deferred revenue. The company’s fiscal year earnings estimate of $0.10 to $0.17 on $145-$150 million in revenue was revised to a loss of $0.11 to $0.13 on revenue of $132-$134 million. The fiscal year ends June 30. Shares dropped from Friday’s $16.05 close to just above $12 by Tuesday morning, but had rebounded to $13.47 by Tuesday’s close. Above is the one-year GWAY share price (blue) vs. the S&P 500 (red).


Reader Comments

4-30-2013 10-18-31 PM

From Big Tex: “Re: Epic deals. St. David’s Healthcare in Austin and Methodist in Houston are both heading to Epic, though I don’t think either has officially announced yet.” Unverified.

From John: “Re: interesting comment from an FBR analyst covering Nuance’s poor earnings announcement. ‘While several industry/external (smart phone consolidation, transcription transition, EMEA weakness) factors have put pressure on mobile and healthcare growth, we believe the blame lies squarely around Nuance’s execution in the field, coupled with management’s feverish acquisition strategy over the last year, which has put onerous integration risks back into the Nuance story. While we believe potential activism could put a floor on Nuance shares and ultimately enhance shareholder value over time (e.g., management changes, split-up of the company, M&A path), we find it hard to remain positive on the Nuance story as the company goes through a challenging transition process in its business over the next six to nine months.’” Carl Icahn just announced that he’s loaded up on more shares, so the surprisingly poor results for both revenue and earnings help make his eventual argument that the company should be broken up or sold outright.

4-30-2013 8-17-49 PM

From Mr. Eko: “Re: HIMSS Middle East. Started Monday. Some American-based companies there are Cerner, GE, and Medicity. Judy Faulkner, CEO of Epic, was spotted yesterday morning eating breakfast in the Four Seasons hotel. Rumor has it they are pitching to the Ministry of Health for Saudi Arabia.”

From Giles: “Re: healthcare IT decision making. Interesting reader comments. What’s your opinion?” I agree with some of the comments that healthcare organizations are quicker to promote and retain executives who wouldn’t qualify for comparable jobs in most other industries based on their education and experience. However, healthcare is a different world, trying to balance the demands of an increasingly interventionist government, regulators, special interests, politicians, clinicians, community leaders, and giant insurance companies with the patients and families who are hardly typical customers. I’ve seen cases where hotshot IT people from allegedly more progressive sectors were brought in with near disastrous results, even though the IT shop looked like a showcase on paper. Some healthcare CIOs are not very good at strategic planning, management, and customer engagement, but they have a small domain with minimal clout and high operating and capital expenses due to decisions almost always made by someone else with more influence. Healthcare CIOs also aren’t given a lot of unilateral decision-making over anything other than infrastructure – everybody likes to suggest and approve massive change management projects that get incorrectly tagged as IT initiatives, but those folks disappear when their own lack of leadership ability starts sending the project down the drain due to poor user acceptance, lack of resources, and poor project decisions. My opinion, therefore, is that healthcare IT leaders aren’t empowered to make a lot of decisions on their own, are struggling to deal with the mess foisted upon them by their fellow executives and third parties, and are trying to deal with the squeeze of ever-increasing demand with an ever-decreasing budget. I’m fairly certain that swapping them out with fat-resume private sector CIOs wouldn’t make much difference on the plus side of the ledger, but would cause all kinds of unintended consequences to patient care. It’s easy to shoot the messenger, and with regard to many high-profile projects, that’s all the CIO is allowed to be. If nothing else, consider the high degree of CIO turnover – if all it took was new people in the chair, you’d be seeing wide swings in success from that alone and that’s not the case.


HIStalk Announcements and Requests

Nick van Terheyden, MBBS, CMIO of Nuance, posted the cool photo above on Twitter. If you’re traveling anywhere interesting, send a fun local photo with something that identifies HIStalk and I’ll run it here.

4-30-2013 8-00-00 PM

Welcome to new HIStalk Gold Sponsor Porter Research, A Billian Company. The company provides its clients with customized market intelligence and research insight that includes go-to-market strategy, focus groups, win-loss analysis, prospect profiling and lead generation, competitive analysis, customer and market analysis, and M&A research. Don Graham (GM of both Porter Research and Billian’s HealthDATA) and Cynthia Porter (president) have many years of industry experience with major healthcare IT firms. The company offers a brochure, case studies, a newsletter, and white papers that illustrate its expertise. Thanks to Porter Research for supporting HIStalk.


Acquisitions, Funding, Business, and Stock

4-30-2013 7-39-52 PM

Emdeon completes re-pricing of its existing senior secured credit facilities, securing lower interest rates on its term and revolving loans.

4-30-2013 7-38-31 PM

Nuance reports Q2 results: revenue up 15.9 percent, EPS $0.34 vs. $0.43, missing estimates on both and sending shares down 18 percent and increasing speculation that activist investor Carl Icahn will use his recently acquired 10.7 percent of the company’s shares to force a breakup.

4-30-2013 7-47-17 PM

USARAD.com launches SecondOpinions.com, which offers same-day medical second opinions. Radiology-related reports range from $29 for an X-ray to $99 for an MRI. The company also offers second opinions for primary care, surgery, dermatology, and other services.

4-30-2013 9-10-16 PM

Forms automation vendor FormFast opens a UK-based subsidiary.


Sales

Trinity Health (MI) signs a multi-year agreement with Explorys for data analytics solutions.

Saint Mary’s Regional Medical Center (NV), Renown Health (NV), and Chandler Regional Medical Center (AZ) select MRO Corp.’s ROI Online platform to manage release of information.

