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Chatting with John Gomez 4/10/13

April 10, 2013 Interviews 25 Comments

John Gomez is CEO of JGo Labs.

What’s the big news these days?

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

Why do you think Epic has won?

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

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

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

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

What happens now?

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


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

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


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

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

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


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

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

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


Many people say Epic is closed.

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

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


Give me an example of Epic’s openness.

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

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

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


How will the market change?

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

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

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


Where do you see the opportunities?

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


Simplify that statement.

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


What does Allscripts have to do fix itself?

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

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

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

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

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

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

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


What are the biggest market fallacies or myths?

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

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

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


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

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

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

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

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

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

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

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

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

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April 10, 2013 Interviews 25 Comments

News 4/10/13

April 9, 2013 News 14 Comments

Top News

4-9-2013 10-40-32 AM

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

Reader Comments

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

4-9-2013 7-33-51 PM

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

4-9-2013 7-43-59 PM

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

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

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

HIStalk Announcements and Requests

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

4-9-2013 7-45-43 PM

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

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

Acquisitions, Funding, Business, and Stock

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

4-9-2013 10-32-34 PM

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

4-9-2013 10-33-14 PM

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


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

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

4-9-2013 10-34-01 PM

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

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


4-9-2013 6-04-33 PM

Versus promotes Kevin Jackson to VP of technology.

4-9-2013 6-11-33 PM

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

4-9-2013 6-10-41 PM

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

4-9-2013 9-39-25 PM

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

Announcements and Implementations

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

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

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

4-9-2013 1-50-38 PM

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

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

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

4-9-2013 6-53-07 PM

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

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

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

Government and Politics

4-9-2013 10-38-15 PM

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


4-9-2013 10-39-35 PM

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

4-9-2013 7-18-09 PM

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

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


4-9-2013 11-22-30 AM

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

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

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

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

4-9-2013 6-24-06 PM

Here’s the latest cartoon from Imprivata.

4-9-2013 8-20-57 PM

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

4-9-2013 8-25-10 PM

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

4-9-2013 7-40-24 PM

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

Sponsor Updates

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


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

More news: HIStalk Practice, HIStalk Connect.


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April 9, 2013 News 14 Comments

Monday Morning Update 4/8/13

April 6, 2013 News 11 Comments

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

4-6-2013 6-52-41 AM

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

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

4-6-2013 8-50-58 AM

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

4-6-2013 9-30-51 AM

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

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

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

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

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

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

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

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

4-6-2013 10-23-18 AM

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

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

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

4-6-2013 10-34-46 AM

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

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

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

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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April 6, 2013 News 11 Comments

Morning Headlines 4/5/13

April 4, 2013 Headlines 1 Comment

Policy Committee ponders CommonWell influence

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

Baylor Quality Alliance Selects Greenway for Participation in EHR Program

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

HIMSS Analytics Honors Florida Hospital Carrollwood with Stage 7 Award

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

EHR Adoption Encouraged by State Meaningful Use Acceleration Challenge 2.0

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

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April 4, 2013 Headlines 1 Comment

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

April 1, 2013 Interviews No Comments

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

3-31-2013 11-21-45 AM

Tell me about yourself and the company.

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

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

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


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

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

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

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

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


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

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

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

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


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

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

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

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


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

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

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

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

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

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


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

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


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

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

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

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

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


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

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

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

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

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


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

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

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

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

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

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

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April 1, 2013 Interviews No Comments

News 3/29/13

March 28, 2013 News 7 Comments

Top News

3-28-2013 10-09-06 PM

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

Reader Comments

3-28-2013 10-10-32 PM

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

3-28-2013 10-11-45 PM

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

HIStalk Announcements and Requests

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

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

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

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

Acquisitions, Funding, Business, and Stock

3-28-2013 7-47-11 PM

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

3-28-2013 9-08-33 PM

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


3-28-2013 10-14-59 PM

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

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

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

3-28-2013 10-16-16 PM

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


3-28-2013 6-40-34 PM

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

3-28-2013 11-34-52 AM

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

3-28-2013 7-21-23 PM

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

Announcements and Implementations

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

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

3-28-2013 10-17-51 PM

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

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

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

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

Government and Politics

3-28-2013 12-17-15 PM

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

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


3-28-2013 10-19-06 PM

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

3-28-2013 10-20-04 PM

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

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

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

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

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

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

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

3-28-2013 8-28-32 PM

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

Sponsor Updates

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

EPtalk  by Dr. Jayne

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

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

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

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

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

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



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

More news: HIStalk Practice, HIStalk Connect.


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March 28, 2013 News 7 Comments

News 3/22/13

March 21, 2013 News 5 Comments

Top News

3-21-2013 8-44-57 PM

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

Reader Comments

3-21-2013 8-49-22 PM

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

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

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

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

3-21-2013 7-09-09 PM

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

HIStalk Announcements

3-21-2013 4-00-21 PM

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

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

Here are the last of the HIStalkapalooza photos from Medicomp.

3-21-2013 6-58-21 PM

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

3-21-2013 6-59-57 PM

CIO Unplugged Ed Marx and friends.

3-21-2013 7-01-03 PM

Team Orion.

3-21-2013 7-03-49 PM

Team Vitera.

3-21-2013 7-05-39 PM

Bowling tournament winners.

3-21-2013 7-01-46 PM

Jonathan Bush of athenahealth and James Aita of Medicomp.

3-21-2013 7-02-57 PM

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

3-21-2013 7-04-43 PM

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

Acquisitions, Funding, Business, and Stock

3-21-2013 8-07-03 PM

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

3-21-2013 8-08-06 PM

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


3-21-2013 8-51-12 PM

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

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


3-21-2013 6-17-14 PM

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

3-21-2013 6-19-07 PM

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

3-21-2013 7-15-53 PM

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

3-21-2013 7-18-25 PM

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

Announcements and Implementations

3-21-2013 3-11-01 PM

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

3-21-2013 3-31-25 PM

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

3-21-2013 3-32-50 PM

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

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

Meditech certifies NetApp FAS storage for its systems.

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

Xerox announces a cloud-based Mobile Device Management service.

Government and Politics

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

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


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


3-21-2013 8-52-56 PM

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

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

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

3-21-2013 8-54-48 PM

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

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

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

3-21-2013 9-00-01 PM

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

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

Sponsor Updates

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

EPtalk by Dr. Jayne


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

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

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


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

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

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

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

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



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

More news: HIStalk Practice, HIStalk Connect.

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March 21, 2013 News 5 Comments

Morning Headlines 3/20/13

March 19, 2013 Headlines No Comments

Boulder Community Hospital computer system crash frustrates patients

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

Health System Implements new Electronic Medical Records on March 18th

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

Lifespan Takes Major Step to Transform Health Care Delivery

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

KLAS Diagnoses EMR Usability Concerns

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

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March 19, 2013 Headlines No Comments

News 3/20/13

March 19, 2013 News 8 Comments

Top News

3-19-2013 7-54-09 PM

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

Reader Comments

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

3-19-2013 6-56-19 PM

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

EHR Incentive Payments are Taxable Income

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

3-19-2013 6-53-55 PM

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

HIStalk Announcements and Requests

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

Acquisitions, Funding, Business, and Stock

3-19-2013 7-55-29 PM

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

3-19-2013 7-56-15 PM

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

3-19-2013 7-57-08 PM

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


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

3-19-2013 7-58-42 PM

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

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


3-19-2013 6-02-02 PM

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

3-19-2013 6-03-15 PM

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

3-19-2013 7-21-03 PM

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

Announcements and Implementations

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

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

3-19-2013 6-05-33 PM

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

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

3-19-2013 6-29-49 PM

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

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

Government and Politics

3-19-2013 3-10-14 PM

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


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

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


3-19-2013 3-26-11 PM

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

3-19-2013 3-31-57 PM

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

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

3-19-2013 3-51-36 PM

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

3-19-2013 6-19-47 PM

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

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

Sponsor Updates

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


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

More news: HIStalk Practice, HIStalk Connect.

