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From HIMSS 4/16/15

April 16, 2015 News 8 Comments

My headline isn’t exactly accurate – I’m still in Chicago, but I didn’t wend my way back to McCormick Place this morning since I just wasn’t interested enough to bother. Instead, I caught up on some work, bought some clothes at Macy’s on State Street (my favorite store anywhere), and had dim sum in Chinatown.

Interesting: HIMSS scratches Atlanta and New Orleans off the cities list for future conferences, saying they can’t handle the growing attendance. That leaves only Orlando and Las Vegas as HIMSS conference locations since HIMSS had already expunged Chicago permanently (for the second time, in fact, as a result of two different tiffs – once over nasty exhibit hall workers and the second because RSNA got better Chicago hotel room rates). Exhibitors won’t be thrilled since both Orlando and Las Vegas have ample distractions that keep attendees doing something fun instead of trudging the exhibit halls like swag-seeking zombies. I really dislike Las Vegas, but there’s nothing like being handed stripper cards on your way to an educational session. If HIMSS were a stock, it would be split – other than vanity and economy of scale, it would be a lot more interesting and manageable as two separate conferences.

I thought of another company that is growing quickly based on announcements and appearance: Validic.

This week on HIStalk Connect: A number of enterprise health IT Apple Watch apps are unveiled during this week’s HIMSS conference. CMS publishes data suggesting that up to 66 percent of rural US hospitals failed to generate a single patient portal visitor during MU1 attestation. Partners Healthcare joins forces with Samsung to develop a series of remote patient monitoring solutions. Researchers at Vanderbilt University develop genetically engineered microbiome capable of tricking mice into thinking they are not hungry. 

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I was surprised to see this photo tweeted by Athenahealth showing Jonathan Bush returning to his company’s Monday night party with the shaving cream from his HIStalkapalooza-applied pie still on his face. We provided him with cleanup facilities, so I can only assume he wore the foam as badge of honor.

The final HIStalkapalooza count from House of Blues was 788. We invited 1,465, meaning that 46 percent of them didn’t attend. That’s a frustrating part of trying to plan an expensive per-person event, which I fortunately anticipated in assuming a no-show rate of 40 percent in signing the House of Blues guarantee. I’ll try not to think about the fact that the incremental cost of having more than 100 extra folks would have been zero since I was charged for them anyway. At least it’s not like last year when each of those no-shows prevented someone else from coming, although we would have let some walk-ins enter had we known about the no-shows ahead of time.

HIStalk had 13,500 page views on Wednesday, which I believe is a record.

Jenn reported an encounter with the “Epic police” this week. Epic was demonstrating in the Interoperability Showcase and Jenn (who had a HIMSS conference press pass) snapped a photo of what Epic was publicly displaying. Someone from Epic came up, said nobody’s allowed to take pictures of Epic’s screens, and then demanded that the photo be deleted from the camera while they stood there to verify. That sounds like Soviet-style overstepping big time, especially since Jenn was attending as a journalist – if you are showing your product on the big screen, if HIMSS doesn’t prohibit picture-taking in the exhibit hall (which they don’t any more as far as I can after reviewing the attendee agreement), and if the person taking the photo doesn’t work for an organization that has signed a confidentiality agreement with Epic, then I don’t believe Epic people have any legal basis for detaining attendees and demanding that they delete photos. Claims of friendly and open interoperability just don’t jibe with clearly evidenced paranoia and legal muscle-flexing. I think there’s enough Epic out there that whatever national secrets are contained on their screens have already been exposed.

Nordic did some live interviews during the HIMSS conference. Here’s one with Lorre.

Here’s Nordic’s interview with one of our patient advocate scholarship winners, Carly Medosch. We’ll have a writeup from each of them next week. Carly had a flare-up of her condition on Wednesday that required her to visit the ED, so I’ve suggested she write up that experience as part of her narrative as a HIMSS conference patient advocate.

I’m not sure what my HIMSS takeaways are. The focus seemed more on “doing” rather than “buying.” The first glimmer of patients turning into consumers showed itself. Big health systems have gotten bigger and are dealing with electronically absorbing their acquisitions. Every vendor has figured out interoperability according to themselves, yet every provider struggles to get the patient information they need that resides elsewhere. Everybody seems sick of Meaningful Use. What’s your answer to “HIMSS15 was the year of the …”?

I took some of the photos DrFirst took at HIStalkapalooza and turned them into a video (with marginally cheesy royalty-free music that I bought for the occasion for $18 just to stay legal). I’ll probably post more later and I have video from the event coming as well.

Dana Moore had a great time meeting with folks who donated to DonorsChoose. He’ll be writing up what he learned and liked for next week’s HIStalk.

I’ll be back to normal HIStalk writing this weekend for the Monday Morning Update after traveling back Friday. I’m interested to hear your thoughts about the conference this week.

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April 16, 2015 News 8 Comments

Morning Headlines 4/17/15

April 16, 2015 Headlines No Comments

Jonathan Bush on MU: A big joke that is actively unproductive

Athenahealth CEO Jonathan Bush calls the Meaningful Use program a big, fat joke and says of interoperability that the word has bee “beat up so bad, I don’t know if anyone knows what it means anymore. “ He goes on,, “preventing patients from getting their information is borderline immoral.”

Telehealth dropped from 21st Century Cures bill, sources say

The House committee responsible for drafting the 21st Century Cures bill has reportedly removed language that would have mandated that Medicare pay for telehealth services.

Healthcare Data Breaches Increasing, Require Action

Researchers from the Kaiser Permanente Division of Research say that 29 million medical records were exposed in data breaches between 2010-2013, and given the rapid expansion of EHRs in healthcare, the incidents were likely to increase.  

The Combined Effect of the Electronic Health Record and Hospitalist Care on Length of Stay

Researchers find that the the increase in hospitalist programs has had a more significant effect on reducing length of stay for patients than the increased use of EHRs, but that the combined effect of the two were also substantial.

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April 16, 2015 Headlines No Comments

Jenn’s HIMSS Day 4 4/15/15

April 16, 2015 News 2 Comments

The end of my fifth HIMSS marked the first time I’ve ever had a flight cancelled. My unexpected stay in a Howard Johnson 20 minutes from O’Hare with just the clothes on my back and the electronics in my HIMSS book bag gave me extra time to mull over the rest of my HIMSS experience.

The fourth and final day of the conference for me was a bit more scheduled, with a few media briefings and a good chunk of time spent walking around the exhibit hall in one last attempt to get a flavor for what this year’s product offerings were all about. Buzzwords seen on booths and heard in show-floor conversations included value-based care, population health management, interoperability … the usual. Not much has changed in that area from an exhibit hall perspective, with the exception of EHRs no longer being the big-ticket item. They have turned into the backbone for everything else.

I chatted with the folks from Health Care DataWorks, which spent the bulk of its HIMSS promoting a variety of knowledge packs, pre-built dashboards build into its enterprise data warehouse that address 16 hospital areas including ER, OR, and patient-related analyses. HIStalk contributing author and Cedars-Sinai CIO Darren Dworkin made an appearance at a HCD roundtable early in the week to discuss how the health system used HCD business intelligence and analytics to achieve HIMSS Analytics Stage 7 status..

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The folks at biometric identification company M2sys caught up with me to show me their first foray into mobile health. The RightPatient platform includes a mobile health app and wearable integration server that caters to both consumers and providers. The server takes data from consumer wearable devices and delivers it to the appropriate EHR, while the accompanying mobile app is the first I’ve seen that combines many most of us already have on our phones – personal health record, appointment scheduling, activity tracking, medication reminders, alerts, mood and health monitoring, and health games, to name a few. It can even be configured to accommodate the health data of multiple family members, with all data seamlessly transferred to their provider’s EHR.

I’ve been fairly vocal about the problem of having too many patient portals to log into, so it’s interesting to see the similar problem of having too many apps figured out via the aggregation of many into the distillation of one. President Michael Trader tells me that the platform will launch in July, with a mental health version already in the works.

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My last show-floor one-on-one was with the Xerox and HealthSpot team. I have been interested in the HealthSpot remote-consultation kiosk for some time, and was happy to get a personal tour. My big question for CEO Steve Cashman was, “How is this a better option than picking up my phone while at home for care via a telemedicine app?” He confidently told me that going to a kiosk location offers benefits that a telemedicine app can’t match: reimbursement; a pipeline of HealthSpot physicians who also work for local hospitals and health systems; better quality of care; regulatory benefits (he kept bringing up the fact HealthSpot can operate in Texas); and automatic integration of health data via Xerox back-end technology into the patient’s EHR. The company is looking to launch its kiosks in 25 Rite-Aid stores in June. I’d definitely like to give it a try if they ever come to Georgia.

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My inaugural visit to the Interoperability Showcase was an interesting one. The area was divided into a number of different “vignettes,” scenarios of patient care featuring family members going through different medical events. After a brief introduction by a healthcare IT magician in a central seating area, audience members dispersed to one of the vignettes, where we listened to three different docents run through the technologies involved in that particular family member’s diagnosis and treatment.

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I decided to visit the oncology/clinical trials visit of 38 year-old patient Isabel, which involved technologies from Epic, InterSystems, and the CDC. As any hard-working member of the press would do, I whipped out my camera phone to document my experience, only to have the Epic rep immediately tell me that no pictures were allowed. He even followed me out of the presentation afterwards to ask that I delete any screenshots I may have taken. The one above is the only one I managed to get.

I walked over to a different vignette to see if they were as strict with their photography restrictions, only to find out they had no problem with photography. I snapped a few shots, but did notice that the rep working the video screen logged out of whatever application he was demoing as I snapped away. The whole experience left a bad taste in my mouth. Isn’t interoperability at its core about sharing data?

A few other random observations as I attempt to wrap up my coverage:

Interviews with Dana Moore: I heard from Lorre that it was his most worthwhile HIMSS experience, and it was certainly in demand. I love knowing that money raised from Mr. Moore’s time and expertise is going to a good cause like Donors Choose. It’s great to work for an employer that places importance on helping others. I saw several other companies highlighting their charitable efforts, including Dell and QuadraMed. HIMSS attendees also got the chance to spin Divurgent’s vibrantly colored Trivia Charity Wheel. Their spins helped the company raise $5,000 for Lurie’s Children’s Hospital of Chicago.

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Customer service in the Windy City: It was fantastic, especially at McCormick Place. Everyone had smiles on their faces, and one security guard even chased after to me to ensure I went the right way to the West Hall.

