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Curbside Consult with Dr. Jayne 2/27/12

February 27, 2012 Dr. Jayne 2 Comments

Over the past several years (and especially with Meaningful Use) there has been a fairly significant shift in the attitudes of ambulatory physicians who are making the leap to electronic health records. The hospital-based physicians (and ambulatory physicians who see patients in the hospital) are a different story. They’re a captive audience who has always been subject to hospital control and who has a long-standing history of adapting to things imposed by various Big Brother entities: the Joint Commission, the hospital’s formulary team, insurance and hospital case managers, etc.

Those physicians have done pretty well adapting to electronic documentation, computerized order entry, and the like while in the hospital. Hospitals have also tended to phase their implementations over the scope of years – deploying in a modular fashion with lab, nursing documentation, CPOE, and provider documentation all done as separate initiatives. Ambulatory docs who dislike the hospital’s conversion have been able to escape back to the relative safety of private practice and cling to their paper charts.

As ambulatory physicians transition to EHR, though, they tend to deploy more rapidly – wanting to get rid of all the paper immediately, but also with a strong drive to keep the revenue stream steady. When I started deploying EHRs some time ago, we worked with early adopters who believed in the promise of electronic recordkeeping and were more willing to staff up, reduce patient load, or work longer hours to realize their goals. These physicians are now mature users who are leveraging their EHRs to achieve advanced Patient Centered Medical Home designations, increase fee schedules through demonstrable quality, and improve patient satisfaction.

On the other hand, there are now thousands of physicians who previously found the idea of the EHR distasteful and feel forced to make the transition. Whether by peer pressure, payer requirements, or the threat of government-related penalties, they’re now implementing and with a significantly different strategy than may be prudent.

More often, I hear of physicians that want to implement a system fast, cheap, and easy. The rest of us who have done this for a while know that it’s very difficult (if not impossible) to do all three. Often these late adopters refuse to follow vendor advice, consultant advice, or frankly anyone’s advice. Convincing them to cut schedules or hire staff is a challenge. Ultimately, it’s the patients who suffer.

As the healthcare market consolidates, hospitals and health systems are looking to “align” (one of my least-favorite buzzwords) with community physicians to ensure profitable referral, ancillary, surgical, and inpatient revenue streams. Many are offering subsidies and other incentives to bring these providers onto EHR systems.

Often these practices don’t actually want to align, but are feeling cornered and desperate. Some have previously turned down acquisition offers from the same hospital and see taking a subsidized EHR as a way to be somewhat protected from burdensome federal requirements while maintaining at least some degree of autonomy. Others simply can’t afford an EHR without the subsidy. A last group is providers who’d like to be acquired but for various reasons aren’t suitable candidates, but hope that alignment (and sending a steady volume of referrals which of course cannot be spoken about) will result in being ultimately asked to the dance.

These physicians often deploy on an existing system-wide EHR. Since they’re late to the game, though, they haven’t been stakeholders in any of the decision-making that’s already occurred and often have less buy-in to the idea of group goals than those users who are actually part of the group.

Another angle is that even though subsidized, these physicians are paying customers with different expectations than employed physicians and different ideas about governance. Of course, this would have been true even if these subsidized physicians were early adopters, but the differences are magnified by them being late in the EHR game and feeling pressured to demonstrate Meaningful Use as quickly as possible.

I still go out on implementations and perform physician training on a regular basis. Until recently, most of the physicians I have worked with have treated me as a respected colleague who could assist them through the difficult transition. Some have even looked at me as some kind of EHR shaman, able to smooth their journey to the other side with mystical wisdom. Of course, there have always been a few docs who were borderline (or overtly) hostile, but they were few and far between and usually we could leverage their partners or peers to moderate their behaviors.

Lately I’ve run into more and more angry physicians who are completely resistant to the idea of the EHR transition even though they’ve agreed to go paperless. Some are passive-aggressive, but others are openly abusive. This manifests in a variety of ways – disruptive behavior, inappropriate comments during training (think middle school students with a substitute teacher), or refusing to be trained at all. I find the latter group the most frustrating because then they can’t figure out why the system is so hard to use and scream the loudest about lack of support.

Looking at the data on how many physicians are actually using EHRs in practice (let alone being robust users) we’re just approaching the midpoint. If what I’m seeing in the field is any indication, it’s only going to get tougher as the last-ditch adopters come through with increasingly unrealistic expectations and correspondingly difficult implementations.

I feel bad for the vendors and for the teams who have to support these folks (mine included.) I feel bad for the physicians who don’t want to transition to EHR and the staff members that have to work with them every day. But most of all, I feel bad for the patients who entrust them with their care. Regardless of what they think about the EHR, the IT team, or the government, I hope the angry docs remember that after all, it IS all about the patient.

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February 27, 2012 Dr. Jayne 2 Comments

Readers Write 2/15/12

February 15, 2012 Readers Write 8 Comments

Submit your article of up to 500 words in length, subject to editing for clarity and brevity (please note: I run only original articles that have not appeared on any Web site or in any publication and I can’t use anything that looks like a commercial pitch). I’ll use a phony name for you unless you tell me otherwise. Thanks for sharing!

iPad Fatigue: Choose Your Mobile Strategy Wisely
By Chris Joyce

2-15-2012 8-43-25 PM

I get the attraction of the iPad … your own personal device that’s sexy and lean, as opposed to the standard-issue, Windows XP desktop locked down by your hospital’s IT group or the clunky computer on wheels. The simple UI and the glossy new apps let you shed the pain of those legacy systems and, most important, you get mobility.

Given the glacial pace of innovation in healthcare, who can fault people for wanting to use these beautiful devices? We are all trying to create a sea change in healthcare IT, much like the iPhone did for telecommunications. But I’m going to say something that’s wildly unpopular: the iPad is not well suited for healthcare in its current state.

I’ve been working in tablet-based mobility for seven years (yes, there were tablets before the iPad). We’ve studied clinician data collection workflow in registration, the ED, home health, cardiology, radiology, orthopedics, and clinical trials. Trust that my opinions are carefully thought out from experience.

I will concede that the Windows-based tablet manufacturers deserved to be smacked around by Apple for their lack of vision and slow progress. Years ago, I, along with my customer (one of the largest health systems in California that had been using tablets in cardiology for years) sat down with the folks at Intel and Motion Computing to tell them that the C5 was too complicated and expensive. I shared what we needed in the ideal tablet: a bright, 12” screen with stylus support that’s ideal for documents, 8-10 hours of battery life, no external ports or other gadgets, and a sub-$1,000 price tag. Our request fell on deaf ears as they paraded out the next incremental chip set improvement in their roadmap.

When the iPad hit the market, we thought we’d finally gotten our ideal tablet. The price was right, the screen was bright, the battery life was unbelievable, it ran coolly and didn’t burn your arms, it booted in seconds, and the 1.5 pound. form factor (half the current tablets) was simple and elegant. Finally, we had the perfect complement to our mobile forms software. This wasn’t just a Windows laptop with the keyboard chopped off – it was an appliance, a tablet.

But it also has some major shortcomings that our customers are now discovering:

10” display
This is subtle because I like the more portable size, but those standard consents, ABNs and Medicare forms you’ve used for years don’t fit on a 10” display without disrupting the layout. Your app has to be “touch-aware” or you’ll interact with the screen when you rest your hand to sign or add a note. Our customers are counting clicks and don’t like the iPad because they have to scroll to use the forms that once fit on their 12” Windows tablets.

No stylus
This makes capturing signatures, annotations on diagrams, and unstructured notes impossible unless you buy a third-party stylus like Pogo. But that’s like writing with a crayon and there is no place to dock your pen. Are your patients going to be comfortable signing an informed consent with their fingers?

No handwriting recognition
The soft keyboard isn’t practical for a lot of data entry because you are still holding the tablet with one hand and pecking out everything with the other. And bouncing back and forth between numeric and alpha characters drives users absolutely mad. Handwriting recognition has its place in documentation, just like voice dictation, and it can be as fast as paper. There is nothing fast about the iPad’s soft keyboard when at the bedside.

Proprietary operating system and deployment isn’t enterprise-friendly
Obviously Apple wasn’t concerned with compatibility with “legacy” apps like Meditech or MS4, but in healthcare, that eliminates about 90% of current systems. Most hospitals have compromised for “runs on iPad” versus “optimized for iPad” using Citrix or a Web interface.

That leaves the end user with an underwhelming experience. Citrix apps don’t get the intimate integration with the display, touch, or the camera for image annotation. Not many vendors were prepared to rewrite their clinical systems in iOS or HTML5. The HTML5 standard hasn’t been published yet and isn’t consistently supported by all browsers (although it is the future). I know of several major healthcare systems that are still standardized on Internet Explorer 7, so I don’t anticipate adoption of HTML5 to be as high in healthcare as Apple would like you to believe. Again, we (healthcare) are not that nimble.

Lack of rugged form factor
Eventually your iPad will come into contact with fluids or the floor and you’ll realize it’s a consumer-grade device. These devices are often in a hostile environment, very unlike the environment in most iPad commercials.

The hype of hardware
One of our best mobile forms customers is a major health system in the Northeast. They gave each clinician an iPad, only to discover that they took them home to watch Netflix versus using them on their rounds. Hardware alone isn’t the answer. You also need software that’s mobile aware.

When you’re developing your mobile strategy, keep this in mind. The iPad is a beautiful device with multiple applications (just not healthcare data collection). It isn’t going to transform your hospital systems’ user experience. But don’t compromise – there are other options to consider. Look for vendors that can fill the gaps in your EMR with mobility solutions optimized for the right tablet for your environment (iPad, Android and/or Windows) and that upgrade your user experience/productivity.

Chris Joyce is director of healthcare solutions engineering for Bottomline Technologies of Portsmouth, NH.

Clinical Decision Support
By Dave Lareau

2-16-2012 1-09-18 PM

If you have achieved Stage 1 Meaningful Use requirements or are planning to attest in the future, you are likely aware of the required core measure for implementing and tracking at least one clinical decision support (CDS) rule. The goal of this measure — along with maintaining active problem and medication lists and recording vitals and smoking status — is to improve the quality, safety, and efficiency of patient care.

So what exactly is CDS and why is it important? 

In simple terms, CDS gives physicians the clinical information they need for decision-making tasks. For example, during a patient exam, CDS tools can provide prompting to help a doctor determine a diagnosis or select an appropriate treatment plan. Alternatively, a provider may use CDS technology to improve documentation or identify billing codes or determine the most relevant data to forward to a specialist.

CDS technologies are particularly powerful when the engine is mapped to a wide variety of medical concepts and diverse reference and billing terminologies, such as LOINC, RxNorm, SNOMET CT, ICD, and CPT. CDS tools are more robust the wider the engine’s mapping. Strong CDS engines have the ability to identify and interpret patient information from multiple sources, whether the data comes in the form of lab and test results, previous therapies, or patient histories.

It’s important to keep in mind that CDS tools don’t make the actual clinical decisions for a physician, but support a physician’s own decision-making by sifting through existing data and presenting the most relevant information. As more clinical information becomes available online from EHRs and health information exchanges (HIEs), providers will rely more heavily on CDS technologies to identify the most pertinent information for a given situation.

Many commercial EHRs and HIEs have embedded CDS tools to help providers wade through vast amounts of clinical data. CDS technologies work behind the scenes to identify the most clinically relevant information within a practice’s EMR or from a connected reference lab or from HIE records. Search engines consider additional relevant details amongst on thousands of clinical scenarios and then interpret the cumulative data. Physicians are then presented with pertinent information at the point of care and offered details to aid with diagnosis and treatment plans, as well as critical data needed for compliance and reimbursement.

Though Stage 2 Meaningful Use is not finalized, look for the ONC to add additional CDS objectives in the core measures.

Dave Lareau is chief operating officer of Medicomp Systems of Chantilly, VA.

Super-Sized Productivity Gains from Computer-Assisted Coding?
By Akhila Skiftenes

2-15-2012 8-56-48 PM

The required migration from the ICD-9 to ICD-10 has significantly increased the demand for computer-assisted coding (CAC), moving beyond its early beginnings in outpatient specialty areas. The potential benefits from using this technology to make the transition to ICD-10 can be very compelling –improved coding productivity, accuracy, consistency, transparency, and compliance.

Yet CAC products require a substantial investment, and implementing one does not a guarantee that these benefits will be realized. Therefore, it is essential for an organization to complete a thorough analysis before investing in a CAC product.

Exceptional productivity gains have been reported by vendors. However, these are based on a number of assumptions and the specific circumstances for the organizations using the system. The following are key considerations when estimating CAC benefits for your organization.

First, estimates are often based on outpatient implementation data. As more and more hospitals move toward using a CAC in their inpatient areas as well, these productivity estimates need to be adjusted accordingly. Inpatient stays are longer and have more variability, making accurate CAC translations much more complex. Vendor products have made great strides toward accurate inpatient coding, but it takes more computing power and more time, so productivity gains will be lower.

Second, CAC works best when the documentation inputs are standardized. There are four standard formats for documentation: consultation note, history and physical, operative note, and diagnostic imaging report. The more variability in documentation formats for your organization, the longer the CAC process will take and the lower the translation accuracy.

Standard medical terminology used by the electronic medical record system also impacts the effectiveness of CAC. Many EMR systems use ICD-9 verbiage rather than SNOMED-CT for physician documentation. In these situations, the CAC application will translate to a lower level of accuracy since SNOMED-CT has a more modern standard for medical terminology and greater levels of specificity.

Finally, there is a general belief built into benefits estimate that optimizing the CAC process is ongoing. Once CAC is implemented, it is vital for the Health Information Management (HIM) department to audit the output and identify any issues with the software’s documentation interpretation. A critical success factor is the working relationship between HIM and IT, with resources assigned on both sides for continued optimization.

When making a decision about CAC implementation and ongoing support, organizations need to incorporate all of these assumptions into the estimate of how much productivity can truly be realized.

Akhila Skiftenes is an associate consultant with Aspen Advisors of Denver, CO.


Virtual Patient Simulation: Strengthening Medical Decisions, Strengthening Outcomes
By James B. McGee, MD

2-15-2012 9-02-03 PM

Provide better patient care with fewer resources. Essentially, that is what healthcare reform is asking us all to do. Most providers agree that the only way to maintain the quality of patient care and decrease overall cost is to reduce errors, prevent duplicate or unnecessary tests, and discover more effective yet less expensive approaches to care.

As I see it, that is the simple reality we all have to work within. The real question is: what does it mean from a practical standpoint?

It means that the modern delivery of medical care is far more structured, more measured, and more reported on than I—or anyone—ever could have imagined. Even the most recently educated providers now have to learn new skills and processes in order to respond to federal and third-party payer demands. An entire generation of practicing physicians and physician extenders is being asked to change practice habits, yet still engage in complex decision making.

It is a tall order. However, virtual patients (VPs) offer a way to provide examples and feedback that can help train providers to work within the new constraints. Think about it: clinical decision making is a skill. Like any other skill, it needs to be practiced, refined, and updated regularly. Simulation in general offers a safe environment to assess specific skills and receive personalized, dynamic feedback. VPs can simulate a wide range of clinical decision-making scenarios without requiring dedicated space and time the way physical simulators do.

Simulators such as mannequins are a familiar way to practice clinical skills. VPs are a relatively new development best described as interactive web-based simulations used to develop, enhance and assess clinical decision-making for all types of learners (physicians, physician extenders, nurses, students, etc.). Branched narrative style VPs, in particular, do this by presenting a patient’s story and background information. They then challenge learners with multiple decision paths and show the impact of their decisions—without the risk of actually treating patients, of course.

Training with these realistic computer-based cases strikes a practical blend of simulation with the convenience of web-based delivery and centralized reporting. Think of them as “cognitive” task trainers.

Hospitals have long recognized that providers who pursue learning on a regular basis tend to have better patient outcomes at a lower cost of care. Educational programs like VPs provide a mechanism to make good clinicians better and—perhaps best of all—help novices improve the cognitive skills that lead to expertise.

One good example that I am aware of is Warwick Medical School in the UK, which created VPs to train new doctors to handle life-threatening acute medical emergencies. The doctors can practice over and over again. Through the VPs, they receive immediate, personalized feedback while responding to a rapidly evolving, life-threatening clinical challenge. This type of deliberate practice simply cannot be replicated in real life. In an actual emergency the doctors who practiced decision-making skills are more likely to perform successfully.

Given healthcare’s focus on accountability and other reform efforts, it is important to not lose sight of ways providers and nurses can improve the care and the safety of their patients. VPs provide a safe and objective way to identify variations in practice and decision-making; remediate using real-life examples; reassess until competency is demonstrated; and continually reinforce best practices.

In any given community hospital, providers with a wide range of prior knowledge, skills, and attitudes practice under one roof. Patients expect and deserve the highest level of expertise from all of their caregivers. Payers also expect a certain level of performance and have begun to reward superior performers.

Simulation provides an efficient way to assess clinician performance and provide feedback, whether in the form of clinical guidelines, performance metrics or formal educational programs. By strengthening medical decision making, virtual patients offer one way to reach everyone’s ultimate goal—better patient outcomes.

James B. McGee, MD is the scientific advisory board chairman and co-founder of Decision Simulation LLC, co-chair of the Virtual Patient Working Group at MedBiquitous, and assistant dean for medical education technology at the University of Pittsburgh School of Medicine. Additionally, he is an associate professor of medicine in the division of gastroenterology, hepatology, and nutrition and a practicing gastroenterologist.

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February 15, 2012 Readers Write 8 Comments

News 2/15/12

February 14, 2012 News 2 Comments

Top News

2-14-2012 5-48-59 PM

Acting CMS Administrator Marilyn Tavenner tells an AMA audience that she is committed to re-examining the pace at which ICD-10 is implemented in order to give providers more time to make the transition. She says her office will make a formal announcement about regulation changes within the next few days.


Reader Comments

inga_small From Don Pablo: “Re: data breaches. I saw where you are not relaying the stolen laptop breaches since they have become commonplace. I used to work in financial services and watched for reports of breaches. This was my favorite site to check a couple of times a week. I bring it to your attention as not every breach is easily found.”Great site to check out, unless you are obsessively worried about your personal data getting into the wrong hands, because lots of organizations seem to be losing our data.

2-14-2012 9-50-42 AM

inga_small From WellHeeled: “HIStalkapalooza. I just want to be sure it is as black tie and glamorous as last year (so I pack the appropriate Red Carpet attire)…is that the case?” There may not be a red carpet this year, but readers have assured me they are packing their sequins, high heels, and more than one black tie. SmyrnaGirl, for example, tweeted that she is bringing her A game with these hot shoes.

2-14-2012 12-57-52 PM  2-14-2012 12-56-15 PM

inga_small From Lucky Jackson: “Best dressed at HIStalkapalooza. Tell me what I have to do to win one of Mr. H’s big prizes.” In the fashion categories, we have HIStalk King (best-dressed man), HIStalk Queen (best-dressed woman), Best Elvis Impersonator (based solely on attire, so choose your favorite young or old Elvis outfit and don’t worry about the singing), and Best Left-in-Vegas Attire (think showgirl or over-the-top glitz; Mr. H is hoping for a lot of showgirls.) If you want to be in the running for the fashion or the shoe contests, arrive early because our judges will be selecting finalists between 6:30 and 7:30 pm.

mrh_small From Former CIO: “Re: booth crawl. I hope the sponsors will have the answers readily available in the booths. With 50+ answers to get in around 11 hours of booth time, there won’t be much time for sales pitches.” We’ve asked the sponsors to have their booth crew prepared with the answers. I expect some will just post the answer on their wall. As a refresher to the detailed instructions: (a) download the form here and print it off, (b) get your answers from the booths and Web pages listed; (c) post them to the online entry form by Wednesday evening at 7:00, and (d) watch HIStalk Wednesday evening to see if you won. At minimum, you get good exercise and flaunt a confident, purposeful stride as you move from one booth to the next on a Apple-seeking mission instead of just meandering around following the scent of some vendor’s freshly baked cookies. With luck (and the odds should be decent), you’ll pack home one of 55 iPads. And as I mentioned last time, I’m the one grading the entries, and if you miss a question or two, I’ll most likely be lenient because I really want you to have an iPad. I was indifferent to the device when I won mine at HIMSS last year, but it has totally replaced my iPod Touch for around-the-house stuff: checking the weather, looking at e-mail, doing a quick order on Amazon, and reading Kindle books.

mrh_small From Elaine: “Re: HIMSS. Any word on a McKesson event? It would be fun to let loose a bit after hours.” I’ll be honest in saying that I don’t even open any of the HIMSS-related mail I get (sorry, companies who pay big bucks to send it) so I don’t know anything about their event. The only ones that have risen above the noise for me were from companies that contacted me directly: a cool-sounding Cerner event at the Bellagio (called me at work), a great-sounding Iatric Systems lunch (e-mailed), and and SCI Solutions get-together (sent to my Mr. HIStalk e-mail). I’ll make this offer: for companies throwing an event that’s open to anyone (and that includes vendor people, just to be clear) let me know and I’ll mention it here, as long as you’re OK with the possibility that gregarious HIStalk readers will overwhelm you with interest, which we have to re-learn every year with HIStalkapalooza. Everybody ought to have a party invitation or two, don’t you think?

mrh_small From MJOG: “Re: GE Centricity Advance. Discontinued with no warning and very little time to transition. They are offering Centricity CPS, but at $1,500 it is too pricey for the small practices that used Advance. Even their own VARs can’t guarantee a transition within GE’s timeframe. Practices that went live with Advance in January 2012 have to pay in full for implementation of dead software. GE is really out of touch.” I think what you are seeing is what lots of people predicted: when EMR certification turned out to be too easy to achieve and everybody earned it, that left it up to the market to weed out those products and companies that have a less than a fully competitive position in the face of disruptive companies that are happy to sell hosted, easily implemented systems for a few hundred dollars per month. The MU carrot is forcing practices to choose their dance partners nearly simultaneously, so the consolidation writing is on the wall as the rich get richer. It’s painful for existing customers, but is both desirable and inevitable over the longer term. Maybe we should have a mandatory Y2K every 10 years to thin the herd.

2-14-2012 7-33-19 PM

mrh_small From All Hat No Cattle: Re: electronic problem lists. What do you think of this idea?” Reported in a JAMIA article, Brigham and Women’s sets up EHR alerts to prompt the physician to review the problem list if patient data in the EHR suggests that any of 17 specific conditions (asthma, hypertension, diabetes, etc.) might be present but undocumented. The alerts were accepted 41% of the time, more problems were documented, and interventions and quality improvement work could presumably be more specifically targeted. I like the idea only because it has the potential (although modest, I expect) to improve the care of individual patients, unlike the similar adverse drug event triggers that have always seemed to me to be a complete waste of time except as a learning tool that nobody ever seems to learn from. On the other hand, pestering docs with alerts that are not helpful almost 60% of the time indicates a need for algorithm refinement. That’s where these projects end a lot of the time – the available information just isn’t good enough to improve the hit rate.


HIStalk Announcements and Requests

2-14-2012 6-36-04 PM

mrh_small Thanks to Streamline Health, supporting HIStalk as a Platinum Sponsor. The Cincinnati, OH-based company offers the AccessAnyWare document management system, which supports hybrid document-electronic hospitals (which is the vast majority) by organizing their information to streamline processes and improve patient care. Its OpportunityAnyWare business analytics solution aggregates information from disparate systems so that users can perform data mining and collaboration using dashboards that can include an unlimited number of key performance indicators, metrics, and alerts. Its Patient Access solutions integrate document workflow related to referrals, pre-op documentation, and financial forms to eliminate delays and process barriers, accelerating the billing process and increasing employee productivity. They even have a solution (CharityWare) to manage the need-based financial assistance screening process. Before and after stats for several clients are here. The executive team has a ton of healthcare experience and the company’s chairman of the board is our old HIStalk friend Jon Phillips of Healthcare Growth Partners, who I interview once a year or so because his healthcare IT business predictions are uncanny (and it’s about time to do that again.) Thanks to Streamline Health for helping us do what we do.

mrh_small I realized today that I have listed the exotic recipe for the IngaTinis to be served at next week’s event, but forgot to mention the other custom-created specialty cocktails that will be served (the bartenders at First are seriously legendary craftspeople of the alcoholic arts.) The Mr. H Incognito is a rum punch with ingredients that are, like its namesake, best left undisclosed. For you root beer fans – and you know who you are – the ESD Activation Sensation is a mixture of IBC root beer with whipped cream vodka (who knew?) with a brandied cherry garnish. And while I’m on the topic, I should repeat that we are ecstatic to host those lucky folks who received an invitation, but we regretfully cannot accommodate anyone who didn’t (guests, co-workers, hastily propositioned showgirls, etc.) You are welcome to swing by at 8:00 p.m. to see if no-shows have freed up space, but otherwise we’re packed to the rafters.

2-14-2012 6-56-22 PM

mrh_small Thanks and welcome to HealthMEDX as a new HIStalk Platinum Sponsor. The Ozark, MO company offers an integrated clinical and financial system that covers all post-acute care settings: long-term care, home health, hospital, rehab, and Continuing Care Retirement Communities (if you’re a hospital person and think this doesn’t pertain to your organization, it definitely does – the comfortable lines between acute care hospitals and all these other important venues of care are getting blurrier by the minute.) When ACO-type arrangements put you on the hook to coordinate care with these other providers, solutions from HealthMEDX ensure that best practices are followed to meet regulatory requirements, reduce cost, reduce errors, and (pay attention here) reduce those hospital readmissions that come right out of your pocket. Every one of HHS’s favorite programs requires unheard-of levels of data-sharing and coordination to give patients coordinated care at the most cost-effective location. HealthMEDX has solutions running in more than 3,000 facilities and has earned CCHIT certification for Home Health and SNF in addition to ONC-ATCB modular certification for both hospitals and EPs. And lastly, if you’re thinking, “I know I’ve heard of HealthMEDX somewhere,” it’s the company that former McKesson Technology Solutions President Pam Pure joined as CEO right before Christmas. Thanks to HealthMEDX for supporting HIStalk.

mrh_small Inga is interviewed by the folks from Dodge Communications, in which she downplays her role in HIStalk and makes me seem way more interesting and virtuous than I really am. Feeling uncharacteristically affectionate after reading it because she was so sweet in her comments, I wanted to have Valentine’s Day flowers delivered to her, but the florist reacted with a combination of a contemptuous laugh and and annoyed snort when I called up Tuesday morning and cheerfully asked if they could deliver that same day (I may offer her and Dr. Jayne a spa day at HIMSS instead.) Anyway, here’s a quote, which I can verify as accurate because I’ve hung out with her at HIMSS:

I have met quite a few people in HIT over the years and I love the opportunity to catch up with former co-workers and meet new people. I’m always on the look-out for HIT rock stars and always get excited when I see a big-name CIO or certain vendor CEOs. It’s totally a nerdy reaction and I have to remind myself to act cool and not like a 14-year-old who catches a glimpse of Justin Bieber. I also enjoy the exhibits. It’s fun to see what the buzz is and what new things vendors are promoting. I like seeing which vendors are over-the-top in terms of their marketing efforts and enjoy chatting with the smaller vendors assigned to small booths on the outer edges of the show floor. It’s a circus but I wouldn’t miss it.


Acquisitions, Funding, Business, and Stock

Imprivata announces that it added 160 healthcare customers in 2011 and increased its healthcare revenue by 103%.

Lexmark’s Perceptive Software unit posts an operating loss of $4 million for 2011, although Q4 revenue grew 41% from a year ago to $31 million. Lexmark CEO Paul Rooke says the company acquired Perceptive for growth and is pleased with the numbers.

2-14-2012 9-24-11 PM

Lumeris, Highmark, Horizon BCBS NJ, and Independence BC sign an agreement to acquire NaviNet, which offers a real-time communication network for physicians, hospitals, and health insurers.

Medicity will announce Wednesday that 2011 was its busiest year ever, with 43 contracts signed (22 by new customers, 21 by existing customers expanding their use.)

2-14-2012 7-57-19 PM

mrh_small GE Healthcare and Microsoft announce the name of their new joint venture as Caradigm, also announcing company executives and a board of directors comprised of company insiders. We cited a Geekwire article on February 3 speculating that Caradigm would be the name. The companies confirm that they’re working with the CenCal Regional Health Authority in Santa Barbara, CA to obtain permission to use the Caradigm name, which that organization trademarked years ago (their website still comes up at caradigm.com.) GE and Microsoft admit that they invested a lot more due diligence in choosing the Caradigm name than did CenCal RHA, which picked it in an employee “pick a name for our new company” contest 2002. The employee who came up with it got $50 and a pizza party.

2-14-2012 8-46-41 PM

mrh_small A New York Times piece says that Essence Healthcare, financially backed by legendary Silicon Valley investor John Doerr, is finally bearing fruit. Two of its holdings are ClearPractice (EMRs) and Lumeris (analytic software.) Lumeris was just announced as one of the purchasers of healthcare communication network provider NaviNet, where Lumeris software will help physicians answer administrative questions sent via NaviNet.

mrh_small Meditech kills its contested $65 million project to build an office complex in Freetown, MA, moving on to other location possibilities after a protracted archaeological fight with the state’s historical commission. Freetown gets to keep an empty lot that may or may not contain Native American remains, while somewhere else gets 800 high tech jobs.


Sales

2-14-2012 3-27-07 PM

Humility of Mary Health Partners (OH) signs an agreement with Care Logistics to implement the Care Logistics Hospital Operating System at three of its hospitals.

RegionalCare Hospital Partners (OH) selects MediClick’s supply chain and accounts payable solutions.

Community Health Alliance (VA) partners with MEDfx to create a statewide HIE.

Hawaii selects Medicity to provide the infrastructure for its statewide HIE.

2-14-2012 9-29-26 PM

Children’s Hospital and Medical Center (NE) selects iSirona’s device connectivity solution in conjunction with the launch of its Epic EMR.


People

2-14-2012 5-35-34 PM

Diversinet Corp. appoints interim CEO Hon Pak, MD as CEO.

2-14-2012 3-30-21 PM

NexJ Systems appoints Eric Gombrich as SVP and GM of its Health Sciences Group.

2-14-2012 5-30-31 PM
Elsevier promotes Jay Katzen to managing director of its Clinical Decision Support group within Elsevier Health Sciences.

2-14-2012 5-36-39 PM

Randy Drawas joins M*Modal as chief marketing officer.

2-14-2012 5-37-59 PM

PerfectServe names Optum Accountable Care Solutions CEO Todd Cozzens to its board.

William G. Bithoney, MD joins the healthcare business of Thomson Reuters as the national provider business medical leader. He was previously interim president, CEO, COO, and CMO at Sisters of Providence Health System (MA).

2-14-2012 5-45-30 PM 2-14-2012 5-45-00 PM

Healthcare consulting firm WPC names Ray Guzman (Microsoft) as SVP of sales and business development and Brad Hutson as  chief security officer.

2-14-2012 5-39-57 PM

Fletcher Allen Health Care (VT) hires Healther Roszkowski as chief information security officer.

MedHOK appoints David Butterworth (Emdeon) as SVP of business development.

2-14-2012 6-16-18 PM

Glenn Yarbrough joins the Health Information Partnership for Tennessee as director. He was previously with Ardent Health Services and was the CTO of the State of Tennessee.


Announcements and Implementations

2-14-2012 5-47-31 PM

Saratoga Hospital (NY) deploys DigitalPersona Pro and U.are.U Fingerprint Readers for identity authentication.

Norma Tirado, VP of HR and HIT for Lakeland Healthcare (MI), discusses her organization’s implementation of Epic, which goes live this month.

2-14-2012 5-46-42 PM

HIMSS and the nonprofit trade association Open Health Tools announce a collaboration to promote the use of open source tools in healthcare.

