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HIStalk Interviews Keith Figlioli, SVP Healthcare Informatics, Premier

April 19, 2013 Interviews No Comments

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

4-15-2013 7-07-13 PM

Give me some background about yourself and your job.

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

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

 

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

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

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

 

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

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

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

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

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

 

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

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

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

 

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

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

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

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

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

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

 

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

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

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

 

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

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

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

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

 

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

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

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

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

 

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

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

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

 

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

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

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

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

 

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

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

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

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

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

 

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

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

 

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

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

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

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

 

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

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

 

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

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

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

 

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

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

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

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

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

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

 

Do you have any concluding thoughts?

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

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

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April 19, 2013 Interviews No Comments

News 4/19/13

April 18, 2013 News 7 Comments

Top News

4-18-2013 6-10-27 PM

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


Reader Comments

4-18-2013 6-44-17 PM

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

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

4-18-2013 7-02-08 PM

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

4-18-2013 7-29-50 PM

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

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


HIStalk Announcements and Requests

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

4-18-2013 7-35-27 PM

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

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

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


Acquisitions, Funding, Business, and Stock

4-18-2013 8-29-48 PM

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


Sales

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

4-18-2013 4-09-36 PM

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

4-18-2013 4-08-20 PM

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


People

4-18-2013 8-31-05 AM

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

4-18-2013 8-05-01 PM

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

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

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


Announcements and Implementations

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

4-18-2013 4-12-04 PM

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

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

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


Government and Politics

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

4-18-2013 8-19-51 PM

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


Technology

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


Other

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

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

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

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

4-18-2013 8-41-31 PM

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

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

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

4-18-2013 8-57-38 PM

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

4-18-2013 9-04-56 PM

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

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


Sponsor Updates

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

EPtalk by Dr. Jayne

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

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

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

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

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

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


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 18, 2013 News 7 Comments

HIStalk Interviews Farzad Mostashari, MD, National Coordinator

April 17, 2013 Interviews 7 Comments

Farzad Mostashari, MD, ScM is the National Coordinator for Health Information Technology in the US Department of Health and Human Services.

4-17-2013 7-05-05 PM

Do you think the free market works when it comes to EHR functionality, vendor development priorities, and vendor transparency?

That’s a really, really good question, and one that we think about all the time. We try to be thoughtful about where the market can work, should work, is working, and where the market needs a helping hand to work well.

Let me give you some examples. When it comes to interoperability, there is a need to get vendors to work together on consensus-based standards. Purely market driven approaches to this haven’t worked. They didn’t work for 25 years in health IT. In other industries, what it requires is that there becomes a dominant player that beats everybody else out and makes their proprietary standard the de facto standard oftentimes. Maybe that will work in health IT, but it just takes too damned long.

We think that having a convening role for government, a goal-setting function, kind of what we’re doing with our standard interoperability framework, where you get them together and say, this is a real problem, we want you to work together, and we’ll help, but let’s find a solution to this. That approach has worked to accelerate the standards.

The other part of the equation to make the market work is that the customers have to ask for it. If the customers are asking for documentation and billing machines and bells and whistles around that, then by golly that’s what the industry, listening to their biggest customers, is going to build. Meaningful Use was a way for us to say, this whole other series of functionalities that EHRs can do can enable around population health management, which wasn’t even a glimmer a few years ago.

But we could say, this is our policy. You need to be able to measure your own quality, make a list of patients, have decision support. The industry, in some cases reluctantly and in other cases enthusiastically, has now moved strongly in that direction just in time for their customers who need that functionality to flourish in accountable care. The same for patient engagement. These are all things where a coordinated policy between the payment side, the policy side, and Meaningful Use helps steer the market in a direction in anticipation and preparation.

There are other parts where the market is going to respond just fine. The issue of usability is, for example, one where I’d rather have market demand push vendors to compete fiercely on usability. Something we can help there would be around removing some of the information asymmetries. If we can develop common sense guides for how to evaluate usability, the work being done with NIST and our SHARP grantees and so forth, that will help the purchaser incorporate usability more in their purchasing decisions. But there, I think, independent competitors competing fiercely should and have been driving the market forward on usability.

I guess the answer to your question is, it depends. We have to be thoughtful about where we think the market’s going to work well and where we need to create the market context.

 

People sometimes think that all the initiatives are punitive for vendors, but in some ways they are more of an indictment of their customers for not demanding what the healthcare system should offer patients. It’s not the vendors’ fault that they gave customers exactly what they wanted.

In another way, if you don’t change the payment system, then we’ll get what we pay for, right? Everyone responds to their context. The goal here is to create a context where everybody acting in their own self-interest creates a public good.

 

It must be maddening for a man of science to have to deal with the politics of your job. For instance, the report from the Republican senators that just came out.  How hard is it to try to do what’s right for patients and do it scientifically defensibly when you’ve got politicians trying to get involved?

I actually think that when you have expenditure of public funds, we are accountable. We have to be able to respond to appropriate oversight on the part of the Congress. If there’s one lesson I think in this, it’s that we have to redouble our efforts to engage with the legislative branch and to make sure that they’re aware of all that is happening.

For people who don’t live it and breathe it every day, it helps for them to hear from us, and it also helps for them to hear from people on the front lines in their own communities who they trust to say, hey look, has there been progress on interoperability or not? Is Meaningful Use really a cakewalk designed to push money out, or is it actually pretty challenging and those achievements are a wealth of phenomenally hard work on the part of providers, hospitals, doctors, nurses, and vendors?

It comes with the territory. We have to be accountable, and we do have to engage more.

 

Is there an endgame to Meaningful Use stages?

The legislation has incentive payments for Medicaid out through 2021. There’s not an end stage, per se, in terms of the payment adjustments. I think we take it a year at a time, a stage at a time.

It’s clear to me that we’re going to need to continue to advance. History isn’t going to be when we reach nirvana in terms of advancing interoperability, for example. These systems are dynamic. I hope that there will continue to be innovation, and maybe three years from now, we’ll have completely new ways of sharing images, and the standards, requirements, and criteria for electronic health records will have to be updated.

But I think it’s a step at a time we’re focused on now, just getting from Stage 1 to Stage 2. That’s going to take a lot of hard work on everyone’s part, but it will be well worth it.

 

How would you characterize the state of innovation in healthcare IT, and do you think Meaningful Use encourages it?

I think it’s amazing. It’s unbelievable. I’m floored every day I meet with entrepreneurs, startups, innovators, big companies doing innovative things, startups doing innovative things, patients that are building on top of a digital infrastructure.

The key thing here is that when you have health records on paper and pen, the data is dead. It can’t be used for anything else. It can barely be used in the next visit. When you have digital health, that data is oxygen for innovation.

One indicator of that is the number of new companies in the field. The number of new certified products, but much beyond certified products, it’s all the things that go around it like analytics, patient engagement, population health management, vendors. The VC figures from this first quarter are stunning. While investment and venture capital in biotech or whatever is down, in digital health, it’s skyrocketing. I think the state of innovation is very strong right now.

 

Your office is requesting more money in the 2014 budget. What are your plans for the extra funds?

The plan is really to use those funds to offset the loss of the HITECH funds. Our budget now, the appropriated budget after sequester, is $3 million less than what it was in 2006 when the office first got a budget. There’s obviously something wrong with that picture.

The only reason we’ve been able to respond to the obligations of the office in coordinating has been because we’ve had the HITECH funds, $2 billion, most of which went to grant programs, but a chunk of which went to support our standards interoperability activities, privacy and security activities. What we want to do is to continue to maintain the coordination role and continue to push interoperability and exchange most of all and to maintain and improve our certification.

 

Obviously people picked out the EHR vendor fee. Do you have a feel for how that fee should be assessed fairly and how the money will be used?

A couple of points on that. If this is going to work, it’s got to add value to the software developers, more value than they would pay, obviously. Otherwise, it’s not going to work.

Why do we think that software developers would derive more value? Because if we can’t support the certification program, well, just think about … one glitch that takes one day extra for one developer day for every vendor, that adds up really quick.

The vagary and uncertainty of the budget process … I don’t have a budget now for September. I don’t know what my budget is. I don’t know when I’ll know what my budget is. The industry would be insulated from the year-to-year budget uncertainty if there were a user fee that would cover the cost of the certification program that they rely on.

 

Folks thought they would see national EHR problem reporting. There were different groups looking at different pieces of that and I’m not sure where it stands. Do you see it happening that there will be centralized reporting of patient impact from EHR problems?

Overall, obviously we believe, and the data supports, that the best thing for patient safety is for everyone to get off paper. But that having been said, we commissioned, based on concerns that we had, a report from the Institute of Medicine that said basically we don’t have good reporting of patient safety events exacerbated by or enabled by health IT. Our surveillance action plan does use existing authorities from ONC, from leveraging the patient safety organizations, and from CMS.

What we’re saying is that EHR-related patient safety is part of overall patient safety reporting surveillance and improvement. It’s not its own thing. We don’t want to set up a siloed system just for the reporting of EHR safety events. We want to use the same mechanism as a patient safety organization, the same protections under there, the same surveying and Joint Commission requirements, and strengthen them, focus them  in a way so they can be used to cover the health IT issues as well.

That will require some funds, and again one of the things we’re asking in our 2014 budget request are funds to be able to incorporate more of the safety analysis and mitigation factors.

 

When you talk to people, what are the most common complaints you get about EHR products or EHR vendors?