West Florida ACO will deploy Sandlot Connect, Dimensions, and Metrix from Sandlot Solutions for patient health information management.

Methodist Health System (NE) selects Wolters Kluwer ProVation Medical software for its gastroenterology procedure documentation and coding.

Amerinet contracts with Cornerstone Advisors Group to provide HIT advisory and implementation services to its group purchasing members.

Tri-State Orthopaedics (IN) selects SRS EHR for its 24 providers.

4-30-2013 10-35-53 PM

Saudi Arabia’s King Fahd University Hospital will implement Nuance Healthcare Dragon Medical 360 | Network Edition hospital-wide.

The Cleveland Clinic’s MyPractice Healthcare Solutions will provide project management and implementation assistance to Glens Falls Hospital (NY) as it deploys Epic at its physician and specialty practices.


People

4-30-2013 12-25-15 PM

MedMatica Consulting Associates appoints Jerry Howell (KPMG) CEO and a member of the company’s board of directors.

4-30-2013 12-33-30 PM

Thomas H. Lee, MD (Partners HealthCare) joins Press Ganey as chief medical officer.

4-30-2013 12-54-50 PM

CSI Healthcare IT hires Martin O’Neil (Charts In Time) as health information management practice director.

4-30-2013 1-23-24 PM

Meditab Software appoints Adele Nasr (WebMetro) VP of marketing.

4-30-2013 7-55-42 PM

A. John Blair III, MD, CEO of EMR consulting firm MedAllies, is elected chair of independent Direct community DirectTrust.org.

4-30-2013 8-19-02 PM

Christopher Mansueti, former VP of client services for RelWare, died Friday, April 26 of amyotrophic lateral sclerosis. He was 53.


Announcements and Implementations

VHA, Inc. adds physician dashboards to enhance its VHA IMPERATIV Advantage performance improvement solution, which leverages transactional-level data through Truven Health Analytics and UHC.

MDI Achieve, provider of the MatrixCare EHR for long-term acute care, will integrate with Homecare Homebase, a provider of homecare and hospice technology solutions.

Heywood Hospital (MA) streamlines clinician workflow following its implementation of Accent On Integration’s Accelero Connect integration platform.

4-30-2013 3-38-00 PM

Samaritan Albany General Hospital (OR) moves from Meditech to Epic this week.

Transylvania Regional Hospital (NC) goes live on Cerner.

Children’s Hospitals and Clinics of Minnesota implements wireless data transmission between Cerner’s EMR and CareFusion’s infusion pumps.

PeriGen recognizes its client Banner Health (AZ) for reducing unnecessary early-term deliveries by 22 percent, earning the health system a Showcase in Excellence Award from the Arizona Quality Alliance.

Florida Hospital Tampa implements the EarlySense bedside patient monitoring system.

A Modern Healthcare article covers the State of West Virginia’s VistA implementation. It’s paying Medsphere $8.4 million per year for support and an unspecified amount to InterSystems for Cache’ licenses. The state also added financial systems from NTT DATA to replace VistA’s minimal capabilities. Update: Modern Healthcare issued a correction to this article – Medsphere has been paid $8.4 million over the life of the contract (since 2005), around $940,000 per year.

4-30-2013 9-37-04 PM

The Pittsburgh paper profiles Omnyx, a five-year-old digital pathology systems vendor formed as a joint venture between UPMC and GE Healthcare.


Government and Politics

Arizona lawmakers pass legislation that will require health insurers to pay for telemedicine treatment for certain specific conditions for patients living in 13 rural counties.

Rep. Ted Poe (R-TX) introduces a bill that would prohibit HHS from mandating providers to switch to ICD-10 code sets, which Poe contends would cost about $80,000 for individual doctors and $250,000 for practices with five to 10 physicians.

4-30-2013 3-33-08 PM

A bipartisan group of 67 senators sends President Obama a letter calling for him to be more directly involved in the VA’s disability claims backlog situation. The senators note that the average wait time for first-time disability claims is around 316 days, with a delay of up to 681 days in certain parts of the country. Of 900,000 pending claims, more than 600,000 are over 125 days old.


Innovation and Research

4-29-2013 2-10-36 PM

A peer-reviewed article published by the CDC finds that the interface technology of Intelligent Medical Objects is superior to population classification techniques as a disease surveillance tool. The findings are based on a study that showed IMO terminology service was 32 to 42 percent more accurate in identifying coronary heart disease compared to algorithms using reimbursement coding and classification techniques in identifying coronary heart disease.


Technology

AirStrip Technologies settles its patent dispute with MVisum, Inc., a competitor it accused of infringing on its patent for real-time viewing of patient data on mobile devices. MVisum agreed not to offer infringing products that include “streaming or displaying real time or near real-time patient physiological data.”

NextGen Healthcare launches Comparison Utility, a proprietary ICD-9/ICD-10 comparison tool that is available a no charge to its customers.

4-30-2013 9-04-40 PM

Healthcare Holdings Group acquires the exclusive rights to 3D-Practice’s patient education graphics technology, which it will embed in its ChartZoneMD EHR.


Other

Athenahealth and MIT’s H@cking Medicine host a May 4-5 Hack-a-Thon aimed at at bringing about disruptive and meaningful solutions to healthcare challenges.

4-30-2013 7-24-51 PM

Anthony Weiner, the former Congressman who resigned after admitting to sending sexually suggestive text messages and photos to several women, is making big money as a corporate consultant. One of his clients is EMR vendor CureMD.

4-30-2013 8-15-35 PM

Here’s Imprivata’s latest HIT cartoon.