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March 19, 2013 News 8 Comments

Morning Headlines 3/19/13

March 18, 2013 Headlines 3 Comments

Cerner Has Acquired Labotix Automation Inc.

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

EHR vendor to report HIPAA breach

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

AHCJ unveils hospitalinspections.org

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

athenahealth Delivers 96 Percent Meaningful Use Attestation Rate Among Participating Providers

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

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March 18, 2013 Headlines 3 Comments

Morning Headlines 3/18/13

March 17, 2013 Headlines No Comments

House Republicans Question FDA on Mobile Medical Software: Taxes

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

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

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

Class Calls IRS Rude, Crude and Abusive

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

Making "Meaningful Use" of HHS Data

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

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March 17, 2013 Headlines No Comments

News 3/15/13

March 14, 2013 News 6 Comments

Top News

3-14-2013 4-25-56 PM

Wells Fargo Securities slices and dices CMS Meaningful Use data to arrive at the 2012 year-end table for EPs above. It finds that 65 percent of physicians have registered and 25 percent have attested.

Reader Comments

inga_small From TechTalk: “HIStalkapalooza. Are there video or stills of HIStalkapalooza expected?” In case you missed this last week in the midst of HIMSS craziness, here is the link to the video. We also have a few pictures on our HIStalk Facebook page. We appreciate Medicomp Systems for sponsoring the event, with the help of a production team from Patrice Geraghty (bzzz productions), Cindy Wright and Shannon Snodgrass (Thomas Wright Partners), and Anthony Istrico (Istrico Productions).

From Close but Not Inside: “Re: Voalte. What happened to Rob Campbell, CEO and founder? Erased from the site.” Voalte just announced that Trey Lauderdale has been moved to president and four new VPs have been hired: Phil Fibiger, engineering (Canonical, Ltd.); Bob Porterfield, product and alliance management (Capsule Tech); Frank Watts, sales and marketing (F. Watts & Associates); and Don Fletcher, chief architect (Google). No word on Rob.

3-14-2013 6-32-09 PM

From Carly: “Re: Howard University Hospital. Brought its first unit live on Soarian CPOE earlier this month. Rollout to general medicine coming later in the month. Physician participation has been strong and enthusiastic.”

3-14-2013 6-33-52 PM

From Natalee: “Re: Nordic Consulting. We have not been sold. We’ve enjoyed a recent surge in growth, and continue to be focused on helping our clients successfully install and support their Epic system. Perhaps your readers are referencing an investment partnership Nordic made last October.” Natalee is from Nordic Consulting and responded to a reader’s rumor report from right before HIMSS. Here’s a statement from CEO Mark Bakken about the October investment:

We’re thrilled to have partnered with three IT investment groups who share our vision and commitment to excellent customer service. One of the most exciting things we’re doing with the help of their resources is developing new strategic lines of business, branded Nordic’s SUMMIT Series of Epic Solutions. These new services, focused on Optimization, Upgrades, Remote Services, and Reporting/Analytics, provide strategy and execution expertise to clients enabling them to achieve peak performance from their Epic system and realize the business value and patient care benefits that are now within reach.

From Moe Betta: “Re: New Orleans airport delays caused by TSA cutbacks. BS. After over a dozen visits to New Orleans, they can’t do anything efficiently. Aside from the sometimes intriguing and tasty cuisine, the city operates in a third-world atmosphere. It was that way long before Katrina and will be forever. Sunday in and Thursday out has always been a HIMSS disaster at the airport. Yet, that is part of its ‘charm,’ a trip outside – but inside – the US.” Most interesting to me was that the long security line was divided into two lines, but once you got around the corner, they merged back into one line. Queuing theory experts and Disney fans would have been horrified. Seth Frank, VP of investor relations for Allscripts, agreed in an investor presentation: “Last week at HIMSS conference, the big healthcare IT annual powwow, which was in New Orleans, hopefully, never to go back there again — I love New Orleans, great town, just not for 35,000 people.”

HIStalk Announcements and Requests

inga_small This week’s HIStalk Practice highlights include:  over 13,000 pharmacies now accept e-prescriptions for controlled substances. A survey of 2,600 primary care physicians reveals that 87 percent of doctors believe they receive too many EHR-based alerts. Emdeon begins working with CMS to map new HIPAA 6020 standards. HHS wants 50 percent of doctors online with EHRs by the end of the year. The average physician could lose over $43,000 over five years with EHR adoption. Culbert Healthcare Solutions’ Brad Boyd offers suggestions for the best ways for organizations to incorporate external data into their BI efforts. Dr. Gregg imagines the future of healthcare. It’s all good stuff so pop over and catch up on the latest ambulatory HIT news, check out a few of our sponsors’ offerings, and sign up for the e-mail updates. Thanks for reading.

On the Jobs Board: SCRUM Master, Healthcare Technology Project Manager, Practice Management/EMR Sales Executive, C-Level Healthcare Technology Sales Executive.


3-14-2013 6-37-09 PM

Integris Health (OK) will implement Phytel’s population health and care management tools at its physician practices.

South Jersey Healthcare (NJ) selects Surgical Information Systems Perioperative Management to work with its Soarian Clinicals.


3-14-2013 4-45-50 PM

Arcadia Solutions names Sean Carroll (Nuance) CEO.

Announcements and Implementations

3-14-2013 6-39-45 PM

The NHS invites Humetrix to present its iBlueButton platform at the NHS Innovations Expo 2013 in London.

iMDsoft releases MVpanorama for actionable cross-patient information and allocation of nursing resources.

Hawai’i Pacific Health goes live at its first of four locations with iSirona’s medical device integration solution.

NTT DATA is recognized by Canada’s Top 100 Employers program.

SuccessEHS goes live with a production connection to the South Carolina HIE (SCHIEx) as one of the first ambulatory EHR vendors to do so. 

3-14-2013 6-41-01 PM

Cerner will add symptom-specific patient questionnaires from Primetime Medical Software to its patient portal.

St. Joseph Mercy Oakland (MI) implements the latest version of Voalte’s iPhone for clinical communication.


Fired Allscripts executives Glen Tullman and Lee Shapiro say they will be starting a mobile healthcare company.

WellStar Health System (GA) leases 21,000 square feet of an off-campus data center to handle its Epic implementation.

Strange: authorities say a homeless man was able to live in a Louisville hospital because he always wore scrubs, a lab coat, and a surgical mask. He was caught after using a restricted computer system, which a helpful doctor helped him access by logging in under his own password.

3-14-2013 6-09-03 PM

Weird News Andy christens this story “Fickle Finger of Fake.” Five doctors in a hospital in Brazil are suspended for using fabricated silicone fingers to clock in their colleagues on fingerprint-reading time clock readers. One TV network says the ringleader was the head of the ED, whose daughter was paid for three years despite never actually showing up. Authorities say up to 300 paid employees may exist only in silicon finger form.

Sponsor Updates

  • Alesco Medical becomes a channel distributor of e-MDs.
  • Thousand Oaks Radiology Group (CA) chooses McKesson Revenue Management Solutions.
  • KBQuest will showcase the Kony Solutions mobile platform at the Microsoft Tech Days conference in Hong Kong.
  • The British National Formulary offers direct access to the DynaMed evidence-based clinical information resource to its subscribers.
  • Commonwealth Orthopaedic Centers (KY) selects SRS EHR/PM for its 17 physicians, 10 physician extenders and 2 PT locations.
  • Ping Identity is showcasing PingOne Single Sign-On at the Ultimate Connections Conference in Las Vegas this week.
  • Cancer Treatment Centers of America expands its MedAssets relationship to include Capital and Construction solutions to drive construction costs down.
  • GetWellNetwork CEO Michael O’Neil shared his personal experience as a cancer patient and how patient engagement improves outcomes and satisfaction at The Thirteenth Population Health and Care Coordination Colloquium in Philadelphia this week.
  • Aycan, GE Healthcare, Siemens Healthcare, TeraRecon, and Vital Images participate in the European Society of Radiology’s Face-off.
  • Ingenious Med releases a white paper on the breakdowns in communication during patient handoffs and offers best practices.
  • Emdeon begins mapping HIPAA 6020 standards for CMS.
  • Informatica adds support services to its MySupport portal including eService apps Call Me, simple online escalation and online bug tracking.