The biggest thing I hear about is usability issues. In particular, when we talk about making it meaningful, it’s only the providers and software developers who can make it meaningful. That’s my concern.

If you take Meaningful Use as a checklist of things you have to do to get a check, you can do it. You’ll get your check, but it would have been a waste of your time. These are functionalities that if implemented well will serve organizations very well in delivering better care to patients and also in new payment models. But if you do it the quickest line, like let’s just slam something in to get the thing certified, you’ve got to go six levels deep just to fill out the smoking score even though you already filled out smoking in other parts of the chart, that drives providers nuts, and it should.

That’s the part that I really call on everybody to work on. Not to just meet the minimum of the Meaningful Use requirements, but use it as a springboard and go above that and really incorporate it into workflows and make it meaningful.

 

It’s hard to be against usability, but there isn’t a lot of progress that I’ve seen in vendors that are willing to rewrite their products. Do you see that as an area in which the market is responding effectively or does there need to be more than suggestions of how it should look?

I think when it comes to user issues that have an impact on patient safety, we have a particular obligation to make sure there’s a minimum floor. That’s why we took the eight medication-related certification criteria in Meaningful Use and required that vendors undergo a user-centered design process for those. I’ve heard from a lot of usability consultants and vendors that said for the first time, they’re actually implementing user-centered design processes for those medication events. I guess we needed to do that, right?

There are other aspects of usability. Many providers say to me, I can’t deal with three different user interfaces. Why don’t you just mandate one user interface? Why didn’t you just buy one EHR for the country? Why don’t you just use VistA?

I guess I have to disagree. Innovation around usability is something I do see the market stepping up to, that it should, and that I’m actually seeing in evidence. If you walk the floors at HIMSS, you still see some user interfaces that look like Access, but for the most part, the vocabulary is more that of Amazon than of Microsoft Access. The iPad, for example, coming into healthcare. What vendor can’t and doesn’t have to redesign the user interface to work with mobile and tablets?

The other thing that’s driving this is that the market is moving to a segment that is less forgiving. It used to be that if you were a software developer, it’s almost like your early adopters were building the product with you, and they didn’t mind that they had to rebuild the registry kind of thing. Nowadays, we’re not talking about the early adopters or even the early majority. We’re talking about the late adopters that are now being reached in new implementations. You really have to make the systems a lot more usable to get their satisfaction.

It’s also becoming increasingly possible to switch products. Those who bring pressures on vendors to make their products more usable, their products are more usable today than they were when I did product selection for New York City seven years ago.  They’re more usable than they were three years ago. I hope they’re going to be a lot more usable three years from now based on the market pressures.

 

One of the things that’s frustrating to technology people is the inference that healthcare should work like banking or online commerce, but we can’t even get agreement on the equivalent of an account number in a national patient identifier. Is that issue dead or alive?

I think the analogy to banking is flawed. In banking, it all boils down to one quantity – money, dollars, cents. The fundamental object you’re dealing with is one thing. If all we had to communicate was people’s weight or height, we’d be all set. We’d be all set – there would be no problem. We could do that if we only had to worry about hemoglobin levels. Solved, right?

But we don’t. We have 500,000 clinical concepts in SNOMED. We have all the medications, all the observations, the social history. It’s the order of complexity. If you screw something up, it’s people’s lives. It’s just so overly simplistic to say, oh, why can’t healthcare be like banking?

And here’s the other thing. How long did it take those ATMs to work with each other? You know? It took like 15 years. I think people need to be a little more patient and cut healthcare some slack here. We’re actually making good progress on interoperability and interchange.

 

The one part of the banking analogy that is true that the Visa network was formed and banks agreed to share their information for their individual as well as collective good and things started to move electronically. Do you see either the government’s programs or CommonWell or any of those as being that watershed moment where everyone agrees it’s in everyone’s interest to share data?

I think it is happening. One other thing that is scrambling the equation in a positive way are patients and their family members, caregivers taking a more active role in their own health and healthcare. I see the industry responding to interoperability demands that are, I believe in large part, pushed by customers saying I need to interoperate. It’s the top of mind issue for providers and hospitals and IDNs and a top of mind issue for vendors who are responding to that.

I think patients are going to have an important role and will be able to get their data and share it with whoever they want to share it with, kind of an HIE of one. I think the pieces are coming together.

 

When you look at the future of HIEs and Regional Extension Centers, do you think they will successfully wean off government grants and survive independently?

I think some will and some won’t. The ones that are adding value will do well. People who are getting value will pay for the services at a price point that’s competitive. If they’re not adding value, we always knew this was a one-time funding, that they’re going to have to have a sustainability path moving forward.

On the Regional Extension Center side, one of the things that I think is just a pity is that we have built up an unprecedented workforce, an army of relationships and data flows and infrastructure for Meaningful Use across the country, that could be leveraged to meet the real coming series of demands around practice redesign and reengineering and quality improvement using the health IT. If we think about on the health IT side, we may be 50 percent of the way done in terms of just getting EHRs in place. We’re about 5 percent done in terms of changing workflows to really take advantage of that.

The redesign of care processes to meet the demands of new payment models – pay for performance, patient centered medical home, value-based purchasing, ACOs, CCOs, bundled payment. That’s not easy, and just as docs didn’t go to medical school to be IT project managers, they didn’t go to medical school to learn anything about practice reengineering either. That’s the one piece that I sure wish there were the national resources to enable that practice redesign on a large scale.

 

Do you have any concluding thoughts?

You have to be optimistic to be in technology. It helps to see every day the new stuff. It’s what gets us through the real-world difficulties of transitioning to a new paradigm. It’s hard. I know how hard it is. I helped 230 practices go through go-live. It’s hard. You’re not done after you go live, you’ve just started.

We just have to remember and look back sometimes. My goodness, how far we’ve come in how short a time period. A lot of problems we’re seeing right now are blessings. We should have such problems. When people are describing the problems they’re actually having making interoperability work, it’s so far and more advanced than earlier discussions where it was just a buzzword. Now it’s real, and people are talking about certificate management instead of “we want to do information exchange.”

I think we’re in a really exciting period. Healthcare is changing really rapidly. Technology is improving really rapidly. The consumer technology space and our understanding of human behavior is growing by leaps and bounds and marketing and behavior changes. It’s a really, really exciting time to be at the confluence of all of that.

One last thing I want to talk about is, we talked about safety issues, I think we should also always have on top of mind is around security of patient information. I think healthcare really needs to wake up to the need for them to meet their patients’ expectations that healthcare providers really do everything they need to do to keep that patient information private and secure. So many of the breaches we see, the failure to encrypt laptops and give data to business associates without having the assurances in terms of how they’re going to treat it … it just shows a lack of attention.

I think that’s changing. I think there’s a lot of education that can be done. I think there’s more we can do with the vendors to make them default settings and strengthen and harden our systems. More than anything, we have to always keep the security of patient information at top of mind and not relegate it to an also-ran, or after all the other issues are taken care of then we’ll see if we can do something about security. We really can’t. We’ve got to build it in.

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April 17, 2013 Interviews 7 Comments

News 4/17/13

April 16, 2013 News 4 Comments

Top News

4-16-2013 9-28-53 PM

4-16-2013 9-34-13 PM

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


Reader Comments

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


HIStalk Announcements and Requests

4-16-2013 6-51-38 PM

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

4-16-2013 8-15-22 PM

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


Acquisitions, Funding, Business, and Stock

4-16-2013 9-00-49 PM

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

4-16-2013 9-24-32 PM

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


Sales

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

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

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

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


People

4-16-2013 3-50-19 PM

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

4-16-2013 6-23-59 PM

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

4-16-2013 2-48-32 PM

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

4-16-2013 8-32-21 PM

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

4-16-2013 7-59-29 PM

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

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

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

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


Announcements and Implementations

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

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

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

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

4-16-2013 10-49-13 PM

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

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

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

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

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

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


Government and Politics

4-16-2013 3-23-17 PM

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


Innovation and Research

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


Other

4-16-2013 10-52-40 PM

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

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

4-16-2013 10-51-19 PM

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

4-16-2013 8-56-03 PM

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

4-16-2013 9-10-46 PM

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

4-16-2013 9-14-19 PM

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

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

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


Sponsor Updates

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 16, 2013 News 4 Comments

News 4/10/13

April 9, 2013 News 14 Comments

Top News

4-9-2013 10-40-32 AM

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


Reader Comments

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

4-9-2013 7-33-51 PM

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

4-9-2013 7-43-59 PM

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

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

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


HIStalk Announcements and Requests

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

4-9-2013 7-45-43 PM

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

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


Acquisitions, Funding, Business, and Stock

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

4-9-2013 10-32-34 PM

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

4-9-2013 10-33-14 PM

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


Sales

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

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

4-9-2013 10-34-01 PM

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

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


People

4-9-2013 6-04-33 PM

Versus promotes Kevin Jackson to VP of technology.

4-9-2013 6-11-33 PM

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

4-9-2013 6-10-41 PM

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

4-9-2013 9-39-25 PM

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


Announcements and Implementations

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

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

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

4-9-2013 1-50-38 PM

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

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

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

4-9-2013 6-53-07 PM

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

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

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


Government and Politics

4-9-2013 10-38-15 PM

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


Technology

4-9-2013 10-39-35 PM

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

4-9-2013 7-18-09 PM

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

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


Other

4-9-2013 11-22-30 AM

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

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

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

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

4-9-2013 6-24-06 PM

Here’s the latest cartoon from Imprivata.