Optum launches a cloud-based healthcare environment and Optum Care Suite, a set of applications that provide detailed health intelligence on patient, system, and population health. We interviewed Optum SVP Ted Hoy about the announcements this week.

VistA provider DSS launches a mental health kiosk for behavioral health hospitals.


Government and Politics

Federal authorities say they recovered $4.1 billion in healthcare fraud judgments last year, up about 50% from 2009.

President Obama’s fiscal year 2013 budget proposal includes $66 million for ONC, an 8% increase over FY2012. That includes $12 million for standards and interoperability work for data exchange, $7.8 million to support EHR adoption, and $5 million for health privacy and security efforts. The proposed budget also includes a 5% cut for the Office for Civil Rights.

mrh_small The VA wants a 7% increase in its FY 2013 IT budget, looking for $3.37 billion. It wants $169 million to continue development of a shared EMR with the Department of Defense, $53 million to develop a Virtual Lifetime Electronic Record, and $1.45 billion for hardware maintenance. The VA seems to be less optimistic that it seemed previously about turning over its VistA data centers to DoD, saying that unless DoD carves out specific space within its data centers to allow VA personnel to run its own systems, they will pursue setting up interim data centers. Nice digging by the folks at Nextgov.

mrh_small In Canada, the illegally accessed medical records of a high-ranking member of the country’s Veterans Review and Appeal Board are used in a smear campaign by fellow agency members who disagreed with his review decisions. Up to 40 officials accessed the files of the decorated veteran in order to use his service-related disabilities to discredit him.


Technology

The US Patent and Trademark Office awards DR Systems a patent related to methods of matching medical images according to user-defined matching rules.


Other

2-14-2012 3-14-44 PM

KLAS examines medical device integration systems, focusing on Capsule’s DataCaptor, Cerner’s iBus, and iSirona’s DeviceConX.

2-14-2012 6-11-03 PM

CapSite’s 2012 US Smart Infusion Pump Study finds that 34% of hospitals are in the market for new infusion pumps.

The Tulsa newspaper profiles a BCBS Oklahoma project in which physicians at University of Oklahoma in Tulsa who offer a patient-centered medical home can review the medical claims data of covered patients to get a better picture of their health status.

mrh_small A Bloomberg article says that TV cable carriers are building up their broadband revenue from hospitals and practices, offsetting declining residential cable subscriber counts by charging medical users higher prices for using their networks. Cox says telecommunications companies such as AT&T and Verizon have 80% of the healthcare business, which it estimates at $460 million in the areas it serves. Comcast says healthcare represents a big chunk of the business services market that it estimates is worth $10-15 billion per year. Cable companies can offer lower prices through bundling, but they are less competitive in the areas of data security and wireless communications. AT&T says its healthcare revenue is $5 billion per year.

In the UK, an orthopedic surgeon criticizes thieves who steal live communications cable, which in repeated incidents has taken hospital systems offline, caused surgeries to be postponed, and forced hospitals to deal with downtime of telephone systems and PACS.

2-14-2012 9-32-02 PM

Rice Memorial Hospital (MN), preparing for a computer system conversion, offers patients a 25% amnesty discount to pay old bills so the hospital can shut down its retired billing system earlier.

mrh_small This isn’t really healthcare related, but it’s too funny not to mention. A Marshall University student files suit against a fraternity and one of its members after a party at the fraternity house, in which the allegedly intoxicated fraternity brother tried to shoot a bottle rocket out of his rear. The plaintiff says the bottle rocket exploded in the brother’s rectum, which according to the suit, “startled the plaintiff and caused him to jump back” and fall off the deck, with the resulting injuries costing him playing time with the baseball team.


Sponsor Updates

  • WellPoint (CO) selects Health Language Inc’s LEAP I-10 to transition to full ICD-10 compliance.
  • SRS releases an enhanced version of its certified EHR.
  • Heritage Valley Health System (PA) enhances its mobile iPad app using the dbMotion platform.
  • Fletcher Allen Health Care (VT) will deploy MEDSEEK’s patient portal and optimization services.
  • Wellsoft launches its redesigned website.
  • Orion customer Inland Empire HIE launches its pilot running six hospitals, seven practices and a health plan.
  • CareTech Solutions releases an interactive brochure explaining the capabilities of a hospital-specific help desk.
  • A Vitera Healthcare survey finds that 25% of practices are not aware of the required transition to ICD-10, though larger organizations appear more aware and have a greater sense of urgency.
  • Beacon Partners’ Ben Tobin provides tips for managing revenue cycle and cash flows in the midst of health reform.
  • The Advisory Board Company announces a webinar highlighting its Crimson Critical Advantage platform.
  • Trustwave partners with John Gomez’s JGo Labs to enhance and evolve Trustwave’s healthcare product line.
  • Tri-River Family Health Center discusses its use of RelayHealth to  communicate and reduce non-emergency phone calls.
  • Caremore (CA) purchases PatientKeeper’s Charge Capture software.
  • UMass Memorial (MA) standardizes on Informatica’s data integration platform for integrated views of patients, providers, and encounters.
  • Intelligent InSites announces that its RTLS solution supports ThingMagic Astra passive RFID readers.
  • Emdeon joins the Interoperability Showcase at HIMSS.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

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February 14, 2012 News 2 Comments

HIStalk’s Guide to HIMSS12

February 11, 2012 News 2 Comments

Download a PDF version of this document here.

2-5-2012 3-43-02 PM

3M Health Information Systems       

Booth 3334

Contact: Jolie Gordon, Marketing Communication Specialist
jegordon@mmm.com    801-560-4788

booth crawl smakk

Best known for our market-leading coding system and ICD-10 expertise, 3M Health Information Systems delivers innovative software and consulting services designed to raise the bar for clinical documentation improvement, computer-assisted coding, mobile physician applications, case mix and quality outcomes reporting, and document management. Our robust healthcare data dictionary and terminology services also support the expansion and accuracy of your electronic health record (EHR) system. With nearly 30 years of healthcare industry experience and the know-how of more than 100 credentialed 3M coding experts, 3M is the go-to choice for 5,000+ hospitals worldwide that want to improve quality and financial performance.



12-23-2011 6-54-08 AM

Access

Booth 860

Contact: Cody Strate, Director of Sales
cody.strate@accessefm.com
303.257.3183

booth crawl smakk

Access is the world’s leading electronic forms (e-forms) management, automation and workflow software provider. Our solutions transform any paper-intensive forms process into a paperless, collaborative one.     Stop by HIMSS Booth 860 to see how Access can help you achieve paperless:

  • Registration and consent forms on demand with electronic signatures & barcodes
  • Human resources, financials and clinical processes, including new employee onboarding, capital requests, and physician referrals
  • Clinical data bridge to your enterprise content management system

Learn more at www.accessefm.com.


Advisory Board Company

Booth 7310

2-4-2012 5-18-13 PM

Contact: Leah Bruch, Senior Manager Strategic Marketing
bruchl@advisory.com
202.266.6775

booth crawl smakk

The Advisory Board Company is a global research, consulting, and technology firm partnering with 125,000 leaders in 3,200 organizations across health care and higher education. Through our innovative membership model, we collaborate with executives and their teams to elevate performance and solve their most pressing challenges. We provide strategic guidance, actionable insights, web-based software solutions, and comprehensive implementation and management services.

Learn more at www.advisory.com.


1-15-2012 11-40-22 AM

AirStrip Technologies, Inc. 

Booth 870

Contact: Kimberly Kuzawa, Executive Assistant
Kimberlykuzawa@airstriptech.com
832.330.4419

booth crawl smakk

Native applications from AirStrip Technologies securely send critical patient information from hospital monitoring systems, bedside devices, electronic health records and home devices to a clinician’s smartphone or tablet. FDA cleared, CE Mark certified and designed to meet HIPAA security requirements, AirStrip applications are powered over wired and wireless networks, delivering live patient data anytime, anywhere.


2-4-2012 2-51-19 PM

ANX   

Booth 13429

Contact: Mike Nunez, Director, Healthcare Business Development
nunezm@anx.com
806.797.2923

ANXeBusiness provides innovative solutions that transform the exchange of data throughout the entire healthcare community. This solution set creates an easy, reproducible, cost efficient and secure exchange between hospitals and laboratories. This allows the hospital and laboratory to focus on what they do best; the complete patient continuum of care. To learn more about ANXeBusiness, please visit us at www.anx.com.


1-15-2012 11-48-10 AM

API Healthcare

Booth 2617

Contact: Kenny Amburgey, Vice President of Client Strategies
kenny.amburgey@apihealthcare.com
262.385.7732

booth crawl smakk

Solutions designed for the unique demands of the healthcare industry. API Healthcare solutions create the crucial link that allows you to effectively balance the financial realities of healthcare with the delivery of high quality patient care.   Robust integration and data driven staffing tools are what make API Healthcare workforce management solutions powerful:

  • Fully integrated, single platform technology
  • Complete multi-dimensional insight into all areas of an organization allow for intuitive, cost effective decisions
  • Data driven staffing tools ensure the right patient and the right caregiver match, every time
  • Streamlines processes, increases efficiency and optimizes every aspect of your workforce

1-15-2012 11-48-59 AM

Aspen Advisors

To schedule a meeting:

Contact: Daniel Herman, Managing Principal and Founder
info@aspenadvisors.net
800-697-4350

booth crawl smakk

Aspen Advisors is a professional services firm with a rich mix of respected industry veterans and rising stars who are united by a commitment to excellence and ongoing dedication to healthcare. Our experienced team is highly skilled in all aspects of healthcare technology. We understand the complexities of healthcare operational processes, the vendor landscape, the political realities, and the importance of projects that are executed successfully – the first time. Every client is important to us, and every project is critical to our reputation. Established in 2006, we’ve grown significantly year-over-year and have earned accolades for our culture and growth.

We were named an “Up and Comer” by Healthcare Informatics in 2010 and ranked #20 in Modern Healthcare’s list of the top 100 “Best Places to Work in Healthcare” in 2011.   Our hallmarks are top quality service and satisfied clients; we’re proud of our KLAS rankings and that each of our clients is 100% referenceable. For the last four consecutive years, Aspen has ranked in the Top 5 in KLAS’ “Best in KLAS Awards” report in the Planning and Assessment category and were included in the Top 20 in the Clinical Implementation Supportive market segment.    Interested in learning more about how Aspen Advisors can help you address the issues on your top priority list?  Or looking to join a firm where healthcare IT consultants aren’t commodities, communication isn’t curbed, and potential never gets stuck in a pigeon hole?

To learn more about Aspen Advisors – either as a prospective client or prospective associate, please consider scheduling an in-person meeting at HIMSS or visit us at http://www.aspenadvisors.net.


1-15-2012 11-49-41 AM

 

AT&T

Booth 3829

Contact: Deborah Sunday    Marketing Director
ds823e@att.com
678.230.3440

AT&T ForHealth℠ is committed to serving the technology needs across the continuum of care — from hospitals to physicians to patients. Our suite of innovative wireless, cloud-based and networking services and applications empower clinicians by placing vital patient health information at their fingertips. Learn how to rethink healthcare delivery by visiting AT&T ForHealth in Booth #3829 at HIMSS12 in Las Vegas. Also, be sure to visit and hear AT&T speakers in the HIMSS Knowledge Centers for Mobile Health (#12928, Hall G, Kiosk 14 ), Cloud Computing (#13624, Hall G, Kiosk 5) and Accountable Care Organizations/Value-Based Purchasing (#6466, Hall D, Kiosk 8)


 

1-15-2012 11-50-45 AM

Aventura

Booth 8300

Contact: Brian Stern, VP of Sales
info@aventurahq.com
888.484.4643

booth crawl smakk

Aventura improves the current workflow of doctors and nurses. We give clinicians the information they need, when and where they need it. Our context aware computing intelligence orchestrates technologies already in place making them responsive to the user. The result is improved clinician satisfaction, increased EMR use at the point of care, and an increased focus on the quality of care.


1-15-2012 11-51-54 AM

Awarepoint Corporation

Booth 3412

Contact: Merrie Wallace, Executive Vice President, Product Solutions and Marketing
marketing@awarepoint.com
888.860.3463

booth crawl smakk

Awarepoint’s aware360Suite provides intelligent workflow solutions that meet departmental and enterprise-wide patient tracking needs. The solution visualizes patient flow without requiring personnel to manually update care status information. Patient location, movement and interactions with tagged personnel and clinical equipment trigger updates to the web-based software, which employs workflow rules to recognize patient care milestones. By improving patient visibility throughout the enterprise, Awarepoint helps administrators and clinicians to advance the QUALITY of care, the EFFICIENCY of care, the EXPERIENCE of care, and the ECONOMICS of care.


1-15-2012 11-52-52 AM

Beacon Partners   

Booth 3926

Contact: Katelyn MacKay, Business Development Coordinator
kmackay@beaconpartners.com
781.681.7407

As one of the largest healthcare management consulting firms, Beacon Partners is chosen by organizations in the healthcare community to provide advisory services to improve overall operational, clinical and financial performance with the adoption of information technology. With our strategic approach and depth of experience, Beacon Partners is qualified to help organizations navigate the challenges in healthcare and optimize their potential to deliver the highest possible level of patient care.


1-15-2012 11-55-13 AM

BESLER Consulting

To schedule a meeting:

Contact: Jim Hoffman, Chief Technology Officer
jhoffman@besler.com
732.392.8214
Available at HIMSS Tuesday or Wednesday

BESLER develops software tools and provides consulting services that help acute care hospitals get paid everything they deserve.  Our BVerified ™ online solutions allow our customers to manage underpayment recoveries that have traditionally been accomplished via a consulting engagement, providing typical saving of 50%.  We’ve just launched our two newest products and we’re the only company with an end-user technology solution to address the Medicare IME and Transfer DRG underpayment issues.


 

1-15-2012 11-55-54 AM

Billian’s HealthDATA

Booth 7707

Contact: Jennifer Dennard, Social Marketing Director
jdennard@billian.com
678.569.4872

Billian’s HealthDATA is the leading provider of comprehensive market intelligence on the healthcare industry, covering facilities across the continuum of care – from Hospitals and Hospital-Affiliated Physicians to Long Term Care. Billian’s dedication to providing high-quality data via products like the Portal, coupled with partner company Porter Research’s custom market research services, provides customers with healthcare business intelligence about multiple markets in scaleable formats


1-15-2012 11-58-04 AM

Bottomline Technologies

Booth 12928 (Mobile Health Knowledge Center, Hall G)

Contact: Sarah Stevenson, Healthcare Marketing Manager
sstevenson@bottomline.com
603.380.8577

booth crawl smakk

For more than 20 years, Bottomline has been focused on software applications that optimize document-driven processes. As a result, Bottomline possesses both the proven solutions and the tested domain expertise to deliver consistent customer value and significant return on investment. Bottomline’s medical forms solutions are used by 900+ hospitals to reduce costs, increase productivity & improve patient safety. Our goal is to help hospitals, clinics and practices adopt electronic medical records – from registration and consents to clinical documentation – an evolution that has been plagued by counter-intuitive approaches that aren’t as flexible and fast as paper.


1-15-2012 12-01-45 PM

CAP Professional Services   

To schedule a meeting:

Contact: Chip Perkins, Managing Director
cperkins@cap.org
847.832.7280

CAP Professional Services, a division of the College of American Pathologists, works to align health care information and technology to drive performance and quality. We are advancing health information excellence by focusing on services such as: Health Information Strategies and Management, Clinical Data and Terminology Services, and Laboratory Services. For more information, call 847-832-7700 or email capsts@cap.org.


1-15-2012 12-03-12 PM

CapSite

To schedule a meeting:

Contact: Bryan Fiekers, Director of Business Development
bryan.fiekers@capsite.com
802.383.8205

CapSite is a healthcare technology research and advisory firm. Our mission is to help healthcare providers and vendors make more informed strategic decisions.The CapSite Database is the trusted, easy to use online database, providing critical knowledge and evidence based information on healthcare technology purchases. CapSite™ data provides detailed transparency on healthcare technology pricing, packaging and positioning.When it all comes to healthcare technology research, it helps to see all the details. Those details are now available with CapSite™


1-15-2012 12-03-51 PM

Capsule Tech, Inc

Main Booth 6141
HIMSS Intelligent Hospital Pavilion Booth 12442
Interoperability Showcase Booth 11000
Medical Devices Integration Knowledge Center Booth 14647

Contact: Heather Hitchcock, Vice President of Global Marketing
marketing@capsuletech.com
978.482.2337

booth crawl smakk

Capsule is the leading provider of medical device integration. Capsule’s Device Connectivity Solution is the most proven, vendor neutral solution available for device connectivity. It features a patient-centric design that is completely flexible and scalable and integrates with existing technologies and clinical workflows. Stop by our booth 6141 to see why over 1000 hospitals have chosen Capsule for device integration.


2-13-2012 2-10-10 PM

Care360

Booth 2813

Contact: Joel Williams, Associate Director-Sales Support and Operations
Info@Care360.com
www.Care360.com
888.835.3409

booth crawl smakk

Racing to Expand Your Physician Community? Accelerate your competitive advantage by joining our existing Care360 network of more than 200,000 physicians in 80,000 physician offices. Care360® EHR is a certified EHR solution that can be up and running in as little as 30 days, allowing physicians to transition workflow from paper to electronic management in a modular approach. Care360 EHR with Data Exchange connects hospitals to physician practices with a web-based platform to share information. ChartMaxx® DMI/ECM enables healthcare organizations to see immediate improvements through electronic document and content management, eForms and automated workflows that cross existing sytems. To learn more, visit Care360.com


2-13-2012 2-17-29 PM

Certify Data Systems, Inc.

Booth 5934

Contact: David Caldwell, Executive Vice President
sales@certifydatasystems.com
713.446.3376

Certify Data Systems, Inc., is a pioneer in health information exchange (HIE) technology. The company’s Enterprise HIE Platform has been adopted by the nation’s leading hospitals and health systems.  The bi-directional HIE platform, provides true interoperability between disparate Electronic Health Record (EHR) systems, enabling hospitals and health systems, their affiliated physician practices and laboratories to exchange essential health information in real-time without changing workflow.  Moreover, Certify’s “network approach” is easy to deploy, scale, manage and support. For more information, please visit http://www.certifydatasystems.com. Follow us on Twitter at @CertifyData.


2-4-2012 2-56-12 PM

Command Health   

To schedule a meeting:

Contact:
Evan Frankel, Director of Product Management
evan.frankel@commandhealth.com
303.301.0430

booth crawl smakk

Command Health is the leader of narrative note technology, focusing on unifying clinical documentation from disparate sources across the continuum of care. Combining verbal interaction with visual integration, Command Health enables the efficient and accurate capture of patient data that is easy to find, use, share and search by converting locked, inaccessible data into actionable, meaningful information. Using proprietary natural language processing (NLP) technology combined with human intelligence, Command Health delivers the most comprehensive clinical data available, helping providers reduce costs, assess risk and manage outcomes.


2-11-2012 7-59-14 AM

CTG Health Solutions   

Booth 2070

Contact: Carl Ferguson, Jr., Managing Director
carl.ferguson@ctghs.com
214.695.4227

CTG Health Solutions is a leading healthcare IT consulting firm providing strategic, clinical, financial, operational, and technology solutions. Offering advisory services, strategic/tactical planning, vendor selection, implementation, legacy system support, program/project management and advance technology services, CTG helps healthcare organizations address regulatory mandates of meaningful use, 5010, ICD-10, HIE, electronic medical records, accountable care and evolving health reform. CTG Health Solutions is a business unit of CTG (NASDAQ: CTGX) a publicly owned IT services and solutions company founded in 1966 that generated revenue of $331 million in 2010. More information is available at www.ctghs.com.

Experience matters. Over the last 25 years, CTG Health Solutions has provided healthcare IT, and operational and strategic consulting support to over 600 healthcare organizations. Since 2008, CTG has continuously been named to Healthcare Informatics top 100 healthcare IT providers and the Modern Healthcare lists of the largest healthcare management consulting firms. CTG was also cited in the March 25, 2010, issue of Information Week as one of the top three firms for healthcare organizations looking for help in implementing EMRs and other health IT investments.


1-15-2012 12-11-03 PM

Cumberland Consulting Group

Booth 5147

Contact: Jim Lewis, Managing Partner
jim.lewis@cumberlandcg.com
615.373.4470

booth crawl smakk

Cumberland Consulting Group is a national technology implementation and project management firm serving ambulatory, acute, and post-acute healthcare providers. Through the implementation of new technologies, Cumberland works with providers to advance the quality of care delivered, and improve business performance. Cumberland Consulting Group offers an invigorating, positive work environment and a commitment to superior talent acquisition, development and retention.Cumberland was named Best in KLAS for IT Planning & Assessment in the 2011 Best in KLAS Awards: Software & Services report, finishing in a first-place tie.

Cumberland Consulting Group Says: Stop by and meet some of our top implementation consultants and learn about Cumberland’s excellent delivery record, straightforward implementation methods and lean operating model that delivers big company results at a very attractive price. Be sure to catch Cumberland’s Erik Howell presenting Physician-to-Physician: Driving Inpatient CPOE Clinical Transformation, Session 184,Thursday Feb. 23 at 2:15pm.


1-15-2012 12-11-56 PM

CynergisTek   

To schedule a meeting:

Contact: Stephanie Crabb, VP of Client Services
stephanie.crabb@cynergistek.com
512.402.8550 or 954.298.4702

CynergisTek is an authority in healthcare information security management services and solutions.  We assist hospitals, payers, vendors and other valued business partners to the healthcare industry with the development and management of standards-based, industry-appropriate, business-driven and compliance-aware information security programs.  CynergisTek is a full-service firm offering solutions in the areas of strategy and governance, compliance and risk, technical security management, managed security solutions and partner technology resales and implementation.    CynergisTek was chosen to provide advisory and consulting services throughout the organization’s audit experience by one of the first 20 entities targeted by OCR for its HIPAA Audit Program.  CynergisTek has led dozens of risk assessment projects for organizations attesting for Meaningful Use.  CynergisTek has established its Surveyor program to provide critical third-party review of business associate compliance with HIPAA and to support organizations with independent review of IT security performance as part of their M&A due diligence activities.  CynergisTek has led dozens of data discovery and data loss breach risk assessments to help organizations identify where PHI/PII reside in their organizations and how that data is being handled.
CynergisTek is working on the front lines, side-by-side, with our clients to address the most pressing IT security, privacy and data governance challenges.  We are visionary.  We are practical. We make our clients better.


 

2-4-2012 2-57-20 PM

DrFirst, Inc.

Booth 5456

Contact: Timur Tugberk, Events, Brand, and Media Coordinator
ttugberk@drfirst.com
301.231.9510 ex. 2835

Founded in 2000, DrFirst is the nation’s leading e-prescribing and solutions platform provider to physician practices, major health plans, health systems, hospitals, and EHR vendors. Through its Open Borders Program, DrFirst solutions integrate with over 200 EHR, practice management and HIT systems. A Surescripts Gold Certified solution provider for four consecutive years with its award-winning Rcopia electronic prescription management system, DrFirst utilizes the Surescripts network for pharmacy connectivity, health plan information, and patient medication history. For more information, visit www.drfirst.com.


1-15-2012 12-25-57 PM

eClinicalWorks   

Booth 531

Contact: Heather Caouette, Marketing
heather.c@eclinicalworks.com
508.836.2700

eClinicalWorks offers ambulatory clinical solutions consisting of EMR/PM software, patient portals and a community health records application. With more than 180,000 providers and 370,000 healthcare professionals across all 50 states using its solutions, customers include physician practices, out-patient departments of hospitals, health centers, departments of health and convenient care clinics. At HIMSS, please visit the eClinicalWorks booth to see the latest in iPad and patient applications, community analytics and ACO capabilities.


1-15-2012 12-28-11 PM

Elumin Healthcare Solutions

To schedule a meeting:

Contact: Mark Williams, CEO & President
mwilliams@eluminhs.com
425.369.8211

Elumin works with healthcare organizations across the country to improve quality, efficiency and their bottom line through the use of information technology throughout the continuum of care. Our work ultimately leads to greater clinician, physician, staff and patient satisfaction. Many of Elumin’s consultants are clinicians, and many have worked in hospitals and physician practices as business and clinical leaders. Many are certified and experienced in premier technologies such as Allscripts, Epic, Cerner, NextGen and Siemens. On average, our consultants have more than 15 years of experience. We strive to achieve 100% referenceability among our clients. Elumin is 100% focused on healthcare.

Elumins services include:  advisory services, system implementations, data conversions, clinical optimization, revenue cycle management, legacy platform support, ICD-10, 5010 migration, and interim staffing. Our team of experienced healthcare professionals thrives on implementing best practices, optimizing technology and guiding clients through the change management process.

Elumin representatives will be attending the 2012 HIMSS conference Monday Feb. 20 – Friday, Feb. 24. They look forward to meeting new healthcare industry leaders and sharing insight on trending topics.  Let us help you bring light to the best of healthcare technologies’ promise.


1-15-2012 12-28-51 PM

Encore Health Resources

Booth 123

Contact: Randi Fiedler, Director, Sales Operations
rfiedler@encorehealthresources.com
832.289.0923

Encore Health Resources helps implement and optimize EHRs and complex clinical systems to get value from the data. We do this through our tools, knowledge base and proprietary approach, and by employing healthcare IT professionals with deep operational experience.

Encore was formed by healthcare IT veterans Dana Sellers and Ivo Nelson. We are one of the fastest growing independent consulting firms in the history of our industry. That rapid growth is attributed to our principles’ sterling reputation, our staff’s depth of experience, and our commitment to remaining 100% referenceable with each and every one of our clients. Encore has consistently been named one of the “Best Places to Work in Healthcare” by Modern Healthcare magazine.


1-15-2012 12-30-58 PM

ESD

Booth 4616

Contact: Jessica St. John, Director of Business Development
jstjohn@contactesd.com
419.841.3179

ESD is a leading healthcare IT consulting firm that assists organizations implement new or updated heathcare information technology. Experienced clinical consultants provided by ESD work closely with hospitals, clinics and health systems to evaluate current capabilities, establish clinical transformation strategies and assist clinicians in the transition to new or updated solutions, with the end goal being a successful transition to new technology. ESD’s headquarters is located in Toledo, Ohio and has five satellite offices located in Atlanta, Detroit, Cincinnati, New York and Houston.

Whether it’s time to implement a whole new system throughout your organization or just a component to one department, we have the experience and resources to both complement your team, and meet your goals.


1-15-2012 12-31-56 PM

Etransmedia Technology, Inc

Booth 13635

Contact: Craig Cane,VP, Business Development
craig@etransmedia.com
845.594.7247

booth crawl smakk

Etransmedia Technology, Inc is a premier provider of information solutions to the healthcare industry, delivering comprehensive integrated software, service and connectivity solutions to simplify critical functions in the healthcare community. Etransmedia is committed to providing the right solutions to build an effective community of care, driving revenues and efficiencies for ambulatory, acute and diagnostic facilities, and increasing the availability of information to providers making critical care decisions.


2-5-2012 3-36-28 PM

First Databank (FDB)   

Booth 2338

Contact: Denise Apcar, Brand Communications Manager
dapcar@fdbhealth.com
800.633.3453

First Databank (FDB) provides drug knowledge that helps healthcare professionals make precise medication-related decisions. With thousands of customers worldwide, FDB enables our information system developer partners to deliver a wide range of valuable, useful, and differentiated solutions. As the company that virtually launched the medication decision support category, we offer more than three decades of experience in transforming drug knowledge into actionable, targeted, and effective solutions that improve patient safety and healthcare outcomes. For a complete look at our solutions and services please visit fdbhealth.com


 

1-22-2012 3-25-33 PM

Fulcrum Methods

Booth 13247 Kiosk 6

Contact: Rick Beberman, Corporate Programs
rbeberman@fulcrummethods.com
510.287.3927

booth crawl smakk

Fulcrum Methods has developed toolkits to assist hospitals and health systems with project management and meaningful use.  We deliver work plans, guidebooks, libraries of deliverables, and online assessment tools to help organizations with vendor selection, systems implementation, long-range planning, establishing a program management office, managing organizational change, and meeting meaningful use requirements.

We have a great client list – Stanford University Hospital & Clinics, Lucile Packard Children’s Hospital, University Hospitals, MaineHealth, University of Kentucky HealthCare, John Muir Health, Community Medical Centers, and NorthBay Healthcare, among others. Our tools are encyclopedias of best practices and designed to develop core competencies, reduce execution risk, accelerate project rollout, and keep organization knowledge in-house.


1-15-2012 6-25-39 PM

GetWellNetwork 

Booth 7910

Contact: Tony Cook, Vice President Marketing
tcook@getwellnetwork.com
202-321-9396

GetWellNetwork entertains, educates, and empowers patients throughout the patient journey using the bedside TV in the hospital, mobile devices, Web or Cable TV at home. Our patient-centered approach improves both satisfaction and outcomes for patients and hospitals. Additionally, the company extends the value of existing IT investments by integrating seamlessly to leading HIT systems including Cerner, McKesson, Epic, Meditech, GE and Siemens.

GetWellNetwork is recognized by KLAS® as the leader in Interactive Patient Systems and is exclusively endorsed by the American Hospital Association. More information about GetWellNetwork can be found at www.GetWellNetwork.com.


2-4-2012 2-59-29 PM

Harris Corporation   

Booth 834

Contact: Amy Ferretti, Vice President, Marketing
amy.ferretti@harris.com
925.518.9895

Harris is advancing healthcare for more than 300,000 users at over 2,000 provider organizations delivering care to nearly 13,000,000 patients – by delivering proven solutions that enable healthcare organizations to constantly improve quality of care while containing costs, increasing revenue, and addressing the new world of accountability and value.   We provide a portfolio of solutions that promote interoperability, streamlined workflow, and analytics; all of which are adaptable to our customer’s specific care delivery setting and the unique requirements of their physical, technical, and user environments.

  • Health Information Exchange
  • Patient Portal
  • Provider Portal
  • Business Intelligence
  • Workflow Management
  • Image Management
  • Managed Services
  • Systems Integration  Communications

1-15-2012 6-27-49 PM

Hayes Management Consulting

To schedule a meeting:

Contact: Bill Gannon, Director
bgannon@hayesmanagement.com
541.647.0825

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Hayes Management Consulting is currently helping clients prepare for Meaningful Use, ICD-10 migration, and other initiatives by providing strategic guidance and hands-on expertise in EHR system implementation and optimization, project management, project resources and more.


 

1-15-2012 6-32-21 PM

Healthwise 

Booth 4627

Contact: Dave Mink, Account Executive
dmink@healthwise.org
208.331.6971

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Healthwise leads the way with ONC–ATCB-certified patient education that contributes to improved care quality. Helping hospitals meet Meaningful Use criteria today, and tomorrow’s ACO goals, the Healthwise Patient Education Solution seamlessly integrates into EMRs, PHRs, and websites. Ask about our new shared decision-making tools and patient response. www.healthwise.org.

 


2-4-2012 3-01-26 PM

Holon Solutions   

Booth 12214

Contact: Sandra Schafer, Vice President of Marketing and Business Development
sschafer@holonsolutions.com
678.324.2039

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At Holon we believe that collaboration improves lives. Holon’s CollaborNet™ facilitates collaboration among healthcare providers by creating secure networks that manage the assembly, packaging, routing and delivery of vital health information. Holon’s CollaborNet connects providers regardless of their level of technological sophistication, using the systems in place and with or without standard communication protocols. CollaborNet is flexible and adaptable and can support changes to communication standards and methods as they develop. CollaborNet builds value from the bottom up by delivering information WHEN, WHERE and HOW you need it. For more information please visit us at www.HolonSolutions.com.


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Iatric Systems, Inc.

