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Monday Morning Update 3/10/14

March 9, 2014 News 4 Comments

Top News

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The Wall Street Journal reports that transcription and speech recognition software vendor MModal will file bankruptcy this week, loaded with $750 million in debt as a result of its leveraged buyout in August 2012 and facing declining sales. The company expects to work out a debt restructuring plan in advance that will allow some of its creditors to swap the money they are owed for equity in the reorganized company. UPDATE: MModal provided this statement in response to the HIStalk news item:

MModal is continuing discussions with certain of its lenders and bondholders regarding a range of financial restructuring options to enable the company to reduce its debt and enhance its financial flexibility. We believe these discussions have been constructive and we are working towards a resolution that has the support of our lenders which would provide a positive outcome for all of our stakeholders, including our customers, employees, and suppliers. We fully expect to continue operating in the ordinary course of business and providing our customers the high level of support they have come to expect from MModal. The company has solid revenue, strong operating margins, cash flows consistent with industry norms, a large customer base, and we are continuing to invest in the future. Our operations are strong and we are generating exceptional quality metrics and high customer satisfaction. We are executing on our vision to provide the healthcare industry’s most advanced clinical documentation solutions.


Reader Comments

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From Caterwaul: “Re: readers during HIMSS. How many do you get?” Around 8,000 visits daily during the conference, peaking this year at 9,000 visits and 17,000 page views on Wednesday, February 26. For the month, it was 125,000 visits and 207,000 page views. The graph above covers the last 30 days.

From The PACS Designer: “Re: iPhone 6. Excitement is starting to build for the next generation of the iPhone, will feature for the first time a quad-core 64 bit processor along with iOS 8. Also expected at  launch is a heart rate monitor along with the much anticipated iWatch. It looks like Apple’s going for a big splash of new products in 2014.” Sometimes it feels as though the iPhone is like the iPod – a mature, somewhat commoditized market in which minor feature differentiation passes for innovation. Apple and competitors can do only so much in screwing around with the screen size and construction materials, so the real improvements have to come from the OS.

From Jeff: “Re: headlines. Is is possible to get the morning headlines and any M&A news in a daily email?” I hadn’t thought of doing that since I assume most readers just go to the site, but it’s possible. Weigh in on the reader survey if you’d like since that’s where my to-do list will come from.

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From Olga: “Re: reader comments. I get the feeling that comments are filtered since controversial topics don’t always have many.” Comments are not filtered. I approve every one except these: (a) unverifiable claims that a specific person is quitting or being fired; b) repetitive, annoying diatribes posted by the same person using different names, as in the multiple anti-EMR identities of Not Tired of Suzy, RN; (c) comments trying to publicize a company or site. I should add that the Akismet spam filter automatically deletes comments that come from known spammer IP addresses or that contain questionable content, like a bunch of links. You might be surprised at some of the comments that I’ve rejected: claims that a specifically named CEO forced a female VP to attend an orgy, assertions of deviant behavior by well-known industry figures, and full-out personal attacks on people named in given post.


HIStalk Announcements and Requests

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Half of the HIMSS conference attendees who responded to my poll said it was a good overall experience, with the remaining 25 percent each declaring it to have been either poor or great. New poll to your right, just for (anonymous) fun: how much money did you make from your primary job in 2013?

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Here are more mug shots. Theo, 18 months old, doesn’t seem to mind Dad’s mishap traveling home from HIMSS that will require Mom to fix the handle. To the right, Colleen says she has one wish for Christmas since nurses need high-capacity mugs.

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Every year right after the HIMSS conference I ask readers to complete my survey telling me what they like, don’t like, and recommend for HIStalk. It only takes a few minutes and I plan my entire year from the feedback. You will make a difference, earn my gratitude, and be entered in a drawing for three $50 Amazon gift cards. Thank you.

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I won’t overdo the DonorsChoose project updates, but I wanted to share an example of the student letters you receive when you fund a classroom project. This one from a second grader says, “Thank you for the nonfiction books. We use them for learning and reading stations. We love them.” Lots of charities do good work but spend too much of their donations on fundraising and salaries. DonorsChoose has amazing stats: 94.4 percent of donations go toward programs and services instead of overhead, the CEO is paid only $240K, and it earns an amazing score of 67.83 out of a possible 70 on Charity Navigator. I was jaded about charities having worked in wasteful hospitals until I did my homework and came up with DonorsChoose and Salvation Army. I don’t donate a penny until I check Charity Navigator because marketing overhead can be up to 90 percent for some causes that run TV ads.

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

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Upcoming Webinars

March 19 (Wednesday), 1:00 p.m. ET. The Top Trends That Matter in 2014. Sponsored by Health Catalyst. Presenters: Bobbi Brown, VP and Paul Horstmeier, SVP, Health Catalyst. Fresh back from HIMSS14, learn about 26 trends that all healthcare executives ought to be tracking. Understand the impact of these trends, be able to summarize them to an executive audience, and learn how they will increase the need for healthcare data analytics.


Acquisitions, Funding, Business, and Stock

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The private equity owners of payer-provider connectivity vendor Ability Network are seeking a buyer for the company, expected to fetch up to $500 million.


Government and Politics

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Former White House advisor and oncologist Ezekiel Emanuel, MD, PhD (Rahm’s brother) writes a Wall Street Journal piece on the infighting involved in creating the Affordable Care Act. Everybody knows that HHS on one hand declares itself technologically innovative and its ONC organization demands that healthcare providers advance their technology prowess, while the CMS side of HHS’s house spends vast taxpayer fortunes on its primitive systems and the marginally competent bureaucracy required to maintain them. On bundled payments:

We presented the idea of phasing in bundled payments, especially for chronic conditions, to the rest of the White House reform team, where we found some strong support. But then we hit a brick wall. Many of our colleagues who worked for Medicare feared that creating the bundles would be too hard and warned that Medicare didn’t have the computer infrastructure to handle it. The arguments went back and forth, but the Medicare bureaucracy wouldn’t budge. Ultimately, the ACA authorized 10 demonstration projects that could be expanded if they worked—a good start, but a far cry from the more ambitious bundling plan many of us had hoped to see.

Delaware’s health department wants $87 million in FY2015 capital to upgrade its eligibility systems to meet Affordable Care Act requirements, adding that it’s too good of a deal to pass up since federal tax dollars will cover 90 percent of the cost. A Republican state representative isn’t impressed with the department’s plans. “We could have started our own endowment. It’s just staggering. This math is out of control. It’s extremely, extremely disingenuous to say this (Affordable Care Act) is saving us money.”


Innovation and Research

Engineering cadets from the United States Air Force Academy develop Neumimic as their capstone project, working with a local hospital to design a stroke recovery application based on Microsoft Xbox Kinect. The system allows patients to exercise specific muscle groups at home without a physical therapist.


Other

It’s spring-forward time as I write this on Saturday morning. Thanks if you are one of the folks who will be babysitting hospital systems tonight to make sure everything works with the change to Daylight Saving Time.

The folks at SIS put together a hilarious video that parodies vendors preparing for the HIMSS conference. It contains quite a few inside references from HIStalk (like companies that claim “HIPPA” expertise). Leave a comment with those you notice since I’m sure I didn’t catch them all.

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An interesting and scary use of big data: auto repossession companies are using vehicle-mounted recognition technologies to cruise the parking lots of malls and stadiums, capturing the license plate numbers, location, and timestamp of every car they pass. The information goes to a company in Texas whose database contains 1.8 billion scans that include the majority of American vehicles. The company is just beginning to realize the value of that information, planning to sell it to private investigators, insurance companies, and banks, who only need to match up the plate numbers to other state databases to know where any given person has been.

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Somehow this local newspaper’s headline seems Onion-like.

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Family members of deceased patients in China, like those in India, are increasingly turning violent toward the doctor or hospital involved, with 17,000 recorded incidents in 2010. An ED doctor in Guangdong province was forced last week to march with 100 friends and family members of a patient who died, accusing the doctor of malpractice. The hospital called police and he was released 30 minutes later.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 9, 2014 News 4 Comments

Morning Headlines 3/7/14

March 7, 2014 Headlines 3 Comments

Moody’s: 6 Hospitals With Credit Challenges Related to EHRs

Moody’s recaps the EHR-related credit downgrades that took place at US hospitals during 2013.

Use of Telemedicine Can Reduce Hospitalizations of Nursing Home Residents and Generate Savings for Medicare

A Commonwealth Fund study finds that nursing homes that used telemedicine to provide after-hours care significantly reduced hospitalization rates for their residents, compared with facilities not using this service.

Effects of Meaningful Use Functionalities on Health Care Quality, Safety, and Efficiency

ONC publishes a dashboard that consolidates 2010-2013 literature focused on MU related outcomes changes.

HIE solutions see drop in provider satisfaction

KLAS rates HIE solutions and finds that Epic, Orion, and Siemens are doing the best. Researchers note that “What is surprising is that despite the millions of dollars HIE vendors invested to add needed functionality, only about half of them are seeing their provider satisfaction scores improve."

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March 7, 2014 Headlines 3 Comments

News 3/7/14

March 6, 2014 News 1 Comment

Top News

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The Defense Health Agency, established in October 2013 as a successor to TRICARE, requests $1.6 billion to support its health IT systems in 2015. It also wants $91 million for R&D to develop a new EHR by 2017 and $68 million to integrate its systems with those of the VA. Meanwhile, the VA’s 2015 budget requests include $269 million for EHR development.


Reader Comments

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From TooMuch Coffee: “Re: WA state healthcare insurance exchange. You mention that 15k applications are stuck in limbo. I agree that’s not great, but they have signed up around 500k successfully. The site basically works, unlike OR and HI sites.” I’ve written about Oregon’s struggling exchange, so here’s the story on Hawaii’s: it received $204 million in federal funding, went live two weeks late due to software problems, has enrolled fewer than 5,000 people (at a cost of about $46,000 each), and has already been declared unsustainable without ACA rule changes since few potential customers and insurers are interested and it’s supposed to be self-funding its $15 million annual operating budget with 2 percent of the take. Meanwhile, the US Government Accountability Office says it will audit Oregon’s exchange, which cost $304 million and hasn’t enrolled a single person without manual help.

From Concerned: “Re: UHN in Toronto. Can anyone confirm that they are replacing QuadraMed EHR with Cerner?”

From Nobody Knows: “Re: value-based risk contracts. Is there a resources that details which payers and providers are engaging in them vs. those doing fee-for-service? I’ve tried AIS, HIMSS Analytics, and Billian’s and so far, no dice. Even a high-level report would be nice.”


HIStalk Announcements and Requests

inga_small This week on HIStalk Practice: You won’t want to miss the summary of my chat with eClinicalWorks CEO Girish Navani, who shares his thoughts on the MU program, population health, and health information exchange, plus provides an estimate of the company’s valuation if it were to go public. Despite the growing number of  employed physicians, work still needs to be done to integrate physicians and develop performance-based reward programs. The pay gap between primary care providers and specialists narrowed in 2013. I recap some vendor announcements from last week and muse on various HIMSS sights and sounds, including the future of Practice Fusion; Allscripts and its new tag line; what’s driving Aprima’s recent growth; and, the hot topic of ICD-10. Thanks for reading.

This week on HIStalk Connect: Samsung unveils the Galaxy S5, which integrates with both its two new smart watches and its new activity tracker. Basis, the maker of the B1 activity tracker, is acquired by Intel for a rumored $100 million. The FDA is looking for a vendor to develop social media analytics tools.

On the Jobs Board: Chief Market Strategist – Healthcare, EHR Tester, Epic Activation Consultant.

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Welcome to new HIStalk Platinum Sponsor CompuGroup Medical. You see the count of big global customer numbers in their graphic above and the owner-led and publicly traded company is expanding its US sales. Offerings include CGM Clinical (integrated PM/EHR), CGM DAQbilling (PM), CGM webEHR (EHR), CGM webPRACTICE (PM), and CGM Enterprise (PM/EHR for community health centers); LIS, outreach, and reference lab solutions; the eSERVICES Patient Portal, EMEDIX Reimbursement Solutions, and the SAM disease management platform. The new CEO of CGM US is Norbert Fischl, who has an interesting background as leader of the company’s Northern European region, managing director of a software company, McKinsey consultant, and an Internet entrepreneur. Thanks to CompuGroup Medical for supporting HIStalk.