4-9-2013 8-20-57 PM

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

4-9-2013 8-25-10 PM

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

4-9-2013 7-40-24 PM

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


Sponsor Updates

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 9, 2013 News 14 Comments

Curbside Consult with Dr. Jayne 4/1/13

April 1, 2013 Dr. Jayne 2 Comments

Every time I am invited to present at the hospital’s quarterly medical staff meeting, I feel like I should wear personal protective equipment. No one is hurling rotten tomatoes when we talk about EHR, but the verbal assault can be equally messy.

I was asked to present at the recent meeting with the goal of discussing our ICD-10 transition plan. Despite previous mistakes by our (now-disbanded) ICD-10 Task Force, our new team is confident that our vendor is ahead of the pack. I thought I would escape without too much drama. Thoughts of melting snow and approaching spring weather must have tricked me into forgetting the tendency of my colleagues to go completely off the agenda.

When we implemented EHR, we carefully audited the coding/billing functionality to make sure that not only did it adhere to CMS guidelines, but to the stringent standards of our auditors. We manually audited behind any computer-assisted coding for a period of time until we were comfortable that the algorithms were appropriate. At that point we discontinued full audits, but continued spot audits on high-dollar or high-risk episodes of care. We also continued our regular audit protocol where each physician had a set of charts audited each quarter with coding feedback delivered from our teams.

When the EHR was initially deployed, we saw a shift in the distribution of ambulatory Evaluation and Management codes, but this was expected. It also matched with published data that showed primary care physicians tend to under-document the care they deliver. We were happier with our increased documentation of the care we were appropriately providing.

Over time our EHR has matured and has had added to it a variety of individualized order sets, care plans, patient instructions, and documentation macros that allow our users to personalize their notes. Our coders have stayed on their toes, making sure visit documentation continues to be individualized despite these labor-saving features. We definitely don’t want to fall victim to the problems that can arise from cloned documentation or any other inappropriate use of the EHR.

Since we’ve been live so long and our medical staff has grown so much, many of our newer colleagues didn’t go through this initial auditing process and don’t understand the ongoing auditing that is in place. Without this comfort level with the EHR, they are extremely nervous about what will happen with ICD-10. Our EHR is moving to a new level of assisted coding to aid with the transition. 

People are, for lack of a better description, freaked out. The question and answer period following my ICD-10 presentation spiraled into paranoia and outright fear.

Providers have long been worried about audits that would demand large repayment sums based on a sampling of charts. Now they are worried about criminal prosecution on top of financial penalties and potential exclusion from federal health care programs. Several more vocal colleagues demanded that we go back to 100 percent chart review by certified coders, which is just not tenable given recent budget cuts. Others asked the medical staff to consider endowing a legal defense fund.

Fear of law suits has led to exorbitant health care costs through the practice of defensive medicine. Fear of audits will lead to more spending on non-patient-facing services such as chart reviews and coding audits. I for one would rather spend my healthcare dollar lowering the patient-to-nurse ratio and decreasing preventable harms. What do you think about the increase in audits related to the increase in EHR documentation? E-mail me.

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E-mail Dr. Jayne.

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April 1, 2013 Dr. Jayne 2 Comments

News 3/29/13

March 28, 2013 News 7 Comments

Top News

3-28-2013 10-09-06 PM

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


Reader Comments

3-28-2013 10-10-32 PM

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

3-28-2013 10-11-45 PM

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


HIStalk Announcements and Requests

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

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

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

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


Acquisitions, Funding, Business, and Stock

3-28-2013 7-47-11 PM

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

3-28-2013 9-08-33 PM

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


Sales

3-28-2013 10-14-59 PM

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

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

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

3-28-2013 10-16-16 PM

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


People

3-28-2013 6-40-34 PM

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

3-28-2013 11-34-52 AM

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

3-28-2013 7-21-23 PM

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


Announcements and Implementations

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

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

3-28-2013 10-17-51 PM

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

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

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

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


Government and Politics

3-28-2013 12-17-15 PM

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

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


Other

3-28-2013 10-19-06 PM

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

3-28-2013 10-20-04 PM

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

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

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

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

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

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

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

3-28-2013 8-28-32 PM

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


Sponsor Updates

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

EPtalk  by Dr. Jayne

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

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

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

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

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

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

Print


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 28, 2013 News 7 Comments

News 3/27/13

March 26, 2013 News 6 Comments

Top News

3-26-2013 9-45-15 PM

An Institute of Medicine review finds that the military’s assistance programs for veterans are not meeting the needs of service members who served in Iraq and Afghanistan, with half of the 2.2 million former troops struggling to adjust to civilian life because of the stigma associated with mental health and substance abuse issues, use of an unproven tool to assess post-injury brain function, lack of proven efficacy of the VA’s depression treatment protocols, lack of policies that would prohibit veterans exhibiting suicide risk from owning weapons, and poor integration between the EHRs used by the VA and DoD.


Reader Comments

3-26-2013 6-55-16 PM

From Emmie Yoo: “Re: MU2 attestation timing. I’m curious whether you have a feel for when in 2014 hospitals will likely begin attesting for Stage 2 MU. I know it opens on October 1, 2013, but do we really think many hospitals will try to meet MU2 in the first half of federal fiscal year 2014?” Hospitals and consultants, please leave a comment with your thoughts.

3-26-2013 6-57-46 PM

From Raptor: “Re: athenahealth. Has anyone questioned the legitimacy of their claimed 96 percent MU rates? I think the key word is ‘participating,’ which is only a fraction of their usership. It’s not hard to reach 96 percent when you don’t think a majority of your physician users are even trying to make MU.”

3-26-2013 6-53-16 PM

From Non-Sequitur: “Re: help me find a sponsor! I scoured the Resource Center this morning but have not been able to locate one of your new sponsors that was profiled in the past six weeks. They had developed a niche solution for licensing and access challenges with legacy systems when moving to next-generation applications, allowing legacy data to be accessible without paying extending licensing for the replaced systems. MANY thanks for your amazing site. I am enjoying having introduced a relative healthcare novice to your site. He shows up at my cubie every few mornings to discuss one (or more) of your postings. You guys absolutely rock!” Two new HIStalk sponsors offer data archiving options: Legacy Data Access and MediQuant. You’ve also motivated Inga and me to reach out to sponsors to make sure they’ve sent us their Resource Center listing since that’s the easiest way to find them. Thanks for the nice comments.

From Amish Avenger: “Re: hacker article. This is a great Onion-like article title.” It sure is – World’s Health Data Patiently Awaits Inevitable Hack says the high-profile hacks of major sites like Twitter and Evernote make it obvious that healthcare’s turn is coming, especially since small companies don’t have the expertise to properly secure their niche systems. The security researcher quoted might have overstepped his expertise in declaring that Google Health was shut down due to liability concerns. “What the hell happened to Google Health? Gone! They didn’t want the liability. The complexity of this is mind-boggling. Heath care is really in for a beating from the security side… if Google can’t stop this, how is a hospital going to stop this?”

From Primary Care Doc: “Re: Eric Topol’s highly publicized use of an iPhone app on the way home from his HIMSS keynote.” I’m running the comments below because I had the same reaction to the Twittersphere’s instant arousal by Dr. Topol’s use of an iPhone EKG app to diagnose a fellow airline passenger on his way home. First, the cynic in me found it to be an awfully strange coincidence and an opportune PR moment. Second, diagnosing fib is not hard since the signs are straightforward and patients usually have a history of it. Third, diagnosis is a snap compared to treating it, and treatment isn’t even usually necessary in an acute situation. The value added by EKG apps is to save the cost and inconvenience of having a technician run the test, which isn’t relevant in this case. But I’m usurping Dr. PCD’s forum:

He was keen on sharing with us how he saved a patient’s life while on the plane by using technology. He diagnosed a man’s heart condition as a rhythm problem, atrial fibrillation, by using his phone. He was short on details in saying exactly what he did with the diagnosis. Did he have his paddles with him and shock the man’s heart into normal rhythm or did he have a syringe loaded with a beta blocker in his pocket and gave the man a shot right then and there? To those technology fans out there who feel that they can replace the stethoscope with an app or iPhone, I can also tell you that just pressing one’s ear to the patient’s chest or feeling the pulse should suffice. It is what one does with the information that matters, not merely obtaining it. Last week one of my patients was upset because his ophthalmologist cancelled his cataract surgery because of an EKG read by machine showing atrial fibrillation. I looked at the EKG and it was completely normal even when repeated. The machine had read it wrong. This is the difference that Ed Park was talking about between the "promise and the reality.”


HIStalk Announcements and Requests

3-26-2013 6-26-43 PM

I’ll be sharing the results of my latest reader survey shortly, but I’ve already acted on one suggestion from it. I added a “comments” link at the bottom of each post, so you won’t need to scroll up to click it.

Another reader survey response asked about comments that are submitted but that I don’t run. Those are few in number, but they include comments that:

  • Disparage an individual by name or recognizable position in a way that could be considered libelous
  • Seem to have been posted primarily promote the commenter or their company
  • Make unverified statements about the financial performance or business prospects of a public traded company

3-26-2013 7-02-09 PM

Welcome to new HIStalk Gold Sponsor The SSI Group. The 25-year-old Mobile, AL-based revenue cycle company offers industry-leading claims management, EDI technology, document management, revenue cycle analytics, attachment processing, RAC tracking and defense tools, and business process outsourcing  to its 2,400 customers. Its ClickON technology has more than 200,000 built-in edits that deliver Claredi-certified transactions. SSI’s EHNAC-certified clearinghouse has 800 payer connections and processes over 350 million transactions per year valued at more than $700 billion in claims revenue. See the customer testimonials and case studies from Adventist Health, Baystate, Carilion, Lee Memorial, and others. Thanks to The SSI Group for supporting HIStalk.