Booth 7905

Contact: Judy Volker
Judy.Volker@iatric.com
978.805.3191

booth crawl smakk

If you’re attending HIMSS12 to find ways to get the most out of your HIS, be sure to visit Iatric Systems booth. There you’ll learn about solutions that can be integrated with your HIS in order to help you achieve interoperability, meet Meaningful Use objectives and support your ACO initiatives.

Recognized by Inc. 5000 as one of the fastest growing privately held companies for the past four years, Iatric Systems helps hospitals and health systems leverage their HIS investment with software, interfaces and reporting services. Since 1990, more than 1,000 hospitals worldwide have implemented Iatric Systems solutions; optimizing patient care and staff workflow in clinical, financial and administrative areas. Iatric Systems was acknowledged on the Healthcare Informatics Top 100 Healthcare IT Revenue list in 2009/2010/2011 and the Modern Healthcare Top 100 Best Places to Work in Healthcare IT in 2009/2010/2011.

Get your chance to win an iPad 2 during the HIStalk Booth Crawl: Be sure to stop at the Iatric Systems booth for the chance to win the perfect, portable tool for checking e-mail, surfing the Web, playing games, reading books and visiting important Websites like Iatric.com.


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ICA  

Booth 4831

Contact: John Tempesco, CMO
john.tempesco@icainformatics.com
615.866.1465

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ICA’s CareAlign® care management solutions connect the healthcare community with proven interoperability technologies enabling health information exchange and improved care delivery. This patient-centered modular approach offers immediate value and return-on-investment to communities, IDNs, hospitals and physicians through the delivery of clinical information to the point-of-care improving quality while reducing costs.  Visit booth #4831 for a demonstration of the CareAlign solution suite.


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iMDsoft   

Booth 4215

Contact: Steve Sperrazza, Vice President, North America Sales
sales@imd-soft.com
866.4 iMDsoft, 781.449.5567

iMDsoft is a leading provider of Clinical Information Systems for critical and perioperative care. The company’s flagship family of solutions, the MetaVision Suite, was first implemented in 1999. It captures, documents, analyzes, reports and stores the vast amount of patient-related data generated in a hospital. Over 125 hospitals worldwide use MetaVision to support their workflow, and arm their healthcare professionals with timely, accurate, and actionable information. iMDsoft products demonstrate 100% implementation success rate and a 100% customer retention rate.

Come visit our booth to find out why 4 of the top 10 US hospitals have decided that MetaVision is the best choice for improving care quality and financial performance. Providing an integrated edge where it matters most, MetaVision delivers high-impact results such as 30% fewer mortalities, 100% billable anesthesia records, total elimination of prescription errors, 99% compliance with PQRS measures and doubled protocol compliance.

Learn more about how MetaVision interoperates with the latest technologies and seamlessly integrates with hospital systems at the HIMSS12 Interoperability Showcase held in collaboration with Integrating the Healthcare Enterprise (IHE), from 21-23 February.


1-16-2012 9-00-49 AM

Imprivata   

Booth 3160

Contact: Jim Whelan, VP of NA Healthcare Sales
jwhelan@imprivata.com
508.395.2235

Learn directly from hospital CIOs on how they saved their clinicians more than 15 minutes per day and improved workflows with Imprivata OneSign. Hospital CIOs and Directors using Epic, McKesson, Siemens, Meditech and Healthland will be available to answer your questions. After the presentations, you can try a hands-on demo of No Click AccessTM to applications and roaming virtual desktops throughout the Imprivata booth. Imprivata is also raffling off 30 Kindle Fires, which will be raffled off after each theater presentation!


2-4-2012 3-03-13 PM

Informatica   

Booth 9107

Contact: Jonathan Shafer, Senior Customer Marketing Campaign Manager
jshafer@informatica.com
650.385.5000

Informatica Corporation is the leading independent provider of enterprise data integration software and services. Using Informatica solutions, healthcare organizations can access, discover, cleanse, integrate, and deliver all enterprise data to improve health outcomes, meet compliance mandates, streamline operations, increase agility, and refocus energy on the consumer. More than 4,100 companies worldwide and hundreds of healthcare companies rely on Informatica for their end-to-end enterprise data integration needs.


1-16-2012 9-01-34 AM

Ingenious Med   

Booth 4663

Contact: Laura DePeters,Marketing Manager
laura.depeters@ingeniousmed.com
404.786.2340

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Ingenious Med’s Inpatient Physician Management Platform is the leading charge capture and physician performance solution in the health care industry today. Our cloud-based, charge capture and analytics platform provides real-time data that helps hospital systems and physician groups maximize revenue, improve physician productivity, enhance quality of care, and increase diagnosis and billing accuracy and compliance.


1-16-2012 9-10-19 AM

Intelligent Medical Objects Inc.   

Booth 1256

Contact: Dennis Carson, Director, Marketing & Tradeshows
dcarson@imo-online.com
636.477.8710

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Interoperability For Healthcare Institutions IMO® Vocabulary products provide a common linkage across all electronic patient records, regardless of the standard needed for that particular data set (ICD9-CM, SNOMED® CT, HCPCS, RxNorm, ICD-10-CM). Most code mappings are updated several times per year, including regulatory updates. IMO® removes the burden of managing updates for you. Terminology Mapping For EMR Software Vendors    IMO® Vocabulary products let you focus on what you do best: provide great software to the healthcare industry. We furnish up-to-date code and terminology mappings, with expanded search capabilities, across standards needed for EMRs, EHRs and PHRs (ICD9-CM, ICD10-CM, SNOMED® CT, HCPCS, RxNorm). Get ready for ICD-10 now!


1-16-2012 9-07-51 AM

Intellect Resources       

To schedule a meeting:

Contact: Stowe Blankenship,Business Development Executive
336.790.8724 x 303
sblankenship@intellectresources.com
http://www.facebook.com/IntellectResourcesFan@wespeakHIT

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We speak the language of Healthcare IT. Intellect Resources is proud to offer comprehensive consulting, recruiting and hiring solutions within the Healthcare IT market. Our talent offerings include recruiting, project management, implementation, upgrading and optimization of EMR systems, training and go-live support and the revolutionary Big BreakSM hiring process.     Big BreakSM is patent-pending American Idol style audition process where candidates compete to become a healthcare IT trainer and instruct healthcare personnel on the use an EMR program. Big Break offers hospitals systems a unique and innovative talent pool at a fraction of the cost of traditional solutions.

For more information visit www.intellectresources.com or www.irbigbreak.com.


1-16-2012 9-09-30 AM

Intelligent InSites   

Booths 12217, 12442-18

Contact: George Sun, VP of Sales
george.sun@intelligentinsites.com
972.567.2114

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Intelligent InSites helps hospitals improve care and reduce costs by transforming automatically-collected data into actionable insights.Through its interoperable, hardware-agnostic, healthcare real-time location system (RTLS) software platform, Intelligent InSites gathers data from real-time location, condition sensing, and other systems; then delivers meaningful information to the right person, at the right time, on the right device.

By leveraging this real-time data and InSites’ applications, such as asset management, patient flow, temperature monitoring, and business intelligence, healthcare organizations are able to achieve meaningful and measurable hard-dollar cost savings while improving patient satisfaction and patient care. The InSites RTLS solution for Patient Flow enables hospitals to improve capacity management and key metrics such as Left Without Treatment (LWOT) and Length of Stay (LOS). It also improves rounding management, along with ED and OR workflow. With the InSites solution, hospitals can monitor patient flow and progress from admission to discharge, analyze throughput and proactively react to potential bottlenecks – all in real-time.  The InSites RTLS solution for Asset Management enables hospitals to optimize equipment inventories and equipment procurement, as well as reduce rental expenses. By eliminating time needed to find available equipment, hospitals can increase value-added time for nursing staff, clinical engineering, and facilities management, leading to improved patient and staff satisfaction.The InSites Business Intelligence (BI) solution enables easy-to-use data mining of vast quantities of contextual data stored in the InSites Business Intelligence database, allowing healthcare users to analyze trends, identify process improvement opportunities, and report on Key Performance Indicators (KPIs). This enables hospitals and healthcare systems to achieve powerful and flexible enterprise-wide visibility into their processes and make transformational impacts on their organization’s performance.


1-16-2012 9-11-07 AM

iSirona  

Booth 12414

Contact: Peter Witonsky,President & CSO
peter.witonsky@isirona.com
610.772.7648

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iSirona helps clinicians make more informed decisions about patients by providing an easy to use approach to medical device integration. Using iSirona’s software solution, hospitals can connect virtually any medical device to their CIS, providing clinicians with faster access to more accurate patient information. In 2011, iSirona was ranked #1 by KLAS for medical device integration systems.


2-5-2012 3-40-42 PM

Levi, Ray and Shoup, Inc.   

To schedule a meeting:

Contact: John Runions, Director, Worldwide Business Development / Alliances
john.runions@lrs.com
217-725-4017.    John Runions

Does your hospital struggle with printing issues? For more than three decades, LRS has been helping hospitals meet the need for reliable document delivery of critical healthcare documents. LRS works directly with leading Electronic Medical Records (EMR) software providers to provide a seamless platform for assured delivery of any document from any system — to any destination in your environment. This all managed from a secure central point of control designed to save effort, money and time when seconds count.


2-4-2012 3-05-13 PM

Lifepoint Informatics   

Booth 153

Contact: Lee Barnard, Chief Business Development Officer
lbarnard@lifepoint.com
201.560.3802

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Lifepoint Informatics is a leader in health IT focusing on laboratory outreach connectivity, health information exchange and clinical data interoperability to deliver on its mission to help healthcare providers improve patient care and lower costs through the use of information technology. Since 1999, Lifepoint Informatics has enabled over 200 hospitals, clinical labs and anatomic pathology groups to grow their market share and extend their outreach programs through the deployment of its ONC-ATCB certified Web Provider Portal and its comprehensive portfolio of ready-to-go EMR/EHR interfaces.
For more Information please visit www.lifepoint.com.


1-22-2012 3-29-38 PM

Macadamian   

To schedule a meeting:

Contact: Didier Thizy,  Director of Healthcare IT
didier@macadamian.com
613.219.5708

Macadamian is a global UI design and software innovation studio with significant  sector expertise in healthcare and life sciences. We work with Healthcare and medical  device companies to create visually stunning, intuitive, and commercially-successful software  products. We can help you transform your ideas into market-ready products that will stand  out from your competition.


2-4-2012 3-06-07 PM

MED3OOO   

To schedule a meeting:

Contact: Nicole Contardo, Corporate Marketing Director
Nicole_Contardo@MED3000.com
919.794.5881

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Since its founding in 1995, MED3OOO has grown to become a leading provider of healthcare management, operations, and information technology services across the United States.  With over 2,100 employees, MED3OOO provides sophisticated management services and innovative technology products which differentiate its physician, hospital, employer, government, and payer clients.  The company provides a complete platform of clinical and business performance solutions, including PM, EHR, RCM, population health management, and smart communication systems, along with management, knowledge and operations, and affiliation strategies which help its clients improve clinical and financial outcomes. MED3OOO partners with organizations across the healthcare spectrum who truly understand that Outcomes Matter.


1-22-2012 3-32-48 PM

MedAptus

To schedule a meeting:

Contact: Jennifer Crowley, Marketing Director
jcrowley@medaptus.com
617.896.4099

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MedAptus is the Gold Standard in the healthcare revenue cycle for achieving effective charge management, compliance and workflow efficiency. With our powerful and easy-to-use Intelligent Charge Capture, many of the nation’s most prestigious healthcare organizations rely on MedAptus for financial optimization. Our solutions increase revenue, enhance EMR investments, re-engineer manual processes and yield substantially improved productivity. For more information about how MedAptus can help you improve your financial performance while helping you prepare for ICD-10, visit www.medaptus.com.


1-22-2012 3-36-54 PM

Medicomp Systems

Booth 855

Contact: James Aita, Sr. Product Manager
jaita@medicomp.com
703.803.8080×221

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Medicomp Systems innovates and continuously improves medical information technologies that provide clinicians with the power and freedom to focus on the patient. Medicomp’s EHR tools are dynamic and easy to use, based on the way clinicians think and work, and provide immediate access to the total patient picture. At the heart of every product is the powerful MEDCIN® Engine, a robust clinical data engine used by clinicians and hospitals throughout the world.


1-22-2012 3-39-03 PM

MEDSEEK

Booth 1345

Contact: Mandi Coker, Director, Corporate Marketing
mandi.coker@medseek.com
205.982.5821

MEDSEEK’s digital health solutions help healthcare organizations predict patient health requirements, plan capital investments, influence patient behavior, activate patients, expand business and manage patients across the continuum  of care to find new cost savings and revenue streams. Find out how to strategically engage and manage your patients today – 888.MEDSEEK or sales@medseek.com.


1-22-2012 3-39-47 PM

MedVentive   

Booth 6466-1, ACO Knowledge Center

Contact: Nancy Brown, Chief Growth Officer
nbrown@medventive.com
781.290.2511

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MedVentive provides the tools and experience you need for two key issues faced in evolving into an ACO: understanding patient populations and being financially at risk for the quality and cost of care. MedVentive Population Manager provides the IT infrastructure needed to support FTC required Clinical Integration and overall population management. MedVentive Risk Manager provides the analytic platform to manage your multi-payer risk contracts.


1-22-2012 3-40-43 PM

Merge Healthcare   

Booth 1023

Contact: Brenda Stewart, Director, Marketing Communications
brenda.stewart@merge.com
773.726.8901

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Merge Healthcare is a leading provider of enterprise imaging and interoperability solutions.  Merge solutions facilitate the sharing of images to create a more effective and efficient electronic healthcare experience for patients and physicians.  Merge provides enterprise imaging solutions for radiology, cardiology, orthopaedics and eye care; a suite of products for clinical trials; software for financial and pre-surgical management, and applications that fuel the largest modality vendors in the world. Merge’s products have been used by healthcare providers, vendors and researchers worldwide to improve patient care for more than 20 years.  This year, we are thrilled to showcase our comprehensive enterprise imaging solutions that allow you to image enable your EHR. You will also have the opportunity to register for FREE image sharing via our new cloud platform, Merge Honeycomb™, and learn how to earn Meaningful Use incentives with our specialty EHR solutions. Additional information can be found at www.merge.com.


1-22-2012 3-42-08 PM

MyHealthDIRECT

To schedule a meeting:

Contact: Zac Fritz, SVP of Sales and Marketing
zfritz@myhealthdirect.com
262.309.2090

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MyHealthDIRECT provides the nation’s only ‘healthcare scheduling exchange’ (HSE) for health plans, hospitals, health systems, ACOs and HIEs.Their SaaS-platform is proven “commercial-grade” and “enterprise-ready” and is scalable, flexible, and secure. The MyHealthDIRECT HSE-platform is the industry’s only technology with proven application across the entire care continuum: from care coordination efforts and call centers to mHealth initiatives or Direct-to-Consumer (D2C) strategies and ACO referral management. MyHealthDIRECT: The nation’s only ‘healthcare scheduling exchange’.


2-4-2012 3-08-21 PM

NextGate   

Booth 7000

Contact: Richard Garcia, VP Marketing
richard.garcia@nextgate.com
626.262.4010

Information is good. Knowledge is better! The NextGate® Registry Suite for Healthcare goes beyond standard integration to satisfy today’s intricate, multi-entity healthcare data exchange requirements.   HIEs, ACOs, IDNs and similar organizations need a dynamic, sophisticated framework to coordinate information from diverse sources to support coherent and meaningful data exchange. The registry suite uses the leading MatchMetrix® data integration platform to analyze and integrate the different data elements of a complex activity, promoting greater efficiency and insight. The suite includes an EMPI, Provider Registry and Directory, Location Registry, Activity Registry, Code Set Registry, Enterprise Transaction Registry, and a Relation service to define associations between objects. With over 75 million unique identities managed by MatchMetrix and hundreds of registry implementations, NextGate offers unequalled expertise in deploying master index and data integration solutions. Be certain about the data you exchange!


 

2-4-2012 3-09-32 PM

Nordic Consulting Partners, Inc.

To schedule a meeting:

Contact: Drew Madden, President
drew.madden@nordicwi.com
608.268.6900

Nordic was founded by former Epic consultants, and is the largest Epic-only implementation firm in the country.We focus exclusively on Epic software implementations. We’re located in Madison, WI, home to Epic Systems, Inc., which gives us access to some of the top EMR experts in the industry. Our team of senior consultants average 6-year of Epic implementation experience; 80% are former Epic employees with an average of four certifications each. They’re seasoned professionals who have worked with hundreds of hospitals and clinics nationwide. Whether you need help with a short-term project, or a team of consultants to oversee implementation from start to finish, our staff will be valuable members of your team.Nordic works with healthcare organizations in 14 states, with clients that include Children’s hospitals, University hospitals and community healthcare providers of all sizes. We understand their dedication to patient care and the high standards their EMR projects must meet. Nordic will help you build the right team for your organization.


 

2-4-2012 3-10-22 PM

NTT DATA Healthcare Technologies (formerly Keane)   

Booth 3064

Contact: Larry Kaiser, Senior Marketing Manager
lkaiser@keane.com
631.824.5318

In business since 1975 and based in the United States, NTT Data Healthcare Technologies offers complete IT solutions to hospitals and long-term care facilities throughout the country. NTT DATA’s proprietary software and services help health organizations increase efficiency, reduce medical errors, meet regulatory requirements, and enhance the revenue cycle. An electronic health record (EHR) solution, the Optimum suite of fully integrated certified clinical applications helps hospitals and healthcare facilities reduce medical errors, increase efficiency, and improve the delivery of care.

Stop by for a cup of cappuccino and find out how NTT DATA Healthcare Technologies can help you today.


1-22-2012 3-49-35 PM

Nuance Communications, Inc.

Booth 3523

Contact: Mark Erwich, Senior Director, Marketing
mark.erwich@nuance.com
781.565.5000

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Nuance Healthcare, a division of Nuance Communications, is a market leader in providing clinical understanding solutions that accurately capture and transform the patient story into meaningful, actionable information. Thousands of hospitals, providers and payers worldwide trust Nuance voice-enabled clinical documentation and analytics solutions to facilitate smarter, more efficient decisions across the healthcare enterprise. These solutions are proven to increase clinician satisfaction and HIT adoption, supporting organizations to achieve Meaningful Use of EHR systems and transform to the accountable care model. Recognized as “Best-in-KLAS” 2004-2011 for Voice Recognition we invite you to learn more at booth #3523.


 

2-4-2012 4-47-43 PM

Orchestrate Healthcare   

Booth 4269

Contact: Charlie Cook, President
charlie@orchestratehealthcare.com
970.963.0251

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Orchestrate Healthcare won the 2011 Best in KLAS – Technical Services award. Come speak with us about why our KLAS score keeps rising every year and why we continue to win Best in KLAS awards. Orchestrate Healthcare was founded on the principals of: honesty, integrity and hard work.These key principals have lead to triple-digit growth since day one.  Orchestrate Healthcare has also had tremendous success with our client feedback to KLAS Research. Orchestrate Healthcare won Best in KLAS – Technical Services in 2008.  In 2009, we improved our KLAS score by a full point over our 2008 score, and placed 2nd in the 2009 Best in KLAS – Technical Services category.  In 2010, Orchestrate Healthcare again increased our KLAS score to 94.2, but took 2nd place by 1/10th of a point.  In 2011, we increased our score to 96.4 and won Best in KLAS – Technical Services for the 2nd time in the last 4 years.  Out of 19 companies in the KLAS Technical Services category, Orchestrate Healthcare is the ONLY company to have 100% positive client commentary for the past 24 months.  Orchestrate Healthcare has a philosophy of “do what’s right for the client” every day, and the management of the company stands behind you to do whatever it takes to exceed the client’s expectations.The KLAS scores and all the positive client commentary reflect that commitment to quality.


2-4-2012 4-51-27 PM

PatientKeeper Inc.   

Booth 1045
Mobile Health Knowledge Center booth 12928

Contact: Cristina Christy,Senior Events Manager
cchristy@patientkeeper.com
781.373.6378

PatientKeeper® Inc., the leading provider of physician healthcare information systems, offers hospitals and practice groups highly intuitive software that streamlines physician workflow to improve productivity and patient care. PatientKeeper’s CPOE, physician documentation, electronic charge capture and other applications are used by over 40,000 physicians nationwide, and run on desktop and laptop computers and popular handheld devices and tablets. PatientKeeper’s software integrates with existing healthcare information systems at hospitals and practice groups to create the most effective solution for driving physician adoption of technology, meeting Meaningful Use and transitioning to ICD-10. (www.patientkeeper.com; Twitter: @patientkeeper)


2-4-2012 4-52-22 PM

Practice Fusion   

Booth 4074

Contact: Kimberly Okazaki, Marketing Coordinator
kokazaki@practicefusion.com
415.992.6462

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Practice Fusion provides a free, web-based Electronic Health Record (EHR) system to physicians.With charting, scheduling, e-prescribing (eRx), lab integrations, referral letters, Meaningful Use certification, unlimited support and a Personal Health Record for patients, Practice Fusion’s EHR addresses the complex needs of today’s healthcare providers and disrupts the health IT status quo. Practice Fusion is the fastest growing EHR community in the country with more than 130,000 users serving 30 million patients. The company closed a $23 million Series B round of financing led by Founders Fund in 2011. For more information about Practice Fusion, please visit www.practicefusion.com.


2-4-2012 4-55-53 PM

Quality IT Partners, Inc.   

To schedule a meeting:

Contact: Donna Eversole, MBA, BSN, RN, CPHIMS, Director Healthcare Practice
deversole@qitp.com
904.610.7933

Quality is a hands-on, technology-driven consulting company.  We assist healthcare organizations with complete end-to-end systems planning, acquisition, customization, implementation and maintenance including technical and operational support.  We specialize in assisting clients in transitioning from dated, expensive legacy technologies to modern, cost-effective solutions using leading-edge implementation practices. Our implementation professionals are experienced clinicians and financial consultants and have experience with all major HIS vendors. We view each assignment as an opportunity to transfer our knowledge and experiences to our clients’ staff.


2-4-2012 5-02-09 PM

Shareable Ink   

Booth 7100

Contact: Suzanne Cogan, Vice President, Sales and Marketing
scogan@shareableink.com
877.572.7423 x802

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Shareable Ink is the enterprise cloud-based platform that incorporates natural input tools, including iPads and digital pen and paper technology.   Clinicians can continue documenting in the fastest, most efficient manner. The resulting structured and clinically-encoded output populates the EHR with discrete data, as if typed in directly. Built-in analytics give hospitals and practices insight into their operations – from a clinical, quality, and efficiency standpoint.

Information Week recently named Shareable Ink one of 12 EHR vendors that “stand out” – out of 1,300 Meaningful Use-certified systems. Visit us at HIMSS for an interactive demo featuring our Physician Progress Notes with Charge Capture and Patient History & Signature Capture solutions. We’ll also have a special unveiling of our iPad App – you won’t want to miss it!  For everyone who mentions ‘DOCTOR’ at our booth, we’ll be making a donation to one of our favorite charities, Doctors without Borders.


2-4-2012 5-04-00 PM

SRSsoft   

Booth 12721

Contact: Evan Steele, CEO
esteele@srssoft.com
800.288.8369

SRS is the leading provider of productivity-enhancing EHR technology and services for high-performance physicians—with a successful adoption rate unparalleled in the industry. Offered via the Unified Desktop™, the robust EHR, SRS CareTracker PM, SRS PACS, and SRS Patient Portal increase speed, boost revenue, free physicians’ time, and heighten patient care and satisfaction. For more information on SRS, visit www.srssoft.com, e-mail info@srssoft.com, fax 201.802.1301, or call 800.288.8369.


2-4-2012 5-03-10 PM

Software Testing Solutions   

To schedule a meeting:

Contact: Maegan Scarlett, Marketing Specialist
himss@sts-healthcare.com
877.765.0100 ext. 1

You’re not still running those old terminal based legacy applications in your institution for CPOE, lab, blood bank and anatomic pathology – so why are you still testing them the same way?  Now you can achieve a predictable time, cost and quality for your upgrades. Software Testing Solutions’ (STS) innovative automated testing & validation products for hospital software systems including Epic, Sunquest and SCC Soft, deliver exhaustive testing quickly and efficiently, saving time & money while reducing risk, increasing patient safety and ensuring regulatory compliance. Contact us today for more information.


2-4-2012 5-09-42 PM

Streamline Health   

Booth 2058

Contact: Rick Leach, Senior Vice President and Chief Marketing Officer
rick.leach@streamlinehealth.net
513.794.7112

Streamline Health provides healthcare information technology solutions that help hospitals and physician groups improve efficiencies and business processes across the enterprise to enhance and protect the revenues. Our enterprise content management solutions transform unstructured data into digital assets that seamlessly integrate with disparate clinical, administrative, and financial information systems. Our business analytics solutions provide real-time access to key performance metrics that enable healthcare organizations to identify and manage opportunities to maximize their financial performance. Our integrated workflow systems automate and manage critical business activities to improve organizational accountability to drive both operational and financial performance. For more information visit www.streamlinehealth.net.


2-4-2012 5-06-57 PM

Sunquest Information Systems, Inc.   

Booth 423

Contact: Kymberly Calvo,Marketing Communications Specialist
kymberly.calvo@sunquestinfo.com
408.702.1151

Sunquest Information Systems is committed to patient safety, workflow excellence, predictive medicine, and physician & patient affinity.  Utilizing this dedication, Sunquest proudly offers global diagnostic IT solutions that transform the delivery of healthcare for more than 1,400 organizations and 380,000 users worldwide.   Come by Booth 423 and discover the value Sunquest’s products deliver to our clients every day.  Experience Sunquest’s community-based outreach tour featuring our fully integrated suite of products built on technology that enables and supports business growth and operational efficiency.  Sunquest’s closed-loop collection and transfusion management tour will highlight solutions designed to virtually eliminate patient identification, labeling and transfusion errors at the bedside, in the ED or in the surgical suite. Sunquest is your path to the heart of healthcare.


2-4-2012 5-10-47 PM

Surgical Information Systems   

Booth 1339
Allscripts Booth 3016
Siemens Booth 2423
Interoperability Showcase Booth 11000, Hall G

Contact: Emmy Weber, VP of Marketing
weber@sisfirst.com
678.507.1706

booth crawl smakk

Surgical Information Systems (“SIS”) provides software solutions that are uniquely designed to add value at every point of the perioperative process. Developed specifically for the complex surgical environment, all SIS solutions – including anesthesia – are architected on a single database and integrate easily with other hospital systems. SIS offers the only surgical scheduling system and the only anesthesia information management system endorsed by the American Hospital Association (AHA), and both a rules-based charging system and analytics module that has been granted Peer Reviewed status by the Healthcare Financial Management Association (HFMA). Visit SIS at HIMSS12 to see the latest in perioperative IT including anesthesia, patient tracking and analytics modules.


2-4-2012 4-57-44 PM

Transcend Services and Salar   

Booth 4674

Contact: Donna Rhines, Director of Marketing
donna.rhines@trcr.com
678.808.0680

booth crawl smakk

Transcend/Salar delivers clinical documentation solutions that are flexible to fit the needs of our clients. We offer the industry’s only physician-centric, single-source solution for advanced electronic clinical documentation. Our full spectrum of services and products include: full- to partial-outsourced transcription services, a world-class transcription platform, dynamic clinical documentation templates and physician charge capture.

Transcend/Salar products have highly-customizable physician interfaces that integrate easily with existing electronic medical record systems. Clients that utilize Transcend experience increased physician adoption through flexible solutions that fit the physician workflow. With Transcend/Salar, physicians and hospitals alike achieve notable productivity, financial and patient safety improvements. Encore™, Transcend’s powerful backend speech recognition transcription  platform and Salar’s transformational, physician-centric, inpatient documentation  and billing products (TeamNotes™, TeamRelay™, TeamQuery™ and TAP Charge  Capture™). Experience a demo or a presentation and see how you can benefit.

  • Substantial cost savings
  • Improved efficiency and significant productivity increases
  • Expedited physician workflow and optimized physician billing
  • Real-time physician query and concurrent documentation review  + Increased inpatient revenue
  • Meaningful Use Stage 1 certification

2-4-2012 5-21-21 PM

Trustwave   

Booth: 8805

Contact: Dan Kunkel, Healthcare Solutions
jvickery@trustwave.com
312.873.7659

Trustwave is a leading provider of information security and compliance management solutions to businesses and government entities throughout the world. Trustwave provides a unique approach with comprehensive solutions such as the award-winning TrustKeeper® and other proprietary security solutions including SIEM, WAF, EV SSL certificates and   secure digital certificates. Specifically for hospitals, IDNs, insurers and physicians, Trustwave Healthcare Solutions offer customizable data protection, and help safeguard PHI and address HIPAA requirements.      For more information, visit www.trustwave.com/healthcare.


2-4-2012 5-15-18 PM

T-Syste 

Booth 4012

Contact: Ann Baty,Senior Marketing Coordinator
abaty@tsystem.com
469.791.2445

booth crawl smakk

T-System, Inc. sets the industry standard for clinical, business and IT solutions for emergency medicine, with approximately 40 percent of the nation’s emergency departments using T-System solutions.To meet the individual needs of hospitals, T-System offers both paper and electronic systems. These tools help clinicians provide better patient care, while improving efficiency and the bottom line. Today, more than 1,700 emergency departments rely on T-System’s gold-standard content and workflow solutions. For more information, visit www.tsystem.com. Follow T-System on Twitter (@TSystem) and like T-System on Facebook.

Stop by our “virtual” emergency department at Booth 4012 to see and try our solutions in action. Find out how The T SystemEV has helped more than 42 hospitals attest to  Stage 1 Meaningful Use. Learn about how our new revenue cycle management services can boost your bottom line. Document a patient encounter with DigitalShare and T Sheets or try T-System clinical decision support. Answer a question about Continuity, our new ACO solution, for a chance to win an iPad 2.

We will also be demonstrating at the Interoperability Showcase (Hall G, Booth #11000) how the emergency department might contribute information that would enable a smoother transition of care. T-System Vice President of Solution Development Bill Hall will give a presentation, “Interoperability and the ED: Replacing Care Transactions with Transitions,” at the Showcase on Tuesday at 1:15 p.m. Additionally, two T-System clients will be presenting the senior executive session, “Emergency Medicine EHR Helps Drive Meaningful Use Readiness” on Tuesday at 11 a.m. in Marcello 4506. To learn more about these presentations and our industry leading ED solutions, visit us at Booth 4012.


2-4-2012 5-22-55 PM

Versus Technology   

Booth 5852

Contact: Stephanie Bertschy, Director of Marketing
skb@versustech.com
231-946-5868

Versus gives healthcare institutions the power to locate patients, staff and equipment in real-time, and automate a multitude of clinical tasks. The result: optimized workflow, improved patient care and streamlined processes that set a higher standard in healthcare. Since 1988, hundreds of hospitals have strengthened performance with Versus locating advantages.


2-8-2012 6-49-36 AM

Virtelligence Consulting

Booth 720

Contact: JoAnn Simon, Vice President
jsimon@virtelligence.com
952.548.6611

Founded in 1998, Virtelligence is a privately held premier Healthcare IT consulting firm that offers solution advisory and Healthcare IT consulting services to payers, providers, and life science organizations nationwide. In today’s competitive Healthcare IT marketplace Virtelligence stands as one of the most trusted Consulting partners in the industry. Our success comes from a solid understanding of our client’s business and access to the best Healthcare IT resources available. Our personalized approach has given us the competitive edge in providing innovative advice and world-class service to our clients.