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Here’s another update on one of our DonorsChoose projects that was paid for by the top-of-the-page ads. The 35 freshman girls in the Illinois high school taught by Teach for America teacher Ms. Schwartz are using the notebooks and colored pencils we provided to create College Bound Journals. They will fill them with goals, thoughts about their futures, and information they gather about college campuses and majors. You can see in the photo sent by the teacher that they’ve already started.  

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More remote mug sightings.

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Anne-Marie wasn’t able to get way from the family medicine practice she manages to attend the HIMSS conference, so she made her own mug. She says it’s not nearly as cool as the original, but I disagree.

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It’s time for the once-yearly HIStalk Reader Survey. It’s quick and I use the results to plan the entire next year of HIStalk, so I would really appreciate your taking five minutes or less to give me some guidance. I’ll sweeten the pot by randomly drawing three responses to receive $50 Amazon gift cards. Thanks in advance – most of the good ideas I’ve put in place came from responses to this survey.


Upcoming Webinars

March 19 (Wednesday), 1:00 p.m. ET. The Top Trends That Matter in 2014. Sponsored by Health Catalyst. Presenters: Bobbi Brown, VP and Paul Horstmeier, SVP, Health Catalyst. Fresh back from HIMSS14, learn about 26 trends that all healthcare executives ought to be tracking. Understand the impact of these trends, be able to summarize them to an executive audience, and learn how they will increase the need for healthcare data analytics.


Acquisitions, Funding, Business, and Stock

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MedAssets reports Q4 results: revenue up 4.1 percent, adjusted EPS $0.28 vs. $0.25, beating estimates on both.

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Clinical prediction software vendor Health Outcomes Services completes a $5 million financing round. CEO Jim Wilson has worked for McAuto, EDS, and Cerner and was president of Craneware before joining HOS.


People

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ArborMetrix appoints former CMS administrator and FDA commissioner Mark McClellan, MD, PhD (Brookings Institution) to its board.

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Idea Couture hires James Aita (Medicomp) as head of healthcare solutions.

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Bart Foster, founder and CEO of self-service medical kiosk maker SoloHealth, is replaced by Chairman Larry Gerdes (both above.) The company’s CFO has also resigned and an undisclosed number of employees have been laid off. Gerdes sold transcription vendor Transcend Services to Nuance for $300 million in 2012. One of SoloHealth’s investors is healthcare IT long-timer Walt Huff, the “H” in HBOC, where Gerdes was an executive from 1977 to 1991.   

Tamyra Hyatt (McKesson) joins Azalea Health as VP of marketing.


Announcements and Implementations

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The New York eHealth Collaborative and the Partnership Fund for NY call for applications for participation in the second class of the  NY Digital Health Accelerator, where 10 early- and growth-stage companies will each receive mentoring and $100,000 of investment capital.

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North Dakota officials announce the official rollout of the state’s HIN, which will connect all of North Dakota’s hospitals by the end of the year.

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The US Army deploys a software upgrade to its battlefield Medical Communications for Combat Casualty Care EMR, also known as the MC4 system, that includes an upgraded operating system, enhanced security, and patient safety improvements related to allergies and medication history.


Government and Politics

HHS includes $75 million in its 2015 budget for ONC, a $14 million increase over last year.

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ONC updates its Health IT Dashboard to include a Rand Corporation-prepared review of literature on the impacts of HIT, with a focus on MU functionalities.

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Analysis of full-year 2013 MU attestation data by Wells Fargo Securities finds that 92 percent of hospitals stuck with the same vendor for at least two years. Meditech, Allscripts, and Siemens topped the list of hospitals that stayed the vendor course, Cerner and CPSI were average, and Healthland, McKesson, and HMS lagged. It also finds that small hospitals seem to be dropping out in big numbers by the third year, perhaps because they’ve paid their EHR costs in the first two years and don’t want to deal further with MU complexity.


Innovation and Research

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Hospitalization rates declined at nursing homes that used after-hours telemedicine services, according to a Commonweath Fund-sponsored study. Researchers estimate that the use of telemedicine services could net Medicare a $120,000 savings annually per nursing home.


Technology

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Azoi announces Wello, a $199 case that turns an iPhone into a monitor for blood pressure, ECG, heart rate, blood oxygen, temperature, and lung functions.


Other

3-6-2014 12-47-31 PM

Epic, Orion, and Siemens earn the highest customer satisfaction scores in a KLAS survey on HIE solutions. Overall provider satisfaction with HIE solutions has dropped an average of eight percent since last year.

Becker’s Hospital CFO looks back at hospitals whose bond ratings have been downgraded by Moody’s Investors Services because of EHR-related budget problems: (1) Health East Care System (MN), which is spending $145 million on Epic; (2) Community Medical Center (MT), which is having cash flow problems after installing Cerner and NextGen; (3) Saint Luke’s Health System (MO), implementing Epic for $200 million; (4) Scott & White Healthcare (TX), seeing increasing costs with Epic; (5) Washington Hospital Healthcare (CA), having increased costs and a negative margin after implementing Epic; (6) Robinson Memorial Hospital (OH), with losses partially attributed to its Allscripts Sunrise implementation.

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Bloomberg News calls Mount Sinai Hospital (NY) “a heart surgery factory with obscene levels of pay,” claiming the hospital coaches patients to feign heart attack symptoms in the ED to get their stents covered by insurance, earns referrals from doctors with financial ties to the hospital, and pays its head of interventional cardiology $4.8 million per year. The head of another New York interventional cardiology program summarizes, “You essentially have physicians combing the streets of Staten Island, Queens, Brooklyn, and Bronx looking for patients they can screen on a treadmill to feed into the cath lab, where the big reimbursement comes.”

In Canada, Pierre Le Gardeur Hospital cancels all elective procedures after experiencing an unspecified computer system problem.

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Weird News Andy has his ear to the UK ground in noticing this story, in which the British public reacts to news that a marketing company used a 47 million-record hospital data extract to target Facebook and Twitter ad campaigns. Another company was found to have loaded the entire database to Google’s servers to create interactive maps. The Hospital Episodes Statistics database had been made available by the government to researchers and approved private companies. The government has a PR nightmare on its hands because de-identification is hard to describe to laypeople who react to “my hospital records are on the Internet.”


Sponsor Updates

  • Vonlay concludes an Epic engagement with Aspirus (WI).
  • Physicians Interactive and McKesson Patient Relationship Solutions will jointly deliver Coupons on Demand, which will provide clinicians access to online cost-saving offers for medications.
  • Kinston Pulmonary Associates (NC) will implement NextGen PM and EMR from TSI Healthcare.
  • InterSystems joins the Global Alliance for Genomics and Health.
  • Gastroenterology-specific EHR provider gMed will add medical content from Health Language to its system.
  • E-MDs releases details on its June 5-7, 2014 User Conference and Symposium in Austin, TX.
  • CIO profiles ICSA Labs, which is now the largest government-approved EHR testing and certification body.
  • Hardin Memorial Hospital (KY) reports improved clinical response times since integrating telemetry alarms with Voalte smartphones.
  • Divurgent raises $5,000 during HIMSS for the Florida Hospital for Children.
  • RazorInsights ONE-Electronic Health Record achieves Stage 2 ONC certification.
  • Daniel Flanagan, executive consultant for Beacon Partners, discusses in the company’s blog his recommendations to ensure a clearinghouse is ready for the ICD-10 transition.
  • MedAssets estimates that its latest National Sourcing Collaborative event will drive $5 million annually in added value for its participating clients.
  • Connance expands its patient-pay solution to include predictive analytics and additional platform reporting and consumer engagement functionality.
  • On the company’s blog, MEA | NEA CEO Lindy Benton explains the significance of electronic submission of medical documentation (esMD) and health information handler (HIH).

EPtalk by Dr. Jayne

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One of my fondest memories from medical school is working the ER during Mardi Gras. I sewed up more than one reveler who didn’t really need anesthesia because they were already feeling no pain. I chuckled when one of my former classmates sent me this story about the germs residing on Mardi Gras beads. Who would have thought that beads that have been thrown around in the midst of public drunkenness might have germs? I wonder if there’s an ICD-10 code for that? Maybe there’s one for choking on the baby in the King Cake as well.

One thing I found lacking at HIMSS was the presence of wearable devices (other than on attendees). I didn’t see much vendor promotion or anything cool enough that I’d consider it (although watching people try to interact with Google Glass was pretty funny). I don’t have any experience with Fitbit, but after reading this article I heard about on Twitter, I might consider one just to have this app. The Sleep Tracker Hack, which emerged from the recent Netflix Hack Day, helps a viewer find her place after sleeping through streaming media. I just might know someone who has fallen asleep in the middle of re-watching “Grey’s Anatomy” for the last several weeks. Unfortunately the hack was part of an internal hackathon, so it may never see the light of day.

I believe in patient engagement and making health-related technology accessible to patients, but there’s such a thing as going too far. I was reading a piece about the Bellabeat Connected System that turns a smart phone into a fetal heart monitor. It also mentioned the Huggies “TweetPee” that sends a tweet when the baby wets its diaper. Seriously? Unless your infant has a urologic problem, I’m not sure tracking urination on social media will do much more than drive followers crazy.

One of my favorite HIMSS connections reached out earlier this week to ask if I would be willing to help mentor a physician who would like to join the CMIO ranks. When I first started out, I had no one to look to for advice, so I was happy to oblige. One of his questions was what I think is the most important CMIO function. I’m not sure I can pin down a single one, but one of the most important in my book is being able to be the peacemaker among IT, the operations folks, and the physicians. Certainly there are other constituencies, but those are the three that tend to be the most contentious.

I’m still surprised that nearly a third of health systems still don’t have a CMIO. The organization where my mentee works falls into that category, but at least they understand that they need to work towards filling that role even if they aren’t ready to admit they need an honest to goodness CMIO. Whether we’re called Medical Directors or Directors of Informatics or Physician Champions, we can still help organizations move forward.

His hospital is currently struggling with physician engagement and clinical oversight, so it makes sense that a physician would be uniquely positioned to assist. He’s not highly techy, but I think that’s OK – if we can master anatomy and pathophysiology, we can learn enough about networks and software to be meaningful participants. The key is knowing who our experts are and being willing and able to leverage them appropriately.

He’s worried that his hospital isn’t really ready to formalize physician leadership in the IT space. There have been comments made about fears that the CMIO “will come in and boss IT around because he’s a physician” or that he will preferentially take the physicians’ side in arguments. I’m encouraging him that even though his role is emerging,  he should ensure that  it’s well defined and that leadership is prepared to support him. Without those elements, the risk of frustration will be fairly high for all involved.

At this point, I think he’s wise to negotiate for a formal position, but I’d recommend going for something part time that lets him dip his toes in the waters of clinical informatics without locking in at an organization that might not be as ready to move forward as he thinks they might be. That will buy him some time to work on professional development and to build the skills he’ll ultimately need if he wants to make a career of this. I’ll keep you posted as I hear from him. I’m looking forward to remembering what it was like to be young and idealistic before the CMIO life started beating me down.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

 

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March 6, 2014 News 1 Comment

CIO Unplugged 3/6/14

March 6, 2014 Ed Marx 8 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Executive Success – The Secret Unplugged, Part 2

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This is the second guest post from my wife Julie. The first one is here. She writes what she feels and it is unfiltered, straight from her perspective. She would not have it any other way! I am thankful to have married a very strong woman.

“No, no! Take your finger off that send button, Edward Marx.”

Yes, I had to stop him before he sang his own praises on this blog. For heaven’s sake, he just finished pouring out his heart in a four-part series on Identity based on humility, and now he was about to shoot himself in the foot.