Size and scope of the conference: I found the exhibit hall strangely confining despite its expansiveness. The press room was too far away from the exhibit hall to warrant my making the trek once or twice a day for a free meal, reliable WiFi, and quiet workspace to gather my thoughts and plan my show reviews. I’m not sure who thought putting zero restrooms in the exhibit hall would be a good idea – it certainly wasn’t for me. Like Mr. H and 35,000+ of our closest friends, I probably spent more time walking from point A to point B than in meetings, talking with vendors, or attending keynotes combined. For the record, I went through 10 Band-Aids on my poor blistered feet over my four days there.

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Exhibitors: I managed to run into HIStalkapalooza sponsors Divurgent and Sagacious Consultants during my exhibit hall trek. Both teams kindly squeezed together for group shots. I can’t wrap up conference coverage without mention our gracious neighbors in the exhibit hall – Medisas and Oxford Healthcare IT. The Medisas team put up with a variety of shenanigans in and around the HIStalk booth, while the Oxford team kept us well fed with their daily buffet of Chicago-style hot dogs and Garrett’s popcorn.

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Overall, I felt like I barely scratched the surface of what the show had to offer. I didn’t make it to any educational sessions other than Monday’s keynote, a similar experience to many of the providers I spoke to. It seems most people prefer to spend their time at HIMSS connecting with colleagues, and visiting vendors they otherwise wouldn’t be able to get to throughout the year. Perhaps next year I’ll take a different approach and spend most of my time in sessions rather than on the show floor. Given that it’s in Las Vegas, I can only hope the House of Blues there will be happy to host our next HIStalkapalooza. I hear Lorre is already entertaining sponsorship requests.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

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April 16, 2015 News 2 Comments

Dr. Jayne at HIMSS 4/15/15

April 15, 2015 Dr. Jayne No Comments

I’m way behind on my writing, mostly due to the overwhelming nature of the exhibit hall coupled with entirely too many social events. I had decided to walk to McCormick Place Monday morning but abandoned my quest after the first half mile due to the drizzle. I was joined on the bus by two women who joked about the window curtains, saying that if they were rock stars they’d close them and kick back. If they were rock stars they’d have couches and tables rather than the flimsy cup holder that turned my bottle of Diet Coke into an ankle-seeking missile.

They joined me in rolling our eyes at the people on the bus who jumped up and rushed the front as soon as the bus stopped. I’m not sure what happened to waiting until those in front of you exit, but that wasn’t the only bus ride where that happened. I had been trying to time my arrival to the opening of the exhibit hall, but was early since I decided to catch the shuttle at the Hilton. I picked up some breakfast and was nibbling a sandwich and juggling my stuff. I want to offer a profound thank you to the gentleman who gave me his chair and proved that manners still exist.

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Shortly after that, I saw a tweet from Jessica Kahn that highlighted images of women at HIMSS with the hashtag #overit. Sex definitely still sells, as proved by a vendor event I attended that featured scantily-clad Go-Go dancers. I did overhear several attendees comment that they thought there were fewer “booth babes” than in previous years. The wildest thing I remember seeing was in 2011 when one vendor had contortionists on stage in their booth. As a clinician, it was fascinating, but still not appropriate.

I did make it to a couple of sessions, but none of them had anything earth shattering. Monday’s agenda was aggressive and included hitting several booths before making my way to play Quipstar at the Medicomp Systems booth. The amount of work that goes into putting together a full-scale working game show set is huge. Their backstage area hosts a variety of technology that keeps the game up and running. I’m not sure how many trucks it takes to haul it, but the infrastructure of their two-story booth is pretty impressive.

My performance as a contestant, however, was not impressive. Despite winning the double-points bonus question, I finished second and will be taking home six gallons of popcorn, which I’m sure my staff will enjoy. The real prize was their donation of $1,000 to Wings of Hope. Nominated for the 2011 Nobel Peace Prize, they set up field bases in developing nations. The bases help build clinics and schools, and establish air ambulance service for rural areas. As a non-sectarian, non-political organization, they can often work in areas that will not accept other charities. They also operate a Medical Relief and Air Transport Program in the US that flies children for medical treatment free of charge.

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I returned to Quipstar later in the day to escort Jonathan Bush to the booth. He played for the St. Boniface Haiti Foundation against former ONC Deputy National Coordinator Jacob Reider. St. Boniface Haiti Foundation helps bring healthcare, education, and community development to the people of Haiti. The highlight of the round was seeing them take a selfie together. The contest was also full of entries for my “things I thought I’d never hear at HIMSS” list, but they were throwing them out too fast for me to jot them all down. Dr. Reider won the round, earning $300 cash which he added to the Medicomp donation to Engeye, which is dedicated to improving health and education in Uganda.

Later I stopped by the Dell booth to put together some cute headbands for Brooke’s Blossoms. They will go to pediatric cancer patients. We always like hearing about HIMSS events that benefit others, so if you have pictures or write-ups, feel free to share them. I wanted to hit several other booths, but was struggling mightily with the floor plan, mostly due to confusing booth numbering and crazily staggered aisles.

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I left the exhibit hall early to get ready for HIStalkapalooza and was glad that I did since the bus ride to my hotel involved nearly 45 minutes of bumper-to-bumper traffic. Luckily the taxi to the House of Blues was much quicker. I had the opportunity to chat with my Secret Crush, David Dieterich, who was admiring my escort’s crushed velvet jacket. Although my crush initially bought my cover story, I’m pretty sure he figured out my secret identity.

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The third floor at the House of Blues was the place to be for dinner, with minimal buffet and bar lines. I snagged a front row seat to enjoy the music while having dinner with a couple of friends. Although I couldn’t experience the sponsor opera boxes because I didn’t have a wristband, they looked cool. After dinner, it was time to grab some pecan pie and head to the dance floor for the HISsies.

As an avid baker, I enjoyed Judy Faulkner’s comments about liking to bake pies. She said she was reluctant to put the pie in Jonathan Bush’s face because it would be an insult to the pie. BTW, apple is her favorite. Once the HISsies were over and the pie was abused, Party on the Moon took the stage. They were even better than I remembered and I hope we can make them a permanent fixture. I overheard several hysterical comments throughout the night, including one attendee’s remark that the lead singer looked like the love child of Farzad Mostashari and Usher.

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I admired many footwear choices, lamenting the fact that I just can’t do stilettos anymore. I wish I could have gotten a better picture of the red boots above — they were phenomenal. If the owner sees this, please send me a picture and description for my wish list. I could probably tolerate those for a couple of hours. Since I listened to my Shoe Advisor’s pronouncement that “wedges win every time,” I was able to stay on the dance floor until the bitter end, then hit two after-parties before collapsing at The Palmer House.

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A reader shared a pic of the Athena Cloud Party, describing it as “insane.” I’m wondering if Jonathan Bush had any comments to make about HIStalkapalooza? I know there were plenty of other events Monday night – send your best pics and a description and I’ll run them next week.

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April 15, 2015 Dr. Jayne No Comments

From HIMSS 4/15/15

April 15, 2015 News 9 Comments

From Canuck: “Re: British Columbia EMR. Big implementation gone sour with a reported $125 million spent so far with nothing to show. This story barely touches upon the issues encountered thus far, issues we’ve all seen in other similar projects.” British Columbia parts ways with IBM two years into a 10-year, $700 million project that remains 85 percent incomplete. The health minister still expects to get the project done on time and budget, which is ridiculously optimistic given government IT performance worldwide even when it doesn’t involve dumping the prime vendor. Perhaps the US Department of Defense should notice that its big EHR bidders haven’t performed well in comparable but much smaller projects outside the US, although fault is often hard to assign to either government or prime bidder incompetence. I can’t name a single big government IT project that was delivered on time and on budget, but I can name a bunch that were abandoned with no benefit whatsoever.

From Due North: “Re: NantHealth. Cancelled their HIMSS conference presence at the last minute, eating the huge deposit. Everyone I knew there is gone.” Unverified, but new President Bob Watson was available only in the private meeting rooms over by HIMSS Bistro, which I happened to see while having a lakefront lunch there today. 

Here’s an interesting rumor I heard today from a fairly good source: Karen DeSalvo will reportedly leave her HHS position in a couple of weeks. I hope it’s not true because she’s a credit to public service and has in her short tenure done a very good job in walking the ONC tightrope that tries to balance innovation, public health, and Meaningful Use. The source suggested that Micky Tripathi turned down an offer to serve as interim, which would be a surprising offer given that he’s brilliant but not an MD like all of the National Coordinators so far. I’m almost always a cynical sourpuss when it comes to industry leadership and yet I find myself hoping she not only continues as National Coordinator,  but is given more federal responsibility despite serving within a lame duck administration. The rumor wasn’t clear, so perhaps there’s a bigger role for her within HHS, such as with CDC or NIH. Or maybe it’s not true at all. Feel free to ask her after her Thursday morning HIMSS keynote if you’re still in Chicago. She gets my vote for whatever she wants to do, as does her predecessor Farzad.

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Here’s Regina Holliday’s latest artwork, which she painted right in the HIStalk booth this week. It’s in honor of HIStalkapalooza, with the pie representing the one Judy Faulkner presented to Jonathan Bush and the beauty queen sash indicating, “We are your biggest fans,” which Regina said she heard repeatedly from folks at the event in reference to HIStalk.

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I met one of our HIStalking scholarship winners today when Lorre introduced me to Mélanie Péron, our representative from Paris. She cried, hugged, and expressed endless appreciation for the opportunity to attend the conference representing patients. She triggered instant insight on what it takes to be successful as a patient advocate. We healthcare people are used to geeks calmly presenting reams of worksheets, but we are justifiably easily moved by people who can tell a heartbreaking or inspirational story, who get fighting mad at injustice or incompetence, or who tug at our hearts with sadness when the industry in which we work in caused harm to their loved ones or failed to prevent it. We all know it could have been us our our family members on the wrong end of a bad but unfortunately not uncommon healthcare experience. Maybe that handful of people we brought to Chicago are dwarfed by the 43,000 others here who are more interested in finding expensive dinners or selling systems, but their activism keeps us all honest and pushes our faces to the mirror of what’s wrong with healthcare that only we can fix. It’s brilliant. I’m glad they were in Chicago this week and I’m anxious to hear their thoughts about the big business aspects of a sometimes indifferent care delivery system that they’ve now witnessed firsthand.