2-4-2012 5-24-09 PM

Vitalize Consulting Solutions, an SAIC company   

Booth 3338

Contact: Cyndi Cahill, SVP Marketing and Sales Support
ccahill@getvitalized.com
610.444.1233

Vitalize Consulting Solutions, an SAIC company (VCS) provides diversified clinical, business, and IT solutions for healthcare enterprises nationwide and in Canada. VCS’ comprehensive programs and services lineup includes system implementation, integration, optimization, project management, custom reporting, education, and knowledge transfer expertise. To facilitate clients’ strategic IT initiatives, our consultants first listen to, then advise, and ultimately strengthen their customers’ IT team. Primarily engaged with Allscripts™, Cerner, Epic, McKesson, MEDITECH and Siemens users, and the Ambulatory and Practice Management arenas, VCS cultivates enduring relationships by supplying experienced professionals who consistently exceed clients’ expectations. Since being acquired by Science Applications International Corporation (SAIC) in August 2011, VCS is now able to provide expanded service lines to its current and future clients, ultimately strengthening our solutions. Please visit us at www.getvitalized.com for more information.


2-4-2012 5-26-00 PM

Vocera Communications, Inc.   

Booth 2245
HIMSS Interoperability Showcase

Contact: Diana Cropley, Marketing
info@vocera.com
800.331.6356

Vocera provides mobile communication solutions focused on addressing critical communication challenges facing hospitals today. We help our customers improve patient safety and satisfaction, and increase hospital efficiency and productivity through our Voice Communication, Secure Messaging, and Care Transition solutions. Exclusively endorsed by the American Hospital Association, the Vocera solutions are installed in more than 800 hospitals and healthcare facilities worldwide.


2-4-2012 5-28-00 PM

Winthrop Resources   

To schedule a meeting:

Contact: Dan Many, Director of Business Development
dmandy@winthropresources.com
952.656.7687

booth crawl smakk

Winthrop provides custom technology leasing solutions allowing hospitals to remain independent of technology providers, to refresh technology when needed, and to preserve cash.  We believe that spending cash or bank financing to buy technology assets doesn’t make sense since those assets lose value quickly, require increasing expense to keep running, and need to be upgraded and changed to support organizational goals and regulatory requirements.


2-4-2012 5-30-45 PM

ZirMed   

Booth 3638

Contact: Kent Rowe, VP Sales
sales@zirmed.com
877.494.1032

We’re ZirMed, a leading provider of healthcare revenue cycle technology and information solutions.  Serving 113,000 healthcare providers across all care settings who in turn provide services to more than 1 in every 10 Americans, we are a nationally recognized leader in understanding the flow of money and information in healthcare.  Addressing the entire revenue cycle, our offerings include eligibility verification, claims management, patient payment estimation, patient payment processing, online bill pay, online and offline statement delivery, innovative lockbox services, analytics, coding compliance,  and more.  Delivered via a SaaS model, our solutions are compatible with any industry standard Healthcare Information or Practice Management System, and can be used directly within the ZirMed domain or embedded within partner software applications.  ZirMed received a “Best in KLAS” ranking for 2011 from independent healthcare IT research firm KLAS, and ranked #1 in overall satisfaction three years in a row.  For more information about how our solutions simplify the complexities of payments for providers and patients visit www.zirmed.com.

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February 11, 2012 News 2 Comments

News 2/10/12

February 9, 2012 News 15 Comments

Top News

The State of New Jersey will hand out $40 million in federal Medicaid money for first-round EHR incentive payouts this week. The largest payouts for hospitals and practices were $2.96 million and $403,750, respectively.


Reader Comments

inga_small From Truth Seeker: “Re: attestations. Each time I try to download the CMS attestation stats via your link, I get a 37,500 line spreadsheet that lists all of the vendors and products by state. I cannot find a column that lists the number of successful attestations (which, of course, is what I want to see)! Am I doing something wrong? Maybe this is why there are only 120 downloads.” I have downloaded the same data into Excel and then done various manipulations with groups and subtotals. If anyone has figured out an easier way to analyze the data, please share.

2-9-2012 8-24-11 PM

2-9-2012 8-24-58 PM

mrh_small From Dr. Denominator: “Re: attestation data. The information someone sent you was inaccurate on the inpatient side. I don’t blame them since the data is very messy. The mistake most people make is attributing Epic physicians to Epic hospital numbers, because a couple of large, multi-specialty Epic clinics attested on the inpatient platform even though they are EPs. There are also some hospitals that reference multiple Meditech systems and show up on multiple rows, even though it is a single provider. And HCA needs to be folded into the Meditech numbers, because it is Meditech software after all.” And has been stated, none of this includes Medicaid attestation data either, so it’s probably dangerous to draw too many conclusions from it.

inga_small From Zen: “Re: animated ads. When are you getting rid of the rest of the animated ads?” With all the HIMSS prepping over the last few weeks, I have not made the time to pester the last few sponsors that have yet to provide us with non-animated ads. I admit I love the change and look forward to the day when there is total stillness on the left side of the page.

2-9-2012 9-42-12 AM

inga_small From HITandTiaras:Re: judges. Who are the judges for the shoe and fashion contests at HIStalkapalooza?” For the “Inga Loves My Shoes” contest, RelayHealth’s Lindsay Miller will be returning and will be joined by Timur Tugberk from DrFirst. Our fashion judges will be Health 2.0’s Matthew Holt, the glamorous Rebecca Armato of Huntington Hospital, and last year’s red carpet lovely Jennifer Lyle of Software Testing Solutions. Matt wanted me to let contestants know that due to his poor sense of fashion, he is willing to accept all bribes.

2-9-2012 7-40-31 AM

inga_small From Carla Tortelli: “Re: HIStalkapalooza. I understand there will be IngaTinis. What exactly is that?” As far as I am concerned, it is any yummy martini-ish cocktail. However, the ESD folks told me that this year’s version is a mix of green tea vodka, orchard pear liqueur, elderflower blossom, fresh pear juice, and vanilla bean-infused honey. My consulting physician Dr. Jayne has advised me of the benefits of green tea and has assured me it increases calorie burning and stamina. I’ll thus be drinking a few.

mrh_small From Cold in Tampa: “Re: Vitera update. Police were called to the Tampa, Alachua, and Scottsdale offices to ensure the quiet exit of over 300 laid-off employees.”

2-9-2012 6-30-12 PM 2-9-2012 6-26-51 PM

mrh_small From SageYouLater: “Re: Vitera layoff. I count 33 gone in my area. Boxes were dropped off and an armed police officer was on site to make sure nobody caused trouble. Some we’d have voted off the island ourselves, but some were really good. Vitera’s parent private equity company made it clear that their goals are to increase revenue 30% in three years, requiring them to make acquisitions (AKA buy growth if you can’t grow it). Freeing up cash to acquire companies is how they’ll get that growth, probably via LBOs since it’s easier and there is no profitability target in their objectives. These guys are not product people, they are finance people.”

mrh_small From NervousIT: “Re: our little hospital. News of a potential affiliation with a much larger organization broke out last week. Should I be nervous? How do these things typically go?” I’ve been through the process a couple of times from the big hospital IT side of the table, so here’s my experience in a nutshell, which may or may not be representative (OK, it might be a little bit tongue in cheek):

  1. The big hospital sends its mid-level managers, who make twice as much as your highest paid person, to snoop around and try unsuccessfully to hide their contempt of your comparatively simple but more effective operation.
  2. They say they are there to learn and assist, but in reality they are thinking, “How fast can we rip out their stuff and replace it with products that we already know and therefore are less of a pain for us to support, no matter what users prefer?”
  3. The systems they want to put in your hospital are more complicated, partly because big hospitals like big, complicated products, but also because big hospitals have big egos and manage to make everything 10 times harder than it needs to be because all kinds of job-paranoid mid-level IT managers are always trying to justify their existence by increasing the level of specialization and complexity wherever possible.
  4. Every decision is made on the basis of which option presents the least risk to the IT organization. Risk means anything that could require more employees, increase help desk calls, or put the bonuses of the top IT executives in jeopardy.
  5. Any semblance of being a friendly, well-respected IT operation goes down the tubes as the new suits insist that nobody can talk to anybody without a help desk ticket, IT employees aren’t allowed to solve problems or make changes without reams of documentation, and vigorously enforced PC policies ensure that everybody except executives in IT and Finance are using the same hardware and software that has been dumbed down and locked down so that the lowest level employee in dietary or facilities maintenance can’t do anything that might require a help desk call. Think of this as computer socialism.
  6. Endless meetings will be held in which nobody in the room has the authority to make a decision, but everybody is empowered to veto someone else’s recommendation or insist that the issue be studied further with even more people invited to the table. The chairs in conference rooms never have time to get cold before the next set of IT posteriors land on them.
  7. You will for the first time see ambitious, back-stabbing IT managers trying to distance themselves from their humble programmer or networking origins by wearing a suit at all times and riding herd on their tiny fiefdoms like they are Steve Jobs, except without the charm, vision, passion, and brains.
  8. On the other hand, you will probably get better benefits and possibly a raise, at least as long as your job isn’t too closely identified with one of the systems that will be unceremoniously dumped, in which case you may find yourself attached to it. You may not be able to look users in the eye, but your career prospects may improve because of better training, exposure to systems for which experts are needed, and a more recognizable employer name on your resume. If you are lucky, you may even get to stay on the periphery and avoid the soul-sucking part of the IT organization entirely. You’ll also realize that it’s not just IT described above – pretty much all big-hospital departments stack up to their small-hospital counterparts in exactly the same way.

HIStalk Announcements and Requests

2-8-2012 1-50-39 PM

inga_small From the HIStalk Practice world this week: Epic, Allscripts, and eClinicalworks represent over half of all EP attestations to date. I share the names of a few ambulatory EMR vendors I intend to visit at HIMSS. Proposed legislation would make it easier for providers to practice telemedicine in multiple states. Questions that practices should not send to technical support. Dr. Gregg overviews CareCloud’s EMR. Hayes Management Consulting’s Rob Drewniak shares tips for preparing for data breaches. Thanks for signing up for e-mail updates while you’re checking out the news. And thanks for reading!

2-9-2012 12-22-39 PM

inga_small Speaking of IngaTinis, Medicomp will be serving up a few when I participate in their Quipstar live game show Wednesday, February 22. The game is designed to demonstrate how quickly providers can be trained on Quippe and how easy it is to use. If you are interested in winning an iPad2 or some other nifty prize, you can register to participate. Before I agreed to play, the Medicomp folks had to meet a list of my diva demands that included IngaTinis for everyone and green M&Ms for my dressing room. I couldn’t refuse when they also agreed to make a hefty donation to my favorite charity. I’ll be playing to win.

2-9-2012 6-57-06 PM

mrh_small I have to hand it to new HIStalk Platinum Sponsor Nordic Consulting for choosing one of the most memorable names I’ve heard, especially considering that they are located in Madison, WI. Nordic is the largest Epic-only consulting firm in the US, with 100+ consultants averaging four Epic certifications each and six EHR projects under their belt. Every Nordic consultant is Epic certified and 80% of them are former Epic employees (being in Madison obviously gives them an advantage in attracting top talent.) They’re prepared to help you run validation sessions, complete your Epic builds, perform system testing, create training materials, and provide go-live support. Eighty percent of the company’s engagements last more than a year and 90% of its placements are renewed at least once. Whether you need one Epic-certified consultant or an entire implementation team, and whether it’s clinical, financial, or interface applications you need help with, Nordic Consulting can help. I appreciate their support of HIStalk.

2-9-2012 7-21-29 PM

mrh_small Supporting HIStalk, HIStalk Practice, and HIStalk Mobile at the Platinum sponsorship level is White Plume Technologies of Birmingham, AL. Their name is memorable as well, referencing the last line in the play Cyrano de Bergerac (“and that is … my white plume”) that symbolizes courage, integrity, and honor. White Plume helps 7,800 physician customers improve their PM/EMR systems (covering “the stuff they left out,” as they say), capturing charges better and faster to the tune of an average net savings of $0.83 per encounter. The company is so confident in its low-risk solution that it will happily sign daily contract commitments, letting its value stand on its own legs. Specific modules in its ePass (Electronic Practice Acceleration Solution Suite) include AccelaCAPTURE (an intelligent superbill on a tablet PC,) AccelaMOBILE (charge capture, rounding lists, and appointments on mobile devices,) AccelaSMART (rules-based management and workflow engine,) AccelaPASS (charge passing and validation,) and AccelaSCAN (a paper superbill with quick-scan processing, up to 1,200 encounter forms per hour.) Some of the vendor systems they work with: McKesson, NextGen, GE Healthcare, athenahealth, Allscripts, Vitera, and LSS. I found a YouTube video called Waiting on the EMR of the Future that provides some background, and they have a Top 5 Things to Know and slideshow on their site. Thanks to White Plume for its support of HIStalk, HIStalk Practice, and HIStalk Mobile.


Acquisitions, Funding, Business, and Stock

2-9-2012 10-39-42 AM

McKesson acquires peerVue, Inc., a provider of radiology workflow solutions.

2-9-2012 9-27-55 PM

Qualcomm makes a strategic investment in AirStrip Technologies via its Qualcomm Life Fund investment group.

Access signs a partnership agreement with pen tablet vendor Wacom to create a new e-Signature solution that will work with the Access Intelligent Forms Suite.

2-9-2012 9-27-02 PM

Revenue cycle management outsourcer Avadyne Health merges with revenue cycle workflow provider Benchmark Revenue Management. The combined companies will operate as Avadyne Health.

Nuance announces Q2 results: revenue up 19%, EPS 0.03 vs. $0.00, falling short of expectations after complicated acquisition costs. Shares dropped over 13% in Thursday after-hours trading.

Shares in CSC, which just announced the hiring of Misy PLC CEO Mike Lawrie as its new CEO, delays its fiscal year forecast and writes down $1.5 billion related to its disputed NPfIT contract in the UK.


Sales

The Arkansas State Health Alliance for Records Exchange selects OPTUMInsight’s Axolotl HIE for its statewide health record exchange.

WellStar Health System (GA) selects Merge Healthcare’s cardiology solution and Advanced Radiology of Columbia (MO) contracts with Merge for its radiology suite.

2-9-2012 9-31-00 PM

King’s Daughters Medical Center (KY) selects ProVation MD for its cardiology procedure documentation and coding.


People

Ken Edwards, formerly of GE and IDX, joins ZirMed as VP of operations.

2-9-2012 6-01-43 PM

Henry Schein names Gerard K. Meuchner (Eastman Kodak) VP and chief global communications officer.

2-9-2012 6-02-52 PM

Former Eclipsys CEO Andrew Eckert, now CEO of CRC Health Corp., joins Awarepoint’s board. The company also also names Carlene Anteau MS, RN (McKesson) VP of product marketing and Erica Davidson (Breg, Inc.) as VP of human resources.


Announcements and Implementations

Physicians at St. Mary-Corwin Medical (CO) begin electronic order entry in advance of the hospital’s May 8 Meditech go-live.


Government and Politics

The VA starts implementation of patient Wi-Fi systems in all of its hospitals.


Other

mrh_small Weird News Andy rebrands himself as Wow News Andy in apparently excitement over this story. NASA’s implantable Biocapsule can diagnose and treat astronauts on long space journeys, using carbon nanotubes to secrete therapeutic molecules created by cellular metabolism.

mrh_small A pretty good Forbes article by the CEO of healthcare consumer software vendor Avado says hospital CEOs should avoid the mistakes made by their newspaper industry counterparts. He had this to say about IT:

Just as newspapers were implementing multimillion dollar IT systems while nimble competitors were using low and no cost software to disrupt the local media landscape, health systems are similarly implementing complex systems to automate the complexity necessary in a multi-faceted system. Meanwhile, disruptive innovators are implementing new models at a fraction of the cost and time. For example, it’s well understood that a healthy primary care system is the key to increasing the health of a population. Imagine if a fraction of the billions being spent by mission-driven, non-profit health systems on automating complexity was redirected towards the reinvigoration of primary care. They’d further their mission and lower their costs. Of course, they’d likely see revenues drop but presumably maximizing revenues isn’t the mission of a non-profit.

Healthcare billionaire and healthcare IT dabbler/investor Patrick Soon-Shiong  is reported to be interested in buying the Los Angeles Dodgers.


Sponsor Updates

  • eClinicalWorks provides details of its April 28-29 user group meeting in Chicago.
  • PatientKeeper announces that Ashe Memorial Hospital (NC) successfully attested for Stage 1 MU using PatientKeeper’s CPOE solution.
  • EHRScope announces its appointment as the Nuance distributor for Dragon Medical Spanish, v11.
  • PeaceHealth’s Sacred Heart Medical Center at RiverBend (OR)  expands its use of Versus Technology’s RTLS into the labor and delivery area.
  • Compuware announces a live customer Webcast featuring CHRISTUS Health SVP and CIO George Conklin.
  • T-System releases a demo of its new ACO solution, T-System Performance Care Continuity.

EPtalk by Dr. Jayne

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Medicomp Systems announces their Quipstar game show promotion for HIMSS12. You heard all of us gush about it last year, so be sure to experience it yourself. Those selected will have a chance to compete for cash and prizes. Topics include ICD-10, Meaningful Use, and “other industry challenges.” I wonder if they’ll include such questions as: what clothing item is Inga HIStalk obsessed with? Does Dr. Jayne prefer diamonds or pearls? What medical specialty shares Mr. H’s affinity for the forehead-mounted reflector?

Clinical decision support fans take note: an editorial in the Journal of the American Medical Association this week discusses “The Harms of Screening.” It highlights the varied (and often conflicting) recommendations that providers are faced with daily. If providers can’t agree among themselves what is the best course of action, how can we expect vendors to know what to build? The answer, in case you’re curious: build all of the various recommendations and let your clients turn off the ones they don’t want, rather than asking them to customize in the ones they do want.

Another piece in the same issue titled “Integrating Technology Into Health Care: What Will It Take?” tackles low uptake rates for electronic health records and personal health records. The authors note that “to fit into the lives of patients, technology must help patients do the jobs that they perceive as high priority in their lives.” Unfortunately “many patients perceive financial health and other concerns as more pressing jobs to be done than physical health.” Judging from the patients I’ve seen this week, those more pressing concerns include whether to get a new iPhone or just replace the case that’s losing its little crystal decorations; whether the new Kate Spade purses are really that cute; and whether or not the Super Bowl is overrated.

Early last year, the Office of the Inspector General (OIG) wanted to study why physicians opt out of Medicare. Now they’re ending the investigation, citing a lack of centralized data. Additionally, the poor quality of the data it did receive from Medicare Administrative Contractors and legacy carriers made them unable to “determine the characteristics of physicians who opt out of Medicare, the trend in the number of opted-out physicians, and why physicians choose to opt out of Medicare.” Two thoughts strike me here. First, if I gave bad data to Medicare, I’d be fined with penalties (just an idea? Maybe, maybe not). The second: have they heard of SurveyMonkey?

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It’s been a while since I’ve been in the operating room, but unfortunately I’ve seen what happens when something is left in the body. Most surgical sponges have a portion of the weave that is visible on x-ray if the situation arises where one can’t be found. To help prevent lost sponges in the first place though, the University of Michigan is using barcoding technology to scan sponges when they’re used and again when they’re removed.

Only a few weeks left to get your Meaningful Use on for 2011. Have you attested yet? I’m still looking for some understanding of why some of those attestations have been unsuccessful. If you’re one of the unlucky few and are now working through the appeals process, we’d love to hear your story.

Score one for software developers working late nights. The Centers for Disease Control reveals that salty snacks such as potato chips are not the chief source of sodium in the American diet. The culprits include bread and rolls, cold cuts and cured meats, pizza, poultry, soups, sandwiches, and cheese. I didn’t see dark chocolate on there either, so I guess I’m good to go.

Have a question about Meaningful Use, the ideal percentage of cacao in chocolate, or which shoes are less cute (and thus more easily donated to Souls4Soles?) E-mail me.

Print


Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

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February 9, 2012 News 15 Comments

News 2/3/12

February 2, 2012 News 6 Comments

Top News

Shares of EHR vendor Greenway Medical Technologies rise 30% on its Thursday IPO, making GWAY the day’s biggest gainer on the New York Stock Exchange. Shares closed at $13, valuing the company at $358 million on revenue of $90 million. The company had revised its IPO price downward from $13 to $10 at the last minute, obviously leaving money on the table in hindsight.


Reader Comments

2-2-2012 8-03-14 AM

inga_small From Mr. Hospitality: “Re: HIMSS schedule. Do you know if there is a way to drop the HIMSS schedule into Outlook? Didn’t there used to be a way to do that?” I don’t use Outlook, but I couldn’t figure out an easy way to create a schedule in general from the HIMSS website. However, the HIMSS folks say an app is coming next week. I actually found it here, though it looks like it’s not quite complete since some sessions still lack specific details. The HIMSS12 Mobile Guide does allow you to select favorites and thus create a personalized schedule, though it’s not integrated with Outlook or other calendars.

2-2-2012 6-41-44 PM

mrh_small From IT Guy: “Re: Reliance Software Systems. RelWare. the company that was developing the EMR for Henry Ford Health System, is no more. HFHS announced that it would implement Epic and sunset RelWare’s EXR product, leaving the company with no clients other than Ford. They have closed their doors and let their staff go.” Unverified. I e-mailed the company and received no response. Henry Ford went live less than a year ago on EXR.

mrh_small From Randy Lugano: “Re: EMR character limit on assessments. Is this a common feature in popular EMRs?” A physician’s article in The New York Times in December bemoans her EMR’s 1,000-character limit as she tries to compose a usable assessment of a complicated patient.

I nip and tuck my descriptions of his diabetes, his hypertension, his aortic valve stenosis, trying to placate the demands of our nit-picky computer system. Nevertheless, I am still unable to fit a complete assessment into the box. In desperation, I call the help desk and voice my concerns. “Well, we can’t have the doctors rambling on forever,” the tech replies … Nobody, for example, leafs through a chart anymore, strolling back in time to see what has happened to the patient over many years. In the computer, all visits look the same from the outside, so it is impossible to tell which were thorough visits with extensive evaluation and which were only brief visits for medication refills. In practice, most doctors end up opening only the last two or three visits; everything before that is effectively consigned to the electronic dust heap. Most importantly, the electronic medical record affects how we think. The system encourages fragmented documentation, with different aspects of a patient’s condition secreted in unconnected fields, so it’s much harder to keep a global synthesis of the patient in mind. Now I’ve learned that file-size restrictions will limit the extent and depth of analysis. What will happen to the tradition of thorough clinical reasoning?

mrh_small From CDMer: “Re: HIT testing. Another can of worms along the path of standardization.” NIST solicits bids for a Health Information Technology Testing Infrastructure that will “harmonize the efforts of healthcare standards test development and delivery to meet the demands for conformance and interoperability within the healthcare domain.”

mrh_small From NYizMee: “Re: McKesson’s huge profits. I can’t understand how this company keeps making money. They do nearly everything so badly.” Healthcare has been very good to the company and its customers chose it willingly, so they must be doing something right.

2-2-2012 7-23-37 PM

mrh_small From David Chou: “Re: Cleveland Clinic Abu Dhabi. Would love to share a Forbes piece on what we are doing.” David is the senior director of IT operations there. The 2.3 million square foot, 364-bed facility will open at the end of this year.

mrh_small From Looking Out for the Little Man: “Re: CPSI. The little guy down in Mobile seems to be helping smaller hospitals meet MU, right behind Epic in the number of hospitals to attest.” The company’s fact sheet says 134 of its hospital clients have attested, giving it 22% of all attested hospitals, second only to Epic’s 164 hospitals.


HIStalk Announcements and Requests

2-1-2012 12-21-16 PM

inga_small Here’s a few things you might already know if you are a faithful HIStalk Practice reader: first-fill medication adherence improves when physicians e-prescribe. Doctors still prefer desktop PCs over other devices for accessing patient data in the office or at home. Some common problems causing 5010 rejections. CareCloud CEO Albert Santalo gives the low-down on his company in our interview. Dr. Gregg shares the inside scoop on the startup Health Care DataWorks. If you haven’t been a faithful HIStalk Practice reader, it’s not too late to change your ways and see the light of the ambulatory HIT work. Thanks for stopping by.

mrh_small Listening: reader-recommended Rodrigo y Gabriela, a duo of former itinerant street musicians who play amazing guitar that includes everything from classics to heavy metal (one YouTube commenter called it “thrash metal flamenco.”) Check out Gabriela using her acoustic guitar like a drum kit.


Acquisitions, Funding, Business, and Stock

 

2-2-2012 5-39-13 PM

Clinical communications vendor PerfectServe closes on $10.9 million in Series C financing, led by PJC Capital.

2-2-2012 5-40-27 PM

Staff scheduling systems vendor OnShift closes on $3 million in Series B financing led by a client of West Capital Advisors.

2-2-2012 5-42-30 PM

TELUS Health Solutions announces the acquisition of Wolf Medical Systems, Canada’s largest cloud-based EMR vendor, and the creation of a new business line, TELUS Physician Solutions.

Trademark filings suggest that a possible name of the GE Healthcare-Microsoft joint venture is Caradigm. That trademark was held by Santa Barbara Regional Health Authority, but appears to have expired.

Canon Europe acquires Netherlands-based PACS vendor Delft Diagnostic Imaging, saying it plans to focus on medical imaging for future growth.

Medical payment processor MediSwipe acquires the assets of ReachMeDaily.com, a private social media platform that connects senior citizens in residential centers with their families.

2-2-2012 8-12-58 PM

California startup TigerText, which offers HIPAA-compliant text messaging for hospitals, raises $8.2 million in a second round of funding.

2-2-2012 8-23-35 PM

Telehealth vendor InTouch Health, which claims 400 hospital customers of its FDA-approved remote presence devices, gets a $6 million investment from iRobot Corp., best known for its Roomba vacuum cleaner.

2-2-2012 8-40-11 PM

The Advisory Board Company reports Q3 results: revenue up 33%, EPS $0.46 vs. $0.24.


Sales

2-2-2012 8-41-59 PM

MedLabs Diagnostics (NJ) chooses the Ignis Systems EMR-Link lab outreach solution to provide area practices with lab ordering and reporting capabilities.

The Danish health system selects InterSystems to develop and support its national HIE.

Upper Chesapeake Health (MD) picks Forerun’s FlexChart physician documentation software for its emergency departments.

2-2-2012 5-45-41 PM

Rush-Copley Medical Center (IL) selects Medicity’s HIE technology to facilitate affiliated physicians’ access to clinical results and reports.

NorthCrest Medical Center (TN) chooses Allscripts Sunrise Clinical Manager, adding to its previous deployments of the company’s ED and ambulatory EHR solutions.

Merge Healthcare signs 10 new Merge RIS customers, raising to 30 the number of radiology practices using it as a Complete EHR.

2-2-2012 6-13-40 PM

Scripps Health (CA) selects MEDSEEK’s enterprise software suite.

St. Mark’s Medical Center (TX) selects McKesson Horizon Medical Imaging for use with its Paragon HIS.

2-2-2012 6-12-34 PM

The Nebraska Medical Center expands its use of products from Streamline Health Solutions, adding its Epic integration suite to the content management and HIM workflow solutions it was already using.


People

2-2-2012 5-50-13 PM

Greater Houston HIE changes its name to Greater Houston Healthconnect and names James Langabeer PhD, formerly of the University of Texas Health Science Center, as president and CEO. He replaces Kay Carr, who became CEO last March.

2-2-2012 5-51-57 PM

API Healthcare appoints Peter Goepfrich (Vital Images, PwC) as CFO.

2-2-2012 6-06-28 PM

Brad Swenson rejoins technology financing company Winthrop Resources Corporation as SVP, chief product strategy and business development officer. He was previously with Surescripts. We interviewed him in May 2011.


Announcements and Implementations

Awarepoint signs 191 contracts for its aware360Suite in 2011, increasing its client base to 123 healthcare systems and 186 hospital sites.

Telehealth and remote monitoring solution provider Cardiocom and Delta Health Technologies, a provider of IT systems for homecare and hospice agencies, announce completion of a bi-directional telehealth interface between their systems.

2-2-2012 8-49-29 PM

St. Joseph’s Hospital and Medical Center (AZ) announces its deployment of MobileMD for the exchange and communication of clinical information.


Government and Politics

2-2-2012 2-49-22 PM

MGMA sends a letter to HHS Secretary Kathleen Sebelius outlining problems that practices are having with the 5010 transition and urging an additional delay in enforcing the change. MGMA warns that unless the government takes the necessary steps to resolve issues, many practices will face significant cash flow disruptions for practices and operational difficulties, a reduced ability to treat patients, staff layoffs, and even practice closure.


Other

Anthelio partners with Healthland to provide migration and implementation services for Healthland clients migrating to Healthland Centriq EHR.

2-2-2012 8-50-43 PM

The defunct St. Vincent’s Hospital – Manhattan (NY), obligated by state law to maintain medical records for six years after discharge, petitions the bankruptcy court to force Allscripts to help the hospital transfer its data from its own servers to a less-expensive system. The former hospital says Sunrise Clinical Manager is costing it $17K per month and another company offered to extract its store it for $1,200 per month, but Allscripts won’t help unless the hospital keeps paying the monthly tab.

UMass Memorial Healthcare announces plans to lay off 700 to 900 employees, under the gun to trim $50 million from its budget to avoid a loss for the year.


Sponsor Updates

  • Billian’s HealthDATA reports that 35-45% of doctors are affiliated with hospitals in 10 states, with internal medicine ranked as the top specialty.
  • CapSite’s SVP and GM Gino Johnson will present an overview of the HIE market at this month’s ZirMed’s Thrive User Conference.
  • T-System announces that 42 hospitals have attested to Stage 1 MU using its T SystemEV emergency department information system.
  • GE Healthcare introduces the latest version of its Centricity Patient Online portal.

EPtalk by Dr. Jayne

CMIO magazine publishes its 2012 Compensation Survey. No surprise: 87% of CMIOs are men, although women are increasing in the field – up from 8% to 13% this year. Apparently I fall into their target demographic since the majority of those surveyed work at multi-hospital organizations in the south.

2-2-2012 6-24-47 PM

For those of you who may be just a teensy bit behind in your ICD-10 implementations, my favorite Geek Doctor John Halamka offers the request for consulting assistance that his organization used. Also included is a letter to stakeholders to identify which applications use ICD-9 and need to use ICD-10. He promises to share as much as he can as their project plans and timelines unfold, so stay tuned.

I wonder if ICD-10 has a code for this? Physicians report an increase in cyberchondria. Patients reading online information are increasingly displaying unfounded anxiety about their health. To combat the increased worry, physicians report spending more time in office visits to discuss why patients think they have particular diseases and convincing them that it may be unlikely.

2-2-2012 6-25-50 PM

Some websites have recently caught my eye. AdverseEvents has gathered information from the FDA’s database. Users can search over 4,500 medication records. Clarimed is similar, but has information on medical devices as well as drugs and procedures. I’m sure the cyberchondriacs found them long before I did.

I just have to laugh. Earlier this month, the Department of Health and Human Services published new standards for electronic funds transfers (EFT) in healthcare as required by the Affordable Care Act. This is supposed to result in billions of dollars of administrative savings for physicians, hospitals, insurers, and states over the next decade. HHS Secretary Kathleen Sibelius is quoted as saying, “Thanks to the Affordable Care Act, healthcare professionals will spend less time filling out paperwork and more time focusing on delivering the best care for patients.” Unfortunately, the recent federal initiatives have actually increased burdensome busywork for me, as I am forced to review mind-bogglingly annoying reports about how many times I’m checking or not checking a particular box required for Meaningful Use calculations. Additionally, any reduction in paperwork due to EFT changes will likely be offset with increased mounds of insurer paperwork trying to deny care for sick patients.

A new study reports that “the majority of U.S. physicians are moderately to severely stressed or burned out on an average day.” That’s not good news for the people caring for you and your loved ones. Only 15% of physicians feel their organizations are helping them deal with the situation. Burnout has been shown to increase the risk of medical errors. Physicians cite their top stressors as the economy, healthcare reform, Medicare/Medicaid policies, and unemployed and uninsured patients. No surprises there. Executives, take note: show your docs some love and get those severely impacted staffers some help before it’s too late.