Sponsor Updates
  • DrFirst publishes a white paper highlighting the 428 percent growth in e-prescribing for controlled substances.
  • Medseek holds the inaugural meeting of its Clinical Advisory Council , formed to enhance patient engagement.
  • MedAptus highlights three customers and their seamless integrations between the MedAptus charge capture solution and their EHRs.
  • GetWellNetwork recognizes 12 hospitals and individuals for improving clinical care and outcomes through the use of IPC technology.
  • Inland Northwest Health Services releases its 2012 Community Report.
  • Martin’s Point Health Care (ME) discusses how its use of PopulationManager by ForwardHealth Group has improved its ability to respond to patient needs, identify gaps in care, and make systemic changes based on performance.
  • Imprivata hosts May 9 Webinar introducing the benefits of OneSign for healthcare.
  • Nuesoft hosts a May 8 Webinar on  using technology to improve revenue cycle.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 30, 2013 News 4 Comments

Morning Headlines 4/26/13

April 25, 2013 Headlines 3 Comments

Cerner profit up as support, maintenance grows

Cerner reports Q1 results with a $110 million profit, up from $88 million, on $680 million in revenue. EPS $0.62 vs. $0.51. Support, maintenance and services revenue increased 16%, but system sales revenue dropped 12%.

Certification for electronic health record product revoked

ONC has revoked the EHR certification status of two EHRs, Santa Fe Springs Cali-based EHRMagic-Ambulatory and EHRMagic-Inpatient, after complaints from customers led auditors to discover that the platforms did not have the minimum required functionality and should never have passed certification tests in the first place.

Doctor: ‘I gave up on health care in America’

A family practice doctor from Colorado unwilling to comply with Meaningful Use requirements moves to Australia where he reports making $100,000 more than he made practicing in Colorado and with a much lighter schedule.

Nuance Communications Taps Goldman for Advice as Icahn Amasses Stake

Nuance has turned to Goldman Sachs for strategic guidance as billionaire Carl Icahn, known for his penchant for hostile corporate takeovers, continues to amass the company’s outstanding stock. Icahn currently holds a 9.3 percent stake in the company.

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April 25, 2013 Headlines 3 Comments

News 4/26/13

April 25, 2013 News 8 Comments

Top News

4-25-2013 7-33-10 PM

Cerner posts Q1 results: revenue up 6.1 percent, EPS $0.62 vs. $0.51, beating adjusted earnings estimates but falling short on revenue. A 12 percent decline in system sales was balanced by a 16 percent increase in support, maintenance, and service revenues. From the conference call, the company announced one win over Epic in the quarter, talked up its international business, and touted its population health management efforts. Neal Patterson participated, finishing up with, “You can see from the CommonWell Alliance that we use our leadership position in the industry for the greater good, but also to basically highlight where basically we have bad actors around subjects such as interoperability.”


Reader Comments

From Med Student: “Re: Meaningful Use Stage 3. If you could change anything in Stage 3, what would you include or cut out?” I’m curious about that myself, so please leave a comment with your thoughts.

From Herky: “Re: warm-blooded. Spotted at TEDMED last week, riding the bus together from the Kennedy Center to GWU for Great Challenges Day: Allscripts CEO Paul Black and former CEO Glen Tullman. I guess all those rumors about bad blood between the two were ill founded.”


HIStalk Announcements and Requests

inga_small Some hot news you may have missed this week on HIStalk Practice: compensation for medical directors is increasingly tied to quality metrics, as are job responsibilities. Advice for physicians engaging in Web-based messaging services. Details on athenahealth’s emergency response process, which was activated during last week’s manhunt for the Boston Marathon bombing suspects. EMR adoption by primary care physicians in Canada has doubled from 23 percent in 2006 to 56 percent in 2012. Rather than sell out to hospitals, practice management consultants offer alternate alignment models for consideration. Dr. Gregg puts his spin on the phrase that pays and playing in the healthcare sandbox. Take or moment or three to catch up on the latest ambulatory HIT news and sign up for e-mail updates while you are there. Thanks for reading.


Acquisitions, Funding, Business, and Stock

4-25-2013 7-30-54 PM

Hill-Rom Holdings reports Q2 results: revenue up three percent,  EPS $0.37 vs. $0.43.

4-25-2013 7-31-34 PM

Streamline Health’s Q4 numbers: revenue up 49 percent, EPS –$0.63 vs. $0.00.

4-25-2013 7-32-28 PM

Lexmark subsidiary Perceptive grew Q1 revenue 47 percent to $44 million.

4-25-2013 9-05-02 PM

Informatica reports Q1 results: revenue up 9 percent, EPS $0.16 vs. $0.24.

4-25-2013 9-08-55 PM

Qlik Technologies announces Q1 results: revenue up 22 percent, adjusted EPS –$0.09 vs. –$0.03, beating expectations on both.

Nuance seeks the advice of Goldman Sachs following the acquisition by activist investor Carl Ican of 9.3 percent of the company’s shares.


Sales

The Michigan Health Information Network partners with Surescripts to allow users of Surescripts’ Clinical Interoperability network to send electronic health information to the State of Michigan’s public health reporting system through the HIN and the Michigan Department of Community Health.

Presence Health (IL) awards Harris Corp. a three-year contract to create a private HIE.

4-25-2013 7-35-58 PM

The University of New Mexico Health Sciences Center purchases MDaudit Professional billing compliance software from Hayes Management Consulting.

Syracuse Community Health Center (NY) selects NextGen Healthcare’s Ambulatory EHR, PM, and Electronic Dental Record solutions for its 16-location FQHC.

MModal signs seven new hospitals and imaging centers for its Fluency for Imaging radiology workflow technology.

