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March 29, 2012 News 2 Comments

Top News

3-29-2012 9-40-00 PM

Vocera shares gain 40% over the $16 offering price in the company’s Wednesday IPO. Shares were up another 19% Thursday to $24.91, giving VCRA a 56% jump in the company’s first two days of being publicly traded.


Reader Comments

3-29-2012 9-45-10 PM

From Max: “Re: Microsoft/Sentillion. The bloodbath is in full effect. Employees received either a 60-day notice this week or an offer to move to Caradigm. I’ve heard losses on the Amalga side were significant.” Unverified. I asked my Microsoft contact, who says that like most companies, Microsoft doesn’t comment publicly on HR-related questions.

From HMSUser: “Re: HMS CEO. ‘Resigned’ last Friday, rumor that more high-level people will be shown the door.” Unverified, but Tom Stephenson’s bio has vanished from the executive team page. HMS’s parent company, HealthTech Holdings, has been owned since 2007 by private equity firm Primus, whose other healthcare IT-related investments include InSite One, Medhost, and Passport Health Communications.

From Epic-urious: “Re: Epic leading the market and gunning for the big guys. I’ve only read a few new customer updates. Where are all of these new customers?” Just to be clear, Epic is the big guy now, so there’s nobody left to gun for in terms of penetration of patients and providers (not necessarily in  number of hospitals since it’s a lot easier to dominate the market selling to one 1,000 bed hospital than ten 100-bed ones.) The company doesn’t announce sales, so new customers come to light only casually, like at conferences with mostly large-hospital attendees, where just about everybody finds out simultaneously that they’re all implementing Epic. Another way to look at it: the lack of significant sales announcements from Epic’s competitors, who do indeed happily announce new sales when they can get them.


HIStalk Announcements and Requests

3-29-2012 9-30-41 PM

inga_small This week on HIStalk Practice: a physician being sued by his former practice resigns over “technology troubles” and “billing errors” that he claims were the caused by computer problems. CMS offers help to providers not deemed “successful electronic prescribers” in 2011. Nancy Pelosi’s connection (or lack of one) between Practice Fusion’s rapid growth and the Affordable Care Act as she cuts the ribbon at the company’s new building (above.) Brad Boyd urges providers to continue moving forward on their ICD-10 transition. In our reader survey, 85% said reading HIStalk Practice helped them perform their job better last year, so if you’re in ambulatory HIT and need performance enhancement, you should be reading.

Listening: new from The Mars Volta, complex, perfectionist progressive rockers from El Paso, TX. An Amazon reviewer said it well: they’re what Led Zeppelin would have sounded like time warped into 2050. Dead ringers for Manfred Mann’s Earth Band at the 4:10 mark of the video, but very Zeppelin-like at 5:00. And I’m reflecting on the amazing musical contributions of Earl Scruggs, who almost single-handedly gave non-hayseed credibility to both the banjo as a musical instrument and to bluegrass as a uniquely American musical genre and who died Wednesday at 88. Foggy Mountain Breakdown was the speed metal of its day and it still sounds amazing as I listen to it right now.


Acquisitions, Funding, Business, and Stock

3-29-2012 9-47-54 PM

ClearDATA Networks, which provides healthcare cloud computing services, secures funding from Norwest Venture Partners and several angel investors.

3-29-2012 9-48-34 PM

Seven-month-old hospice management software vendor Hospicelink of Birmingham, AL says it expects $50 million in sales by the end of 2012. Color me skeptical.

3-29-2012 9-49-13 PM

Ann Arbor, MI-based HIE vendor CareEvolution is expanding its 22-employee workforce to 38, expecting to hire three software developers per quarter. I notice from the company’s site that they claim a trademark on the term One Patient, One Record, which I would associate more with Epic than CareEvolution, which I’ve heard of only once when a reader said they did an impressive demo but still lost the West Virginia Health Information Network bid. UPDATE: the company clarified the newspaper article – it has 38 employees now (22 of them in Ann Arbor) and will add another 15. WVHIN did choose Thomson Reuters’ HIE Advantage, but that product actually runs CareEvolution’s HIEBus under an expanded agreement between the companies signed in February 2011, so CareEvolution is in place (and scheduled for go-live next month) even though the announced winner was Thomson Reuters.

3-29-2012 9-52-02 PM

BlackBerry maker Research in Motion reports sagging sales, a quarterly loss, and an executive housecleaning. The CEO says he won’t rule out selling the company now that he’s seen from the inside just how dire the situation is, although he’s hoping for a turnaround. The steep downward slope above is the one-year share price, down 75%.


Sales

3-29-2012 9-56-45 PM

Asante Health System (OR) selects iSirona’s medical device connectivity solution to populate patient data in its Epic system.

Memorial Hospital of Union County (OH) selects Wolters Kluwer Health’s Provation MD for its gastroenterology and pulmonology departments. In addition, Duke University Health System (NC) licenses ProVation Order Sets.

3-29-2012 9-57-48 PM

Duke University Health System (NC) selects M*Modal Speech Understanding technology to support the Epic system it’s implementing.

Two practices within the University at Buffalo School of Medicine select PatientKeeper Charge Capture, which will be integrated with UBMD’s GE Centricity Group Management PM product.


People

3-29-2012 5-38-12 PM

EMR vendor CareCloud appoints PowerReviews CEO Ken Comée to its board.

3-29-2012 5-39-26 PM

Online physician networking site Sermo names former Revolution Health president Tim Davenport CEO. He replaces founder Daniel Palestrant, who left the company in January to run Par80, a startup focused on patient referrals.

3-29-2012 5-41-45 PM

Aventura hires Brian Stern (NewsGator Technologies) as SVP of sales and marketing and Brandi Narvaez (Sentillion, Vitalize – above) as chief customer officer.

3-29-2012 5-42-52 PM

eMerge Health Solutions, a provider of voice-powered documentation systems, hires Trent McCracken as president and CEO. He was previously owner of a telecommunications software company.


Announcements and Implementations

St. Francis Hospital & Health Services (MO) will go live on Epic Saturday morning.

3-29-2012 9-59-45 PM

The Verizon Foundation donates $100,000 to launch a telemedicine pilot project at Children’s Hospital of Philadelphia. CHOP will offer community hospitals consults with its pediatric specialists.


Government and Politics

The New York eHealth Collaborative and the New York State Department of Health form the Statewide Health Information Network of New York Policy Committee, tasked with updating and creating policy measures to protect PHI while expanding the state’s ability to electronically share clinical data.

The White House announced Thursday that various government agencies will invest $200 million of taxpayer money in so-called “Big Data” R&D. A NSF/NIH project will look at large-scale health and disease databases.

It’s not healthcare related, but it’s another hugely expensive government computing foul-up: the State of California pulls the plug on a $2 billion court system that still isn’t fully rolled out 11 years after the project started. The project was originally supposed to cost $260 million, with a state audit last year finding that the massive overruns were due to poor management of contractors. An IT project failure expert said, “I am dumbstruck over the incredible waste and obvious poor planning associated with this system. This failure only adds to California’s reputation as the land of IT boondoggles”


Technology

Henry Ford Hospital (MI) implements telerounding, in which minimally invasive surgery inpatients are given an iPad to post-operatively communicate with their remotely located surgeons using the FaceTime video chat app.


Other

Weird News Andy likes this video story of a BYU nurse practitioner student whose professor, while observing her practice thyroid exams in her third week of class, happens to notice that she has a hard-to-spot tumor. The mass turned out to be highly aggressive, but she’s OK after fast-track surgery and radiation therapy. She will take a nurse practitioner job at the Thyroid Institute of Utah when she graduates this summer.

