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Curbside Consult with Dr. Jayne 6/24/13

June 24, 2013 Dr. Jayne 7 Comments

There are some days where I just have to shake my head. Today is one of them. I received some news from one of the hospitals where I moonlight. It was the kind of news that defies all logic, and especially in the era of healthcare cost cutting, makes you wonder what in the world people are thinking. In trying to process through it, I’ve decided that there must be some kind of extraterrestrial accounting system (not to mention logic) that only applies to hospital administration.

It reminded me a little of the starship Bistromath in Life, the Universe, and Everything by Douglas Adams. For those of you who aren’t sci-fi aficionados, the Bistromathic Drive is a propulsion system that “works by exploiting the irrational mathematics that apply to number on a waiter’s bill pad and groups of people in restaurants.” Read the full description — it’s good for a laugh. I always think of it when I’m with a group trying to figure out who owes what part of a check.

I’m not against hospital administrators. This is not an “us vs. them” rant. I understand they have to make the same types of difficult choices that all of us do in trying to deliver high-quality, cost-effective care to the right people at the right time. Some of my best friends are administrators. They seem to be between the proverbial rock and the hard place a good percentage of the time, especially those at non-profit and safety net facilities. How they juggle the competing requests for resources and determine how one priority takes precedence over another is often beyond me.

What did they do this week however that was so logically convoluted I had to take my jaw off the floor? The administration of a semi-urban safety net hospital decided to close the “quick care” part of the emergency department. I’ve written about my work here before, joking that we could provide more cost-effective care by stationing a well-trained Boy Scout with a first aid kit at the front door.

People come to this hospital for everything under the sun. I’ve worked on the express care unit for half a decade because the “real” emergency physicians don’t want to go there. Those of us that are board certified in other specialties enjoy the work because it looks a lot like a primary care practice although without a stable patient population.

Quick care has been doing its part to keep the overall ED wait times low. We handle all patients door-to-door in close to 60 minutes or less, which is amazing when you consider the population, their lack of follow-up, and the volume. The hospital is one of the busiest facilities in the region, which is why I was completely floored when I received notice today that the quick care unit was closing. Since this isn’t my full-time hospital, I had no idea it was coming. Worse yet, neither did the staff with whom I just worked last week.

The hospital has decided to take the unit and roll it into the rest of the ED. As another part of the cost-saving measure, they’ve decided to terminate the services of all the part-time physicians. Quick care patients will be handed by nurse practitioners and physician assistants embedded in the “regular” emergency department.

Why doesn’t this make sense? Several things jump out at me.

The physical quick care unit will be repurposed and the patients will be physically seen in the existing ED. This is a net loss of nine beds. The existing ED physicians will be expected to supervise the midlevel providers in addition to their normal shift duties. Nursing staff ratios will be kept the same and the quick care nurses were laid off as well. I almost cried when I realized that. These men and women are the rock stars of the ED, handling nine patients at a time and keeping the flow moving while doing the same level of documentation as the rest of the ED, often having to clean rooms themselves because of the lack of other support staff and sometimes taking care of really sick overflow patients still at a 9:1 ratio. They are hard workers who know just how to juggle patients to keep the visits under 60 minutes. Most of them have been in quick care for more than a decade.

It was this realization that led me to believe they must be using some kind of Bistromathic accounting. In this healthcare climate, who lays off nurses? Especially nurses who can juggle patients and flip rooms as fast as this crew? Who thinks they can just take an additional 50 to 60 patients per shift and funnel them into the ED workflow without drastically sabotaging the ED wait time statistics? And with nine fewer beds? I also wonder who thought the ED physicians would be game to supervise additional midlevels without compensation, which is part of the package.

I think there may have been a bit of sorcery involved as well because none of the line staff seemed to know this was coming. I’m sure the department chair and the nursing directors were in cahoots with the administrators and accountants, but the rest of the team sure wasn’t. Keeping a secret like that is pretty impressive. They managed to keep it quiet a good long time too, only showing their hand the week before the closing. I guess I won’t be bringing my famous chili dip to the July 4 shift party after all.

For those of us that don’t have regular shifts, it was like a death in the family – realizing that you may never again see people you’ve (literally) shared blood, sweat, and tears with. For the handful of staff that are losing their full-time jobs, it’s stunning. Maybe it will go better than I expect, although I can’t wait to see the next quarter’s numbers for wait time, patient satisfaction, and provider productivity.

I’m mourning for my colleagues and missing them already. I suppose it’s a good thing since I’ll have unexpected free time. But if you happen to need a skilled adrenaline junkie to pick up some shifts, give me a call.


E-mail Dr. Jayne.

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June 24, 2013 Dr. Jayne 7 Comments

Readers Write: What’s in YOUR Medical Record?

June 21, 2013 Readers Write 4 Comments

What’s in YOUR Medical Record?
By Ken Schafer

6-21-2013 8-07-36 PM

If my wife were admitted to the hospital with diabetic ketoacidosis (DKA), I’m pretty sure I wouldn’t want her electronic record to erroneously record a leg amputation (BKA). I’m equally confident that if this documentation mistake were made, I wouldn’t care too much how it happened. I would just want it fixed.

And if incorrect documentation on my diabetic wife resulted in an incorrect treatment course, which resulted in her death? You might end up with a $140 million verdict like this one.

Inga’s post on The Atlantic’s “The Drawbacks of Data-Driven Medicine” (from Big Datty,on 6/12/13) illustrates something that we all know to be true. Our medical records often contain mistakes, and electronic errors perpetuate themselves embarrassingly quickly. But her comments – and the source article – miss two very important points.

Doctors are responsible for the content of the records they create. This is true regardless of the method used to document patient encounters. Blaming the speech recognition system for hearing “DKA” instead of “BKA” makes no more sense than blaming a keyboard for a typographical error. If the physician picked the wrong checkbox on an EHR interface, would that be the fault of the EHR? Of course not.

Speech recognition, keyboarding, and dropdown menus are all methods for data capture. For that matter, so is a more traditional transcription process. But all of these methods have one element in common: the final content should be reviewed and validated by the documenting clinician. Physicians who fail to do this put their patients at risk.

Doctors make mistakes. I know a radiologist who dictated “liver” when he meant “heart.” The transcriptionist dutifully returned the report with the word “liver,” and it was signed by the physician. When the mistake was discovered, the audio was retrieved. The doctor listened to himself dictate the wrong organ, and blamed the transcriptionist. The point? Doctors are people, and people make mistakes, whether they own up to them or not.

That same physician was convinced speech recognition would eliminate transcription errors, and he was right – sort of. What speech recognition systems really do is eliminate transcriptionists, not errors. If radiologists are involved, there will still be errors. There’s no speech recognition system that will hear the word “liver” and change it to “heart.”

In fact, in our DKA:BKA example, the doctor may have had a bad day and actually said BKA to the speech recognition system. No matter what, though, the doctor made a mistake – either in what he said, or in what he saw on the screen and failed to correct.

Those with experience greater than mine often post to HIStalk about the shortcomings of EHRs in terms of the data they contain, with usability and completeness being favorite topics. My concern for our records is more specific. Especially when speech recognition is involved, what metrics do we have in place to make sure that narrative data is recorded accurately? If doctors are responsible for the content of their documents, and we know they make mistakes, how do we monitor and improve the quality of the narrative components of our EHRs?

As the government, physicians, patients, and the free market determine what systems we are to use and how they should work, we should never lose sight of this one truth: no matter what’s in the record, it should be right.

Ken Schafer is executive vice president, industry relations for

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June 21, 2013 Readers Write 4 Comments

News 6/21/13

June 20, 2013 News 4 Comments

Top News

6-20-2013 11-41-31 AM

Healtheway announces its nine founding organizations. The public-private partnership will provide operational support for the eHealth Exchange, formerly known as the Nationwide Health Information Network Exchange.

Reader Comments

6-20-2013 7-27-05 PM

From Site Watcher: “Re: HIStalk. Happy 10th anniversary!” Thanks! It has gone by quickly.

From Doug: “Re: Meaningful Use security risk analysis. I would be interested in which of your sponsors offers consulting engagements, especially those appropriate for a 100-bed community hospital.” Thanks for showing preference to HIStalk’s sponsors, any of which that can help Doug can contact me and I’ll forward your information.

From Vascular Surgeon: “Re: health data. A Wired graphic from April finds that Kaiser Permanente’s data set is 31 petabytes, six times the size of the digital collection of the Library of Congress.”

HIStalk Announcements and Requests

inga_small Highlights from HIStalk Practice this week include: the top ambulatory EHR, PM, and clearinghouse products according to the KLAS Mid-Term Report (and don’t miss the readers’ comments about the rankings.) A computer outage in the Canadian province of Alberta causes 202 practices to lose access to patients’ charts for over five hours. Almost half of practicing physicians are dissatisfied with their jobs. CMS publishes updated 2014 clinical quality measures for EPs. Technology could improve treatment outcomes for children with chronic illnesses. I whine and wonder about waiting at my doctor’s office. I love new readers almost as much as I love ambulatory HIT news, so sign up for the e-mail updates when you are perusing the news. Thanks for reading.

Some of the interesting recent posts on HIStalk Connect are (International) White Collar Healthcare, Mobile Health App Platform Choices, Apple Markets Its Role in Global mHealth, and Start Me Up HIT Event. Get e-mail notification of new HIStalk Connect posts by signing up.

I’ll be surveying the HIStalk Advisory Panel of primarily CIOs again this week. Let me know if you have a question you’d like me to ask them.

6-20-2013 7-40-56 PM

Welcome to new HIStalk Platinum Sponsor Logicare. The Eau Claire, WI company offers patient instructions for hospitals, clinics, and EDs that integrate with all major EHRs including the VA’s VistA. Clinicians enjoy the ability to create a patient-specific teaching document in just a few clicks, while patients can actually understand that document since the content is written at a sixth-grade reading level. Patient instructions are offered for 6,300 topics and the system has earned numerous ONC certifications, making it easy to meet the Meaningful Use requirement to provide electronic discharge instructions (flash drive, secure e-mail) at the time of discharge for patients who request them. Thanks to Logicare for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

6-20-2013 8-46-41 PM

Clinical Outcomes Management Systems, a provider of disease management technology for the long-term care industry, secures a minority investment of $21 million from Summit Partners.

6-20-2013 8-48-21 PM

Agilum Healthcare Intelligence raises $1.82 million of a $2.32 million equity offering.


Polyclinic Surgery Group (WA) selects ProVation medical software from Wolters Kluwer Health.

The Georgia Department of Community Health selects Truven Health Analytics to build and implement the Georgia Health Information Network.

6-20-2013 8-50-36 PM

Chinese Hospital (CA) will deploy NextGen Inpatient Clinicals.

6-20-2013 8-53-41 PM

KishHealth System (IL) selects PerfectServe clinician-to-clinician communications platform for two of its hospitals.

WellStar Health System (GA) will deploy Capsule’s DataCaptor software across its five hospitals.


6-20-2013 5-59-28 PM

Eastern Maine Healthcare Systems announces that VP/CIO Catherine J. Bruno will retire in December.

6-20-2013 6-02-28 PM

Ernst & Young names Encore Health Resources CEO Dana Sellers its 2013 Entrepreneur of the Year for Healthcare in the Gulf Coast Area.

Jerry Dennany (Allscripts) joins RazorInsights as CTO.

UltraLinq Healthcare Solutions appoints Ross Hoffman, MD (MedSolutions) CMO.

Announcements and Implementations

Caradigm announces the availability of Provisioning v4.0, which manages clinician access to applications while supporting data privacy regulations.

6-20-2013 1-14-17 PM

EHealth Technologies breaks ground on its new company headquarters in Rochester, NY.

Cerner launches a pilot of the Primary Health Network, a health model that uses retail locations as access points for wellness screenings.


Government and Politics

6-20-2013 11-19-59 AM

The HHS Office of Inspector General audits four Texas RECs and concludes that each has met the scope of services in their cooperative agreements with the ONC. The audits are the first of their kind by the OIG and focused on outreach activities, vendor selection and implementation assistance, and workflow analysis.

The VA announces the availability of eBenefits, an online portal that will allow veterans to file disability compensation claims electronically.

Today’s best use of a “This Is Spinal Tap” reference in a tweet comes from, interestingly enough, the federal government.


6-20-2013 8-55-12 PM

Unionized nurses with Affinity Medical Center (OH) call on hospital officials to delay this weekend’s implementation of Cerner EMR, saying patients will be at risk because the nurses have not received sufficient training and will be short staffed during the first days of the live. The nurses detailed their concerns in a letter to hospital officials, but claim that hospitals officials refused to meet with them and would not accept the letter.

Here’s athenahealth’s Jonathan Bush speaking at TEDMED 2013 on healthcare profits, pointing out that non-profit hospitals often make bigger margins than Exxon. “In the mid-1990s, healthcare was annoyingly affordable – annoying if you’re one of the hospitals.” He names names.

6-20-2013 8-56-53 PM

Cone Health (NC), facing a $30 million annual budget shortfall, will lay off 150 employees. Both Cone and nearby Wake Forest University Baptist Medical Center say their Epic implementation costs hurt their bottom line at least temporarily.

Sponsor Updates

  • HealthEdge, a provider of IT solutions for healthcare payors, partners with NTT DATA to transition Independent Health and Riverside Health to the HealthRules product suite.
  • Divurgent posts a video of its DIVOLYMPICS employee spring games event.
  • Two members of Wellcentive’s implementation team earn NCQA certification as content experts for patient-centered medical homes.
  • Access partners with The Last Well to bring clean water to all of Liberia.
  • A Deloitte Center for Health Solutions report explores how CIOs are navigating  day-to-day management challenges.
  • Visage Imaging publishes “Three topics you may have missed from #SIIM13” as a follow-up to the recent Society for Imaging Informatics in Medicine 2013 meeting.
  • ISirona President Peter Witonsky lists key criteria for evaluating a medical device data system.
  • GetWellNetwork announces the Transformative Health Series, a series of short films that recount the personal journeys of patients, families, caregivers, and healthcare professionals who are shaping the patient engagement movement.
  • API Healthcare opens its annual conference with a keynote address featuring Paul Spiegelman, author of Patients Come Second: Leading Change by Changing the Way you Lead.
  • Verisk Health announces the agenda and speakers for its 2013 national conference September 18-20 in Orlando.
  • The Association for Healthcare Documentation selects Emdat as a nominee for the Innovation Through Technology Award.
  • A local publication features Canton-Potsdam Hospital (NY) and its online bill-pay service operated by Instamed.
  • Strata Rx announces the schedule for its O’Reilly Strata Rx Conference September 25-27 in Boston.
  • Aspen Advisor consultant Claudia Blackburn will discuss how to empower population health during a June 25 Webinar.
  • Wellsoft’s EDIS earns the top rating for EDIS and Imprivata takes the top spot for Single Sign-On in the KLAS 2013 Mid-Year Performance Software & Services report.
  • Former CMS Administrator Donald Berwick, MD discussed the future of healthcare at this month’s 22nd Annual Midas User Symposium.

EPtalk by Dr. Jayne


The American Medical Association’s House of Delegates met in Chicago this week. One of their resolutions addresses sitting in the workplace. Employers are encouraged to make alternatives available including standing desks, treadmill desks, and isometric balls. I’d love to have a treadmill desk, although I spend half my day on conference calls which would render it almost useless. Several schools in my area are experimenting with standing desks in the classroom, citing famous users Thomas Jefferson, Winston Churchill, Charles Dickens, and Ernest Hemingway.

I loved this piece on batch workflow for the medical office that turned up on KevinMD this week. It should be required reading for EHR users. Author Dike Drummond, MD compares physicians that respond to popups and messages in the EHR to a dog with a tennis ball that can’t choose to not chase it once thrown. Watching my colleagues become totally distracted with Instant Messenger, Twitter, Facebook, and e-mail all day long, I can’t help but agree.