4-25-2013 7-35-00 PM

Fisher-Titus Medical Center (OH) selects Wolters Kluwer’s ProVation Order Sets.

UC Davis Medical Center (CA) selects TriZetto’s ClaimLogic as its claims processing solution, where it will integrate with Epic.


People

4-25-2013 6-17-53 PM

The Patient-Centered Outcomes Research Institute hires Bryan Luce (United BioSource Corporation) as chief science officer.

4-25-2013 6-18-33 PM

Interactive patient care system provider Skylight Healthcare Systems names Lisa Romano (TeleTracking Technologies) chief clinical officer.

Cleveland Clinic Innovations names its current GM of IT Commercialization Gary Fingerhut as the organization’s interim director, taking over for founding executive director Chris Coburn, who is heading to Partners HealthCare to lead innovation efforts.


Announcements and Implementations

Atlantic General Hospital (MD) implements Allscripts Sunrise.

Physicians’ Alliance of America launches iMedicor SocialHIE, giving its 34,000 physician members the ability to electronically exchange clinical information.

4-25-2013 9-57-08 PM

Athenahealth announces its marketplace for third-party solutions.

4-25-2013 8-24-52 PM

HCS, which offers the Interactant suite, launches a new logo and website.

UMass Memorial Health Care deploys MedAptus Technical Charge Capture.

4-25-2013 8-11-18 PM

Patient Logic launches its physician documentation system at three small hospitals. Its sister HealthTech companies are HMS and Medhost.

Children’s Specialized Hospital (NJ) launches GetWellNetwork’s GetWell Town interactive patient system, funded by a grant from L‘Oreal USA.

The physician informaticist who heads up MedAppLab in Germany says diagnostic or prescriptive smartphone apps present too many possible sources of error to be recommended for use, including the quality of peripherals such as headphones.

4-25-2013 8-54-16 PM

Online storage vendor Box says its product is now HIPAA compliant, also announcing 10 partner applications that include the drchrono EHR, in which Box has taken an undisclosed equity position.

Lott QA Group and HRS announce an ICD-10 testbed for coding and clinical documentation.

4-25-2013 7-37-03 PM

John Halamka says in his blog that Beth Israel Deaconess Medical Center will go live on its homegrown electronic medication administration record in June. He says it’s Web-based, mobile-friendly, and integrated into existing systems. It will support the use of iPhones for viewing, iPads to verify orders at the Omnicell cabinets, and wall-mounted computers with bar code readers for verification.


Government and Politics

CMS proposes raising the maximum reward for reporting Medicare fraud from $1,000 to $9.9 million; denying Medicare enrollment to providers affiliated with an entity that has unpaid Medicare debt; and denying or revoking billing privileges to individuals with felony convictions.



ONC revokes EHR certification on EHRMagic-Ambulatory and EHRMagic-Inpatient following notification that the products did not meet the required functionality and should not have passed certification. InfoGard Laboratories, which certified the products originally, retested them after reviewing additional information and gave them a failing score. Above is the reaction of Candid CIO Will Weider.

AHA tells CMS not to add additional HIE requirements for providers, but instead focus more on implementing current HIT initiatives.

4-25-2013 3-49-10 PM

Meanwhile, the founding members of the CommonWell Health Alliance tell CMS they are committed to collaboration with HIT suppliers, adding that they will use existing standards and supplement them only when needed. Members also emphasized the importance of creating an open forum for secure patient data exchange and removing data access barriers.

4-25-2013 8-04-04 PM

A North Carolina Senate panel approves a bill that would require hospitals to create easily understood bills that include definitions for any medical terminology. State Senator Jeff Tarte, a former hospital CIO via a stint with Ernst & Young, says transparency is tough to solve and just creating nicer bills isn’t going to fix the problem.

A federal grand jury convicts the former medical records director of a Florida-based partial hospitalization program for leading a scheme that submitted $63 million in fraudulent Medicare and Medicaid claims. The therapy provided to the severely mentally ill patients involved watching Disney movies and playing bingo.


Other

4-25-2013 7-24-03 PM

A new KLAS report says that patient accounting systems are the next hot thing in 200+ bed hospitals because of accountable care needs, the tapering off of Meaningful Use system selections, and the impending transition to ICD-10. Integration is a priority, leaving Epic and Cerner as the only inpatient billing systems that also cover ambulatory billing, with Cerner still scoring low but trending up. Update: KLAS says my summary is misleading, so here is their exact wording: “Epic and Cerner are the only vendors whose inpatient billing systems are integrated with both their inpatient EMR and ambulatory billing systems.”

4-25-2013 7-52-13 PM

A solo family physician in rural Colorado says he “gave up on healthcare in America,” sold his practice to a hospital, and moved to Australia because of the 2 percent Medicare penalty he would have been charged in 2015 for not adopting an EHR that he couldn’t afford anyway. He says in Australia people love his American accent, he gets a lot of time off, and he makes $250,000 a year for a light schedule vs. the $100,000 he was making for being overworked in Colorado. “Primary care is highly respected here. That’s not the case any more in America. In the United States, health care has become more about the business of making money. The personal side of medicine is going away.”


CommonWell, challenged directly on Twitter by Terry Bequette, state HIT coordinator for the State of Vermont, says “all HIT developers” are welcome to join.  

WakeMed (NC) creates a video celebrating its 52 years and touting its new $100 million Epic system, which it is implementing along with nearby Triangle-area academic medical centers Duke University Hospital and UNC Health Care.

Truven Health Analytics reports that 71 percent of ER visits made by patients with employer-sponsored insurance coverage are for conditions that did not require immediate attention or could have been prevented with outpatient care.