Hill-Rom joins Stryker and Zimmer in laying off hundreds of its employees to offset the cost of complying with a new medical device tax that takes effect next year. The 2.3% tax, enacted in the Affordable Care Act, is based on company revenue regardless of profitability. The industry estimates the tax will cost its members $30.5 billion and could result in the loss of up to 38,000 jobs.

3-29-2012 9-07-00 PM

Howard University Hospital (DC) notifies 34,000 patients that their health information was potentially exposed in January when a laptop was stolen from the car of a contractor who had downloaded the information in violation of hospital policy. The contractor had quit working for the hospital in December 2011, but reported the theft on January 25 of this year.

The government’s bet-the-farm idea of paying hospitals for quality didn’t move the needle on deaths or readmissions in its own demonstration project, a study published Wednesday in the New England Journal of Medicine found. The Harvard public health author says incentives are the right idea, but the metrics aren’t yet right. He also says it’s nice when processes are executed consistently, but the only thing that counts is that patients get healthier, and that didn’t seem to happen here.

It’s definitely not up to the high snark standards of The Onion, but this satirical article called Myanmar Embraces Facebook as Electronic Medical Record is kind of funny. “Whilst Facebook users can currently Add and Delete Friends, the updated site is going to allow users to Add Doctors, Nurses and other allied health professionals, who can be granted varying degrees of access to confidential medical data. ” You just know someone out there is working on this already.

3-29-2012 8-17-57 PM

I probably would find a new press release headline writer.

Here’s what HITECH has driven providers to. Physicians at Samaritan Healthcare (WA) gripe at a hospital board meeting about the hospital’s new Meditech system, which the hospital freely admits it implemented for only one reason: to get a $2.2 million HITECH check. According to one doctor, Meditech is “… time-consuming, it is frustrating, it is archaic, it’s hard to work with … It didn’t matter what we said, you were going to go ahead and implement this because there were the economic benefits being reaped by the hospital at our expense.” In response, the hospital CEO admitted that the system isn’t ideal, but says now that the money’s in the bank, Meditech is history, its replacement to be paid for by the HITECH money Meditech earned for the hospital.

3-29-2012 9-00-20 PM

Strange: two-thirds of respondents to an online poll run by the Chinese Communist Party’s newspaper choose a “smiley face” as their reaction to a story about a medical intern who was murdered by an enraged patient in a hospital, apparently because doctors are right up there with government workers in being hated for insisting on being paid bribes to do their jobs. The poll was quickly taken down. The government reported that over 5,000 medical personnel were injured by patients in 2006, the last year such statistics were published. Experts blame the anti-doctor mood to the lack of a medical malpractice system to provide compensation for errors, physician salaries that start at only $500 per month, and the fact that doctors are legally paid commissions for orders written. It was also reported that some doctors are taking kickbacks from funeral homes for promptly alerting them of the newly deceased.


Sponsor Updates

  • EHRtv runs an interview with David Caldwell, EVP of HIE vendor Certify Data Systems, filmed at the HIMSS conference. We interviewed CEO Mark Willard last month.
  • Salar and Transcend will participate in the Society Hospital Medicine 2012 Conference April 1-4, 2012, in San Diego, CA
  • MedAssets launches its Population Health solution suite to support the industry’s transition to fee for service and accountable care.
  • Greenway Medical Technologies announces the availability of PrimeMOBILE for Android and tablet devices.
  • TELUS Health Solutions will license Get Real Consulting’s InstantPHRO to resell into Canada under the TELUS Personal Health Record brand.
  • MEDSEEK announces that its eHealth ecoSystem V4.0 is 2011/2012 compliant and certified as an EHR Module.
  • Queensway Carleton Hospital (Canada) is delivering ED records to more than 120 family doctors using TELUS Health Solutions’ CareShare technology. 
  • GetWellNetwork announces its fifth annual users conference, to be held April 30 – May 2 in Orlando.

EPtalk by Dr. Jayne

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All eyes are on the Supreme Court this week. Oral arguments for the cases challenging the Affordable Care Act concluded Wednesday. This has been a busy week at work so I haven’t been able to process the transcripts as quickly as I’d like. Stay tuned for my detailed reaction in Monday’s Curbside Consult. I find the whole process fascinating. It wakes up the non-medical part of my brain with the interplay of the Justices’ personalities and the complexities of legal theories of intent, severability, and judicial restraint.

The focus on PPACA overshadowed dialogue on last week’s ruling that state workers cannot sue their employer for violating a part of the Family and Medical Leave Act. A 2003 decision allows suits against state agencies for violations related to leave taken to care for family members, this decision involves leave take by employees to take care of their own health. There are already many loopholes in FMLA due to multiple court challenges over the past two decades. Additionally, states have made their own requirements and definitions, turning it into a patchwork. It’s a great example of what might happen to PPACA over the next few decades should it be allowed to stand.

My other exciting reading this week has been the recently-issued NIST protocol on EHR usability. The three-step process includes EHR application analysis, user interface expert review, and user interface validation testing. There are some interesting points in the document. Check out Appendix A, which discusses the use of human factors engineering by the Department of Defense, the Nuclear Regulatory Commission, and the Federal Aviation Administration.

It also provides questions used to evaluate an EHR’s “aesthetic and minimalist design” and “pleasurable and respectful interaction with the user,” including whether the EHR has artistic value. I never found that documenting as required by CMS (and now other payers) is particularly pleasurable, nor do I find artistic value relevant to patient care. I don’t care how ugly it is — I just want it to be easy to use and comprehensive.

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AHIMA announces the Grace Award, which recognizes excellence in health information management. Nominations are open through June 30 and the award will be presented at the annual meeting in September. I give this new award a thumbs up for aesthetic and minimalist design (NIST would be proud.) It would look great on my credenza.

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Wireless medical monitoring devices are highlighted in an article published yesterday. I like the idea of an edible sensor integrated into a medication that can document when it was taken, although I don’t want to receive patient information on my phone so that I can try to interpret it “all without a visit to the doctor.” Let’s take it one step further and integrate a monitoring sensor into every Girl Scout cookie produced, and if too many are consumed at a single sitting, it can send warning texts to purchasers. Having just found a stash of Thin Mints at the back of my freezer, I could definitely use the moral support.

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March 29, 2012 News 2 Comments

Readers Write 3/26/12

March 26, 2012 Readers Write 2 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!

If You Did It, Enter It in the EHR
By Mitch McClellan

3-26-2012 4-25-12 PM

I was recently asked the following by a colleague:

We know that every organization has some physicians who just will not fully use the EHR. They will have nurses, MAs, and other clinical staff do all of the data entry. They may just hand the staff a piece of paper and have them enter the problem list. A specific example would be the MU requirement for weight counseling – do you think it is acceptable for an MA to indicate in the record that the physician did the weight counseling? Clearly it makes sense to have nurses and other clinical staff enter medications and even other orders and even start notes, but where do you draw the line?

This question certainly walks the line between facilitating accurate data entry vs.what is appropriate.

If an organization is truly going to embrace this much-needed change in healthcare, they need to enforce that their clinicians do the right thing. In this case, it would be physicians taking 100% ownership of entering the documentation specific to weight counseling. They are the ones actually provided the counseling.

I understand that is a black-and-white response, but I strongly believe that if an organization’s culture accommodates physicians who choose not to do their complete EHR responsibilities (e.g. not documenting the counseling that YOU provided), then it defeats the entire purpose of what we’re doing.