I confess. It’s tough living with a “celebrity,” especially when his prominence is bigger in his head than it is in the mortal world.

Don’t get me wrong, I’m extremely proud of him for winning the “John E. Gall CIO of the Year” award. After all, how many execs choose to trample their way out of the policy box their organizations try to keep them in? How many execs have disrupted their workplace practices and standards and influenced their peers and followers to change their own organizations?

Ed has a voice that speaks volumes to improving healthcare on the technology side. He draws out leadership talent in people everywhere he goes. He absolutely deserved to win the award.

Ed was equally proud of winning the HIStalkapalooza IT Leader of the Year award.

But I can always hear the tremble in his voice that asks, “Why are these people following ME? What if I lead them in the wrong direction?”

Ultimately, time will tell on the direction part. But my response to the first question would be “vision.” Am I right? We like to go somewhere important and add significance to our sphere of influence.

Now that the 2013 award ceremony is over, my hope is that you show your admiration and appreciation by applying all the spoken and unspoken lessons you’ve learned from the 2013 CIO of the Year and revolutionize your own domain. Don’t live vicariously through Ed’s achievements and settle for complacency in your own world. Seriously, one man can only accomplish so much, but an army of like-minded leaders can advance the IT kingdom beyond its present borders and into a model worth imitating.

Yes, you do have what it takes. For some of you, the secret is to bust the box. And that would be an applause heard around the world.

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Julie’s personal highlights from the HIMSS conference:

  • A man came up to congratulate my father-in-law and said, “I want to be just like you.” (Wow! I’ve never met anyone who aspired to be an old German fart. Or a holocaust survivor.)
  • A taxi driver mistook Ed for The Edge from U2 (this is becoming the norm.)
  • A man (name withheld) said, “I appreciate Ed, but Julie always makes me smile.” (Ahh shucks.)
  • Three of Ed’s direct reports (names withheld) serving others who had fallen ill and required medical treatment
  • Taking pictures of Ed posing with Disney princesses at Epcot
  • Argentine Tango at HIStalkapalooza

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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March 6, 2014 Ed Marx 8 Comments

Morning Headlines 3/6/14

March 5, 2014 Headlines No Comments

Kaiser Permanente board member quits amid questions over conflicts

Dr. Christine Cassel, chief executive of the National Quality Forum, quits her board positions with Kaiser Permanente and Premier Inc. after ProPublica reported that she was being paid a cumulative $400,000 for her advisory role with the companies.

Defense Health Agency Wants More Money For IT Operations In 2015

The DHA has requested $1.6 billion to support operations and maintenance of its health information management systems in 2015, seven percent more than its 2014 budget.

Obama’s Budget for 2015: 10 Points for Hospitals Know

Becker’s Hospital Review evaluates President Barak Obama’s 2015 budget proposal, highlighting Medicare payment reforms, critical access hospital reimbursement changes, and increased funding for Medicaid/Medicare fraud detection programs.

US health information breaches up 137%

More than seven million health records in the United States were affected by data breaches in 2013, an increase of 137% over the previous year, according to the annual breach report..

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March 5, 2014 Headlines No Comments

Readers Write: The Data Problem

March 5, 2014 Readers Write No Comments

The Data Problem
By Randy Thomas

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Dr. Jayne asked important questions in her Curbside Consult about big data, EHR conversions, the “sheer magnitude of bad data out there,” and how best to insure the integrity of health data.

The best way to address the issue of bad data is to follow the old adage,“Begin with the end in mind.” Implementing an enterprise-wide EHR is a massive, complex undertaking. It involves considering the needs of many stakeholders when defining the build requirements. For example, workflow must support ease of use and not interfere in patient care delivery and related work processes. Furthermore, many implementation decisions focus on driving clinician adoption to ensure that both quality and efficiency objectives are met (not to mention regulatory requirements related to Meaningful Use.)

With all the multi-threaded work streams and decision processes involved in planning and executing an EHR implementation, the re-usability of captured data frequently falls out of scope. That leads to the bad data problem.

Re-usability means using data captured in any source system (EHR, ADT  materials management, patient accounting, registration, operating room, emergency department, etc.) for reporting, measurement, and analytics. Re-using the data captured in these source systems accelerates the value realized from implementing such systems and supports a virtuous cycle of performance improvement across an enterprise.

It all relates to, “You can’t manage what you don’t measure.” That is, you can’t measure something if you don’t have the right data. This leads back to the decisions made in implementing EHRs and other systems. You need to start with what data is required to measure and analyze what’s important to the organization and ensure that data can be consistently, reliably, and accurately captured at the point of origin (e.g., at registration or in the care process).

It’s not realistic, however, to expect that every bit of data about a patient should be captured in a discrete form for re-use. What’s required is a balance between supporting ease of use in the appropriate workflows and the availability of data for reusability.

An effective way to strike this balance is to create a list of data elements the organization agrees is necessary for analytics. Some detective work is required: tracing the journey of that data back to the source system and ensuring that each data element is captured as expected in the intended workflow. This requires collaboration across a multi-disciplinary team — one involving experts in quality reporting, data analysis, and clinical (or operational) workflow.

The inventory of data elements can be used to identify where each data element can be captured in the source system (e.g., EHR, ADT, etc.). This is the “data chain of trust.” Team discussion and compromise are required to design workflows that both support ease of use and capture data reliably and consistently.

With a documented inventory of data elements married to how that data will be captured in the source systems, data can start flowing into an analytics environment. Applying sound data governance principles and implementing a data profiling discipline will ensure data consistency and reliability.

Organizations don’t have to begin with a large set of discrete data, but they must recognize that any level of measurement, reporting, and analytics requires consistent, reliable, accurate data starting at the point of capture in the source systems. They should begin with the data most important to each organization and ensure that data can flow from origin to analytics in a chain of trust that is known and transparent.

From there, health systems can incrementally increase the available data as they come to understand why it’s important to capture data discretely and accurately and as more stakeholders benefit from access to that data. With the increasing value realized comes the understanding that, “It’s all about the data.”

Randy Thomas is associate partner of health analytics with Encore Health Resources.

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March 5, 2014 Readers Write No Comments

Lorre’s HIMSS Conference Summary

March 5, 2014 News 4 Comments

2-25-2014 5-30-55 AM

Last week as I was staring into the House of Blues stage lights at HIStalkapalooza wearing a gown, high heels, and a sash reading, “HIStalk To Me,” I was struck by how different it was from any other job I have had. I had to pause for a moment to remember how it all happened. Twenty years ago I was a mining industry accountant and usually wore steel-toed boots and a hard hat. That seems like another lifetime now.

A seemingly random opportunity landed me in healthcare IT, where I have been for 18 years. I worked for vendors in operations leadership and business development. I have an MBA and I am an LSS Black Belt. I thrived on the never-ending challenges, non-stop travel, and endless demands for my time.

Finding myself on stage with this dream job was the culmination of a whirlwind of recent events, too many to list. I love working with the HIStalk team and I know I am in an enviable position.

HIMSS14 started for me at the beginning of September. I had just joined the HIStalk team when I met with Mr. H and Inga to discuss my role. We already agreed I was going to be responsible for the webinar program and HIStalkU, but we knew that I as the only non-anonymous member of the team could do more.

We talked about trade shows in that September meeting, but it wasn’t until the mHealth Summit offered HIStalk a free booth as a media partner that we decided to try it since we had nothing to lose other than time and travel expenses. I have been to HIMSS and AABB many times and worked in the exhibit hall. I showed up at our impressive vendor booth and stood around talking with customers and prospects all day. How hard could it be to create a micro version of that for HIStalk?

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We considered mHealth Summit a trial run for HIMSS and decided to go with the bare minimum. I had never furnished a booth and the logistics are daunting. I learned that nothing comes with the booth. Mr. H and I debated about whether there would be a table at the front of our booth and decided to wait and see. We didn’t have any giveaways.

When I finally found our booth the morning before the exhibit hall opened on a snowy December day outside of Washington, DC, there was only a tiny patch of green carpet holding a chair and a trash can. There was no table or separation wall. Fortunately I was able to rent a table with a skirt and it was delivered in plenty of time. I had amazing booth neighbors who helped me hang our banner and they even let me use one of their power outlets.

There were 400 exhibitors and 5,500 attendees at mHealth. I was pleasantly surprised by how much booth traffic we generated. We weren’t selling anything or giving anything away. I was there to say thank you for reading and thank you for sponsoring, nothing more. There was a steady stream of people each day even though the conference doesn’t draw our core reader demographic. I met writers who later contributed to HIStalk and a few people interested in sponsoring. The best part was how much people just wanted to say hi and express their dedication to HIStalk. I was convinced a booth at HIMSS was a must-do.

HIMSS is a much bigger deal when compared with mHealth with 1,230 exhibitors and 37,000 attendees. It was painful trying to choose one of the available booth locations, all on the fringe and all seemingly uninteresting, but we did. We learned a lot from the mHealth Summit and acted on some great ideas for inexpensive booth signage.

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Our giveaways were simple but fun. We designed two lanyard pins, one to commemorate the 10-year anniversary of HIStalk this past June and the other representative of our first HIMSS conference as an exhibitor. We had coffee mugs printed with the top HIT news stories of 2013 according to HIStalk. They turned out to be a hit, and even readers who didn’t attend the conference have asked for the pins and the mugs.

When I visited the exhibit hall Sunday afternoon, I was shocked to find it far from ready for the next day. Some of the giant booths looked only half built, debris was everywhere, and forklifts raced dangerously back and forth. I couldn’t imagine everything being ready in time to open the hall at noon on Monday. I wanted to deliver the HIStalk sponsor booth signs, but the hall was such a mess and the odds of being struck by a forklift were so high that I decided to wait.

I hosted a cocktail reception for our sponsors Sunday evening. It went smoothly and everyone said they had a great time. I met a lot of interesting and energetic people and I was impressed by their obvious affinity for HIStalk. Dr. Gregg was on hand to assist me and Inga and Dr. Jayne spent some time there (anonymously, of course.) Even Mr. H made a quiet appearance, after which he left just as quietly.

Monday morning I arrived at the exhibit hall early and raring to go. I had to hustle to cover every square foot of the exhibit hall, my arms loaded with signs. Thankfully Dr. Gregg was there, too, and when we realized I was running out of time, he helped me get it done. According to my Fitbit, I exceeded my 10,000 steps/five miles goal before 10 a.m.

Our little booth was quite a way from the major thoroughfares, so I was surprised by the immediate flow of visitors when the exhibit hall opened. It was consistent throughout the show. Countless readers and sponsors stopped by to say hello and to tell me how much they love HIStalk. We had even heavier traffic when one of our VIP guests (Ed Marx, Vince Ciotti, and Robert Murphy, MD) greeted their fans in our booth.

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Once again, Dr. Gregg was a life saver. Not only did he help me with the booth setup and delivering the signs, he gave me breaks throughout each day so the non-stop visitors wouldn’t be disappointed to find an empty booth. Mike Cannavo (“The PACSman”) was also a blessing. He covered the booth, brought me lunch, and kept our swag collection current. The number of people visiting our booth was so remarkable that someone in the booth next to ours asked, “What are you selling?” I smiled when I replied that we are selling nothing — we are just saying hello and thank you.

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There was so much fun on and off each day that it would be impossible to mention it all. My top 10 are:

  1. Working with the people in the Epic booth to stage a picture of them looking at their cell phones
  2. Watching people apply temporary tattoos to the strangest places (Ed Marx takes the prize for his lower back tramp stamp)
  3. Arriving at the booth one morning to find a box of warm scones from MedData
  4. Handing out the HIStalk sponsor booth signs and seeing how everyone lit up
  5. Chatting with Ed Marx, Vince, and Dr. Murphy
  6. Seeing the women who stopped by to show me their shoes
  7. Having Inga, Dr. Jayne, and even Mr. H stop by the booth without anyone realizing it except me
  8. Receiving my own copy of Struck by Orca
  9. Trying on a Super Bowl ring
  10. Receiving countless comments and compliments and passing them along to the team

I reconnected with many colleagues and customers from the past. I receive e-mails regularly from people who see my LinkedIn profile and wonder if working for HIStalk is a real job. Talking with them wasn’t any different. Yes, it is a real job, although it is fun and exciting and it doesn’t usually feel like work. I love to chat with readers and sponsors and work on webinars. I get a lot of satisfaction from helping them develop and deliver interesting and educational productions.