EPtalk  by Dr. Jayne

The National Rural Health Resource Center offers an HIE tool kit that includes guide to Direct connectivity standards and an ROI calculator.


Through the retrospectoscope: CT scans on mummies from various parts of the world reveal evidence of heart disease. The presence of vascular disease was independent of the presumed diet consumed in the socioeconomic groups represented by the mummies. Several media outlets are using this to counter the theory that fatty diets and our modern lifestyle cause atherosclerosis. Bring on the curly fries!

Death by smart phone: researchers from West Virginia University are proposing that cell phones be rendered inoperable in moving cars. Drivers using cell phones cause more than 330,000 injuries per year including 2,600 deaths. Texting may account for more than 16,000 deaths between 2001 and 2007. I shudder every time I am cut off by a chatty driver who has no idea I’m in the lane. Of course blocking phone use in a moving car would also impact passengers. This may be responsible for a sharp uptick in teenagers forced to carry on a conversation with their parents which I definitely support.

A recent survey published in Health Affairs suggests that the majority of practices will lose money when adopting electronic health records. Major drivers of positive return on investment included the degree to which providers used the EHR to increase revenue and ceasing use of paper records. I continue to be amazed each time I step into a practice that professes to use EHR yet continues to either document on paper and scan, or document on paper and then key in the findings. Usually the providers are lamenting that they’re slower since they are on EHR and I wind up giving them a free informatics consult.

Speaking of EHR practices that still use paper, I had a patient appointment earlier this week at a rival academic medical center. Following the visit, I was given the opportunity to sign up for the patient portal. I was impressed by the ease of signing in using the combination of my Yahoo credentials and a token code given at the office. I was unimpressed that my chart has my name spelled wrong and a work phone number that I don’t recognize. Since my demographics were correct at the office, I sent a secure message to ask for a revision. The office again confirmed the accuracy of the outpatient chart and responded back that they had no idea who to contact or how to get it fixed. Since the Terms of Use included the vendor’s information, I know it’s a solid and highly regarded one. Just goes to show how a poor implementation can wreak havoc for patients.



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

More news: HIStalk Practice, HIStalk Connect.

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March 14, 2013 News 6 Comments

News 3/13/13

March 12, 2013 News 2 Comments

Top News

3-12-2013 7-37-49 PM

Healthcare data vendor IMS acquires six-year-old, 60-employee Seattle startup Appature, which sells software for tracking drug company marketing activities to physicians. Rumored price was more than $100 million.

Reader Comments

3-12-2013 5-47-53 PM

From IT Dad: “Re: porno nurse. The company was Onyx. I’m a 50-year-old male and I was shocked when I saw it and shocked that someone thought this would be a good idea. I just kept on walking. I was insulted that they would treat women that way and immediately though of my daughter and my female co-workers. I would not even consider stopping at their booth as I did not want to be seen there.” I e-mailed an Onyx contact for a comment and received no response. I was torn whether to run the reader-submitted photo above (taken by a real nurse, I might add) since that might seem equally chauvinistic, but decided readers need to see at least a small-scale version to understand what the fuss is about. The China-based Onyx sells medical displays, of which the scantily clad phony nurse appears to be one.

From Odla: “Re: Neal Patterson. Funny that Neal was seen at several booths at HIMSS. He was at the Optum booth for a bit until an exec recognized him and politely suggested he might want to return to the Cerner booth.”

3-12-2013 6-19-28 PM

From The PACS Designer: “Re: ECM. TPD will be posting interesting apps that address Big Data concerns in our path to enterprise content management (ECM). As a lover of what Hadoop can bring to healthcare, there’s an app that employs Hadoop called Platfora.”

From Captain Ron: “Re: HIMSS. I witnessed a classic moment at HIMSS last week that I had to share. I visited the QlikView booth to watch CHOP present on self-service analytics. Very impressive stuff and they’ve integrated QlikView in Radar. So the funny part … multiple folks there from Epic and one guy in particular decided he should interrupt and share how Epic can help solve this problem. I wonder how Epic would feel if QlikView came and interrupted their customer presentation? #BOUniversesarenottheanswer.”

From PartyReviews: “Re: HIMSS parties. Hit a few parties at HIMSS. Yours was the best of the bunch. Funny how a blog is out partying the big vendors. Consulting firms all had more of a reception format. Deloitte was kinda stiff as you’d expect, Impact Advisors and a few others were OK. Encore had their traditional and apparently popular Pub Night which I hit two times during the week. Each night there were over 300 people there. Guess people really like the free beer, wine, and mixed drinks. No vendors were over the top as has been normal in the past. I got into bed Mon-Wed at 2 a.m., 1 a.m., and 3 a.m. respectively. Only in New Orleans. And we wonder why HIMSS is a burn out?”

Acquisitions, Funding, Business, and Stock

3-12-2013 8-04-12 PM

Athenahealth completes its acquisition of Epocrates.

3-12-2013 8-04-49 PM

TeleTracking Technologies reports a 42 percent increased in booked revenue in the 2012 fiscal year.

3-12-2013 8-05-27 PM

ISirona announces revenue growth of 172 percent for 2012.
A proxy advisor firm urges HP shareholders to give the boot to two of the company’s directors at its upcoming annual meeting for their role in the disastrous acquisition of Autonomy in 2011, one of them being McKesson Chairman, President, and CEO John Hammergren. A group of New York City pension funds also urges voting against the re-election of Hammergren and G. Kennedy Thompson for their involvement in acquisitions that caused HP to lose $17 billion in the past year and for the quick hiring of CEO Leo Apotheker, who was then fired less than a year later.

Ireland-based bedside computing vendor Lincor Solutions receives a $9.5 million investment from Edison Ventures, which it will use to relaunch the company in the US by moving its headquarters to Nashville, TN and creating 30 jobs. The MediVista platform offers access to clinical applications, bed status management, patient entertainment and education, and communications.

3-12-2013 7-20-48 PM

Medical supply vendor Becton Dickinson & Company acquires Austria-based Cato Software Solutions, which offers oncology planning, monitoring, and drug preparation software.

3-12-2013 8-06-14 PM

Lexmark acquires two companies that will be rolled into its Perceptive Software unit. AccessVia sells software that allows stores to print electronic shelf tags, while Twistage provides media management software that its CEO says could be used to distribute medical images and attach video to a patient’s EMR.


3-12-2013 3-54-49 PM

East Texas Regional Healthcare System selects Siemens MobileMD HIE to coordinate care among its 15 facilities.

The Salisbury, Wight and South Hampshire Domain NHS Trust  Consortium (UK) awards its VNA and data migration contract to Acuo Technologies.

Coastal Medical (RI) adds the eClinicalWorks Care Coordination Medical Record to advance its ACO-related objectives.

3-12-2013 8-07-48 PM

Iowa Health System will implement a suite of Infor applications, including Infor Lawson Supply Chain Management and Enterprise Financial Management.

The Virginia Department of Behavioral Health and Development Services selects Siemens Healthcare’s Soarian clinicals and financials and the MobileMD HIE platform.


3-12-2013 6-51-24 AM

Suzanne Cogan (Shareable Ink) joins Orion Health as VP of sales.