2-2-2012 6-26-51 PM

Medical Economics publishes its must-have gadget guide. One of my favorites is the MobiUS SP1 hand-held ultrasound unit which can transmit images via cell phone or Wi-Fi. Another favorite is the SleepView Monitor, which allows home testing for sleep apnea. If I would have had one in my little black doctor bag during a recent trip, I’d have slapped it on the gentleman near me on the plane. I seriously thought I was going to have to resuscitate him.

Hints on the Microsoft/GE venture’s name from Weird News Andy: “So, a portal-like product that allows information to flow between logical entities. Drawbridge is a little too intimidating. Hatch is too nautical. Aperture is too esoteric. Gates. That’s the ticket.”

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Speaking of little black doctor bags, I’m still looking for the perfect little black dress to go with mine (and with the shoes!) for HIStalkapalooza. I thought I had my date squared away, but in a surprise last-minute showing, one of my secret crushes has agreed to attend (sorry, Farzad, I waited as long as I could – but if you decide to attend, I’m sure we’d be accommodating.)

Have a question about home monitoring devices, Las Vegas bail bondsmen, or why the soles of Christian Louboutin shoes are red? E-mail me.

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Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

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February 2, 2012 News 6 Comments

Monday Morning Update 1/30/12

January 28, 2012 News 13 Comments

1-27-2012 7-57-44 PM

From You Know Who: “Re: RelayHealth. Jim Bodenbender out, announced abruptly on phone call. Jeff Felton, who ran the RelayHealth Pharmacy group and was a transplant from McKesson San Francisco, is taking over the entire division.” That appears to be true from the company’s management team page, on which Jeff Felton (above) is now listed as president.

1-28-2012 8-36-46 AM

From RAC Frustration: “Re: electronic RAC responses. I see that Medical Electronic Attachment (MEA) has become the latest company to be certified by CMS. I am curious how many HIStalk readers will use the esMD (electronic submission of medical documentation) for RAC and MAC responses?” MEA’s progam uses an NHIN gateway to send electronic responses to CMS’s post-payment audit requests of several flavors (RAC, MAC, CERT, PERM, and ZPIC.) I’m interested in how much transaction volume the average hospital will experience to keep CMS happy once esMD Phase 2 goes live in October and all documentation requests will be sent electronically. Comments welcome.

Surely the calendar is playing a cruel joke: it can’t be just three weeks until the HIMSS conference, can it?

My Time Capsule editorial this week from five years ago: Want Physicians to Use Systems? Standardize Screens Like You Do Back-End Databases. A free sample: “Hospitals never seem to get how illogical it is to physicians that every hospital buys a different system, but expects community-based doctors who cruise in for an hour a day to master all of them without burning up more hours of their self-employed day. They seem puzzled when doctors jeer at their zealous requests to bone up on Cerner when he or she is fuming at Eclipsys across town and McKesson at the university hospital.”

Listening: reader-recommend James, which I would characterize as jangly Britpop with strong vocals. They (it’s a band,  not a guy) remind me of the Smiths. They aren’t totally obscure, having sold 25 million albums in their 30 years. They probably would sell more if they had a more search engine friendly name, although come to think of it, that’s another similarity between them and the Smiths. 

1-27-2012 4-50-23 PM

A lot of money and effort is spent putting on the exhibit and educational tracks of HIMSS, but that’s just to provide the backdrop for the real reason people attend: to connect with folks for business and pleasure, two-thirds of respondents said. New poll to your right, as suggested by a reader: what reaction do you have when you hear that a vendor uses offshore programming resources?

1-27-2012 7-23-04 PM

Thanks to CSI Healthcare IT, supporting HIStalk as a Platinum Sponsor. The company is a leading national provider of IT and training professionals, both contract and permanent. The company’s team of 75 recruiters can often find local qualified resources, minimizing billable travel expenses to the client. Its pricing model has saved health system customers such as Sutter, Baylor, Texas Health, Clarian, and Sentara up to 60%. The company is vendor neutral, providing resources for projects involving McKesson, GE Healthcare, Allscripts, Epic, Cerner, Meditech, NextGen, and others. It can handle work ranging from providing a single resource to managing the projects of large health systems, also offering a specific package called Epic Community Connect that helps health systems provide Epic’s ambulatory systems to community practices (marketing, contracting, readiness assessments, implementation, and support.) Thanks to CSI Healthcare IT for supporting HIStalk.

Federal CTO Aneesh Chopra resigns and is expected to run for lieutenant governor of Virginia. You aren’t surprised if you read HIStalk on January 13, when my non-anonymous, well-placed informant chose the fantastic phony name of DeepThrowIT to tell us that Chopra was heading out. I think that might have been my first non-healthcare IT big scoop rumor.

1-27-2012 6-12-04 PM

I recently quoted some Epic facts provided by Chief Administration Officer Steve Dickmann in a recent talk he gave to a Madison group. The full video is here, from which I pulled a few more:

  • The company started in a basement in 1979 doing UW psych department work.
  • Epic went from 2.5 employees in 1979 to 30-40 employees in 1994, but then changed direction to focus on the electronic medical record.
  • The product was changed from text-based to a graphical GUI in 1994, the same year when the database was scaled up for large enterprises.
  • Epic Web came out in 1997; MyChart in 2000.
  • The company gained competitive advantage from Y2K because it had minimal remediation to accomplish while its competitors had to redirect resources to work on that problem.
  • Epic also gained competitive advantage from being in Wisconsin, which was an early adopter of large integrated delivery systems.
  • Epic does not subcontract or acquire software; everything was developed in Wisconsin.
  • The original motto was “Do good, have fun.” The “make money” part was added later.
  • Epic focuses on large hospitals and clinics, children’s hospitals, and academic hospitals and turns away other prospects. The only exception they will make is for hospitals located in Wisconsin.
  • Epic doesn’t do acquisitions because they would have to rewrite the code anyway to keep a truly integrated product.
  • Competitors have 20-30% of their employees doing sales and marketing, while Epic has 1%.
  • Epic’s culinary team has 70 employees and it also staffs its own horticultural team. It does not contract those functions out.
  • All of Epic’s implementers fly out Monday afternoon, which ties up a good bit of the Madison airport’s capacity with 600-700 people all leaving at about the same time.
  • Each customer has an assigned tech support team that knows the customer’s people and systems. The team is available 24×7.
  • 91% of the HIMSS EMRAM Stage 7 hospitals use Epic.

1-27-2012 8-19-04 PM

Supporting HIStalk as a Platinum Sponsor is Versus, which offers real-time location systems for patients, staff, and equipment. Hospitals use that information to automate workflow, improve efficiency, increase patient safety, boost patient satisfaction, and increase revenue. The company provides interesting examples: (a) advancing patients to the next level of care based on events, such as completed labs or EKGs; (b) locating telemetry patients in distress wherever they are; (c) alerting the physician when patients are ready to be seen; (d) reminding staff to wash hands; and (e) alerting housekeeping to clean the room when the patient’s badge is dropped into the discharge bin. The Traverse City, MI company has been around for over 20 years, with its combined infrared/radio frequency system being endorsed by the American Hospital Association. Hospital customers have documented improvements such as cutting equipment losses from $1.5 million to $40,000 year, eliminating the need for clinic waiting rooms, reducing telephone calls by 75%, and increasing bed capacity by 25% with no construction. Interesting stats: the company has over 600 facilities using 500,000 of its components to track more than 1 million patients per year. The big announcement a few weeks back was that The Johns Hopkins Hospital chose Versus to manage staff and assets in real time for some locations after a three-year pilot of several RTLS systems, with additional deployments scheduled. Thanks to Versus for supporting HIStalk.

The Peace Corps has an RFI out for an EMR product, just in case you’d like to sell them one. They’re actually looking to have OpenEMR customized, along with Microsoft Dynamics 2011 and BizTalk for reporting.

In England, Homerton University Hospital allows its original NPfIT contract for Cerner and BT expire and signs its own seven-year extension directly with Cerner, declining to open the opportunity to other vendors because of its working relationship with the company.

1-27-2012 9-04-08 PM

The Bipartisan Policy Center releases its recommendations for using healthcare IT to improve care and reduce costs. Quite a few industry names served on the task force and provided their input. Some of its observations and recommendations:

  • Even with new delivery models, the healthcare system continues to financially reward procedure and patient volume rather than better care. Recommendations: purchasers and plans should reward care that is higher quality and lower cost, incorporate those models into Medicare physician payments, expand pilots of new care models, and share lessons learned with private sector pilot projects.
  • Despite a lot of HIE activity, not much patient information is actually being exchanged. Recommendations: improve the HIE business case by adding more stringent information exchange requirements to Stage 2/3 of Meaningful Use, develop long-term standards that make sense for healthcare delivery, assess the level of information exchange that is occurring, do more work related to two-way data exchange, and clarify the role of health information exchange in the several programs funded by HITECH.
  • Consumer engagement with electronic tools is minimal. Recommendations: raise public awareness, help providers engage their patients to use technology, improve the usability of consumer tools and provide easy data import/export for consumer-facing applications, launch an awards program for consumer tools outcomes, share lessons learned, ramp up Meaningful Use requirements to include more consumer tools, and offer incentives to chronic disease patients to use electronic tools to manage their health.
  • EHR and Meaningful use adoption is still low. Recommendations: raise awareness of incentive programs and expand RECs and similar programs, clarify Meaningful Use requirements, roll out lessons learned form federal programs to the whole industry and not just government contractors, encourage sharing of best practices, and improve EHR usability.
  • Consumers are worried about privacy and security. Recommendations: require all entities that use PHI to comply with policies at least as stringent as HIPAA, clarify government guidance across agencies, development a national strategy for patient identification (a national ID was not specifically mentioned), and issue common sense security practices to providers.

1-28-2012 8-34-29 AM

I’ve previously mentioned the MIAA EHR mobile viewer app developed by a three-person Palomar Pomerado Health development team for its own use with its Cerner systems. A preview at a Toronto mobile healthcare conference generates interest, with the app going to pilot in March. The hospital hopes to commercialize it. Said a Canadian hospital IT director at the conference, “We need to look seriously at how a publicly-funded hospital in the States has been able to advance their technology like this when we seem to stumble on things like policy and rules.”

The Pennsylvania Health Department finds that nurses at St. Luke’s Hospital overdosed three patients in the past two years by incorrectly programming their PCA pumps. Hospital employees said the hospital did not require training on the devices.

An article covering successful businesses that did not use outside financing provides an example in eClinicalWorks CEO and co-founder Girish Kumar Navani, quoting him:

I don’t foresee leaving the company for at least 10 years. I would like to leave it a private company with no external investors and absolutely no thoughts whatsoever about Wall Street. I am having fun and take great pride in my freedom. There is no reason I would give that up. We are a cash flow positive company. We have recurring revenues and no debt. We have a large customer base that is growing exponentially.

1-28-2012 8-15-21 AM

Compuware says it will take its Covisint subsidiary public in its next fiscal year, which starts in April. Covisint, which has $74 million in annual revenue, offers an exchange platform that connects hospitals and practices, including services for identity management, collaboration, master patient index, and record location.

Vince’s latest HIS-tory: Part 2 of Health Micro Data Systems.

A column in The Atlantic revisits a 1995 article it published about Newt Gingrich, saying that some of his goofy, overly dramatic “we are at a crossroads” ideas (like colonizing the moon) prove that he can’t separate something that sounds cool if given little thought from pushing the government into spending huge amounts of money just to find out how cool it is or isn’t, even though the free market is better equipped to make that call. Healthcare technology was mentioned in that 1995 article:

Gingrich also thinks health care technology is cool. Serious students of this subject worry that insurance insulates patients from the cost of technology, thus yielding lots of high-cost, low-benefit use and in turn steering too much of society’s resources to the further development of such machinery. But Gingrich wants more. In 1984 he wanted more cat-scan machines, and he wanted the government to provide a $100 million incentive for the development of user-friendly dialysis machines–even though "there are already companies and researchers interested in this problem." The point here isn’t that Gingrich will now waste tons on technology. The current political climate will restrain this tendency. The point is that–in case you hadn’t noticed–there is little careful thought underpinning his enthusiasms, nothing solid beneath his unshakable self-assurance and his intense disdain for disagreement.

E-mail Mr. H.

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January 28, 2012 News 13 Comments

Monday Morning Update 1/23/12

January 21, 2012 News 8 Comments

1-21-2012 9-08-49 AM 

1-21-2012 10-21-53 AM

From KC HIT BootsOnGround: “Re: Missouri’s statewide health information network. A rumor no more … Cerner will not serve as the technical service provider. Statement attached.” Above are last April’s announcement that negotiations had commenced and Thursday’s announcement that they have ended.

1-21-2012 10-23-01 AM

From Al Faretta: “Re: Baptist Montgomery. Just wanted to let you know that our clinical system is not McKesson – it’s Cerner. Thanks for all you do – I start my morning with you!” Thanks. That eliminates McKesson’s sole entry in the Thomson Reuters Top 15 Hospitals list and boost’s Cerner’s presence there.

1-21-2012 9-04-41 AM

From Karen Thomas: “Re: Main Line Health. I wanted to clarify the systems used at Jefferson Health System, JHS. JHS is comprised of Main Line Health and Thomas Jefferson University Hospital. TJUH uses GE as their EMR. The Main Line Health System uses Siemens Soarian in four of our hospitals and Cerner in one of our hospitals. I understand that this does not change the point of the author, George, but I thought I should point out that GE is not the EMR for JHS. Also, all the Main Line Health hospitals have recently achieved HIMSS analytics Stage 6 designation.” Thanks for the clarification. Karen is VP/CIO of Main Line Health.

From PharmGuy: “Re: Prognosis Health Information Systems. The CTO, who was the brains behind the company and a co-founder, is gone.” I asked Prognosis President and CEO Ramsey Evans about Isaac Shi. He responded as follows:

Isaac is a co-founder of Prognosis and remains a significant shareholder. He has the gift to see the “big picture” and introduce innovative solutions to the marketplace. His leadership of our ChartAccess EHR has been the foundation of our rapidly growing company. As you realize, our marketplace demands a fully integrated clinical and financial solution. As a result, we’ve broadened our focus and Isaac’s responsibilities changed as our strategy has evolved. With the 2006 vision now becoming a reality and confidence in our path forward, Isaac made a decision to look at some other opportunities to expand on his vision. He remains in good standing with Prognosis and is very supportive of our company’s direction.

1-21-2012 8-42-07 PM

From Alzado: “Re: separated at birth? Being an HIT guy and a music connoisseur, I figured you would recognize the resemblance.” I do, but I’ll leave it up to readers to figure out how those categories fit this photo. Hint: two first names, both starting with J.

From Pippy: “Re: HIStalkapalooza. Have the invitations gone out yet?” Everybody who signed up will get a response by the end of the week, hopefully – either an invitation or an apology that we couldn’t invite everyone (it’s about 50-50 since we had over 1,000 requests). As much as I like hearing from readers, I respectfully request (based on experience from previous years) that folks don’t e-mail Inga or me to ask (a) what happened to their e-mail, since we can’t control your spam filters, or (b) if we can slip them an invitation even though they didn’t get one or didn’t register in the first place. I’m already overwhelmed. But here’s some good news – next year’s HIStalkapalooza in New Orleans is already somewhat underway, with a sponsor and venue secured. I’m really lucky that companies volunteer to underwrite not only the cost of putting on the event, but to manage the surprisingly complex logistics required to do it right for readers.

From The PACS Designer: “Re: Blue Button initiative. TPD was first introduced to healthcare blogging by Shahid Shah, a fellow blogger, who started HITSphere to power this whole healthcare phenomenon by highlighting HIStalk and other websites. Now, he has blogged about the VA’s Blue Button Initiative and what he sees as its key benefits. Since it is on the NHIN Watch website, you’ll have to create an account there to read his seven key positives of the project. ”

1-21-2012 6-58-36 AM

The level of HITECH payouts is about what most readers expected, although a significant minority thought it would be more. New poll to your right: what do you like best about the HIMSS conference?

My Time Capsule editorial from 2007: Crossing the Cliché Chasm: Banished HIT Words for 2007. It obviously wasn’t effective since most of 2007’s overused words are still being repeated endlessly. A snip: “Thought leaders – people smarter than you and me, at least in their own minds. Companies often present their high-ranking employees as thought leaders when they want to sell you something. Thought leaders don’t have real jobs –they just think and cling to HIMSS podia. Picture that Rodin statue wearing a suit or black turtleneck and bringing Dilbert-laced PowerPoints.”

I just noticed that with increasing readership, we’ll be close to hitting the 5 millionth HIStalk visit right around when the HIMSS conference starts. That’s since I started it, way back in June 2003. I sometimes question whether it’s worth the effort, but I still have a blast doing it every single day, as much or more than I did 8.5 years ago.

Listening: I got several outstanding recommendations from reader Cody, including one I posted here way back in 2007 that deserves a revisit: The Hives, a hard-working Swedish garage rock band that doesn’t take itself too seriously (they wear matching but ever-changing black and white costumes and use old-school corded instruments) playing real, raw rock music with a stage presence and energy that makes them probably the best live band in the world. Proof: the live versions of Tick Tick Boom or Hate to Say I Told You So, which is like a 40-years-ago Mick Jagger without the scowling. They’re playing Coachella in April and my MP3 player starting today. When it comes to music, it’s not about their look, their audience demographic, or their age – it’s about how their music makes you feel. If you can sit immobile while The Hives are playing, then we differ.

Vince’s HIS-tory this week pays tribute to Bill Corum, who passed away earlier this month. Vince will have some fun stuff upcoming – I got an e-mail from Elaine Heusing, whose enjoyed seeing a cover of the magazine her father produced, Healthcare Computing and Communications, on one of Vince’s slides. I suggested to Vince that he cover some of those publications of yesteryear and the people who put them out. Back in the day, you waited anxiously for your mail copy of the magazines (even thought most of them were 70% ads, with mostly harmless and vendor-friendly prose intended to not threaten that ratio) and even faxed copies of newsletters like H.I.S. Insider. The folks who published those magazines and newsletters were highly respected, many of them with healthcare IT experience that went above just writing about it.

1-21-2012 7-26-50 AM

Welcome to new HIStalk Platinum Sponsor First Databank. The company requires minimal introduction since its electronic drug databases power a great number of the clinical IT systems out there, but here’s a recap. The San Francisco-based FDB’s team of pharmacists, physicians, and technologists, working with its system developer customers, turn drug information into tools that reduce medication errors by empowering clinicians as they make medication-related decisions: drug information, drug selection, clinical decision support, clinical alerts, and patient education. FDB has developed the first physician-friendly CPOE drug database, the OrderView Med Knowledge Base, that gets clinicians quickly (two clicks, in many cases) to the desired medication without bogging them down with needless details related to dispensing or billing (making prescribers choose a warfarin 5 mg and a warfarin 2 mg to get the desired dose of 7 mg is lame – that’s a dispensing decision that prescribers shouldn’t have to worry about.) The company offers case studies of how developer customers have used its products: Design Clinicals (medication reconciliation), athenahealth (meet Meaningful Use requirements), DMD America (drug pricing analysis), and Personal Caregiver (consumer drug information for mobile devices). FDB, whose vision is “A World Free of Medication Errors,” has been delivering drug knowledge solutions for over 30 years and it was recently ranked #1 among drug database vendors in nearly all key indicators in the just-published KLAS report on clinical decision support. Thanks to First Databank for supporting HIStalk.

The Virgin Islands Health Department conducts an EMR and HIE town meeting with mixed results. An interventional cardiologist talks up how much he likes the EMR, but loses his computer connection while demoing it, leading another doctor in the audience to comment that lost connections are typical in her practice and that the infrastructure may not be up to the challenge. Another doc said computerization slowed them down so much that patients were waiting 2-3 hours to see a doctor and she was thinking about finding a different career purely because of the EMR.

Robert Schwab MD, chief quality officer at a couple of Texas Health hospitals, warbles The Ballad of Go-Live in recounting their Epic go-live week by week.

In England, reliably anti-NPfIT MP Richard Bacon calls for the Cerner Millennium patient scheduling system to be shut down after problems are reported by two NHS trusts. Surgeons complained that their surgery schedules listed incorrect procedures and cases that were not within their specialties. Another trust had so many problems with long call wait times and delayed appointments that they had to stop charging patients for parking.

The VA, fulfilling its data center consolidation plan, will move VistA hosting to Defense Information Systems Agency facilities operated by Verizon subsidiary Terremark Worldwide. In a related story that I missed while taking a break last weekend, the military’s AHLTA system goes down for 10 hours after an upgrade-related problem with its commercial data storage software. An unidentified source says the outage highlights the lack of Military Health System contingency plans for AHLTA, such as a failover data center.

Kronos acquires the OptiLink acuity-based staffing solution from The Advisory Board Company. Kronos will use the system to enhance its healthcare workforce management solutions, saying it will support collaborative cost management efforts between hospital finance and nursing departments.

I like this week’s e-mail from Kaiser’s George Halvorson. He’s throwing down the gauntlet on HIV treatment next week and the CMS Health Care Innovation Summit, challenging organizations to meet KP’s HIV death rate that’s less than half the national average and even 20% better than the VA. KP will also share its tools and strategies. Most interestingly, KP has eliminated HIV treatment disparities, with no outcome differences by race, with a goal of eliminating race-related differences in 16 NCQA HEDIS categories. Well done.

A belated holiday-related charity update: HEI Consulting offered a matching donation challenge to benefit Community Services League, raising $15,000 for the Jackson County, Missouri self-sufficiency organization.

Paul Beckwith, former assistant controller of clinical intelligence vendor TheraDoc (acquired by Hospira in December 2009 for $63 million,) is sentenced to 18 months in federal prison for moving $1.3 million of the company’s money to his stock trading accounts. He initially profited from trading and moved the money back monthly, but like many gamblers and speculators, started losing and got desperate to recoup his losses by betting even more. The company got almost all of its money back.

The Secretary of State of Massachusetts goes public with his spat with Meditech over a proposed construction site, saying of Founder and CEO Neil Pappalardo, “Mr. Pappalardo wants the right to do whatever he wants and not be responsible for anything — including the rights to dispose of skeletal remains if they find them.” A public hearing is scheduled for Tuesday on the construction project, which pits jobs against archaeology.

GE reports Q4 numbers: revenue down 8%, EPS $0.35 vs. $0.42. GE Healthcare reported a revenue increase of 1% to $5.16 billion, but operating income dropped by 5% to $953 million.

GE Healthcare lays off an undisclosed number of employees (“less than 50”) at its South Burlington, VT office, citing “changing market demand and technology needs” in healthcare IT.

Police in Russia investigate whether frequent power outages were responsible for the deaths of eight newborns in 10 days, all of whom were on respirators that apparently had no back-up power source.

1-21-2012 10-01-59 AM

Clinical documentation vendor MD-IT names Bard Betz as CEO, replacing former President and CEO Tom Carson. Kevin Shaughnessy is promoted to president.

A baby born 16 weeks prematurely at 9.5 ounces (considerably less than a can of soda) is discharged after a five-month stay at LA County-USC Medical Center. The hospital declined to state who is paying the estimated $500-700K cost.They’re still not sure if the baby, now at 4 pounds 11 ounces, has permanent neurological damage.

1-21-2012 8-50-07 PM

Reader James thought maybe Weird News Andy preempted him on this story, but he nailed it. A man building a shed thinks he cut himself with his nail gun, at least until he has X-rays, when doctors told him he had actually shot a nail into his brain. His response: “Did you get that out of the doctor’s joke file?” The response: “No, man, that’s in your head.” While being transported by ambulance to another hospital for surgery, he cheerfully posts his X-ray on Facebook. After surgeons successfully removed the nail and replaced a chunk of the man’s skull with titanium mesh, he said, “We need to get the Discovery Channel up here to tape this. I’m one of those medical miracles.”

E-mail Mr. H.

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January 21, 2012 News 8 Comments

HIStalk Interviews Dan Paoletti, CEO, Ohio Health Information Partnership

January 20, 2012 Interviews 1 Comment

Dan Paoletti is CEO of Ohio Health Information Partnership of Hilliard, OH.

1-20-2012 4-07-20 PM

Tell me about yourself and about OHIP.

I’ll start with the Partnership since that’s really what it’s about. The Partnership is a non-profit created about 2 1/2 half years ago by the Ohio Hospital Association, the Ohio Medical Association, the Osteopathic Association, the State of Ohio, as well as another non-profits. It was designed to apply for the federal ARRA grant dollars that had just been issued. We were awarded the state-designated entity for health information exchange in Ohio by the governor at that time and were awarded those federal dollars as well as we were awarded about $28.5 million of Regional Extension Center monies to help providers adopt electronic medical records.

My background is very simple. I was vice president with the Ohio Hospital Association. Previous to that, I worked for Johnson & Johnson. I’m kind of a data geek. I am really here just to facilitate the grassroots effort of the Partnership.

Ohio is progressive when it comes to healthcare technology, even down to Board of Pharmacy regulations that are both admired and feared. Compared to how other states or organizations have set up their HIEs and RECs, how is your structure different or better?

It’s hard to compare if we’re actually better, but I think we are different. We decided very early on that we were going to use the resources and the expertise that existed already in the communities throughout Ohio. There was no reason to layer on another complex organization on top of all that. We are really a facilitating body to gather together the resources that exist in the state, like connecting the dots and get everybody working in the same direction.

Most of the work is being done at the community level, the grassroots level. It took us a while to get started. We started off pretty slow, but right now I believe we have more doctors than anybody signed up in the country. We just passed 6,000 primary care providers that are using our Regional Extension Center services. That grassroots effort is really the key. That’s what makes the difference.

Early on, groups thought their problems were going to be technical, so they were quick to go through a rigorous process of selecting technology vendors and looking at infrastructure. What blew up in their faces was issues related to bringing competitors together at the table or privacy issues that were a lot different than they expected. When you look at your long term strategy, the question always is, “Well, what’s your business model once the grant money runs out?”

Great question. You did hit the nail on the head with that. It’s really not a technology issue, it’s a trust issue. 

It goes back to our roots. Our board consists of stakeholders from throughout Ohio that have a lot vested in this and building the trust among each community. We’re targeting not Ohio necessarily as a state, but community by community, and using the community leadership to really get people to the table. That’s the key. It’s not about the partnership. It’s not about the health information exchange, it’s about assisting and solving problems in those local communities. That’s really what’s generated the success model to date.

Privacy is a huge issue. We’ve decided with CliniSync , which is what our health information exchange is called, it’s an opt-in model. We have developed a policy that users of the program will assist and educate the patients that are going into the exchange, what that means. It’s not a law, it’s not a state-level policy, but it’s users of the CliniSync program. We’ve tried to address those very carefully. It’s taken us a long time, but we’ve gotten buy-in from most of the major players and small providers in the state. We’re ready to move forward, and we are.

You must have a good message to get that number of providers on board since they typically understand that there’s patient benefit, but it requires extra work and potentially money from them, plus having to work with competitors that they’re not especially fond of. What selling points make them want to hook up to the HIE?

The core message is it’s about the patient. This is about what’s best for the patients in Ohio and the folks that are receiving care in Ohio. The providers in the state understand that. That’s really what’s most important.

We’re not competing about data. It’s not about competing on that. It’s about competing on service and quality. All of this can have a great effect on that as well as bring efficiencies to the table. Once you sit down and look at specific issues around what the electronic medical records and what the exchange can do for that community-based model and really take it down to that level, people understand. It’s keeping the focus on the patient. That really has had a tremendous affect.

Like all statewide organizations, you’ve got some high-profile, big-ego organizations involved. You also have some that are using systems like Epic, which touts its own private HIE capabilities among Epic users. Has that been a problem when you’re working with groups like Cleveland Clinic?

It’s not a problem. It’s one of those issues that you have to really get down to the patient level and figure out what’s best for the community. I’m not sure about this statement, but I think by the end of this coming year in 2012, we’ll probably have more Epic installs than state in the country. 

It’s a unique challenge, but when you look at specific community models, not everybody in every community is using the same systems. You have to be able to communicate with home health agency. You have to be able to communicate with the skilled nursing facility and the competitor down the street. If that patient is moving in and out of all of those, there’s no way that one system solves all that problem.

What we’ve tried to do is position this product as very community-focused, a neutral third party that is a gateway. We’re not storing data. We’re not a data repository. It just allows people to communicate with each other. The focus on the patient has been the key to getting people to work together.

In your experience connecting these different clinical systems that are out there both in the practices and the hospitals, have you found that you had to blaze new ground with vendors who weren’t comfortable with either the technology or the concept of sharing information?

That’s an interesting question. I don’t think technology is quite at the point where we thought it was to allow for the free flow of information. But we’ve worked very closely with most of the vendors, especially the ones that have the bulk of the market, and for the most part they have really been great to work with. They are looking for some standardized process to make all this happen. They really do want this to happen now that this is real, because it is happening and this transformation of healthcare is real. 

It has been a challenge. We’re finding a few that are ahead of the others, but we’re using them to blaze that new ground in sharing that information with the others. Even among the vendor community, what we’ve found is they really do work well together as long as you’re not taking sides. That neutrality is key. But it is blazing new ground, without a doubt.

You had an announcement within the last couple of weeks about using the Direct system to communicate with another state, which sounded good on paper, but somebody might say, “Well, it’s not really that relevant. Most care is local.” Why was that event important?

It really did not affect any patient care. This was really a test of whether we could accomplish it.

If you look at what ONC has tried to do – and I would like to just say that this is all happening, this transformation in healthcare around electronic medical records and exchange, is really a result of this stimulus act, and it’s a result of a lot of the great work that ONC has done — Direct is something that they thought was a way to quickly allow people to exchange information. We want to help them be successful. It was really a communication between two clinics. We really didn’t have a whole lot to do with it except to help them facilitate that process. They wanted to see if it could happen, so it was really instigated by the providers themselves.

The important piece was that you had providers that were trying to exchange information across state boundaries. It wasn’t the fact that we could do it, it was their interest, and we were help in enabling that. But what is important about that is there is information that without sophisticated health information exchange in using this Direct Project, these Direct protocols, it can really help the patients.

Let me give you an example. You have a mental health patient that shows up in the ER. That sensitive type of information is very difficult to exchange in a health information exchange, especially with the laws in Ohio. We see the Direct protocols as a way to exchange some information, with the patient’s permission, explicitly to another provider that they might be going to for a follow-up care. We think there are some definite use cases that that can help. It’s an easy way for doctors to do that. Was it going to change the world? No. But it’s a start.  The exciting part is that it was between the providers. That’s what we want to emphasize.

According to the announcement, that was the first time Direct had exchanged data across state lines. I would have thought it was further along than that. Is there a technical reason that it hasn’t been done or was it just that nobody felt the need to do it?

I think it has a lot to do with everybody ramping up. The Direct protocols are fairly new. People are ramping up trying to create those protocols and create the secure e-mail systems. There’s nothing new about secure e-mail, but getting the providers provisioned with an address and making sure that everything adheres to HIPAA compliance and all of that — it’s complicated for a lot of folks to get that up on a large scale; especially with a lot of folks that received these state-designated entities. We’re getting close. We just happen to be a little bit out in front, but I think you will see a huge charge of other states and other entities doing this now. We just happen to be a little in front.

What does the big picture look like when there are HIEs springing up from two places that are a mile apart to crossing multiple states, you’ve got the Direct protocol out there for folks to use, and maybe private HIEs that vendors have set up. How will the average medical practice be interoperating?