Medhost files a lawsuit against Health Management Associates, claiming the hospital operator continues to use its ED software despite not having paid the third installment of $4.5 million last year.

4-25-2013 10-13-15 PM

Henry Ford Health System (MI) reports a 15 percent decrease in net income, primarily due to an increase in uncompensated care and the $36 million it spent to implement Epic. According to the CEO, “We knew that 2012 and 2013 would not be easy years for the system because of the Epic costs.”

A court orders UPMC to allow employees to use its computers and e-mail system for union-organizing activities.

Weird News Andy says this is like a reality show for doctors. Utah pediatricians trying to relate better to their teen patients hire acting students to simulate clinic visits and act out medical scenarios. The students are enjoying it so much that they have volunteered to continue after school is out.

WNA also likes this story, in which Seattle police are investigating reports that a nurse imposter entered patient rooms at Swedish Medical Center and cut the IV lines of patients to steal what sounds like narcotic-containing PCA cartridges.

4-25-2013 11-13-38 AM

inga_small In patient fashion news, Henry Ford Health System introduces a new double-breasted hospital gown that closes in the back, uses snaps instead of ties, and is made of thicker fabric than traditional gowns. One of the gown designers notes that, “By creating a hospital gown that is safe, stylish, and comfortable, we’ve made the patient feel more at home, like they’re wearing their own garments." Kind of makes me want to schedule some elective surgery just to try one out.


Sponsor Updates
  • Aprima Medical Software, Greenway Medical Technologies, and Allscripts forego interface fees as preferred partners for Greater Houston Healthconnect’s regional HIE.
  • Elsevier issues a brief that identifies the need for and potential impact of evidence-based medicine.
  • Wellsoft will participate in next month’s 2013 Emergency Medicine Update conference in Toronto and the e-Health 2013 conference in Ottawa.
  • Barb White, director of healthcare solutions for AT&T, discusses cyber attacks and security breaches in healthcare. 
  • MedAssets’ Sandy Hoffman co-hosts the Fifth Annual Mouse Races for MS in Cape Girardeau, MO on April 27.
  • Laura Kreofsky, principal advisor with Impact Advisors, discusses how EPs are spending their Meaningful Use incentives.
  • Prognosis suggests topics to discuss with current or potential vendors to avoid EHR dissatisfaction.
  • Penn State makes the DynaMed clinical reference database available to all students and staff. 
  • Boston Children’s Hospital Chief Innovation Office Naomi Fried and Carnegie Mellon University professor Alan Russell will provide the keynote addresses at the iHT2’s Health IT Summit in Boston May 7-8.
  • ADP AdvancedMD hosts a May 8 Webinar on engaging patients in their healthcare. 
  • NextGen Healthcare hosts a May 1 Webinar on effective claims processing.
  • Stuart Long, Capsule’s chief marketing and sales officer, discusses the benefits of medical device integration and how it works in a hospital.

EPtalk by Dr. Jayne

ONC issues the Apps4TotsHealth Challenge to encourage integration of the TXT4Tots message library into new or existing platforms. The library includes evidence-based messages focusing on nutrition and physical activity and is targeted to parents and caregivers of children 1-5 years old.

The National Institutes of Health is using IT to boost energy savings. Maneuvers that would benefit healthcare entities include forcing computers to go on standby at the end of the day and software to aggressively manage environmental systems.

Children’s National Medical Center is using video games as a way to measure and manage chronic pain. Applications are used for physical therapy as well.

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Overheard in the physician lounge: two of my colleagues were discussing slick new carts that have appeared on the floors. I’m happy to note that they are from HIStalk sponsor Enovate.

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I received a HIMSS e-mail regarding the annual conference experience and asking me to take a brand survey on my “emotional connection” to HIMSS. I was asked to select images that fit attributes for the HIMSS brand on “touch, taste, scent, sight, and sound.” Maybe I’m too much of a literal person, but I found the concept odd. It also didn’t fit my screen without scrolling, making it a non-starter.

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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 25, 2013 News 8 Comments

News 4/24/13

April 23, 2013 News 4 Comments

Top News

4-23-2013 8-43-50 PM

Nextgov uncovers a scathing internal Pentagon memo that says DoD’s plans to acquired commercial off-the-shelf software fly directly in the face of the President’s call for a joint DoD-VA EHR based on open standards.


Reader Comments

4-23-2013 9-46-12 PM

From Wesley: “Re: Encore Health Resources. They have laid off multiple people in recent weeks.” I asked Encore CEO Dana Sellers, who provided this reply:

Encore continues to experience strong, healthy growth thanks to wonderful clients and the best consultants in the industry. As a result, we’ve done some realignment of our Client Services organization over the past few weeks to better position Encore to execute our strategy: the delivery of a full life cycle of consulting solutions with a focus on business intelligence and performance improvement. In fact, to meet our increasing business demands, we are actively recruiting for Client Services Executives in Nashville, Florida, Colorado, and California. Send some great folks our way, would you?

From John Porta: “Re: Advisory Panel CIOs not finding value in the HIMSS conference. Who does find value, the marketing VPs? Sales employees think it’s the biggest waste of their time in the pipeline, which is why they spent their days on their phones while ignoring the giveaway seekers and non-buyer IT staff. Why do vendors spend an average of probably $250K to be there preaching to the choir? Maybe just  companies trying to justify their marketing existence. I believe the HIMSS conference is an ongoing, self-perpetuating, ad-selling, marketing come-on. Few companies have the balls to pull out.”