Dr. Gregg tweeted earlier in the week about the fundraising effort for Scanadu Scout, being billed as the first real medical tricorder. I e-mailed myself to look at it later and am happy to see that they have raised over a million dollars. I also learned that the Scout is built on the same platform as the Curiosity Rover, which is pretty cool if you’re a science geek like me. Scanadu hopes to use backers to gather data to help refine its algorithms as well as to prepare for FDA approval as a medical device.

Speaking of Twitter, Bill Gates @BillGates noted this week that he is “Excited to join the 200M+ strong @LinkedIn community.” I wonder if his connections will start endorsing him for skill sets that he doesn’t actually have, which is what my connections recently started doing? It’s definitely been amusing.

I’m excited about the new HIStalk webinar series, but unfortunately my day job keeps interfering with my potential attendance. Next week’s webinar addresses “Using Clinical Language Understanding & Infrastructure Planning as Key Strategies to Ensure Clinical Revenue Integrity with ICD-10” and you can register here. I’ll likely register anyway with the hopes that my conflicting meeting will cancel – hope to see you there!


We’ve all heard horror stories about organizations dumping medical records rather than shredding them or unintentionally misplacing paper charts. Now that patients are receiving copies of their visit summaries and other documents at every visit, there’s an increased chance that we’re going to see more than grocery receipts and shopping lists blowing in the wind. Kudos to my friends at DISC Corporation who made sure the full-color copies of a patient’s colonoscopy report made it to the shredder. Not every patient-facing document has a patient or practice address, so that was probably the most ethical course of action.


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

More news: HIStalk Practice, HIStalk Connect.


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June 20, 2013 News 4 Comments

News 6/19/13

June 18, 2013 News 4 Comments

Top News

6-18-2013 7-20-54 PM

Robert M. Wah, MD, a reproductive endocrinologist, chief medical officer for Computer Sciences Corporation, Navy veteran, and ONC’s first deputy national coordinator, is elected president of the AMA. He’ll take office in June 2014.

Reader Comments

6-18-2013 8-22-09 PM

inga_small From Alectrona: “KLAS Mid-Term report. Epic was the only acute care EMR to earn a green stoplight.” In KLAS-speak, a green stoplight indicates a customer satisfaction that’s at least six points above the average for that product segment. EpicCare Inpatient scored 90.4 compared to the 12-month segment average of 73.2. Cerner Millennium PowerChart came in a distant second at 77.5. The average score for community hospital EMRs was 70.6, indicating a good deal of discontent across both segments. Ambulatory EMRs fared better, led by PCC EHR (94.5), EpicCare Ambulatory (88.3), and SRSsoft EHR (86.7).

From Stephanie: “Re: EMR. Can you recommend a system that would be ideal for a small, new epidemiology practice?“ I’ll open the floor to suggestions, particularly for EMRs known to work well for a practice of that type.

From Re-Org: “Re: Springfield Clinic. Dual-headed CIO initiates re-org and dismantles the clinical informatics department, which merges with IT. Top talent jumps ship along with dual-headed CIO. HR will no longer meet with confused, misled, and frustrated employees.” Unverified.

HIStalk Announcements and Requests

6-18-2013 6-32-28 PM
Welcome to new HIStalk Platinum Sponsor SpeechCheck. The Yorkville, IL company can help prevent errors that occur when physicians (especially radiologists) fail to correct mistakes created by speech recognition systems, which is often a problem with their rapid rollout. Those mistakes can cause embarrassment, loss of reputation, patient care problems, and lawsuits. The company analyzes a facility’s reports, trains their physicians, and develops measurable quality standards that include a goal of 98 percent accuracy and zero critical errors. The result is improved care, risk management, and increased reimbursement. Choose from four service packages that offer choices for type and frequency of auditing, creating or reviewing templates, one-on-one physician training and conversion to self-edit , and compliance updates. See where you stand by finding your documentation quality metric. As the company says, we’ve all seen radiology reports where the technology failed to wreck a nice beach recognize speech. President and CEO Lee Tkachuk is a friend of HIStalk going way back; she also leads ChartNet Technologies and Keystrokes Transcription Service. Thanks to Lee and SpeechCheck for supporting my work.  

Maybe I should have taken a picture with my iPhone. I noticed a guy standing at the urinal in the restroom at work doing his business while frantically keying into his iPad mini with both hands. I dawdled at the sink to see if he washed his hands afterwards since I wondered if he could stand the separation from his beloved gadget. He did, not that it mattered at that point.

Acquisitions, Funding, Business, and Stock

6-18-2013 8-25-02 PM

CareCloud secures $20 million in Series B financing led by Tenaya Capital, bringing its total funding to $44 million.

6-18-2013 8-24-24 PM

Mobile health monitoring provider Medivo raises a $15 million Series B round.

PaySpan, a provider of automated healthcare payments and reimbursements, acquires the assets of mPay Gateway, a point-of-service patient payment solution for healthcare providers.


6-18-2013 8-28-29 PM

St. Mary’s Health Care System (GA) selects Merge’s iConnect Access and iConnect Enterprise Archive for enterprise imaging.

OnePartner HIE will add the Allscripts dbMotion platform to enhance reporting and connectivity.

Nature Coast ACO (FL) expands its relationship with eClinicalWorks to include eCW’s Care Coordination Medical Record.

Community Health Network (IN) will deploy OpportunityAnyWare business analytic solutions from Streamline Health Solutions.

WellStar Health System (GA) selects Avantas to provide consulting services and its Smart Square labor management software to improve labor performance in its nursing units.

Lehigh Valley Health Network (PA) will implement Salar’s TeamNotes solution to capture clinical documentation and comply with ICD-10.


6-18-2013 5-56-57 PM

HIMSS Analytics promotes Bryan Fiekers (above) to director of consulting solutions sales and Matt Schuchardt to director of market intelligence solution sales.

6-18-2013 5-59-41 PM

CareCloud hires Tom Cady (athenahealth) as VP of professional services.

6-18-2013 6-02-18 PM

Former CMS Administrator Donald Berwick announces that he will run for governor of Massachusetts.

6-18-2013 6-03-18 PM

John Frenzel (Conifer Health Solutions) joins Convergent Revenue Cycle Management as CFO.

Announcements and Implementations

Cedars-Sinai Medical Center reports it has recovered more than $300 million by reducing net A/R with the help of Hyland Software’s OnBase ECM platform.

6-18-2013 8-31-48 PM

Mary Greeley Medical Center (IA) implements PeriGen’s PeriCALM fetal surveillance solution, interfacing it to Epic Stork.

Glenn Medical Center (CA) goes live on CPSI.

Laurel Regional Hospital and Prince George’s Hospital Center, affiliates of Dimensions Healthcare System (MD), activate Cerner.

6-18-2013 8-33-15 PM

EvergreenHealth (WA) goes live with PatientKeeper Charge Capture.

Bumrungrad International Hospital (Thailand) deploys the Intelligent InSites RTLS solution.

ARC Community Services (WI) implements Forward Health Group’s PopulationManager to monitor addiction treatment programs.

Cerner will embed the MedAssets Claims Management solution within its patient accounting solution.

6-18-2013 8-34-41 PM

University of Ottawa Heart Institute (Canada) goes live on the Med Access EMR.

Adventist Health finishes its implementation of Strata Decision Technology’s StrataJazz for operating budgets and management reporting and will begin rolling out additional StrataJazz modules for capital planning and strategic planning.

Government and Politics

inga_small National Coordinator Farzad Mostashari, MD has supposedly confirmed that the ICD-10 transition date will not be extended beyond October 1, 2014. If CMS weren’t notorious for soft deadlines, would this even be news?

White House Senior Advisor Ryan Panchadsaram, a former executive of Ginger.io and former Rock Health fellow, talks about patients accessing their electronic records at TEDMED 2013.


6-18-2013 1-05-28 PM

The first of 4,000 Cerner employees begin moving into the first of two high-rise towers at the company’s new Cerner Continuous Campus in Kansas City, KS.

6-18-2013 8-36-18 PM

The Meditech system of Memorial Hospital (IL) has been down since June 11 after upgrade-related problems and won’t return to normal operation until June 24, forcing the hospital to go back to paper charts for almost two weeks.

6-18-2013 7-54-38 PM

The UK government fines North Staffordshire Combined Healthcare NHS Trust $86,000 for exposing the medical information of three patients by manually entering the fax number of a psychiatric facility incorrectly and sending it instead to someone’s house.

Sponsor Updates

6-18-2013 1-50-56 PM

  • Optum donates $10,000 to Arnold Palmer Hospital for Children (FL) in connection with its successful “Make Every Step Count” campaign during this week’s HFMA-ANI conference.
  • PeriGen pledges support for the first published draft of nursing care quality measures developed by the Association of Women’s Health, Obstetric  and Neonatal Nurses.
  • e-MDs expands its headquarters to three locations in the Austin, TX area.
  • An eClinicalWorks survey finds that the primary motivator for becoming an ACO or PCMH is to improve patient outcomes, with respondents also stating that an integrated EHR would be the most valuable IT feature.
  • 3M Health Information Systems introduces the 3M CAC System, a computer-assisted coding solution for small hospitals.
  • Bay Area News Group includes First DataBank on its list of Top Workplaces based on employee feedback.
  • David M. Walker, former US comptroller general, provides the keynote address at the SCI Solutions Client Innovation Summit October 15 in Braselton, GA.
  • Advocate Health Care (IL) says its use of the Healthcare Workforce Information Exchange from API Healthcare has given the organization the ability to link patient satisfaction with employee satisfaction.
  • Craneware introduces enhancements to its Chargemaster Toolkit software.
  • Hayes Management Consulting discusses common areas to consider for increased EHR efficiency.
  • GetWellNetwork integrates its Interactive Patient Care solution with Rauland Responder nurse call system to improve nursing workflow and communication.
  • Capsule posts a white paper that discusses medical device connectivity that is vendor-neutral, open architecture, and device-specific.
  • SRSsoft completes the first phase of certification for the 2014 Edition of the SRS EHR.
  • HIStalk sponsors AT&T and Ping Identity are included on Computerworld’s “100 Best Places to Work in IT 2013.”
  • MedAssets introduces its Procure-to-Pay Solutions suite, which is designed to enhance the management and oversight of contract compliance, standardization, and pricing accuracy.
  • Beacon Partners hosts a four-part Webinar on getting the maximum value from HIT systems beginning with a June 21 discussion on optimizing systems to improve workflow around patient access.
  • T-System posts a video highlighting its RevCycle+ solutions for physician.


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

More news: HIStalk Practice, HIStalk Connect.


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June 18, 2013 News 4 Comments

Morning Headlines 6/18/13

June 17, 2013 Headlines 1 Comment

Vitera Healthcare Solutions Announces Acquisition of SuccessEHS

Vitera announces the acquisition of Birmingham, AL-based SuccessEHS. Both vendors operate in the ambulatory EHR space. The acquisition expand Vitera’s user base to 10,500 organizations, 415,000 medical professionals, and 85,000 physicians. Financial details were not disclosed.

Mostashari asserts no more ICD-10 delays

Farzad Mostashari, MD gave the keynote address at the HIMSS Media ICD-10 Forum this week, during which he reiterated that there would be no additional deadline extensions for the ICD-10 switchover on October 1, 2014.

Apollo to scale up IT’s role in services 

Apollo Hospital is the first in India to be named a HIMSS (Asia Pacific) Stage 6 hospital, going live with CPOE and physician documentation on its Med-Mantra EHR.

Smooth move to electronic records in PT

Jefferson Healthcare, a Port Townsend, WA-based 25-bed critical access hospital and nine supporting clinics, goes live with Epic on Saturday morning at 2 a.m. The project was reportedly on time and on budget. Jefferson Healthcare is part of the Swedish Health Network.

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June 17, 2013 Headlines 1 Comment

Monday Morning Update 6/17/13

June 16, 2013 News 7 Comments

6-16-2013 6-49-56 PM

Three-quarters of poll respondents don’t believe EHR vendors should sell the de-identified data of patients who haven’t approved that practice. New (reader-suggested) poll to your right: what will be the effect(s) of the EHR Developer Code of Conduct? You may choose more than one answer and add your comments after voting.

6-16-2013 7-50-27 PM

Fans of the smoking doc HIStalk logo will like the old-new mash-up done by the folks at Billian’s HealthDATA. Inga and I think it’s pretty cool.

6-16-2013 7-31-27 PM 6-16-2013 7-41-01 PM

Welcome to new HIStalk Platinum Sponsor O’Reilly Strata Rx Conference, which runs September 25-27 at Boston Marriott Copley Place. It focuses on improving healthcare by acquiring, analyzing, and applying big data (the conference tagline is “Data Makes a Difference.”) Presenters include Jonathan Bush of athenahealth; James M. Maisel, MD of ZyDoc;  Richard Elmore of Allscripts; Jordan Shlain of Healthloop; Dale Sanders of Health Catalyst; and Michael Weintraub of Humedica. Fun events include speed networking, a startup showcase, and a five-minute presentation track. Use code HIST by August 15 and you’ll get 20 percent off on your registration, which ranges from $645 for Wednesday only to $1,925 for a three-day, all-access pass. Thanks to O’Reilly Strata Rx Conference for supporting HIStalk. I’m looking for interesting fall and winter conferences to attend if I can find the time and this one looks like a contender.

6-16-2013 7-17-14 PM

Speaking of HIMSS EHRA’s Developer Code of Conduct, its website doesn’t indicate which vendors have signed it, but Epic has, according to its site.

6-16-2013 9-18-56 PM

Mediware will announce Monday that it has acquired Fastrack Healthcare Systems, which will add home medical equipment systems to Mediware’s Alternate Care Solutions business.

Another acquisition will be announced Monday afternoon involving two physician practice system vendors, but I’m non-disclosed on that one.

Here’s a pretty funny video of athenahealth’s Jonathan Bush in a fake screen test (aka an athenahealth pitch) for Health Datapalooza.

From an AAFP interview with Farzad Mostashari: “I think that [physician EHR dissatisfaction] number may grow, because as we expand beyond the early adopters, the expectations for usable and intuitive technology are higher. I sure hope that the EHR vendors are hearing the same levels of dissatisfaction from their customers and their prospective customers that I’m hearing. I hope vendors are focusing on user-centered design in the next iterations of their software instead of adding more bells and whistles.”

6-16-2013 9-20-17 PM

Passport announces CareCertainty and PatientSync, which provide real-time notifications  of care transitions for population health management.

6-16-2013 9-21-30 PM

An article in the Madison newspaper provides a factoid about the brick building at 2020 Old University Road in Madison: it was the birthplace of both Epic and American Girl.

6-16-2013 7-23-04 PM

David LeClair, one of 140 athenahealth employees bicycling an 180-mile route from Maine to Massachusetts in the Trek Across Maine fundraiser for the American Lung Association, was killed Friday by a passing tractor trailer. He was 23.

6-16-2013 7-29-40 PM

Lucile Packard Children’s Hospital at Stanford notifies 12,900 patients that their information was present on a broken, unencrypted laptop that was stolen in May.

Among the 11 medical schools earning a $1 million AMA grant for education innovation are New York University and Indiana University, which will develop a virtual EHR using de-identified patient data to each students how to manage population health.

Winner of ONC’s Family Caregivers Video Challenge is “Grandma Safe and Sound,” in which Rachel Rust describes using Independa Angela, a tablet- and TV-based system that gives users video chat, e-mail, health information, schedules, reminders, and photo sharing, to help care for her 91-year-old grandmother. The announcement was six months ago, but I hadn’t seen it until ONC tweeted it.

6-16-2013 9-22-49 PM

AMIA launches a Student Design Challenge to re-invent electronic clinical documentation to reduce clinician burden, improve decision-making, encourage teamwork, and support reuse of the captured data. Graduate student team entries are due July 31.