The EHR revolution is strongly driven by the fact that paper is not efficient and creates too many points of failure. Not only is the medium (paper) antiquated, so are many of the policies and processes that support those paper workflows (e.g. documenting a note that you then pass on to someone else to then "document a note" on your behalf).

Unfortunately, I believe most physicians are put into a "get it done now vs. a get it done right" scenario due to the payers’ stringent reimbursement policies. I completely understand the time demands on these physicians. But the rule I try to instill with all of my groups is that, "if you did it, then you must enter it in the HER." Otherwise, the effectiveness and efficiencies of an EHR are lost if the old way of doing things is still embraced.

The groups that I’ve worked with would require the physician enter that piece of documentation themselves instead of the MA. The only groups that I’ve worked with that would allow this scenario to happen would be if it was the physician’s nurse — not an MA –entering the documentation. To me, the issue is twofold. The first is workflow (reasons already stated), the second is the lack of credentials of an MA. I know I’d want a higher-credentialed healthcare provider entering that information if it’s not the physician themselves.

Mitch McClellan is manager of implementations at MBA HealthGroup of South Burlington, VT.



Optimization
By Dave Vreeland

3-26-2012 7-26-43 PM

Cumberland brought together a select group of HIT executives from some of the nation’s leading health systems for a recent breakfast discussion The topic: optimization.

Now that many are on track for Stage 1 Meaningful Use and other compliance deadlines, the focus is beginning to shift beyond go-live toward getting the most out of HIT systems. The panel, made up of Cumberland’s Brian Junghans, HCA’s Dr. Divya Shroff, and Memorial Healthcare System’s Jeff Sturman, shared how non-profit Memorial and industry giant HCA are tackling optimization.

The takeaway: success largely hinges on solid communication and the collaboration of two very different worlds – IT and clinical. Clinicians are arguably the keystone in achieving effective system adoption and long-term optimization.

Junghans points out that IT folks tend to think in terms of projects, which have a defined beginning and end. When it comes to IT implementation projects, the end is go-live. In contrast, optimization is an ongoing effort.

Dr. Shroff points out that clinicians have more of an optimization mindset, with a continuous focus on improved quality of care, optimal patient outcomes, and best practices.

With techies and clinicians in different mindsets, speaking two different languages, communication issues are common. HCA has success placing physicians and other clinical professionals like Dr. Shroff in clinical transformation roles. Valuable insight and hands-on experience makes these clinicians effective ambassadors for both the IT and clinical teams. 

Sturman and the Memorial team have incorporated clinical aspects into their approach to optimization. The team makes regularly scheduled rounds to observe workflow, system usage patterns and identify opportunities for improvement throughout each of their six hospitals, clinics, and ambulatory practices.

The importance of a clear distinction between IT support and optimization teams was also stressed. HCA trains the IT support team to triage incoming calls, address specific break/fix issues, and refer optimization matters to the optimization team.

Both organizations have seen success with various efforts to improve clinical/IT relations and are on track with current and long-term efforts toward optimization.

In addition to a number of lessons learned and critical success factors to consider during and after the implementation process (summarized in our presentation Beyond Go-Live: Achieving HIT System Optimization), it was interesting to hear this room of executives from diverse organizations, representing both the clinical and IT fields, reinforce the significant impact collaboration between the two worlds has on the success of end-user adoption and achieving true optimization.  

Dave Vreeland is partner with Cumberland Consulting Group of Franklin, TN.


Stage 2: The Vendor View
By Frank Poggio

3-26-2012 7-47-00 PM

On March 7, 2012, a draft for comment on the new Stage 2 rules was published in the Federal Register. Actually there were two separate parts to the rules. They are:

  1. The CMS part that is aimed at provider requirements necessary to meet Meaningful Use, and
  2. The ONC piece that addressed proposed changes to the certification process for EHR vendors.

On the provider side, there are innumerable blogs and Web sites that are covering the provider issues, which deal mostly with a few added MU criteria such as electronic medication administration records, menu options in Stage 1 that are now mandatory in Stage 2, greater emphasis on exchanging patent care information across care levels, and greater patient access to care information.

This article will focus on the “second side” of the regulations — the elements that most impact the system suppliers, with emphasis on the impact to niche or best-of-breed (BoB) vendors.

The full text of the new ONC Certification proposed rules can be found at here.

Before we hit the high (and low) points of the rules keep in mind these are proposed rules. If there is anything you don’t like about them, have suggestions for improvements, etc. you have from now until June 7 to post comments on the federal Web site. Speak now or forever hold your price! (No that is not a typo … see the Ugly).

Here’s the Good, the Bad, and the Ugly of proposed certification changes for vendors.

The good news:

Privacy and Security — will it go away?

EHR Module certification gets a little easier for niche and best-of-breed vendors (BoB). The big change here is that Module certification no longer requires you to address any of the privacy and security criteria. In the past, there were eight P&S criteria (number nine was always optional), and in our working through many ATCB tests, if you said the right phrase, you could get a waiver on three others (Integrity, General Encryption, and HIE.) Proposed under the Stage 2 as a niche/BoB vendor, you can ignore all the P&S criteria. To get certified under Stage 2, it would seem all you will need to do is pass any one Inpatient, Ambulatory, or General criteria, just ignore the P&S criteria, and you’re home free.

ONC said they made this change because many of the smaller firms complained that the P&S criteria did not apply or were too burdensome. This may sound too good to be true. Maybe it is. Read what ONC says in other parts of the document:

Finally, we propose to require that test results used for the certification of EHR technology be available to the public in an effort to increase transparency around the certification process. We believe that there will be market pressures to have certified Complete EHRs and certified EHR Modules ready and available prior to when EPs, EHs, and CAHs must meet the proposed revised definition of CEHRT for FY/CY 2014. We assume this factor will cause a greater number of developers to prepare EHR technology for testing and certification towards the end of 2012 and throughout 2013, rather than in 2014.

This is classic ONC. They say you don’t have to get certified. There is no law that says any vendor MUST – even a full EMR vendor. They believe the market will tell you. And by the way, ONC will be publishing the details of your certification so the world can compare you against your peers.

As we tell our clients, the MU criteria you choose to test on is dictated more by your competition and clients, not by the ONC.

Gap certification for Stage 2

A question that we have heard frequently was if I was certified on 20 criteria for Stage 1, under Stage 2, would I have to be tested again for those same criteria? Under the proposed Stage 2 rules, you would not need to get re-certified on Stage 1 criteria. You will only have to be tested on new criteria you select, and tested on Stage1 criteria that has changed or been revised by ONC.

A good example is the encryption P&S test. The focus now will be on encryption for data at rest. They state:

EHR technology presented for certification must be able to encrypt the electronic health information that remains on end user devices. And, to comply with paragraph (d)(7)(i), this capability must be enabled (i.e., turned on) by default and only be permitted to be disabled (and re-enabled) by a limited set of identified users.

So if you tested out on encryption under Stage 1 and want to carry it forward into Stage 2, you’ll probably have to show how you default encryption for user devices.