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Our HIStalk friend Marty Mercer says HIStalkapalooza is the best party he’s ever attended, possibly because he was being fawned over by two members of Party on the Moon.


Today’s Conference Notes

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I started my day with a visit with HealthLoop. They were handing out badge ribbons indicating “Empathologist” because they create electronic connections to patients that make them feel connected and engaged in a high-touch way, including scripted electronic check-in. The messaging extends the patient experience before and after the planned encounter, such as sending pre-surgical patients a daily reminder by phone or email to get up and walk around or otherwise prepare for their procedure or to recover from it afterward. It boosts patient satisfaction while delivering patient education. It can even route patients automatically to doctor rating sites and collect survey information for patient-reported outcomes. It was a quick but positive look.

I then stopped by Medfusion, which offers a free “portal of portals” in aggregating multiple portals into its vendor-agnostic one. It was pretty cool in that it can tie together multiple portals to look like a single one to the patient, displaying everything via a slick app. Vendor- and provider-specific portals are really ridiculous in this day and age where every patient would have to manage 10 of them to keep up (and instead never bother to log on at all), so combining them all visually is about the best we can hope for at present.

Next I visited Influence Health, whose EHR-agnostic product brilliantly combines patient engagement, provider marketing, and a patient portal. Consumer choice means providers need to selectively market their services and it’s interesting how Influence Health does it with a consumer user interface that is as familiar as Facebook and Outlook. The company seems to get the connection between clinical patient engagement and provider marketing better than anyone. I only saw a short demo, but it looked solid and smart to me.

A reader asked me to check out Patient Route, way back on the no-man’s land of the HX360 pavilion (which was maddeningly difficult to navigate even with booth number in hand – it literally took 20 minutes to find them even though I was within 100 feet of their little stand). They do some kind of predictive throughput and staff modeling based on historical and real-time information, although I have to say the pitch I was given was not particularly well thought out or informative. About all I heard is that the Brigham is using it to push more surgeries to their suburban hospitals where they get paid more for the same work and don’t have capacity limitations. They didn’t give me enough information to form an opinion.

I checked out MedCPU and was guardedly impressed. The company’s clinical decision support product brings in the usual HL-7 data but also decomposes the free text information that forms most of the available patient data, using natural language processing, text extraction, and a clinical context engine. It turns all of that text into discrete information that is used to provide EHR warnings via a Citrix DLL, so that it sits in the EHR window but separate from it and thus requires no integration effort. It gives clinicians warnings of conditions that are far too subtle for normal field-based CDS to detect. My “guardedly” adjective refers only to the fact that I want to talk to a live site, which the company is arranging. If it works as billed, it’s really well beyond the rather primitive CDS such as drug-drug interaction warnings and drug-lab contraindications. Eyal Ephrat, MD has a track record that instills trust, having founded E&C Medical Intelligence (now PeriGen, which does great work). He and I got a bit deep into the bowels of their patented technology and I want to learn more from actual users.

A reader suggested I look at Innovatient, which offers in-room entertainment, patient assignment, and some nurse call system overlap. I can’t say it struck me as offering anything not already readily available from Oneview, GetWellNetwork, and other vendors, but they have 10 live sites and maybe there’s more than I noticed.

Another reader wanted me to look over Patientco. I can’t get too excited about patient bills and payment options, but if I did, I would love it. They print easily understood bills (designed using sound psychological principles right down to the colors used) and make it easy for patients to settle up online. Patientco is about as cool as billing can get and customers are seeing higher collections and patient satisfaction from using it.

Yet another reader asked me to check out Healow, part of eClinicalWorks. I don’t have much of a reaction – it seemed to be a basic phone-powered portal into a provider’s eCW system with some wearables connectivity built in.

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NextGen had this cool, computer-controlled waterfall that actually spelled out words and presented pictures using only water patterns. It was bizarre but fascinating.

Today’s MedData scones: banana-maple and pumpkin. My Fitbit can’t count enough steps to offset the calories I took in enjoying them.

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HIMSS requires exhibitors to refrain from heading out before Wednesday’s 4:00 exhibit hall close time, but plenty of them (HIStalk included) were boxing up well before then.

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Some strange Epic booth art.

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Epic’s KLAS results posted on their booth walls shows Cerner second with no green at all, Allscripts flailing around in the middle spot, and Meditech dropping precipitously toward the all-red CPSI bottom feeder level.

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This is pretty amazing. Centura SVP/CIO Dana Moore met with interested vendors today at a price of a $500 donation to DonorsChoose in return for 20 minutes of his uninterrupted time (which was matched by a generous, anonymous vendor so that we raised $6,000 for needy classrooms today). I expected Dana to nod politely and check his watch constantly from boredom, but instead he told Lorre that it was the best two hours he’s ever spent at a HIMSS conference. Every one of the six vendors had a solution to one of his current problems and one of them had a solution that he didn’t even know existed. His positive experience makes me think we should replicate it on a larger scale at some point, carefully matching provider executives with vendors based on needed, available solutions.  


HIStalkapalooza Photos from DrFirst

Thanks to DrFirst for providing photography and videography at the event. I’ll probably turn some of the many great photos into a video slideshow or something since it’s great for folks to see themselves having fun. As much as I fussed for many months about the effort and personal cost exposure of running the party, it felt worth it to see the crowd responding so positively to the HISsies and the band.

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I’ll get back to a more regular posting schedule since I’ll pass on returning to the conference Thursday. It’s been a long week.

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April 15, 2015 News 9 Comments

Morning Headlines 4/16/15

April 15, 2015 Headlines No Comments

Bipartisan Senate ends flawed Medicare payment formula

On Tuesday, Senate passed the SRG replacement bill that cleared the House last week, winning 92 – 8 bipartisan support.

GE Healthcare: We’re leaving the hospital EMR business

At HIMSS, GE Healthcare reportedly confirms rumors that it will phase out its Centricity EHR business line, but then later this week introduces a new financial management  product under the Centricity line.

Health IT chief DeSalvo urges more patients to seek access to electronic records

ONC chief Karen DeSalvo, MD spends part of her week at HIMSS defending her recent decision to remove the minimum 5 percent threshold for patients who view, download, or transmit their medical record.

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April 15, 2015 Headlines No Comments

Jenn’s HIMSS Day 3 4/14/15

April 15, 2015 News 2 Comments

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My third day at HIMSS started off with the #HITchicks tweetup at the HIMSSpot in between the exhibit halls. A group of about 50, including a smattering of men, attended to talk and tweet about the role of women as patient advocates and the highlights of HIMSS15 thus far. It didn’t take long for the “booth babe” conversation to take off, with one audience member shouting out HIStalk for bringing attention to the unfortunate trend a few years ago, and consistently calling out those companies that choose to hire pretty faces in tight-fitting spandex to shill their products. I thought it was especially fitting that me, Lorre, and friends of HIStalk added the badges below to our HIMSS15 wardrobes. Kudos to HIStalker Steve Blumenthal, business and corporate law attorney at Waller Lansden, for supplying them. He’s got a pretty sharp sense of humor for a lawyer.

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The tweetup had not one but three highlights for me: University of Michigan Hospitals and Health Centers CIO Sue Schade – CHIME’s CIO of the Year – stopped by the voice her support for the group. Kym Martin, a four-time breast cancer survivor and patient advocate (not to mention the lovely wife of HIStalk Blues Brother Ross Martin, MD), shared her story of patient advocacy and journey as a four-time breast cancer survivor. Last but not least, ONC National Coordinator Karen DeSalvo, MD stopped by to share her experience as a woman who has worked in academia, public health, and now on the national political stage.

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My next stop was the ONC press briefing, where staff gave a run down of the office’s accomplishments over the last year. Interoperability and partnerships were definitely the overarching theme. DeSalvo took the briefing as an opportunity to announce the availability of $1 million in grant funds to support health IT projects for the Community Interoperability Health Information Exchange Program. The program will award funds to 10 organizations, including those that are not eligible for MU incentives. Applications for the program are due June 16.

We didn’t get too far into the Q&A before someone brought up the patient engagement crowd’s (including Farzad Mostashari, MD’s) uproar over the decision by CMS to change the Stage 2 requirement so that providers now have to show that one patient, rather than 5 percent of their patients, accessed their information online. DeSalvo calmly stressed that ONC is absolutely committed to ensuring that patients have access to their health data, adding that she is encouraged that a dialogue is taking place on the issue. She also reminded reporters that this is a proposed rule, and that formal comments on the rule are encouraged. I understand why some might call this a step backward for the MU program, but I can’t help but think many providers are breathing sighs of relief. You can’t force people to use the Internet, especially those that don’t have access to a computer or reliable WiFi. As DeSalvo reiterated throughout her response to this question, the true challenge will be a cultural one, not necessarily one solved by technology, which is why it’s so important for the ONC to partner with other federal agencies as they attempt to evolve their focus beyond EHRs.

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My next stop after a quick lunch in the press room as at the Emdeon booth, where I moderated a panel discussion with Emdeon’s Gene Boerger and CareCloud’s Albert Santalo on fueling product innovation with big data. I was slightly jealous of the stylish and super-comfy shoes the Emdeon staff were sporting, not to mention the cushioned carpet in their booth. I enjoyed wandering around both sides of the exhibit hall afterwards, snapping pictures of those that had unique designs, catchy marketing gimmicks, and bustling crowds.

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My remaining time at the conference was spent at our booth, where I got the chance to witness The Walking Gallery converge, courtesy of HIStalk’s good friend Regina Holliday. I especially loved the vibrant color of Farzad Mostashari, MD’s jacket. Let the data flow ….

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My day concluded with a quick stop by the Patientco party, where I ran into Caroline Wood and Sherry Farrugia of Georgia Tech. Talk soon turned to a company called Evidation Health, launched last month by GE Ventures and Stanford Health Care to improve health outcomes with evidence-based digital health tools. Their excitement about the startup was palpable, so I may have to crash the road trip they’ve got planned to go out there later this year.