6-16-2013 9-23-30 PM

An interesting blog post by Barbara Bronson Gray, RN wonders why we someone doesn’t offer a Genius Bar for everyday health issues. The obvious answer: Apple charges a premium for its products and can therefore afford to spend money improving user satisfaction at no charge, while in healthcare someone would have to be paid to provide services for free. It would be nice for hospital EDs, though.

6-16-2013 9-24-51 PM

A Harvard Law symposium contribution on the re-identification of genomic data sets cautions hype-happy newspapers and blogs to understand and accurately portray what they’re writing about, concluding, “… while this recent re-identification demonstration provided some important warning signals for future potential health privacy concerns, it was not likely to have been implemented by anyone other than an academic re-identification scientist; nor would it have been nearly so successful if it had not carefully selected targets who were particularly susceptible for re-identification.” It doesn’t mention similar recent articles describing re-identification of health information for accident victims by matching their records to newspaper accounts, but the conclusion might be similar.

6-16-2013 8-41-57 PM

Surgeon and mHealth innovator Rafael Grossman, MD, FACS describes his experience with Google Glass and his ideas for developing medical applications for it. Examples: sharing live OR video, distance education, telemedicine, surgical back-up, and viewing EMR data without being distracted. He calls on the American College of Surgeons to lead the way in using Glass to improve healthcare.

6-16-2013 8-52-14 PM

A Dallas newspaper article profiles Vivify Health (mobile apps for patient engagement and population health management) and Axxess (home health agency software.)

6-16-2013 8-58-57 PM

England’s National Audit Office finds that the now-defunct NHS National Programme for IT (NPfIT) cost a lot more than the benefits it delivered, and it’s doubtful it will ever pay for itself although estimation is difficult because of uncertainty. Three significant programs (Summary Care Record and the South and London programs) have delivered only two percent of the expected benefits.

Here’s Part 2 of Vince’s HIS-tory of Epic.


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

More news: HIStalk Practice, HIStalk Connect.


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June 16, 2013 News 7 Comments

News 6/14/13

June 13, 2013 News 3 Comments

Top News

6-13-2013 10-58-55 PM

The FDA urges medical device makers to protect their products against hackers and malware and offers guidance for developing security controls that would protect the confidentiality and integrity of data and limit malfunctions in the event of computer viruses.

Reader Comments

6-13-2013 10-40-52 PM

inga_small From Biker Dude: “Re: HIStalk Practice. What do I win if I am your 500,000th visit?” Thanks for noticing that HIStalk Practice is about to hit a milestone in the next couple of weeks. No prize for making the visit counter hit 500,000, though every reader has my undying gratitude for the support.

inga_small From Mojo: “Allscripts. I heard they are scheduling a conference call Friday to announce another reorg. Have you heard anything like this?” No, although another reader shared news that Allscripts had sold off its forms division (who knew they still had a forms division?) Unverified but neither piece of news would not be surprising given that CEO Paul Black has now had six months to get a lay of the land and the company reported a loss in Q1.

From Zee: “Re: inbox. I want to do a prototype on how we could improve the old-style physician inbox so that read-only information can be delivered in a meaningful way on a tablet. Replicating the current functionality as is isn’t innovation.” Sounds like a fun challenge to visualize how an improved inbox might work. Send me your ideas and I’ll run them here.

HIStalk Announcements and Requests

inga_small HIStalk Practice highlights from the last week include: CMS pays out $547 million in PQRS and e-prescribing incentives in 2011.  Physician compensation is increasingly tied to measures of quality and patient satisfaction. AHRQ offers a guide for primary care physicians connecting to RHIOs. As of the end of April, one out of two Medicare EPs were meaningful users of EHRs. MyMedicalRecords ends a lawsuit with Emdeon but initiates a new one with Jardogs. Emdeon CEO George Lazenby discusses his company, the industry, and potential opportunities. Rob Drewniak of Hayes Management Consulting looks at healthcare data governance and data stewardship. Thanks for reading.

On the Jobs Board: Compliance Program Manager, Software Engineer, Territory Sales Manager – South Eastern US.

6-13-2013 9-31-14 PM

Welcome to new HIStalk Platinum Sponsor Sagacious Consultants of Lenexa, KS. Sagacious means smart and having good judgment (I had to look it up), and the company applies those qualities to its singular focus: Epic. A full 97 percent of its employees came from Epic, collectively holding every Epic certification. The company has worked with 40 Epic hospitals and physician practices on full implementations, big bang installs, upgrades, and rollouts. It can provide build analysts, team leads, project managers, trainers, and go-live support. KLAS ranks it #1 in satisfaction for staffing and implementation support, with 100 percent of clients saying it keeps its promises and 100 percent saying they would hire the company again. Consultants work from their homes nationally, reducing travel billing and making them happier besides. Thanks to Sagacious Consultants for supporting my work.

6-13-2013 10-42-39 PM

The next HIStalk Webinar will be “Using Clinical Language Understanding & Infrastructure Planning as Key Strategies to Ensure Clinical Revenue Integrity with ICD-10” on Tuesday, June 25, 2013 from 1:00 – 1:45 Eastern time. It is sponsored by Nuance Healthcare and will be presented by Mel Tully MSN, CCDS, CDIP, senior vice president at J. A. Thomas and Associates. Register now.

6-13-2013 8-57-22 PM 

A reader provides this photographic evidence of a pop-up HIStalk presence in Paris, as evidenced by a “I Could Be Mr H” banner in the shadow of the Eiffel Tower. Snap a picture with something HIStalk showing HIStalk in an interesting location and I’ll run it here.

Listening: new Black Sabbath, with “13” being the first new studio album since 1995 and the first with Ozzy in 35 years. I’ve listened to it at least 10 times and it’s a perfect 1970s sludge metal sound. It’s magnificent.

Acquisitions, Funding, Business, and Stock

6-13-2013 10-43-58 PM

Allscripts prices a private offering of $300 million aggregate principal amount of its cash convertible senior notes due 2020. The conversion price represents a 30 percent premium to June 12’s closing price of $13.22 per share.

Emdeon acquires Goold Health Systems, a provider of pharmacy benefits and related services to state Medicaid agencies.


Christus Health selects McKesson’s suite of documentation management solutions for integration with the health system’s existing HIS.

6-13-2013 10-45-37 PM

Swedish Covenant Hospital (IL) selects eClinicalWorks EHR and RCM solutions for its 150 employed physicians.

The DoD awards PSI and partners TechWerks and Mediware a $9.2 million follow-on task order to sustain and maintain the DoD’s enterprise blood management system.


6-13-2013 11-37-45 AM

inga_small Aneesh Chopra,  former US CTO and one of technology’s most beautiful men, loses his bid to be Virginia’s Democratic nominee for lieutenant governor.

6-13-2013 8-38-30 PM

Quantros names Dmitri Daveynis (HP) SVP of engineering.

6-13-2013 8-40-35 PM

US Surgeon General Regina Benjamin announces her resignation after four years in the post. Benjamin does not provide specific details on her future plans, but Democratic Party officials have identified her as a potential candidate for a Congressional seat being vacated in her home state of Alabama.

Announcements and Implementations

Healthix and the Brooklyn Health Information Exchange will merge into a single RHIO and retain the name Healthix. A new board of directors will govern the entity and leadership and staff from both RHIOs will continue to support the organization.

Salford Royal NHS Foundation Trust implements Allscripts Sunrise Clinical Manager three months ahead of schedule and on budget.

KershawHealth (SC) implements a paperless clinical data bridge solution from Access to transfer EKG traces and other clinical data into its EHR.

6-13-2013 10-47-59 PM

Marshfield Clinic (WI) will form Marshfield Clinic Information Services, a  separate for-profit subsidiary that will support the clinic and technology and services to other customers. The clinic’s 350 IS employees will join the new entity.

IBM, the Premier healthcare alliance, and four healthcare systems launch the Data Alliance Cooperative, which will allow members to share experiences and co-develop solutions that integrate data across the care continuum. Initial focus will be on reducing medication non-compliance and readmissions through predictive modeling.

Innovation and Research

6-13-2013 10-50-30 PM

Interested in Google Glass? Kyle, who writes for HIStalk Connect, is part of Pristine, a startup that’s developing Glass apps for physicians. He has received his pair and invites readers to give them a try at a party in New York City on Thursday, June 20 from 6 to 9 p.m. at Galway Pub. E-mail Kyle to RSVP and bring friends if  you like.


6-13-2013 10-53-33 PM

Nuance releases a new version of Dragon Medical Practice designed for smaller practices that includes voice shortcuts to aid searches for medical information and more than 90 specialized medical vocabularies.


6-13-2013 10-54-53 PM

Care Logistics sues Ohio-based Catholic Health Partners of Cincinnati and Mercy Health Systems of Toledo, claiming it has lost $50 million after the health systems reneged on a 2008 deal to serve as reference sites for the company’s bed management software in return for royalties. 

Inga is so proud of beating Weird News Andy to this story. A trucker sues a urologist for what he claims was a botched penile implant that caused him to have an erection for eight months. The doctor says the man should have told him when his scrotum swelled to volleyball size, but the man says he was told to expect swelling. The patient, who changed his wardrobe to baggy sweatpants and long shirts, made his case to the jury: “I could hardly dance, with an erection poking my partner … It’s not something you want to bring out at parties and show to friends.”

Sponsor Updates

  • CollaborateMD will add educational content from Elsevier into its ClaimGear solution for medical billing and coding education.
  • NoMoreClipboard will integrate ICA’s HIE offerings with its PHR and patient portal.
  • Vitera Healthcare releases Vitera Medical Manager EHR, a Web-based EHR, analytics, and transaction platform for its customers.
  • Ingenious Med integrates Wolters Kluwer Health’s Health Language code search engine into its point-of-care charge capture solution.
  • Impact Advisors Principal John Stanley discusses analytics as it relates to HIE.
  • Emdat publishes a case study highlighting Illinois Bone and Joint Institute, which reduced its documentation costs by 50 percent after implementing Emdat’s medical documentation platform.
  • Porter Research discusses the role of NLP technology in healthcare transformation with Nuance CMIO Nick van Terheyden.
  • Perceptive Software CTO Brian Anderson offers five predictions for business process management, enterprise content management, and capture and search.
  • The office manager for Summersville Pediatrics (SC) shares her practice’s experience migrating from MyWay to Aprima.
  • PeriGen publishes a case study featuring Summit Healthcare’s (AZ) experience of implementing advanced perinatal technology.
  • David Laureau, CEO of Medicomp Systems, discusses the importance of giving providers the data required to better manage the health of individual patients in real time and at the point of care.
  • VitalWare’s VP of Compliance Jill Wolf will discuss the benefits and limitations of predictive modeling at next week’s HIMSS ICD-10 Forum Washington, DC.
  • Wolters Kluwer Health’s customer advisory board says that improving clinical outcomes through expanded integration of clinical decision support is a top priority.
  • iSirona will remain in Panama City, FL after the county and state promise $1.8 million in incentives. The company will 300 new jobs in the next three years.

EPtalk by Dr. Jayne

The United States Supreme Court ruled this week on Oxford Health Plans v. Sutter. Essentially this paves the way for physicians to use class arbitration to resolve issues with payers. Dr. Sutter, a pediatrician, alleged that Oxford systematically bundled, downcoded, and delayed patients for more than 20,000 network physicians but Oxford claimed physicians had to participate in arbitration as individuals. The case has been in the courts for more than a decade. I like to see the little guy stick it to the payer at least once in a while.

Medicare will be issuing a redesigned Medical Summary Notice to beneficiaries. Aimed at preventing fraud and abuse, it will show the services and supplies billed to Medicare during the past three months, the amount paid, and the patient responsible portion.

I’d like to see all payers take this approach. I’m still getting Explanation of Benefits statements from a procedure last year that the practice erroneously billed yet keeps trying to hit me up for the insurance balance. Guess what, not paying it. And to my orthopedic surgeon – guess what, you’re going to be refunding me all the co-pays you’re making me pay for follow-ups in the global period. Dr. Jayne has her summary plan description and knows how to read it. And if you cross me, I might just demand an electronic copy of my record, which I know will cause much consternation in your office. Welcome to the era of patient empowerment.

Athenahealth offers an ICD-10 Guarantee for practices that are live by June 30, 2014. Additionally, practices experiencing cash flow disruptions may be eligible for cash advances against outstanding claims. There’s a fair amount of fine print involved, but I like the idea.

Apple announced this week that the next generation of its mobile operating system will contain a virtual “kill switch,” or activation lock to allow stolen devices to be deactivated.

A couple of my friends convinced me to sit for the Clinical Informatics subspecialty certification from the American Board of Preventive Medicine. In reading through the various requirements I have one major concern (other than the cost of the exam, which is substantial). The criteria require current certification by one of the other ABMS specialty boards. This is problematic for informaticists who have let their clinical certifications lapse. I understand why they’re doing it, but the thought of maintaining two certifications isn’t a happy one. I’d be interested to hear from others who are planning to take the exam.

E-mail Dr. Jayne.


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

More news: HIStalk Practice, HIStalk Connect.

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June 13, 2013 News 3 Comments

News 6/12/13

June 11, 2013 News 12 Comments

Top News

6-11-2013 11-33-45 PM

The HIMSS EHR Association announces the EHR Developer Code of Conduct, which is available for companies that develop complete EHRs. Principles include (a) communicating product information accurately; (b) designing products with patient safety in mind; (c) participating in a Patient Safety Organization for reporting and reviewing patient safety problems; (d) sharing product-related best practices with customers; (e) notifying customers of software bugs that could impact patient safety; (f) excluding contract language that prohibits customers from speaking up about safety concerns; (g) supporting interoperability through use of standards; (h) giving customers their data if they switch vendors; and (i) documenting how the product handles coding and quality measurement. It’s nicely done, and while I’d rather see these items in my contract instead of in a voluntary set of principles issued by a trade association, I like the idea of laying them out publicly.

Reader Comments

inga_small From Nick Carraway: “Re: TeraRecon changes. Longtime president Robert Taylor is gone. CFO Lakshmi Lakshminarayan is serving as interim CEO.” We requested confirmation from TeraRecon and haven’t heard back. Lakshminarayan is listed as interim CEO on the company’s Website.

6-11-2013 7-47-46 AM

inga_small From Georgia Peach: “Marketing gimmick. I got a HFMA ANI postcard from an exhibitor in the mail that made me laugh out loud, especially because I’m a parent.” Now that’s a genius marketing promotion. Any parent who has felt the pressure to return from a trip with goodies for the kids will appreciate this giveaway, which includes two iPad minis so the winner can keep one for himself and give the other to a spouse or “favorite child.”

6-11-2013 11-36-58 PM

inga_small From Becky Badger: “In case it’s not on your radar, the Digital Health Conference is here in Madison this week and Judy Faulkner is a speaker this year. That’s notable because she rarely strays from the standard circuit.” Judy will participate in a panel discussion Wednesday morning on interoperability and information exchange. The other panelists are both Epic customers (Kaiser and St. Mary’s Hospital), so don’t be surprised if third-party EHRs fail to get much airtime in the interoperability discussion. Epic is also sponsoring the event.

From SNOMED Junkie: “Re: resignations. Both the CEO and chief technical architect of IHTSDO resigned today. That’s the non-profit that manages SNOMED content and distribution.” The announcements suggest that the Denmark-based organization made the change as part of a review of its long-term direction.

From Chas Incharge: “Re: McKesson Provider Technologies. They have lost market share but haven’t downsized marketing. Now it appears they want the marketing and sales team that oversaw the huge market share loss to do marketing for all technology business units. I’m a long-timer worried about my stock value. Harumph!” Unverified.