Acquisitions, Funding, Business, and Stock

3-26-2013 7-38-24 PM

Technology-driven concierge medical practice One Medical Group raises $30 million in funding, increasing its total to $77 million. The company accepts insurance with an annual membership of around $200.

3-26-2013 9-07-04 PM

Hospital physician scheduling technology startup QGenda will move its headquarters and 30 employees from the Perimeter area of Atlanta to Buckhead. The company’s revenue has doubled every year since its founding in 2008

SAIC announces Q4 results: revenue up 8 percent, EPS $0.54 vs. –$0.49, beating on earnings.


Sales

Presbyterian Homes of Georgia selects Health Care Software’s Interactant suite of EMR and financial solutions.

3-26-2013 4-59-37 PM

Medical University of South Carolina Health System chooses Elsevier’s CPM CarePoints care planning and documentation solution.

Molina Healthcare (CA) will implement Elsevier’s MEDai Navigator analytics solution to manage its Medicaid population.

3-26-2013 5-05-00 PM

Centegra Health System (IL) signs a multi-year contract with MedAssets for group purchasing, supply chain optimization, and construction services.


People

3-26-2013 3-25-04 PM

Mount Sinai Medical Center (NY) promotes Bruce Darrow, MD from interim CMIO to CMIO.

3-26-2013 6-51-39 PM

Cornerstone Advisors names Patty Guinn, RN (Dearborn Advisors) as director and practice leader of clinical informatics.

ONC promotes Chief Grants Management Officer Lisa Lewis to deputy national coordinator for operations.


Announcements and Implementations

3-26-2013 5-13-15 PM

Edward Hospital & Health Services (IL) implements several Infor Lawson applications to accompany its existing Infor Human Capital Management solution.

New York’s State Health Information Network (SHIN-NY) goes live with its first electronic transmission of secure EHRs information using Etransmedia Technology’s Direct Care Coordinator solution.

Allscripts and Integrated Health Information Systems will jointly develop a Singapore-based technology laboratory to accelerate IT solutions for public hospitals in Southeast Asia.


Government and Politics

3-26-2013 9-06-53 AM

VA Secretary Eric Shinseki says his organization will clear a backlog of veterans’ disability claims by the end of 2015. Seventy percent of the VA’s  895,000 pending claims are older than 125 days. Shinseki blames the backlog in part on the large amounts of paper-based claims and records that require conversion to an electronic format and the lack of synchronization between the VA and DoD.

 

Several new rules that expand and update HIPAA’s security provisions will go into effect this week, though compliance for most of them will not be required until September 23.


Innovation and Research

Rock Health creates FDA 101, a timely and very nicely done overview of FDA regulations for digital health entrepreneurs.


Technology

3-26-2013 3-50-00 PM

McKesson launches ANSOS2Go, an Android-based mobile app for its ANSOS One-Staff workforce management suite.

Ingenious Med will combine inpatient and outpatient functionality into its impower charge capture platform.


Other

3-26-2013 3-51-28 PM

Boulder Community Hospital (CO) reports that its Meditech system is back online following a two-week downtime caused by an unspecified malfunction of both its primary and offsite secondary servers. The hospital was able to recover all of its data except that entered during the eight hours after the last good backup and has now moved to creating hourly incremental backups.

Granger Medical Clinic (UT) suffers a possible data breach when 2,600 paper appointment records awaiting shredding disappear.

Johns Hopkins Bloomberg School of Public Health recently offered a free eight-week data analysis course via Coursera that covered using big data to find the answer to a given question. The first session just concluded and further sessions haven’t been announced, but Coursera has other statistics courses available. You’ve seen all the articles and companies about analytics and business intelligence, so if you want some career insurance at no charge and with minimal inconvenience, Coursera might be the way to go.

In England, an NHS study finds that physicians ignore 98 percent of drug safety alerts, which it concludes is because prescribing systems don’t issue the warnings until the end of the prescribing process and starting over is too much trouble.

3-26-2013 12-45-22 PM

Only about 11 percent of healthcare dollars paid to providers are tied to performance instead of fee-for-service, according to analysis by the non-profit Catalyst for Payment Reform.

In Australia, Victoria University’s Centre for Applied Informatics develops software that processes incoming streams of physiologic data and predicts vital signs 20 seconds into the future, also providing real-time warnings and retrospective reviews of patient condition in surgical cases.

Also in Australia, EMR go-live at the new Royal Adelaide Hospital is delayed due to difficulties in modifying the unnamed $427 million US system to handle complex South Australia billing requirements. I believe the system is Allscripts Sunrise Clinical Manager judging from previous announcements.

3-26-2013 5-43-42 PM

I’m fascinated by Andy Enfield, the 43-year-old coach of NCAA Sweet 16 overachieving underdog Florida Gulf Coast University. He was high school valedictorian, played college ball at Johns Hopkins, took an MBA from Maryland, coached in the NBA, and co-founded TractManager, a Chattanooga, TN-based healthcare contract management company that’s worth $100 million. He’s also married to a former Maxim magazine cover girl.

The University of Pennsylvania seeks a declaratory judgment against St. Jude’s Children’s Research Hospital, which sued Penn last year claiming that the university violated its patent for genetically modifying immune cells to treat cancer. Penn turned the process over to a drug company in a $20 million deal, but St. Jude’s says it holds the patent.


Sponsor Updates

  • Michael Elley, CIO of Cox Medical Center (MO), describes his hospital’s use of T-System to redirect patients from the ER to primary care.
  • Allscripts offers a sneak peek at the education session planning for its 2013 Allscripts Client Experience.
  • GetWellNetwork previews agenda items, speakers, and panel participants for its GetConnected 2013 user conference April 15-17 in San Diego.
  • The CRN Partner Program Guide awards Trustwave’s channel program a 5-star rating.
  • Loren Russon, senior director of product management with Ping Identity, evaluates the 3Scale API conference.
  • InstaMed releases its 2012 Trends in Healthcare Payments Annual Report.
  • HealthMEDX CEO Pamela Pure relates how her personal experiences with post-acute care facilities led her to HealthMEDX.
  • eClinicalWorks introduces private payer incentive consulting services to advise providers on incentive revenue opportunities.
  • Beacon Partners hosts a March 29 Webinar on the risks business associates pose to healthcare organizations.
  • Ingenious Med opens a customer support office in Nashville, TN.
  • Huntzinger Management Group hosted Palo Alto Medical Center’s Paul Tang, MD, MS at its event during the HIMSS conference.
  • MED3OOO names Judy Stovall from PriMed the winner of its video case study contest.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 26, 2013 News 6 Comments

News 3/22/13

March 21, 2013 News 5 Comments

Top News

3-21-2013 8-44-57 PM

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


Reader Comments

3-21-2013 8-49-22 PM

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

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

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

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

3-21-2013 7-09-09 PM

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


HIStalk Announcements

3-21-2013 4-00-21 PM

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

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


Here are the last of the HIStalkapalooza photos from Medicomp.

3-21-2013 6-58-21 PM

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

3-21-2013 6-59-57 PM

CIO Unplugged Ed Marx and friends.

3-21-2013 7-01-03 PM

Team Orion.

3-21-2013 7-03-49 PM

Team Vitera.

3-21-2013 7-05-39 PM

Bowling tournament winners.

3-21-2013 7-01-46 PM

Jonathan Bush of athenahealth and James Aita of Medicomp.

3-21-2013 7-02-57 PM

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

3-21-2013 7-04-43 PM

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


Acquisitions, Funding, Business, and Stock

3-21-2013 8-07-03 PM

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

3-21-2013 8-08-06 PM

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


Sales

3-21-2013 8-51-12 PM

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

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


People

3-21-2013 6-17-14 PM

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

3-21-2013 6-19-07 PM

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

3-21-2013 7-15-53 PM

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

3-21-2013 7-18-25 PM

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


Announcements and Implementations

3-21-2013 3-11-01 PM

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

3-21-2013 3-31-25 PM

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

3-21-2013 3-32-50 PM

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

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

Meditech certifies NetApp FAS storage for its systems.

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

Xerox announces a cloud-based Mobile Device Management service.


Government and Politics

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

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


Technology

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


Other

3-21-2013 8-52-56 PM

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

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

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

3-21-2013 8-54-48 PM

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

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

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

3-21-2013 9-00-01 PM

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

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



Sponsor Updates

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


EPtalk by Dr. Jayne

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

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

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

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

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

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

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

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

Print


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 21, 2013 News 5 Comments

Readers Write: Vendors – Welcome to the World of HIPAA

March 20, 2013 Readers Write 4 Comments

Vendors – Welcome to the World of HIPAA
By Frank Poggio

For the last decade or so, vendors were on the fringes of the HIPAA regulations. Just sign a somewhat innocuous BA agreement and let the provider worry about the details of compliance.

As of January of this year, the Office for Civil Rights (OCR) formally “invited” vendors into the HIPAA labyrinth of rules and regulations. In the new 500-page HIPAA Omnibus Final Rule, Covered Entities (providers) are required to send out new Business Associate agreements to their suppliers and vendors. You should get yours soon, and as an IT supplier, you will see several new requirements.