4-23-2013 9-46-55 PM

From Iggy: “Re: MModal. Debtwire said that on April 3, executives told their debt holders that they fell out of compliance in the period ending March 31 and One Equity will ‘cure’ this. Is this routine?” I asked Ben Rooks, who writes HIStalk’s “Healthcare IT from the Investor’s Chair,” who with help from his friends at investment bank Houlihan Lokey provides this explanation:

Loans such as the one that allowed One Equity to borrow money to purchase MModal (the Leverage in the term LBO, or Leveraged Buy Out) have certain ongoing requirements with which the company must comply (known as “covenants”). In this case, there was actually only one such covenant, but it allowed for a maximum amount of net leverage (how much debt each dollar of EBITDA — earnings before interest, taxes, depreciation, and amortization — must support). This metric rose since the deal closed, reaching 6.43x at the end of last year in contrast to the 5.35 that was projected. Interestingly, it was set at 6.5 in Q1, then drops sequentially by .25 until it reaches 5.75 in Q1 2014 (presumably as the company both pays down its debt and grows its revenues and EBITDA). According to Standard & Poor (the debt rater in this case), “MModal has seen its revenue weaken as a result of a slower-than-expected transition to its new products strategy and competitive pricing pressures” and it downgraded the debt a notch. Realizing that these things can happen, however, the loan agreement allows the sponsor (One Equity) to cure the problem, typically by adding more equity dollars or else guarantying part of the loan. Incidentally, M*Modal might not be public, but its debt is, so this was, in fact, disclosed publicly, just not as loudly as in the case of public companies.


Acquisitions, Funding, Business, and Stock

4-23-2013 9-47-45 PM

LifeIMAGE closes a $15 million Series C round of financing.

Henry Schein, Inc. secures $300 million of committed financing with The Bank of Tokyo-Mitsubishi UFJ, Ltd. based on the securitization of its A/R.

4-23-2013 9-48-31 PM

CTG reports Q1 results: revenue up five percent, EPS $0.24 vs. $0.20. CTG attributes its growth on increased demand for EMR and other health information technologies.

4-23-2013 9-49-11 PM

Healthcare learning platform vendor HealthStream announces Q1 results: revenue up 25 percent, EPS $0.07 vs. $0.05, beating earnings expectations and sending shares up 16 percent Tuesday.

Israel-based medical social data mining vendor Treato raises $14.5 million in funding. The company’s platform extracts patient comments from blogs and discussion forums, applies natural language processing and other analytics, and provides an overview of patient comments about drugs and conditions. According to the company’s CEO, “Until now, everyone wanted to hear the doctor’s voice. Now, because of social changes and even legislation, everyone wants to hear the patient’s opinion. Regulation no longer pays for the doctor to treat, but for the patient to heal.”


Sales

Nightingale Preventive Care, a provider of healthcare services in Kmart stores, selects HealthFusion’s MediTouch EHR.

4-23-2013 9-50-47 PM

Riverside Health System (VA) chooses HealthMEDX Vision for EMR and billing for its Lifelong Health and Aging Related Services division.

Orange Accountable Care (FL) selects Halfpenny Technologies to provide a lab data interface for referring physicians using risk management services from Orange Health Solutions.

Scott & White Healthcare (TX) contracts with KPMG LLP to assist with its Oracle PeopleSoft v0.2 Human Capital Management reimplementation project.

Ardent Healthcare will expand its use of Infor’s human resources and financial management suites.


People

4-23-2013 9-40-49 AM  4-23-2013 9-42-41 AM

Huron Consulting Group hires Todd Christiansen (IBM Global Business Services) and Joseph Gaetano (Siemens Medical) as managing directors in its healthcare practice.

4-23-2013 7-15-38 PM

Anthony Caponi (Maxim Healthcare Services) joins Direct Consulting Associates as VP of sales.

4-23-2013 7-19-35 PM

MediRevv hires Randy Blue (Resource Corporation of America) as director of sales.

4-23-2013 9-02-49 PM

VC firm Polaris Partners names Tim Kilgallon as CEO in residence, focusing on consumer-directed digital health opportunities. His healthcare IT experience includes stints with Pointshare Corporation and Medaphis.

4-23-2013 9-07-37 PM

Health program and population health management software vendor Aegis Health Group promotes Bill Walker to CTO.

4-23-2013 9-33-06 PM

Mobile applications platform developer Kony Solutions, announcing 90 percent year-over-year growth, names Abhay Parasnis (Oracle) as president and COO.

Gary Peat (Council Capital) joins eDoc4u as SVP of corporate and business development.


Announcements and Implementations

The Patient-Centered Outcomes Research Institute will fund up to $68 million to support organizations focused on the advancement of comparative clinical effectiveness research.

Hamad Medical Corporation in Qatar will implement Cerner Millennium across its primary care centers and eight hospitals.

Allscripts releases Allscripts Care Director to enable care coordination across all care settings.

4-23-2013 7-25-45 PM

Emmi Solutions wins a communication award from The Center for Plain Language for its Heart Failure Transition multimedia series.

4-23-2013 9-55-07 PM

Gwinnett Hospital System (GA) adopts the ChartWise:CDI clinical documentation system.


Government and Politics

HHS considers amending the HIPAA Privacy Rule to allow states to report information on potentially dangerous mental health patients to the National Criminal Background Check System, the database that houses information on individuals prohibited by law from possessing firearms.

4-23-2013 11-42-37 AM

CHIME calls on HHS to extend certification requirements to include the HIE market.

CMS and ONC will convene a May 3 meeting on appropriate coding using EHRs from 9:00 a.m. until 2:00 p.m. in Baltimore. The session will also be streamed online.