I’d like to speak for Ohio if I could. The picture here is really community based. The reason that’s important is that the majority of care occurs inside a community. That community could be a single town, it could be a county, it could be multiple counties. But there is some geography where the bulk of care occurs. Ensuring that that information can be exchanged, whether there’s two regional health information exchanges that exist within that community or whether it’s a community without any ability to exchange. The vision that the partnership board and the grassroots stakeholders in the state that are part of OHIP see is that the partnership can be that gateway to facilitate that.

Again, it’s not about us. It’s not about our ability to store and retrieve data. It’s about our ability to allow others to communicate with each other. And for a while – I don’t know whether it will be five years, 10 years, 20 years — there’s still going to be some middleware required to allow that type of exchange to occur. I think that was the vision of ONC — to facilitate this.

In Ohio, our model is just a little bit different, but we’re pleased because we have a lot of folks that have already expressed interest and commitment to make that happen regardless of where they stand technology-wise. That’s our vision, it will be interesting to see what happens though in the next five or 10 years.

The jury seems to somewhat be out on whether Regional Extension Centers are really increasing EHR adoption and whether they’re helping technology improve outcomes and reduce costs. Do you get the sense that they’re accomplishing what they were supposed to?

Our process is a little bit different. It all starts with electronic medical record adoption. It’s hard to accomplish all that without widespread adoption, so that’s where we spent the last two years, really working with our community leaders to adopt the electronic medical records. The next stage is working with the community stakeholders to begin to exchange that information and get a solid base of exchange going so we can start to work as a community on the outcomes and improving quality.

It’s connecting the dots. It’s been a phased approach. I think it will be difficult to accomplish the vision that many people have set without that kind of phased approach. We think we can, because we are accelerating things here in this state. Adoption is the key.

There was huge interest in HITECH money early on, but it’s starting to look like some folks gave up or decided it wasn’t worth doing. Are you seeing people who thought they might be going with electronic health records who saw the wall in front of them and decided to stick to where they are?

In the beginning, there was a lot of doubt and a lot of concern. I do think we did have some people drop off. But what we did here in the state is develop that grassroots support mechanism, so the physician and the practices and the small hospitals weren’t out there by themselves. They had a support structure in place. Because of that support structure, I think you will see an incredible acceleration of Meaningful Use attestation in 2012.

Ohio, I believe, ranks third as far as Medicaid payments for Meaningful Use and we also are at the top as far as Medicare attestation. Our goal for next year is to help 10,000 providers attest to Meaningful Use, not just primary care providers, but all providers. It’s pretty lofty, but because of that support structure, we’re trying to accelerate and keep things moving forward, because without that, we’re not going to see the benefit. That’s our number one priority. The key is that support structure — they have to have somebody to fall back on.

Is there resistance to the check-off for Meaningful Use that it isn’t really directly related to patient care?

That’s a very difficult thing to answer, especially where we are right now. Is the Meaningful Use criteria going to directly affect patient care? I think it will, in the sense that as providers have to work towards meeting that, it’s going to naturally bring along more and more of the practices as far as how it’s going to affect that patient outcomes. It was a great starting point, but what people have to realize is there’s only so much at the federal level that they can make happen. It really comes down back to that community level in putting the support structure in place to help people meet Meaningful Use. 

Then make the next step to help them exchange that information, then get these projects together that will help providers learn from each other and really make the impact on patient care in the outcomes and the efficiencies — because we have to have the efficiencies as well. It will happen. It’s just coordinating all that together, which is a monumental task. 

Every transformation is hard. It’s about having that support structure in place at the grassroots level to help facilitate that. It will happen. We spent a lot of time looking at the return on investment of electronic medical records, return on the outcomes of care of electronic medical records. I think there’s enough documentation out there now to prove that yes, it does have an affect. We want to be able to prove it has a significant effect. We think in a couple of years that we’ll be able to do that.

If you look down the road, let’s say five years, how will you know that you’ve done the job you hoped to do?

I can tell you the goals we have in place. Our board and our stakeholders make sure that we’re very goal-oriented.

To document success is the number of providers that have adopted; the number of providers that have attested to Meaningful Use; the number of providers and institutions that are sharing information; and then ultimately getting the entire community — the payer community, the employer community, the patient-consumer community, as well as the provider community — to get enough data to document that we have had an impact on the outcomes and the cost of care. And getting everybody involved in that process.

Can I give the exact metrics that we’ll need to prove that? No. But we have enough momentum now that I believe in five years, at least in Ohio, we’ll be able to prove what kind of success that this whole thing has caused. We’re pretty excited about that.

Any concluding thoughts?

This is really an exciting time for Ohio. ONC has enabled us to jump on board with this and provided the funds we’ve needed to help create transformation here in the state. It’s not about our organization. It’s really about the folks out in the community doing the work. We’re here to help them, and we hope to be one of those models of success that people can point to and say, “Look, if you can do it like this, you’ll be successful.”

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January 20, 2012 Interviews 1 Comment

News 1/13/12

January 12, 2012 News 12 Comments

Top News

1-12-2012 2-56-44 PM

Adventist Health expands its affiliation with Cerner, announcing plans to implement Cerner Ambulatory EHR across its 130 clinics.


Reader Comments

1-12-2012 8-54-21 AM

inga_small From Booth Babe: “Re: HIMSS and HIStalkapalooza. Have mercy on the aching feet of worn out tradeshow floor ‘workers’ who have only minutes to spare getting from work to FUN. Do you know how often during aching feet moments we think of the upcoming party and how it drives us through each additional hour until we can cut loose and have some fun?! I would never have time to deck out as some of those fashionistas did last year, though they looked fabulous and were fun to see. Maybe you should add a category for best ‘survivor’ shoes for tradeshow performance. ” Gee, the term “survivor” shoes is right up there with the “straight from the exhibit hall” style company logo shirts. That being said, I have a couple pair of great shoes similar to the ones above that are comfy enough for the trade shoe floor, yet stylish enough for a quick transition to Vegas nightlife. E-mail me if you want details on the brand.

1-12-2012 7-21-44 PM

From ThickAndThin: “Re: McKesson. To acquire European firm MACH4 Pharma Systems?” Unverified. The England-based company sells drug packaging and preparation automation for hospital pharmacies.

1-12-2012 9-06-17 PM

mrh_small From DeepThrowIT: “Re: White House CTO Aneesh Chopra. Word on the street is that he will announce in the next few weeks that he will be leaving his job. No word on where he’s going next.” He’s a young guy (39) with a lot of enthusiasm and charisma, so if the rumor is true, we’ll see whether he pursues money (running a private company) or power followed by money (running for office.)

mrh_small From LeftCoaster: “Re: EDI 5010. Oregon and Washington hospitals are experiencing significant issues with transmission and receipt after mandated January 1 use, but deferred enforcement until April 1. Clearinghouse vendor [vendor name omitted] is a huge problem – they are not responding to support calls and hospitals are considering switching. Both Cigna and Providence Health Plan claim they are unable to transmit payments and organizations are having major cash flow problems, particularly community hospitals. Anyone else having problems?” Unverified, so I removed the vendor’s name. Further reports are welcome.

mrh_small From Nasty Parts: “Re: [vendor name omitted]. Is moving away from their legacy EHR product and all efforts will be put behind a SaaS product they bought last year. 400+ people will be RIF’d as a result in the near future.” I removed the vendor name while we try to get confirmation (which I don’t expect to be successful), but Nasty Parts has been accurate about this company in the past.


HIStalk Announcements and Requests

1-13-2012 1-52-10 PM

inga_small Highlights from HIStalk Practice this week include: Dr. Gregg explains why he is skipping the HIMSS soup line this year. Hospitals now employ 20% of physicians. CareCloud grows rapidly. A breakdown of EP attestations by EMR product. Age affects physicians’ perceptions of HIT. A little bit of ambulatory HIT news is like a ray of sunshine of a cloudy day. In other words, by signing up for e-mail updates on HIStalk Practice, you can keep the winter doldrums at bay. Thanks for reading.

1-12-2012 6-24-41 PM

mrh_small Welcome to Humedica, sponsoring both HIStalk and HIStalk Practice at the Platinum level. The Boston informatics company offers SaaS-based clinical business intelligence solutions that create a real-time longitudinal patient care view, giving providers insight into their patient populations, the outcomes of the treatments and procedures, and how those factors impact quality, outcomes, and cost. For physician practices, the company’s MinedShare Ambulatory product supports clinical, operational, and financial benchmarking. Humedica partners with Anceta, the informatics subsidiary of AMGA, to allow its members to collaborate on quality improvement and to share best practices. I interviewed President and CEO Michael Weintraub last month, where he talked about the company’s top-rated performance in KLAS, its partnership with Allscripts, the $50 million in capital investment the company has received, and what’s next for the industry after EMRs. Thanks to Humedica for their support of HIStalk and HIStalk Practice.

mrh_small Speaking of Humedica, the company announces a predictive analytics tool that analyzes EMR data (not claims information) to identify high-risk CHF patients and intervene before they require hospitalization. Preventable heart failure admissions cost up to $35 billion per year, with 40% of Medicare CHF patients readmitted within 90 days. MinedShare client Community Physician Network (IN) says the tool will help it perform in an Accountable Care Organization model by avoiding unnecessary admissions and providing better patient outcomes.

1-12-2012 7-37-05 PM

mrh_small Reminder: you app and Web developers still have plenty of time to enter Nuance’s 2012 Mobile Clinician Voice Challenge, considering that it takes only a couple of lines of application code to speech-enable your mobile or Web app for clinicians and the deadline isn’t until February 3. Prizes and fame could be yours. Even non-programmers can get a shot at the prize kitty by tweeting about the contest.


Acquisitions, Funding, Business, and Stock

1-12-2012 9-10-22 PM

T-System acquires Practice Management Associates, a provider of coding and billing services for EDs.

TriZetto Group, which last week acquired Medical Data Express, acquires Kocsis Consulting Group.

Practice Fusion raises an additional $2 million in funding, raising its total to $38 million from Band of Angels, Felicis Ventures, and other investors.

1-12-2012 9-08-50 PM

Columbia University signs an exclusive agreement with Health Fidelity to commercialize its MedLEE text-based natural language processing technology. Fidelity offers its own NLP solution called Fidelity Platform, which uses MedLEE to extract medical data from unstructured text and generate SNOMED codes from it.

1-12-2012 9-11-13 PM

In Europe, CompuGroup Medical acquires Netherlands-based ambulatory and pharmacy systems vendor Microbais Werkmaatschappij BV. The transaction also gives CompuGroup a 51% stake in healthcare connectivity startup MediPharma Online.


Sales

1-12-2012 2-49-30 PM

Barnabas Health (NJ) adds MedeAnalytics’ Revenue Cycle Intelligence solution to compliment its existing Patient Access Intelligence solution.

1-12-2012 3-05-03 PM

El Paso Children’s Hospital (TX), which opens next month, selects RCM provider Cymetrix for business office technology and services.

The DoD awards GE Healthcare a three-year, $43 million extension of its contract for patient monitoring systems.

Illinois Neurological Institute selects JEMS Technology to provide tele-stroke evaluation.

Massachusetts Eye and Ear selects PatientKeeper Charge Capture and PatientKeeper P4P for its 250 clinicians.

1-12-2012 9-12-42 PM

Catholic Health East signs a five-year, $40 million contract to implement AUXILIO’s managed print services in its 19 hospitals.


People

1-12-2012 5-51-40 PM

Former Google Health exec Missy Krasner joins Morgenthaler Ventures as executive in residence. She was also previously senior communications director at ONC under David Brailer.

1-12-2012 12-15-24 PM 1-12-2012 12-16-26 PM

Medical appointment booking site ZocDoc adds former Senators Tom Daschle and Bill Frist to its advisory board.

1-12-2012 8-09-15 PM

Encore Health Resources promotes Thomas J. Niehaus from EVP of client services to president and COO. Dana Sellers remains as CEO. In case you missed it, Mr. H recently interviewed Joe Boyd, Encore’s chairman of the board.

1-12-2012 5-54-01 PM

 

Lisa Conley, formerly with McKesson, joins Sunquest Information Systems as VP of North American sales and global marketing.

1-12-2012 8-00-32 PM

Industry long-timer Kerry de Vallette joins OPTIMA Credentialing as EVP of sales and marketing.

1-12-2012 8-53-47 PM

Interactive patient care systems vendor Skylight Healthcare Systems names Scott Johnson as VP of sales. He was previously with A-Life Medical and Philips.


Announcements and Implementations

1-12-2012 2-58-53 PM

North Hawaii Community Hospital begins implementation of its HIE, which uses Wellogic’s technical platform

Intelligent Medical Objects announces the successful integration of 2012 ICD-10-CM within its newly released IMO Problem IT 2012 Regulatory 1.3 software.

Nuance Communications expands the availability of Dragon Medical to French-speaking Canadian providers with the delivery of Dragon Medical 11 French.

mrh_small Yale New Haven Hospital SVP/CIO Daniel Barchi provides an update on its Epic project. Six practices of 27 physicians are live, with e-prescribing at 91% and 80% of encounters closed the same day. Physician productivity for those docs is nearly back to pre-Epic levels. Greenwich Hospital will be the first hospital to go live in April. Daniel is one of few CIOs who has implemented Epic in two large health systems (he came from Carilion) so I asked him how it was the second time. He says Epic’s greatest strength is that they fully believe and trust their own process — developing their own software, rarely partnering with other companies, and creating finely detailed training plans. The benefit for customers, he says, is that if you just follow their plan, you will have a successful go-live.


Innovation and Research

Researchers at the University of Washington develop medical robots that support the open source Robot Operating System, saying it’s time to get away from proprietary, one-off medical robots and allow universities to collaborate in sharing their applications.


Technology

 

inga_small Ford partners with Microsoft, Healthrageous, and BlueMetal Architects to develop “the car that cares,” which would monitor the health and wellness of drivers. Data would be collected biometrically and through voice capture, then uploaded into HealthVault.  And I thought texting while driving was distracting.

1-12-2012 8-05-40 PM

A doctor in Canada gets her smart phone PHR app certified by Canada Health Infoway, only the second app to earn that distinction. She named it Mihealth, with the “Mi” referring to her feeling that adopting digital data in Canada was Mission: Impossible.

1-12-2012 8-35-45 PM

The Qualcomm Tricorder X Prize offers $10 million to anyone who can create a Star Trek-like tricorder that can diagnose medical conditions non-invasively. The X Prize Foundation chairman helpfully adds, “We don’t have a requirement that it makes the same noise.”


Other

An AHRQ study finds that 5% of Americans account for 50% of the country’s $1.26 trillion in healthcare costs. The top 1% of spenders account for 22% of the costs.

1-12-2012 12-30-11 PM

inga_small Could there be a connection? Life expectancy is up two years since 2000 and Hostess, maker of Twinkies, DingDongs (my personal fav), and HoHos, files for bankruptcy protection. Experts blame a shift toward healthy foods.

mrh_small Here’s a point/counterpoint issue to mull over. Inga and I disagree on the value of CMS’s attestation statistics. Inga thinks the percentage of each vendor’s customers that have attested is a good benchmark, so she did lots of spreadsheet work to compare vendors and to assume that varying percentages among them must be reflective of product capabilities and ease of use in meeting Meaningful Use requirements. I said the information is useless for that purpose since it’s more reflective of unmeasured customer demographics and buying criteria than anything else and that it would be wrong (not to mention statistically indefensible) to use the CMS figures to infer that vendors with a higher percentage of successfully attested users have a better product for earning Meaningful Use money. Feel free to take sides. One thing’s for sure: vendors who massage the data into slick marketing collateral won’t be footnoting their handouts with statistical disclaimers.

Weird News Andy says “the eyes have it” in referring to this story, in which researchers are working on a smart contact lens that can continuously and non-invasively monitor glucose levels, electrolytes, and cholesterol, sending the results electronically.

1-12-2012 8-31-07 PM

Former Steve Jobs mentor turned nemesis John Sculley, who served as Apple CEO for 10 years, is interviewed at the Consumer Electronics Show, where he was promoting a company he advises and invests in, Audax Health. He describes his interest:

The area I am particularly excited about now is healthcare. Healthcare has been the last major industry that hasn’t been touched by technology in terms of productivity and consumer adoption in the way so many other industries have. While I’m not bringing any technology experience to the healthcare industry, I do see some similarities between what I was asked to do when I came to Apple, which was to bring big brand consumer marketing to Apple and carry it over to the whole Silicon Valley industry – because everybody does that today – well that same opportunity exists today in healthcare. Health innnovation enabled by digital technologies to build big consumer service brands, is an incredibly interesting complex problem to work on. Audax is really the first social health company and it’s focused on consumer engagement in the healthcare space bringing in a lot of the social media technologies and experiences that have been learned from companies like Facebook and Zynga and others.

The federal government adds insurance fraud to the list of charges faced by a Louisiana doctor that also includes possession of child pornography. The doctor was medical director for a company that monitored neurophysiologic surgeries over the Internet, billing insurance companies for their time. He and the company are accused of billing for surgeries in which no Internet connection was established, padding their billed hours, and instructing non-physician employees to log on to the monitoring system and pose as physicians for billing purposes.

An Indiana health insurance plan alerts 2,700 members that their records may have been exposed on the Internet in February 2011, when a server was inadvertently opened up to the Web during an upgrade.


Sponsor Updates

1-12-2012 2-09-49 PM

  • SRS helps its customer Midwest Ortho (IL) celebrate its successful MU attestation with a tasty-looking cake.
  • Pete Rivera of Hayes Management Consulting  discusses building leaders and improving team effectiveness.
  • Picis will participate in this month’s 2012 Military Health System Conference in Maryland.
  • OnX and MEDSEEK enter into a strategic partnership that allows OnX to distribute all of MEDSEEK’s enterprise patient engagement solutions.
  • MED3OOO shares details of InteGreat EHR’s improved KLAS scores.
  • Minnesota’s REC recognizes e-MDs customer Christopher Wenner, MD for being one of the state’s first providers to achieve Meaningful Use.
  • Gateway EDI and AAPC align to offer ICD-10 training for practices, starting with a January 24 Webinar.
  • Orion Health opens its 14th international office in Paris.

EPtalk by Dr. Jayne

It may only be Thursday as I write this, but I’m really wishing it was Friday. This has been a hectic week full of clinical snafus and customer services annoyances.

The first guilty party is HIMSS, whose registration system apparently malfunctioned last month. HIMSS12 registrants were charged a zero dollar amount for their HIMSS renewals. I received an e-mail notice about the registration problem and was told that someone would call me to discuss whether or not I really wanted to renew. They did, while I was seeing patients. I didn’t want to ignore it and risk a snafu in Las Vegas.

I called the customer service number left on my voice mail and the answering staffer had no idea what I was talking about. After more than 15 minutes on the phone and two call transfers, they finally got their act together. I hope the conference itself runs much more smoothly. And to HIMSS, let me introduce you to the concept of service recovery. If you accidentally undercharge people, let it go and use it as a lesson learned. Did that many people really register on those two days that you are going to suffer without the extra $160 per person? Goodwill is invaluable.

The second guilty party was the staff at Well-Known University Medical Center whose performance at the check-in desk gave new meaning to the phrase “epic fail.” Not only did they insist that my insurance information wasn’t in the system (doubtful since it just paid a claim last week on another appointment) but they were also rude about it. As I sat in the waiting room, I was also annoyed by their ham-handed questioning of patients on race and ethnicity. I wanted to jump up and intervene with some better scripting.

If organizations can’t even handle those customer service basics, I have no idea how they’re going to achieve Meaningful Use, let alone be a meaningful participant in an ACO. Not to mention that they didn’t ask everyone about race and ethnicity. I’m not sure if they just “assumed” for the rest of us or if they decided to judge by appearance.

The final straw was a resident physician who actually was using his BlackBerry to e-mail or text during my visit. Really. Talk about smartphone distractions. He set it on the table between us and typed as he was doing the exam. I know for sure he wasn’t documenting in the EHR because the scribe was tapping away at the PC in the corner.

The resident didn’t think it was funny when I asked him if I was keeping him from something important. He did sheepishly put it in his pocket. Maybe he should have noticed the “faculty” label on my encounter bill. Oops!

Lest you think I’ve just become Angry Jayne, some good things did happen this week. Inga and I strategized on the coveted HIStalkapalooza beauty queen sashes and I have narrowed down the list of candidates who are vying for the chance to escort me to the event.

HIMSS released their list of its 2011 Best Hospital IT Departments. Texas Health Resources, whose IT shop is led by contributor Ed Marx, is listed for large hospitals.

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I’m curious about Nemours/Alfred I. DuPont Hospital for Children, which is described on the “medium hospitals” list as having 237 IT staff for its 180 licensed beds. I could certainly do a lot more with 1.3 staffers per patient. I wonder what their nursing ratio is?

Life Technologies Corp. announces that its new Ion Torrent genome sequencer will be able to map an individual human genome in a single day for less than $1,000. Although technically this is HOT, sequencing of a person’s genome brings up lots of controversial ethical and legal issues, not to mention the cost of the human expertise needed to transform the genetic data into something meaningful and to then counsel patients.

The absolute highlight of my week, though, is this delightful video about computers in medicine circa 1964. Thanks to Rockstar HIStalkapalooza correspondent Evan “Velvet Jacket” Frankel for making my day. See you at HIMSS.

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Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

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January 12, 2012 News 12 Comments

2012 Mobile Clinician Voice Challenge 1/4/12

January 4, 2012 News No Comments

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Nuance, an HIStalk Founding Sponsor since July 2005, has made a significant contribution to Homes for our Troops in honor of HIStalk’s readers and in appreciation of HIStalk’s sharing of this information with them.

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The Problem

Clinicians and their mobile devices are everywhere. Doctors, nurses, and other licensed professionals are interpreting clinical information and making clinical decisions right now using smart phones and tablets, often from locations outside the four walls of the hospital, clinic, or medical practice. They need better ways to interact with these systems beyond tiny keyboards.

The Solution

Give mobile clinicians a voice by speech-enabling your applications, both Web-based and mobile, with as few as two lines of code and in as little as a couple of hours. Free them from the limitations of poking at keyboards that are too small for normal fingertips –let them document on the go using their voice.

Link.

The Challenge

The 2012 Mobile Clinician Voice Challenge offers over $25,000 in prizes for most innovative, speech-enabled healthcare application (Web-based or mobile) developed using the HIPAA-secure, cloud-based Nuance Healthcare Development Platform. The contest runs through February 3, 2012, with winners to be announced at the HIMSS conference.

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The Prizes

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Full Details

Information is available on the contest page. See the text ad in the right column of HIStalk as well, which will run throughout the contest.

Not a Developer?

Tweet about the contest using @NUAN_Healthcare and #2012mobilechallenge and you’ll be entered in a daily giveaway for contest tee shirts and an iPad 2.


Contest Video

Link.


An interview with Jon Dreyer, senior manager of mobile solutions marketing, Nuance Communications, Healthcare Division


Describe Nuance’s philosophy about the mobile clinician.

The “mobile clinician” is quickly becoming synonymous with the modern clinician. In fact, physician smart phone adoption, which is currently at 72%, outpaces the general U.S. adult population by more than 50%.  And by the end of 2012, mobile device adoption among healthcare professionals is expected to reach 85%.

Whether racing from exam room to exam room or working remotely, mobile access to clinical information and mobile collaboration tools are essential for caregivers. This new breed of healthcare professional is in need of better experience-enhancing technologies, such as speech recognition that is available on any device at any time, in order to be completely untethered, yet still be fully plugged in to interact with and contribute to the care delivery process.


With voice-powered applications becoming common, especially on smart phones, do you see that as becoming a standard for systems designed for clinician use?

Absolutely. Voice will continue to grow as a primary form of input into mobile devices for consumer markets as well as within healthcare. Touchscreen devices with small onscreen or physical keyboards will never catch up to the speed of data entry on a desktop environment. Speech recognition overcomes the challenges associated with touch typing and bridges the gap to provide a ubiquitous experience for all users on all devices and platforms.

Keep in mind that speech recognition software designed specifically for healthcare professionals has been in use for more than a decade. On a daily basis, hundreds of thousands of clinical users across all healthcare specialties rely on the technology to reduce turnaround times, cut costs, and improve the overall delivery of patient care.

Given the dramatic rise in mobile device adoption over the past few years, and its projected growth, it’s only natural that the speech recognition experience clinicians have come to appreciate on their desktop is something that they will expect from their mobile and web-based apps as well.


Give me some cool ideas or apps you’ve seen that would be a good choice to speech enable just in case developers out there need some inspiration.

We have more than 100 partners in our evaluation program today. Healthcare app developers are rapidly embedding secure, cloud-based, medical speech recognition in point-of-care documentation/mobile EMRs, reference and content databases, disease management, clinical trial, pharma, and specialty-specific reporting tools. The applications run on a variety of devices and operating systems that are supported by the development platform, including iOS, Android, Web Browser (Internet Explorer, Safari, Firefox, Chrome), and native desktop applications.

Examples of clinical scenarios and apps that use speech recognition powered by Nuance Healthcare include:

  • Mobile EMR access. With speech recognition as part of the workflow, physicians can easily voice document findings and clinical notes without having to return to a workstation or office.
  • Interactive patient-side care. Specialists using mobile applications can now visit patients post-surgery and retrieve, as well as document using their voice, all relevant information on their mobile devices.
  • Trauma communication and coordination. With specialized, speech-enabled mobile apps, clinicians can capture in their own words the patient story without delay. In a trauma scenario where every minute matters, this streamlined mobile approach helps to speed communication across care teams while expediting prep time for surgery.
  • Diagnostic image view and reporting. Radiologists can now access patients’ diagnostic images via their mobile device and dictate reports from anywhere and at any time. The time in which patients receive feedback and care can be significantly shortened.


Do you have any words of encouragement for those who are thinking about entering the challenge?

Healthcare app developers should join the challenge because there’s really no reason not to participate.  Not only is it free to evaluate the Nuance Healthcare cloud-based medical speech recognition technology, but it’s also easy to integrate, deploy, and maintain. It requires minimal development effort (most evaluation partners have their integrations up and running within a few hours of registering) and clinical end users will benefit greatly from having access to medical speech recognition from their mobile and web-based apps.


Contest Notes

  • The contest is open to any developer who is a legal resident of the US.
  • You can submit multiple entries.
  • Apps do not need to be live and/or commercially available.
  • Apps do not need to be written specifically for the contest – it’s OK to integrate the speech service into an existing app.

Links

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January 4, 2012 News No Comments

Curbside Consult with Dr. Jayne 1/2/12

January 2, 2012 Dr. Jayne 7 Comments

What Gets Measured Gets Managed

During the last five years, we have seen significant shifts in how healthcare is delivered and in the way in which different healthcare services are valued. Most of us have realized for quite some time that fee-for-service medicine is clinging to life. Pay-for-outcomes is going to be the order of things from here on out.

Hospitals are no longer going to be paid to ameliorate hospital-acquired conditions or to deliver care to patients who were impacted by preventable harms. Physicians are going to be judged on their patients’ lab data and biometric information rather than the number of visits they bill.

Care will be transformed regardless of how we feel about it, whether it’s by the name Accountable Care, Shared Savings, or Pay-for-Performance. It’s something we all need to get used to.

My colleagues were ringing in the New Year this morning in the time-honored tradition of complaining around the coffee pot. (Most of us were rounding a bit later than usual and I did see a couple of bloodshot eyes.) It seems that many independent physicians, particularly those in small practices, don’t know where to start. (Employed docs are generally confused too, although to a slightly lesser degree.)

I decided to introduce them to Peter Drucker, whose famous statement, “What gets measured gets managed,” should be well understood by now. But let’s just say I was more than surprised by the blank looks in front of me.

Several of the docs didn’t understand that Meaningful Use is going to get trickier as time goes on. Although there are some metrics for Stage 1, many of them are easily achievable with a minimum of work. (Apparently though not as easy as people might think – I’m still stumped by the phenomenon of people unsuccessfully attesting. If you don’t have the numbers, why would you attest? Still waiting for someone to shed light on this.)

Although we don’t have final metrics for Stage 2 and beyond, it’s virtually guaranteed that the bar will be higher and the hoops smaller. In talking with the docs in the lounge, though, many of them don’t have a clue how to approach care metrics – even those with sophisticated software. I’m seeing far too many physicians who are barely using their certified EHRs, who are confused by some of the terminology, or who are hung up on wanting flash and sizzle.

I felt like I was giving a Grand Rounds presentation because our friendly chatter turned into a lecture that I probably could have given CME credit for. Docs don’t seem to understand that you have to know what you’re looking at in order to drive change. It’s not going to drive itself. You have to figure out what you want to work on, then measure it, then work on it, then measure it and work on it some more. Lather, rinse, repeat.

It seems pretty straightforward, but maybe it’s not, so allow me to share some other “secrets” that your docs may not know.

First, don’t get hung up on the fact that your EHR vendor may or may not have a registry or dashboards. Maybe they do and it’s just called something else, or maybe they don’t. One doc I was chatting with was caught up in the fact that he didn’t have his vendor’s dashboard product live yet. He was either under the impression (or in denial – it’s debatable) that he couldn’t start managing care until he had the pretty charts to back up the data. He didn’t like it too much when I called baloney on that one.

Most certified EHRs have at least some minimally decent ability to do reporting. That’s really all you need to start. If you have discrete data, you can report on a wealth of conditions. Prostate cancer screening? Check. Blood pressures? Check. Documentation of advance directives? Check.

You don’t need pie charts to tell you how to care for patients. When your report has blanks on it because you haven’t documented an item for a particular patient – that, my friends, is an opportunity for care.

Second, don’t get baffled by the metrics. Looking at some of the NCQA or NQF or MU measures and how they’re calculated makes my head spin as much as yours does. If you’ve never tried to do quality improvement before, start with something basic.

If it’s important to you to make sure every patient over 50 has a documented cholesterol test, start there. Don’t get hung up in the numbers and managing everyone down to an LDL of 70 or figuring out complicated exclusions. Start with something manageable, such as actually testing everyone. Run reports, do outreach, give it a month or two, then run those reports again and see if you’re making a change.

Third (and this is one of those points where I’m glad I’m anonymous – my CIO is probably spitting his coffee as he reads this) you don’t even have to have an EHR to make a difference. (I think I heard a few vendor gasps out there, perhaps the hissing of the word “heresy,” but it’s true.) You can make tangible gains in patient care without even a single chart pull. If you have a practice management system (that’s a “billing system” to some of you docs) with even rudimentary reporting capabilities, you can find opportunities to deliver care.

How so, you ask? Take an all-too-common diagnosis like diabetes (250.xx in ICD-9 terms.) Run some claims reports. Run a report of patients seen in the last three years with that group of diagnoses codes on a claim (or pick a single one like 250.00 if you’re scared at what you might find) and the date of their last billable visit. Presto! Anyone who hasn’t been seen in the last six months is an opportunity for care. This, of course, assumes that you actually bill the codes you’re addressing at the visit and not just cloning the last visit’s codes, which may or may not have included the diabetes. Primary care physicians are notorious for under-documenting the work they do.

Calculate the percentage of diabetics who haven’t been seen in the last six months and you just created your first metric. (If you passed epidemiology and biostatistics, which you must have to have graduated, you can calculate this. Trust me.) Send some postcards and make some calls (HIPAA-appropriate of course) and get those patients to come to your office for an actual billable visit. Report again in two to three months and see how you did. If you need a graph to show you the results, allow me to introduce you to my friend, Microsoft Excel. But I’m betting the numbers will speak for themselves.

Finally, it’s not just enough to have the data. You have to make it visible to make it actionable. Post your goals and action plans in a visible place in the office. Post monthly outcomes numbers. Celebrate those victories. When the numbers aren’t in your favor, take some time to figure out why and how you can do things differently. Involve everyone in the office. Even if you’re only focusing on a single metric each month, you WILL make a difference in the lives of your patients.