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After that it was on to the Edifecs #HIMSSandHers meetup, where I happily talked shop with Politico’s Ashley Gold. I left with a T-shirt and a selfie stick, my favorite piece of HIMSS swag so far. Despite being thoroughly exhausted, I’m already looking forward to seeing what my final day of HIMSS will bring.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

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April 15, 2015 News 2 Comments

From HIMSS 4/14/15

April 14, 2015 News 11 Comments

From Thinking Ahead: “Re: HIStalkapalooza. How can we sponsor next year’s event?” Contact Lorre. I think this year’s sponsors feel they got their money’s worth since it let them have a “party within a party” that offered cool exposure that impressed prospects, but didn’t cost them much since the fixed costs were spread over several sponsors. I question my sanity in assuming so much work and financial risk just to throw a free party where I don’t know all of the attendees, but for at least one evening per year, it almost seems worth it. I haven’t fully decided about doing it again next year.

From Donnie Brasco: “Re: Epic. Announced that Care Everywhere is free until 2020. The $2.35 per patient per year Epic to non-Epic exchange fee was eliminated. Haven’t heard start date or other details.” Epic was taking in only a tiny bit of revenue anyway, and given the negative (and often inaccurate) press as well as the occasional Congressional scorn, it’s a smart move to just waive the small fee rather than defending it.

From GE Hellcare: “Re: Centricity Enterprise. Announced as retired during HIMSS. No more inpatient EHR. They haven’t decided whether to sell it to another company or retire it.” I hadn’t heard that, but then again it’s not exactly a force to be reckoned with either way.

From Tom Terrific: “Re: MedCity News referring to HIStalk as ‘the National Enquirer of health IT.’ I may never read that site again!” I was peeved that a snarky report that recapped HIStalkapalooza made it sound like HIStalk is some kind of tabloid journalism site that isn’t respected or trustworthy, which seems a bit ungrateful given that the writer enjoyed their evening at my expense and filled some of their news space recapping the Jonathan-Judy portion of it (which, now that I think of it, sounds a lot more like ‘National Enquirer’ celebrity gossip masquerading as news than anything I write). I’ll compare experience, issues analysis, news relevancy, and rumor accuracy with anyone.

From Lincoln: “Re: Allscripts. I heard UCI is dropping Sunrise for Epic, the last of the UCs to do move there.”

Centura Health SVP/CIO Dana Moore’s dance card is filled for his 10 until noon time slot in our booth Wednesday, but if you’re willing to donate $500 to DonorsChoose to get 20 minutes of his undivided attention, Dana says he’s willing to stick around later. Remember that we also have an anonymous vendor that is matching that amount, so each 20-minute taker sends $1,000 to underserved classroom projects. One vendor’s executive says she doesn’t really have anything to pitch to Dana, so she’ll use her time to teach him how to make balloon animals. See Lorre in the booth Wednesday morning.

News: the Senate passed the SGR doc fix bill late Tuesday without ICD-10 additions, requiring only the President’s signature to avoid cutting doctor payments (at the expense of adding another $141 billion to the deficit).


Announcements That Are Kind of Interesting

  • Arcadia Healthcare Solutions announces $13 million in new funding.
  • InstaMed offers its payment network customers the ability to charge patients using Apple Pay.
  • Identity management vendor CrossChx raises $15 million.

Today’s Conference Notes

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We had The Walking Gallery in our booth this afternoon. Each painted jacket tells a story of suffering and loss amidst a struggle with a sometimes uncaring, bureaucratic, paternalistic, or inefficient medical establishment. You should care because it’s about patients and we’re all a patient at one time or another – working in healthcare doesn’t protect you or your family from its problems.

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Our favorite attorney Steve Blumenthal (on the right) hung out in the booth today and handed out swag. He tried to get approval to give away little bottles of whiskey since his company is in Nashville, but being lawyers, they scotched the idea (no pun intended) fearing mass litigation from conference attendees who might injure themselves in an alcoholic stupor. He made himself a badge labeled “HIStalk Booth Babe” that featured a silhouette of a reclining obese male (he’s pointing at it in the photo). He says he’s pretty funny for a lawyer but it’s not exactly a high bar, so I’m not sure if the “bar” part was an intentional pun.  

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I still haven’t received any of the HIStalkapalooza photos or video folks were taking for us, but here’s a great band shot from Nordic. Guys loved those red dresses. I should have Lorre check the band’s rider and production details to see if they intentionally installed a hair-blowing fan to make the angelic-sounding ladies look more model-like – I noticed their tresses were undulating fetchingly in the apparently intentional stage breeze.

Want to see the big HIMSS conference keynoters? Plan on sticking around longer than you should since HIMSS backloads the big guns – George Bush is at 4:30 Wednesday and Karen DeSalvo isn’t until 8:30 Thursday morning after everybody who has real work to do is already back doing it.

I remember when vendors weren’t allowed to offer food from the exhibit hall, not even packaged candy. Now you can get just about everything – I’ve had margaritas, mini hot dogs (the sauerkraut was smelling up the adjacent booths), and of course the amazing scones from MedData – my favorite was on tap today, peach with passion fruit icing. Seriously good. I would have had a second one with my HCI-provided beer except they ran out. MedData even delivered some scones to our booth. I’ve heard a scary rumor that Las Vegas doesn’t allow ovens in the exhibit hall and that’s a problem for next year’s scone supply.

Tip: if you want to take UberX back to your hotel, they can’t pull into the taxi loop at the door and the app won’t let you call a car – instead, walk a block or two to the right and then place your Uber request. Even with surge pricing I was able to get back to Bridgeport for $13 this afternoon.

I meant to check out NantHealth since last year I couldn’t figure out what they do even after the booth people tried to explain it to me (clearly they didn’t really know either). I haven’t found their booth so far.

The companies that seem to be on a growth rocket ride, at least from their conference presence, include Access and CoverMyMeds. I’m sure there are others, but those made my radar.

Speaking of growth, here’s a project for all you analytics people. Get copies of the HIMSS exhibitor guide from the previous couple of years. Assign weighting factors to each vendor in the exhibit hall that are both positive (bigger booth, more desirable location, consecutive years of exhibiting) and negative (dropping out of exhibiting or taking a smaller booth). Who is trending up or down? Who stopped showing up at all? How many first-timers returned? How many companies shot their financial wad on one big HIMSS presence and then sank without a trace?

I took a look at Medhost’s YourCareEverywhere, which is sort of a patient portal for hospitals that run its systems. It looked pretty good.

I thought Marshfield Clinic had given up trying to turn its CattailsMD ambulatory EHR into a commercial product, but they’re back with a new cloud-based version. I watch part of a demo and it looked OK but nothing special. I don’t know why with all the EHR vendors out there someone would buy from a provider, but Farzad was checking it out, so maybe it’s cooler than I thought. They only ever sold 34 Cattails systems and now those users have to move to the new one.

PeraHealth says it has grown a lot and they list a bunch of big-name academic medical centers as customers for its Rothman Index patient early warning system.

The Anthelio folks say they’ve grown a lot. I liked them.

I got a quick look of PerfectServe’s slick Synchrony secure communication app. They’re planning to expand it to cover nurses.

I sat through part of a demo of Oneview Healthcare, which offers a cool tablet-controlled in-room patient display where patients can order meals within their prescribed dietary restrictions, input questions that employees are prompted to answer, view educational material (which can be prescribed by clinicians), and a lot more that I couldn’t stay to see. It’s worth a look.

It was bad enough that the exhibit hall is divided into two wildly non-linear sets of booths, but today I found that way down on one side is a real no-man’s land housing the cybersecurity, disaster recovery, and HX360 tracks. You go through some depressing loading dock type doors into what looks like a truck garage and there are a bunch of nondescript booths, mostly free of people, energy, and buzz (although the Leidos cybersecurity speaker had a pretty good crowd). I felt bad and strolled through all the aisles trying to raise spirits by just having a visitor poking around, but the reps had mostly already flatlined their interest and were counting down the minutes until quitting time. I figure some of the products back there surely have a chance to be eventually successful, but the HIMSS setup as so awful that it was creepy just hanging around back there, so I bailed. Here’s how remote it was: there were a ton of empty soft couches, tables, and chairs with no takers. Haul that messy barbeque sandwich there at tomorrow’s lunch and you’ll have a place to eat it instead of spilling it on your shirt and shoes.

I saw a display that offered, in large letters, a “Wellenss Kiosk.” I didn’t have the heart to snap a photo to run here.

Speaking of food, we had a great CMIO lunch today in Bistro HIMSS in the Lakeside building near the exhibit hall. The buffet was really good, the lake view was nice, and it was comfortable and reasonably quiet. Anybody can stroll up and buy lunch for $24. Thursday’s menu sounds excellent and we have a handful of leftover tickets, so maybe I’ll buy someone lunch if I’m in the mood. The CMIOs seemed to enjoy getting together today with Lorre.

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Cerner takes direct aim at Epic on one of its booth signs.

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This prize must have had the nerds salivating.

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Clever badge ribbons.

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I thought I might learn something about the just-announced IBM Watson Health, but this guy was way over my head with P53 genetic variants.


HISsies 2015 Winners

The winners are here.

More Wednesday. I’m taking a look at products claiming to be innovative for patients and families. Let me know if there’s anything else I shouldn’t miss.

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April 14, 2015 News 11 Comments

Morning Headlines 4/15/15

April 14, 2015 Headlines No Comments

IBM Creates Watson Health to Analyze Medical Data

IBM’s Watson team announces Watson Health, a partnership with Apple, Johnson & Johnson, and Medtronic as well as the acquisitions of Explorys, a data analytics startup and Cleveland Clinic spinoff focused on spotting patterns in diseases, and Phytel, a software vendor focused on reducing readmissions.

Surescripts Advances Nationwide Healthcare Interoperability with Broad Implementation of National Record Locator Service

Surescripts leads a coalition of EHR vendors that includes Epic, eClinicalWorks, and Greenway Health on an initiative to create a national record locator service.

InterSystems Announces HealthShare Personal Community, a Comprehensive Patient Engagement Solution

InterSystems launches an MU2 certified vendor agnostic patient portal.

KPMG To Acquire Healthcare Consulting Firm Beacon Partners, Inc.

As was rumored on HIStalk last week, KPMG will acquire health IT consulting firm Beacon Partners for an undisclosed sum.

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April 14, 2015 Headlines No Comments

Dr. Jayne at HIMSS 4/13/15

April 14, 2015 Dr. Jayne 1 Comment

I made it to Chicago despite an extremely turbulent flight, opting to take an earlier route to Midway instead of O’Hare. The taxi queue was epic and made me long for the organization of Las Vegas. I did run into several friends in line, although none we headed to the same hotel. Although I’m usually annoyed when my taxi driver talks on the phone while driving, this one was lecturing his high school daughter on her GPA and the importance of getting into a good college, so I just relaxed and enjoyed the ride.