3-12-2013 5-56-49 PM

Conifer Health Solutions names Allen Hobbs (MedAssets) chief client officer.

3-12-2013 12-56-17 PM

The AAFP’s TransforMED subsidiary names Russell Kohl, MD (OU School of Community Medicine / Oklahoma College of Medicine) medical director.

3-12-2013 5-57-53 PM

Infor names Barry P. Chaiken, MD (DocsNetwork) CMIO.

3-12-2013 5-58-57 PM

Ping Identity hires Michael J. Sullivan (IHS) as CFO.

3-12-2013 5-59-45 PM 3-12-2013 6-01-28 PM

HHS Secretary Kathleen Sebelius names new and continuing members to the US Technology Standards Committee including Jeremy Delinsky (athenahealth) and Eric Rose, MD (Intelligent Medical Objects).

Announcements and Implementations

CareCloud opens a Boston office, where it expects to house 35 to 40 employees by the end of the year.

Johnson County Healthcare (WY) goes live this week with CPSI.

PatientKeeper deployed its CPOE solution at 19 community hospitals during the first 60 days of 2013.

Eight vendors participated in the inaugural IHE 2013 North American Connectathon, which performed testing to specified requirements for the IHE USA Certification pilot conducted by ICSA Labs.

Final HIMSS conference stats: 34,696 total attendees, 13,985 professional attendees, 1,158 exhibiting companies.

3-12-2013 8-09-10 PM

The New Orleans airport warned travelers last Wednesday of expected delays on Thursday due to the conclusion of the HIMSS conference and sequester-driven TSA staffing reductions.

e-MDs launches a cloud-based EHR/PM solution and introduces Solution Series 7.2.2, an updated version of its client-server suite of EHR/PM products.

Government and Politics

HHS Secretary Kathleen Sebelius fires up her Twitter.

Lt. Dan called this perfectly. Internal VA documents reveal that the agency is taking much longer than it reported to process service-related benefit claims by veterans, with delays averaging more than 1.5 years in major cities. The number of veterans waiting for more than a year for their benefits jumped from 11,000 in 2009 to 245,000 by the end of 2012. Despite spending $537 million on a new computer system, the VA still process 97 percent of claims on paper.


Billian’s HealthDATA finds that medical records-related costs of hospitals typically account for less than three percent of total general-service operating expenses and almost seven percent of total general-service salary expenses.

3-12-2013 4-08-18 PM

The University of Mississippi Medical Center will expand its telehealth program to improve access for smaller hospitals and clinics and will create 201 new jobs over the next three years.

Sponsor Updates

3-12-2013 12-29-44 PM

  • Divurgent’s Signature Drive at HIMSS raises $5,000 for the Children’s Hospital of New Orleans.
  • Aspen Valley Hospital (CO) increases front office payments and reduces payment processing administrative time by 65 percent after deploying InstaMed’s healthcare payment network.
  • Hyland Software and Merge Healthcare expand their partnership to include an integrated image viewing and storage solution.
  • CareTech Solutions introduces CareTech Solutions Pulse, an integrated IT monitoring service that integrates monitoring of hospital clinical, business, and ancillary applications, as well as the infrastructure on which they run.
  • The Virtual Influence Planning group, Medseek’s independent consulting firm, expands its services to include patient portal adoption and marketing plans for healthcare organizations. Medseek also introduces its Influence platform, which will provide hospitals with a comprehensive view of individual patients.
  • Orion Health and NexJ Systems will distribute joint capabilities and technologies, such as NexJ Connected Wellness and the Rhapsody Integration Engine.
  • CCHIT certifies NextGen Ambulatory EHR version 5.8 compliant with the ONC 2014 Edition criteria and certified as a Complete EHR.
  • The Advisory Board Company announces the agenda and keynote speakers for its Crimson Clinical Advantage Summit May 20-22 in Scottsdale, AZ.
  • Picis announces that is annual Exchange conference will be consolidated with the Optum Provider Exchange Conference September 23 in Orlando, FL.
  • Philips Healthcare introduces its IntelliSpace eCareManager 3.9 patient management software, which includes the ability for staff to get a patient population level view of data.
  • The NCQA awards SuccessEHS client Scenic Bluffs Community Health Centers (WI) the highest level of recognition for its PCMH program
  • CAP Professional Services and the Lab Interoperability Collaborative look at the top 10 challenges facing hospitals seeking to report lab results electronically.
  • GetWellNetwork debuts myGetWellNetwork, a digital platform to help patients and providers manage recovery, chronic conditions, and preventative care online. 
  • Ephraim McDowell Regional Medical Center (KY) shares how Accent on Integration helped the organization integrate its Philips OBTraceVue platform with its Meditech HIS.
  • Surgical Information Systems announces the availability of SIS Com Version 3.3, which includes enhanced functionality and a more streamlined look.
  • Imprivata launches Cortext 2.0, its free HIPAA-compliant texting solution.
  • St. Barnabas Medical Center is using Access’s e-forms and wristband bar-coding solution alongside Cerner Millenium and Siemens Invision to enhance its EMAR process.
  • Visage Imaging will exhibit at the SIIM Philadelphia Regional Meeting on March 18 in Philadelphia, with Director of Solutions Architecture and Customer Experience Director Bobby Roe co-leading a roundtable session entitled “Cool Technologies in Imaging Informatics.”
  • Vitera Healthcare releases a hosted version of its Medical Manager practice management platform.
  • McKesson Canada’s RelayHealth aligns with QHR Technologies to integrate QHR’s Accuro EMR System with RelayHealth’s services.
  • SC Magazine names Trustwave the Best Network Access Control product.
  • The HealthLogix HIE platform from Certify Data Systems passes numerous Integrating the HIE profile tests at the 2013 IHE North America Connectathon.
  • Nuance launches Clintegrity 360, a computer-assisted system for clinical documentation improvement and coding.
  • RazorInsights integrates Patientco’s patient financial engagement billing software into its HIS system.
  • MetroHealth Medical Center, an affiliate of Case Western Reserve (OH), will deploy Wolters Kluwer Health’s ProVation Order Sets as its evidence-based order set solution.
  • Kareo lists the top six EHR features that small practices need.
  • Ingenious Med reports a 380 percent increase in the usage of its impower mobile applications in 2012. Twenty-one percent of its licensed impower clinicians now use mobile devices.
  • Deloitte interviews 12 CIOs in major health systems about the challenges of managing their IT departments.
  • InstaMed projects triple-digit growth in the wake of healthcare reform and reports having processed more than $60 billion in healthcare payments as of March 2013.
  • GE Healthcare is developing Guided Analytics and AutoBed applications for the Caradigm Intelligence Platform.
  • AT&T CMIO Geeta Nayyar discusses mobile health and how it can provide care where needed.
  • Cerner will integrate Nuance’s clinical documentation improvement technology into its Millennium EHR and RCM solutions.
  • Advanced Orthopedic Center (FL) selects SRS EHR for its nine physicians.
  • Access extends its relationship with Inpact LLC, a provider of online and social media communities for HIT, to include sponsorship of Siemens Healthcare Social.
  • As part of its $80 million healthcare integration contract, Harris Healthcare receives authorization to deploy a solution that enables the VA and DoD to share EHRs.
  • Johns Hopkins Hospital shares how LRS helped the organization simplify document management in a March 14 Webinar.
  • Capario announces a three-part Webinar series called Mastering the Art of Getting Paid starting March 20.
  • Covisint will feature Andras Cser with Forrester Research in a March 13 Webinar detailing the benefits of cloud-based identity and access management.


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

More news: HIStalk Practice, HIStalk Connect.

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March 12, 2013 News 2 Comments

Morning Headlines 3/12/13

March 11, 2013 Headlines No Comments

UConn Health Center Warns Patients of Privacy Breach

The University of Connecticut Health Center is notifying patients of a privacy breach that could affect around 1,400 patient records, saying that a former employee inappropriately accessed patient records that were beyond the scope of the employee’s responsibilities.