From Big Datty: “Re: Atlantic article. BKA in the EHR repeatedly, but the patient had both legs. Doesn’t anyone examine the patient any more?”The Drawbacks of Data-Driven Medicine” mentions an intern presenting a patient on rounds as having a below-the-knee amputation that had been noted on three previous discharge summaries. When the rounding team actually looked at the patient instead of the computer screen, both legs were intact. The incorrect information had been caused by speech recognition, which misunderstand DKA (diabetic ketoacidosis) as BKA (below the knee amputation) and nobody noticed.

Acquisitions, Funding, Business, and Stock

Great Point Partners makes a $10 million growth recapitalization investment in iVantage Health Analytics, a provider of healthcare informatics and business analytics solutions.

6-11-2013 8-08-02 AM

Parallon Business Solutions, a provider of business and operational services for the healthcare industry, will acquire The Outsource Group, a healthcare RCM company.

6-11-2013 7-18-19 PM

Ivo Nelson (IBM/Healthlink, Encore Health Resources) launches Next Wave Health, which will provide management advice, operational support, and capital to healthcare IT startups. Working with him will be Mike Davis, formerly of HIMSS Analytics and The Advisory Board Company.


Centra Health (VA) selects HealthMEDX Vision and the Exchange platform to manage post-acute patient care and facilitate patient data exchange.

6-11-2013 11-39-47 PM

Methodist Le Bonheur Healthcare (TN) will deploy McKesson’s enterprise medical imaging products.

Horizon Health Center (NJ) expands its relationship with eClinicalWorks to include its  Care Coordination Medical Record.

Piedmont Eye Center (VA) selects SRS EHR.

The Veterans Benefit Administration awards Harris Corp. a four-year, $37 million contract to provide technical services for the agency’s enterprise data warehouse.

Partners HealthCare (MA) will implement the Health Catalyst Late-Binding Data Warehouse across its two academic medical centers and community and specialty hospitals. Partners and Health Catalyst will also co-develop new clinical applications for the warehouse platform.

6-11-2013 11-40-40 PM

Hospital for Special Surgery (NY) contracts with SCI Solutions for its rules-based referral management system.

CAQH selects Passport Health to develop a national COB solution to improve the sharing of patient coverage data between healthcare providers and payers.


6-11-2013 7-16-48 PM

iSALUS Healthcare promotes Kimberly Poland to VP of client engagement.

6-11-2013 12-34-46 PM

Delta Health Technologies hires Lorraine Lodigiani (MedAct Software) as VP of marketing.

6-11-2013 12-54-32 PM

Zachary Landman, MD (Massachusetts General Hospital) joins DoctorBase as CMO.

6-11-2013 1-06-04 PM

Intellect Resources names Susan Williams (High Point University) VP of recruiting services.

6-11-2013 1-42-48 PM  6-11-2013 1-41-27 PM

Shareable Ink will on Wednesday name former Allscripts Chief Customer Officer Laurie McGraw as CEO, taking over for company co-founder Stephen Hau, who will transition to CTO.

Announcements and Implementations

VitalWare and Panacea Healthcare Solutions will co-market their CDM and pricing systems.

King’s Ridge Christian School (GA) becomes the first student health clinic to implement simplifyMD’s EHR software.

6-11-2013 10-22-21 PM

Yale New Haven Saint Raphael Campus and 63 practices and clinics went live on Epic on June 1, which followed the February 1 go-live of Yale New Haven Health System and the Yale School of Medicine, Epic’s third-largest go-live ever. CIO Daniel Barchi credits the Epic teams of the hospital and medical school and the clinician preparation at YNHHS Saint Raphael Campus for the smooth transition. The two remaining go-lives are Bridgeport Hospital and Yale Health, with the $293 million project targeted to finish ahead of schedule and under budget.

Urgent care provider CareSpot implements the PatientPoint Care Coordination Platform, including PatientPoint electronic check-in tablets, in 40 locations.

6-11-2013 11-11-19 PM

LifeNexus announces iChip, an insurance card chip that retrieves a patient’s personal health record.

6-11-2013 11-45-30 PM

San Joaquin General Hospital (CA) implements the Logical Ink mobile data capture solution from Bottomline Technologies to automate patient registration and identify trends in population health.

Het Oogziekenhuis Rotterdam (Netherlands) goes live with iMDsoft’s MetaVision in its OR, holding unit, and PACU.

AirStrip’s applications earn DIACAP certification from the US Air Force, indicating that their use of authentication and encryption meets Department of Defense security requirements.

Lake of the Woods Hospital (Ontario) goes live on Meditech.

GE Healthcare will invest $2 billion over the next five years to develop software for hospital operations, clinical effectiveness, and care optimization.

Salem Community Hospital (OH) implements the PatientSecure biometric patient ID system.

HIMSS will release a healthcare IT value model on July 15 that will incorporate user satisfaction, care delivery, user education, prevention, and financial return.

Government and Politics

The Justice Department and Securities and Exchange Commission, investigating a suspicious surge in insurance company stock prices, find that hundreds of HHS employees had early knowledge of an impending Medicare change and could have tipped off investors.

Innovation and Research

6-11-2013 11-46-43 PM

The Boston newspaper covers startups working on healthcare application for Google Glass, including an app for hospital rapid response teams and another for patients and families.


6-11-2013 3-02-19 PM

Verizon launches the Blackerry Q10, which it claims is tailored for the healthcare market. It will use the BlackBerry Enterprise Service 10 Regulated Service to help providers remain HIPAA compliant.


6-11-2013 11-50-36 PM

Six of the eight women allegedly sexually assaulted by former Epic project manager Brian Stowe are identified as his Epic co-workers, according to the criminal complaint. He’s accused of drugging them and filming the assaults. He was charged with 62 counts of felony and posted $500,000 in bail within 90 minutes of his May 31 arrest, but was re-arrested Monday on federal charges of sexual exploitation of a child. He has lost his job with Epic.

An Alameda County (CA) drug bust uncovers drugs along with personal information on about 4,500 Sutter Health patients. Officials are unclear about how the information got there, but say the data may contain patient demographics, including financial details and Social Security numbers.

Cerner paid $193,759 last year to a company controlled by its vice chairman Clifford Illig for use of its aircraft, also paying $184,579 to a second company owned by an Illig-controlled trust for fuel. Meanwhile, CEO Neal Patterson’s employment agreement promises him up to $110,000 for personal flights on aircraft that Cerner owns or leases and cash for any unused portion.

Weird News Andy says, “Soy vey!” A case study in NEJM describes a 19-year-old who drank a quart of soy sauce on a dare, leading to a hypernatremia-induced coma that lasted three days.

Sponsor Updates

6-11-2013 10-59-18 AM

  • ICA donates $6,000 to Pryor Ministry Center in the name of Lisa Lyon, clinical informatics coordinator at Cherokee Nation and recipient of ICA’s HIMSS13 booth giveaway. ICA partners HealthCare Anytime and CSC also contributed to the donation.
  • Ping Identity announces PingFederate7, an upgrade to its identity bridge software and cloud identity management platform that provides standards-based user provisioning, authentication, and authorization with support for cross-domain identity management and OpenID Connect identity standards.
  • Midas+ names 24 hospital customers as winners of its Midas+ Platinum Award based on a data analysis of utilization efficiency and outcomes.
  • PatientKeeper offers a June 27 Webinar on voluntary physician adoption of CPOE featuring the IS director and chief hospitalist of Community Memorial Health System (CA.)
  • VitalWare introduces VitalSigns, a claims auditing and ICD-10 financial risk assessment tool.
  • Ingenious Med reports that clients using its PQRS registry had a 100 percent reimbursement rate in 2012.
  • Medicity publishes a white paper on engaging patients within an ACO.
  • TELUS Health Solutions releases a white paper on the value of using and approaches for implementing home health monitoring solutions.
  • Frank Grella, director of patient financial services for T-System customer Conway Medical Center (SC), will discuss how his organization increased collections using a specialized ED billing solution during next week’s HMFA13 conference in Orlando.
  • Direct Consulting Associates interviews Michael Elley, CIO/VP of support services for Cox Medical Center (MO), who shares his thoughts on HIT leadership and management challenges.
  • iMDsoft and Anesthesia Business Consultants (ABC) partner to offer iMDsoft’s mobile solution for electronic documentation with ABC’s F1RSTUse EHR platform.
  • The Philadelphia newspaper interviews InstaMed Founder, President, and CEO Bill Marvin, who shares details of his company’s business model and history.
  • Park Place International joins the Citrix Solution Advisor program, allowing the company to offer Meditech-approved Citrix solutions to hospitals for three-tier connectivity.
  • SIS offers suggestions on choosing the right mobile device for OR use.


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

More news: HIStalk Practice, HIStalk Connect.


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June 11, 2013 News 12 Comments

Morning Headlines 6/7/13

June 6, 2013 Headlines No Comments

Ambulatory Physician Leadership Reports a 30-Point Usability Gap between EMR Vendors

A new KLAS report looks at ambulatory EMR usability by measuring performance across various common tasks such as e-prescribing, physician documentation, and medication reconciliation. Athenahealth come out on top, followed by Epic.

China’s PLA Among Eight State-Sponsored Groups to Hack VA, Ex Official Says

Former VA chief information security officer Jerry Davis reports that eight different state-sponsored organizations have been hacking into VA networks and databases that contain millions of veterans patient information. The continued breaches are due to weak user authentication and a lack of encryption of VA databases.

Cleveland Clinic Making Electronic Medical Records More Transparent To Patients Online

Cleveland Clinic will add physician notes, images, and results to its MyChart patient portal. A recent Robert Wood Johnston trial concluded that giving patients unrestricted access to physician notes led to increased patient engagement rates.

Dozens of health groups to create massive gene database

More than 70 medical, research, and advocacy groups are joining forces to create a massive databases of genetic and clinical data that will be accessible to doctors and researchers worldwide.

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June 6, 2013 Headlines No Comments

News 6/7/13

June 6, 2013 News 14 Comments

Top News

6-6-2013 10-40-50 PM

The former chief information security officer of the VA says the department’s networks and databases were hacked by at least eight foreign governments, including Russia and China. Jerry Davis, who was CISO from 2010 until February 2013, testified that the VA didn’t encrypt databases containing patient information, employed weak user authentication, and failed to address a backlog of 13,000 security-related corrective actions. A VA auditor says her group has identified 4,000 current security vulnerabilities, and when asked who was responsible, she blamed recently resigned former VA CIO Roger Baker.

Reader Comments

6-6-2013 7-58-13 PM

From Digital Bean Counter: “Re: Robert Wood Johnson / CMS data article on LinkedIn. I added a comment stating why I thought the CMS study is misleading and referenced Data Nerd’s recent Reader’s Write post on HIStalk. My comment was deleted. How are we to have a transparent industry if the organizations we work with are not willing to be transparent themselves?” RWJF issued a challenge for developing an app that would somehow make the useless CMS information valuable, to which I would issue a challenge of my own: explain exactly what a consumer would do with this information to save the healthcare system money.

6-6-2013 10-31-19 PM

From Another Epic Go-Live: ”Re: Plains Regional Medical Center, Clovis, NM. On June 1, the 106-bed hospital became the first of Presbyterian Healthcare Services’ (NM) eight hospitals to go live with Epic. The rest will be rolled out over the next year.”

From Sad Day in Madison: “Re: accused predator. Many are shaken since he is one of the ‘fast crowd’ of young Madison professionals who fly out every week, make a lot of money, and hit the bars on the weekend.” Brian Stowe, a 28-year-old Epic project manager, is charged with sexual assault after prosecutors say he drugged at least nine women and filmed himself with them. Police recovered videos and pictures as evidence. They also retrieved the Epic-issued laptop that was visible in them with the help of Epic’s HR people. The court commissioner set bail at $500,000 because Stowe has wealthy parents and access to savings from his job.

6-6-2013 9-25-26 PM 6-6-2013 9-26-19 PM

From Small World: “Re: Duncan James (above left) replacing Vern Davenport (above right) at MModal. Isn’t this the second time? Vern was CEO of Misys Healthcare when they owned what is now QCPR.” QuadraMed acquired Misys CPR in the fall of 2007, but Vern stayed with Misys until a few months later when Misys and Allscripts merged. He stayed with Allscripts for almost three years, then went to Quintiles for a short stay, and then to Medquist, which eventually acquired MModal.

6-6-2013 4-01-04 PM

inga_small From Ed Marx: “Re: European shoes. Saw these shoes and thought of you.” Ed is touring Europe and has been kind enough to send me a few photos to satisfy my shoe obsession. Always good to have options for next year’s HIStalkapalooza!

HIStalk Announcements and Requests

inga_small Some of this week’s highlights from HIStalk Practice include: eClinicalWorks, Allscripts, and NextGen are the dominant EHR providers for freestanding practices while Epic, Allscripts, and Cerner dominate hospital-owned practices, according to a HIMSS Analytics/CapSite report. CIMRO, the REC for Nebraska, sells off its HIT consulting division, ensuring the continuation of the consultant practice after CIMRO’s grant funding runs out. Athenahealth extends a guarantee that it will waive customer service fees if not ready for the ICD-10 transition by the October 2014 deadline. Children are more likely to be fully vaccinated for influenza when a popup alert is added to the EMR. A nasty storm could be brewing in Massachusetts as officials determine how to interpret and implement a state law requiring the meaningful use of EHR in order to obtain licensure. iPads and iPhones are physicians’ favorite devices for interacting with EHRs and staff. Dr. Gregg offers some clever humor for those rough HIT days. Join the fun and sign up for the e-mail updates when you checking out these stories. Thanks for reading.

6-6-2013 7-16-27 PM

Welcome to new HIStalk Gold Sponsor CliniComp. The company’s Essentris EMR suite lineup includes solutions for CPOE, critical care, perinatal and fetal, ED, acute care, data repository, and real-time clinical surveillance. CliniComp takes full contractual responsibility for their systems, eliminating the need for IT resources for configuration, testing, training, and servicing and allowing customers to focus on patient care. It’s a provider of EMRs for the Department of Defense. Thanks to ClinicComp for supporting HIStalk.

Here’s a CliniComp video on the Essentris clinical workflow suite.

On the Job Board: Senior Product Manager, Compliance Program Manager, Systems Implementation Engineer, Dental Imaging Specialist. HIStalk sponsors get free job postings.

6-6-2013 7-35-40 PM

The new Webinar program is going gangbusters with a bunch of them upcoming. I recruit at least two experts to review a recorded practice session with me, and the Webinar doesn’t get the green light until we think it’s of suitable quality for the HIStalk audience. If you are a provider executive willing to help me as an occasional reviewer, let me know. It takes about an hour to watch the video and jot down your recommendations, and you can do it whenever it’s convenient. I’ll send you a nice Amazon gift certificate for your time. I can use IT executives (CIOs and IT directors) and CMIOs or other informatics clinicians. My most pressing need is for a couple of HIM and clinical documentation improvement experts for the next scheduled Webinar.

Acquisitions, Funding, Business, and Stock

6-6-2013 10-33-56 PM

Endo Health Solutions says it will consider options for its HealthTronics urology business, will eliminate 15 percent of positions, and reduce annual spending by $325 million. The company reduced earnings estimates by two-thirds.

Ascension Health Ventures makes a strategic investment in GetWellNework.

Xerox acquires Tallahassee, FL-based LearnSomething, whose employee e-learning solutions are used by 85 percent of US retail pharmacy chains to educate staff about new products.


Dignity Health, Legacy Health, and Catholic Health Initiatives will use Blackbaud CRM for fundraising.

6-6-2013 10-36-36 PM

Thomas Jefferson University Hospitals (PA) selects ICD-10 Intelligence and Compliance and Revenue and Integrity solutions from MedAnalytics.

Neosho Memorial Regional Medical Center (KS) chooses Access to provide bar-coded wristbands and face sheets.

AMEOS Group will implement Cerner Millennium and Lighthouse at two of its German facilities.


6-6-2013 6-45-30 PM

QPID hires Janine Powell (Encore Health Resources) as VP of client services.