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The event that was a personal stretch for me came when Mr. H asked me to accept HIStalk’s “Sunquest Industry Pioneer Award.” In my 16 years working for Sunquest, I received many opportunities to learn and grow and I almost always loved it. The same team presenting the award fired me two years ago. I can almost hear the collective gasp — why would I admit something like that publicly, and in writing no less? Let’s face it — we are all one merger, acquisition, unattainable goal, or difference of opinion away from being redundant or no longer a fit for the position. It isn’t personal. I showed up at the booth and everyone was friendly and warm. The HIStalk team stood within earshot and watched proudly. I thanked Sunquest not only for the award, but for their support and sponsorship of HIStalk. It was closure and it felt good.

Participating in the planning of an event like HIStalkapalooza was a whole new experience for me. Since the sponsor is responsible for it, it should be easy for the HIStalk team, right? No way! There is constant back and forth interaction and negotiation. It isn’t easy to strike a balance between what our readers and sponsors expect and what the sponsors of the event think they should get out of it. It was both frustrating and fun to be part of it. I learned a lot, along with everyone else, and I’m sure next year will be better because of it. The event itself was a huge success. The HISsies were entertaining and Farzad, Carl, and Ed all made an appearance to accept their awards. The food was terrific and people raved about the band for days afterward. Imprivata and all of the co-sponsors did a great job.

HIMSS14 was great for me. I met a lot of terrific people, I gained a whole new appreciation for those responsible for planning events, and I had fun. I am already thinking about what to do next year in Chicago.

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Email Lorre or follow her on Twitter.

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March 5, 2014 News 4 Comments

Morning Headlines 3/5/14

March 5, 2014 Headlines No Comments

FCC Chairman Announces New Connect2Health Task Force

FCC Chairman Tom Wheeler announces the formation of a new task force that will work to accelerate the adoption of health care technologies by leveraging broadband and other communications services.

Association Between Participation in a Multipayer Medical Home Intervention and Changes in Quality, Utilization, and Costs of Care

JAMA publishes a study following the performance of a Patient Centered Medical Home from its launch in 2008 through 2011, and concludes that participation in a PCMH does not directly correlate to reductions in utilization of hospital, emergency department, or ambulatory care services or reductions in total costs of care over three years.

Wake Forest Baptist’s operational revenue rises in second quarter of fiscal 2014

Wake Forest Baptist’s chief financial officer credits reduced expenses related to its Epic implementation in part for its financial turnaround. The medical center reported a loss of $23.5 million, an improvement compared with a loss of $49.8 million for the same period in the previous year.

Castlight Health amends IPO filing, hopes to raises up to $140 million

Castlight Health has updated its February IPO filing to reflect that it plans to sell between 11 million and 12.6 million shares of common stock for  $9 to $11 per share, bringing the total it hopes to raise to $140 million.

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March 5, 2014 Headlines No Comments

News 3/5/14

March 4, 2014 News 7 Comments

Top News

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FCC Chairman Tom Wheeler announces the formation of a task force that will seek ways to increase use of broadband to deliver telehealth, mobile apps, and telemedicine. Heading up CONNECT2HEALTHFCC will be Michele Ellison, a lawyer who runs the agency’s enforcement bureau. Wheeler said in the announcement, “We must leverage all available technologies to ensure that advanced health care solutions are readily accessible to all Americans, from rural and remote areas to underserved inner cities. By identifying regulatory barriers and incentives and building stronger partnerships with stakeholders in the areas of telehealth, mobile applications, and telemedicine, we can expedite this vital shift.”


Reader Comments

From Just Tim: “Re: MU stages beyond stimulus payments. What is the legislative basis to extend the MU program? MU requirements were supposed to run in conjunction with years in which payments were made, not years after penalties kick in. I’d certainly agree that if someone never got to Stage 3, they could reasonably be penalized on an ongoing basis. Otherwise, we’ve just created a large bureaucracy with the power to continue to push unfunded mandates.” Legal scholars and political junkies, the less legislative among us are calling.

From Dim-Sum: “Re: military EHR replacement. Word on the street is that the vendors of choice and partners are as follows. Six service integration (SI) firms will bid Epic. The team that is getting the most news is Leidos/Accenture/Harris. Cerner has a single exclusive SI partner (still doing research to see who that SI is). Allscripts cannot find a partner for their Sunrise. Meditech has the incumbent Northrop Grumman. McKesson walked away from GDIT/Vangent. Siemens has a yet to be named DoD giant. Competitive bids will require an investment by prime and sub software solution firm of about 1.5-2 percent of the total contract value. That means that to win a $5B deal with the DoD, the investment for resources, capabilities, compliance, and regulatory wherewithal (see FISMA, FedRAMP, DIACAP, 508, JITC etc) is $50 million USD. Good Luck beltway bandits and COTS EHR dreamers.” Unverified.

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From Brenda: “Re: Washington’s insurance exchange. Add it to the list of those having issues. By the way, I’ve recommended HIStalk to countless people and I’m glad our company has been a sponsor for about a year now.” The Healthplanfinder exchange has 15,000 applications that are stuck because the user-entered information can’t be matched to the state’s Medicaid benefits database or contain incomplete information (hello, programmer edits?) I speculate that the state incurred the wrath of the grammatical gods when it combined “health plan finder” into a single word.  

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inga_small From Charger: “Terrific correspondence from Orlando; much appreciated since I could not attend! I’m sure you have been deluged with coffee mug requests and are out of stock, but may I place an order for one upon receipt of any new inventory? I will gladly swap you one of my local Karl Strauss Brewery pint glasses in return.” Thanks for the generous offer, but sadly all the coveted coffee mugs are gone. Lorre and I are trying to convince Mr. H that the timing is perfect for the opening of an online store featuring HIStalk swag. Beauty queen sash, anyone?

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More mug sightings: Investor’s Chair contributor Ben Rooks, who obviously works standing up while looking at green ivy outside his San Francisco office; and Mike Jefferies of Longmont United Hospital, whose Spotify-HIStalk two-monitor setup looks a lot like mine. I still have a few more photos to run next time.

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From Dr. Travis: “Re: Nordic’s new office. Thought this was very cool.” I had to clarify with Travis since this is a Midwestern, tailgating, and college thing that much of the country won’t understand: it’s a cornhole platform.  

From Ion Exchanger: “Re: HIMSS booth. You had traffic in your booth back in the hall. You should get another exhibitor to give you space free in return for drawing people.” That idea has come up on occasion, although not usually from people offering space. Our first-time exhibitor experience was good, especially since it was a low-rent, homebrew operation designed solely to give Lorre a way to say hello to interested readers and sponsors. I think I’ve decided to do it again in Chicago.

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From Dr. Matt: “Re: QlikView. First there’s an Epic partnership and now I find at HIMSS that Health Catalyst offers QlikView on top of their data warehouse. Why are these big players using it?” I’ll let those organizations speak for themselves.

From Doctor N: “Re: HIMSS conference. It was my first one. Only the HIStalk people made me feel valued as a practicing physician. The insults, lack of humility, time away from my clinic, and the lack of vendor understanding of how medicine really works will keep me from returning soon. The sessions could have been done online and the networking conversations were shortened because everyone was in a hurry to get somewhere else. I believe I have seen the American medical industrial complex at its worst. I was surprised at the number of vendor folks who are physicians and how little they know about how we pay for healthcare: SGR (which will worsen matters for providers) and $156 billion being cut from Medicare Advantage plans. They have no clue that I’m not paid for population health and most docs in my community hardly even know the meaning of the term. It is like we are buying the horseshoe, barn, and saddle in the hope that we’ll get a horse for a present. HIStalkapalooza, however, did not disappoint!”

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From Spelling CMIO: “Re: a tech solution to HIT spelling problems. As technology professionals, we ought to be able to bring our expertise to bear on the current plague of spelling confusion. I suggest we start to use regular expressions, like: HIM*S* and HIP*A* so that all variants can be brought under the welcoming umbrella of mediocrity. Heck, we could even bust out CM*S to obscure the failure to include ‘and Medicaid’ in the name of our favorite bureaucracy. We could even try E[Pp][Ii][Cc] to free the caps-lock crowd from their yoke of humiliation.” Scanning for “HIMMS” news stories turns up 56, which is pretty sloppy.

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From Frank Poggio: “Re: ONC. Issued new 2015 test criteria while at HIMSS last week. They kept repeating that this new (and extensive at 242 pages) test criteria is ‘voluntary’ for vendors. Here comes another wolf in sheep’s clothing. Do you really think the 2015 Criteria will be ‘voluntary’? How can they generate a revised list of criteria that fixes bugs and not make it required? How can they add something critical to patient safety such as UDI and not make it required? Breaking out CPOE components has been something niche vendors have been asking for since the start. So will those vendors ignore it and stick with 2014 criteria? I have worked through dozens of tests with clients since the inception of ONC and every time they expand or make a test update it soon becomes mandatory by the authorizing testing labs … and with some ATLs sooner than others. I give the 2015 version at most four months before it becomes mandatory.”


HIStalk Announcements and Requests

Listening: new from the all-female, LA-based spacey rock quartet Warpaint, which sounds a bit like Cocteau Twins (and that’s a good thing). I’m also enjoying defunct, brilliant Irish pop band The Thrills.

Some random thoughts I had regarding the HIMSS conference:

  • I was surprised and happy that the vendors of much-hyped analytics and population health management products were restrained in their pitch. Many companies talked about those products, but I didn’t hear a lot of wild claims.
  • The terms “big data” and “cloud” weren’t repeated reverentially and annoyingly to the extent that might have been expected.
  • What is population health management, exactly? It will be whatever payers say it is, no different than “quality.”
  • I’m not impressed with “big data” when healthcare is woefully indifferent to “little data.” We ignore evidence-based medicine, warnings for inappropriate or duplicate tests and drugs, and quality measures. We are sloppy about monitoring our supply chain and controlling our labor and materials costs. We pay little attention to the free exchange of information we hold about patients. We don’t like the idea that patients themselves should see our digital secrets. We should be using the information we have to its fullest before trying to tackle giant databases containing even more insights that we’ll ignore. Speak up if your hospital is different.
  • I’m not sure if patient engagement was just a token HIMSS nod or a real movement. I don’t see stretched providers getting excited about engaging patients unless government or competitive pressures force them to. It was nice to see patient advocates at the podium, even if only sporadically.
  • People are beginning to realize that EHRs aren’t necessarily the center of the universe. Small vendors are creating specific applications that use the EHR, which makes them easier to develop, cheaper, easier to use, and easier to buy since any buyer’s remorse will be several zeroes cheaper than the EHR itself. A question to ask of the dwindling number of EHR vendors might not be what their system does, but what does it allow to have done by other sources? Those companies were in the hall.
  • The government has taken a lot of innovation out of the system with Meaningful Use and ICD-10. I said from the beginning that taking MU money means making the federal government your incessantly nagging partner, but with penalties following rewards it wouldn’t have mattered anyway. I got the sense that attendees were more interested in what HHS and ONC say than what vendors were telling them.
  • Financial uncertainty as well as a big implementation and optimization ramp-up business has increased the willingness of providers to pay a premium to use consultants since they don’t want to get locked into salaried employees for specific short-life tasks. Consulting companies seemed to be generating a lot of interest.
  • Hospitals, like every swollen, inefficient, and political bureaucracy, will do whatever it takes to protect their own interests. They have money and clout and they aren’t just going to happily reduce their profits, headcount, or ambitions to reduce overall healthcare spending. Integrating their acquisitions will be a target market.
  • HIMSS is always like a boat show, but this year I’m not sure many boats were sold.