The biggest one is that system vendors that touch Protected Health Information (PHI) in any way must agree to commit to achieving full compliance with HIPAA rules by September 23, 2013. Touching means  coming in contact with — whether you create, capture, edit, change, store, pass on, reformat, convert, etc. a single piece of PHI even for even one patient. The HIPAA rules do not differentiate between full EHR systems, EHR modules, application type, middleware, report tools, conversion, or archive tools, etc. Basically, if your system touches it, you own it.

As an extreme example, say your software does only parking lot management for a hospital. If you somehow capture any personal ID data, your firm will have to meet HIPAA compliance.

A more realistic example is the typical analytics tool that takes detailed information, aggregates it, and generates only summary, management, or trend reports. Your analytical system (such as grabbing a UB bill file and calculating averages) may never report out or allow access to any specific patient PHI, but since you received the data on a case-by-case basis even though you may have stripped out the PHI before you stored the records, your firm and software must meet HIPAA compliance.

The Final Rule is clear that if you touch PHI, even if you don’t look at it, you must comply. There are no exemptions for encrypted data, servers in locked cabinets, or remote cloud systems.

As a vendor, what must you do to be HIPAA compliant? Your firm must supply documentation of:

  1. Policies addressing HIPAA privacy and security issues
  2. Privacy and security procedures
  3. Workforce HIPAA training
  4. HIPAA-compliant workflows
  5. Compliance for an audit or data breach investigation
  6. HIPAA compliance of any subcontractors you use

Your clients may require an independent audit of the above at your expense as a requirement for you to continue as their vendor. If you do not provide it, their legal counsel may advise them to replace your system with that of a competitor. Remember, the above must be in place before September 23, 2013. Lastly, if you or your provider client has a data breach and OCR finds you lacking in compliance, you could be fined $1.5million per breach.

As I noted in a past HIStalk Readers Write piece, ONC in Stage 2 “exempted” EHR Module vendors from testing on the privacy and security criteria (if the vendor so chose), but they did state that the vendor must still be HIPAA compliant. Which means, implement the ONC privacy and security criteria.

Welcome to the wonderful world of HIPAA.

Frank Poggio is president of The Kelzon Group.

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March 20, 2013 Readers Write 4 Comments

Morning Headlines 3/20/13

March 19, 2013 Headlines No Comments

Boulder Community Hospital computer system crash frustrates patients

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

Health System Implements new Electronic Medical Records on March 18th

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

Lifespan Takes Major Step to Transform Health Care Delivery

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

KLAS Diagnoses EMR Usability Concerns

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

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March 19, 2013 Headlines No Comments

News 3/20/13

March 19, 2013 News 8 Comments

Top News

3-19-2013 7-54-09 PM

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


Reader Comments

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

3-19-2013 6-56-19 PM

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

EHR Incentive Payments are Taxable Income

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

3-19-2013 6-53-55 PM

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


HIStalk Announcements and Requests

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


Acquisitions, Funding, Business, and Stock

3-19-2013 7-55-29 PM

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

3-19-2013 7-56-15 PM

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

3-19-2013 7-57-08 PM

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


Sales

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

3-19-2013 7-58-42 PM

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

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


People

3-19-2013 6-02-02 PM

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

3-19-2013 6-03-15 PM

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

3-19-2013 7-21-03 PM

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


Announcements and Implementations

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

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

3-19-2013 6-05-33 PM

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

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

3-19-2013 6-29-49 PM

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

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


Government and Politics

3-19-2013 3-10-14 PM

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


Technology

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

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


Other

3-19-2013 3-26-11 PM

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

3-19-2013 3-31-57 PM

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

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

3-19-2013 3-51-36 PM

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

3-19-2013 6-19-47 PM

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

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


Sponsor Updates

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 19, 2013 News 8 Comments

News 3/13/13

March 12, 2013 News 2 Comments

Top News

3-12-2013 7-37-49 PM

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


Reader Comments

3-12-2013 5-47-53 PM

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

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

3-12-2013 6-19-28 PM

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

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

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


Acquisitions, Funding, Business, and Stock

3-12-2013 8-04-12 PM

Athenahealth completes its acquisition of Epocrates.

3-12-2013 8-04-49 PM

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

3-12-2013 8-05-27 PM

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

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

3-12-2013 7-20-48 PM

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

3-12-2013 8-06-14 PM

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


Sales

3-12-2013 3-54-49 PM

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

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

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

3-12-2013 8-07-48 PM

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

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


People

3-12-2013 6-51-24 AM

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

3-12-2013 5-56-49 PM

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

3-12-2013 12-56-17 PM

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

3-12-2013 5-57-53 PM

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

3-12-2013 5-58-57 PM

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

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

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


Announcements and Implementations

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

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

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

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

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

3-12-2013 8-09-10 PM

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

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


Government and Politics


HHS Secretary Kathleen Sebelius fires up her Twitter.

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


Other

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

3-12-2013 4-08-18 PM

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


Sponsor Updates

3-12-2013 12-29-44 PM

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 12, 2013 News 2 Comments

Curbside Consult with Dr. Jayne 3/11/13

March 11, 2013 Dr. Jayne 2 Comments

Lt. Dan’s inclusion of “Cisco Study Reveals 74 Percent of Consumers Open to Virtual Doctor Visit” in this morning’s headlines caught my eye. According to the summary, “given a choice between virtual access to care and human contact, three quarters of consumers find access to care more important than physical human contact with their care provider and are comfortable with the use of technology for the clinician interaction.”

I’m not opposed to virtual visits – in fact I’d love to do them for certain patients or for certain conditions. In my market, however, clinicians contracted with the majority of commercial payers are not able to bill for these visits, and patient willingness to pay out of pocket is extremely low. Several of my colleagues have attempted to bill patients for after-hours telephone visits and the practice has been the subject of scorn, not only in the physicians’ lounge, but also with the local medical society.

A true virtual visit is more than a phone call. It’s a scheduled time to talk about the patient’s issues, review medications, review home vital signs, blood sugar readings, diet logs, and other patient data points. Based on a careful history and these elements, changes to the regimen can be made and behavioral interventions can be supported. The history elements, data, care plan, and goals still need to be documented in the patient chart, however, and that takes time. Unless you’re operating under a capitated model where you’re being compensated for these services through a per-member/per-month payment, you can’t perform these services without some sort of compensation.

Virtual visits also generate real liability. They can allow for physicians to care for greater numbers of patients which can increase risk if there is not close adherence to protocols and guidelines or if patients are not well known to the clinician. This makes the need for appropriate scheduling and documentation even more important. Virtual visits aren’t something physicians should be expected to cram onto their schedules in lieu of overbooks to the office schedule.

I do find Cisco’s findings somewhat contrary to my experience in solo practice. When I employed a nurse practitioner to care for my patients as my informatics duties grew, there was a lot of resistance to the team-based approach by some of my elderly patients, who grew up in an era where seeing the doctor was something special and had a unique value outside of the actual medical care. Some patients chose to wait weeks to see me rather than accept same-day appointments with someone other than “my doctor.”

This attitude is somewhat borne out in a later statement in the piece where it was noted that “consumers will overlook cost, convenience, and travel, to be treated at a perceived leading healthcare provider to gain access to trusted care and expertise.” I’m not saying I was a leading healthcare provider (in fact, when I was first in solo practice, I was a fresh grad with a bit too much idealism) but I was a good listener and genuinely cared for my patients. I’m not sure that level of empathy can be easily translated to the virtual experience. I had the privilege of truly getting to know my patients, who also felt they were able to know me.

We exchanged more than symptoms and diagnoses. We also swapped recipes and baked goods, stories of our small community, handicrafts, and more than our share of heartache. I had the distinct privilege of being able to function as an “old school country doctor” in the middle of the suburbs. This was mainly because the opening of my practice solved an access problem, but also gave patients a place they could think of as their medical home, whether it was a designated Patient Centered Medical Home or Center of Excellence or any other buzzword of the day.

I miss having continuity patients and I think about some of my favorite patients often. Every once in a while I will run into one while working in the emergency department and that is a rare treat. Although virtual visits may be cheaper (if they are ever reimbursed where I live) and more expedient, I don’t think they’re going to be as good for building that level of “trusted care” that patients expect when they’re faced with a life-threatening condition. What do you think about virtual visits? E-mail me.

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March 11, 2013 Dr. Jayne 2 Comments

Morning Headlines 3/4/13

March 4, 2013 Headlines 1 Comment

Cerner, McKesson, Allscripts, athenahealth, Greenway and RelayHealth Announce Ground Breaking Alliance to Enable Integrated Health Care

The major news from HIMSS today is that the Cerner-McKesson announcement turned out to be much larger than suspected, including a total of six major players coming together to form the CommonWell Health Alliance. The organization will be an independent non-profit for EHR vendors together that want to achieve a higher level of interoperability between systems.

Nuance and Cerner Partner to Offer Point of Care Solution for Clinical Documentation Improvement

Cerner announces that it will integrate Nuance’s suite of clinical language understanding products to support physician documentation in a new workflow that will allow physicians to dictate notes while the tool simultaneously performs quality review, prompting clinicians for clarifying information where needed.  

ICD-10 Snapshot Study

A recent survey of 260 healthcare professionals involved in ICD-10 planning reveals that only 55 percent of respondents are confident that they will meet the October 1, 2014 deadline. Primary concerns center around additional training needs and a lack of time. 43 percent of respondents reported frustration with vendors "not providing an adequate schedule to ensure we will be ready by the deadline."