6-6-2013 6-46-11 PM

PatientsLikeMe names Marcia Nizzari (Good Start Genetics) VP of engineering.

6-6-2013 6-47-08 PM

Passport Health Chairman Jim Lackey joins NextGxDx’s board.

6-6-2013 6-47-40 PM

iHT2 CEO Waco Hoover is selected to co-chair the 2013 WEDI Report Initiative.

6-6-2013 8-20-07 PM 6-6-2013 8-20-40 PM 6-6-2013 8-21-14 PM

J. C. Lundquist, Jeff Nestor, and Linda Jackson join Lucca Consulting Group as regional VPs.

Announcements and Implementations

HealtheConnections, the RHIO for Central New York, goes live on eHealth Connect Image Exchange integrated with its Mirth HIE platform.

6-6-2013 10-38-10 PM

Cleveland Clinic announces that it will give patients access to physician notes, pathology reports, and health issues via its Epic MyChart patient portal.

The State of Georgia launches the first phase of GeorgiaDirect, a secure e-mail system based on the Medicity platform.

HealthBridge and the Ohio Information Partnership, which manages the CliniSync HIE, launch connectivity using Direct.

6-6-2013 8-16-19 PM

GE Healthcare kicks off its Centricity Imaging IT Tour 2013 with stops this week in Texas. The 60-hospital road show runs through early October.

Innovation and Research

More than 70 medical, research, and advocacy groups in 41 countries will create a research database of their genetic and clinical data. Among them are NIH, Dana-Farber, Harvard, MIT, Johns Hopkins, and Stanford. The organizations will develop ways to standardize the data and to implement privacy controls that respect patient choice.


6-6-2013 10-05-14 PM

Miami Children’s Hospital (FL) rolls out the Fit4Kids Care iPhone app that provides indoor campus way-finding, wait times, a physician directory, and the ability to purchase gift shop items and order room service.

6-6-2013 10-12-54 PM

All Facebook employees will by the end of 2013 use hGraph, an open source visual representation of health status. It can use EHR information to create many of its views.


Seattle Children’s Hospital reports that queries that took five minutes to run now finish in under four seconds after moving to IBM Big Data technology.

6-6-2013 3-44-34 PM

Greenway Medical Technologies opens its new corporate headquarters in Carrollton, GA.

6-6-2013 3-52-55 PM

Athenahealth scores highest in ambulatory EMR usability according to a new KLAS report. Success in achieving high usability in different EHRs ranged from 55 percent (McKesson) to 85 percent (athenahealth).

States are selling de-identified patient hospitalization information, but privacy expert Latanya Sweeney says the de-identification method isn’t hard to crack when you match the information against other databases. She paid $50 for records and was able to connect them to newspaper stories about accidents and crimes, thereby re-identifying the detailed medical records of 35 patients. An executive of a hospital performance data company says his employer immediately removes the ZIP codes provided by the states, saying they provide an easy link to other databases such that, “You might as well have the patient’s electronic medical record number.”

A Forbes opinion piece says electronic medical records are making doctors unhappy, saying (a) they turn doctors into box-checkers; (b) 75 percent of their capability does nothing except meet government mandates; (c) there’s no proof that government-mandated data collection improves care; and (d) conversion to ICD-10 will be expensive and will benefit mostly data miners.

The HIMSS EHR Association will announce creation of an EHR Developer Code of Conduct next week in Washington, DC.

The three doctors in Canada whose former employer refused to provide them with electronic copies of their patient files will get the information after all. Midway Walk-In Healthcare Centre followed the legal guidelines in sending paper medical records for a $35 fee, but pointed out that the law doesn’t require it to provide copies of electronic records even though a significant amount of  patient information is stored only in electronic form. The Ministry of Health intervened, convincing the owner of the walk-in clinic to obtain an electronic copy of the information from the clinic’s EMR vendor and send it to the departed doctors within 24 hours. The College of Physicians and Surgeons of Saskatchewan couldn’t help negotiate because the owner of the walk-in clinic isn’t a doctor.

Weird News Andy observes that migraines suck, but so does the cure. A writer in England says her migraine headaches were cured by hirudotherapy, applying leeches to her skin to remove blood.

Sponsor Updates

6-6-2013 2-07-45 PM

  • Billian’s HealthDATA and Porter Research employees participated in the Women in Healthcare Luncheon sponsored by the Georgia Association of Healthcare Executives.
  • Caradigm announces that one million caregivers are now users of its Identity and Access Management solutions.
  • Emdeon will present a series of educational sessions during AHIP Institute 2013.
  • HIMSS Analytics publishes the 5th annual US Ambulatory Electronic Health Record and Practice Management Study (previously published by HIMSS acquisition CapSite) which includes information on HIStalk sponsors ADP AdvancedMD, Aprima, eClinicalWorks e-MDs, GE, Greenway, McKesson, MedPlus MED3OOO, NextGen, OptumInsight, and Vitera.
  • Research and advisory firm Aite Group names PatientPay as the only new online bill pay provider working through PM software for maximum workflow efficiency. 
  • eHealth Technologies enhances its eHealthViewer ZF viewer to include real-time medical imaging collaboration and interaction.
  • T-System offers tips for earning optimal reimbursement for observation status.
  • Financial Post profiles TELUS Health, which has grown to be Canada’s largest EMR provider.
  • CCHIT certifies NextGen Electronic Dental Record version 4.3 with ONC 2014 Edition criteria as a Complete EHR.
  • Orion Health will participate in next month’s HIC 2013, Australia’s longest-running and largest HIT event.
  • Informatica introduces Vibe, an embeddable virtual data machine that provides a single simple virtualized data infrastructure.
  • Allscripts and its recent acquisition dbMotion host over 200 attendees at its dbU population health forum, which included a discussion of how Allscripts is driving care coordination, population health management, and consumer engagement. 
  • Frost & Sullivan recognizes Acuo Technologies with the 2012 North American Award for Market Share Leadership for its vendor-neutral archiving and enterprise imaging technologies. 

EPtalk by Dr. Jayne

Despite our voluminous coverage of Meaningful Use, CMS, and the ONC, HIStalk isn’t just about the US healthcare scene. Reports from across the pond note that an air ambulance had to abort its landing because off-duty “junior doctors” were hosting a BBQ near their lodging, which is close to the pad. For those of you who wonder where Oban is, it’s not far from Loch Lomond in Scotland.


Three physician Senators (Tom Coburn, John Barrasso, and Rand Paul) join Senator John Boozman in trying to block the implementation of ICD-10. The Cutting Costly Codes Act was introduced in the House in April. In addition to halting ICD-10, it calls for a study on preventing disruption during the migration from ICD-9.

The Senate has been busy in other ways, with Chuck Grassley and Ron Wyden calling for increased transparency in Medicare claims data. They plan to reintroduce the Medicare Data Access for Transparency and Accountability Act. The aptly acronym-bearing Medicare DATA Act as initially introduced  would create a publicly searchable Medicare payment database as well as ensuring that data on payments to physicians do not fall under an exemption for Freedom of Information Act requests.

Since I’ve apparently got a DC vibe going on this week, I’m interested to see what readers think about the Safeguarding America’s Pharmaceuticals Act. It’s aimed at creating a national system to make it easier to trace drugs from synthesis to market, which in theory should help fight drug counterfeiting. I’m counting on all of you because my knowledge of pharmacy IT systems is limited to calling retail chains in my area to see when they will be ready to accept electronic prescriptions for controlled substances and asking them not to send multiple refill requests before adequate time has elapsed for a physician response. What vendors do you think would jump into this space?


Here’s your opportunity to test your EHR’s ability to generate drug recall reports and your staff’s skill at documenting over-the-counter and herbal remedies. After years of us thinking Ginkgo Biloba was good to support memory, the National Institutes of Health releases a study indicating it might actually be a carcinogen.

One of my staff shared this piece about medical directors who search social media looking for “worrisome” issues during the hiring process. The article coaches would-be Facebook stalkers on what is appropriate to consider when determining if candidates match the office culture. It also reminds readers to steer clear of information that doesn’t belong in the hiring process including race and ethnicity, disability, religion, and pregnancy. It recommends considering using a third-party screening firm that is familiar with appropriate state laws.

I talked earlier this week about smart phones making us dumber. A regular reader sent me the link to this Northwestern University study on parenting on the digital age. Nearly 40 percent of families fell into the heaviest media use category with 11 hours of screen media per day. A New York Times blog notes that this time may have been double counted with parents using multiple screens, such using a computer while watching TV.

Researchers were surprised that parents were introducing their children to technology rather than simply responding to requests. Based on the behavior I see at the hospital (where the iPhone is the most popular childcare provider, at least in the ER) I’m not that surprised. There are ways to distract a hurt child that don’t involve Angry Birds. How about a book? Or telling them a story? I know my dad reads HIStalk regularly, so here’s a shout-out in thanks for all those retellings of Herkimer the Helicopter.


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

More news: HIStalk Practice, HIStalk Connect.


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June 6, 2013 News 14 Comments

Readers Write: The Year is 2025…

June 5, 2013 Readers Write 4 Comments

The Year is 2025…
By Nick van Terheyden, MBBS 

6-5-2013 9-45-36 PM

In 1963, Spock uttered the words: “Computer, compute to the last digit the value of Pi," and with that launched us into a world of human to computer interaction. Reaching that vision took many more years and it was not until the 1990s that the first realistic tools emerged onto the market.

By 2001, it was clear that speech recognition technology was set to revolutionize healthcare’s clinical documentation industry, but there were many naysayers stuck in the paradigm of dictation and transcription who were unconvinced that the technology could ever be better than a human at transcribing doctors notes from audio into text. Acceptance of speech recognition took longer than many had hoped, but innovation helped accelerate adoption.

Still, delivering on the vision laid out in the Star Trek episode mentioned above would require a little longer since that vision included not just speech recognition, but also intelligent understanding.

I recently had a conversation with an analyst about how healthcare technology would evolve by 2025. Today, the pace of change in speech recognition is incredible, and I’m seeing something similar in the field of natural language understanding (NLU). As such, it is clear to me that we will see a similar explosion of NLU, making it pervasive in every aspect of our interaction with technology.

NLU will in time make technology fluent in human communication. The days of learning a system are numbered as we move away from requiring humans to learn a “language” to communicate with technology. NLU is poised to reinvent the relationship between people and technology, and nowhere is the potential of this innovation more pervasive than healthcare.

To get a sense of how deeply natural language technology has already entered our lives, you need only to sit in your car, pick up the phone, or even start talking to your television. In healthcare, these intelligent systems equate to allowing clinicians to spend more time practicing medicine vs. filling in forms and entering data.

A recent study found that medical interns spend 12 percent of their time examining and talking to patients, but more than 40 percent of their time behind a computer. And it’s not just clinicians who want to change this statistic – it’s patients who are frustrated with focus being placed on the technology instead of the patient-doctor interaction.

My daughter remarked on this lack of human-to-human connection after a recent doctor’s visit, which opened my own eyes even more so to both the benefits and downfall of technology in healthcare. Luckily, tools like speech recognition and natural language understanding can help streamline the transition to digital care and enable the physician to focus their efforts on the patient instead of the extensive documentation process and check boxes associated with the visit.

As I look ahead, by 2025 I think NLU will be readily available for physicians and patients alike and will have a profound impact on healthcare as such. Here’s an example of a patient interaction I imagine taking place in the not too distant future:

“Please book the next available appointment with Dr. Jones for my annual checkup.”

The system knows my calendar and Dr. Jones’ calendar and my health coverage. As a result, it is able to compare the two schedules to find the next convenient slot for a 30-minute appointment. It would also know that the standard 10-minute appointment would be insufficient. It offers me the options, I confirm, and the appointment is set in both calendars.

If we add this type of medical intelligence to the world of the physician, the interaction would look something like Project “Florence.” Today, the first virtual assistants for healthcare, like Florence, are just entering adolescence. As intelligence capabilities improve, we can expect to see NLU permeate throughout the patient-physician interaction, intelligently listening in to the exchange and extracting out clinically actionable data for summarization and presentation to the patient and clinician for review.

In essence, smart NLU will help drive complexity out of how physicians and patients engage with technology as part of the two-way care process. That’s something even Spock would be excited for.

Nick van Terheyden, MBBS is CMIO of Nuance.

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June 5, 2013 Readers Write 4 Comments

News 6/5/13

June 4, 2013 News 3 Comments

Top News

6-4-2013 11-24-49 PM

inga_small Constellation Software acquires QuadraMed through its subsidiary, N. Harris Computer Corporation. According to Constellation, the purchase of QuadraMed “provides Harris with a platform to support its entry in the US healthcare information technology market.” Financial terms were not disclosed, though Francisco Partners has to be pleased to divest QuadraMed from its portfolio given QuadraMed’s fairly tired product line. FP sold off the company’s most valuable asset, the Quantim HIM product division, to Nuance in September 2012. We ran a reader rumor Sunday (in the Monday Morning Update) that something was going on with QuadraMed courtesy of Misys-Ex, who reported that managers were clearing out their offices and employees would be told how long they had left to work for the company. Meanwhile, President and CEO Duncan W. James leaves QuadraMed to serve as CEO of MModal.

Reader Comments

6-4-2013 11-23-21 PM

inga_small From Ritchie Valens: “Re:MModal. Shakeup at the top. One Equity Partners is calling the shots now that they are private. They are bringing in their own people since the company has been losing money.” MModal names Duncan W. James, former president and CEO of QuadraMed, as its new CEO, replacing Vern Davenport. The company also promotes David Woodworth from VP of finance to COO, replacing Amy Amick, and names Graham King (McKesson/HBOC) as chairman of the board. The official press release says Davenport and Amick have “chosen” to leave the company.

6-4-2013 7-56-50 PM

6-4-2013 7-56-06 PM

From GreenJoy: “Re: font.  I wonder if you can make the HIStalk font darker? As my eyes age, the font seems to blend into the gray background.” Here’s good way to make it more contrasty and also printable: click the “View/Print Text Only” link at the bottom of the post.

From FDASIA Attendee: “Re: FDASIA. On Friday morning after @farzad_onc gave his rousing inspiring presentation to the workgroup and us attendees, the Chair asked for exemplars of HIT situations from the workgroup. Notably Dr. Paul Tang of Palo Alto Health Foundation spoke of three incidents, the third being most interesting. He reported a death due to a double dosing of potassium ordered by a doctor via CPOE.  The point was that the CDS (decision support) failed to warn of the excess.”

From FindingSanity: “Re: CompuGroup. CompuGroup Medical AG removed its last US CEO, Henrik Cruger, in May. The new CEO, Norbert Fischer, has replaced him, but not publicly. This is the sixth CEO change in the five years since the German company opened up US operations. Layoffs and office closures preceded the changeover. Poor sales, poor product performance, and a never-ending trail of unhappy customers has been unfixed with each sudden regime change. Germany continues to struggle not only with the US healthcare market, but with understanding how to run an American company with American customers who all quit believing the company years ago.” Unverified.

Acquisitions, Funding, Business, and Stock

6-4-2013 11-26-05 PM

SimplifyMD raises $1.3 million of a planned $1.8 million round of funding.

6-4-2013 11-26-58 PM

Patient engagement platform vendor Seamless Medical Systems closes $2 million in early stage funding.


Baptist Memorial Health Care will implement Omnicell’s G4 Unity medication management solutions across its 14 affiliated hospitals.

MedCentral Health System (OH) selects Wolters Kluwer Health’s ProVation Order Sets.

6-4-2013 11-30-10 PM

Boone Memorial Hospital (WV) selects Medhost’s EDIS.

Practice management service provider MyHealthNetwork (GA) will use Valence Health’s population health management and clinical integration solutions to identify customized patient populations.

Twenty-five bed Memorial Medical Center (WI) selects CPSI as its EMR vendor of choice after finding that NextGen, according to the local newspaper, “was not equipped to meet MMC’s needs as a facility.”