Acquisitions, Funding, Business, and Stock

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Telus Health acquires Med Access, a British Columbia-based vendor that claims its EMR is #1 in Canada with 4,000 users.

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Clinicient, a provider of RCM and clinical solutions for rehabilitation therapy, raises $15 million in Series C funding from Catalyst Investors and names Rick Jung (Medsphere) chairman and CEO.

Castlight’s IPO could raise up to $140 million based on a revised filing made this week.


Sales

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PatientPoint awards Xerox a $28 million contract to work with hospitals and physician practices to introduce PatientPoint’s digital check-in and population health management software and to provide training and support.

Denver Health selects Besler Consulting to assist in the identification of Medicare and Medicare Advantage Transfer DRG underpayments.

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UCSF Medical Center will implement Oneview Healthcare’s patient empowerment program at three Mission Bay hospitals.

The University of Miami Health System selects Lockheed Martin to manage its healthcare data, develop predictive models for risk identification, and build automated systems to give providers data at the point of care.

Florida International University’s faculty practice chooses PatientKeeper Charge Capture.

Citizens Medical Center (TX) selects MModal for transcription services and front-end speech recognition.

West Florida ACO will implement eClinicalWorks Care Coordination Medical Record.

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Forbes names Epic’s Judy Faulkner as #520 on its list of “The Richest People on the Planet,” estimating her net worth at $3.1 billion.


People

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Accretive Health appoints Patrick Funck (Segwick) SVP/CIO.

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HCI Group names Bill Bria, MD (Shriners Hospital for Children) as CMIO and Robert Steele (Sterling Healthcare Initiatives) as SVP of delivery operations.

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Greater Houston Healthconnect CEO Jim Langabeer, PhD resigns to return to his previous employer UT Health Science Center, with CTO Phil Beckett, MD named acting CEO.

Carolinas HealthCare System hires Nancy Olson, RN-C, MBA, PhD (Providence Health & Services) as its first chief nurse informatics officer.


Announcements and Implementations

inga_small WEDI, in partnership with EHNAC, will create a Practice Management Accreditation Program to review PM vendors in the areas of privacy, security, mandated standards and operating rules, and operational functions. While I am all for having minimum performance standards, is this really the best time to ask vendors to jump through one more hoop to remain competitive in the marketplace? It’s no surprise that we are seeing limited advances in product usability and innovation.

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The local business journal profiles St. Francis Hospital (CT), which goes live on Epic next month following a two-year, $120 million transition. Above is VP/CIO Linda Shanley.

Summit Health (PA) implements Wellcentive’s population health management solutions and services.

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Ontario’s Group Health Centre goes live on Epic.

Wellmont Health System (TN) transitions to Epic in its physician offices and hospitals.

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North Oaks Medical Center (LA) goes live with a two-way interface between Epic and the Masimo Patient SafetyNet remote monitoring and clinician notification system.

GetWellNetwork debuts GetWellNetwork Ambulatory, which is available on mobile and stationary devices and integrates with EHRs to provide personalized information, healthcare tools, and patient pathways.

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CoverMyMeds launches an API that enables providers of EHRs, e-prescribing systems, and PM systems to offer an NCPDP standards-compliant electronic prior authorization solution.

John Gomez launches Sensato, which will offer healthcare privacy and security assessments, guidance, and tools.

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UC Irvine Health deploys WANdisco and Hortonworks Hadoop data technology to provide real-time information for patient care. They run Allscripts Sunrise, I believe, and an unnamed data warehouse technology described in the announcement as one that “struggles with availability issues as well as the volume and variety of data it can handle.”


Government and Politics

inga_small The FDA is seeking a contractor to monitor social media chatter about drugs, medical devices, and other regulated products in order to track conversation shifts following FDA warnings. I found this move especially interesting in light of the heavy Twitter traffic during HIMSS and my realization of  the potential value of mined Twitter data. Now I’m wondering if anyone has figured out a way to combine data from social media chatter with old-school opinion polls from phone and mail surveys. That could be powerful.

ONC releases additional draft electronic clinical quality measures for review and testing for the possible inclusion in the MU and other federal programs.

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The front-page story of the March 10 issue of Time says that Healthcare.gov had so many problems that the White House was ready to shut it down and start over right after its launch. It says that it’s not clear even now who was supposed to be in charge of the launch and that people knew upfront that the site’s design was flawed.

Speaking of Healthcare.gov, HHS says it will need $1.8 billion in FY2015 to run the federal health insurance exchange.


Other

A three-year study finds that patient-centered medical homes do little to reduce costs, decrease utilization, or improve care, leading researchers to conclude, “Medical home interventions may need further refinement.”

The use of patient portals for secure messaging does not significantly change the frequency of face-to-face visits, according to a Mayo Clinic study. Weakness of the study are that portal messages were studied in a vacuum rather than in the context of all provider communication, it looked only at the number of visits rather than patient outcomes, and most of the study subjects were Mayo Clinic employees.

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Baylor Regional Medical Center announces that it will not accept the Malcolm Baldridge National Quality Award following allegations that it improperly managed a neurosurgeon who is accused of botching surgeries while under the influence of drugs. An extensive profile in the Dallas Morning News paints a disturbing picture of a physician who was labeled a sociopath and serial killer by colleagues. We featured the story in September 2013 with this summary:

A Dallas news magazine recounts the fascinating tale of a newly licensed MD-PhD neurosurgeon whose incompetence left several patients maimed or dead while the state’s medical board couldn’t stop him from practicing. Colleagues called the doctor the worst they had every seen and said his skill level was no higher than a first-year resident as he kept inadvertently slicing arteries causing patients to bleed to death, and in one case the OR team had to forcibly remove him from the OR to prevent him from killing his patient. His marketing team and his 4.5 star Healthgrades.com rating brought in plenty of new patients to his loftily named practice, Texas Neurosurgical Institute. Surgeon readers will be horrified by this recap by a peer who had to clean up one of his messes: “He had amputated a nerve root. It was just gone. And in its place is where he had placed the fusion. He’d made multiple screw holes on the left everywhere but where he had needed to be. On the right side, there was a screw through a portion of the S1 nerve root. I couldn’t believe a trained surgeon could do this. He just had no recognition of the proper anatomy. He had no idea what he was doing.” The article blames the situation on malpractice caps, laws that hold hospitals liable for damages only if their intentions are provably malicious, and a nearly powerless medical board charged more with keeping licensure records and counting CE hours than watch-guarding patient safety.

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Mike “PACSMan” Cannavo summarizes HIMSS14 from the imaging perspective in an Aunt Minnie article (simple registration is required.) He tells me that HIMSS rules even though RSNA is a bigger conference because, “The balance of power has definitely shifted from departmental solutions to facility-wide ones and IT and the CIO/CTOs make those decisions here.” Another of his observations:

HIMSS may, and probably will, command the lion’s share of the trade show budgets for VNA and cloud companies from now on. Considering there were more than two dozen vendors playing in this arena alone, plus the majors who showed various central data repository (CDR) solutions, this can affect other trade shows in terms of booth size and revenue. Given that attendance at most radiology-specific shows has been flat or declining and time spent at the shows has declined each year, HIMSS poses even more of a threat.

A group of former senators (Tom Daschle, Trent Lott, John Breaux) forms the noble-sounding Alliance for Connected Care, which will lobby Congress to protect the interests of its big-company members (Verizon, WellPoint, CVS, and Walgreens) as well as patients who benefit from telehealth services. In addition to seeking friendly governmental consideration, the group wants to lift geographic treatment limitations and build the case for telehealth as an effective care delivery mechanism. Surprisingly, HIMSS isn’t among its lengthy list of advisory board organizations. I’m always suspicious of the motivations of retired politicians anxious to make up for the income they lost while holding office, but in this case their announced intentions seem appropriate.

Brian Ahier got a one-on-one interview with National Coordinator Karen DeSalvo at the HIMSS conference. She says everybody has been focused on collecting information via EHRs, but now it’s time to allow patients to participate and acknowledge that “health is more than getting people to a doctor” since only 10-20 percent of outcomes can be attributed to the healthcare system. She clearly has a public health mindset as did her predecessor and she gets a “bravo” for that.

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The CFO of Wake Forest Baptist Medical Center (NC) lists reduced Epic expenses as one element of its improved financial performance in which six-month operational losses were reduced from $49.8 million to $23.5 million. The hospital still has high expectations for Epic, saying in a bond ratings agency report, “Management believes that future financial performance must be improved from current levels, and continues to aggressively pursue both short- and long-term strategies to drive growth, reduce cost and leverage our investment in Epic.”

In England, a three-year-old cardiac surgery patient dies when the scheduling system of the hospital to which he was transferred fails to generate his follow-up appointments. According to the hospital’s pediatrics manager, “Samuel’s appointment request must have fallen through the cracks between the old and new system. The new system is now up and running as best as it can be, but as long as there is still humans entering the information there will always be room for error.”

Weird News Andy notes that Banner Health didn’t have a banner day when it inadvertently printed subscriber Social Security numbers on its health magazine’s mailing labels.


Sponsor Updates

  • Greenway Medical names Phreesia its Marketplace Partner of the Year.
  • Aprima Medical announces that over 1,500 former Allscripts MyWay customers have migrated to its platform.
  • PerfectServe introduces automatic electronic PHI filtering capabilities that remove ePHI from the body of messages sent to non-secure mobile devices.
  • Lisa Reichard, director of community healthcare relations for Billian’s HealthDATA, writes a fun blog post that includes her top 10 tales and takeaways from HIMSS14.
  • Extension Healthcare will participate in the AONE 2014 Annual Conference in Orlando March 12-15.
  • The Tennessean interviews Cumberland Consulting Group CEO Jim Lewis about the company.
  • Boston Software Systems offers a white paper that examines three steps to a successful migration. 
  • An HCS case study highlights Christian Health Care Center (NJ) and the benefits it realized following the implementation of HCS Interactant.
  • TriZetto Provider Solutions advises customers that it will continue to accept claims in print image, NSF, and legacy formats even after the ICD-10 implementation deadline.
  • E-MDs publishes video testimonials from multiple providers.
  • Clinithink’s VP of solutions Russ Anderson suggests leveraging the use of Clinical Natural Language Processing to control patient leakage.
  • Health Catalyst offers a white paper with keys to a successful data warehouse and analytics implementation.
  • Vital Images experiences significant growth across Europe, the Middle East, and Europe.
  • CommVault achieves certified integration with its Simpana 10 software and the SAP HANA platform.
  • TeleTracking Technologies, Hill-Rom, and GOJO will co-market integrations with the Hill-Rom Hand Hygiene Compliance solution.
  • Cornerstone Advisors reports that its staff has grown to 39, a 25 percent increase in the past year.
  • Divurgent will provide support to Medsphere clients in their MU, ICD-10, and value-based purchasing initiatives.
  • Gartner positions Qlik in the Leaders Quadrant of the 2014 BI and Analytics Platform Magic Quadrant report.
  • HIMSS Analytics names Allscripts its first Certified Educator of the EMR Adoption Model.
  • The Cleveland Clinic and Dell will offer Epic EMR consulting and implementation services to other health systems and practices.

Contacts

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

More news: HIStalk Practice, HIStalk Connect

 

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March 4, 2014 News 7 Comments

Morning Headlines 3/4/14

March 3, 2014 Headlines 2 Comments

TELUS Health Acquires British Columbia-Based Electronic Medical Record Provider Med Access Inc.

Vancouver, British Columbia-based TELUS Health acquires Med Access Inc., an ambulatory EHR vendor that services 2,000 physicians across Canada. Financial terms were not disclosed.

Impact of Patient Portal Secure Messages and Electronic Visits on Adult Primary Care Office Visits

A new study published in Telemedicine and e-Health follows 2,357 patients for three years following a patient portal implementation and finds that rolling out secure messaging has no impact on total volume of office visits.