Besides catching up on new products and doing research, the main reason I come to HIMSS is to catch up with colleagues. It’s nice to be able to chat in person and the event brings so many people together. A friend who has missed the last couple of HIMSS conferences met me and we enjoyed the long walk to the convention center for registration. Other than a few sprinkles, the weather was gorgeous. The only thing that could have been better would be if Google Maps had not been providing walking directions that felt like we had been bar-hopping first.

While waiting outside the opening reception, I ran into a CMO friend that I hadn’t seen in several years and we talked about her new work with the VA system. Our employed specialty physicians provide a lot of care to veterans outside the VA clinics, so we talked about some strategies for making sure all the information is shared not only within the VA but with the community physicians who deliver increasing amounts of care for veterans.

The reception opened a bit early and there were plenty of bars and buffets set up. The band was named The Fat Babies and was playing to the backdrop of scenes from The Untouchables on the video screens above and behind them. I haven’t seen it in years and the younger Kevin Costner and Sean Connery reminded me that I’m not getting any younger either. I’ve officially been in healthcare IT for more than a decade. Had you asked me at the start whether I’d be doing it full time, I’d have thought you were crazy.

The reception brought some interesting characters my way. Since I was there early enough to grab a table, I made a good target for solo attendees looking for a place to set their drinks while they ate. People aren’t afraid to just introduce themselves and start talking, and my wing-man got to see me almost choke when one of the random people started talking to us about absolutely ridiculous things. Despite the titles on his badge, he had only a loose grasp of some of the key concepts in health IT, so we educated him on the Direct protocol and how physicians need to incorporate received data into patient charts – not just leave it in some email box. I had to leave my wing-man after the reception, but he promises to share many stories about other characters on our upcoming stroll through the exhibit hall.

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After the reception, we headed towards the river with a stop at Rebar at Trump Tower. It has a beautiful view and apparently also was hosting a get together for Healthfinch, so we enjoyed seeing celebrities come and go. After a quick dinner we headed to the Divurgent/Experis reception at Roof on the Wit. I was traveling with a pack of party animals who decided to have a contest to see how many people each knew. The competition was stiff and I was quickly reminded that even though I’ve been around a while, I’m but a young pup when it comes to networking. I did run into Nordic’s Drew Madden who showed off what must be the year’s hot accessory – snazzy socks. He informed me that he brought a special pair of shoes for HIStalkapalooza.

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On the way to catching my beauty rest, I happened upon the Aventura team at the Palmer House bar. I didn’t make it to the HIStalk sponsor reception (it’s a little tricky to do that and remain anonymous) but they promised a pair was waiting at their booth. I’m excited and think I’ll sport them at Quipstar rather than the sparkly numbers I brought.

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April 14, 2015 Dr. Jayne 1 Comment

From HIMSS 4/14/15

April 14, 2015 News 1 Comment

HIStalkapalooza took up a lot of my time yesterday, so I didn’t even have time to post. This will be a dribs-and-drabs version – I’ll have more time the rest of the week to get organized. Let me know if there’s something I should make sure to see since I’m just flailing around for the most part.


From Anonymous Vendor President: “Re: Dana Moore and DonorsChoose donations. We will anonymously match whatever total you raise up to $5k. Let’s make this thing really work! Many of my family and countless within our company have ties and heartstrings attached to the cause.” Centura SVP/CIO Dana Moore will be in our booth Wednesday, meeting with vendors for 20 minutes each in return for their $500 donation to DonorsChoose. I’ve scheduled six sessions with him so far, meaning with with the very generous anonymous matching funds, we’ll be donating $6,000 for individual classroom projects via DonorsChoose. I have a bunch of teacher thank-you emails to get through from the projects already funded. Next up is the fun of funding new projects. Thanks to everyone involved.

From Kaboodle: “Re: MedStar in Maryland. You failed to mention their GE Centricity EHR crash, where all clinics were down and back to paper. But, but mind you, care was not affected!” Unverified. I haven’t heard anything about it.


HIStalkapalooza

I haven’t had much time to do the post-mortem on HIStalkapalooza since I didn’t get back until well after midnight. House of Blues was perfect and ran things with great skill, the food and bar service was really good, and the band was as outstanding as I remember them from last year. I was backstage the whole time so I didn’t experience the event as an attendee this time around, which I sort of regret, but I could feel the energy and excitement. Some notes:

  • Lorre Wisham worked on the event for many months going back to last spring. She arranged everything you saw or did as an attendee, wrangling an enormous list of to-do items (contracts, menus, sponsors, band details, banners and signs, etc.) The many hundreds of hours were in addition to her doing her “real” HIStalk work.
  • I would have gone seriously broke without the financial help of the event sponsors since we had to sign band and venue contracts almost a year ago, putting me at complete financial risk if sponsors hadn’t participated. Thanks to Elsevier, Santa Rosa Holdings, Divurgent, Sagacious Consultants, Aventura, CommVault, Falcon Consulting Group, Greenway Health, PatientSafe Solutions, Sunquest, Thrasys, and Validic for making it happen. Those who had opera boxes seemed to be enjoying themselves as Lorre checked in with them several times through the evening.
  • Sagacious did a superb job checking people in (and apparently, according to their report, keeping quite a few people out who showed up but weren’t supposed to be there). HOB says we had close to 1,000 people in the house (of 1,500 invited), meaning their folks got everybody in professionally and cheerfully. Elsevier ran the red carpet and I heard people enjoyed that.
  • The House of Blues staff was super professional and treated us like the big-name acts they host there.
  • Rocking doctor Ross Martin kicked it off in style despite a technical snafu that prevented us from enjoying the big finish of his freshly updated Interoperetta. I’ll try to get something on audio or video from Ross so we can hear the full version.
  • Barry Wightman and Jennifer Lyle were great hosts on stage. It’s harder than it looks to engage a huge room full of partygoers and managing the people and equipment on stage.
  • Special thanks to Judy Faulkner and Jonathan Bush for presenting each other awards on stage in a funny but classy manner.
  • I can’t really say anything about Party on the Moon because if you were there, you already know how electrifying they were, and if you weren’t, words alone can’t describe it. Lorre had vendors coming up to her wanting to know how to book them for their own events. The 13 band members came all the way from Atlanta on their tour bus to spend the evening with us. You know a band is killing it when, as one attendee pointed out, you have nerdy IT guys so anxious to participate that they dance with each other. There were some great moments out there in the audience. According to one attendee, “Easily the best party I have ever been to, as good or better than any fraternity party.”
  • We have photos and video coming from several sources that I haven’t had time to review yet. Stay tuned and we can all relive the evening all over again.

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Neil Versel took some good pictures of the Judy and JB show, even though he annoyed me by dismissively referring to HIStalk as the “National Enquirer of health IT.”

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A nice HOB exterior shot by Rudy Flores. The stencil over the light that shines the logo — I now know having ordered three of them for this event — is called a “gobo,” just in case you want to increase your vocabulary.


Somewhat Interesting News Announcements

  • IBM creates Watson Health with the announced acquisition of Explorys (analytics and population health management) and Phytel (population health management). The company also announced health partnerships with Apple, J&J, and Medtronic.
  • Surescripts creates a National Record Locator Service along with EClinicalWorks, Greenway, and Epic that will allow providers to locate and exchange patient health records using the Carequality trust framework.
  • InterSystems announces a vendor-neutral, interoperable patient portal.
  • HIMSS turns the work of its interoperability workgroup into a certification program for EHRs, HIEs, and HISPs, run by ICSA under the name “ConCert by HIMSS.” I don’t think of HIMSS as the group that should be certifying products, but apparently their opinion differs from mine.
  • KPMG acquires Beacon Partners, as was predicted in an HIStalk rumor report a couple of weeks ago.
  • Peer60 publishes a free report titled “Will mhealth Drive Patient Engagement?” that questions whether EHRs provide adequate mobile support to meet consumer expectations.

Today in our booth (# 5371)

All day (I think): Regina Holliday will be painting
11:00 Funny lawyer Steve Blumenthal will be handing out swag and dry humor.
2:00 NVoq will hand out Garrett Popcorn (it’s the great Chicago kind that costs a fortune in the airport).
3:00 Your HIStalkapalooza host Barry Wightman will be autographing copies of his book “Pepperland” (which I enjoyed a lot).
4:30 The Walking Gallery will meet.

I forgot that we intended to auction off Regina’s HIStalking original painting from which we made the scholarship winner tee shirts. Make Lorre an offer if you are interested. Maybe she can post the highest current bid on an index card underneath it or something.


My Fitbit shows that I walked 12 miles Monday. It felt like I wasted a lot of time just walking around, but that’s par for the course on the first day of the conference.

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The folks at XG Health Solutions (a new HIStalk sponsor that I haven’t announced yet) invited me to a breakfast briefing covering their new apps. It’s a Geisinger spinoff that will sell software based on work done there to present clinicians with a better view of EHR data and collect additional information to make it easier to quickly understand patient problems and concerns and to document additional specialty-specific findings (rheumatology is the first one). Partnerships were announced with Epic, Cerner, and Athenahealth, whose EHRs will exchange information with the XG apps using SMART on FHIR. They have four apps going to beta testing by summer and plan to roll out six over the next 18 months.

From the hallway conversations I heard and my own opinions, here are the positives: Geisinger has developed a lot of expertise and content that’s less ivory tower than most big academic medical centers, they put some thought into involving the patient in the use of their apps, and the SaaS-based subscription means new best practices can be put into place quickly. Negatives: the company has significant venture capital ownership (they aren’t Geisinger, in other words), you might suspect that Geisinger applied soft pressure to the newly named EHR vendor partners to get on board with uncertain future commitments, and so far they’re a company that hasn’t done much to dent the market other than to do Geisinger stuff and make announcements. Success in commercializing hospital software is elusive, and while Version 1.0 is easy, it’s Version 2.0 that gets ugly with upgrades, design decisions, and testing. The first non-Geisinger betas will be important.  

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Some notes from my circuits around the exhibit hall (actually both of them – it’s a split hall that ensures confusion and uneven booth traffic). My badge is intentionally unimpressive to vendors, so I get the same treatment as everybody else.