Electronic discharge tool helps rein in HF readmissions

Analysts at Intermountain Healthcare in Salt Lake City designed a retrospective study that evaluated heart failure discharges between January 2011 and September 2012.Their goal was to assess whether the use of electronic discharge orders affect adherence to core measures and 30-day, all-cause readmissions of patients with HF. At the conclusion of the study, the readmission rate for patients whose discharge involved the electronic tool was 15.5 percent compared with 18 percent when the tool was not used.

CHS, Cleveland Clinic Form Strategic Alliance

Cleveland Clinic announces a strategic partnership with Community Health Systems’ network of 135 affiliated community hospitals. Cleveland Clinic will help CHS establish clinical integration programs at its affiliated hospitals, which will provide a mechanism for the sharing of data and in time will support predictive modeling initiatives.

In Pursuit Of Interoperability For The Common Good

Forbes publishes a guest article by Arien Malec, VP strategy and product marketing at RelayHealth, and David McCallie MD, VP medical informatics at Cerner, regarding CommonWell. The article is short on details and concludes by broadcasting an open invitation to all vendors to join the alliance.

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March 11, 2013 Headlines No Comments

Morning Headlines 3/11/13

March 10, 2013 Headlines 3 Comments

Department of Veterans Affairs Review of Alleged Transmission of Sensitive VA Data Over Internet Connections

An audit report released by the Office of the Inspector General validates earlier rumors that the VA has been routinely transmitting sensitive patient information across unencrypted telecommunication networks, including patient names, Social Security numbers, birth dates, and EHR data.

Business news briefs: Human error the cause of UPMC electronic issue

A system-wide problem with UPMC’s EHR (Cerner) resulted in all facilities shifting back to paper charting for three hours. Human error was identified as the root cause.

Cisco Study Reveals 74 Percent of Consumers Open to Virtual Doctor Visit

Cisco releases a press release, blog post, and infographic advertising the findings of its Customer Experience Report on health care. The study concludes that 74 percent of consumers are OK with virtual doctor visits.

Health Care Providers Give Cloud Vendors High Marks on Security

KLAS releases a report on cloud-based software solutions. Security and reliability were the two primary factors identified as preventing widespread adoption, despite high marks in both areas from actual users.

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March 10, 2013 Headlines 3 Comments

Monday Morning Update 3/11/13

March 9, 2013 News 12 Comments

3-9-2013 5-55-05 PM

From Beth: “Re: athenahealth. My little brother just got a job at athenahealth in Boston. Should I congratulate him, or give him stolid advice on keeping a work-life balance? What are the differences between Epic and athenahealth for an implementer?” Good question, which I will defer to readers since I have no first-hand employee knowledge of either company having spent my working life in non-profit hospitals.

3-9-2013 9-38-25 AM

From Cat’s Eye: “Re: Neal Patterson. Let’s start a game of Where’s Waldo? with him. Here he is in the UpToDate booth.” I have to admit that I like Neal’s look.

From Boy George: “Re: HIStalk. HIStalk has not been a HIMSS booster and I know as a fact that HIMSS is acutely aware (and envious) of your sponsorship exposure and HIStalkapalooza.” I would hope HIMSS has other HIT worlds to conquer without worrying about my microscopic corner of it. I’ve been writing HIStalk for 10 years while working in a non-profit hospital, so I work pretty hard for whatever success I get, and that success wasn’t (and isn’t) my motivation anyway. As for HIStalkapalooza, I’ll give credit to the companies that sponsor it and the folks who spend the evening with us each year. I do greatly admire the companies that sponsor HIStalk since for most of them, it’s not just a traditional ad buy but rather their interest in truly supporting what I do. I had none for the first few years of HIStalk and I don’t take any of them for granted. I seem to vaguely remember AMIA or CHIME or some group wanting to work with me years ago, but they realized that I’m a loose cannon.

From HIMSSed Out: “Re: booth experiences. Jeff at eClinicalWorks gave a very concise perfectly targeted presentation of their software doing a sore throat visit. No excess, no droning on, just answered my questions in a timely manner. Well done. Lyndsey at athenahealth did a very nice sore throat demo showing me what I needed and answering questions expertly. AND she blew me away when escorting me to be scanned and then handed me a KINDLE to read their material on. Put me down as impressed by the demo, low key attitude, and rocking gift!” I criticize the folks who use the booth as their employee lounge without naming names, but I like calling out those people who do a good job. There is no reason reps need to use their phones during booth duty – assign someone to monitor and return their calls and e-mail if need be, but if you give anyone under 40 a smartphone they’re going to be screwing around with it nearly constantly because that’s what they do off the job and they can’t resist its lure.

From Frank Poggio: “Re: MU. Farzad Mostashari recently said the MU Incentive bonus was safe. So much for political promises. The sequester cuts include an across-the-board reduction in Medicare payments of 2 percent effective April 1 and include cuts to MU bonus money. In my opinion, this will be just the beginning. Big deficits usually mean big cuts for providers. The Obama administration sold the HITECH act to Congress based on a projected savings of $800 billion per the original Rand study, which just a few months ago Rand said was full of errors.” Government doesn’t have “get smaller” in its vocabulary, so I’m pretty sure agencies will apply their sequester reductions in the most publicly visible way possible, i.e. shutting down national parks and closing offices early in the hopes of creating public outrage. There is no way that the government is so efficient that a 2 percent cut should even be noticeable, but they will make it so in protest.

3-9-2013 9-40-41 AM

From Guy with the Funny Accent: “Re: HIStalkapalooza. No longer talking to Bonny Roberts as she wouldn’t let me wear the Mr. HISTalk ‘Secret Crush’ sash on the final day of the exhibition.” I like that my secret crush is protective of her regalia. I think I may have blushed a bit as she read her poem on stage and I’m not so sure Bonny didn’t as well since she wasn’t planning to recite her work in front of a bunch of people. She figured out who I am when I lauded her demo style in the Aventura booth a couple of years ago, and with minimal provocation, recited my comments verbatim as we were entering Rock ‘n’ Bowl. She is, as they say, a trip.

From A. Vendor: “Re: HIMSS. It was a wonderful experience for a first-time vendor. HIMSS staff were absolutely wonderful in making preparations and taking care of our needs during the show. It couldn’t have been more effortless. Other than a modest case of booth envy, things went very well and exceeded my expectations. People who were looking found us. We met many interesting colleagues and a number of old friends. In addition to a few good leads, we stumbled into some unexpected opportunities we hadn’t expected. I’m definitely up for 2014, and maybe a little wiser.” I think part of being happy with the exhibitor experience is setting reasonable expectations, like having a central location to meet with clients and prospects, maybe picking up some foot traffic even in the hinterlands, and having access to other vendors in the hall during off hours. Non-vendor HIMSS attendees miss the point that many deals are struck between vendors during the show – marketing agreements, signing up to help with consulting and staffing needs, and perhaps finding an investor if that’s on the agenda. One vendor told me that the VC folks were rapid-firing from one booth to another without regard to what company occupied it, barking out a series of questions about their business in hopes of finding companies to invest in.