Saudi Arabia is Building a Massive Nationwide eHealth Network

Saudi Arabia publishes a 10-year eHealth strategy that calls for an integrated national-wide health information network that will connect 3,500 healthcare facilities, representing 70,000 beds.

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March 3, 2014 Headlines 2 Comments

Readers Write: National Patient Identifier: Why Patient-Matching Technology May be a Better Solution

March 3, 2014 Readers Write 3 Comments

National Patient Identifier: Why Patient-Matching Technology May be a Better Solution
By Vicki Wheatley

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Advances in technology, combined with The Patient Protection and Affordable Care Act, have begun to revive calls in the media for a national patient identifier—similar to the national provider identifier (NPI) assigned to physicians. The HIPAA legislation of 1996 included provisions for such an identifier, but they’ve never been enacted out of concerns for privacy and security.

Despite current law prohibiting the use of national patient identifiers, many proponents say creating such an identifier would make it easier to track patients across the continuum of care, leading to more effective treatments and better outcomes for patients. Others believe existing credentials such as Social Security numbers make a national patient identifier unnecessary. Lost in all the debate, however, are patient identification issues that will always exist—whether a national patient ID does or not.

Although adding a national patient identifier would provide one more data element to help confirm a patient’s identity, it still wouldn’t resolve some key record-matching challenges, nor would it fully enable organizations to use data for analytics, population health management or accountable care.

For a national identifier to work, even in theory, every single potential patient in the country would need to be assigned one—and only one—number and use it consistently. This holds true whether we generate a new identification number or use an existing one, such as a Social Security number.

For the sake of argument, let’s say Social Security numbers were to be used as national patient identifiers. Truth be told, many individuals living in or visiting the US don’t have Social Security numbers, like newborns or foreign visitors. Others may be fraudulently using someone else’s number for employment or other purposes. Additionally, using Social Security numbers as patient identifiers likely would raise security and privacy concerns due to the amount of financial and personal information already tied to them.

Just as the NPI has not been the fix-all for helping healthcare organizations exchange provider information, implementing a national patient identifier or using Social Security numbers will not resolve patient identification issues either. The reason: it won’t address concerns regarding existing information discrepancies or duplicate patient records. Additionally, like any identifier, it can be mis-keyed, transposed, or even stolen. Adding yet another identifier does not solve the patient matching conundrum.

Rather than advocating for a panacea that won’t solve the problem, healthcare organizations should instead focus on strengthening their existing enterprise patient-matching strategies, which can be easily implemented within individual organizations.

In order to provide optimal care, clinicians need to have an accurate view of the individuals they treat. Likewise, organizations as a whole must know who their patients are, what coverage they have, and which payer’s rules they must adhere to in order to receive payment. All of this information is particularly valuable when patient data is being used for analytics, accountable care, or population health management.

Thus, resolving patient identification problems is essential not only for enabling quality care, but also for supporting the financial viability of the healthcare organization. The challenges are further compounded by the fact that patient data resides across disparate systems encompassing the patient’s entire continuum of care. As a result, available patient data must be accurately linked together from within and across multiple organizations.

Unfortunately, however, errors occur. Registration staff may inadvertently transpose numbers, record nicknames instead of legal names, or fail to validate and update key data elements. Patients change addresses, phone numbers, insurance coverage, and names all the time. Data provided and collected is not always complete or accurate. Some patients forget information; others even want to hide it. To err is human, but mistakes introduced into patient records lead to discrepancies and duplicate patient records that complicate the patient identification process.

Patient-matching technology within an enterprise master patient index (EMPI) allows hospitals and health systems to bring together disparate information from various IT systems within or across organizations. This is essential for effectively managing the patient population and preparing for payment reforms. For example, an EMPI that compares patient data using probabilistic matching tools and algorithms can generate a unique enterprise identifier for each patient, eliminating the need to change information in source IT systems and enabling exchange of clinical and financial data. With an EMPI, multiple key data elements such as name, birth date, gender, address, other identifiers, and even biometrics can be used to accurately identify patients, ensuring the data in front of providers matches the patients they’re treating.

It’s a fact: as long as people are involved in providing and entering information, some level of human error remains inevitable. Yet by employing a strong strategy to address underlying identification issues, hospitals and health systems can compensate for some of the human elements that will always complicate patient identification—with or without a national patient identifier in place.

Vicki Wheatley is executive vice president of enterprise master person index solutions of QuadraMed of Reston,VA.

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March 3, 2014 Readers Write 3 Comments

Readers Write: Dr. Gregg’s “HIStalk: The Movie”

March 3, 2014 Readers Write No Comments

HIStalk: The Movie
By Dr. Gregg

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It’s Oscar night tonight. I know this because in my house, that’s a pretty big deal; my wife is one of the most star-struck people walking the planet.

And, as it’s a night of glam and glitz and red carpets and such, it seems an appropriate time to announce the upcoming release of the star-studded extravaganza, “HIStalk: The Movie.”

No doubt you’ve heard the rumors… and it’s true! HIStalk is coming to the big screen. Featuring a cast of some of HIT’s biggest stars, including:

The one, the only – MR. H! Nobody tells it like the inimitable, and wholly inscrutable, Mr. HIStalk. Now he tells it like it is in full, glorious Technicolor with thundering DTS surround sound. Hear Mr. H blast the blatantly bland and debunk buffaloing bloggers. See him – fully facially pixelated – tear through HIT hype and tripe. Watch as he snags rumors from the ethers and exposes the raw underbelly of the simmering underworld of HIT.

The perpetually 28 year old party girl – Inga! Nobody glides through the HIMSS exhibition halls with more panache than the sultry Swede. Watch her dance the night away with HIT celebs Farzad, Jonathan, Ivo, and many more meaningfully-used macho men. Sporting in the finest footwear this side of the Champs-Elysées, she’ll dance her way straight to your hard drive.

The ever-running, always stunning – Dr. Jayne! Hear the good doctor call out unscrupulous C-suite commands for harmful cost-cutting. Watch her shoot down ill-considered patient care policies and lambast ludicrous Luddites. She’ll run a marathon of mischief as she bears the banner for CMIOs everywhere.

The million dollar mobile man – Dr. Travis! Once again riding the WiFi waves of justice, Dr. Travis will keep you in mHealth stitches as he exposes new tech that doesn’t deliver and sorts out the portably important from the connectedly comic.

The man – Lt. Dan! Need we say more?

The vivacious new HIStalk vamp – Lorre! Supremely smart and stunningly sassy, this demure little vixen will warm your digital hearts as she becomes HIT’s newest pin-up girl. We’ve no doubt that after the world sees her stunning debut performance that she’ll be adorning screensavers like no one since Farah Fawcett.

You’ll gasp in awe at the beautiful panoramic sets designed and painted by the hand of Regina Holliday.

You’ll be blown away by the homespun humor and heartwarming insights into all things HIT based upon Ed Marx’s award-winning story.

You’ll never forget the effortless flow and seamless style of Dr. Rick’s screen adaptation.

You’ll delight in the scintillating score by the lyrical genious, Dr. HITECH, founder of The American College of Medical Informatimusicology (ACMImimi.) Performed by the entire ensemble of illustrious ACMImimi fellows, you’ll hear health information rock like you’ve never heard it before.

Get out the popcorn and pull up your favorite easy chair for tonight’s Oscars, but get ready really enjoy them next year when “HIStalk: The Movie” will undoubtedly take home all the golden statues setting new standards for both Hollywood and HIT.

From the trenches…

"Never give up. And never, under any circumstances, face the facts.” – Ruth Gordon, Best Supporting Actress, “Rosemary’s Baby”

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

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March 3, 2014 Readers Write No Comments

Curbside Consult with Dr. Jayne 3/3/14

March 3, 2014 Dr. Jayne 1 Comment

HIMSS Wrap Up

Every year at HIMSS there’s too much going on and not enough time to write about it. We try to hit as many booths as possible while attempting to attend some educational sessions as well, but there just aren’t enough hours to do it all. I had several sheets of notes in my bag, so please bear with my somewhat rambling wrap up.

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Someone reached out to me over the weekend to follow up and share photos of the Verisk Health service project benefitting the Second Harvest Food Bank. I had mentioned last week about seeing the  woman in the carrot costume at the Phytel booth and didn’t realize that Verisk Health was the main sponsor. They ended up with over 250 HIMSS participants who prepared 4,100 food packs for kids. Thanks to those who turned out to help. They are planning to host similar events at AHIP and NHCAA, so if you’re attending either of those events, keep an eye out for the location and time. Thanks to Verisk Health for sponsoring HIStalk as well – I hope they keep me posted on future events so I can alert our  readers.

Several vendors were showing off their “big data” but weren’t ready to address the “big questions” that come with it. Having dealt with numerous EHR conversions, I’m keenly aware of the sheer magnitude of bad data out there. Those aggregating it tend to assume that the data they’re getting is good. I really pushed one of the major national vendors on how they handle data integrity and the answers were less than satisfactory. I could tell they understood the problem because they provided the example of allergy data where one vendor has separate fields for the allergy and the reaction and another vendor combines them. The rep wasn’t able to explain how they’re handling it even though they were displaying a patient chart that showed allergy data from both sources. I asked for a follow up contact, but I’m not holding my breath.

CHADIS (Child Health & Development Interactive System) is a vendor I wish I’d come across earlier. We have struggled with implementing our patient portal for pediatric patients due to privacy issues, and ultimately our health system placed it on hold. Their product is tailored to the pediatric population with online screening that covers all the Bright Future requirements. They also somehow managed to obtain permission to use most of the popular pediatric developmental screeners. That doesn’t sound like a big deal, but knowing that my vendor has struggled for years to try to obtain permission to use one particular screener, it’s pretty exciting to those of us that see children in practice. CHADIS includes a research database and is interoperable with many EHRs, so I’ll be checking them out in more detail.

After Mr. H mentioned he was having difficulty finding note pads, I had my eye out for them. I spotted a handy notebook at the Accretive Health booth. The gentlemen manning the booth (which was on the fringes of the exhibit hall) at the end of the day were very engaging. One of them was leadership development author Ken Jennings, who was happy to chat about his book The Greater Goal and send me home with a copy as well. I noticed his Air Force Academy ring and we talked about the difference between a military education and a civilian one. The teenager who mows my lawn wants to attend the Academy and he was kind enough to offer himself as a resource. Those little moments where we can connect as people (and not just as vendor/prospect), especially after a long day, are one of the things I look forward to at meetings.

There were several people I wanted to connect with and missed, including Jonathan Handler, CMIO at MModal. Since he was in the board review course I attended, I was planning to ask his thoughts on what the vendor space thinks about the Clinical Informatics certification. My employer refused to pay for me to take the exam (they barely gave me the day off to sit for it) and I wonder if vendors are more generous. If they have certified informaticists on board and are using that for marketing purposes, they ought to!

I wanted to mention a little more about the educational session I attended on Monday: “Converting Your Legal Medical Record – It’s Both Technology and Process.” I’m glad I arrived early because I had some time to look through the printed HIMSS pocket guide to figure out the lay of the land and do some last-minute exhibit hall planning. I was looking for the location of the press room and noted that HIMSS had a designated “Nursing Room.” I thought that was pretty progressive until I noticed it was in the same location as the designated “Prayer Room.” What were they thinking?

Back to the educational session, the presenters were from Main Line Health (which was converting their hospital system) and Leidos Health, which assisted in the effort. They did a great job with the presentation despite some technical difficulties and had a good sense of humor about it. Having lived through multiple conversion projects, I can say that their advice was spot-on. They admitted they wish they could have started earlier and spent more time documenting the current state and figuring out how that was going to impact the new system.

They talked about building their clinical crosswalk and how they planned to handle the audit trails once the legacy system was decommissioned. They had a great statement about organizational resistance: during early meetings, they spent 50 percent of the time mourning the loss of the old system and the remainder doing actual work. I’ve been to a lot of meetings like that. If only the attendees realized that no amount of begging or pleading is going to bring an old system back once it’s been marked for death, we could be so much more productive.