HIMSS 2013 iHIT Study – Final Report

HIMSS releases its 20132 Impact of Health IT report. The results paint a suspiciously rosy picture of end user satisfaction, including 83 percent of respondents agreeing that HIT applications support clinical processes and workflows. The survey-takers were comprised of 63 percent nurses, 22 percent pharmacists, and 11 percent physicians working at larger than average (and most likely more technologically refined) hospitals with an average 681 beds.

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March 4, 2013 Headlines 1 Comment

Monday Morning Update 3/4/13

March 1, 2013 News 3 Comments

From HyWay: “Re: Costco. They sent an e-mail to customers who purchased Allscripts MyWay through Costco’s program saying they are working with Allscripts to ‘offer solutions for members who do not feel the move to Pro is right for them.’ In the mean time, Costco has initiated arbitration proceedings against Allscripts to make sure its users get the service they expected when they bought MyWay.” Unverified, but the forwarded e-mail appears to be authentic. Its tone was amicable.

From The PACS Designer: “re: iWatch. While we wait for the anticipated Apple iTV later this year, there’s something else to look forward to and that’s an Apple iWatch. TPD posted about the Pebble watch, and speculation is that the so called iWatch will be much more innovative and unique in its style and features. Apple has a patent requesting pending on a Amoled flexible wristband device to consider as the possible final product launch, or it could still be a traditional watch similar to the Pebble.”

I’m actually writing this Friday night since I’ll be traveling to New Orleans on Saturday, so don’t be confused when I also post on Saturday and/or Sunday and the days look goofy. Inga, Dr. Jayne, and I will be writing profusely from the HIMSS conference, and to avoid giving you inbox fatigue, I’ll collect the individual links into a single e-mail blast each day.

3-1-2013 2-33-25 PM

Speaking of New Orleans, only Dallas saved the city from a last-place finish in the locations respondents would most like to see HIMSS conferences held. All the southern cities fared poorly in the poll except Orlando, which is about as southern as Ohio and New Jersey in every way except location. The three-city rotation should be Orlando, Las Vegas, and overwhelming winner San Diego if HIStalk readers rather than HIMSS were choosing. Not only is this year’s host city nearly bottom ranked, but so is the 2015 one, Chicago. I’m glad to see I’m not the only one who misses San Diego, which HIMSS outgrew, but the convention center is planning a $500 million expansion that will place it back among the A-list. New poll to your right: is the industry experiencing an EHR backlash? You only get a yes/no choice, but the poll accepts comments in which you can further elucidate your position.

Lt. Dan had e-mailed me off the record about problems he’s having personally because of the lack of VA-DoD system integration. I suggested he write it up since he’s both a veteran and an HIT person, not to mention the author of HIStalk’s daily headlines and most of the posts on HIStalk Connect. I think his piece, Making the Transition: What the iEHR Failure Means for Veterans, paints a clearer picture of the problem than you’ll get from the agencies themselves.

3-1-2013 6-36-01 PM

Welcome to new HIStalk Platinum Sponsor Caristix, which offers HL7 software for interface lifecycle management. The company offers Cloak (HL7 de-identification), Pinpoint (interface troubleshooter), Conformance (interface specs development), and Test (complex interface validation and simulation). They will also help get you connected to the Mirth open source integration engine. You can download trials of everything from their site, and also the entirely free HL7 profile reader and an HL7 listener and router for recording and playing HL7 messages to validate connectivity. They have tools for providers and vendors alike. Interface folks will enjoy their HL7 Survival Guide, a no-nonsense guide to interface projects and technology. I featured the company in my Innovator Showcase just over a year ago, which included an interview with one of its customers and another with President Stéphane Vigot. Thanks to Caristix for supporting HIStalk.

My predictable YouTube cruise resulted in this Caristix video.

3-1-2013 7-08-30 PM

Welcome to new HIStalk Gold Sponsor eHealth Technologies. The company’s eHealth Imaging Solutions provide single-click access to diagnostic quality X-rays, CT scans, ultrasounds, ECG, etc. from an existing EHR or HIE solution. Clinicians gain the ability to view and collaborate using eHealthViewer ZF, a zero-footprint unified imaging platform that allows secure viewing of any image over the web. eHealth Imaging Solutions supports trauma and emergency access to images, allows transferring DICOM images between PACS locations so that radiologists can view outside exams, and provides cloud-based archival and disaster recovery solutions. Hospitals, IDNs, and HIEs can strength their referral networks, reduce the cost of physical media, meet MU Stage 2 image sharing requirements, reduce patient risk from unavailable images and radiation exposure from duplicate exams, and lower IT costs with the zero-footprint viewing platform that runs on all browsers and platforms (including iOS and Android). Thanks to eHealth Technologies for supporting my work.

Here’s a video I found featuring customers describing the benefits of eHealth Technologies for accessing images.

3-1-2013 3-12-21 PM

The Department of Defense chooses Health Language from Wolters Kluwer Health to provide terminology solutions to support enhanced documentation, population analytics, and business intelligence reporting across the Armed Forces Clinical Database.

3-1-2013 7-45-26 PM

TeleTracking will announce its Real-Time Capacity Management platform at HIMSS, with clients on hand in Booth #6619 to describe their experience with the company’s systems.

3-1-2013 7-46-23 PM

NextGen Healthcare will unveil NextGen Population Health at the HIMSS conference, which will help providers meet patient-centered medical home and ACO goals.

3-1-2013 7-48-09 PM

Vitera Healthcare Solutions releases Intergy v8.10, which includes enhancements for ICD-10, Meaningful Use, patient engagement, disease management, and performance-based reimbursement.

3-1-2013 7-53-04 PM

Covenant Health (TN) and Capital Region Health Care (NH) choose McKesson Paragon.

Hackensack Alliance ACO chooses Health Catalyst for care coordination, to be announced Monday. 

Patients whose hospitals or physician practices are customers of lifeIMAGE will be able to review their medical imaging results online using a free new service offered by the company, which also announces its support for Blue Button.

3-1-2013 7-53-51 PM

HIMSS Analytics will showcase the products and services of the recently acquired CapSite at the conference in Booth #4929, including the CapSite Database (pricing and contracts) and an expanded Consulting and Research & Advisory Services offering.

Optum will resell MModal’s Fluency Direct speech understanding solution as part of its documentation and coding systems.

Medical documentation vendor Command Health will use Clinithink’s CLiX natural language processing technology to turn physician narrative into indexed and tagged free text. Clinithink also announces that Health Evolutions Partners operating partner and former Microsoft Health Solutions Group VP Peter Neupert has joined its board.

3-1-2013 7-57-49 PM

Baystate Health (MA) chooses Awarepoint’s RTLS solution for asset management and capacity management in its three hospitals.

3-1-2013 3-53-35 PM

Vonlay has posted a page that displays photo-containing tweets that use the #HIMSS13 hashtag, which they also did during Epic’s UGM. It has several photos already but will surely blow up with tons of them come Monday (you’ll see a gazillion pictures of a microscopic Bill Clinton later in the week).

Quest Diagnostics, which includes Care360 and MedPlus, will host several speakers in its HIMSS theater, including HIStalk Connect’s Travis Good, MD.

We reported that Practice Fusion has discontinued its billing system partnership with Kareo based on the wording of an e-mail sent to Practice Fusion users that referred to the relationship in the past tense while announcing enhancements to Practice Fusion’s own billing system. According to Kareo, the business relationship continues and users of the products will continue to benefit from the integration.

3-1-2013 6-29-03 PM

I said from the beginning that Groupon’s business model was unsound for several reasons (low barrier to entry, discounting rarely earns businesses loyal customers) but I’ll give its now-fired 32-year-old CEO Andrew Mason kudos for writing the best executive resignation letter in history. Snips from it:

People of Groupon, after four and a half intense and wonderful years as CEO of Groupon, I’ve decided that I’d like to spend more time with my family. Just kidding – I was fired today. If you’re wondering why… you haven’t been paying attention … As CEO, I am accountable. You are doing amazing things at Groupon, and you deserve the outside world to give you a second chance. I’m getting in the way of that. A fresh CEO earns you that chance … For those who are concerned about me, please don’t be – I love Groupon, and I’m terribly proud of what we’ve created. I’m OK with having failed at this part of the journey … If there’s one piece of wisdom that this simple pilgrim would like to impart upon you: have the courage to start with the customer. My biggest regrets are the moments that I let a lack of data override my intuition on what’s best for our customers. This leadership change gives you some breathing room to break bad habits and deliver sustainable customer happiness – don’t waste the opportunity! I will miss you terribly. Love, Andrew.

3-1-2013 6-33-58 PM

Secure Threads introduces bring-your-own hospital gowns intended to prevent medical errors by having the patient’s name, blood type, allergies, age, medical conditions, and emergency contacts embroidered into the fabric.

Safe travels and an enjoyable and productive week for all those traveling to New Orleans. For those who aren’t attending, feel free to goof off all week while your boss is away.




Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 1, 2013 News 3 Comments

News 3/1/13

February 28, 2013 News 2 Comments

Top News

2-28-2013 9-14-26 PM

A House panel, obviously fed up by the DoD’s cavalier attitude toward the VA’s VistA system compared to its own AHLTA EHR, demands to know why DoD won’t adopt the highly successful VistA. DoD says it’s looking at VistA yet again, but says it will evaluate it against commercial systems in attempting to “skate where the puck will be” and is concerned about multiple VistA versions and lack of conversion documentation. Congressman Jeff Miller (R-FL), as puzzled as the rest of us about whether VA-DoD will adopt a single EHR or try to cobble their respective systems to merely look like one, summarized as, “It sounds to me like we’re doing a U-turn and going back to the exact same thing again.” Outgoing VA CIO Roger Baker says estimates to develop the integrated system had doubled to $12 billion. One might assume that given Epic’s previous rumored involvement, its Coast Guard EHR experience, and its track record in large and diverse organizations, it might enter the picture in some fashion as the words “commercial systems” are uttered in polite company.


Reader Comments

From Jardone: “Re: Jardogs. A sale to Allscripts is imminent. Layoffs began yesterday, which appear to be across the board. Since Jardogs is owned by Springfield Clinic, no severance will be paid. Today is the last day for many, including myself.” Unverified. I e-mailed our contact at Jardogs inviting a response, but haven’t heard back. Jardogs, which offers patient engagement and health management solutions, is an Allscripts partner.

From Looking Deeper: “Re: MU Stage 2 requirements. Do your readers have tips for getting clarification for questions that aren’t resolved in the documentation? We would like to contact CMS. It’s a shame they don’t have an e-mail address or form.” A reader reports having successfully used this form, selecting “EHR Incentive Program” as the topic. She got a response in three weeks.

2-28-2013 9-18-23 PM

From Festus: “Re: coding issues. Jail time?” A 63-year-old cardiothoracic and vascular surgeon is serving a 10-month sentence for Medicare fraud, convicted for upcoding his cases. The US Attorney says his case sends a message to doctors, while professional organizations say that message is that doctors shouldn’t accept Medicare payment because nobody can comply with its complex requirements and now they could be imprisoned for making mistakes. According to the Association of American Physicians and Surgeons, “This precedent criminalizes false statements in a private setting without any proof of billing fraud and a greater interference with the day to day practice of medicine is difficult to imagine.” The doctor’s dictated reports from 10 years ago were found to have specified the wrong kind of graft in two of 2,400 operative reports. He says he was too busy to keep up with the reports and had been told to use a code that was similar if he couldn’t find the right one. AAPS says the irony is that he could have justifiably billed a lot more than he actually did even with the mistake. The charges say the surgeon did more than just choose the wrong CPT code – they say he also falsified his progress notes. It would be interesting to see if those were generated with computer assistance since that’s the only reasonable excuse.

From CEO: “Re: HIStalk. I start every day by catching up and reading HIStalk. It really is a wonderful source of content that helps me keep a good pulse on the industry. Thank you for serving so many of us!!!” Inga was happy to read this CEO’s e-mail in response to receiving his HIStalkapalooza invitation as one of few positive comments we’ve received lately, as most of our recent e-mails are from people complaining about not being invited to HIStalkapalooza because they didn’t register. I suppose I should be flattered that people care that much about attending.

2-28-2013 9-21-20 PM

From CatsEyes: “Re: three tidbits. Did you mention that Dr. Tonya Hongsermeier (above) left Partners CIRD to become CMIO of Lahey? Lovely and very smart person. And with Partners, Boston Medical Center, Lahey, and Lifespan all going to Epic. From New Haven to Mid coast Maine – Epic rules.” I left out Tidbit #1 since it involved a sales VP whose new job I couldn’t immediately confirm. I’m dating myself by admitting that when I hear Tonya’s name I still think of her being at Cerner, which she hasn’t been forever.


HIStalk Announcements and Requests

2-28-2013 9-10-58 AM

inga_small I took an unplanned three-hour field trip to the ER on Wednesday. Of course I asked the staff all sorts of questions about what technology they had in place (and why they were using so much paper.) Turns out I am just fine and my stress over selecting the perfect pair of shoes for HIStalkapalooza does not seem to be a contributing factor. Mr. H, however, thinks all the e-mails begging for last-minute HIStalkapalooza invites may have put me over the edge.

inga_small Have you stayed current with HIStalk Practice? If not, some of this week’s highlights include: only 60 percent of physicians are interested in participating in ACOs. ISALUS Healthcare introduces a new version of its OfficeEMR. Memphis Obstetrics & Gynecology Association goes live on MED3OOO’s InteGreat EHR. Practices have an increased need for population patient health tools. I love new e-mail subscribers, so take a moment to register for updates when checking out these stories. Thanks for reading.

2-28-2013 5-29-58 PM

Welcome to new HIStalk Platinum Sponsor Forward Health Group, located on Capitol Square in Madison, WI. The orange above looks juicy and that’s no coincidence – the company’s PopulationManager tool serves up QI and outcomes data to health systems that’s fresh, never frozen, squeezing it from your current systems, claims data, or administrative data. It’s accurate, actionable, complete, and timely, not to mention physician accepted at the individual patient level. The founders started out working in public health reporting back in 2004, meaning they had to figure out early on how to extract and aggregate data from a veritable science fair of disparate IT systems to create apple-to-apples measurements (that’s my second fruit analogy if you’re scoring at home.) It’s a fruit punch (fruit reference #3) of advanced informatics, population health best practices, and elegant visual explanations. They’ll set up a meeting or come to you at HIMSS or at HIStalkapalooza to tell you more – just e-mail them. Thanks to Forward Health Group for their berry (#4) much appreciated support of HIStalk. I have a feeling they’re a lot of fun, so you might be on the lookout for CEO Michael Barbouche or docs John Studebaker, MD and Sean Thomas, MD Monday night at Rock ‘n’ Bowl.

I found this Forward Health Group video that talks more about Fresh Data.

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Thanks to Levi, Ray & Shoup, which not only issued a press release calling out my recent interview with SVP John Howerter, but used most of it to say nice things about HIStalk. I enjoyed talking with John because I consider myself something of an expert on print spooling-related problems in hospitals (having gotten myself hopelessly stuck in the middle of those problems many times over the years, unfortunately) so I was asking questions from my own experience.

2-28-2013 6-36-30 PM

Verisk Health is supporting HIStalk as a Platinum Sponsor. The company builds solutions for every payer type, including medical cost management, government reporting, payment accuracy, and revenue compliance. They can help identify risk, save money, and improve care. Providers interested in accountable care programs need tools for cost control, quality improvement, and population health management, and that also means you would probably benefit from getting a free copy of Verisk’s provider toolkit. Edward Hospital (IL), for example, is using PopulationAdvisor (through Premier) to monitor its clinical and financial performance, combining Premier’s comparative provider database with Verisk Health’s risk-based payer analytics to gain a better understanding of outcomes and cost of care provided both inside and outside the hospital. Verisk Health President Joel Portice has been around the industry for a long time, holding executive roles with Intelimedix, HCI, Enclarity, and Fair Isaac (not to mention that he’s also a novelist). Thanks to Verisk Health for its support of HIStalk.


HIMSS Conference and Social Events

inga_small Wen Dombrowski, MD, who tweets under @healthcareWenF, forwarded me this list she compiled of socials, Tweetups, and physician exec events. She is doing a Segway tour Saturday afternoon that sounds particularly fun.

2-28-2013 6-24-02 PM

I’m posting this shoe porn for Inga and Dr. Jayne, sent in by the (male) president of a new sponsor who clearly understands their fixation. Very hot.

2-28-2013 12-46-25 PM

inga_small The weather forecast for New Orleans looks pretty darned good. The mild temperatures suggest open-toed shoes as a viable option. Heavy coats can remain at home, or at least in the hotel room.

HIStalk’s Guide to HIMSS13
HIStalk’s Guide to HIMSS13 Meet-Ups
HIStalk’s Guide to HIMSS13 Exhibitor Giveaways


Acquisitions, Funding, Business, and Stock

Practice Fusion buys 100Plus, a startup co-founded by Practice Fusion CEO Ryan Howard that provides analytics-drive personalized health predictions.

Health Catalyst increases its Series B round by $8 million with participation from Kaiser Permanente Ventures and CHV Capital.

2-28-2013 7-49-14 PM

Revenue cycle solutions vendor Cymetrix Corp. acquires analytics vendor CareClarity.


Sales

2-28-2013 5-12-48 PM

Resolute Health (TX) selects Allscripts Sunrise Clinical Manager EHR and Allscripts Community Record for HIE and analytics.

Physician-hospital organization St. Vincent’s Health Partners (CT) chooses McKesson Population Manager and McKesson Risk Manager to manage the health of high-risk populations.

2-28-2013 3-21-03 PM

PeaceHealth will integrate Streamline Health’s AccessAnyWare enterprise content management solution with Epic ambulatory.

Evolution Health will deploy Greenway Medical’s PrimeSUITE across its national network of house call providers.

2-28-2013 9-24-44 PM

Northeast Georgia Health System (GA) will implement McKesson Paragon.

Daughters of Charity Health System will implement CliniComp’s Essentris Fetal mobile EMR in all of its hospitals. 


People

2-28-2013 5-14-12 PM

API Healthcare names Daryl Joslin (Defran Systems) chief marketing officer.

2-28-2013 5-15-29 PM

WorldOne, the parent company of Sermo, names Kerry Hicks (HealthGrades) chairman.

2-28-2013 5-16-25 PM

Press Ganey Associates adds Ralph Snyderman, MD (Duke University Health) to its board.

2-28-2013 8-11-21 PM

Beverly Bell (CSC) joins Health Care DataWorks as chief nursing officer and VP of implementation services and business performance management.