A bipartisan group of senators unveils a discussion draft of a bill to create a nationwide electronic system for tracking the distribution of prescription drugs. The proposed measure would require every entity in the prescription drug supply chain to provide electronic transaction information when there is a change of ownership, plus shift the country from a lot-level drug tracing system to a unit-level tracing system.

4-23-2013 2-40-32 PM

CMS and ONC post a joint fact sheet that breaks down the progress made since the passage of the HITECH Act that also includes the latest numbers on EHR adoption, e-prescribing rates, and the increased emphasis on interoperability and exchange.


Technology

Medical device company Smiths Medical will develop connectivity between its infusion systems and Epic using IHE standard profiles to establish communication between the systems.


Other

A small-scale Johns Hopkins study finds that first-year residents in academic medical centers spend just 12 percent of their time interacting with patients, while computer duties take up 40 percent of their hours. Patient time has been significantly reduced since a similar 2003 study, suggesting that mandatory reduced hours may have caused an undesirable balance of work duties. The researchers say better EMR systems would reduce some of the computer time required. The study’s senior author, a hospitalist, concludes, “All of us think that interns spend too much time behind the computer. Maybe that’s time well spent because of all of the important information found there, but I think we can do better.”

4-23-2013 9-56-36 PM

The Kansas Department of Health and Environment will officially take over the Kansas HIE effective July 1. The HIE board acknowledged in September that it financially unsustainable and voted to relinquish its functions to the state.

John Halamka reflects on hospital lessons learned from last week’s Boston Marathon bombings in his “Life as a Healthcare CIO” blog. Among them: making sure systems can support working from home, limiting data center access, increasing on-screen warnings to staff about looking up patient information, and improving HIE capabilities.

A review of CEO salaries of non-profit Chicago hospitals finds 20 who made at least $1 million in total compensation in 2011, with the CEO of Northwestern Memorial HealthCare leading the pack at $4.6 million.

Two former patients of Glens Falls Hospital (NY) file a class action lawsuit against the hospital and its contractor Portal Healthcare Solutions after the medical records of 2,300 patients are left on an unprotected computer network for four months.

Microsoft will sponsor an April 25 panel discussion on Unintended Consequences: Patient Perspectives on the HIPAA Omnibus Rule at the Microsoft Innovation & Policy Center in Washington, DC. Panels will include Iliana Peters (OCR), Corinne Cary (New York Civil Liberties Union), Deborah C. Peel, MD (Patient Privacy Rights), and Hemant Pathak (Microsoft).

4-23-2013 8-49-10 PM

Baltimore-based Healthify, a new startup led by Johns Hopkins University graduates and students, develops a free electronic waiting room questionnaire that can screen for health determinants such as psychosocial risks, nutritional status, housing, education, and substance abuse, all of which significantly increase the odds of an individual requiring hospitalization.

No-frills clinics in India say they can offer heart surgery for $800 by operating in prefabricated buildings that have air conditioning only in the OR suites and that require family members of patients to help care for them. The company’s founder, a noted heart surgeon, says that while Stanford Hospital is spending $600 million to build a 200-300 bed hospital and a new London hospital will cost $1.5 billion, the clinic can build and equip a hospital for $6 million and have it up and running within six months.

Weird News Andy says this might make sense. In England, NHS is considering sending recovering elderly patients to “hospital hotels” run by private hotel chains. It’s modeled after a similar program in Scandinavia and would relieve “bed blocking,” where local councils have cut funding for home health and residential services, leaving patients stuck in expensive hospital beds they don’t really need.

4-23-2013 7-37-54 PM

WNA also likes a story that he titles “A different kind of Brazilian close shave.” A Brazilian fisherman accidentally fires a foot-long harpoon into his skull, then decides to go home to sleep it off. His aunt calls the fire department 10 hours later. He’s in ICU and has permanently lost sight in one eye.


Sponsor Updates

4-23-2013 7-29-06 PM

  • Infor will donate $5 to charity for each attendee of Monday night’s Infor Healthcare party, held in conjunction with Inforum in 2013 in Orlando.
  • Greenway Medical will add RemitDATA’s comparative analytics solution into its PrimeDATACLOUD Remittance Intelligence service, giving practices reimbursement and productivity insights and performance benchmarking.
  • Jill Farnsworth and Mike Grisaffee from Encore Health Resources  will participate in educational sessions at the HIMSS Texas Regional Conference May 14-15 in San Antonio.
  • Healthcare Anytime offers a June 4 Webinar on surviving the avalanche of patient data.
  • Bottomline Technologies donates $2,500 to a memorial fund for Joshua Krantz, a recently deceased employee.
  • The Denver Post names Ping Identity Top Workplace for the second consecutive year.
  • InstaMed launches the InstaMed Healthcare Payments Account, which helps providers get paid faster and through more channels.
  • Visage Imaging releases version 7.1.3 of the Visage 7 Enterprise Imaging Platform, which incorporates over 1,000 enhancements and product fixes.
  • T-System will deploy the NextGen PM solution for its RevCycle+ solution clients.
  • Craneware showcases enhancements to its Bill Analyzer and InSight Audit solution during this week’s HCCA 17th Annual Compliance Institute in National Harbor, MD.
  • eClinicalWorks offers a series of Webinars in April and May on its upcoming eBO Version 6 release.
  • Henry Johnson, MD, VP and medical director for Midas+, a Xerox company, discusses value-driven analytics and the best big data trends for healthcare.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 23, 2013 News 4 Comments

Morning Headlines 4/22/13

April 21, 2013 Headlines No Comments

Why Boston’s Hospitals Were Ready

The city-wide coordination of patient care following the Boston Marathon bombings is profiled by The New Yorker. While three victims were killed in the initial attack, every one of the 170-plus wounded victims that were alive when they arrived at the hospital have survived.