  • Trying to find a given booth even when you know its number is maddening given the gerrymandered aisles. The printed floor layout is laughable – you would need a high-powered microscope to read any part of it except the anchor booth companies (which may be the intention, come to think of it).
  • Booth reps were screwing around with their phones literally from the moment the exhibits opened. It was depressingly easy to find booths where every single person was staring in rapt attention at their phones while prospects passed by without even being acknowledged. Vendors are really stupid in not coaching and policing their people.
  • Even the fake patient in the hospital bed was surreptitiously killing time with her phone while waiting for her next scene. Check her out in the photo above – I wasn’t quite sure what was going on under those sheets until I came around to the head of the bed.
  • I have three mandatory HIMSS kickoff rituals – I have to stroke the sultry curves of the latest Enovate cart; I have to have amazing scones from MedData (the orange chocolate chip were great, but I swung by later for one that had ham, cheese, and what looked like chives); and I have to see the magic guy in Hyland’s booth (above), who is simply amazing not only magically, but in snarky humor and getting people to come closer. I don’t usually like that kind of stuff, but he has been my favorite part of HIMSS for a bunch of years.
  • Amazon Web Services had a little booth, which was interesting.
  • A guy from Network Detective for Healthcare pitched their product that analyzes the network looking for HIPAA-related problems. It seemed pretty cool, especially the report showing the results in plain English with cross-references to HIPAA sections.
  • Scotland-based Nugensis had guys in kilts and bottles of Scotch on the shelf.
  • I tried to use the HIMSS app, but it locked up, spammed me with some guy’s endless and boring motivational quotes, and then started pushing ads as notifications. Big waste of time. The conference is basically just one giant advertising platform already.
  • The NextGen booth was very cool with clear walls and a waterfall.
  • Elsevier demoed their Tonic iPad app that collects information from patients. One of the cool aspects is that it can steer patients to automatically log on to the patient portal without their even realizing that it’s a separate app, which is nice for Meaningful Use. I didn’t see many products Monday, but this one was my favorite. That’s my bad iPhone picture of it above with the beer mug.
  • The nice folks at zCover gave me a new iPhone case to replace the one they gave me a couple of HIMSS conferences ago. Stop by and they’ll even put it on for you.
  • The FHIR puns were plentifully irritating. IT geek humor doesn’t usually work.
  • Kforce was giving out pretty decent pizza way back in a low-density corner of the hall.
  • Sagacious had their fun HIStalkapalooza posters out.
  • InterSystems had a huge audience for one of their presenters. Their presence was significant.
  • I stopped by the Microsoft booth and, as happens every single year, the reps were too busy yapping at each other to even look at all those prospects invading their space. As also happens every year, I stood patiently in front of a display (mobile devices and Surface this time) and the nearest Microserf stormed by scowling while nearly pushing me out of his way. Perhaps that’s why, unlike years past, their booth didn’t have much traffic.
  • The Georgia display featured the sign I had made for them a few months ago following Atlanta’s HIStalk poll win.
  • Bathroom capacity and seating space were ridiculously inadequate. I hiked forever down a long hall following the restroom sign, only to be met with the dreaded “pardon our dust” sign that said to find another restroom without actually saying where one might be. Another one had a grand-looking entrance, but inside was just one stall and one urinal. I’m thinking of one of those parking space type apps where I hire people to sit in the very few actual seats where people can relax or eat, then providing an app for attendees to find and buy their seats. It makes me uneasy to watch guys in crisp white shirts slopping down a wildly overpriced commissary barbeque sandwich while standing in front of a trash can.

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Tahoe Forest Hospital (CA) names CIO Jake Dorst as interim CEO. He’ll also continue as CIO.

The outcome of dueling lawsuits between Allscripts and Medfusion may hinge on interpretation of the use of an Oxford comma in their agreement, which is pretty fascinating.

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A reader wants to know if anyone else thinks that having costumed female entertainers at the HIMSS opening reception crossed the border into sexism territory. I wasn’t there, but if they didn’t have any men, that might at least make me think about it. I noticed fewer obvious booth babes in the hall this year, so maybe the “skin to win” sales approach is finally and deservedly dying off. It would seem especially inappropriate to have a provocatively clad model pretending to be a company rep in trying to get the attention of a female CEO, CIO, or CMIO.

A terribly written and insight-free Forbes article click-baitingly titled “Two Dirty Little Secrets About Electronic Health Records” says EHRs are “a threat to freedom of speech and academic freedom” in claiming that EHR vendors (and Epic specifically) requires customers to sign non-disparagement clauses. The author works up righteous indignation for Bob Wachter, MD, who the author says had to get Epic’s permission to write about a UCSF medication error and to use Epic’s screenshots to illustrate it. The problem is the author just made stuff up rather than asking anyone involved and Bob had to correct him – Epic doesn’t include non-disparagement language in its contracts, although the screenshot part is true and Bob’s not thrilled about that (he emailed me to clarify that the author was wrong on the first point and has since changed the story). The second big secret is that EHRs are designed to help with billing and management. The author magnanimously proclaims that, “I’m not against EHRs,” which would be comforting except nobody’s ever heard of him and his mastery of the subject is clearly minimal.

That’s all for now. I’m headed over to McCormick Place later than I’d like.

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April 14, 2015 News 1 Comment

Jenn’s HIMSS Day 2 4/13/15

April 14, 2015 News No Comments

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I can’t even begin to break down my second day at HIMSS without first mentioning the highlight: the now-epic pie-throwing incident at HIStalkapalooza involving Judy Faulkner and Jonathan Bush. Both were good sports, and both had only gracious things to say to one another as they accepted their respective HISsie Awards. More on the party towards the end of the post.

My second day at HIMSS started off with a quick trek in the rain to the shuttle stop, followed by a pleasant conversation with Intelligent Medical Objects President and CTO Regis Charlot. (Note to HIMSS newbies: Shuttle rides, elevator rides, and lines can be great opportunities to strike up a conversation with your next client. A simple “Good morning. How are you enjoying the show?” typically kicks off great conversation.) Charlot waxed poetic about the challenges providers are facing when it comes to transitioning to ICD-10, though he did reiterate that IMO’s clients (and the general populace) are in good shape. Providers have accepted their fate and seem to be working diligently to prepare for the October 1 switch. His crystal-ball predictions for healthcare involves Intel’s Edison platform, a “[h]igh performance, dual-core CPU and single core micro-controller that supports complex data collection,” and that seems like it will help drive super-computing in the wearables space. Seems like it might have a unique play in telemedicine and the quantified self movement.

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My next stop was the morning keynote, which included a rousing performance by a local gospel choir and a not-quite-so rousing introduction from HIMSS Paul Kleeberg. “This sounds like an infomercial,” was one audience member’s description of Kleeberg’s contribution. The real meat of the keynote was given by Alex Gourlay, executive vice president of Walgreens Boots Alliance and president of Walgreens . It was engaging, as keynotes go. He emphasized the role of retail clinics and pharmacists in achieving the Triple Aim, outlining the many partnerships Walgreens has entered into (WebMD, PatientsLikeMe, Qualcomm Life, MDLive) in an effort to take e-prescribing, telemedicine, medication compliance, and better outcomes to the next level. Gourlay also announced that the company will be launching a medication reminder app for Apple Watch next month.

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I had the pleasure of sitting next to two women from MultiCare Health System (WA), both of whom seemed very excited by what Walgreens is doing in the mobile space. Debbie Embree, director of applications, and Brenda Bowles, RN director of clinical informatics, told me they were going to spend their time at the conference looking for ways to push their patient engagement strategy beyond their Epic MyChart portal and out into the retail space. Personal device integration via mobile apps is likely their next step.

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After a mind-numbingly slow exodus from the keynote with 3,000 of my closest friends, I made it to the HIStalk booth. I spent a great five hours in the exhibit hall meeting and greeting loyal readers and attendees who had never heard of us but just couldn’t resist picking up a bag of Garrett’s Popcorn, courtesy of our friends at nVoq. I finally got the chance to spend time with The Walking Gallery Founder Regina Holliday and our HIStalking patient advocate scholarship winners, who, despite a few hiccups with registration, seemed very excited to be at HIMSS. Regina’s live painting was definitely a crowd-pleaser, and I appreciated the opportunity it gave us to talk with attendees about the importance of patient advocacy in the world of healthcare IT.

Several hot topics bubbled up in my booth conversations with providers: The majority of them seemed to be wandering the exhibit halls looking for solutions and strategies around security and privacy, patient engagement, and ICD-10. Not a one had anything positive to say about the education sessions. As Dr. Jayne explained to me, the sessions suffer from the fact that they had to be submitted nearly a year ago, and have likely lost their luster in the preceding 10 months or so.

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Other booth drive-bys included a chat with AJ Montpetit from the Mayo Clinic Center for Innovation, looking quite dapper in bowtie and pink mustachioed socks.

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I also had a chance to meet Modernizing Medicine CEO Dan Cane and his colleagues. The company, which made headlines a few weeks ago for its partnership with IBM Watson, is busy expanding office space and hiring new staff. You can read my interview with Cane about the Watson partnership here.

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I managed to do a quick walk-about, and ran into the #IHeartHIT meetup at the HIMSSpot. It was great to see patients and HIMSS15 social media ambassadors like Linda Stotsky share their healthcare IT stories. There definitely seems to be a stronger patient presence at this year’s conference. I’m really looking forward to reading about the HIMSS15 experiences of our HIStalking team.

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It was great to see the Georgia Dept. of Economic Development and the Metro Atlanta Chamber, sponsors of the morning keynote, proudly displaying the sign we awarded them earlier this year for being nominated as “the Nation’s Capital of Health I.T.”

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After my jaunt through .05 percent of the exhibit hall, I spent a final hour at our booth then rushed back to my hotel to change into HIStalkapalooza-worthy attire. As I mentioned above, the party was amazing. (Check out the #HIStalkapalooza hashtag on Twitter for great pictures and recap.) Our sponsors did a tremendous job of making sure everyone got in, got fed and watered, and got on the dance floor. Party on the Moon was phenomenal. I must have danced for an hour-and-a-half straight, which does not bode well for my feet during the rest of my time in Chicago!

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I even managed to snag a few dances with “Jenn’s Secret Crush” Cynthia Porter, who, despite holding the stuffy title of president of Porter Research, really knows how to have a good time.

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Lorre and I were not the only ones decked out. This year’s HIStalk King and Queen were definitely worthy of their titles, and displayed just as much dancing prowess as they did fashion savvy. All in all, my second day at HIMSS was a blast. I appreciated the opportunity to chat with readers at our booth, dance with sponsors at our party, and finally rest my swollen feet at the end of the night.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.
Contact us online.
Become a sponsor.