Announcements and Implementations

2-28-2013 3-30-39 PM

City of Hope (CA) implements Harris Corporation’s BI Practice Variation dashboards to identify opportunities for improving clinical outcomes, safety, and documentation.

Taylor Regional Hospital (GA) and Griffin Hospital (CT) complete activation of PerGen’s PeriCALM perinatal system in their labor and delivery departments.

Awarepoint makes its aware360 Suite for Workflow Automation services available on a cloud-based platform.

Wolters Kluwer Health introduces ProVation Care Plans powered by Lippincott’s Nursing Solutions, which provides tools for maintaining evidence-based interdisciplinary care plans.

First Databank announces new medication decision support tools that include interoperability mappings (linking RxNorm to FDB data, for example), enhanced AlertSpace functionality to reduce alert fatigue, and state and federal controlled substances information.

2-28-2013 9-26-16 PM

EHR vendor Practice Fusion announces that it has discontinued its relationship with billing system vendor Kareo due to “due to Kareo’s recent price hikes” while also acknowledging that “billing has not been our strongest feature.” The Practice Fusion announcement did not mention that Kareo announced its own free EHR last week. We invited both companies to respond and received this from Kareo:

Kareo is committed to delivering an open platform and supporting multiple EHR options driven by customer requirements, including partner-based solutions and Kareo EHR. Kareo will continue to work closely with our EHR partners to enhance and support our existing integrated solutions while adding new options over time. We believe this approach provides our current and future customers with the greatest flexibility to choose the best EHR for their specific needs. Kareo is proud of our reputation as a provider of intuitive and affordable solutions, and we are committed to delivering the highest value to our customers. The pricing plans for our customer base remain in place and have not changed in any way.

2-28-2013 9-27-22 PM

The iPad-powered Sparrow EDIS from Montrue Technologies becomes the first ED system to earn certification under the 2014 Meaningful Use criteria.

Allscripts will demonstrate award winners of its Allscripts Open App Challenge at the HIMSS conference, presenting $150,000 in prizes to 15 winners at Booth #3441 on Monday at 3:00 p.m. The company will also donate $5 to one of three charities (#AHA, #ACCS, or #JDRF) for tweets to @Allscripts answering the question, “What does Open mean to you” or “How have you benefitted by using Allscripts?”

Surescripts will announce Friday that electronic prescribing service NewCrop will connect to The Surescripts Network for Clinical Interoperability, which allows providers to securely share clinical information.

QuadraMed announces that Shands HealthCare (FL) will integrate the company’s AcuityPlus nurse resource management system with the Epic system that Shands is implementing.

VMware announces vCloud for Healthcare, which will allow healthcare IT customers to use a common cloud infrastructure inside and outside hospitals.

2-28-2013 8-27-39 PM

Sharp HealthCare (CA) and the Foundation for Health Coverage Education launch the for-profit PointCare Web-based eligibility software vendor, saying it will “change the tone of financial conversations with their uninsured patients.” Uninsured patients take a short quiz that identify the government programs that 80 percent of them are eligible for.


Other

2-28-2013 12-04-01 PM

Athenahealth will invest up to $10 million and lease up to 60,000 square feet of office space in Midtown Atlanta for more than 700 employees.

A CHIME survey finds that the average base salary for healthcare CIOs in 2012 was $208,417, with respondents holding the EVP/CIO title averaging 50 percent more. More than half held a master’s degree, earning 10 percent more than those with a bachelor’s degree. Three-quarters of the CIOs reported receiving a raise of less than five percent in 2012.

2-28-2013 8-55-32 PM

The Nashville business paper profiles Shareable Ink President and CEO Stephen Hau. The 50-employee, 82-hospital software company relocated there from Boston in 2010.

Security researchers using CyberCity, a military-developed model city used to study cyberattacks, find that the city’s electronic medical records system is full of security holes. “OpenEMR from a security perspective is a disaster,” overlooking the fact that few if any US hospitals use that particular open source system.

I’ve gotten wind of an upcoming announcement from Michelle Obama’s Partnership for a Healthier America in which several EHR vendors that I won’t name (mostly the usual suspects, with some surprises) will pledge to add five anti-obesity features to their products at the March 6-8 PHA summit in Washington, DC. The features are BMI and weight classification percentiles, activity and dietary assessments, weight goal monitoring, referral to providers and community resources, and the ability to create a Healthy Weight Plan.

2-28-2013 9-32-23 PM

In Australia, Canberra Hospital will upgrade its ED system security after several employees were found to be altering patient data to make wait time statistics look more favorable. Most of the employees could not be identified because the EDIS was set up with generic user IDs like “nurse” and “doctor,” with managers claiming that the department could not function if users had to sign on and off individually. The upgrade will include quick logon/logoff. A server crash of the same EDIS caused the hospital to go on diversion Wednesday as the ED went back to paper.

In Canada, doctors in Nova Scotia complain of system crashes and response time problems with their $4 million Nightingale Informatix EMR, for which they were paid $10,000 each in government incentives to use. The company acknowledges software problems.

Cerner is among four dozen medical device and supply vendors that will pass along the new PPACA-mandated 2.3 percent medical device excise tax directly to their hospital customers.

Weird News Andy wonders if Meaningful Use statistics could be similarly fudged. The acting CEO of an English hospital resigns after an investigation finds that Royal Bolton Hospital coded its patient deaths due to septicemia at quadruple the expected rate, with interim findings indicating “cause for concern.” Hospitals get paid more for treating septicemia.

inga_small Researchers find that drinking red wine may protect against noise-induced hearing loss. When not drinking Hurricane Ingas, I will make a point of sticking to red wine when club hopping in the Big Easy.


Sponsor Updates

  • PatientKeeper will feature a number of hospital executives in Booth #2210 at HIMSS.
  • Wellcentive will join the Accountable Care Community of Practice.
  • Santa Rosa Consulting will feature The Honorable Tommy Thompson and Fred L. Brown at its customer and industry appreciation event at HIMSS next Tuesday.
  • Gates Hospitalists (MO) secures Medicare reimbursement using Ingenious Med’s PQRS Registry.
  • Nuance leases an additional 28,000 square fee of office space in Cambridge, MA to accommodate about 175 employees.
  • A local paper profiles Lyster Army Health Clinic (AL) and its use of RelayHealth’s secure messaging solution.
  • Iatric Systems adds CynergisTek as a reseller of its Security Audit Manager and Medical Records Release Manager solutions.
  • Lifepoint Informatics will sponsor the G2 Pathology Institute Conference February 28 – March 1 in Fort Lauderdale, FL.
  • CSI Healthcare IT spotlights Evan Ritter, its top sales performer of 2012.
  • University Health System (TX) reports a cost savings of over $13 million within a year of contracting with MedAssets for consulting, analytics, and process improvement services.
  • Covisint will integrate Milliman’s opportunity-based population analytics capabilities into its healthcare platform.
  • AT&T lists six questions to ask healthcare cloud vendors to ensure data security.
  • eClinicalWorks  shares details of how Coastal Medical (RI) achieved a 200 percent return on its original investment and improved care coordination utilizing the company’s EHR.
  • A Nuance Communications’ survey finds that 80 percent of US doctors believe virtual assistants will change how they interact and use EHRs and will benefit patients by making them more engaged in their own healthcare.
  • McKesson names the Bread of Healing Clinic (WI) the company’s first recipient of its Practice Choice EHR software as part of the McKesson Give Back initiative.
  • Impact Advisors Principal Rob Faix is featured in a podcast discussing PHI data breaches.
  • St. Luke’s Cornwall Medical Group (NY) shares how it increased cash collections by 17 percent utilizing Greenway’s PrimeRCM.
  • Mitochon Systems will integrate drug safety information from PDR Network into its Electronic Medical Office platform.
  • Merge Healthcare will bundle MModal Fluency for Imaging and MModal Catalyst for Radiology with its Merge PACS portfolio.
  • Signature Sleep Services, dba Sleep360, will market and integrate ZirMed’s RCM solutions with its platform of sleep medicine tools.
  • Georgia-Pacific Professional introduces the SafeHaven monitoring system, which combines Versus RTLS technology with Georgia-Pacific’s dispensers and skin care products. 

EPtalk  by Dr. Jayne

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Several readers have asked Inga and me for HIStalkapalooza fashion advice. DO wear sassy bowling shoes or a cool retro bowling shirt. DON’T wear anything from MSN’s list of ugliest shoes of all time.

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With HIMSS starting in a few days, my inbox is really filling up. If you’re exhibiting, that means you are a technology company of some kind or at least peripherally in the technology sphere. Up your game (and the chances that your message will actually be read) by proofreading your content and removing tags like that in the e-mail above prior to sending.

Even with a relatively full inbox, it’s a slow news week as everyone saves up their big news to announce at the show. You don’t have to make a big splash at HIMSS to be a success. Vendors are quietly certifying their products for Meaningful Use 2014 and I salute them.

I’ve had a lot of questions about what I’ll be looking at during the show. Rest assured I’m making my list and checking it twice. I plan to spend plenty of time in the far reaches of the exhibit hall looking for the next big thing, so stay sharp because you never know when we might come by your booth.

I’m off to the Crescent City tomorrow and will bring you the news and happenings of HIMSS. For those of you unable to attend, thank you for keeping the availability high, the loads balanced, and the issue resolution times low. We’ll raise a glass in your honor at HIStalkapalooza. Laissez les bons temps rouler!


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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February 28, 2013 News 2 Comments

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