6-4-2013 11-31-36 PM

Ocean Beach Hospital (WA) chooses Healthland Centriq EHR.

The University of Arizona Health Network selects Capsule’s medical device integration solutions for its ED, OR, and ICU.

The DoD awards Philips Healthcare Informatics an $88.5 million medical imaging contract.


6-4-2013 7-10-05 PM

Vocera Communications promotes Brent D. Lang from president/COO to president/CEO, replacing Robert Zollars, who will remain as executive chairman of the board.

6-4-2013 7-12-14 PM

Rick Gilfillan, MD, head of CMS’s Innovation Center, will leave his post at the end of June.

6-4-2013 7-59-45 PM

Jeffrey Ferranti, MD, MS is promoted to CIO/VP of medical informatics at Duke Medicine (NC).

6-4-2013 8-24-39 PM

Diane Adams (Allscripts) is named chief people officer of QlikTech.

Announcements and Implementations

Cerner names Abu Dhabi Health Services Company, King Faisal Specialist Hospital & Research Centre (Saudi Arabia), and the UAE Ministry of Health winners of its Cerner Achievement & Innovation Awards 2013, which recognize excellence in adopting HIT in the Middle East.

The SSI Group and ICA will combine EHR and claims data to give payers and clinicians insight into patient populations.

Covenant Medical Group (TX) implements PerfectServe’s secure clinical communication platform.

Australia’s NSW and Queensland Public Hospitals will begin implementing Cerner Millennium late 2013.

Sanford Bemidji (MN) goes live on Epic.

Wolters Kluwer Health releases a Controlled Substances File for its Medi-Span drug database solution to help providers, pharmacies, payers, and EHR vendors adhere to controlled substance prescribing and reporting requirements.

PatientCo will integrate Streamline Health’s business analytics solution into its patient financial engagement platform.

Government and Politics

inga_small HHS Secretary Kathleen Sebelius announces the release of hospital outpatient charge data and details about which  EHRs are being used by EPs for MU attestation, saying that, “a more data driven and transparent healthcare market can help consumers and their families make important decisions about their care.” If that’s the case, why doesn’t Big Data CMS address possible concerns about privacy and security and then release much, much more data from its vast stores?

Innovation and Research

6-4-2013 11-34-53 PM

The Robert Wood Johnson Foundation launches a developer competition that will award $120,000 in prizes for creating technology components that turn the recently released CMS hospital pricing data into “intuitive, actionable tools.” Developers who can do this will earn their prize given that the CMS information is close to worthless, even to those few consumers who are willing and able to try to make sense of bizarre hospital Medicare and Medicaid pricing practices (from that same CMS, ironically enough) that probably don’t pertain to them.

Healthcare crowdfunding site Health Tech Hatch runs a Blue Button CoDesign Challenge to accept idea submissions that complete the sentence, “Build me a Blue Button-enabled tool that …” and then letting the community vote (through June 11) for the developers that will be chosen to build Blue Button prototypes for judging in August. Above is National Coordinator Farzad Mostashari describing the contest from Health Datapalooza on Monday.

The White House proposes patent troll legislation that would require companies threatening patent lawsuits to disclose who actually owns the patent, to initiate protection of end users of technology that is the subject of a patent claim, and to review policies and increase education. A commissioned study finds that patent trolls file 62 percent of infringement lawsuits vs. 29 percent just two years ago. The study specifically quoted health IT examples, including (a) the difficulty in separating function vs. means of delivering the function in medical imaging software, and (b) a healthcare technology vendor that had to cease research on a particular technology while being sued by a patent troll, causing its sales to drop by a third.

An NIH-funded study at Partners HealthCare finds that EHR information can complement evidence-based clinical decision support by identifying physician “group intelligence,” with the example being a better way to identify ordering of excessive lab tests by looking at patient subpopulations and concurrent medical situations instead of just lab data alone.

6-4-2013 10-20-58 PM

Kaiser Permanente announces the launch of its first application programming interface, which will allow developers to build apps using a database of Kaiser’s hospital and medical office locations. Hopefully their experience will encourage them to eventually open up access to something more useful. Travis has already played with the API and has thoughts on HIStalk Connect.


6-4-2013 11-38-02 PM

Palomar Medical Center blames declining reimbursements, state budget cuts, and sequestration for its decision to lay off 84 employees, or about two percent of its workforce, as of July 26. It opened a billion-dollar new hospital in August 2012.

Heritage Provider Network awards $500,000 to POWERDOT.HPN, whose team is leading in a challenge to create an algorithm that predicts how many days a patient will stay in the hospital.

6-4-2013 10-53-20 PM

Practice Fusion launches Insight, a real-time analytics service that sells the patient information stored in its free EHR database to drug companies, including “real-time data covering diagnoses, prescribing behaviors, patient demographics and more.”

6-4-2013 7-33-11 PM

inga_small The Annals of Internal Medicine publishes a report finding that less than 10 percent of physicians have EHRs that meet Meaningful Use criteria, leading the authors to remark that the results “should be of concern to policy makers.” What should be of concern to just about everyone reading the report (including the publisher) is that the findings are based on data collected from late 2011 to early 2012. Perhaps none of the Annals of Internal Medicine editors have noticed recent reports that more than 50 percent of EPs have demonstrated MU, and EHR adoption has grown dramatically in the last 18 months.

The Pennsylvania Patient Safety Authority finds that using a hybrid mix of paper and electronic records for clinical documentation, either during an EHR transition or as a workaround, causes errors, mostly because of faulty handoff processes.

6-4-2013 7-41-35 PM

Boston Children’s Hospital (MA) is piloting MyPassport, an iPad app that helps patients identify their caregivers and understand their care better.

Three doctors in Canada change practices only to find that their former employer refuses to provide the electronic medical records of their patients, offering only the partial information kept on paper. The law requires only that paper records be made available.

Weird News Andy wants to know whether it’s cider or balsamic. A cheap vinegar test, serving as a replacement for unaffordable Pap smears in India, reduced cervical cancer deaths by one-third in a study of 150,000 women living in India’s slums. Minimally trained locals simply swab the cervix with diluted vinegar and check for a color change that indicates the presence of abnormal cells. Despite the benefits, the challenges in India are substantial: most women give birth at home having never visited a physician, the culture doesn’t allow them to make decisions for themselves without the approval of a man, and one health worker was beaten by a local mob when women found they had to take their clothes off for the screening.


Sponsor Updates

  • HealthMEDX announces the general availability of a bi-directional pharmacy interface between its Vision product and Omnicare.
  • Crain’s Chicago Business names Impact Advisors and Allscripts to its list of the 50 fastest-growing public and private companies in the Chicago area based on five-year revenue growth.
  • Craneware showcases its Pharmacy ChargeLink technology at this week’s American Society for Health-System Pharmacists 2013 Summer Meeting and Exposition in Minneapolis.
  • Lifepoint Informatics will serve as a gold sponsor at next week’s MDx NEXT conference on molecular diagnostic testing and genomic medicine. Also at the MDx NEXT Conference: Halfpenny Technology will demonstrate its clinical data exchange solution for molecular laboratories.
  • Besler Consulting and TeleTracking Technologies are awarded “Peer Reviewed by HFMA” designation.
  • John Fangman, MD and Michael Barbouche of Forward Health Group spoke at HealthDatapalooza IV this week in Washington DC, presenting with the Aids Resource Center of Wisconsin on managing high-risk HIV/AIDS populations.
  • ZirMed will launch a new brand and demonstrate its RCM, clinical communications, and analytics solutions at the HMFA 2013 Annual Institute conference June 16-18 in Orlando.
  • Info-Tech Research Group recognizes CommVault as an industry “champion” in virtual backup software, e-mail archiving, and backup software for heterogeneous environments in its “Vendor Landscape” report.
  • The Advisory Board Company launches the National Population Health Symposium September 13 in Washington, DC to give provider thought leaders the opportunity to collaborate on managing risk and migrating to a population health delivery system.
  • MediGain and ADP AdvancedMD post a video of their co-hosted Webinar on helping physicians prepare for healthcare reform.
  • Billians HealthDATA adds the latest AHRQ data to its online hospital database line-up.
  • Alere Analytics launches its clinical surveillance solution for infection control and medication management.
  • CareTech Solutions will participate in this month’s Ohio Hospital Association Annual Meeting and the Michigan Association Annual Meeting.
  • Ryan Tracy, MD of Diablo Valley Pediatrics and his staff discuss how their use of ADP AdvancedMD EHR eliminated manual process inefficiencies.
  • Care Team Connect hosts a July 10 Webinar on preventing readmissions.
  • Versus client Western Maryland Health System is featured in a June 20 AHA webinar on staff safety.
  • Informatica kicks off its Informatica World 2013 user conference and will make keynote sessions available via live Webcast.
  • EMDs highlights its support of the University of Texas Health IT program.
  • Hayes Management Consulting expands its clinical and revenue cycle optimization service lines to include increased focus on measuring outcomes and outcome-driven operational improvement services.
  • In a June 20 Imprivata-sponsored Webinar, Larry Ponemon reviews the findings of Ponemon Institute’s study entitled, “The Economic & Productivity Impact of IT Security on Healthcare.”
  • Beacon Partners hosts a June 7 Webinar with executive consultant Cindy Friend discussing how the PCMH model supports ACOs.
  • Nuesoft looks at the need of specialists for customized EHRs.
  • The Huntzinger Management Group launches Huntzinger Staffing Solutions, which will HIT implementation resources.


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

More news: HIStalk Practice, HIStalk Connect.


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June 4, 2013 News 3 Comments

News 5/31/13

May 30, 2013 News 5 Comments

Top News

5-30-2013 8-38-04 PM

A letter to the editor in The New York Times by National Coordinator Farzad Mostashari says public policy is making the healthcare system smarter, citing the recently announced figures that half of practicing physicians and 80 percent of hospitals are using EHRs.

HIStalk Announcements and Requests

inga_small Some HIStalk Practice highlights from the last week or so: WNA makes a rare HIStalk Practice appearance to comment on a physician who has quit taking insurance. Physician satisfaction with their EHR vendors has declined over the last year. Almost one-third of physicians buying EHRs today are replacing legacy EHRs. Physicians fear that declining reimbursements, rising costs, and ACA-related requirements will threaten practice profitability. Athenahealth recognizes Midland Orthopaedics with its athenaVision award. Most nurse practitioners believe a practice led by an NP should be certified as a PCMH, but most physicians disagree. Dr. Gregg posts a letter to Allscripts. Thanks for reading.

We’ve had some interesting posts on HIStalk Connect lately, so you might want to sign up for e-mail updates if you follow mHealth, innovative technology, and startups. Lt. Dan also does a Friday weekly news recap there that provides a great summary. Some recent articles:

Tim Cook Discusses Wearables, Acquisitions, and Executive Changes at D11 Conference
The Third Screen Revolution in Healthcare Is Before Us
How Consumers Enter the System
EHRs Propagate “Best” Practices
Healthcare Q&A
VentureHealth Launches Equity Backed Crowd Funding Site
Texting for Health Revisited

Acquisitions, Funding, Business, and Stock

5-30-2013 10-27-09 PM

Shareable Ink raises an additional $3 million, bringing its total funding in the last three years to over $14 million.


Bon Secours Health System Center for Clinical Excellence and Innovation selects Quantros to advise on performance improvements to advance ED quality and safety.

5-30-2013 3-59-37 PM

Southpoint Surgery Center (FL) selects Wolters Kluwer Health’s ProVation MD and ProVation MultiCaregiver.

5-30-2013 4-00-19 PM

The Pennsylvania eHealth Partnership Authority signs a five-year agreement with Truven Health Analytics for its HIE solution.

Clyo Internal Medicine (OH) selects simplifyMD as its EHR provider.

5-30-2013 4-01-48 PM

The University of Miami and the University of Miami Health System will deploy Hyland Software’s OnBase enterprise content management solution across 60 academic departments, 30 outpatient facilities, and three hospitals.

5-30-2013 4-03-04 PM

John C. Lincoln Health Network (AZ) selects Besler Consulting to assist in the identification of Medicare Transfer DRG underpayments.


5-30-2013 4-04-35 PM

AirStrip names OptumInsight CEO Bill Miller to its board.

5-30-2013 5-23-59 PM

Verisk Health EVP Brian Smith joins the advisory board for telemedicine provider SnapMD.

5-30-2013 2-19-16 PM

Explorys appoints Cleveland Clinic CFO Steve Glass to its board.

Announcements and Implementations

5-30-2013 5-31-21 AM

Advocate Physician Partners (IL), a care management collaboration with Advocate Health Care, implements its 500th independent physician on SynAPPs, Advocate’s cloud-based version of eClinicalWorks EHR.

Practice Fusion announces preferred billing partnerships with ADP AdvancedMD, CollaborateMD, and NueMD.

The Idaho Health Data Exchange and St. Luke’s Health System launch Image Exchange viewing capabilities by eHealth Technologies.

5-30-2013 10-29-54 PM

Malcom Randall VA Medical Center (FL) installs Welch Allyn’s Connex Electronics Vitals Documentation System.

Edward Hospital & Health Services (IL) deploys Levi, Ray & Shoup’s VPSX print management and document delivery system its Epic system.

5-30-2013 10-31-36 PM

PDR Network will distribute drug company patient support coupons from OPTIMIZERx via EHRs.

SCI Solutions releases Order Facilitator v10, which includes mobile ordering, expanded messaging, and enhanced capabilities for lab order requisitioning, collection, and labeling.

Nuance publicly confirms for the first time that its speech recognition technology powers Apple’s Siri, with CEO Paul Ricci stating at a conference, “We are the fundamental provider of voice recognition for Apple.”

In England,NHS chooses BJSS and Valtech as finalists to develop an electronic referrals service to replace Cerner’s system.

5-30-2013 8-17-36 PM

The MUSE conference is underway this week in National Harbor, MD, wrapping up Friday. The photo above of Farzad Mostashari delivering the keynote was posted to Twitter by Dan McQueen.

5-30-2013 9-03-02 PM

CureMD will demonstrate a new chemotherapy administration module of its oncology EHR that it says took five years to develop next week at the American Society of Clinical Oncologists conference in Chicago.

Government and Politics

CMS advises practices on the role of clearinghouses in the ICD-10 transition, noting that, “While clearinghouses can help, they cannot provide the same level of support for the ICD-10 transition as they did for the Version 5010 upgrade.”

The HHS Office of Inspector General finds that healthcare provider information maintained in the National Plan and Provider Enumeration System (NPPES) and Provider Enrollment, Chain and Ownership System (PECOS) was often inaccurate, occasionally incomplete, and generally inconsistent between the two databases. In NPPES, 48 percent of records contained inaccurate data; 58 percent of PECOS records contained inaccuracies. 

5-30-2013 8-03-47 PM

HHS launches the “Information is Powerful Medicine” campaign that targets HIV/AIDS sufferers.

A group of Senate Republicans calls for an independent investigation of HHS Secretary Kathleen Sebelius, claiming that her fundraising efforts for Enroll America, a non-profit that promotes the Affordable Care Act, is inappropriate and possibly illegal in appearing to solicit donations from industries she is responsible for regulating.


5-30-2013 2-41-02 PM

The Health Information Trust Alliance, which promotes data security among healthcare providers, experiences a cyber attack of a non-critical, standalone public Web server. HITRUST a test database with fictitious data was compromised.

Bon Secours Hampton Roads Health System notifies 5,000 patients of a potential EHR security breach after discovering that two clinicians had accessed patients’ medical records “in a manner that was inconsistent with their job functions and hospital procedures.” The hospital has terminated the pair and is offering affected patients free credit monitoring services.