Component EHR vs. Complete EHR

A typical misunderstanding we came across many times during past year taking our clients through the certification process was a CIO at a hospital would say to the vendor that he/she believed they had to install a full EMR from a single vendor to meet all the MU criteria. In the proposed regulations, ONC has clearly addressed this question. On page 104, they say:

Certified EHR technology means: 1. For any Federal fiscal year (FY) or calendar year (CY) up to and including 2013: i. A Complete EHR that meets the requirements included in the definition of a Qualified EHR and has been tested and certified in accordance with the certification program established by the National Coordinator as having met all applicable certification criteria adopted by the Secretary for the 2011 Edition EHR certification criteria or the equivalent 2014 Edition EHR certification criteria; or ii. A combination of EHR Modules in which each constituent EHR Module of the combination has been tested and certified in accordance with the certification program established by the National Coordinator as having met all applicable certification criteria adopted by the Secretary for the 2011 Edition HER certification criteria or the equivalent 2014 Edition EHR certification criteria, and the resultant combination also meets the requirements included in the definition of a Qualified EHR.

In effect, a provider could meet the MU criteria using as many suites of BoB systems as they believe necessary. They do not have to be from one or the same vendor.

 

Now some bad news:

Criteria components

Many BoBs struggled with the make up of the criteria for Vitals and Demographics and several other clinical criteria. On the surface, they seemed easy to pass. The problem was they contained some data elements that were not typically found in BoB systems. For vitals, the hurdle was growth charts. For demographics, the hurdle is date and time of death. To pass these criteria, some vendors would use user-defined fields or create new inputs that they knew their clients would never use. Repeatedly I was asked by niche and BoB clients, “Why would you ask a patient during a registration process, ‘When did you die?’” Now there’s a comforting dialog!

Keep in mind several or the participants in building the HITECH/MU program were academics and researchers who would find that piece of information critical to their retrospective medical data analyses. Also, vendors of full EMR systems would easily have that piece of data readily available in their medical record abstract system. But for an ancillary or niche vendor, not likely. As far as I know, there were no niche or BoB vendors represented on any of the HITECH Policy or Standard Committees.

You may wonder why any firm would go through the trouble of adding a useless data element. Again, keep in mind what ONC said above: market will require certification. It can be virtually impossible to sell an ancillary system such as surgery, ICU monitoring, therapy, anesthesia, etc. if you had to tell your prospect your product was not certified for vitals.

Unfortunately this issue is still there for BoBs. The big change is on the provider side. ONC has greatly liberalized the granting of exceptions to providers for MU attestation if the MU criteria (or element of the criteria) do not apply to their practice of facility. As an example, a psychiatrist does not have to do growth charts for his patients — an exemption will be readily available. But the vendor who sold him the system still must!

Continuing this topic, in a recent interview Dr. Mostashari chided EHR vendors who "aren’t making meaningful use of Meaningful Use." Instead of attempting to seamlessly incorporate MU standards into their interfaces, Mostashari said "vendors did what vendors do—they slammed in the criteria and got certified.”

I submit that ONC slammed these regulations into being as fast as they could due to Congressional and Executive pressure, so one good slam deserves another. Maybe if ONC took a moment to look at the impact of certification on niche and BoBs — which are mostly the smaller, more innovative developers — and adjusted the criteria, we all could stop slamming.

 

And now the ugly:

As I mentioned in an earlier HIStalk post, ONC wants comments on vendor product price transparency. Here’s the ONC statement:

During implementation of the temporary certification program, we have received feedback from stakeholders that some EHR technology developers do not provide clear price transparency related to the full cost of a certified Complete EHR or certified EHR Module. Instead, some EHR technology developers identify prices for multiple groupings of capabilities even though the groupings do not correlate to the capabilities of the entire certified Complete EHR or certified EHR Module. Thus, with the transparency already required by §170.523(k)(3) in mind, we believe that the EHR technology market could benefit from transparency related to the price associated with a certified Complete EHR or certified EHR Module. We believe price transparency could be achieved through a requirement that ONC ACBs ensure that EHR technology developers include clear pricing of the full cost of their certified Complete EHR and/or certified EHR Module on their websites and in all marketing materials, communications, statements, and other assertions related to a Complete EHR’s or EHR Module’s certification. Put simply, this provision would require EHR technology developers to disclose only the full cost of a certified Complete EHR or certified EHR Module.

As a former CFO, I know that the through definition of ‘full cost’ would take at least another 500 pages in the Federal Register. After the vendors in the audience come down off the ceiling, you’d probably like to share your reaction with ONC. Just click here.

Frank L. Poggio is president of The Kelzon Group.

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March 26, 2012 Readers Write 2 Comments

News 3/23/12

March 22, 2012 News 4 Comments

Top News

3-22-2012 9-10-24 PM

Thomson Reuters reportedly puts its healthcare data and analytics unit back on the market after shelving the process last year due to tough market conditions. Multiple bidders may be vying for the business, which is expected to fetch up to $1 billion.


Reader Comments

mrh_small From Willy Loman: “Re: Imprivata. Being sued for patent infringement for its OneSign SSO.” I Googled and came up with a new suit brought by CeeColor Industries LLC claiming that Imprivata is infringing on its 1999 patent for proximity-based security using electronic sensors. Imprivata’s OneSign uses a webcam with optional facial recognition software to validate a user and lock their session when they walk away. I can find nothing about CeeColor Industries, which suggests that their primary business, if they have one beyond just owning a patent, at least isn’t extortion by litigation. Companies get sued all the time for reasons both valid and not, so I wouldn’t get too excited about this lawsuit just yet. I interviewed Imprivata CEO Omar Hussain a year ago and asked him about Secure Walk-Away and how the webcam aspect works. Above is a video that explains it.

 

3-22-2012 6-52-20 PM

mrh_small From James: “Re: Roy the HIStalk King. We (Medicomp) had Roy’s HIStalkapalooza sash framed. He seems very happy about it ;)” Roy Soltoff from Medicomp was not only named HIStalk King, he also served as part of Inga’s security detail for her Quipstar competition. You can see Roy in action in the excellent HIStalkapalooza video that ESD put together (he wins at the 2:30 mark.) His beauty queen sash looks good up there on his wall and the color / black and white photo effect is cool (either that or Medicomp and its people are very drab.)  

mrh_small From Roller Boy: “Re: Allscripts. Downgrades from Jim Cramer and JP Morgan have created the perfect storm. Night and weekend meetings with board and execs with talk of impending changes.” Unverified and unwarranted, I’d say, given that shares are down only 6% in the past month, although the Nasdaq was up 4% in that same period. Other brokers have stood by their recommendations and neither Cramer or Morgan said anything new – they just recited the obvious challenges the company faces in integrating and selling Sunrise after its $1.3 billion acquisition of Eclipsys, if indeed that’s such an important driver of their business. My interview with Phil Pead and Glen Tullman about the acquisition is here and worth a revisit since I asked some tough questions, like how their performance should be graded two years down the road (that date is coming up soon.) I also said this about Eclipsys when the deal was announced in June 2010:

Despite the arguably superior CPOE and clinical documentation capabilities of Sunrise, it has competed poorly against Epic and Cerner … Nearly 40% of ECLP revenue supposedly comes from about 20 big customers … Eclipsys most likely paid big money for its recent acquisitions, buying the former Medinotes/Bond practice EMR products, EPSi financial management, and Premise throughput management as it desperately sought to diversify away from its at-risk Sunrise user base. Those acquisitions didn’t seem to do much for the company’s performance … It’s late in the HITECH land grab to try to integrate companies and products in the hopes that enough hospitals are left that haven’t locked into their vendor partners to prepare for Meaningful Use. This would have been a much better deal a year ago.

mrh_small From HITwatcher: “Re: system sales. A quiet year as everyone is hunkered down protecting their base while Epic continues to go after the huge brass rings. Will Partners really announce a choice of Epic by April 1? Dunno, but they will go that route, then on to HCA for the no pie-in-face lady.”