JennHIStalk

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April 14, 2015 News No Comments

Morning Headlines 4/14/15

April 13, 2015 Headlines No Comments

Former ONC chief opposes CMS rule weakening patient access to records

Former ONC lead Farzad Mostashari, MD spoke out against CMS’s recent decision to strip MU2 of its five percent view/transmit/download requirement, saying “If this proposed rule stands, it would roll back a lot of progress that’s been made incorporating patient engagement into workflows. To meet even a low threshold, providers have had to change their processes to engage patients.”

athenahealth Announces athenaText App for Apple Watch

AthenaHealth follows in Cerner’s footsteps in announcing an Apple Watch app. Unlike Cerner, Athena’s app is aimed at providers, while Cerner’s will be marketed directly to patients. 

An ACT Relating to telemedicine

Washington state becomes the 23rd state to pass a bill requiring private insurers to cover telehealth services.

Practice Fusion and AstraZeneca Partner on Population Health Management Initiative for Asthma and Chronic Obstructive Pulmonary Disease

Freeware EHR vendor Practice Fusion announces a program sponsored by AstraZeneca in which COPD and Asthma patients in Practice Fusion’s system whose care does not meet evidence-based clinical guidelines will be identified and their care providers alerted.

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April 13, 2015 Headlines No Comments

Jenn’s HIMSS Day 1 4/12/15

April 13, 2015 News 1 Comment

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Ah, HIMSS. This year marks my fifth, and like the previous four, I doubt it will disappoint. There’s just no other event that can offer up such a unique mix of nonstop networking, educational sessions catering to every HIT acronym under the sun, exhibit hall #HIMSSanity, sleep deprivation, and over-the-top caffeine consumption. I genuinely enjoy it every year, mainly for the relationships made and fostered. HIMSS 2010 in Atlanta was, in fact, where I first heard about HIStalk and Mr. H’s predilection for walking around with a paper bag over his head to keep his anonymity in tact.

Speaking of Atlanta, my day started well before the sun rose on an overbooked Delta flight full of folks en route to HIMSS. Honeywell, Oneview Healthcare, Patientco, McKesson, and Gozio Health were all represented. I didn’t even attempt to enter the always notoriously long taxi queue at Midway in Chicago, instead opting to reach my hotel via a 20 minute subway ride that cost all of $3. I found myself further impressed with Chicago when the clerk at my hotel allowed me to check in at 10:30 a.m. A 30-minute lie-down after a 4:45 a.m. rise wound up being essential to staving off the aforementioned #HIIMSSanity.

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Refreshed, and with a few hours to spare, I spent time wandering around Chicago’s Museum campus and nearby lakefront. The weather was slightly warm and sunny, with just a hint of the city’s famous wind. I had a thoroughly enjoyable time eating my first “Chicago-style” hot dog while people-watching on a park bench. It’s not often that I get to while away an hour and a half doing not much of anything. The lure of the convention center came soon after lunch, and I found myself walking three short blocks to grab the shuttle to McCormick Place. (Is it just me, or does the shuttle drop off in the dark bowels of the trade center remind anyone else of the Lonely Mountain?)

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After grabbing my press pass, I ran into Sara Zellner at Health Data Consortium giving away “I Love Health Data” buttons. (I’m a sucker for fun “pieces of flair.”) She reminded me that HDC’s annual Health Datapalooza is coming up at the end of May in Washington, D.C., with HHS Secretary Sylvia Burwell and Acting CMS Administrator Andy Slavitt scheduled to speak.

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From there, it was a quick quarter mile (kidding, it was probably only a fifth) to the Venture+ Forum, a day-long event featuring startups pitching in three-minute lightning rounds to a panel of devil’s advocates. I came in at the tail end of the forum, only getting to see full pitches from Heal, Medivizor, Sensentia, and Open Health Networks. Heal’s app for on-demand house calls caught my eye, as did the realization that anyone thinking of speaking in public should avoid saying “um” at the end of every sentence and remember there is a slide deck to scroll through at the beginning of the presentation, rather than halfway through. It seemed like the Forum was at capacity of around 150 or so, which probably means it will warrant a bigger space next year.

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A number of other pre-conference symposia took place on Sunday, including the inaugural Revenue Cycle Solutions Summit. Patientco’s Josh Byrd sent me this report:

The Revenue Cycle Solutions Summit provided over 200 attendees with thought-leading presentations from providers who are paving the way for what the revenue cycle of the future will look like. The common thread weaved throughout was a focus on patient-centered care after the episode of care. Highlights included:

  • Mike Simms, VP of revenue cycle at Cone Health talking about how to choose vendors who align with your key revenue strategy;
  • Leigh Williams, director of revenue cycle at University of Mississippi, who shared how they engaged physicians in using HIT to achieve financial success;
  • Andrew Ray, manager of physician revenue cycle operations at Stanford Children’s Hospital, who talked about how to centralize and automate the revenue cycle to increase reimbursement and decrease denials; and
  • Key members of the HIMSS Revenue Cycle Improvement Task Force, who shared insights on how they are working together to bridge the gaps between payers, vendors, banks, providers, and other key stakeholders to create a better patient financial experience.

Josh told me that the attendee mix was mostly CEOs and CIOs, so it will be interesting to see how many CFOs attend next year’s event. Could HIMSS be looking to give the HFMA ANI conference a run for its money?

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After a quick change into Roaring 20s-inspired flapper garb, I put in an appearance at the opening reception, which I found surprisingly well attended given the amount of smaller HIMSS symposia receptions taking place at the same time. The jazz band was great, and definitely got me excited about performances by Ross Martin, MD and Party on the Moon at HIStalkapalooza.

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My next and final stop of the evening was the HIStalk Sponsor’s Reception, which was a great opportunity to meet and greet the people behind the companies whose support makes HIStalk happen. I can’t thank them enough. Special thanks to the lovely folks at Aventura who gifted me with these classic kicks, which I may have to put on tomorrow once the HIStalkapalooza red carpet shoe-judging festivities have concluded and the dancing is ready to begin.

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Stay tuned for more updates. I’m off to get some shut-eye, still debating whether or not to start my morning off with some YogaEspresso. Down dog and healthcare IT seem like a natural combination, don’t you think?


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.

JennHIStalk

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April 13, 2015 News 1 Comment

Morning Headlines 4/12/15

April 12, 2015 Headlines No Comments

Medicare and Medicaid Programs; Electronic Health Record Incentive Program– Modifications to Meaningful Use in 2015 through 2017

HHS publishes a revision to the Meaningful Use program that shortens the 2015 reporting period to just 90 days and reduces the requirement that five percent threshold for view/download/transmit to just a single patient.

Report To Congress, April 2015:  Report on Health Information Blocking

ONC submits its congressionally-mandated report on EHR vendor information blocking, acknowledging that there is only anecdotal evidence of information blocking practices, but also establishing a list of behaviors it would interpret to be detrimental to national information exchange efforts, including charging for information exchanges and developing systems in non-standard ways. In its conclusion, ONC  recommends field-based certification requirements and mandated data exchange features.

PatientBond Acquires c2b Horizons, Forming First Patient Engagement Technology Company with Embedded Consumer Psychographic Profiling

PatientBond, a patient engagement solutions vendor, has acquired c2b Horizons which makes embedded consumer profiling tools. Financial details were not disclosed.

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April 12, 2015 Headlines No Comments

From HIMSS 4/12/15

April 11, 2015 News 7 Comments

Top News

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HHS proposes to shorten the Meaningful Use attestation period to 90 days for 2015 in an announcement released, as always, late on a Friday (they also seem to like to put out big news right before the HIMSS conference). It also proposes removing requirements that are duplicative or no longer needed. Interestingly, HHS wants to reduce the five percent threshold for view/download/transmit to just a single patient – if even one patient retrieves their information, then the capability has been proven and the requirement is met. That addresses the argument that providers can’t force patients to access their data who are unwilling or technically unprepared to do so.


Reader Comments

From Hermanically Sealed: “Re: Evan Nordgren lawsuit against Epic for not paying overtime. Stories reported that the employees were encouraged to donate their settlement money to the health center where Judy Faulkner’s husband works as a physician.“ Unverified. I haven’t seen anything about donation requests. Sounds unlikely to me and easy enough to prove if you’ve received such suggestions.


HIStalk Announcements and Requests

I’ll be posting differently this week, with less emphasis on the clutter of questionably interesting announcements and more on the conference. I may post more than once daily and Jenn will post separately, but I’ll probably send just one email blast daily to avoid overloading inboxes.

I VRBO’ed a little apartment  in Bridgeport, south of downtown within a few blocks of US Cellular Field (the unfortunately and opportunistically renamed Comiskey Park, which was a replacement for Old Comiskey Park). It costs less than a boxy hotel room, is in a cool neighborhood with interesting restaurants within walking distance, and is a short Uber ride to downtown or McCormick place. It’s much better having a kitchen, plenty of room to spread out, and a bay window looking out at White Sox fans heading down the sidewalk to the game than sitting in an airless room in a sterile building packed to the gills with lost, badge-wearing geeky HIMSS peers clogging up slow elevators and chattering way too loudly from being jacked up on exhibit hall adrenaline.

Saturday was stunningly beautiful in Chicago, with temperatures in the mid-60s with blue skies and sunshine. The trees are still denuded, but the grass has greened up and daffodils are poking up. I did some site checking of the House of Blues (looking great there), walked around the river, took a boat ride, and went to the Bulls game courtesy of a reader who invited me. I even Uber’ed back after the game, got picked up quickly near United Center, and didn’t even get hit with the dreaded surge pricing.

I downloaded the HIMSS15 mobile app and found it to be pretty buggy, requiring a bunch of iPhone restarts and confusing password prompts that didn’t make it clear whether it was the HIMSS website password or a new one (I’m still not sure since I had to do a password reset just to get it going). It has pretty good information, although I’m not sure the educational session list will replace the need for the little spiral-bound book that I always carry, assuming they’re still printing them. I used to study the agenda carefully and plan which educational sessions to attend weeks ahead, but they’ve been disappointing in the past few years (too much vendor involvement, boring presenters, too much reliance on PowerPoint, etc.) and I’m going to fewer and fewer of them.