In England, Royal Berkshire Hospital says its problem-plagued Cerner Millennium EPR forced it to write down $23 million. According to the hospital’s CEO, “Unfortunately, implementing the EPR system has at times been a difficult process and we acknowledge that we did not fully appreciate the challenges and resources required in a number of areas.”

Australian researchers review the use of CSC and Cerner CPOE systems in a small-scale study that suggests systems with more drop-down menus may increase error risk.

EMR reminders driven by a connection to New York City’s vaccine registry increased children’s flu vaccine rates by 9 percent, and when physicians chose not to order the vaccine, they documented the reason 98 percent of the time. The results were presented at a pediatrics conference earlier this month.

Despite performance challenges with Meditech 6.0, 95 percent of the company’s customers surveyed by KLAS say Meditech is part of their long-term plans, citing affordability and usability.

5-30-2013 10-34-42 PM

A New York Times article says Beth Israel Medical Center (NY) allowed an elderly heiress worth $300 million to occupy one of its rooms for the last 20 years of her life, but launched “an all-out fundraising campaign” in having executives hang around her room to hit her up for donations and drop hints about making a will. The CEO’s mother even watched a Smurfs video with her hoping to get on her good side.  

Weird News Andy titles this story Step 1: Insert Pencil. A German man complaining of headaches and a runny nose is found to have a four-inch pencil embedded in his head, lodged there 15 years previously in a childhood accident.

Sponsor Updates

  • SIIM and Brad Levin of Visage Imaging have developed a three-minute survey for IT imaging leaders to bring visibility to imaging challenges before next week’s SIIM13 conference in Dallas.
  • Dorland Health names Vocera subsidiary ExperiaHealth the winner of its Case in Point Platinum Award for Discharge Planning Program for its use at Cullman Regional Medical Center (AL).
  • RazorInsights exhibits its ONE Enterprise EHR at next week’s Alabama-Georgia Rural Health Clinic Conference in Opelika, AL.
  • SuccessEHS client ARCare (KY/AR) achieves Stage 6 on the HIMSS Analytics EMR Adoption Model.
  • Imprivata announces that it has the highest market share of any SSO solution among US Meditech EHR hospitals (36 percent) and that the number of hospitals using Imprivata OneSign has increased about 57 percent in the last year.
  • e-MDs posts a Webinar that includes advice for physician practices on health information exchange and Stage 2 MU.
  • Impact Advisors principal Laura Kreofsky and senior advisor Jason Fortin discuss why achieving Stage 2 MU could be challenging.
  • Awarepoint is named a Red Herring Top 100 North America Tech Startup.

EPtalk – by Dr. Jayne


ICA achieves EHNAC Accreditation as a Direct Trusted Agent. Other vendors recognized include Cerner, Max.MD, and Surescripts. All four were accredited for Registration Authority, Certificate Authority, and Health Information Service Provider criteria.

The HIMSS14 Call for Proposals ends next week. It’s hard to submit timely topics nearly a year in advance, but if you’re like those of us in the nonprofit trenches, it may be the only way to have a trip to HIMSS approved. You wouldn’t want to miss an opportunity to attend HIStalkapalooza, would you?

Speaking of educational opportunities, CMS offers a National Provider Call on June 5 to help providers get started with PQRS and the Value-Based Payment Modifier programs. CMS experts will also be available after the presentation to answer questions.


The University of Illinois at Chicago creates an ICD-9 to ICD-10 website. Maybe I have a warped sense of fun, but I enjoyed fiddling with it, and the results make for some frightening diagrams to spice up ICD-10 presentations.

A friend of mine e-mailed this blog by Reid Blackwelder MD, president-elect of the American Academy of Family Physicians. He tells the tale of a neighbor who fell and was taken to the ER where he was possibly misdiagnosed and discharged, then had to return for more extensive testing and a final diagnosis. Along the way, key clinical signs (like his inability to walk) were missed. Treating the numbers (test/lab/film) rather than the patient has become epidemic in the US. Is it defensive medicine, time pressure, the influence of Big Data, or simple lack of caring? I don’t know the answer, but we have to figure out a way to do better.

The article came at the same time that I was having a heated e-mail exchange with an IT colleague about whether we should push our vendor to incorporate genomics content in the EHR. I find it difficult to think that the average physician is going to be able to understand and act on genomic data when our healthcare delivery system so stressed that stories like Dr. Blackwelder’s exist. Of course that’s assuming we figure out a way to pay for gene sequencing and the subsequent treatments suggested by the data, which was the source of the original heated exchange.


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

More news: HIStalk Practice, HIStalk Connect.


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May 30, 2013 News 5 Comments

HIStalk Interviews Frank Naeymi-Rad, Chairman and CEO, Intelligent Medical Objects

May 29, 2013 Interviews 8 Comments

Frank Naeymi-Rad, PhD is chairman and CEO of Intelligent Medical Objects of Northbrook, IL.

5-29-2013 7-22-20 PM

Tell me about yourself and the company.

I received my computer science doctorate degree from Illinois Institute of Technology. My dissertation research work was in developing medical dictionaries that support electronic medical records, decision support, and information retrieval used at the point of care.

I got introduced to medical terminology when I was teaching classes to medical students, where I was directing academic, research, and administrative information services at the Chicago Medical School. These classes included use of computers for directed history and physical documentation, informatics workup, and concepts in medical artificial intelligence as senior electives.

During the senior elective setting, I wanted students to build knowledge for different decision support applications. The major task and challenge that we had developing knowledge for the decision support was standard terminology. Each system had its own dictionary. The systems we used were MEDAS, Dxplain, QMR, Knowledge Coupler, and Iliad. The medical students had to build knowledge for pattern recognition as well as rule-based decision support and application.

The knowledge created by students for a given diagnosis was then compared to knowledge within these expert systems for the same topic. The key learning objective was that everyone learned how the computers were used to make decisions and the results could be manipulated to reflect the new discoveries.

During that process, the most important aspect that came out was when we compared students’ patterns to other expert systems. It became clear that what was missing was standard medical terminology. This became the topic of my dissertation. It was really the concept of capturing and preserving the truth, what the source of truth about a given decision was and how the decision was made by the computer.

It was then necessary to reverse engineer the patterns back to the original form to explain why it led to the need to build a dictionary that students used to codify the rule. This allowed us to compare the pattern across multiple domains using the same foundation dictionaries. This led to my dissertation topic, which was a feature dictionary for clinical systems and electronic medical records.

The ultimate test was how the students’ knowledge would perform when interfaced to real patient data. Into the late 1980s and early 1990s, there were no coded electronic records. This led to the development of a history and physical documentation program on the Apple PowerBook for medical students. This program was expanded as a tool for second-year students as part of a supplement for the introduction to the clinical medicine class.

This program allowed students to develop comprehensive documentation for the history and physical exam. While the objective was to a develop a patient electronic record that could be used to test the student decision support pattern, instead it led to the creation of an electronic medical record which was used a the Cook County ER. IMO was created to help commercialize the product that was sold to Glaxo Wellcome, which at that time was called HealthMatic.

Later on, HealthMatic was sold to a company called A4 Sytems, and then A4 Systems sold its assets to Allscripts. The EMR that we developed at the medical school, with the help from many of the same IMO team developers working with me at the medical school, helped commercialize it. The current generation is called Allscripts Professional.

You can understand how the team who is working at IMO right now are key players in the industry. This is the same team from the medical school as well as the same team that developed the early clinical documentation for HealthMatic and medical content work for Glaxo Wellcome.


Describe how IMO’s product and the terminology works with EHRs.

Our flagship product is interface terminology. Our primary objective is to capture and preserve the clinical intent and then map that clinical intent — the truth — to their corresponding regulatory requirement. Interface terminology manages and maps between clinicians’ terms and the required regulatory code terminology like ICD-10 and Meaningful Use codes as well as reference terminology like SNOMED CT.

The way we have succeeded is that we have removed the overhead of making a clinician to be a coder. They can say what they want to say. We manage the code and mapping and help our EHR partners to capture and preserve the truth.


Who is your most significant competitor?

The competitors that I see are people who do not really understand the challenge of terminology and the importance of preserving the clinical intent. Fortunately and unfortunately for us, I think the knowledge base within the marketplace is growing. We need a dynamic model to respond to these changes as soon as possible.

We are very happy that we are able to help our partners meet regulatory standards. Adaption of standards is a very daunting task for many of our vendor partners. There has been a lot of movement in our space because most of the new regulatory standards require several new coding subsets.

We expect large and innovative competitors coming into the terminology space. What they are missing is the understanding of the electronic medical record and how terminology should be used within the electronic medical record. Having the EHR knowledge expertise gives a true edge to IMO’s team as the market moves from fee-for-service to fee-for-performance.

There are many competitors within the terminology space. We have competitors who are managing the coding for reimbursement and now have to also do clinical. We have competitors who sell you tools in order for you to manage the complex mapping for the coding within the clinical setting.

Terminology management is hard and tedious work. We have a unique group of knowledge workers and physicians because they are good at it and love doing it. Adding to that our technology team, with the understanding of the electronic medical record and how terminology is used within the electronic medical record, creates a major barrier for others to match the quality of our service delivery.


What parts of HITECH have caused both vendors and providers to seek you out as a company?

It’s compliance to the Meaningful Use requirement and making sure that they are able to manage the changes associated with Meaningful Use requirements. When you look at our portfolio of clients, they initially used us to enhance clinical searching and finding codes for reimbursement. I believe Meaningful Use is creating a unique challenge for them because it is moving the market from fee-for-service to fee-for-performance and that aspect of care creates a unique attribute and need of understanding the use of terminology within the state of care. Our interface terminology service is to make sure that the truth about clinical data is stored as expressed by the clinical team.

For example, when you’re on the same term within the assessment, it may have a different ICD-9 code versus that same term in the history section. Being able to have a concept-based architecture that manages this complexity allows for correct mapping to ICD-9 as well as to ICD-10 complex billing post-coordination, but also maps to SNOMED CT and other required Meaningful Use terminology subsets.

We take that complexity out. We manage that complexity within our tool set and then we deliver those to our client base, allowing their clinical user community intent to be preserved so we can also code for care.


A recent study found that IMO’s interface terminology can identify population health issues when paired with EHR data. What are the implications of what that study found?

The early studies that I did historically looked at finding the clinical truth. You really want to make sure that what clinicians are saying is preserved in their words and that the data being collected is following guidance dictated by the clinical team. The data collection service needs to provide terms that reflect the clinician intent in its original form.

We as a company have been very fortunate to be trusted by and permitted to serve one important population of our society, and that’s the clinician. We believe clinicians are under massive pressure to do their job through primitive electronic documentation services that do not speak their language.

I worked at the medical school for 12 years and I observed students going through all of the different stages of medical training. I understand and appreciate the difficulties physicians have to go through in their medical training. The knowledge base learned as part of their training is their most important tool to make them master problem solvers. Capturing and preserving their clinical intent is always the best card we have in understanding exactly what is wrong with the patient and even when a physician is making a wrong assumption.

Our interface terminology allows the truth to be preserved and not distorted by coding optimization templates or services. Preserving the physician intent is responsible for the success of this study, identifying 99 percent plus patients correctly in this publication. By empowering the clinical team and using IMO interface terminology, we are going to have a near perfect understanding of our patients at risk.


What’s your perception of the state of readiness for ICD-10 transition and what impact this is going to have on providers?

The impact for our vendor partners is going to be nominal because we knew going from 14,000 ICD-9 codes to 90,000 ICD-10 codes will be a massive transformation for many EHR vendors. But for our clients, it’s different because we started distributing ICD-10 mapping last year and we have been working with them to deliver their point of service solution.

As part of our support for ICD-10 CM, PCS, and MU 2, we are expanding our terminology foundations by 3,000-plus concepts and as many as 30,000 interface terms per month. What that really means is that our clients are able to manage all these lexical variants long before the regulatory deadlines for ICD-10 and MU2.


ICD-10 is just a different mapping for you and you allow customers to create or maintain their own in addition to what you supply, correct?

Correct. We don’t allow them to manage their own mapping outside of our mapping because we really believe in this crowd-based or wiki-based model. It creates transparency that our clients have the correct standard mapping. Our mapping obviously grows and changes faster because of this transparent model and medical knowledge changes. We have developed sophisticated tools and workflow to manage all the mapping ourselves. 

Normally when people go to IMO we move them to what we call a migration process to make sure that everybody standardizes their local dictionaries to the same datasets. If there is an error in our mapping or if there is an inconsistency, we can always correct it quickly in the next release. But if we allow local mapping, it really can violate some of the principles that we have. We don’t prevent them from having local variation and mapping. They can have their own lexicons if they want to, but we don’t take responsibility for those maps and will not distribute to other sites.


If they have like a certain phrase that they use locally, they can build it into the equivalent of a dictionary so that even if it’s not commonly used they can still understand?

They could still understand, but they should normally be asking to send it to us. If it matches our editorial policies, we distribute to everybody else. Everybody else would use that as well.

But I think it is important for them to be cognizant of the bigger picture because we really believe that this is the grand opportunity to really make standards like SNOMED and ICD-10 to truly work, because if we map correctly to them, at least these standard coding systems and these regulatory coding systems become more valuable for our future. Obviously they will be changing as well. If people start mapping their own local terms, there’s no way to be able to validate or review that and then challenge it.


That would be unusual, right?

That’s unfortunately not true. There is always going to be new concepts requested. We have term request workflow to incorporate new valid terms in our next release within six weeks and to have everything made available to our community. There are going to be some domains that most likely our clients would need to have their own local terminology, but terminology as it relates to clinicians’ decisions, like the problem list, the past medical history, assessment, and plan, which are foundations for clinical team decision making and requires billing codes that need to be codified correctly.


Has ICD-10 changed your business substantially so that people are seeking you out for a painless solution?

I don’t believe that ICD-10 alone is the issue. The reason our product has been sought out is EHR adoption and usability by clinicians. I really do believe that clinicians are commanders-in-chief when it comes down to fighting diseases and planning treatments. Clinicians are the key stakeholders as we transform from fee-for-service to fee-for-performance. They must be in control.

What our vendors do is use IMO as a source of truth for tracking clinician commands and orders, preserving the patient problem list and differential diagnosis using their dictation into the electronic medical record. ICD-10 is just a byproduct that the EHR vendors needed to comply to. You could say the usability is how the value of IMO is realized when complying with ICD-10, SNOMED CT, and within a few years ICD-11 are byproducts.


What research and development is the company working on?

We have been done with ICD-10 for quite a while. Our biggest research and development is invested in tools to manage our growth that we are facing right now. We are becoming the foundation technology innovation platform for many of our EHR partners. What that really means is that we have worked very, very hard to make sure to marry technology with terminology.

We have a cloud-based solution we call our portal service that allows the physicians to search the way they want to search. We can then rank order the search results in context of the domain that they’re searching for. This new technology allows us to do what we call just-in-time vocabulary releases. We have 60 releases a year total and for diagnostic and procedures 10 releases each. Using the portal eliminates many of the overheads associated with local dictionary normalization.

But these 60 releases a year historically without our technology would be impossible to adopt with import/export technologies. In most cases it takes maybe some times two or three months for people to deploy updates or in many cases people only deploy the regulatory requirements rather than updating on a monthly basis. By having this portal technology available, allowing the marriage of technology and terminology, we are able to make these datasets available at the point of service for our clients almost instantaneously after delivery of our service.

This has really increased our product usage. We have over 350,000 physician users and over 2,500 hospitals using our product. Many of our vendors are moving to our portal as their terminology innovation platform. One comment that we get from our clients is that they know when IMO is not there. That’s by far the biggest compliment that we could get.


What does the physician see differently if they’re using a system that uses IMO versus one that doesn’t?

They can find what they’re looking for and the description that they want to assign to the patient’s problem in the right lexical context and within the top three to five term list results.


Is that time-saving for them?