HIStalk Announcements and Requests

inga_small What you missed if you didn’t check out HIStalk Practice this week: Dr. Gregg’s recent cloud/hosted server debate. Joslin Diabetes Center (MA) offers national telehealth services. Practices adopting the PCMH model of care have higher staff morale but also higher physician burnout. EZ DERM incorporates Nuance’s medical speech capabilities into its iPad EHR. Practice Fusion offers free interfaces to 16 reference labs. While you are stopping by HIStalk Practice, take a moment to sign up for the e-mail updates because it will keep you smart and make make me feel loved.

inga_small My Internet (and cable TV) went out earlier this week, so I have resorted to tethering my laptop to my iPhone for Internet access. It’s not an ideal solution (the connection seems to drop at least once an hour) but it’s actually pretty handy. I’ve used the tethering option a bit in the past when I’ve bee in an area without free Wifi, but never before full time. I wouldn’t trade trade tethering for my high-speed cable, but it’s a surprisingly workable solution. Meanwhile, I keep wondering if no cable TV means no recordings of American Idol on the DVR.

mrh_small On the Jobs Board: Release Manager, Consultant, Application Developer. On Healthcare IT Jobs: Director of Federal Health Business Development, Technical Project Manager, Health Information Systems Programmer/Analysts.

mrh_small Inga, Dr. Jayne, and I are emotionally needy. We yearn for intimacy and fulfillment with our much-loved readers, but alas, our anonymity and geographic separation preclude such contact. Therefore, like a prisoner who proposes surreptitious visual stimulation from the other side of the telephone room glass or requests passionate mail in lieu of physical contact, may I suggest that you: (a) sign up for the e-mail updates; (b) engage in the mutually satisfying activity of liking, friending, and connecting via the appropriate online services in which we dwell; (c) send us news, rumors, or anything else that might serve as a fancy-tickler; (d) review and click some sponsor ads, marveling that otherwise button-down companies publicly support our unpolished journalistic style and sophomoric humor because their executives at times find as amusing and informative as a hyperactive, crude teen armed with neighborhood gossip; (e) check out the Resource Center for more sponsor information and the Consulting Engagement RFI Blaster to painlessly request consulting proposals; and (f) enjoy our fleeting moments together since one of these days when I’m no longer clacking the keyboard, you’ll be bereft of musical recommendations and HIMSS booth critiques. Thanks for reading, since without you all this typing would be pointless.


Acquisitions, Funding, Business, and Stock

3-22-2012 9-34-04 PM

On Assignment, a provider of temporary workers to IT and healthcare companies, will purchase IT staffing firm Apex Systems for $383 million in cash and $217 million in new stock.


Sales

Xerox’s IT division wins a 10-year, $1.6 billion contract to oversee claims processing for California’s Medicaid program.

WESTMED Medical Group (NY) chooses UnitedHealthcare and Optum to help it launch an ACO for its 220 physicians in Westchester County, NY.


People

3-22-2012 5-57-34 PM

The Huntzinger Management Group hires Nancy Chapman (ACS) as practice director of ICD-10 transition and RCM services. We also note that she is part of an exclusive group of 2,324 industry leaders who have joined the HIStalk Fan Club that long-time reader Dann started and maintains on LinkedIn.

3-22-2012 6-01-19 PM 3-22-2012 6-02-39 PM

LifePoint Hospitals (TN) appoints Karla Schnell (North Highland) as senior director of informatics and Paige Porter as senior director of pharmacy informatics.

3-22-2012 7-49-11 PM

National coordinator Farzad Mostashari will present the opening keynote address at the Summit on the Future of Health Privacy in Washington, DC on June 6-7, hosted by Patient Privacy Rights and Georgetown University. Security expert Ross Anderson PhD, FRS will also address the conference and Rep. Joe Barton (R-TX) will receive an award for his support of privacy and security protections in the HITECH act. Registration is free.


Announcements and Implementations

US Preventative Medicine announces an agreement to offer its wellness platform through Dossia’s Health Management System.

3-22-2012 6-04-50 PM

HIMSS names The Health Information Exchange Formation Guide, written by Laura Kolkman and Bob Brown, as its 2011 Book of the Year.

PerfectServe announces that its clinical communication applications are available for BlackBerry and Android smart phones.

iMDSoft’s MetaVision Suite for ICUs and ORs earns ONC-ATCB 2011/2012 certification.

Elsevier signs an agreement with ExitCare LLC to offer its patient education information via Elsevier’s Clinical Pharmacology electronic reference. Elsevier will also offer ExitCare licenses to its customers.

Air ambulance operator Mercy Jets implements iPad-based medical records, allowing its medical teams to monitor vital signs and to document care delivered during patient transport.

In England, Northumbria Healthcare NHS Foundation Trust goes live on NextGate’s Multi-Language EMPI for its clinical portal that links multiple systems.


Government and Politics

3-22-2012 10-01-06 PM

HHS launches a developers’ challenge to design Web-based applications that use Twitter to track health trends in real time, allowing officials to identify emerging health issues.

3-22-2012 10-02-16 PM

The FDA’s Janet Woodcock MD says the agency could do a better job of predicting the effectiveness and safety of new drugs if it were able to collect information from the field electronically rather than relying on voluntary drug company reporting.

3-22-2012 8-02-06 PM

mrh_small The State of Maryland, along with the CRISP RHIO and the Abell Foundation, launches a competition to identify innovative ways to improve public health using clinical information available from Maryland’s HIE, either alone or tied into publicly available data sets (motor vehicle records, birth and death, boards of education, etc. or Maryland subsets of federal databases) Submissions can address either general public health issues or ideas related to the Million Hearts initiative to prevent heart attacks and strokes. Prizes are offered and submissions are due by April 16. If you don’t want to submit, you can vote – the first round of vetting and discussion will involve the public, who can participate right on the site.


Technology

Memorial Sloan-Kettering Cancer Center and IBM collaborate to combine the computational power of IBM Watson with MSKCC’s clinical knowledge and data to create an outcome and evidence-based decision support system.


Other

The Saginaw newspaper describes Covent HealthCare’s used of 14 locally trained scribes in the ED to interact with its Epic system while the physician focuses on the patient. Doctors say they save at least an hour for every 25 patients they see.

3-22-2012 7-11-42 PM

mrh_small HIMSS clarifies that hotel rooms for exhibitors at HIMSS13 haven’t been released yet, so they aren’t showing up on the housing site. They says a “blog site” (obviously this one) said they’re full, which isn’t exactly true – a reader (two, actually) told me that rooms weren’t showing up and I said I don’t know anything about exhibitor housing since I’m a provider grunt, but I did see at least 10 hotels showing non-exhibitor availability. Like most everything else at the conference, high rollers (Diamond members) get first crack. It’s like college football programs that require a big upfront donation to earn the privilege of buying expensive football season tickets.

Epic is awarded a patent for a search method that provides a list of possible appointments that match require provider and resource criteria.

Federal agents seize documents and computers from the town hall of West New York, NJ, reportedly investigating possible insurance fraud by Mayor Felix Roque, a physician who runs a pain clinic. Campaign staffers of the mayor’s defeated political opponent admit that they provided information to federal authorities hoping to discredit him.

mrh_small A highly regarded and long-established family clinic in Wisconsin becomes one of the first in the state to stop accepting Medicare, citing inadequate payments and increasing expenses that include $700K for a new EMR. Says the founder: “I love taking care of Medicare patients, but every time we treat them we have to dig into our wallets. What kind of business model is that?” The doctor’s wife says he says up until midnight at home some nights to finish up his EMR charts.