They shared great examples of what to look out for in system conversions. The legacy system changed physician ID numbers, which created problems with providers showing up as “unknown physician” after the test extraction. Scope creep was a major issue, but many of the expanding requirements involved patient safety or risk elements which had to be considered at some level. They also emphasized the need to have two willing vendors and lamented the lack of an industry best practice in how to approach these projects. They interviewed a variety of consultants prior to the project and received many opinions on the best way to proceed.

One aspect of their conversion is (thankfully) something I haven’t had to experience yet. They found that when the conversion was announced, many of the staff responsible for the legacy system pursued employment elsewhere. There was a tremendous loss of institutional knowledge around the legacy system and they had to add retention bonuses to keep them on board through the knowledge transfer. I can’t imagine what my last two conversions would have been like if I lost key staffers. They also got lucky when their go-live was delayed by another project, which resulted in an extra six months for converting data. They’re still extracting as we speak, but I’m sure that gave them a bit of a cushion. They plan to go live with six years’ worth of hospital data, which is a tremendous amount.

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I snuck out during the question and answer period so I could make it to my next meeting (the fact that the audience didn’t want to come to the microphone to ask their questions was definitely a contributing factor) and get the the exhibit hall when it opened. The rest of HIMSS was a blur and I’m still trying to get caught up. I found this politically incorrect squeezy stress thing in my bag when I got back. I saw them at the Hitachi booth but didn’t pick one up, so I suspect one of the folks I was roaming the hall with was trying to be funny. I’m sure if I put it on my desk at work I’d be summoned to HR before you can say “harassment.”

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I did have one nice surprise this weekend – my Clinical Informatics certificate has arrived! All my certificates are in matching frames (courtesy of my first employer who actually had a budget for that sort of thing) so I hope I can find something that is close or at least complimentary. On the other hand, maybe I’ll go completely wild and frame it in animal print or something unusual. That would definitely start some conversations when people weave their way through Finance and Compliance to make it to my office.

Email Dr. Jayne.

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March 3, 2014 Dr. Jayne 1 Comment

Morning Headlines 3/3/14

March 2, 2014 Headlines No Comments

VA and DOD Need to Support Cost and Schedule Claims, Develop Interoperability Plans, and Improve Collaboration

The General Accounting Office analyzes the VA/DoD decision to abandon its iEHR development program last February. The resulting report suggests that the departments cancelled the project without ever evaluating the impact it would have on the overall cost and timeline of their interoperability goals.

How the Medical Establishment Got the Treasury’s Keys

Uwe E. Reinhardt, an economics professor at Princeton, dissects the formation of Medicare and the subsequent battles for payment reform fought between the federal government and healthcare providers.

McKesson Announces Further Changes to Corporate Governance and Compensation Practices

McKesson CEO John Hammergren voluntarily reduces his pension’s total value from $159 million to $114 million following outrage from shareholders.

Greenway Extends Patient Engagement Service with Acquisition of PeopleLYNK

Greenway acquires PeopleLYNK, a patient engagement tool that automates the process of sending patient reminders, lab results, prescription notifications, and clinical alerts.

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March 2, 2014 Headlines No Comments

Monday Morning Update 3/3/14

March 1, 2014 News 11 Comments

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From Elizabeth: “Re: HIStalk mug. Thanks so much for the HIMSS coverage this year, as always. It was great that you had a booth because I’m pretty sure others would agree that the HIStalk gang are celebrities, albeit anonymous, in this space. I am sending you a little pic of my coveted HIStalk mug in its new home in snowy, cold NY. I think it fits in very well. It was by far my favorite takeaway from the conference, so much so that I wrapped it in a t-shirt from another vendor so it wouldn’t break on the flight home. I am happy to report that it remained safe and intact.” I can’t explain why I like seeing pictures of reader workspaces, but I do.

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From Sipper: “Re: HIStalk mug. Big fan of HIStalk for many years, read it every day, loving my new mug!”

From Posit: “Re: HIMSS thoughts. Educational sessions were strayed, put together in silos, and not given by industry leaders but more by committee members trying to get placed on the HIMSS board. Educational content had nothing new. Hillary was dry, useless, and added nothing to the conversation of healthcare. The CIO Forum was the usual boy’s club, mostly just CIO wannabes as the majority of CIOs were out sunning themselves. The attendance count seemed to include anyone walking in the door. The HIMSS14 handbooks had many typos – sloppy work.”

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From Dr. Info: “Re: HIMSS video. I saw this gem out of the corner of my eye and then had to endure many painful minutes of this insipid self-promotional video before it came around again for a quick photo for your blog. I’m probably the only person who watched the whole thing, including the producers and editors! Maybe they should just change the acronym already.” You would think HIMSS could spell its own name, especially when it was shilling its HIMSS14 TV informercials (“one-third of air time will be dedicated to our sponsors,” which puts even network TV to shame.)

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From Eager Cleaver: “Re: cost of exhibiting at HIMSS. You should get someone with a modest-sized booth to anonymously provide all line-item costs to exhibit. Readers would be shocked.” I did this a few years ago and would be happy to do so again if a company would be willing to share. I would do it for the HIStalk booth, but it was tiny and we did everything on the cheap, so it’s not really representative. Meanwhile, money alone won’t buy you prime hall space, as booth selection is driven by HIMSS points, which is like your grocery store loyalty card with a lot more zeroes. The annual conference brought HIMSS $25 million in revenue, half its total take. Dues made up only 18 percent of its total revenue. According to its 2011 tax forms, Steve Lieber was paid $925K, so he’s surely well over the million-dollar mark by now. Also in the footnotes of the form: HIMSS owns 81 percent of MedTech Publishing (book value $8 million), which means if you get your industry news from Healthcare IT News, mHealth News, or Government Health IT, you’re getting it from the vendor-friendly, HIT-cheerleading HIMSS.

From GreenFlamed: “Re: Dragon Medical Network. v12.50.200.089 is not ready for prime time, especially in Virtual Desktop environments. It takes a crazy amount of support to sustain and keep your end users happy. The new service pack is riddled with bugs and the dictation box transparency feature is broken. We are facing a major Dragon buy-in and adoption crisis currently because it keeps crashing. Are there any other Dragon360 Network users out there using Dragon on a Virtual Desktop environment?”

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Only 20 percent of respondents say their business card titles include a certification. New poll to your right: if you attended the HIMSS conference, how was it overall?

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Some of the classrooms we helped via HIStalk’s donation of proceeds from the big ad at the top of the page to DonorsChoose projects are already benefitting. Mr. Delperdang reports (and sends the photo above left) that his Mississippi high school students are using the inexpensive supplies we donated (remanufactured printer cartridges and a file cabinet, which he calls “a blessing”) to print and file assignments and college applications. Ms. Vega’s Illinois second graders have created a reading station from the set of non-fiction books we purchased, which she says is the most popular learning station in the classroom and that “even my students whom were afraid to speak and share ideas are now sharing their background knowledge with us.” Ms. Opatz’s Utah fourth graders have formed reading groups around the books we purchased for them (photo above right.) We funded a bunch of projects from the ad revenue and will be doing more, so stay tuned.

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Oracle – like its CEO, Larry Ellison – rarely passes on the opportunity to exhibit boorish behavior. The company’s sloppy technical work reportedly assured the failure of Cover Oregon’s health insurance exchange, with the resulting outcry shaming Oracle into making a public promise to fix the problems it caused at no charge beyond the $90 million it was already being paid. The still-dysfunctional site isn’t likely to get better – Oracle has decided without explanation to pull 60 percent of its employees assigned to the project.

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California’s health insurance exchange, fresh off a five-day system outage, says 14,500 people whose applications were partially completed in the days before the unplanned downtime will need to start over.

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The General Accounting Office reviews the progress of the VA and Department of Defense in deciding to pursue their independent EHR plans and make them interoperable. They aren’t impressed: GAO says those organizations don’t have proof that it will be cheaper to run their separate systems than to create a single one. It also points out that despite the VA’s plan to pilot its system by September 2014 and the DoD’s intention to take its system live by the end of FY2016, neither have said what their systems will consist of, when they will be finished, or what they will cost. The report also says the VA and DoD are still fighting over control, with the federally mandated Interagency Program Office (IPO) having no power over funding and staffing. Both the VA and DoD, strangely enough, agreed with GAO’s recommendations that they perform a cost analysis, justify choosing the more expensive choice if that’s the case, create interoperability plans, and strengthen the control of IPO.

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McKesson, bowing to shareholder pressure, reduces the pension of Chairman, President, and CEO John Hammergren from $159 million to $114 million, although one analyst says the company’s executive pension plan is still “the richest in corporate America.” Perhaps an earlier announcement of his forced impoverishment would have allowed him to escape the indignity of winning his second consecutive HISsie award last week for “Industry Figure In Whose Face You’d Most Like to Throw a Pie.”

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It occurred to me while Mark Bertolini was delivering the HIMSS conference’s opening keynote address, his Aetna employees were setting up the company’s booth in the exhibit hall. Somehow that seems wrong. If it weren’t for HIMSS trying desperately (and unsuccessfully) to get people to stick around later into the week, they would have put the second consecutive keynoting Clinton (Chelsea next year?) in that spot as they have done with politicians in the past.

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People have asked what my favorite conference giveaway was. I’ll go with the iPhone 5 cover from zCover. I wasn’t initially impressed because they had a tableful of them and they were packaged in plastic bags, to the point I was about to just toss it in the trash when I got home. It’s a really nice case that fits the phone perfectly (including little covers for each port) and a clip-on back that ties the package together. It has its own buttons that cover the ringer volume and home buttons that make them easier and more satisfying to use. I’m really glad I picked it up – it has replaced my rubber bumper cover.

It’s hardly news since Intermountain Healthcare announced that it was choosing Cerner as a partner last fall partly because it wasn’t confident about hitting Meaningful Use dates, but CIO Marc Probst says Intermountain will forego incentives and accept penalties for not being ready for MU2 in 2014.

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Streamline Health Solutions promotes Richard Nelli to COO.

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Greenway acquires PeopleLynk, which sends patient relationship messages based on EHR events.

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Infor signs a letter of intent to acquire assets of GRASP Systems, including patient acuity, workload management, and patient assignment systems.

Ingenious Med launches its patient encounter platform One by Ingenious Med (IM1), providing care coordination and patient management to acute and sub-acute spaces.

Strata Decision Technology announces sales of its StrataJazz financial platform to Yale New Haven Health System (CT), Northwestern Medical Center (VT), and Southern Illinois Healthcare (IL).  

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ONC and ANA will present a free one-day summit for nurses on March 21 at The Baltimore Washington Medical Center in Glen Burnie, MD. The agenda includes a keynote by Deputy National Coordinator Judy Murphy, a panel discussion about using health IT to exchange information, afternoon breakout sessions, and a town hall discussion. I recommend as a counterpoint to all of that healthy discussion a side trip to my favorite place in Glen Burnie, Ann’s Dari-Creme.

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In Canada, New Brunswick doctors question their medical society for striking a deal that allows only one EHR – the one sold by a for-profit company co-owned by the medical society — to access the province’s databases. Only 240 of 950 eligible physicians have signed up ahead of the March 31 deadline to earn a 50 percent government subsidy, with only 34 of those actually using the mandatory Velante software. Doctors question whether the medical society’s motivation is business success rather than patients, while the province’s health minister says it may have to take over the system if too few doctors sign up. A similar situation exists in Nova Scotia, where the province gave Nightingale exclusive rights to provide a subsidized EHR that connects to the government’s information.

The VA creates a development portal that explains how to create mobile apps for its use.

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CareSync wins the most promising startup contest at the HIMSS conference.