3-9-2013 5-58-09 PM

From Data Sharing Optimist: “Re: CommonWell. Started six months ago when Arien Malec (now Relayhealth/McKesson, but remember he did a stint with ONC and developed Direct) connected with Dr. David McCallie (VP, medical informatics at Cerner) – they are both very good guys and they decided to create some standards for this type of data sharing. They just finished the standards a few weeks ago. Neal and John H. loved the concept, because even though it might have some competitive issues, they both truly want to see the healthcare system improved, as do all the major CEOs. They went to a small group of folks they believed would hop right on board so they could get a press release out by HIMSS. They did not ask everyone, including Epic, but are talking to them now. From what I heard, they didn’t mean it to sound like Epic refused. That was not their intent, but with two weeks to pull things together, they had to limit things. I talked to Carl about it and got the sense that Epic needs to learn more and see if it is real, but would likely join eventually. Use cases will involve a specialist being able to view and even accept data from an outside hospital on a shared patient, as well as pharmacists being able to bi-directionally communicate with doctors.” Someone who knows all the players told me the same thing – it had to be Malec and McCallie since those are the guys smart enough to make it happen and sell the idea to the suits. I think it was a mistake to rush the announcement and play up the participants without having even invited major vendors like Epic and eClinicalWorks, but apparently the PR urge was strong. So far its accomplishments involve press releases and a Web site. One might logically ask questions like: (a) who pays for the service since infrastructure is required? (b) does the EMR user have to buy or install anything? (c) what are the queries running against? and (d) how is this better than companies like Epic and others that already allow sharing information outside their systems? I like the idea of a standard way of doing things without having a particular vendor owning the platform, so we’ll see if it happens or gets smothered in the bureaucracy of these not-always-nimble big companies.

From Ole: “Re: We are in discussions with EmergeMD regarding telemedicine and would like your unbiased opinion.” I don’t know anything about the company, but perhaps readers who do will weigh in. I would have kicked tires on your behalf at HIMSS but I ran out of time. Actually I didn’t run out of time, but I was so tired of traipsing the exhibit hall by early Wednesday afternoon that I went back to the hotel well before the exhibits closed, had a very early dinner, and finally took my shoes off to write HIStalk. I was really tired, although I now know that I was coming down with a bug at the time.

Here’s to you, IT foot soldiers who will be wide awake at 2:00 a.m. Sunday to make sure systems don’t choke when their clocks spring forward. I’ve been there.

3-9-2013 7-41-46 AM

Two-thirds of poll respondents say we’re experiencing and EHR backlash. New poll to your right: why do you think several vendors formed CommonWell Health Alliance?

Speaking of CommonWell, I noticed that they’ve populated the FAQ section of their site. They say the organization won’t actually be established until a 12-18 month proof of concept is completed, making you wonder why it was necessary to announce so early other than to put a stake in the ground.

I hope everybody got out of New Orleans OK. I left Thursday afternoon and the airport was an absolute zoo, so I can only imagine what it must have been like Wednesday evening. Security and check-in lines wound throughout the terminal, the concession vendors ran out of pretty much everything (including cream for the coffee), and the little airport didn’t have enough seats so people were sitting on the floor. It is clear that New Orleans, for all of its virtues, just can’t handle a conference the size of HIMSS without a lot of snafus.

I got home only to be hit with a respiratory infection that sent my temperature soaring and kept me up hacking all night, so I’ll just clean up some loose ends and get back to my Tylenol and Halls cough drops.

UPMC goes to paper for three hours when its patient care systems go down due to human error.

Ernest Health will work with NTT Data to create new post-acute care capabilities in its Optimum product suite.

Heritage Groups makes an unspecified investment in coding services and software vendor Aviacode.

I mentioned several days ago that I received advance word that several EHR vendors would be announced as working with Michelle Obama’s Partnership for a Healthier America in adding obesity-related features to their products. “Several” turned out to be “three”: Cerner, GE, and Physician’s Computer Company. I like the idea and I’m not sure why other vendors didn’t sign on, except maybe because they’re already diverting much of their development budget into complying with federal requirements instead of delivering user-requested enhancements.

Just to clarify a reader’s comment last week: GE Healthcare sold its outsourced physician billing service, not software products like its EMR.

3-9-2013 8-59-10 AM

Another MyWay-related lawsuit is filed against Allscripts. Cardinal Health pre-paid $5 million for 1,250 MyWay licenses for resale in April 2009 and is stuck with the 994 of those licenses that it hasn’t sold and are now valueless since MyWay won’t be made ICD-10 and MU compliant. Cardinal looked at Allscripts Professional and passed because of cost, complexity, and the fact that Allscripts sells it directly and they don’t want any part of that as a substitute. Cardinal is suing for beach of contract and wants the $4 million back for its unsold MyWay licenses.

3-9-2013 8-05-44 AM 

KLAS releases a very small study (100 providers) of cloud computing perception. It says vendors are sloppy with their terminology, calling products cloud-based that are really just hosted and using Citrix or other emulation services instead of true Web services. I like the graphic above.

TeraRecon introduces iNtuition Review, which I’ll describe in the company’s words since it’s a little over my head: “iNtuition has always complemented PACS with advanced functionality to resolve specialized use cases and workflow challenges not adequately addressed by existing PACS solutions. This role is now expanded and enhanced with the new, powerful iNtuitionREVIEW client, designed to complement PACS with multi-monitor display of multi-modality data, in specialized use-cases such as cardiac (CT, MR, Cath, Echo, EKG) or breast (MR, Mammo, Ultrasound). iNtuitionREVIEW is also designed with co-operation and collaboration in mind, with specialized features for the preparation and execution of physician conferences, demos, and multi-disciplinary team meetings.”

Weird News Andy titles this story “An Arresting Development.” A Florida OB-GYN e-mails a patient, threatening to have her arrested if she doesn’t come in for an emergency C-section for her week-overdue delivery. WNA also says he’s not surprised by this 30/70 rule: a third of VA primary practitioners say they’ve missed critical lab results in the EHR due to being overwhelmed with alerts. PCPs said they received an average of 63 alerts per day, with 87 percent saying that’s too many and 70 percent say they can’t manage them all.

Arcadia Software will expand the use of ICU patient monitoring software it developed for Boston Children’s Hospital by collecting data from a network of hospitals to develop insights into treatment decisions and outcomes.

Vince covers the origins of HIMSS in this week’s HIStory.

Final HIMSS Conference Thoughts

3-9-2013 8-13-28 AM

Inga liked this: the Vonlay folks prepared a welcome package for newly anointed HIStalk Queen Sarah, who works there (note the labeled cupcakes). Some companies were planning to frame the sashes their employees wore and some folks were supposedly going to wear their sashes to the conference on Tuesday although I didn’t see any first hand.

A low-key announcement during the HIMSS conference involves the formation of the HIMSS-backed accelerator Avia, which is supposed to help provider organizations implement innovative technologies. I don’t really understand what they’re trying to do even after reading the information on their site. Nor do I understand why HIMSS is involved. HIMSS might as well bite the bullet and just buy some vendors and peddle their products directly since they’ve encroached into almost every other aspect of the market.

Brian Ahier got Karl Rove to talk about healthcare IT on camera at the conference.

Vendors have told me that it’s so expensive to dismantle, ship, and store components of their HIMSS booth that a lot of the glitz you see in the exhibit hall goes right to the trash afterward. Good idea by Orchestrate Healthcare, which bought furniture for its new two-story booth and donated it after the show to the New Orleans chapters of Habitat for Humanity and Ronald McDonald House. There’s even a patient aspect: Ronald McDonald House was planning to convert part of its dining room into a conference room where and families can meet with caregivers and Orchestrate’s donation of tables and chairs made that room immediately available for its intended purpose since they had no furniture otherwise.

3-9-2013 8-43-18 AM

This reader-supplied HIStalkapalooza photo appears – by virtue of an optical illusion — to have captured Jonathan Bush ticking the chin of an unamused Farzad Mostashari.

3-9-2013 9-00-14 AM

The majority of people who left the conference Wednesday missed the most electrifying and informative presentation I’ve seen at a HIMSS conference. I was walking over Thursday morning and a fellow attendee warned me that Farzad Mostashari is a dry presenter because he’s a data guy. I could not disagree more – he is a really good speaker who uses data to support his statements. ONC posted his 2012 keynote on YouTube and I hope they do it again for the 2013 version since everybody needs to hear what he had to say.