3-22-2012 8-55-15 PM

mrh_small A former patient sues a just-closed eight-bed Ohio hospital, claiming the struggling facility refused to transfer him to a more capable hospital because it didn’t want to lose the revenue. The lawsuit claims that lack of prompt treatment of the man’s infection by Physician’s Choice Hospital resulted in gangrene that required surgeons to perform emergency surgery, which included removing skin from his penis. He said it hurt, of which I have little doubt.


Sponsor Updates

3-22-2012 6-50-24 PM

  • T-System posts a new video showing its T SystemEV EDIS.
  • Lifepoint Informatics announces that its March user conference was attended by over 40 clients, with a keynote address by Bruce Friedman MD on “The Continuous Search for Greater Lab Functionality: Best of Breed LIS versus Enterprise-Wide Solutions.”
  • GE Healthcare will introduce Centricity Cardio Enterprise at next week’s 61st Meeting of the American College of Cardiology.
  • TELUS Health Solutions announces the integration of HIPAAT’s privacy consent management services into its Assure EHR Integration Platform.
  • API Healthcare sponsors the DAISY Foundation, which honors nurses through its DAISY Award for Extraordinary Nurses.
  • MedAssets offers a case study of the $65.4 million it helped Texas Purchasing Coalition save from its supply chain.
  • White Plume releases AccelaMOBILE, a free physician charge capture app for mobile devices.
  • The Advisory Board Company launches its Innovations in Impact grant program designed to reward best practice-driven initiatives that articulate measurable, quantitative outcomes goals. The application deadline for the $20,000 per year grants is April 13.
  • Houston Orthopedic & Spine Hospital achieves Stage 1 MU using the Healthcare Management Systems (HMS) EHR. 
  • Gateway EDI earns full EHNAC Healthcare Network accreditation. Gateway also shares results of ICD-10 preparedness survey, which includes the finding that 56% of practices report are moving forward with ICD-10 preparation despite the enforcement delay.
  • DrFirst congratulates 44 of its EHR partners who were awarded the Surescripts White Coat of Quality for 2011.
  • Nuesoft posts a full transcript of its billing webinar series on third-party insurance billing.
  • An article by Santa Rosa Consulting’s Matt Wimberley discusses the opportunity to improve a hospital’s financial outlook through participation in the MU program.
  • Informatica highlights BCBS Michigan’s ICD-10 transition and Ochsner’s standardization on Informatica technologies for its HIE.    
  • Recondo Technology partners with ZirMed to offer the ZPay credit card and check processing solution.

EPtalk by Dr. Jayne

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Several readers were taken with my article on the caduceus vs. rod of Aesculapius debate. Several mentioned Nehushtan, the fiery serpent used by Moses to heal those who looked upon it.

CMS asks  providers who feel they have received an ePrescribing penalty in error to contact them. Impacted providers may have had their G codes stripped by billing clearinghouses or may have reported the wrong annual code. Problems with hardship exemptions may also be the culprit.

HHS’s Office of the Inspector General approves Ascension Health Alliance to form a group purchasing organization, allowing it to offer its contracting services to hospitals and health systems outside of Ascension. The 21-state Ascension, the largest Catholic healthcare organization in the US, says formation of the GPO “demonstrates our commitment to transform healthcare by 2020.”

A research letter in this week’s issue of JAMA discusses the prevalence of physicians using social media to post unprofessional content online. Surveying state medical boards, the authors found violations that included inappropriate patient communication, sexual misconduct, prescribing without a clinical relationship, and online misrepresentation of credentials.

IBM Research teams with an Italian cancer center on a new analytics platform that will personalize treatment based on pathology guidelines and past clinical outcomes as documented in hospital systems. The Clinical Genomics tool can also provide an aggregated view of patient care.

AMA Board of Trustees chair Robert M. Wah MD reflects on his recent trip to the HIMSS conference, calling it “a gathering of more than 40,000 of my closest friends and colleagues.” Dr. Wah has an interesting pedigree: Navy active duty, deputy national coordinator for health IT and founding staffer at ONC, chief medical officer at Computer Sciences Corp., and head of the Navy’s largest OB/GYN training program. He’s an interesting guy and I am glad someone with his experience is chairing the board. I hope the AMA will show real healthcare IT leadership to reverse the black eye it obtained by blocking ICD-10.

3-22-2012 6-28-25 PM

Speaking of ICD-10 codes, one of my Twitter followers keyed me in to this app available on iTunes. For $24.99 and it only one review, I think at this point I’ll take a pass.

Several readers responded to my mention of the allergist who closed his practice to join the Army as a lieutenant colonel. Rank is apparently based on experience and specialty. One reader told a great story about his own Army service, where he had to take away several service weapons from physicians who mishandled or misplaced them, including one major who left his Beretta in the PX while shopping. That’s a little different than losing your sunglasses or your keys.

A shout out to Children’s Hospital Los Angeles Medical Group, which is hosting its annual “Pediatrics in the Islands: Clinical Pearls” conference in Maui. It’s a great conference. but I think it’s time to include some health IT topics, hint hint. Perhaps a celebrity guest speaker?

Print


Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

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March 22, 2012 News 4 Comments

News 3/21/12

March 20, 2012 News 7 Comments

Top News

3-20-2012 9-41-53 PM

Misys, whose only remaining healthcare-related product that I recall is Misys Open Source Solutions, agrees to be acquired for $2 billion by Vista Equity Partners. Competing offers are possible despite a simultaneously announced Misys profit warning after Q3 revenue slid 12%. If the deal goes through, Misys will join a family of Vista-owned companies that includes Sunquest and Vitera.


Reader Comments

3-20-2012 9-43-37 PM

From HIMSS Benefactor: “Re: HIMSS13. Almost all the decent hotels are already booked. What happened? The W French Quarter has a few rooms left at $909 per night! Too much hassle … will have to skip this one.” I just checked the HIMSS online booking site and they’re showing 13 hotels available to attendees, starting at $155. The four-star Marriott on Canal Street is $230 per night and appears available, as is the close-by Courtyard at $180. I tried several of the travel sites to see if maybe HIMSS hadn’t locked down the whole block, but all showed no rooms available. Major concerns about infrastructure readiness abounded when HIMSS last went to New Orleans in 2007 and the experience was uneven in many hotels and restaurants. Having too few or too expensive hotels would give HIMSS a black eye it doesn’t need after massive attendance in Las Vegas. Let’s hope they just haven’t released all the rooms yet since we’re nearly a full year away. Otherwise, I’m going rent a house or two for the week, bring in sleeping bags, and run a HIMSS Hostel at exorbitant nightly rates. I don’t know where I stayed last time – I only remember that it was forgettable.

3-20-2012 7-18-36 PM

From The PACS Designer: “Re: SMArt. With the release of the iPad, TPD thought it would be the right time to mention The SMArt Platform created by the Children’s Hospital Boston and Harvard Medical School. Travis Good alerted us a year ago about it and mentioned that there is $5,000 prize challenge for the winning design. The SMArt platform is envisioned to be an app store for health, with applications geared towards both patients and providers.”

From Doreen: “Re: HIMSS. You should rent one of the tiny booths for around $5,000, use the fact that you have the greatest advertising strength on earth for healthcare IT to tell people you’ll be there, have guest booth hosts like Ed Marx and Dr. Gregg, and offer giveaways.” I had to embellish the idea, of course, by suggesting that (a) I set it up like a welcome center and offer information on HIStalk’s sponsors, or (b) I find some other company in tiny booth Siberia and tell them I’ll be their next-door neighbor and bring lots of traffic their way if they’ll pay for my space. Then I recruit volunteers to serve as my proxy to host the booth in rotation. I was excited about putting out kegs of beer until I Googled the price at the Morial Convention Center: $450 for crappy domestic brands.