”How the Medical Establishment Got the Treasury’s Keys,” an interesting article by economics professor Uwe Reinhardt, recounts irrational and naturally inflationary creation of Medicare in the 1960s as flawed grand plan to reduce poverty:

To help implement that vision, these proponents reluctantly paid the price the providers of health care extracted in return for accepting the legislation: Congress surrendered to the providers the keys to the United States Treasury, full well knowing that this social contract could have only a short shelf life. One would assume that physicians and hospital leaders knew that as well. In other words, the proponents of Medicare who signed on to the deal were anything but stupid. When confronted by the health care sector with a harsh trade-off between their cherished vision for health care, on the one hand, and a sensible payment policy, on the other, they let their vision override economically sound payment policy. Millions upon millions of America’s senior citizens are indebted to them for a program that remains highly popular to this day.

Weird News Andy wonders, “Does the noise in my head bother you?” in reading of a British tourist hearing scratching noises inside her head that turned out to be a happy family of eight flesh-eating maggots. WNA also likes this story, in which stethoscopes were found to carry more bacteria (especially MRSA) than anything other than the fingertips of doctors. It’s probably not realistic that doctors who can’t be convinced to wash their hands would sterilize their stethoscopes. 


HISsies 2014 Winners


Sponsor Updates from Last Week

  • Sagacious Consultants launches Sagacious Dispatch for Epic customers with short-term projects for optimizing their EMR.
  • Orion Health launches Collaborative Care for ACOs.
  • MEDHOST joins CommonWell Health Alliance.
  • Shore Medical Centers (NJ) selects CareTech Solutions Clinical Service Desk for night, weekend and holiday support.
  • Truven Health Analytics introduces Micromedex Pharmacy Intervention and Micromedex Infection Prevention.
  • CynergisTek expands its collaboration with Iatric Systems to offer support and management of Iatric’s Security Audit Manager.
  • Premier reports 90 percent of respondents experienced at least one drug shortage in the last six months that may have caused a medication safety issue or error in patient care.
  • Aventura releases Roaming Aware Desktop Version 5.0.
  • Kaleida Health (NY) selects Orion Health’s Rhapsody integration engine.
  • Covisint receives full accreditation with the Direct Trusted Agent Accreditation Program from DirectTrust.com and the EHNAC.
  • iMDsoft announces its MetaVision for NICUs will be featured at the 20th annual Cool Topics in Neonatology conference.
  • DrFirst’s controlled substance e-prescribing software will be integrated into Greenway’s EHRs.
  • ADP AdvancedMD offers an ICD-10 transition program with preparation resources, product enhancements, and a revenue cycle financing program.
  • UnitedHealthcare announces that InstaMed’s online bill payment service myClaims Managers has grown to 50,000 participating care providers with $20 million in payments processed since July 2013.
  • Emdeon publishes an ICD-10 transition white paper.
  • API Healthcare, a GE Healthcare Company, launches Patient Classification, which matches provider skills to patients.
  • Nuance announces that eCopy ShareScan is integrated with NextGen Ambulatory EMR.
  • First Databank releases FDB AlertSpace for Siemens Soarian.
  • NextGen Healthcare and Cerner announce bilateral integration.
  • Infor offers a promotion package for eGate customers interested in migrating its Cloverleaf product.
  • Infor introduces PeopleAnswers Talent Science to assist healthcare organization to select, retain, and develop clinicians.
  • DrFirst’s Patient Advisor delivers $21 million in prescription savings opportunities for uninsured patients during its first three months.
  • Imprivata will integrate its two-factor authentication management capabilities with DrFirst’s EPCS Gold solution to securely prescribe controlled substances electronically.
  • Physician First ACO (FL) selects eClinicalWorks Care Coordination Medical Record.
  • ADP AdvancedMD announces general availability of its reporting suite AdvancedInsight for physician practices.
  • Central Valley HIE (CA) joins Inland Empire HIE expanding the reach of the Orion Health Collaborative Care within California to 48 central and southern California organizations.
  • Wolters Kluwer Health announces the beta launch of its integrated clinical decision support and workflow management platform POC Advisor.
  • Northeast Georgia Physicians Group achieves Stage 7 of HIMSS EMRAM with Allscripts TouchWorks.
  • Covisint offers three reasons to physicians to avoid PQRS penalties.
  • Etransmedia expands its RCM services with the acquisition of Medigistics.
  • Intel-GE Care Innovations and Caradigm partner to integrate remote patient monitoring and smart sensor technologies to improve care plans.
  • E-MDs launches a SaaS-based RCM service.
  • AT&T announces plans to expand Digital Life into the healthcare market.
  • Predixion Software announces availability of its predictive analytics software on the Windows Azure cloud platform.
  • Baylor Scott & White Health (TX) expands its use of AtHoc Critical Communications platform for IT outages, emergency preparedness, and clinical alerts.
  • Optum launches Optum One analytics platform.
  • Advocate Health Care (IL) selects PerfectServe as its enterprise-wide clinical communications platform.
  • Healthy Catalyst reports that 76 percent of organizations lack basic analytics for Meaningful Use measures in a recently published white paper.
  • Imprivata will integrate HIT Application Solutions’ Notifi platform with Imprivata Cortext, enabling secure communications for continuum of care.
  • The Health Centers of Family Health Care join The Guideline Advantage, which uses Forward Health Group’s PopulationManager platform.
  • Siemens Healthcare launches CareXcell a subscription based solution for population health management.
  • Memorial Hospital at Gulfport (MS) selects Health Catalyst’s Late-Binding Data Warehouse and Analytics platform to provide a unified view of clinical and performance data from their McKesson and Allscripts EHR applications.
  • Capsule Tech reports a 24 percent increase in revenue for 2013, with 1,650 healthcare facility clients worldwide.
  • University Hospitals (OH) will deploy PeriGen’s PeriCALM at UH MacDonald Women’s Hospital and UH Geauga Medical Center, which will include sending OB content into its Allscripts EHR.
  • NantHealth introduces NantHealth Clinical Operating System, developed after consolidating of several healthcare IT companies including iSirona.
  • Capsule Tech introduces SmartLinx Medical Device Information System for point-of-care data delivery.
  • North Memorial Health Care (MN) is awarded joint second place in the annual Healthcare Informatics Innovator Awards after incorporating Health Catalyst’s EDW platform and analytics solution.
  • EClinicalWorks, Greenway, ICA, InterSystems, Medfusion, Medicity, Optum, and Orion Health found Carequality, which will focus on interoperability between existing and emerging HIE networks.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 1, 2014 News 11 Comments

Morning Headlines 2/28/14

February 28, 2014 Headlines 1 Comment

Intermountain to Miss 2014 Meaningful Use Attestation Deadline, Citing Safety Concerns

Intermountain Healthcare CIO Marc Probst says the organization is not planning to attest for meaningful use Stage 2 in 2014, forgoing a sizable incentive payment and triggering penalties in 2016 from CMS.

ICD-10 deadline won’t be delayed, Tavenner tells HIMSS

During a press conference at HIMSS CMS Administrator Marilyn Tavenner announced that there would be no deadline extensions for either ICD-10 or meaningful use Stage 2, but that it would be more flexible with hardship exemption applications from providers that are unable to meet Stage 2 MU on time.

NY startups make the case for funding HIE

New York’s 10 independent and disconnected regional health information exchanges are applying for $65 million in state funding to connect to the Statewide Health Information Network of New York, or SHIN-NY.

Oracle pulls 100 programmers from unfinished Cover Oregon health insurance exchange

Oracle, the main contractor responsible for the failed Oregon health insurance exchange, has reassigned 100 of the 165 programmers working on the project even though the site is still non-operational and plagued with bugs.

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February 28, 2014 Headlines 1 Comment

From HIMSS 2/27/14

February 27, 2014 News 11 Comments

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From Spelling Recognition: “Re: ‘documention.’ Is this a misspelling or or marketing gone wrong?” I suspect the former and dread the possibility of the latter.

From Born Free: “Re: HIMSS opening session. It was nice of the HIMSS chair to recognize physicians in the audience, but as soon as the recognized physicians sat down, the speaker then dissed them through sarcasm about their ego and the 6,500 physicians in his organization that think they know best. It was a little uncomfortable and not very wise considering HIMSS’s desire to add physicians to their membership rolls.” I missed the presentation since I was protesting having an insurance company millionaire talking about how healthcare should work. I don’t like having vendors as keynoters.

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From IT Director: “Re: HIMSS. It was a pleasure to meet Lorre in the booth on Tuesday. If you are going to have a public face I can’t think of a better one! She was engaging and knowledgeable and fun to talk with even if just for a few minutes. I love the fact that you had a booth — that was a cool thing to do.” HIMSS booths are breathtakingly expensive, but it was worth it to be able to meet readers, sponsors, and passers-by (most of them on their way to bathrooms right by our booth given our tiny HIMSS clout and budget). It was great having Lorre there since as the only non-anonymous HIStalk team member since she kept me updated with who dropped by, what they had to say, and what it was like being on the show floor with the other exhibitors. That was all new to me – my only view of HIStalk is sitting alone in front of a PC all day and night. It was cool that other exhibitors brought celebrities to our booth, sent Lorre scones and fun giveaway items, and helped us figure out the exhibit process since we were clueless. I’ve asked Lorre to do a writeup on what it was like for her to meet readers, work the booth, attend the events, and accept our Sunquest Industry Pioneer Award.

From Brian Ahier: “Re: Ed Park of athenahealth at HIMSS. Gave the best presentation at HIMSS.”

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I’m glad the HIMSS conference is over. I’ll be catching up over the next few HIStalk posts. Your comments about the conference, exhibits, companies, and educational sessions are welcome.

I have to say I’m already dreading going to Chicago for the conference next year. All I remember from last time is snow, surly unionized conference center staff, outdated hotels that cost at least double what they were worth, endless cab lines because of the weather, and wearing winter clothes. I like Chicago as a tourist, but not as a conference attendee. HIMSS loves it, of course, because the travel is easier for their people and they get to deal their home city some payola.

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Here’s Lorre’s new BFF Bob Murphy, MD, CMIO of Memorial Hermann Healthcare System (TX), meeting people in our booth.

Orlando attendance set a record at an announced 38,828, although I don’t know how that number was derived. I assume all registrations were counted, including exhibitors and press, but I don’t know if HIMSS counted people sitting at home who paid $49 to watch streamed sessions on the Web. I know this: all event promoters like to provide optimistic attendance statistics and there’s no good way to audit their claims.

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PeriGen was a booth neighbor and CEO Matt Sappern dropped by to say that “HIStalk is the only thing to read each day.”

This week on HIStalk Connect: Epic and Walgreens launch a wide-reaching interoperability partnership to rival CommonWell. HIMSS publishes the findings of its mHealth Technology Survey. Glooko unveils a population health tracker focused on improving care within the diabetic population.

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Jennifer Dennard (@SmyrnaGirl) tweeted out this photo, saying she’s reading up on HIStalk while sipping from our mug now that she’s home from the conference. Our mug supply is exhausted other than a few we set aside for loyal readers who asked us to mail them one since they weren’t at the conference. I like Jennifer’s photo – if you took a mug home, send a picture of it in its new home.

I didn’t hear much about Hillary’s Wednesday keynote other than (a) it was extremely short; (b) like any skilled politician, she didn’t really say anything other than predictably lauding the work of the crowd that brought her there and kissing up to HIMSS. I would have been mad about waiting an hour or two to squeeze into the huge room for her talk given its lack of substance. Hillary’s rumored minimum speaking fee is $200K plus expenses, so she took home a big paycheck in addition to potentially impressing would-be Presidential voters who were apparently happy just to bask in her celebrity.

Hillary mentioned in her speech that corporations don’t have enough females on their boards. She didn’t define “enough” quantitatively.

HHS confirmed during the conference that neither ICD-10 nor Meaningful Use Stage 2 deadlines will change.

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Hearst Health’s newly formed venture unit invests in Tonic Health, which offers an iPad-based data collection tool that counts Partners HealthCare and UCLA Health among its customers.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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February 27, 2014 News 11 Comments

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Reader Comments

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  • U2fan: Great story and very applicable to work life, but I'm wondering if the princesses thought that the Edge was waiting in ...

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