If you don’t believe that what gets measured gets managed (especially if you’re posting it publicly for everyone and their cousins to see) think again. I used to think I was pretty decent with my exercise habits (although it truly is difficult to hit the treadmill with a martini, so I wouldn’t recommend it.) In 2010, I did about 870 miles, which wasn’t totally shabby.

However, a double-dog-dare by some of my staff led to the public posting of our activities, with technical validation courtesy of our friends Garmin and Nike+ to prohibit cheating. (I suppose I could have paid the neighbor kid to jog around with my Garmin on, but that wouldn’t have been very sporting.) We have some serious running junkies on our team, and although I wasn’t delusional about keeping up with them, I felt pretty strongly about being able to beat most of the 20-somethings that populate the cube farm we call home. (Yes, they’re young. Yes, many of them are liberal arts grads. No, we’re not an Epic shop.)

Everyone had to share his or her numbers Saturday night. I almost forgot, so I was frantically uploading with a glass of Bailey’s in hand. I finished respectably with over 1,200 miles, but there’s always 2012:

Just Measure It. Just Manage It. Just Do It.

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January 2, 2012 Dr. Jayne 7 Comments

Monday Morning Update 1/2/12

December 31, 2011 News 2 Comments

Happy New Year!

Given the lame (and guardedly vague) healthcare IT predictions for 2012 that I’ve seen, written by reporters and other non-combatants, I’ll pass on giving my own. Some of the pearls of predictive wisdom: (a) companies may consolidate; (b) consumers will be engaged; (c) ACOs will be formed and will need analytics; and (d) social networks will be used to encourage good health.

My Time Capsule editorial from this same week of 2006: Can EMRs Sweeten their ROI by Moonlighting as Research Databases? A random sample: “Repurposing that existing information by making it available to those willing third-party customers, even when motivated purely by mission-supporting cash, is at least more beneficial to society than running a McDonald’s or building medical office buildings.”

Thanks to the following sponsors (new and renewing) that supported HIStalk, HIStalk Practice, and HIStalk Mobile in December. Click a logo for more information.

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12-30-2011 9-57-58 PM

The HIT bubble is here to stay, most readers believe, which must mean it’s not really a bubble in their minds. New poll to your right: when a hospital says having its clinical systems offline for several hours resulted in no patient harm, do you believe them?

We’ll give the HISsies nominations just a few more days before moving on to the actual voting, so this is last call to get your candidates on the ballot. Some obvious choices haven’t been nominated, I should say.

Here’s Vince’s HIS-tory on outsourcing.

Geisinger Health System (PA) says it will not hire smokers starting in February, when job applicants will be required to take a nicotine test.

12-31-2011 8-00-19 AM

Reading Hospital (PA) retools its executive team to put clinicians in key roles. The new CEO and COO are nurses, while the new CMIO, chief medical officer, and VP of academic affairs are physicians. The CEO, COO, and CFO all came from the consulting company the hospital had engaged to review best practices. The hospital says it’s also implementing a management process that includes physicians in every decision. Also mentioned is the hospital’s $180 million decision to implement Epic, which the hospital’s board chair says “will explode the quality of care and increase patient satisfaction.”

Cleveland, OH health systems Cleveland Clinic and MetroHealth are sharing electronic patient records and Kaiser Permanente will join them shortly. They’re using Epic’s Care Everywhere rather than an HIE, meaning they can access the records of patients who have opted in from 300 hospitals and 4,000 clinics.

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Stanford researchers develop an application that allows technicians to control MRI machines from HP’s TouchPad tablet, which was discontinued within two months of its launch and sold off for $99. The researchers liked it because HP helped them remove its metal parts, a requirement for operating near an MRI magnet.

A British physician advisory group proposes that NHS allow patients to review their own electronic medical records by 2015, including the ability to review physician notes and request prescription refills and appointments online. Expected roadblocks are patient confidentiality concerns, physicians who don’t want patients to see their documentation, and NHS’s potential inability to provide such a service.

A California hospital investigates one of its contracted employees who allegedly posted a photo of a patient’s medical record, including the patient’s name, on Facebook with the comment, “Funny, but this patient came in to cure her VD and get birth control.” Several people scolded the employee on Facebook for violating the patient’s privacy, to which he replied, “People, it’s just Facebook … Not reality. Hello? Again … It’s just a name out of millions and millions of names. If some people can’t appreciate my humor than tough. And if you don’t like it too bad because it’s my wall and I’ll post what I want to. Cheers!”

A man who rear-ended a parked fire truck and then sued the firefighter who saved his life gets nothing in the settlement of his lawsuit. The fire truck was parked in the opposite lane as firefighters were responding to an accident. The driver had a long record of traffic offenses, had been ordered by a court not to drive, was not carrying insurance, and was taking three judgment-altering drugs. He lost control while speeding on the rain-slicked road, crashed into the fire truck, and had to be flown out by medical helicopter. He wanted $300K to settle his suit that claimed the fire truck was parked in his lane, which the crash scene photo appears to show is not the case. The city paid $47,000, of which the man’s children will get $20,000 and lawyers $27,000, claiming it was cheaper to pay the money than the cost of a trial. Since the accident, the driver has been convicted of two additional crimes, one of them a felony that will likely send him to prison.

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I’ll have full details on HIStalkapalooza mid-week, so watch for that if you’re interested. Readers always like to guess a company given a tiny section of their logo, so above is your challenge.


Also coming mid-week is information about an application development contest that we’re helping promote. Here’s the story.

One of our sponsors asked us if we had additional promotional opportunities available, i.e. they wanted to buy a featured post or access to the e-mail list. They were running a fun-sounding contest with some pretty cool prizes, right down the alley of HIStalk readers who have written medically related software (vendors or providers alike.) We said no, we don’t do that – all we offer is sponsorships, all sponsors get the same benefits, and we will never make the e-mail list available to anyone. We always turn down requests to provide more exposure for cash.

Inga and I were noodling around on how we might help in a non-commercial way that would benefit someone other than ourselves, so instead of just saying no, we told them, “Make a big donation to charity and we will help get the word out to our readers as long as we can do it our way.” They agreed. We suggested the charity and the dollar amount, to which the company also (surprisingly) agreed.

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Receiving the company’s ample donation was Homes for our Troops, a top-rated charity (98.5% on Charity Navigator) that builds specially designed houses for severely injured and disabled veterans who receive them at no charge, with the assistance of donated labor and supplies. Our designated recipient is Marine Staff Sergeant Jack Pierce of Temple, TX, paralyzed from the chest down in his third deployment in Afghanistan when his vehicle drove over a 200-pound bomb, killing two other occupants and severely injuring six. The apartment in which he, his wife, and their young son live is not wheelchair accessible.

I’ll be sending the contest information out around Wednesday.

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December 31, 2011 News 2 Comments

HIT Vendor Executives – Part Two of Two 12/30/11

December 30, 2011 News No Comments

We asked several HIT vendor executives the following question: Where do you plan to invest your research and development dollars over the next 1-2 years?

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Tim Elliott, Founder and CEO, Access

We are focusing on three technologies that every hospital needs: electronic signature, a data bridge between clinical devices and systems and EHRs, and paperless, online e-forms.

The next generation of e-signature not only enables patients to quickly and securely authorize e-form registration packets and bedside consents, but also offers administrators the convenience of a server-based model. A clinical data bridge can capture and standardize output from devices (such as EKG traces and surgery images) and systems (perinatal documentation, COLD feeds, etc), and interface these directly into EHRs – with no paper or manual indexing.

Finally, we’re giving hospitals a way to transform slow, inefficient paper-based processes – such as onboarding, capital requests and physician referrals – into fast, collaborative, paperless ones. Users will be able to access electronic forms from their browser, add attachments, apply digital signatures and send through the proper channels, and to track each stage of the process. Upon completion, a copy of the form is archived in the ECM system and data posted to business and/or clinical systems. With healthcare facilities shooting for full EMRs, we’re doing our part to create technologies that fill the gaps, and are focusing our R&D on removing paper from as many processes as possible.


Ray dyer

Ray Dyer, CEO, Acusis

As a clinical documentation solution provider, we continue to look to our customers and healthcare IT market drivers. Given the many transformations underway, driven to a large degree by healthcare provider behavior, we are planning on investing our R&D funding in user intelligence tools including decision support and patient care analytics as well as mobile solutions development. We believe these areas will continue to be driven by customer need and demand, requiring data availability with strong privacy and security provisions. Acusis is poised and preparing to meet these challenges.


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Dan Herman, Founder and Managing Principal, Aspen Advisors

Aspen Advisors’ investments will be focused on the expansion of our current services to address the needs of our clients:

  • Adoption of EMR technologies and clinical informatics;
  • Healthcare reform in support of “accountable care” delivery and financing models;
  • Operational integration of Business Intelligence and Data Warehousing solutions to enhance care delivery, improve quality, reduce costs; and
  • Improved reliability and cost effectiveness of technology infrastructure through the implementation of structured IT service management processes.

We will continue to invest in the development of structured, repeatable, yet flexible methodologies for planning and assessment, implementation management, and operational performance improvement.

We will also continue our investment in training programs for our consultants, so that our clients will continue to see the consistent application of expertise and delivery of service as our firm continues to grow.


Don Graham

Don Graham, General Manager, Billian’s HealthDATA

Our R&D investment will focus primarily on improving our data on outpatient care, and the better use of social media internally to communicate who we are and what we have.

With outpatient surgical visits now accounting for almost two-thirds of all surgical visits in the US, it is an area that our customers – healthcare vendors – are paying more and more attention to. We in turn must provide them with the data they need to best address this trend, which doesn’t show any sign of slowing down in my opinion.

As for social media, it’s proving to be the most effective way to distribute the news. That includes, of course, healthcare news. We realize that our customers and their provider customers are increasingly using social media as a means of communication and self-education, not to mention public relations and marketing. Patient referrals, good and bad, will have an ever-increasing influence on healthcare-related decisions made by the public, and the public’s migration to social media is obvious.

We, of course, want to be where our customers are, whether that be Twitter, LinkedIn, or blogs like HIStalk, so we’ll be ramping up our social media presence internally to make sure that staff are engaged and conversant in the healthcare discussions taking place online.


Stuart long

Stuart Long, President, Capsule

As the leaders in device integration, we’ve always been in the data business. Yet data needs are rapidly evolving. We are going well beyond the basic connectivity of data into information system(s). Basic connectivity is actually well understood as a necessity at this point; hospitals get that automating the vitals collection process is critical to recovering nursing hours, reducing charting hours and improving patient care. What they really need is better, more useful data to help improve decision making, to alert them to impending conditions faster and to improve the quality and safety of patient care overall.

We’ve reached a tipping point; hospitals are starting to scream “information overload.” Our customers are saying “we get so much data, from so many sources, that we need help sorting through it all; we need it presented in a meaningful way so we can act upon it faster.” We hear them loud and clear and will therefore be investing heavily on data; on how we increase the value of data so we can manage and disseminate the discrete data and communicate additional relevant context and meaning of that data to the right caregiver, at the right time, about the right patient. It’s a tall order and will take a lot of work with our EMR partners as well to make it a reality, but I think we are in the right place, at the right time to make it all happen.


Mac Mcmillan

Mac McMillan, CEO, CynergisTek

That’s easy — on the areas of privacy and security representing the greatest challenges for our customers.

We have always prided ourselves on staying out ahead and anticipating the needs of the industry and the needs of our customers in privacy and security. Five years ago, that meant attacking things like data leakage, encryption, and log management/auditing. Today it still involves finding better ways to monitor activity in the enterprise, but it also includes things like securing the cloud, defining managed security services for healthcare, managing the risk associated with the proliferation of mobile devices and medical devices that are not secure, and finding ways to better manage the security requirements with Business Associates.

Healthcare has enough complexity in its environment and more than enough on its plate with HIE, ACO, ICD-10, etc. It needs practical security strategies and solutions that work and are effective at stemming the tide of breaches like we have seen this year. We believe that in order for healthcare to win the battle with privacy and security, it’s going to take an investment in the right technologies and integration of Managed Security Services into compliance programs. We understand that technology alone is not the answer, and so the focus should be on implementation strategies and building the right processes around these technologies that enable them to be successful.


Michael o'neill

Michael O’Neil, CEO, GetWellNetwork

In recognition of the emerging reality that healthcare will be delivered anywhere and everywhere, no matter what the time, device or location, GetWellNetwork will sustain its investment in innovative Web-based, mobile phone and cable television technologies. When used properly, such technologies will support communication, education and even engagement throughout a patient’s care journey — from the home to the physician office, hospital, imaging center, or pharmacy and back to the home once again.

Platform-agnostic, technology-enabled patient engagement will be indispensable to providers, payers, and vendors as they work collaboratively to reduce hospital readmissions, promote self-care, boost patient and member satisfaction, and decrease cost per case. At GetWellNetwork, we are making significant investment in helping providers fulfill Stage 2 and 3 Meaningful Use requirements, and address the evolving challenges of medical home, accountable care and bundled payments.


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Peter J. Butler, President and CEO, Hayes Management Consulting

At Hayes, we plan to invest R&D dollars in our hospital billing compliance software, MDaudit Hospital. It is designed to give auditors access to billing data to support revenue integrity, helping them to eliminate the errors for which CMS routinely recovers payments through its integrity programs such as RAC, MAC, and the efforts of the OIG.

However, we are finding that our clients are increasingly asking us about using this tool for other strategic projects such as ICD-10 documentation improvement, Meaningful Use, and data mining. Therefore, we are exploring related tools to use for these additional purposes. For example, via our recent integration with MediRegs clients can look up diagnosis and procedure codes and documentation requirements while in MDaudit. Additionally, some of our auditors are using MDaudit as a physician training tool on ICD-10 documentation.


tiffany crenshaw

Tiffany Crenshaw, President and CEO, Intellect Resources

Intellect Resources is investing in identifying and breeding new talent for the healthcare IT industry, with emphasis on training and go-lives.  In 2011 we debuted Big Break, a high-energy recruiting event designed to select an entire training and go-live teams in short period of time. Big Break is marketed towards individuals with no or minimal healthcare IT experience who have the right attitude, enthusiasm, and potential.  In an intensive one-day recruiting event, job applicants must complete a series of rigorous tests – one-on-one and panel interviews, extemporaneous public speaking, group work and classroom presentation skills – designed to identify only the best training and go-live talent.   

Once selected, Big Breakers complete an intensive course with classroom and hands-on learning, credentialing them in the appropriate EMR. As a result, a hospital system is able to select an entire training and go-live team in just a few days. Because Big Breakers do not typically have prior industry experience, they can often be secured at a fraction of the cost. As a result, hospital systems are able to breed and retain this new talent at a fraction of industry costs in a short amount of time.


doug burnman

Doug Burgum, President and CEO, Intelligent InSites

In our pursuit of improving care while lowering costs, we’ll be investing in three primary areas in the next 1-2 years.

First, one of Intelligent InSites’ most important objectives is to improve caregivers’ ability to spend more time at the patient bedside. To this end, we’ll be continuing our R&D investment in automating non-value-added manual tasks—including EHR data entry and finding available, clean equipment through easy-to-use applications—to give caregivers more time to spend with patients.

Second, as our solution utilizes RTLS and RFID technologies to know the location, status, condition, and interaction of all tracked equipment, patients, and staff throughout the hospital, we collect a massive quantity of operational data, every minute, every day, month after month, year after year. Through our Business Intelligence solution, we help our customers harness this “Big Data” to produce actionable insights critical to making sound and timely decisions, by utilizing flexible, high-impact, easy to create reports.

Third, because real-time data is generated from a wide variety of data sources, and because real-time intelligence can empower multiple healthcare IT systems, we’ll be continuing our investment in our partner ecosystem. We will continue to integrate with the expanding set of RTLS hardware vendors, and we’ll continue to expand our interfaces with EHR solutions, communications platforms, asset management applications, building management systems, and nurse call systems.

We are excited about investing in the future of RTLS, the “magic” of enterprise RTLS software, and helping our customers to truly improve the care they deliver, while simultaneously lowering their costs.


Tom Carson

Tom Carson, CEO and President, MD-IT

MD-IT has traditionally developed and delivered software functions that provide or support practical use of technology for physicians and patients, and that will continue to be our focus. Like most vendors, we will keep an eye on Meaningful Use requirements and other market developments, but identifying specific features beyond the near term is tough, as the HIT market is quite volatile at this point.

We expect to see evolving demands as the industry moves from what we think of as effectively an EMR version 1.0 environment to a more mature EMR version 2.0 environment that is more sensitive to the needs of physicians and patients as the primary users of these systems. Certainly near-term efforts will be directed to expansion of our popular mobile functionality that streamlines physician workflows, as well as continued broadening of our interoperability functions that link providers, patients, and payors.


12-18-2011 3-31-56 PM

Patrick Hampson, Chairman and CEO, MED3OOO

We are focusing our investments and resources in numerous areas. MED3OOO has committed to focus our knowledge, products and services with a MED360 view of healthcare delivery. We are not like most vendors just supplying systems. Our investments will continue to expand our current operational and technical capabilities and offerings. We will continue to integrate our proprietary systems, and continue our investments in capturing and using data of populations. We will continue to invest in tools that providing information across the entire spectrum of care focused on: efficiencies wherever we can find them, the patient and provider experience, the cost and most importantly the quality of care delivery. We want to be the best partner to providers that is in the industry.

Our investments in point-of-care capabilities will also create a great differentiation for the providers using our proprietary systems. As part of this, we are investing in the area of clinical decision support. “CDS” in an Electronic Health Record can take many forms. It is certainly more than providing guidelines to a provider. We want to focus on the user experience and want to spend a lot of effort with physicians reviewing workflows to determine how CDS can truly add value to the provider and patient when care is being delivered. Our addition of Quippe is just one example of these efforts. Quippe is the state-of-the-art documentation tool in the industry and is the basis of enhanced CDS within our InteGreat EHR offering.

These efforts are also critical to the physicians and hospitals we have partnerships with, but who are on older technologies or legacy systems even though they come from today’s brand vendors. Physicians already have investments in these systems. They too, need these higher level capabilities and they too need knowledge-based solutions. While these systems may be older and not web- based, MED3OOO, as their operating partners we work to provide solutions to improve on the capabilities these older systems just do not have. A system agnostic approach allows us to not just throw them out and waste physician’s precious capital. We try to maintain those systems and it is somewhat like the BASF commercials, “We don’t make things, we make things better.”

Lastly we will continue to expand our significant M3IQ data warehousing capabilities, capturing data from disparate systems, continuing our focus on the promise of combining financial claims and clinical data, and turning that data into actionable, predictable intelligence.


robert connelly

Robert Connely, Senior Vice President, Medicity

We are going through a period of enormous change in healthcare, and it’s clear that healthcare IT will play a critical role in that change. Medicity is focused on a strategy that will enable rapid adaptation to changing requirements while realizing a more cost-effective model that we believe will lead the next generation of information technologies.

Today, we’re building out the underlying IT infrastructure required for tomorrow’s healthcare, including integrating EHRs, building data exchanges, and standing up repositories. We are expanding our analytics capabilities and are involved with developing standards like ONC Direct. 

Many of our R&D efforts are targeted at integrating and improving our family of products. The strategy levers common technology platforms, modular apps, and cloud services. We believe that by porting much of our current functionality into apps designed to run on a platform like iNexx (Medicity’s individual network exchange), we can reduce time to market for new features, control development costs, and provide a greater opportunity to adapt to new needs quickly. 

We believe that technology is evolving to the point that it can adapt to people as opposed to people adapting to the technology.  Towards this end, we continue to invest in emerging technologies and markets.  For example, our efforts range from pioneering pervasive analytics that employ software agents to better analyze information at the source, to enabling consumer platforms to drive better health.  We are also focused on building solutions that leverage payer, provider, and consumer interactions to create more effective care.


peter kuhn

Peter Kuhn, CEO, MEDSEEK

MEDSEEK has always been ahead of the curve, developing strategic patient engagement and management solutions that help healthcare executives realize cost savings by improving care collaboration within existing workflows and find new revenue streams by finding and engaging patients. We were among the first to deploy our enterprise solutions to assist hospitals in finding, engaging, activating, and managing patient populations, and we’ll continue to invest in developing those solutions to allow hospitals to better prepare and position themselves in the rapidly changing world of healthcare reform.

Additionally, the strategic use of predictive analytics will ultimately become the market differentiator for hospitals, which is why we acquired Third Wave Research, Ltd, in 2011 and have been working on integrating their advanced predictive analytics expertise into our existing solutions. We will continue to invest in analytics technology that enables our clients to position for patient engagement, wellness and disease management. The rapid adoption of patient portals and the shift away from fee-for-service in favor of outcome- and quality-based reimbursement models will place more emphasis on finding new cost savings and revenue streams. To differentiate themselves from the competition, hospitals must find ways to personalize the patient experience and better manage the patient population. Effectively promoting profitable services to high-value patients and engaging them in wellness programs will influence healthy behaviors to positively impact outcomes.


Jay mason

Jay Mason, CEO, My Health DIRECT

It has been painfully obvious over the years that our solution was a bit ahead of it’s time. While very successful in directing patients to appropriate care settings in an ER, there wasn’t a pressing need to interact “outside of the walls” broadly or routinely. What we have seen in 2011 and see as our chief role moving forward is to serve as a health scheduling exchange. We will continue to invest our R&D in staying ahead of the curve. Today we can provide true Enterprise  Application Integration (EAI) with any willing trading partner via our own platform’s ability to leverage HL7, API, or CRM-based communication protocols.

So the next year will be more of the same for us — creating the integration tools, onboarding methodologies, and consumer engagement services that will allow our clients to redefine the way they interact and guide their patients and members.


Janet dillione1

Janet Dillione, Executive Vice President and General Manager, Nuance Healthcare

Going into 2012 the pressure is on for healthcare organizations to increase the quality of care delivered while reducing cost and complying with federal mandates. Nuance could not be better aligned to help healthcare organizations succeed in light of such pressures as Meaningful Use and ICD-10 and to ensure that clinical data is created in the most efficient way possible and is built from rich information that can be analyzed and intelligently used to drive broad healthcare enterprise change and improvement.

Over the next 1-2 years, we’ll continue to invest in areas that fundamentally improve the capture phase of clinical documentation, by which I mean empowering clinicians to document anytime, anywhere on any device in the most effective, natural way possible – via voice.  In 2011 we went to the cloud, offering SpeechAnywhere services to development teams across the industry.  Speech-powered clinical documentation is widely in demand and will continue to expand to encompass the complete healthcare enterprise and the mobile clinician workflow.

We’ll also continue to heavily invest and innovate in the area of language understanding and analytics technologies, which make it so clinical data can be extracted from unstructured documents and intelligently leveraged to drive better clinical and business decisions. Through work with 3M, IBM and UPMC, Nuance is making tremendous traction against its mission to transform patient stories into high-value information. Our speech-driven clinical understanding solutions will increase the quality of documentation, improve efficiency and drive better care – all while putting less burden on clinicians.


12-19-2011 5-07-28 PM

Todd Cozzens, CEO, Accountable Care Solutions, Optum

I heard someone say the other day that ACO = HMO 2.0 But With Data. It is indeed all about the data. I empathize with health system CEOs who, after spending anywhere from $100 million (average medium size IDN) up to the $3 billion Kaiser spent on installing EMRs in the last ten years that all they really achieved was computerizing paper records. Little has been achieved in actually doing something with the data. That’s what the next ten years is all about.

  • Population Analytics: EMRs and the early data warehouses being developed on top of them are good at managing a census – sick people that visit hospitals and doctors. Population Analytics manage entire patient populations across all of their interactions with the health system. EMRs rely mostly on clinical data and some financial data. Population Analytics incorporate claims data, clinical data, financial data and actuarial data across ambulatory, in-patient, post acute and home care. We are in the top of the first inning of the biggest wave of change in our healthcare system any of us will see in our lifetime. These tools are also in their 1.0 versions and will evolve. Optum was almost purpose-built to bring all of these capabilities together into one cloud-based, integrated solution.
  • End-to-End (E2E) Financial Efficiencies: Hospitals leak revenue more than any other business in any other industry – with the average health system collecting only 33% of what they actually bill under the current fee-for-service (FFS) system. And on top of this we’re now going to burden hospital finance departments by introducing new fee-for-value (FFV) payments starting with bundled payments and pay-for-performance measures right on up to full risk-bearing entities. In the forward-thinking health systems, we’re seeing the realization that they cannot do this all themselves. Many see FFV as the future so they want their current finance teams to be the experts in the new system. These same health systems are increasingly outsourcing their FFS financial systems to experts who know how to recover lost revenue, realize much higher collection rates and know how to drive cost takeout. We acquired Executive Health Resources to help hospitals drive revenue integrity for the big potential loss area of reimbursable admissions. The Lynx ED coding tool returns an average of $2.5 million lost revenue per medium size hospital. We combined those tools plus others around collections, billing, and Financial Health Record (FHR) to form our E2E solution set and we will invest more in these capabilities in 2012.
  • ICD-10: Health systems are so encumbered with Meaningful Use compliance, RAC compliance, and facing the coming huge cuts in Medicare/Medicaid that they have largely been in denial about the impending ICD-10 deadline. With the introduction of up to 155,000 new reimbursement codes and less than 10% of healthcare providers halfway to ICD-10 readiness, ICD-10 could be an insurmountable challenge. We made a large investment in what we believe to be the best technology available to meet this new challenge. Because of the time caregivers will spend hunting for the right code, ICD-10 will actually make the health system much less efficient unless groundbreaking new technologies emerge. The natural language processing technology that we acquired from A-Life is exactly what’s needed to automate this laborious process. We’ve seen tremendous traction for this solution in the last six months and expect that to continue. Our R&D investment has increased so we believe we will keep and extend our technology lead here.

    paul brient1

    Paul Brient, President and CEO, PatientKeeper Inc.

    PatientKeeper’s number one priority is to deliver healthcare applications that improve the physician workflow. This means that we save physicians time, we help them provide higher quality care, and we help them get paid for more of the services they deliver.  

    We are still spending heavily in R&D to round out our suite of 13 fully integrated applications. Our near-term focus is to continue to add features to our CPOE product, complete our Medication Reconciliation product, release a next-generation charge capture application, and give our tablet/iPad applications feature parity with our desktop applications. The emergence of the tablet as a “first class” device has been eagerly anticipated by the healthcare IT community for nearly a decade and is finally here.  In fact, we have a small but growing number of our 40,000 users who use their tablet/iPad as their only computing device.


    12-16-2011 1-30-45 PM

    Todd Johnson, President, Salar

    While we have always been focused on "the physicians experience," the merger between Transcend Services and Salar has intensified this focus. In the months ahead, we are going to be able to address a physician’s workflow in ways never before thought possible. Understanding all of the external pressures applied to physicians, how remarkable it will be to offer solutions that offer either zero impact on their day-to-day, or better yet, offer drastic improvements to their workflow that they didn’t even realize were achievable? Not only will we be able to satisfy a physician’s interests for time, speed, and efficiency, but we will also be able to free the physicians from those same external pressures. By offering to our hospital customers clinical documentation solutions that meet the needs of coding, compliance, quality, billing, RAC audit mitigation, communication, and patient safety while doing so in a zero impact methodology to the delivery of care, we truly meet the needs of all parties at the table.

    To realize the benefits of this "enhanced physician experience," we will be investing heavily in our web-based platform to complement our existing thick client solutions, natural language processing tools, front end speech solutions, ICD-9 and ICD 10 GEMS mapping solutions, front end computer-assisted coding features, and even an improved workflow for traditional transcription services. We will continue to deliver all of the above through our "have it your way approach," thereby meeting the needs of both our physician users and our hospital customers.

    It’s been a long-time objective of Salar to become the de facto clinical documentation module within a host of HIS systems. We are closer to realizing that objective than ever before. Through some new and unique customer engagements, we will be integrating our platform into industry-standard information systems and, in turn, reaching out to an even broader customer base. The marriage of these solutions and the seamless nature of their delivery are incredibly important to us. Our customers count clicks–and so do we. We will continue to work over the next 1 to 2 years to streamline usability across systems and, ultimately, enhance a physician’s day-to-day experience.


    12-23-2011 12-43-08 PM

    Stephen Hau, CEO, Shareable Ink

    Everyone wants innovation, but no one wants to change.

    It is well understood that the healthcare industry must become more electronic and data-driven. However, we also know that change is hard. Market data reveal that, while most clinicians enjoy the accessibility of patient information that EHRs deliver, the majority does not prefer the Windows 95-style “point and click and drop down list” style of documenting that the standard EHR user interface requires.

    We believe that there must be a better way to extract information from a physician’s head without forcing them to become typists, tap a screen or mouse 30 times to create a “cookie cutter” note, or hire prohibitively expensive scribes out of desperation.

    As such, we have begun to invest aggressively in machine learning and natural language processing. Our system does not require user training. Instead, it has begun to learn from clinicians’ handwriting, gestures, and other natural inputs. The ambitious goal is to deliver innovation without requiring clinicians to alter time-tested workflows.


    12-18-2011 3-23-08 PM

    Ed Daihl, CEO, Surgical Information Systems

    Our R&D focus supports improving the management of perioperative services, the area of the hospital that continues to drive the financial success of the hospital. A recent survey by SIS shows an increased focus on reducing perioperative costs, with 78% working on cost reduction efforts – a 34% increase since 2010. Additionally,  the survey indicated another shift from 2010 with cost reduction efforts being prioritized over reimbursement concerns. In 2010, 25% of hospitals cited maximizing reimbursements as their top financial concern. In 2011, that number dropped by 56%. We believe that perioperative specific analytics is a powerful tool to help hospitals control costs — their top concern — and will continue to work to improve this management tool.

    Additionally, we see the adoption of anesthesia information management systems as a growth area in the industry. Electronic anesthesia documentation streamlines this process and provides accurate and legible anesthesia records. This equates to significant benefits, such as more accurate charge capture, quality improvement, and allows for the anesthesiologist to spend more time with the patient and less time documenting.  The addition of clinical intelligence with anesthesia analytics provides even more value to hospitals and anesthesia providers by unlocking powerful decision making data to help improve both care quality and financial return.


    evan steele

    Evan Steele, CEO, SRS

    Over the next couple of years, SRSsoft will evolve to accommodate the acquisition and sharing of increasingly greater volumes of patient health information, as relevant to our specialist and primary care clients.

    We will remain focused on productivity (naturally!) as we evolve our data capture interfaces. This means that user interfaces will be implemented using techniques that are both ergonomic from a personal user perspective and accommodative of the actual workflow that takes place in the clinical office environment.

    We have put into place, and will continue to enhance, our own dedicated platform for data sharing and interoperability. Our Continuity of Care Exchange (CCX) platform manages connectivity and the physical transport of files, while our Discrete Data Exchange (DDX) components handle the import and export of discrete data to and from our system. We will continue to evolve CCX and DDX over the next couple of years to support increasingly higher levels of interoperability.


    12-18-2011 4-17-10 PM

    Rick Stockell, President, Stockell Healthcare Systems

    Over the next 1-2 years, Stockell Healthcare Systems will be devoting a significant amount of R&D to ongoing regulatory compliance.  In addition, we will continue our ongoing focus on client business process improvement through the development of advanced analytics and information management solutions.


    Richard atkin

    Richard Atkin, President and CEO, Sunquest

    Sunquest is increasing its investment in product development across the board. We now have over 35% of our total resources dedicated to product development and product quality. We will have a particular focus over the next 24 months on developing new functionality in the converging areas of molecular pathology, anatomic pathology, and digital pathology. As a founding Gold Sponsor of the Digital Pathology Association (DPS) and through our partnership with Massachusetts General Hospital, we will be building the next generation of pathology workflow solutions.