HIStalk Announcements and Requests

Medicomp commemorates Inga’s participation in its Quipstar game on the HIMSS exhibit hall floor with a video. Note the Shoe Cam pictures, security entourage, the IngaTini in her hand, her green M&M snack, and the carefully placed reflector thingy that I bought her as part of her disguise. She was scared to death, but determined to earn Mobile Loaves & Fishes the $5,000 charitable donation offered by Medicomp in return for her involvement.

3-20-2012 8-08-54 PM

Welcome to new HIStalk Platinum Sponsor Jardogs. The Springfield, IL company connects patients, providers, and communities with its Jardogs FollowMyHealth Universal Health Record, an ONC-ATCB-certified cloud-based solution that aggregates information from disconnected organizations (it was recently selected by Iowa Health System, I recall). Patients become gatekeepers of their own information from anywhere in the world using a single comprehensive view instead of running around to a bunch of individual, proprietary patient portals. They can electronically complete physician-requested forms that are pre-populated with the practice’s EMR information, check in for appointments, and get real-time updates. Providers improve their patient relationships and address ARRA incentives for patient access (send reminders, provide electronic copies of results and med lists, share information per patient authorization, and connect to public health registries). The company also offers a patient kiosk that streamlines registration and data collection. Next up: home and wellness applications, such as for home physical therapy and potentially for home monitoring. Thanks to Jardogs for supporting HIStalk.


Acquisitions, Funding, Business, and Stock

RCM provider MD On-Line acquires MD Technologies, a provider of RCM products and the Medtopia Manager PM system.

Axial Exchange announces that its care transition solutions, Axial Provider and Axial Patient, are available for cloud deployment. The Raleigh, NC-based company offers care coordination and communications applications that connect first responders, hospitals, physicians, and health plans via a clinical dashboard.

3-20-2012 7-32-13 PM

In the UK, University of Lincoln and the local hospital trust develop a prototype of an orthopedic surgery training simulator that uses the Nintendo Wii to mimic the use of a surgical drill, allowing surgeons to improve their hand-eye coordination.


Sales

3-20-2012 7-46-17 PM

The non-profit United Health Organization (MI) will use video-to-handheld technology from JEMS Technology to connect patients requiring specialized medical attention with off-site physicians for consultation. Volunteer specialists who can’t leave their practices can visually examine the patient and provide treatment recommendations from their mobile devices.

3-20-2012 9-47-44 PM

DR Systems announces new contracts for its Unity CVIS with Twin Cities Community Hospital (CA), Good Shepherd Medical Center (TX), Healthcare Partners Medical Group (CA), and St. Luke’s Cornwall Hospital (NY).

The Maryland Department of Health and Mental Hygiene awards CSC a $297 million contract to replace the state’s Medicaid management information system and to provide fiscal agent services. The contract is for five years with three two-year options.

The Maricopa County (AZ) Board of Supervisors approves a $4.55 million contract to NaphCare for EMR licenses and installation services for its correctional healthcare system, which lost its accreditation in 2008 for issues that included poor recordkeeping.


People

3-20-2012 6-25-58 PM

Two weeks after agreeing to serve as CEO of Cal eConnect, Ted Kremer withdraws his acceptance and announces plans to stay on as executive director of the Rochester RHIO after learning that Cal eConnect’s funding is uncertain. Cal eConnect interim CEO Laura Landry will assume the CEO post.

3-20-2012 6-28-45 PM

Legacy Health System (OR) names John Kenagy PhD as interim SVP and CIO. He was previously with Providence Health & Services.

Healthcare analytics company Qforma appoints Valerio Aimale MD as chief of advanced products, William Howard PhD as SVP of new product development, and Delphina Perkins as director of client services.

3-20-2012 6-32-28 PM

Authentidate Holding Corp. names former Viterion Telehealthcare CEO Sunil Hazaray its chief commercial officer.


Announcements and Implementations

3-20-2012 6-33-20 PM

Cookeville Regional Medical Center (TN) implements MEDHOST’s EDIS.

Susquehanna Health Partners (PA) adopts Summit Healthcare’s Downtime Reporting System to address its business continuity and data protection needs.

3-20-2012 6-43-48 PM

Practice Fusion launches its research website to help public health agencies and physicians predict and manage outbreaks.

3-20-2012 6-58-48 PM

Objective Health, part of McKinsey & Company, announces the release of its Objective Scorecard performance dashboard and analytics solution for hospital executives.

UPenn Health System goes live on Brainware and Ascend solutions for accounts payable automation, helping it manage paper invoices and integrating with its Lawson ERP system.

The EZ DERM iPad EHR adds speech recognition using Nuance’s cloud-based technology. I accidentally strayed onto the cool new EZ DERM video above on YouTube. The company modestly calls its product “The Best EHR in the World.” I can’t vouch for that, but it might well make the best EHR videos in the world.

SAIC’s COO talks up the company’s Vitalize Consulting Solutions acquisition in Tuesday’s earnings call: “SAIC’s acquisition of Vitalize Consulting Solutions continues to support strong, double-digit growth in the commercial health IT arena.” In not-so-positive news, SAIC racked up a $161 million Q4 loss after setting aside $500 million to settle a criminal investigation involving cost overruns on a payroll system it developed for New York City.


Government and Politics

ONC releases a new version of its Connect software that incorporates updated technical standards and descriptions for the NwHIN Exchange. Connect version 3.3 supports such functions as patient discovery, document queries, and information retrieval.

Louisiana behavioral providers say that the state’s new Medicaid reimbursement software, which was supposed to make their claims submission easier, isn’t working. Providers say they can’t always enter new client information and some of what they’ve entered was lost, the progress notes function isn’t working, and nobody’s been able to bill for their services.


Other

TeleTracking posts a fun video of The Capacity Blues, a Cajun-flavored piano tune written and performed by one of its employees in honor of its upcoming New Orleans patient flow symposium.

3-20-2012 7-11-58 PM

Divya Shroff MD, HCA’s chief clinical transformation officer, writes a company blog post called Can Access to an EKG on your Phone Save a Life? in discussing the company’s collaboration with and investment in AirStrip Technologies. Her example involves door-to-balloon time for cath patients, with the potential to send EKGs directly from the ambulance to the cardiologist as both are in transit to the hospital.

I’m watching interviews filmed at HIMSS in Las Vegas by EHRtv that our pal Eric Fishman MD has been posting. Here’s one with Matthew Hawkins, CEO of Vitera, and here’s another with Shareable Ink’s Stephen Hau.

In England, hospital officials admit that they ordered the IT department to clone and snoop around the computer hard drive of a whistleblowing doctor who complained about unqualified staff and and was later fired. His boss justified the action, saying she had heard from employees that he was on the Internet a lot and wasn’t seeing enough patients.

The local newspaper interviews eClinicalWorks CEO Girish Kumar Navani.