New for-profit company to sell software that powers Indiana’s health info exchange

The seven year old Indiana Health Information Exchange is spinning off a for-profit company which will sell its infrastructure technology and professional services to the new organizations undertaking HIE projects.

Applied Health Analytics sets sights on a national network

Startup Applied Health Analytics, which develops evidence-based population health management software for hospitals, is profiled by The Nashville Business Journal.

Cerner and Ciber Will Provide Full Suite of Infor Application Management and Hosting Services for Health Care Organizations

Cerner partners with Ciber, an IT consulting firm specializing in implementation and optimization of Infor’s ERP solutions, to develop a full suite of services including application management, implementation, upgrades, and hosting services for Infor applications. The services will be offered to new and existing Cerner healthcare organizations.

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April 21, 2013 Headlines No Comments

Monday Morning Update 4/22/13

April 20, 2013 News 6 Comments

4-20-2013 3-56-35 PM

From The PACS Designer: “Re: iPen rumors. As we approach the middle of 2013, the focus will be on the next innovation from Apple. iPen talk is not new since there’s been a Cregle iPen 1 that’s available today for writing and and drawing on the iPad. Apple wants to enhance their version by adding a small LED that can record writing and drawing for later viewing. The other possible features of the upcoming Apple pen are the ability to plug into an iPad docking station, adding a tiny SIM card for communications, and a camera device which would make it function as an iWatch, iPod and and iPhone – all in one device.”

4-20-2013 4-26-18 PM

From Bostonian: “Re: Boston. The main activity happened about two miles from my house, unfolding directly (and I mean directly) in front of athenahealth’s headquarters and main offices in Watertown. It was the long brick building with the big windows if you watched on TV.” Jonathan Bush of athenahealth posted this letter to the company’s website, saying that the company remained “wide open for business. WIDE open” as the company told its 1,000 Watertown employees to work from home. The letter added that athenahealth believes terrorism should not be able to generate widespread fear and panic that stops society from functioning.

From Marianne: “Re: Boston. This is such a good article by Atul Gawande. As we sit in our locked homes here in the Boston area waiting for this nightmare to end, it is nice to read about how our hospitals responded so well to this attack.” The New Yorker article gives credit to the hospital incident command system for allowing a quick and effective response to the treatment needs of the victims. Many of us have gone through the yearly drills of pretending to be logistics officer and making fun of wearing our yellow vests or writing down messages on paper to communicate with our pretend incident teams. The thing is, incident command systems work when they need to – it all comes back in the crisis.

From Blue: “Re: HIMSS scammer. A company solicited vendors to pay $5,000 to advertise in a publication that was to feature articles by Farzad Mostashari and Kathleen Sebelius and would be distributed at the HIMSS conference. Companies that paid got no further response, no printed version, and the online version has ‘lifted’ articles and ads from companies that never heard of the company. All was reported to HIMSS, which is looking into the false claim that the journal would be distributed at the conference. Vendors beware!” I notice that the welcome message from Kathleen Sebelius was stolen directly from the HHS site from comments she made at a public event, while Farzad’s alleged interview was lifted uncredited from Kaiser Health News. The companies appearing to have been ripped off in the issue I saw are Practice Fusion, iCharts MD, Availity, ChartLogic, and Accenture.  

4-20-2013 2-01-27 PM

When it comes to offering systems that are “open” in the eye of the beholder, the big winner is “none of the above,” followed by Allscripts, Epic, and basically nobody else. New poll to your right: should ONC assess an EHR vendor fee to help fund its certification programs? You can click the Comments link on the poll after voting to be more explanatory than your yes/no vote.

4-20-2013 3-51-17 PM

The first-ever HIStalk Webinar, Vendor Software Training: What Providers Should Demand, will be offered on Tuesday, May 14 from 1:00 to 1:45 PM EDT, presented by Health Technology Training Solutions. See my Webinars page for information on how HIStalk Webinars are moderated and pre-reviewed by CIOs (and me personally) for education value and presentation style. I hope to not only produce vendor Webinars that are a lot better than some of the clunkers I’ve sat through, but also to give folks who work for non-profits a way to offer their presentation to the HIStalk audience at no cost to themselves since I’m paying for the infrastructure and would like to see it used.

The Nashville business paper profiles Applied Health Analytics, a Vanderbilt partner that offers population health management tools, with special emphasis on hospitals that form relationships with big employers.

Cerner and Ciber will offer application management and hosting services to Infor’s healthcare customers.

Indiana’s HIE will spin off a for-profit company to market its HIE platform that was developed by Regenstrief.

UPMC files suit against Pittsburgh Mayor Luke Ravenstahl, claiming that his challenge of the health system’s non-profit status is “a campaign to target and damage UPMC.” The city’s attorney replied, “It is unclear to me how asking a court to make a determination whether UPMC is or is not an institution of purely public charity is a violation of its constitutional rights. The painfully obvious bottom line is that the last thing UPMC wants is judicial scrutiny of its non-charitable agenda.”

4-20-2013 3-07-23 PM

Weird News Andy wonders how this hospital’s health marketing campaign was approved. A North Carolina hospital pulls the plug on its campaign intended to create community health awareness, purely because of its tag line, “Cheat Death.” The hospital said the phrase worked to generate discussion and awareness, but thinks it can do better in sending a message of community unity.

Vince covers the HIS-tory of GE Healthcare in Part 1 this week.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 20, 2013 News 6 Comments

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

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