Inga and Dr. Jayne are still swooning that the PatientPay folks sent them each a chocolate high heel, thus combining two of their most cherished vices into a single package.

HIStalk traffic was heavy during the conference as it usually is, with visits and page views peaking on Tuesday at 11,000 and 19,000 respectively. Inga, Dr. Jayne, and I were posting and occasionally tweeting from New Orleans, of course, while Lt. Dan kept the home fires burning with daily HIStalk headlines and HIStalk Connect posts. It’s a bit of a potpourri during HIMSS week since we cover whatever is interesting to us, which is almost everything.

More HIStalkapalooza pictures by Istrico Productions. Lots of smiles. I always feel strange seeing my logo (the new one in this case) put on buses, shirts, signage, and electric lights.
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HIMSS Takeaways

Attending the HIMSS conference is like trying to simultaneously watch every channel on satellite TV. You choose what looks good in the guide, but invariably there’s a lot of crap among the good finds in both the education rooms and the exhibit hall. Even then you’ll see maybe 5 percent of what was offered. At any tableful of people, the only shared experiences may well be the keynotes and perhaps a large social event (looking at you, HIStalkapalooza).

That makes it really risky to summarize the experience and draw relevant inferences from it. Here are my thoughts, which may differ wildly from yours.

  • The CommonWell Health Alliance announcement delivered the burst of fireworks that everyone expected, but whether it’s a new commitment to patients or simply an expedient anti-Epic marketing strategy developed by marginally committed members remains to be seen. We don’t really know what will be delivered, whether it will work as described, and how hard it will be for providers to connect to whatever communications infrastructure is developed. If it succeeds, will it put yet another nail in the HIE coffin? Can it be successful without the participation of vendors like Epic, eClinicalWorks, and others? Can vendors really deliver the needed technology along with their ICD-10 and Meaningful Use enhancements, and if so, how will they prioritize the work? It’s easy to get wrapped up in the feel-good, patient-friendly marketing prose and characterize non-participants as patient haters, but let’s see what they can deliver and which companies dominate the process before waving the CommonWell flag.
  • Analytics doesn’t make good booth demos, so it’s hard to have a solid takeaway. Everyone knows they need better data, but approaches range from technical toolkits to turnkey systems complete with algorithms and reports for common requirements. We’re past the multi-year, big-expense data warehouses of just a few years ago, but it would still be easy to make a misstep in the zeal of preparing for ACOs and other delivery changes for which the data requirements are still fuzzy. This may be yet another area where providers will wish they had measured twice and sawed once.
  • New Allscripts CEO Paul Black has wasted no time in trying to erase the painful memory of a series of Keystone Cops-like corporate gaffes that left the company as a punch line. Remarkably, some recent Sunrise sales and the acquisition of Jardogs and dbMotion provides validity to their claims as a serious player, although it’s early in the recovery.
  • The industry is quickly transitioning from the traditional hospital and practice system model, which emphasizes transaction entry and charging, toward a public health focused emphasis that requires heavy consideration of non-episodic patient activity and cost management. This will require yet another round of vendor technology investment on top of ICD-10 and Meaningful Use requirements, polarizing the market even more into those vendors positioned for the future vs. those just trying to milk what market is left selling old-school systems.
  • HIMSS finally recognized the role of patients in the healthcare system, at least superficially. You’ll know the movement is real when real patients and their advocates lead significant sessions, hold non-token HIMSS roles, and are actively represented on vendor advisory groups and even company boards.
  • More and more of the healthcare IT market direction is driven by the government in general and ONC in particular. Vendors and customers aren’t talking a lot about incremental enhancements or product tweaks. It’s all about analytics, transparency, interoperability, and outcomes. It will be a challenge to turn these somewhat vague concepts into concrete development plans.
  • The audience for usability seems to be selective. Lots of people are talking about it, but nobody’s doing much despite government report emphasizing the need to make systems safer and easier to use.
  • The market for consulting services is going to be very strong, but it will shift from system selection and implementation to system optimization. That will drive consulting firms to further specialize into specific practices, most notably for Epic and Cerner. IT systems are necessary but not sufficient to drive the needed changes, and that will favor CIOs who have a good working relationships and reputation outside of IT.
  • mHealth has a decent chance of improving health in nations where the problem is lack of basic health needs and medical services. It doesn’t seem to have the required impact in countries challenged by prosperity-fueled problems like obesity, lack of exercise, and time-challenged citizens who don’t put their health first.
  • The HIMSS conference keeps getting bigger, but nobody knows if the proportion of actual practicing caregivers (rather than former caregivers turned IT cheerleaders) is increasing or decreasing. It’s easier to be irrationally exuberant when the front-line naysayers aren’t in the building.
  • My assessment of the educational program and the CE submission process is that it continues to go downhill, making it almost an afterthought to the cash cow, the exhibit hall.


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

More news: HIStalk Practice, HIStalk Connect.

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March 9, 2013 News 12 Comments

From HIMSS 3/6/13

March 6, 2013 News 22 Comments

3-6-2013 9-03-12 PM

3-6-2013 9-04-30 PM

From BD: “Re: finds from the show. Warm and fuzzies all around us.” Funny, I noticed those exact items too. I was picturing a criminal lifer in the back seat of a cab fingering his .45 nervously, but then being scared off upon learning the news that blasting the cab driver might lead to punishment. Apparently New Orleans has a target audience of literate and easily influenced would-be cabbie killers.

From IVANS to Tell You…: “Re: IVANS. ABILITY Network to acquire IVANS. Press release out tomorrow.” Unverified. Both companies are involved with Medicare/Medicaid connectivity.

From Tweeter and the Monkey Man: “Re: Jardogs acquisition by Allscripts. That effectively eliminates Jardogs from 80 percent of all deals as their portal is no longer agnostic. Will a Cerner community buy an Allscripts product? Doubtful. Watch for a rebrand.”  

3-6-2013 9-54-04 PM

Wednesday of HIMSS week is always kind of a letdown. Everybody’s tired, sluggish from too much food and drink, and many (or most) of them head out for home later in the day. You could feel the energy sucked out of the exhibit hall, which I left early because my feet were tired (I think I’m coming down with a cold) and I had pretty much seen everything (four trips back and forth the length of the hall today alone.) Above is a typical booth view, with everybody heads-down on their phones.

I attended an early ONC session that wasn’t interesting enough to hold my admittedly short attention span. At the end, some douchebag PHR vendor CEO charged the microphone in pretending to ask a question by orating endlessly at the ONC panel, then went off in a long, pedantic description of how wonderful his thumb drive PHR product is (including histrionics like waving it around in the air) and claiming it could replace HIEs. If there was one of those bank teller panic buttons, I’m sure one of the ONC people would have pressed it to have him forcibly removed, but without it they could only smile through gritted teeth hoping he would accidentally come up for air so they could interrupt his infomercial. I was afraid I’d get trampled as most of the theater joined me in fleeing for the exits. I wish I had noted the company’s name to award them the appropriate level of public ridicule.

I hate it when people ask their long-winded questions after a presentation. I’d much rather let them use index cards or tweets so I don’t have to listen to their life story instead of the speaker I came to hear. Why are they encouraged to introduce themselves since nobody cares? Why doesn’t someone hold the microphone and yank it away when they refuse to shut up? When I see the self-important folks sprint over top of each other to line up salivating for their turn at the microphone, I make an equally speedy beeline for the door knowing that the interesting part of the session is officially over.

I say it every year, but the best asset of any vendor is the Hyland magician outside their sports bar exhibit. Not only is his magician’s patter amazing (“Wanna see something cool?” which is probably equally good as a pickup line) but he then works the crowd and talks knowledgably about how the OnBase product connects to Epic or Cerner or whatever. There’s no way he could memorize all that, so he must be an employee who just happens to be a magician. Whatever they pay him isn’t enough.