Absolutely. We are seeing up to three minutes for complex visits and as much as 30 seconds per common visit. The most valuable is a more granular problem list and orders in their clinical speak. We have not measured the IMO factor in follow-up time saving. We hope to work with our partners and perform independent research on the effects of having IMO in time and quality.


Where do you see the company going in the next five years?

Where we are going is to empower our vendor partners to deliver the best EHR solutions in the marketplace. We believe that our technology and removing this complexity associated with its managing terminology makes our partners stronger. They can do more innovations for clinician documentation. That is the most important thing to us.

We believe we want to participate in the success of the care delivery organizations in our country. I believe that as clinicians become empowered in the clinical setting and take over the responsibility of delivery of care using IMO-enabled EHRs, they and care delivery organizations will see a reward based on the quality of care they’re delivering. We would be a key part of this transformation for our vendor partners, their clients, and users.

As we allow our vendor partners to innovate, many of IMO’s portfolio terminology-enabled assets that we have been developing in the last 20 years will become more valuable at the front line and will allow our partners to build a positive distance between their offerings and others not using IMO. We hope to grow with our vendor partners to eventually make the US destination healthcare through new innovations in medical terminology-enabled technology. This is the way it should be.


Do you have any final thoughts?

Thank you for your time and opportunity to present IMO to your audience. We are honored with the finding of the independent study result showing that when using IMO interface terminology, nearly perfect agreement is achieved with greater than 99 percent in a peer-reviewed CDC publication. This article was truly energizing for me and the IMO team working in this space of dictionaries and terminology innovation to capture clinicians’ intent. It seems that finally after all these years we can actually see the fruit of our work, and that is really a good feeling.

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May 29, 2013 Interviews 8 Comments

News 5/24/13

May 23, 2013 News 18 Comments

Top News

5-23-2013 6-21-30 PM

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

Reader Comments

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

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

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

5-23-2013 7-29-45 PM

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

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

HIStalk Announcements and Requests

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

Acquisitions, Funding, Business, and Stock

5-23-2013 11-07-30 AM

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

5-23-2013 11-20-36 PM

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

From the Quality Systems earnings call:

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


East Lansing Orthopedic Association (MI) selects SRS EHR.

5-23-2013 11-21-55 PM

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


5-23-2013 6-14-27 PM

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

5-23-2013 12-26-07 PM

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

5-23-2013 10-16-53 PM

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

Announcements and Implementations

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

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

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

Government and Politics

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

5-23-2013 10-54-10 AM

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

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

Innovation and Research

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


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

5-23-2013 11-25-09 PM

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

5-23-2013 11-31-20 PM

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

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

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

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

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

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

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

Sponsor Updates

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

EPtalk by Dr. Jayne

clip_image004  5-23-2013 6-46-11 PM

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


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

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


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


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

More news: HIStalk Practice, HIStalk Connect.


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May 23, 2013 News 18 Comments

News 5/22/13

May 21, 2013 News 4 Comments

Top News

5-21-2013 7-35-19 PM

Healthland acquires post-acute care software vendor American HealthTech of Jackson, MS.

Reader Comments

5-21-2013 7-49-08 PM

From Dortlund: “Re: GE Healthcare. Charging a premium on top of annual maintenance for MU Stage 2 and ICD-10.” Not to mention spelling “after hours” as “afterhours” for some reason.

5-21-2013 7-56-24 PM

From CMIO: “Re: clinical informatics exam. I applied, paid, and took a board prep course and plan to take the practice test this summer. I did not do a fellowship, but I want to be on the inaugural class of the new board based on three years as CMIO. It is worth it for me, as this is my career and this is my credential.”

5-21-2013 10-12-35 PM

From NoLongerPhamis: “I LOVED the last Slideshare about GEHC/IDX. Almost fell out of my chair laughing. The part about seamless integration of marketing materials was spot on. I was there.” This was in a recent episode of Vince Ciotti’s HIS-tory.

Acquisitions, Funding, Business, and Stock

Healthcare consulting firm Information Resources Associates, Inc. merges with ESD.

5-21-2013 9-03-24 PM

Virtual visit technology vendor ConsultingMD raises $10 million in funding from Venrock.

5-21-2013 9-35-25 PM

Pittsburgh-based wound care EHR vendor Net Health acquires Integritas, which offers EMR/PM solutions for urgent care, occupational health, and hospital employee health. 

Quality Systems, Inc. investor and board member Ahmed Hussein, mostly known for criticizing his fellow board members and launching proxy fights in an attempt to take control of the company, resigns. He owns more than $100 million in QSII shares.


Orange Accountable Care, a subsidiary of Orange Health Solutions, will deploy Sandlot Care Manager, Sandlot Dimensions, and Sandlot Metrix.

5-21-2013 12-47-20 PM

Wellmont Health System (TN) expands its relationship with MModal to include MModal Fluency Direct and Fluency for Imaging as its clinical documentation platforms.

St. Joseph’s Imaging (NY) selects Merge Healthcare’s Outpatient Radiology Suite.

The ERx Group, a staffing provider for rural acute care and critical access facilities, will use T-System’s clinical, financial, and operational technology and services.

Southeast Alabama Medical Center selects Besler Consulting to assist in the identification of Medicare Transfer DRG underpayments.

5-21-2013 10-17-52 PM

Western Maryland Health System (MD) will use Dimensional Insight’s business intelligence solution, The Diver Solution.


5-21-2013 3-43-25 PM

Long-term care EHR provider MatrixCare names Denise Wassenaar (Alliance Pharmacy Services) chief clinical officer.

5-21-2013 3-47-11 PM  5-21-2013 3-45-12 PM

Imprivata, expecting to go public within two years according to its CEO, names John Halamka, MD (Beth Israel Deaconess Medical Center) and former Phase Forward CFO Rodger Weismann to its board.

5-21-2013 3-50-02 PM

Stoltenberg Consulting appoints Douglas Herr (maxIT Healthcare) VP of Epic practice and client relations.

Announcements and Implementations

Peak Health Solutions partners with ChartWise to offer a solution that includes Peak’s clinical document improvement consulting and education program and ChartWise’s CDI software.

5-21-2013 11-17-00 AM

Stillwater Medical Center (OK) integrates its Philips IntelliVue patient monitors and Meditech ED management solution using the Accelero Connect healthcare integration platform from Accent on Integration.

North Shore-LIJ Health System adds cameras in operating rooms at its Forest Hills Hospital (NY) to remotely audit surgical teams for performing timeouts prior to procedures and to alert hospital cleaning crews when a surgery is nearing completion.

5-21-2013 7-44-22 PM

Fox Business News is running a week-long series called “How Private are Your Medical Records?” on “The Willis Report.” Monday’s episode featured Deborah Peel, MD of Patient Privacy Rights and Mark Rotenberg of the Electronic Privacy Information Center.

Covenant Health (TX) and MemorialCare Health System (CA) are named winners of the 2013 Crimson Physician Partnership Awards presented by The Advisory Board Company, saving a combined $20 million by presenting comparative performance information to their physicians.

5-21-2013 9-11-45 PM

CampDoc.com releases an electronic medication administration record module for its summer camp EHR.

Government and Politics

5-21-2013 11-45-17 AM

The Consumer Partnership for eHealth and the Campaign for Better Care submit a letter to the six Republican senators who last month questioned whether the implementation of the HITECH Act was money well spent. The consumer groups argue that MU is working and that delaying Stage 2 implementation and Stage 3 rulemaking will be detrimental to patients, will stifle innovation, and will delay progress towards interoperability.

CMS posts the 2014 ICD-10-PCS files, including code tables, index, and coding guidelines. CMS notes that the FY 2014 ICD-9-CM diagnosis codes will not be updated.

ONC posts positions (1, 2) for medical officer reporting to the Office of the Chief Medical Officer.

5-21-2013 9-28-21 PM

Twila Brase, RN, president and co-founder of Citizen’s Council for Health Freedom, says EHRs are burdensome and inaccurate, adding that they are turning doctors into data clerks. She adds, “Documenting a full clinical encounter in an EHR from scratch can be pure torment. The full chart doesn’t fit on the computer screen. Each element is selected by a series of clicks, double-clicks, or even triple-clicks of a mouse button. Hunting, clicking, and scrolling just to complete a simple history and physical exam is a tedious and time-wasting experience."

A Health Innovation Council commentary article says HITECH is causing, “A massive disruption of providers’ patient care focus as they chase Meaningful Use dollars; increased burdens on physicians, nurses and clinicians since EHRs as currently designed require more, not less, of their time and effort; and an unprecedentedly huge expenditure by providers on EHR hardware and software at a time when providers are under severe financial pressures.” The group recommends that the HITECH program either be redesigned to emphasize patient care, safety, and efficiency or be shut down completely and spend what’s left of the money on rewarding provider care improvement by whatever means they choose.  What is minimally noted in the press release is that the Health Innovation Council was formed and is run by Anthelio Healthcare, the former PHNS, a healthcare IT consulting services vendor.

In the UK, Health Secretary Jeremy Hunt announces creation of a $400 million fund to help hospitals with the cost of replacing paper-based clinical documentation and prescribing with electronic systems.


MyMedicalRecords.com files another patent lawsuit, this time against the recent Allscripts acquisition Jardogs. The complaint states that the FollowMyHealth Universal Health Record infringes on MMR’s personal health record patents.

5-21-2013 12-09-06 PM

LSU Health Shreveport (LA) and Siemens Healthcare inform 8,330 patients of an unintentional disclosure of PHI  stemming from an error in a computer data entry field. LSU and Siemens, which prints and mails bills on behalf of LSU Health physicians, have now identified and corrected the error that caused the names and treatment information for one patient to incorrectly align with another patient’s mailing address.

Palomar Pomerado Health CMIO Ben Kanter, MD presented A Darwinian View of the Electronic Medical Record at a HIMSS SoCal meeting.

UPMC will outsource its transcription services to its development partner Nuance at the end of June, laying off 100 transcriptionists who have been offered jobs by Nuance.

Moore Medical Center (OK) is destroyed by a 200 mph tornado, but the 30 patients housed in the 46-bed hospital all survived, as did all of the hospital’s employees.

5-21-2013 10-19-35 PM

A Silicon Valley newspaper editorial lauds the $220 million Epic implementation at Santa Clara Valley Medical Center (CA), saying it will improve billing efficiency and quality of care, also avoiding the 1 percent Medicare penalty and instead reaping $11 million in HITECH funds.  

Weird News Andy says he’ll take one today if it can help find his car keys. A New York Times article says helper robots will be used to help care for the elderly.

Sponsor Updates

5-21-2013 12-42-24 PM

  • ISirona employees participate in the Emerald Coast Mud Run benefiting Heart of the Bride, which supports orphans around the world.
  • Valence Health offers a May 29 Webinar in its monthly series called Care Coordination and Patient Outcomes: Utilize Innovative Automated Population Health Solutions.
  • DocuTrac, a provider of EMR technology for behavioral health, will add DrFirst’s e-prescribing technology into its QuicDoc EMR Professional and Enterprise edition software.
  • An Imprivata-commissioned survey of Canadian HIT executives reveals key barriers for clinicians when accessing patient data, including a lack of systems integration, privacy and security concerns, and slow access.
  • McKesson’s Horizon Lab 13.5 becomes for the first LIS to receive EHR Module certification for MU Stage 2.
  • Ingenious Med updates its impowermobile charge capture software to include the ability to create a virtual superbill at the point of care.
  • Greenway Medical adds ClientTell’s ReminderManager patient communications solution to its Online Marketplace as a certified API solution for the PrimeSUITE platform.
  • DirectTrust.org and EHNAC extend accreditation to ICA under its Direct Trusted Agent Accreditation Program.
  • IHT2 hosts Health IT Summit Denver July 24-25.
  • In a GetWellNetwork-sponsored Webinar May 29, administrators from Hasbro Children’s Hospital (RI) share details of how it improved patient satisfaction and workflow by joining patient-centered care technology with a meal ordering system at the bedside.
  • Kareo posts a Webinar that answers the top six Stage 2 MU questions and offers three reasons to check out CMS eHealth.
  • Several HIStalk sponsors earn a spot on the Informatics 2013 Top HCI 100 list, including 3M, ADP AdvancedMD, Allscripts, API Healthcare, Beacon Partners, Capario, CareTech Solutions, Covisint, Craneware, CTG, Cumberland Consulting Group, eClinicalWorks, Elsevier, Emdeon, ESD, GE Healthcare, Greenway, Iatric Systems, Impact Advisors, Infor, Intellect Resources, MModal, McKesson, MedAssets, Medseek, Merge, NextGen, NTT DATA, Nuance, Optum, Orion, Passport Health, Philips Healthcare, Siemens Healthcare, Sunquest Information Systems, Surgical Information Systems, T-System, TeleTracking Technologies, TELUS Health Solutions, The Advisory Board Company, The SSI Group, Vitera Healthcare Solutions, Vocera Communications, Wolters Kluwer Health, and ZirMed. Porter Research submitted, compiled, and reviewed sales figures to create the list.
  • The Philadelphia Alliance for Capital and Technologies recognizes InstaMed  as its Technology Growth Company winner and Halfpenny Technologies a Life Science Growth Company finalist at the Alliance’s 2013 Enterprise Awards.
  • Imprivata launches a migration program that enables customers using the Citrix SSO feature to migrate to Imprivata OneSign SSO. Also, Imprivata participates in a breakout session on desktop virtualization and SSO at this week’s Citrix Synergy conference in California.
  • Emdat profiles Illinois Bone and Joint Institute, which realized a 50 percent year-over-year cost savings in documentation and correspondence costs using Emdat alongside its EMR.
  • Beacon Partners hosts a May 31 Webinar integrating business intelligence and analytics through the healthcare enterprise and offers a white paper on why risk assessments help reduce an organization’s risk of a data breach.
  • Awarepoint’s RTLS platform will be featured in an industry-wide interoperability demonstration at the Association for the Advancement of Medical Instrumentation 2013 Conference and Expo June 1-3 in Long Beach, CA.


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

More news: HIStalk Practice, HIStalk Connect.


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May 21, 2013 News 4 Comments

News 5/17/13

May 16, 2013 News 12 Comments

Top News

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

Reader Comments

5-16-2013 8-31-28 PM

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

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

5-16-2013 7-50-36 PM

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

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

HIStalk Announcements and Requests

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

5-16-2013 7-24-53 PM

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

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

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

5-16-2013 8-04-07 PM

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

Acquisitions, Funding, Business, and Stock

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


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

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

5-16-2013 10-13-57 PM

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

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


5-16-2013 12-40-55 PM

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

5-16-2013 6-17-47 PM

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

5-16-2013 6-18-54 PM

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

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

Announcements and Implementations

5-16-2013 7-17-41 PM

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

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

5-16-2013 10-16-04 PM

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

5-16-2013 8-52-13 PM

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

Government and Politics

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

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

5-16-2013 8-21-37 PM

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

Innovation and Research

5-16-2013 9-07-42 PM

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

5-16-2013 9-11-20 PM

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


5-16-2013 11-23-15 AM

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

5-16-2013 8-42-58 PM

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

5-16-2013 12-09-29 PM

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

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

5-16-2013 9-30-15 PM

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

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

Sponsor Updates


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

EPtalk by Dr. Jayne

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

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


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


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

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



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

More news: HIStalk Practice, HIStalk Connect.


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May 16, 2013 News 12 Comments

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  • PM_From_Haities: Re: The Alchemist Does your post on deleting patient data have anything to do with this scandal? http://www.cbsnews....
  • rxpete: Seems like the President of one of your big vendors (Cerner) being a board member might be a bit of a conflict of intere...
  • Honest question: Are you curmudgeon about Health 2.0 (thus no mention) or are there just too many conferences for you to have an opinion ...
  • TheAlchemist: I apologize to HIStalk. Did not realize that the HIT community was such a left-wing advocate group, i.e., 57.52 %. Tha...
  • Whitney: I would love to see an updated version of this!...

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