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Response has been brisk to the gracious offer of Dana Moore, CIO of Centura, to meet in the HIStalk booth with anyone willing to donate $500 to DonorsChoose.org in return for 20 minutes of his uninterrupted attention. Six companies have donated and I’ve funded the first wave of classroom projects that their $3,000 is supporting. The donations paid for the full cost of these projects, all of which are for classrooms in high-poverty areas, most of which involve Teach for America teachers, and many of which include matching funds from other charitable organizations:

  • Two Fire HD devices for a middle school reading program in San Diego, CA
  • A projector for a kindergarten class in Erie, PA
  • Professional development books for kindergarten teachers in Charlotte, NC
  • A Chromebook for an elementary school class in Toppenish, WA
  • Algebra calculators for a high school class in Auburn, WA
  • A sand and water table for K-2 children, all with multiple disabilities, in Rosamond, CA
  • Headphones for K-2 classes in Portland, OR
  • A drawing tablet for the iPad for grades 3-5 in Lockhart, TX
  • Three iPad Minis for a sixth grade class in Oklahoma City, OK

I’ve already received appreciative emails from most of the teachers (it seems to be a pattern that good teachers work through the weekend) and I’ll follow up with photos, teacher comments, and student thank you notes once they put the materials to use. I also have quite a few more projects to fund given the generous response. A couple of companies have taken the “top spot” banners at the top of the page in the next week and most of that money will go to DonorsChoose as well.

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Poll respondents favor disbanding ONC’s certification program after Stage 3, although a few folks wouldn’t mind seeing ONC keep the program alive but with more input from previously attesting users. New poll to your right or here, for those who aren’t attending the HIMSS conference: will you be working more, less, or about the same this week?

I’m puzzled at companies (HIMSS Analytics, among them most recently) that proudly boast via a grandiose press release of having redesigned their websites. People who already follow the company will see for themselves, while those who don’t aren’t likely to rush to the nearest browser to gaze in wonderment. More self-congratulatory marketing run amok.


Last Week’s Most Interesting News

  • The Texas Medical Board, protecting the interests of its members, prohibits prescribing medications for patients who have been examined only by telemedicine.
  • Health IT issues once again make ECRI Institute’s list of top patient safety concerns.
  • Allscripts agrees to pay $10 million to settle a shareholder class action lawsuit claiming the company’s executives misled investors with overly positive comments following its 2010 acquisition of Eclipsys.
  • FTC warns ONC about unintentionally limiting consumer choices in setting or approving interoperability standards.

Webinars

April 22 (Wednesday) 1:00 ET. “Microsoft: The Waking Giant in Healthcare Analytics and Big Data.” Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Microsoft has been quietly reengineering its culture and products to offer the best value and most visionary platform for cloud services, big data, and analytics in healthcare. This webinar will cover the Healthcare Analytics Adoption Model, the ongoing transition from relational databases, the role of new Microsoft products such as Azure and Analytic Platform System, the PowerX product line, and geospatial and machine learning visualization tools. Attendees will learn how to incorporate cloud-based analytics services into their healthcare analytics strategies.


Acquisitions, Funding, Business, and Stock

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Patient engagement solutions vendor PatientBond acquires consumer profiling company C2b Horizons.

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SSI Group will announce Monday that it has acquired patient access management software vendor Provider Advantage. Readers who reported the rumor earlier almost got it right – the only part they missed is that SSI Group was the acquirer rather than the acquiree (and SSI’s response to my inquiry was truthful – they weren’t going to be acquired). I call that a win all around.


People

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Parallon promotes Curtis Watkins to CEO of its technology business unit.

Truven Health Analytics hires former CMS Healthcare.gov official Kirk Grothe as VP of its federal government business.


Announcements and Implementations

MedEvolve, Salar, and Net Health choose VitalWare’s ICD Sherpa as their ICD-10 partner.

Aprima announces a mobile app for its products.

ARC Devices and Orchestrate Healthcare launch ARC VitalConnect, which transmits readings from ARC’s non-touch digital thermometer to EHRs.

Senior care software vendor PointClickCare joins the Surescripts network.


Government and Politics

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ONC delivers its congressionally mandated report on information blocking, defining the term as when “persons or entities knowingly and unreasonably interfere with the exchange or use of electronic health information.” I’m not quite sure how a company could “reasonably” interfere with information exchange, although ONC later mentions possible patient safety concerns that I would take to mean mental health information. ONC admits that it doesn’t really know how extensive information blocking is since stories are anecdotal or how that practice could be assessed other than by in-the-field product reviews. ONC is clear on practices it considers detrimental to information exchange, including contractual restrictions, charging for information exchange, developing or implementing systems in non-standard ways that increase interoperability difficulty or cost, and practices that lock users in with regard to a particular technology (from  vendor’s standpoint, good business practices, in other words). ONC’s recommended actions: start in-the-field testing as part of certification, tighten technical standards, increase product and vendor transparency (although ONC admits it can’t do much in that regard), mandate sharing, clarify to providers what information sharing is allowed under HIPAA, and refer obvious cases for review under anti-kickback statutes or even to law enforcement agencies where appropriate.

The problem with provider information blocking is that only patients could report it and they’re not likely to call up ONC to complain. Vendor practices, whether contractual or technical, are easier, so it seems to me the most effective way to move the market is to call them out publicly (800.ONC.BLOK, anyone?) It would also be nice for ONC to provide suggested contract boilerplate language for providers, especially medical practices that seem inclined to sign everything shoved in front of them by a exuberant salesperson without even reading it, much less altering it favorably. That’s assuming that providers even care about sharing information, which is the biggest unknown of all. I’d like my local paint store to electronically exchange information on textures and shades with their competitors so I have more freedom of choice, but I doubt they share my enthusiasm.


Sponsor Updates

  • Medicity CEO Nancy Ham pens a blog for HFMA entitled, “Do You Know Where Your Patients Are?”
  • MedData launches major upgrades to its client reporting portal and iPhone app.
  • Navicure releases an upgrade to its billing and payments platform.
  • NVoq offers “The Link Between the Simple Checklist and Improved Patient Safety.”
  • Experian Health/Passport launches a video contest to show how its solutions have helped improve client organization’s patient access processes.
  • PatientPay produces a video detailing its new solution that enables practices to get real-time pricing for patients who call to request estimated visit costs.
  • A PDS blog, “When I Was Your Age: The Challenge of Generational Patient Engagement,” is featured in the HIMSS15 blog carnival.
  • PMD offers “Apple’s Most Important iOS Security Update.”
  • Talksoft’s Hamilton, NJ office is featured in the local paper in a piece about recycled office spaces.
  • TeleTracking asks, “Are U.S. Hospital Operations in Need of an Operation?”

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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April 11, 2015 News 7 Comments

An HIT Moment with … Eyal Ephrat

April 10, 2015 Interviews 1 Comment

An HIT Moment with … is a quick interview with someone we find interesting. Eyal Ephrat, MD is founder and CEO of MedCPU of New York, NY.

What are the shortcomings of clinical decision-support modules of EHRs?

Decision support technology was designed with the best intentions, but accuracy remains a huge problem. Prompting the clinical staff with inaccurate or redundant prompts rapidly leads to frustration, alert fatigue, and loss of reliance on this feature. In most instances I’ve seen, decision-support prompts are ignored or turned off by a busy clinical staff, often because inaccuracy makes them unreliable and therefore unusable.

Roughly 70 percent of the patient’s clinical information exists today in free-form format such as dictations, follow-up notes and discharge summaries. As physicians, we just cannot communicate the clinical picture and plan of care through simple point-and-click pull-down menus and structured fields, so we opt for free-form notes. However, the computer cannot read free text, so the decision-support modules don’t see the 70 percent or 80 percent of critical information that exists exclusively in the free-form formats.

The clinical reasoning and thought process cannot be captured through simplistic “If-Then” rules. If the patient’s hemoglobin is 8gm/dL, it’s wrong to fire a simple prompt that alerts the physician to do something with it. There could be many reasons for such a low hemoglobin, ranging form chronic hereditary conditions that warrant no action to acute conditions that require emergency response.

How do you get the necessary data, including free-text information, to perform decision support?

The industry’s current technologies used for data sharing between systems – HL7 via interface engines and Web services – are not enough. They don’t provide all the data required, in real-time, for the accurate performance of the decision support modules. To resolve this critical barrier in information availability, MedCPU developed a unique Reader technology to collect all the data entered into the organization’s EMR via an API with the operating system (Citrix server, etc.) on which the EMR runs, without touching the EMR itself, without consuming computational resources, and without requiring integration to the EMR or the hospital’s IT infrastructure.

This allows us to see, for the first time in healthcare I believe, all the data entered in real-time. Combined with a limited use of HL7 feeds for getting information entered in the ancillary systems, such as dictations, radiology, and discharge summaries, MedCPU is achieving a complete picture about the patient, in real-time, from history until the present encounter.

What results have users seen?

I’ll give you a couple of examples. One hospital that was an early adopter of our VTE prophylaxis module has seen a significant improvement in compliance with the CMS’s VTE prophylaxis guidelines (above 90 percent from about 50 percent prior to the deployment of MedCPU) over a period of a couple of months. Another health system using our radiology module has seen a significant decrease in the amount of inappropriate imaging performed based on the ACR appropriateness criteria while generating higher revenues because of better appropriate documentation.

But we’re most proud of the daily events we see where the system actually prevents clinical errors. Seeing in the logs how the physician or nurse made a certain decision, got a prompt that the decision may be wrong, and as a result cancelled this decision and reverted back to the appropriate care path makes our huge efforts worthwhile.

What effort, expense, and expertise is required to deploy MedCPU?

The effort, expense, and expertise required is extremely low compared with the typical IT deployments we all know and have traditionally experienced. Using our Reader API, we request very little IT involvement on the part of the hospital, approximately 50 hours. The overall one-time deployment of the MedCPU platform in the organization takes about three to four months, during which time we also work with the organization’s clinical leaders in reviewing the best practice protocols contained in our decision support modules. The ability to deliver low-resourced deployment is critical when dealing with the often-overloaded IT departments.

What is the direction of the product and company going forward?

We want to become the high-precision decision support layer each organization critically needs on top of their existing EMR/IT infrastructure. We’re also really excited about our new initiative with the Health Management Academy. We’re launching a multi-health-system initiative that will foster collaboration in finding and testing advanced solutions in order to bring major improvements to their point-of-care clinical, operational, and financial performance.

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April 10, 2015 Interviews 1 Comment

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