People keep asking me whether Epic should join its competitors in CommonWell. My answer: I wouldn’t, at least not yet. My understanding is that the participants signed a non-binding letter of intent and kicked in up to $2 million each to perform vaguely described interoperability work on an undefined timeline. Set an Outlook reminder for a year from now and let’s see if these large publicly traded companies can actually accomplish anything that benefits patients in ways that existing interoperability and HIEs haven’t. By apparently not inviting Epic initially, at least part of their agenda is pretty clear. The HIMSS timing raises the possibility that it’s more of a marketing program than it seems, to the point that I heard that Allscripts didn’t even sign up until Sunday night (Paul Black wasn’t present at the announcement, maybe for that reason). If they can actually make progress quickly, then Epic can always join at that time since they claim membership will be open to everyone. Being in favor of patient-benefiting interoperability doesn’t necessarily mean signing up for CommonWell, and if the market demands such participation, more companies will get on board.

I heard many people today complaining about having eaten too much very rich food this week. Nobody even wanted the beignets vendors were handing out from their booths today. I was glad that I had a delightful river view tapas dinner with a new friend Tuesday night since I was overloaded with gumbo, etouffee, jambalaya, andouille sausage, fried oysters, and bread pudding. My serum Tabasco levels are off the chart.

A pet peeve: sales guys wearing white lab coats. I don’t think they realize how offensive it is to clinicians (me included) who worked hard to earn the right to wear them in appropriate situations. Maybe next HIMSS I’ll don priest vestments to listen to their pitch.

3-6-2013 8-13-55 PM

Bill Clinton drew the largest keynote crowd I’ve seen at a HIMSS conference, totally filling the main hall and darned near overwhelming the huge lobby that served as an overflow area (above). It was like Billstock. I heard that people were so packed inside the hall that they had to clear some of them out because all the blocked aisles were a fire code violation. I guess he was OK in a big picture kind of way, and it’s always fun to get a little bit of inside baseball knowledge from a former president. There were snickers when one of his stories involved “walking down the street with my young intern,” but he clarified that it’s a guy.

Live from the HIStalk Executive Lounge(that’s how Medicomp labeled it) at HIStalkapalooza – attendees issue their predictions for 2013.

3-6-2013 9-44-27 PM 

3-6-2013 9-46-49 PM

Impact Advisors sent over some pictures from their Monday night event at the Grand Isle Restaurant.

Exhibit Hall

3-6-2013 9-55-56 PM

Someone from Microsoft apologized here for their employees texting and ignoring booth attendees, so I figured I’d give them another chance. I walked up to the very same station, stood still and made eye contact, and a MSFT guy who was texting walked very slowly away from me, like he wasn’t in a hurry to get anywhere except away from me. I was then intercepted and engaged professionally and cordially by Sarah, but then again she’s the healthcare marketing executive and you would expect her to be excellent (and she was.) Still, it was a much better experience.

I assume the Microsofties and others who have minimal booth personality are technical people and you can forgive them for that. At the opposite end of the spectrum was the utterly delightful young lady at the Tellennium booth. I told her there’s no way she’s a real employee since she was just too upbeat and magnetic and she proudly said that she’s a “brand ambassador.” I liked her instantly.

Here’s a shout out to Chelsey from Radianse, who had the best engagement style I’ve seen so far this week. She wasn’t arrogant, forceful, or overly rehearsed, but she also wasn’t scared to go shoulder to shoulder into the details of their product. Nice job. She pulled me in off the aisle I was walking down and actually taught me a few things that were good to know.

Spectralink had a pretty cool “man down” phone that automatically opens a call to hospital security if the wearer either drops it or starts running. The call is initiated in speakerphone mode, so if there’s something going on or the wearer is unable to reach the phone, the person on the other end will hear it.

Salar’s booth was in a terrible location behind the menacing adjacent booth that loomed up into the rafters, but Greg Wilson did a nice job engaging me, probably just happy to see an actual person in the HIMSS no-man’s land the company assigned the company since it started over on HIMSS points after being acquired a couple of times. Our sign was out there, which is what caught my eye in the first place.

I saw our signs out at the booths of PDR Network, VitalWare, Divurgent, and SuccessEHS. Thanks to those sponsors.

3-6-2013 8-05-24 PM

Here’s a rare HIMSS sighting of Cerner’s Neal Patterson, who I noticed as he entered the Motion Computing booth this afternoon right after the Bill Clinton break.

Here’s a video of Dr. Jayne playing Quipstar in Medicomp Stadium.

3-6-2013 9-09-44 PM

Some of my favorite people are the ESD crew, who not only sported a fun and beautifully green booth that coordinated with our sign, but who were a blast at HIStalkapalooza this week, sponsored last year’s event in Las Vegas, and might reprise that role in the future. They dutifully posed for a picture. The company really is a great supporter of our work, going way beyond just mailing in a check.

3-6-2013 8-49-43 PM

This company always makes interesting shirts.

3-6-2013 9-19-12 PM

A reader sent this photo of the cool (but kind of creepy) Greenway smart-alecky avatar. The reader says its name is Christo.

3-6-2013 9-22-13 PM

I admire this ingenuity and dedication. Strata Decision Technology is a brand new sponsor and came on board too late for us to make them a booth sign. They e-mailed to say they took a picture of someone else’s, added in their own name, made their own sign, and proudly displayed it in their booth. That is just cool and it honestly moved me, like a lot of things our sponsors do to support our work. I dropped by and chatted anonymously with the folks there, who pleasantly explained what they do when I asked (a single financial platform for capital and operational budgeting, financial decision support, performance reporting, etc.) They didn’t mention it, but I see they announced a new StrataJazz customer today, St. Luke’s University Health Network (PA).

3-6-2013 9-47-46 PM

Charlie from Orchestrate Healthcare sent over this picture of our front-and-center sign. Nice.


  • Bronx-Lebanon Hospital Center (NY) chooses Allscripts Financial Manager.
  • We already stated that the VA’s big $543 million RTLS project involves CenTrak and Intelligent InSites, but CenTrak makes it official.

Mr. H’s Ten Commandments for Booth People

  1. I will either turn my phone off and leave it off or, better still, put it away out of easy reach before commencing booth duty. If I can’t stay focused on doing the job I’m well paid to do for a handful of hours without screwing around with my phone, I should quit and let someone more motivated take my place.
  2. I will stand at all times, sitting only if accompanying a booth visitor.
  3. I will maintain a distance of at least 10 feet from the nearest fellow booth person to avoid the temptation of making co-worker small talk that will discourage visitors from initiating contact.
  4. I will not interrupt my fellow booth person who is speaking to a visitor, even though I might be tempted to help them complete a thought or help out with a demo. Trying to follow two people talking over each other is fatiguing.
  5. I will suggest that the most engaging of our people work the perimeter, with the assignment of quickly engaging passersby and then quickly handing them off to less-gregarious experts who can take it from there. Only the most personable people should serve in this prospect picket role.
  6. I will start conversations with pleasant chit-chat and not an overly rehearsed set of facts or questions no matter how many times I’ve delivered the spiel. Nobody likes to be bombarded immediately.
  7. I will approach every person who pauses, looks at anything in the booth, or appears lost. People of various personality types may signal their potential interest in a variety of ways.
  8. I will have a 10-second answer ready for the inevitable “what does your company do” question.
  9. I will not discriminate how I engage with visitors on the basis of job title or organization except perhaps in the case of a direct competitor. You never know who will be an influencer, either in their current role or down the road, and my time isn’t so valuable that I shouldn’t speak at least briefly to anyone who is interested.
  10. I will remember that visitors have walked miles and are probably carrying several pounds worth of vendor giveaways, so if I convince them to watch a demo, I will personally make sure they have a seat and a place to lay down their bag.


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

More news: HIStalk Practice, HIStalk Connect.

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March 6, 2013 News 22 Comments

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