    The incorporation of digital images of all sorts into the pathology workflow will drive significant growth, change, and efficiencies throughout our clients’ operations. Sunquest will work closely with our clients to enable them to take advantage of the coming changes in science, medicine, and technology. The ongoing evolution of molecular testing is driving a convergence between anatomic and clinical pathology. As healthcare delivery evolves to a more integrated, regional model and incorporates more personalized data, Sunquest will provide the solutions required to thrive in a new age.


    sunny sayal

    Sunny Sanyal, CEO, T-System

    To meet clients’ current and evolving needs, T-System in the next 12-24 months will focus R&D investment on enhancing our emergency department information system, The T SystemEV. Our top three R&D priorities are as follows:

    • Support for regulatory mandates, including Meaningful Use and ICD-10. T-System will seek ONC-ATCB certification for Stage 2 Meaningful Use measures as soon as HHS finalizes the requirements. T SystemEV, already certified for 2011/2012 criteria for Stage 1 Meaningful Use requirements, will be compliant with ICD-10 in 2012, a year before the deadline. Our goal is to give clients maximum flexibility to address clinical, business and regulatory needs
    • Enhance interoperability. T-System will continue to invest and partner with other vendors to ensure that clients can seamlessly connect T SystemEV with disparate inpatient EHRs and other information systems outside the ED.
    • Continue to provide innovative and new functionality. As the care transition hub and starting point for a high volume of patient handoffs, the ED plays a critical role in ensuring the continuity of care. Supporting smooth patient transitions with efficient communication will become even more important as facilities and practices form accountable care organizations (ACOs). T-System will develop solutions and functionality that will help EDs lead the ACO model of healthcare delivery. Additional offerings will continue to improve clinical and financial outcomes that start in the ED and benefit the entire hospital and community.
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December 29, 2011 News 12 Comments

Top News

12-29-2011 10-03-00 PM

CSC says it will have to write off almost the entire $1.5 billion it spent trying to install iSoft’s Lorenzo in the defunct NPfIT project in England. The government has apparently declined to give CSC the new scope of work the company had requested. CSC has also withdrawn its financial forecast and stepped up plans to replace its CEO. It posted a loss of almost $3 billion in its Q2 report filed September 30, mostly due to a write-down of goodwill. The company’s market cap is $3.7 billion. Shares are at $23.68, off more than half since the beginning of the year.


Reader Comments

12-29-2011 8-27-57 PM

From Zafirex: “Re: hardship exemption for e-prescribing. Looks like so many providers are claiming it that CMS is having difficulties. Wonder how many are truly hardships? I doubt CMS could ever verify since it looks like they’re having trouble even producing a list.” Exemption categories include a practice area with no broadband coverage or that has too few participating pharmacies, practices that applied for Meaningful Use before requesting an exemption, practices that prescribe mostly narcotics that are not eligible for e-prescribing, practices that don’t prescribe regularly, or practices that e-prescribe but not for qualifying visits.

From Search Boy: “Re: searching HIStalk. Thanks for the explanation to King Salmon. Is there a way for retrieved searches to be indexed chronologically rather than as a percentage of keyword match?” I haven’t figured out how to do that. Since the pages are stored in a database, I don’t think the search function can determine the original publish date even though it’s in the title.

From Lilies: “Re: Epic. They’re #17 on the list of 25 oddball job interview questions, with ‘You have a bouquet of flowers. All but two are roses, all but two are daisies, and all but two are tulips. How many flowers do you have?’ There are two distinct valid answers.” Three is the obvious answer (one of each flower) that took me about two seconds to get. I assume the second answer depends on the question not stating explicitly that there are no other kinds of flowers in the bouquet (i.e., you could have two Venus fly traps only, making two a correct answer.)

12-29-2011 10-05-51 PM

From Stats Fan: “Re: readership stats. You haven’t given your readership stats lately for me to track.” Good timing since I realized a couple of weeks ago that I’ve been undercounting all along. I had forgotten to add the hit-counting Javascript to the mobile display that you see on iPhones and iPads. That hit me a couple of weeks ago, so I dug around the code and figured out how to fix it, also noticing that a surprising 30-50% of readers use Safari, most of them presumably on iPhones and iPads, which is a lot more mobile readers than I would have guessed. So far for December, it’s 96,250 visits, 148,218 page views, and 22,029 unique people reading (but that’s lower than the real number since I didn’t make the change until the middle of the month.) January and February will be good indicators since the HIMSS conference really pegs the needle on readership. Inga pays a lot more attention to the numbers than I do, so I will await her analysis. Above is where the visitors are from, just in case you are interested. Among cities, it’s Madison, Stone Mountain, Atlanta, New York, and Chicago making up the top five, but the major metro area is Boston with 8.41% of visitors. It’s a 62% male audience, so ladies, tell your friends.

From HIMSS Envy: “Re: HIMSS points. Got me wondering – it would be nice of HIMSS published an annual report for public review. It might not change a thing, but transparency is a powerful motivator. Come to think about it, Mr. H, how about you, too?” I thought HIMSS did a report, but I couldn’t find one. You can get their Form 990 from GuideStar, which always has interesting factoids (like that HIMSS FY 2009 revenue was $44 million and CEO Steve Lieber’s total compensation was $711K). I don’t know what I’d put in an annual report that isn’t already on the About page or contained in the list of sponsors … other than my hospital job, I don’t have any ownership in anything, I have no other income, and I don’t shill stuff like speaking or consulting under the delusion that I have value beyond what you’re reading right here.

From Peds Envy: “Re: tired of writing only good things about Epic. Private practice peds are the worst type of users for Epic. No surprise there. Someone who knows Brown & Toland told me the reaction is 100% unanimous – they hate it.”

From Anonymous Epic Fan: “Re: tired of writing only good things about Epic. Here are a few issues with their implementation methodology and support that even the Kool-Aid drinkers would have a hard time disputing.” Here’s the list from AEF:

  • Epic’s implementation planning materials are weak. They have to be re-worked for each new application / scope mix, and after that is done, little to no effort is made by Epic to customize them based on organization specifics. If you want the project plan to be useful and to have sufficient detail, expect to spend a lot of time and effort re-working what gets initially delivered.
  • Epic suggests you go live on Model workflows as quick as possible. As painful as it may be, it is definitely better from a cost perspective. Then, you plan to do the bulk of the ‘real’ implementation after getting live. This can/may work if the bulk of the existing documentation / orders workflows are paper based and you are implementing all of Epic’s applications, but this approach is suicide if the existing system being replaced has been customized for the end-users and they are happy with them or if you have to rely on the timelines of other vendors to build/test/implement interfaces and data conversions.
  • The Epic Model does not work well for any hospital or outpatient units that are more complicated  then the most typical med/surg units and general practice specialties. Specifically, hospital outpatient departments that bridge the inpatient and outpatient void.
  • The Epic Model completely breaks down if you are not implementing all of Epic’s applications and workflows rely on interfaces to/from legacy systems.
  • With Epic’s implementation team constantly turning over, being spread across more and more customers, and the increasing pressure to implement faster, attention to detail is lacking. In my experience, they are over promising and under delivering more than they did years ago.
  • Time estimates are always low. Everything takes much longer than anyone anticipates. Medication build, consolidating charge masters, cleaning up supply/pick lists, mapping lab components, consolidating multiple sources of payor/plans, cleaning up the provider / credentialing information, getting physicians to agree and sign-off on order set/documentation template content, and working down duplicate patients in your EMPI or mapping data elements for conversions etc.
  • Epic implementation tools / deliverables are often shared just before an upcoming trip for when they are to be used. Though effort is made to customize them based on application mix/scope, they never really get updated to reflect the actual workflows discussed and validated early in the process – especially if they differ in any amount from the ‘model’ workflow. The delivered product if very inconsistent from application team to application team and integrated areas/workflows often get overlooked. So just like the implementation planning materials, expect to spend a lot of time re-working these deliverables to make them useful.
  • All application teams involved in the implementation are siloed, and in addition, the Epic implementation teams, technical support teams, and development teams are also siloed. This causes issues for organizations live on one set of applications, rolling out another set, and implementing a third set.
  • The silos mean that there are application experts, but very few Epic staff have cross-application experience / knowledge and if workflows are interface-dependent, very few have true integration experience.
  • Epic’s training only scratches the surface. The true training is the implementation process and go-live. The shorter the implementation timeline, the more unprepared the customer IT staff is to support the applications when they go live – thus the demand for lots of consultants.
  • The system documentation is very inconsistent and virtually impossible to search on the UserWeb. Unless you know where to find what you are looking for, you often have to e-mail Epic to ask if documentation exists. I is not uncommon to be sent an ‘unofficial’ document created by a frustrated Implementer not being able to rely on the system administration guides themselves. In fact, all of the implementation documentation / guides were historically written and maintained by implementers, but due to the inconsistency between applications and un-sustainability of keeping it up to date. no implementation documentation/guides exist today.
  • Epic’s end-user training materials are great if you are implementing all of Epic’s applications and you are using all Epic model workflows. If anything changes, these are not so great – expect to have to overhaul them.
  • Same goes for the testing scripts. An OK start, but definitely not something that can be used out of the box.

HIStalk Announcements and Requests

12-29-2011 6-44-44 PM

How Apple wins customers for life: I had a five-year-old, first-generation, 1 GB Nano that I only used for the gym. I heard Apple was recalling a few of them because of some explosion-prone batteries, so I put in the serial number on their Web page and darned if mine wasn’t on the list. They sent a postage-paid Fedex box to return it. Today I got back a brand new sixth-generation, 8 GB Nano, which now comes with a color display, gestures, FM radio with live pause, pedometer/accelerometer, and a bunch of other features, all in a package barely bigger than a watch face (in fact, you can buy a watchband that holds it, turning it into a watch.) It’s super cool, and so is Apple. You did good, Steve Jobs – RIP.

12-29-2011 10-21-30 PM

It’s time to wrap up the HISsies nominations soon, so contribute yours now to the blank slate that will be distilled into a handful of choices for the real voting that starts shortly. I’m particularly happy with one nomination for Smartest Vendor Action Taken: “HIStalk sponsors that replaced blinking ads before the deadline.” Well done, and a good observation. My sponsors really are the best – as much as I hated to spring the change on them since it requires work and expense on their end, they’ve been great about it. I’ve enjoyed the nominees for the Beer and Pie categories, as always, and there are some good nominees for the Lifetime Achievement Award.

Speaking of the HISsies, full details and signups will go up next week for HIStalkapalooza in Las Vegas. And also speaking of the HISsies, if you plan to vote (and I hope you do), sign up for the e-mail updates since I e-mail the voting link out to prevent ballot box stuffing that was as rampant as in a third-world dictatorship until I took that step. For that reason, if you aren’t on the list, you can’t vote.

Listening: new from The Roots, which even though I’ve only sampled it so far due to limited time, is just blowing me away. It’s extraordinarily music in the form of a concept album, making it impossible to label as rap, soul, or hip hop even though it includes strong elements of all of those. The accompanying short film is here. Their talent is mind-boggling. Down it goes to the new Nano, which contains only my latest favorites since I intentionally started from scratch: Genesis And Then There Were Three, two albums from Gooder, one from Metric, and Luminiferous Ether by the never-gets-old Zip Tang.

It’s just Dr. Jayne and me tonight as Inga is sojourning in the mythical Land Without Broadband. She will return soon. But in the mean time, Dr. Jayne is doing her usual fabulous job. I’m pretty darned lucky to have two smart, funny, hard-working, and undeniably cute ladies with whom to share the page, don’t you think? I will raise a glass in their honor for New Year’s (probably of Duvel beer since I got some for Christmas and I like it a lot.)

I’m not telling you Happy New Year yet because I’ll be posting a Monday Morning Update this weekend as usual, even if nobody’s around Monday to read it.


Acquisitions, Funding, Business, and Stock

Board members and executives of document management vendor Streamline Health Solutions will buy $400K worth of the company’s stock, news of which sent shares up 9% on Wednesday.

12-29-2011 10-23-11 PM

Healthcare alerting system vendor Extension, Inc. announces what it says is record quarterly growth, adding 17 new hospitals in the third quarter and quadrupling its headcount to 40 over the past two years. They might want to budget for a public relations or media person next since this is easily one of the worst-written press releases ever, starting off with a clumsy opening sentence that sounds as though someone whose native tongue was not English (or at least not good English) sweated over it until nothing interesting remained. It doesn’t get better as you read on.


Announcements and Implementations

12-29-2011 8-34-58 PM

Tampa General Hospital (FL) goes live on its $120 million Epic system, which works out to $118K per bed. The hospital says $40 million of that was for hardware and software, with the rest going for staffing and training.


Other

Weird News Andy sounds like a fortune cookie in summarizing this story as, “Foot in mouth results in mouth in foot.” A man shows up in the ED with a swollen, infected foot, claiming he stepped on a piece of glass on the beach a couple of weeks before. The beach and timeline part of his story were accurate, but not the glass part: doctors removed a tooth embedded between his toes, lodged there during a beach fight when he kicked his opponent in the jaw while wearing flip flops.

Several readers were interested in John Halamka’s post about his wife Kathy’s newly diagnosed breast cancer. The first of regular updates, posted Thursday, is here. Reading his thoughts and analysis of their situation makes you realize that HIT stuff aside, he’s probably a fine doctor as well, not to mention the kind of supportive partner we would all want if faced with a life-changing diagnosis and gearing up to fight it.

12-29-2011 9-26-38 PM

A big health-related software sale you probably didn’t hear about: General Cannabis, which operates the medical marijuana dispensary finder WeedMaps, acquires MMJMenu, whose software for marijuana growers and dispensaries tracks inventory “from seed to sale,” basically an ERP for pot growers. General Cannabis had revenue of $10.4 million in the first nine months of the year and paid $4.2 million last month to buy the Marijuana.com domain.

12-29-2011 9-34-07 PM

John Newman, MD PhD, a UCSF physician and legal scholar, worries that medical copyrights will threaten patient care, citing a recent case in which a company offering a licensed cognitive screening tool threatened legal action against a similar but free online tool. The implication is that tools based on published research, which could be anything from a pain scale to a hip fracture risk predictor, could be claimed as proprietary by a fast-moving company. The author speculates that without new forms of copyrights, “… as physicians walk down the hallway interviewing patients, they’re tallying up the licensing fees they need to pay for doing their day’s work, and hospitals are suing each other or making cross-licensing arrangements to manage each other’s intellectual property.”

12-29-2011 9-41-55 PM

A power surge caused by monthly back-up generator tests at Aspirus Wausau Hospital (WI) takes all communication and computer systems down for five hours, forcing the hospital to go on ambulance diversion. As is always the case, the hospital says patient safety was never at risk, which you might interpret as meaning that those systems contribute nothing to patient safety. They’re on Epic, I believe, not that the hospital’s Wisconsin location didn’t already make that fairly likely.

GE Healthcare agrees to pay $30 million to CMS to settle a False Claims Act charge that it encouraged hospital and cardiology laboratories to overbill Medicare for Myoview, its form of technetium 99 that shows areas of decreased blood flow in the heart.


Sponsor Updates

  • Rockford Orthopedic (IL) announces that 21 providers have successfully attested for Meaningful Use using eClinicalWorks EHR suite.
  • Baptist Health Line (KY) receives its third ICARE award from RelayHealth for work with Western Baptist Hospital’s transfer center.
  • Paul Rooke, CEO of Lexmark, discusses how the company’s acquisition of Perceptive Software and Pallas Athena puts them in a unique position in his interview with All Things D.
  • Health Choice Arizona, achieves a 44% improvement in its completion rate for preventive services pilot program using MyHealthDIRECT.
  • AmkaiSolutions will offer revenue cycle solutions from ZirMed to its outpatient surgery provider software customers.

EPtalk by Dr. Jayne

Where have all the drug reps gone? With significant cuts in the budgets for Big Pharma, many reps have been “made available to the workforce,” as they say. It seems hospitals and health systems are hiring former drug and device reps to sell their facilities to physicians. A recent article discusses how they’re using infection data and patient satisfaction scores to drive business rather than the drug pricing and formulary data of yore. In my book, this is just another thing that sucks up valuable time that we need to care for patients, not to mention sucking up budget dollars that could be better spent on those patients.

I wonder how many physicians who refuse to see drug reps also refuse to see these new “physician liaisons?” And how many health systems place rules around having these reps in the office? At some large integrated health systems, policies ban providers from seeing reps or liaisons from any facility or service provider that competes with a system-operated service line. This includes home health agencies, remote cardiac testing providers, reference labs, and the like. Other health systems restrict the hospital privileges of their employees (prohibiting credentialing at competitor hospitals,) so I’m not sure how big of a target pool these new reps have.

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Weird News from one of my favorite places: South Carolina sports a giant mound of tires that can be seen from space. At least it’s not burning like the one in my favorite fictional town. But kudos to Lee Tire Company, Inc. of Jacksonville, Florida for waiving the usual fees to shred and recycle the tires in an attempt to clear the 50-acre mess.

Inga and I are well into our pre-HIMSS preparations. As you’re thinking about traveling to fabulous Las Vegas, consider this recent article that discusses continued concerns about backscatter scanners at the airport. Until I read this piece, I didn’t know they had been banned in Europe. As someone who has to wear a badge to track my exposure to radiation in the hospital, I do worry about frequent flyers. Many of my friends who work for vendors fly two to four times a week. There’s enough radiation from just being in a plane, let alone adding to it with scanners. I’d love to see the cumulative dose numbers for some of those flyers. Maybe frequent flyer programs should start issuing radiation monitoring badges with their airlines’ logos as a promotional item.

Each time I sit to write for HIStalk, I’m still amazed to be part of this team. It’s particularly amusing when I’m just reading through my “normal” e-mail and find a mention of us – most recently a blurb from MED3000 regarding Mr. H’s recent piece asking vendor leadership about the biggest HIT-related news items of 2011. I hope I don’t have facial leakage when I see these blurbs (yes, I have a bad habit of multitasking during meetings) because I know I feel like smiling.

Speaking of multitasking, one of my Facebook friends shared another article on docs multitasking during critical procedures. Medical schools are apparently having to actually instruct students to focus on the patient instead of the smart phone. Looking at some of the examples given in the article, it sounds like some IT teams need to revisit the websites they allow users to access. I can’t think of too many medically legitimate reasons to be on Facebook, Amazon, or eBay in the operating room or in the ICU.

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I mentioned earlier this month about my inability to keep up with Inga where shoes are concerned. I think I win this round though – I seriously doubt that Santa left a glass slipper filled with Cosmopolitans at her house.

Have a question about managing pesky sales reps, maintaining the perfect poker face, or the best way to garnish a Cosmopolitan? E-mail me.

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Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

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December 29, 2011 News 12 Comments

News 12/28/11

December 27, 2011 News 17 Comments

Top News

12-27-2011 8-39-42 PM

UPMC’s Cerner systems go down for 14 hours at most campuses last Thursday and Friday, forcing them to go back to paper. The PR person blamed “a database bug,” which makes the above Oracle press release from this past summer a particularly fun read. Cerner and UPMC have an atypical vendor-customer relationship since they’ve invested big money together in innovation projects and UPMC runs a Cerner implementation business overseas.


Reader Comments

12-27-2011 7-59-30 PM

From King Salmon: “Re: search. Is here a way to search HIStalk by keyword?” You can use the search box that’s in the right column. It’s not visible on mobile devices, though, in which case you can do a Google search by keyword, then click the gears icon at the upper right of the results screen (that’s where Google has moved the advanced search options, which used to come up on the main search screen.) Then, qualify your search down to the specific HIStalk site as shown above.

12-27-2011 8-27-04 PM

From Booth Boy: “Re: MEDITECH and Cerner. As I predicted, see the attached Las Vegas floor plan. Since they lost their HIMSS points by sitting out a few years, they are way back in the corner by the freight doors. If it’s cold on setup day, they’re going to freeze their butts off because the doors never close.” Just about every year I run the link to the rules of how HIMSS awards its much-coveted Exhibitor Priority Points, which rewards vendors who spend a lot with HIMSS by allowing them to buy bigger and better located booth space. Points can also be earned by buying sponsorships, booking hotel space through their housing company, signing up for corporate membership and paying your dues early, and buying services from HIMSS Analytics. Because they didn’t exhibit, MEDITECH is way down the list in the #727 spot (behind mostly companies you’ve never heard of and even some universities) and Cerner is at #429 (two notches below University of Alabama at Birmingham.) Needless to say, prime exhibit real estate isn’t happening for them this year, so you’ll need to seek them out.  


HIStalk Announcements and Requests

Inga’s taking a short break, so it’s just me (Mr. H) this time around.


Sales

12-27-2011 9-56-43 PM

The board of 125-bed Powell Valley Healthcare (WY) approves the purchase of NextGen EHR to replace its “dysfunctional” and old Healthland system, saying the hospital is getting a bargain because the company offered to drop $400K from the $2.65 million cost if the hospital signed by December 31. The hospital plans to collect $1.5 million in Meaningful Use incentives, which it says it could not have done with Healthland because, according to the IT manager, “The system we have now is not good. It’s terrible. It crashes. I can’t imagine being a nurse or a physician and working with it every day.” The money-losing hospital says buying a new clinical system probably means that other projects, such as needed renovations in surgery and the ED, may not get done, but a board member says the new system is even more important. “This is a have-to. We have to do this. I remember going into the lab a few years ago, and the lab girls were crying, and it was over Healthland (the current system). It needs to be replaced,”


People

12-27-2011 8-10-04 PM

Saint Francis Care (CT) names Linda Shanley as VP/CIO. She was previously with Stony Brook University Hospital.


Announcements and Implementations

12-27-2011 10-12-43 PM

Pikeville Medical Center (KY) goes live on Wellsoft’s EDIS, which is integrated with its McKesson applications.


Innovation and Research

An Ohio ED doctor develops NARx Check, which calculates a drug abuse “credit score” using Ohio’s prescription monitoring program data and alerts ED staff of patients likely to be abusing drugs. The application has generated positive comments from the state pharmacy board and local hospital association.

West Wireless Health Institute says that less than 1% of hospitals have deployed fully functional tablets, mostly because clinical systems vendors haven’t developed iPad-native apps, but also because wireless connectivity is spotty, iPads don’t fit into the pockets of standard-issue lab coats, and typing on an iPad is a pain when PCs are always close by anyway.


Other

The western regional chapters of HIMSS are putting on the one-day Women in Healthcare Information Technology Conference in San Francisco on Friday, January 20.

An insurance company sues the former COO of Christus St. Vincent Regional Medical Center (NM), trying to recoup the $3 million it reimbursed the hospital for fraud losses. The COO allegedly funneled hospital IT payments through corporations that were run by a woman with whom he was having a relationship. He supposedly even paid a part-time student to impersonate an engineer with the phony company when the hospital got suspicious. The hospital fired the COO for cause in early 2008 and says it’s still waiting for authorities to charge him with a crime.

12-27-2011 10-06-44 PM

Jacob Goldman, the former chief scientist of Xerox who created the famous Palo Alto Research Center (PARC) in 1970, died last week at 90. Xerox was happy making money from copy machines and didn’t commercialize PARC’s research, but those discoveries, such as the graphical user interface and ethernet, created the personal computer industry when further developed by Apple, Microsoft, Cisco, Adobe, Sun, and other fledgling Silicon Valley companies.

A new KLAS report says that while only 10-15% of hospitals use real-time location systems, 95% of those that do say they increased operational efficiency.


Several readers sent over a link to this article, in which another conservative publication takes some unfocused political shots at Epic’s Judy Faulkner using healthcare IT as its weapon of choice (actually, they aren’t new shots, just the same old ones recycled yet again for a new audience.) Her oft-recited transgressions:

  • She donates to Democratic political candidates.
  • She represents vendors on the Health IT Policy Committee.
  • She’s anti-competition and anti-innovation, at least according to the unbiased opinion of Allscripts CEO Glen Tullman, an Epic competitor, quoted from an interview we did with him on HIStalk Practice (being a conservative publication, they had to be grasping to quote a long-time supporter and friend of President Obama who had a lot more influence than Judy Faulkner in getting billions in HITECH money included in the stimulus package.)
  • She could have benefitted from politician meddling in which a group urged the VA to buy instead of build systems, mentioning as their argument successful clients that happen to be all Epic users. That’s true, but perhaps a fact worthy of inclusion is that the VA ignored the unsolicited advice and is sticking with its original plan to develop an open source replacement for VistA, so the net benefit to Epic was zero.
  • Epic clients (Geisinger and Cleveland Clinic) were named by President Obama as being good technology users.
  • Epic clients, like those of all vendors, have had some unrelated IT incidents that were listed.

The article concludes, predictably and with no facts whatsoever to back it up, that Epic is preventing patients from getting good care because of “partisan politics” (meaning beliefs that differ from the ones held by the authors.) You would think instead of just Googling up some old articles they could have turned up an actual expert in a hospital somewhere instead of just quoting a competitor’s CEO and a reporter. I’m a conservative more or less (fiscally, anyway) but this is just lazy political editorializing pretending to be reporting, indiscriminately throwing out loads of unrelated mud in the hopes it will stick to someone of a different political persuasion.

Surely someone could build a better case against Epic, although it’s probably hard to write around the inconvenient facts (its customers are among the best hospitals, they are voluntarily buying Epic given the other available options, and Epic tops every industry statistic by a mile, such as big-hospital sales, KLAS rankings, and hospital customers that have been awarded HIMSS EMRAM Stage 7.) Or maybe they can’t. The anonymous anti-Epic comments I get are almost always long on emotion and opinions and short on facts and first-hand knowledge (and they often come from the same handful of posters using different names, which makes me suspect that they are unhappy former Epic employees, spurned job-seekers, or employees of struggling competitors.) I don’t know that I’ve ever seen a negative comment about Epic from someone who actually uses it in a provider role, and I don’t recall hearing remorse from any of those users about losing the systems that Epic replaced. I get tired of writing positive things about Epic and keep hoping someone who’s actually in the game and not on the sidelines will provide an intelligent and convincing counterpoint to why they aren’t as great as the Kool-Aid drinkers say. I’m still waiting.


Sponsor Updates

  • Weed Army Community Hospital (CA) chooses T-System for paper-based ED documentation.
  • Salar suggests three New Year’s resolution in a blog posting.
  • Nuance releases a case study on Emerson Hospital’s (MA) use of Nuance Transcription Services powered by eScription.
  • Digital Prospectors Corp., which offers embedded systems engineering and healthcare information systems consulting services, is featured in Bloomberg Businessweek.
  • Jeff Wasserman, VP of Culbert Healthcare Solutions, discusses physician employment opportunities, job culture, and interview skills in an American Medical News article.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

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December 27, 2011 News 17 Comments

Curbside Consult with Dr. Jayne 12/26/11

December 26, 2011 Dr. Jayne 2 Comments

Technology: The New Scapegoat?

I’ve always been a bit of a tech junkie. If I wasn’t afraid of revealing my age, I could tell some pretty good stories. To me, technology is exciting and invigorating, but also something to be respected. Technology at any level can run amok – think about Lucy in the chocolate factory as a basic example of what can go wrong. And who wants the artificial intelligence to run amok like HAL 9000

In conversations with providers, hospital administrators, and end users, the problem is always “the EHR” or “the system” or “the computer.”

Having lived in an electronic practice for nearly a decade and having used computers in the hospital for almost a decade before that, I can say with a good level of confidence that it’s not always the technology that’s at issue. Systems are only as good as the users who operate them, in conjunction with the training they receive and the proficiency they demonstrate. A recent situation at UC Irvine Medical Center illustrates this.

12-26-2011 7-43-33 PM

Although the headline screams “drug pump issue,” a close reading of the Statement of Deficiencies document (it begins on Page Five) yields some interesting factoids:

  • The hospital deployed new infusion pumps without hospital-wide training.
  • No policy and procedure document was developed (let alone approved) for the safe use of the new pumps.
  • A physician overrode a “soft stop” alert on the pump, leading to a patient receiving a high dose of medication. (I agree that the fact that there wasn’t a “hard stop” alert programmed in, but let’s remember a physician did override the alert.)
  • The hospital was “unable to ensure that MD… was competent in accurately programming the medication infusion pump.” The pump didn’t have a drug library and was programmed with a dose over 30 times that of the prescribed dose.

After two patient-related incidents, the hospital took corrective action, including:

  • Only allowing trained RNs who have documented competency to program the pumps.
  • Ensuring that dose, concentration, and flow rates are chosen from a current drug library appropriate to the care area.
  • Restricting the ability for users to enter dose/rate for non-library medications unless a second user verifies the programming.
  • Requiring re-verification of orders and programming when soft limits are overridden.
  • Instituting hard stops which cannot be overridden for certain medication doses.
  • Instituting independent double check for programming of pumps that deliver certain high-risk medications

These seem like no-brainer fixes to me. I’m glad the hospital put policies in place that should have been there all along (regardless of the newness of the brand of pump, model, etc., these are just good patient safety procedures).

The document goes on to list several other fairly horrifying behaviors, including a director of pharmacy who admitted knowing that no policies were in place and that no one was overseeing pump safety. “We will in the future, but the pharmacy department needs to be trained first.” He/she also stated that the vendor provided inadequate training for monitoring of pump-related events. Blaming the vendor is always easy – it takes a steadfast leader to halt a go-live when adequate training has not yet taken place.

Other scenarios mentioned in the document:

  • A resident physician involved in a pump-related incident that involved infusing a medication over one hour instead of the recommended six hours was “unaware or unwilling to accept the hospital pharmacy directive to infuse the medication over six hours.” The resident’s anesthesia record stated that he was aware that he dosed the medication to infuse over one hour. The resident also violated Department of Anesthesia rules by not paging his attending physician to be present for the end of anesthesia as was required. Oh yeah – he also “overlooked” the patient’s low oxygen level and didn’t take corrective action. When the attending arrived after the resident finally paged, the attending called a Code Blue because the patient “had poor color and was not breathing.”
  • Residents examining patients but not writing progress notes (even after a nursing supervisor notified the attending physician) on several occasions.
  • An oncology staff nurse (whose job duties included validating chemotherapy doses) who was unable to calculate the dose when given a patient’s weight in pounds and a dose in milligrams per kilogram.
  • Contract nurses allowed to operate infusion pumps without training (one with an ungraded proficiency exam in the personnel file — if you made him take it, why not grade it?)

I had to quit reading after a while because I’m extremely compulsive about patient safety and it was just making me increasingly agitated.

Despite the potential harm involved in the pump-related incidents, I’m actually glad they happened. Why? Because the incidents acted as a trigger to expose some significant issues and deficits in patient safety. Patient safety is a culture that requires education and support. It doesn’t happen in a vacuum.

I wouldn’t let an adolescent operate a lawn mower independently without appropriate training, safety gear, and close supervision. We don’t allow teenagers to drive cars (aka operate deadly weapons) without proving a minimum level of proficiency. Yet in this situation, users were allowed to operate equally dangerous machinery without training. The documentation doesn’t mention whether the nurses were forced to operate the pumps over their objections, but the point is they shouldn’t have been asked to use potentially lethal equipment they weren’t qualified (by training and demonstrated competency) to use.

I hope this case serves as a wake-up call for some institutions. I hope end users continue to speak up when they’re asked to do things that are unsafe and that someone listens. Lives depend on it.

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December 26, 2011 Dr. Jayne 2 Comments

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Reader Comments

  • Cynthia Davis: Thank you Ed for speaking from your heart. Having lost family early in me career fueled my passion to help make a diffe...
  • El Jefe: Re nurse Ratched. I for one don't condone what she did...but I sure as hell can understand it....
  • Smalltown CIO: Come on NotQuite. Is this really the kind of world we want to live in where the first thing we do is point fingers and f...
  • Cheryl: Very heartfelt post! I cannot think of one nurse who wouldn't enjoy reading the reason they work reflected back at them....
  • NotQuite: Really Ed? You are writing an article about the greatness of nurses, when two of your nurses were needlessly infected...

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