Dr. Wes says EMRs bury doctors in data without giving them useful information:

There’s so much data that we risk doctors becoming lost in it. It is entirely possible that we are in danger of not being able to find our most important clinical signals amongst the noise and clutter of all the data. Worse: time with patients is disappearing. Our health care information gold rush has acquired teams of programmers to feverishly implement a myriad of bureaucratic information system requirements in just a few short years. To this end, these programmers have been extremely effective. But almost as incredibly, these same programmers have little perspective of what physicians do or how we interact with patients and THEIR data. As a result, doctors are not only confronted by all of this this information placed before them, but waste precious time sifting amongst the data and continue to be the fall-guy for data entry. Codes, quality measures, documentation requirements and, oh, yeah, the progress and operative notes, are all being entered by doctors. In return, our screens have become crowded intersections of buttons, flags, options, icons, colors, warning alerts and (if we’re lucky) text. Oh yeah, and a new “upgrade’s” coming next week.

3-20-2012 9-08-52 PM

Note to companies: just in case you can’t spell HIPAA correctly, at least leave it out of the press release’s big-font headline.

University of Louisiana at Lafayette is looking for healthcare geeks to participate in its free Cajun Code Fest on April 27-28. Speakers include US CTO Todd Park, Intel’s Eric Dishman, and the guy who founded Priceline.com.

3-20-2012 9-52-31 PM

A Crain’s New York study finds that the 25 highest-paid New York City hospital executives earned a combined $60 million in 2010, with New York-Presbyterian’s Herbert Pardes topping them all again at $4.3 million.


Sponsor Updates

3-20-2012 6-46-28 PM

  • CapSite GM/SVP Gino Johnson will provide an overview of the HIE market at next week’s 4th Annual Health IT Insight Summit in Boston.
  • Liaison Technologies will offer Preventice’s wireless monitoring technology to collect and transmit patient data via its cloud services.
  • Bloomberg Businessweek profiles Digital Prospectors Corp.
  • CTG Health Solutions will participate in the Allscripts Central Region Users Group meeting in Des Moines, IA on April 19.
  • Trustwave completes its acquisition of M86 Security.
  • Health Care DataWorks selects Health Language’s Language Engine to map disparate data into its data warehouse.
  • BESLER Consulting will use the Inventu Flynet Viewer to give its hospital customers access to the Medicare Common Working File stored on 14 CMS mainframes, allowing faster and more efficient claims review.
  • DIVURGENT’s David Shiple discusses the proposed MU Stage 2 emphasis on personal health records vs. low consumer interest in using them in a blog posting.
  • The local paper discusses Premier Health Partners’ use of MEDSEEK’s predictive analytic tools for targeted consumer mailings.
  • Merge Healthcare and AG Mednet partner to integrate AG Mednet’s image collection platform with Merge’s Clinical Imaging Management System (CIMS) to enable higher quality images and data flow directly into Merge’s CIMS and EDC solutions. 
  • Capsule announces that it has surpassed the 1,000 mark for healthcare organizations using its medical device integration solution, including 200 new customers added in the last four months.

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

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March 20, 2012 News 7 Comments

Readers Write 3/19/12

March 19, 2012 Readers Write No 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!

Sampling the Legislative Sausage
By Civics 101

Be careful reading the proposed Meaningful Use regulations. Note the “proposed” part. As a Notice of Proposed Rulemaking, it’s unwise to ignore any part of the document.

Every word in the document – even in the preamble — has survived numerous rounds of federal vetting. Every section is important, but especially so are those areas in which public comment is invited. Objectives may be added or removed, so don’t get hung up on those to the exclusion of the preamble or the overall intention.This is not a set of business requirements that is ready to be handed off to programmers to implement.

Read the NPRM as a big picture, keep an open mind, and try to understand the intention, not just the tentative objective list. And above all, don’t forget that while Stage 1 is locked in place, Stage 2 isn’t. My organization and yours need to study the NPRM carefully and comment on what we like or don’t like about what’s been placed before us. Remember all the changes that were incorporated between the Stage 1 NPRM and the final version? Every one of those came as a result of public feedback.

Using the iPad in Surgery
By Michael B. Peterson, MD

I use the iPad every day while rounding at work and connected to the encrypted hospital wireless network, finding web information for patients and showing educational videos. I use a Bluetooth keyboard and sometimes a stylus that fit into a netbook soft case when I need to do heavy typing.

We were doing a complicated vascular surgery, an axillary femoral femoral bypass. I had dissected out the blood vessels on the right groin, but the surgeon working on the left could not locate the critical arteries and branches. The patient did not have any pulses in the groins because of severe vascular disease.

I had the nurse drop the iPad into a sterile sleeve and seal it. I used it to pull up the CT scans on the table and paged to the proper level so we could compare the right to the left. Then we knew where to go. We could place the iPad right on top of the patient and visualize what we needed.

Then while my colleague and our PA completed the left side, I checked my Lotus Notes e-mail, went into the vascular econsult program and triaged some vascular consults to the appropriate clinics, and checked my inbasket in our Epic EMR to read labs and answer messages (the iPad runs Epic very well.) When I was done, we were ready for the rest of the surgery.  

The x-ray viewing is an innovative project on which we are partnering with with Thinking Systems.

We are using the latest Citrix Receiver to host our version of Epic on the iPad and other devices as well. Since the rollout of Epic Summer ’09 across the country in all Kaisers, the old web address we used for Spring ’06 access no longer works for the iPad. In addition, there are additional video requirements for Summer ’09 that our current web servers need that the Citrix receiver cannot handle. Attempting access to the Summer ’09 environment will result in a connection failure with a “USKIN” error message.

Fortunately our Kaiser web engineers were aware of this and understood the need for iPad functionality. They created special web addresses for Kaiser iPad users in Northern and Southern California, Hawaii, and Pacific Northwest. The official term is PNAgent Site. Setting it up is complicated, but the iPad works very well.  

Of course there are ergonomic challenges with a smaller screen, and accurate tapping is critical. But it is so fast and convenient — you don’t have to wander around looking for an unoccupied keyboard and computer. If I need to look up something, I just do it where I am. It has really spoiled me.

I don’t know if there is any way to demonstrate improved outcomes with the iPad. Kaiser is starting to roll it out to other medical centers with different specialties. My general feeling is that with the EMR, there is a 20% productivity hit with data entry and typing your note. It does take longer on the generic computer, but the the iPad is so much faster and it literally puts the medical record at your fingertips… or perhaps the patient’s.  

I plop the iPad down in front of the patient and point out pictures, diagrams, and a quick graphic plot of their rising creatinine. I run the lymphedema pump movie to show them how it works, or review the online video again to remind me or others how that endovascular closure device works again before I actually do it.  

I have invested the time it took to get comfortable with the iPad and arrange it the way I want. I could not do without it. I have very little specialized software on the iPad except for the VPN and the Citrix Receiver. And my medical apps, books, and games!

3-19-2012 8-05-25 PM

Michael B. Peterson MD is a surgeon with The Permanente Medical Group in Hayward, CA. His use of the iPad in the operating room was featured in the April 2012 edition of Macworld. Since Mike is an old friend of HIStalk, I asked him for more detailed information, which he provided above.

What Do You Do Regardless? Five ICD-10 Steps To Continue
By Torrey Barnhouse

3-19-2012 7-40-48 PM

The AMA lobby is strong. US government program delays are common. The two came together on February 16, 2012 when Health and Human Services Secretary Kathleen Sebelius announced a potential delay in the October 1, 2013 deadline for ICD-10 implementation.

The announcement, made just before the start of the HIMSS12 Annual Conference, left a lot of attendees scratching their heads and asking themselves, “Now what?” Most agreed a delay of one year or less gives everyone more time to prepare, train, and test. However, a delay of greater than one year spells chaos for healthcare providers and payers.

While at HIMSS, TrustHCS had the honor of sponsoring an executive roundtable on ICD-10. During the roundtable, speakers discussed five ICD-10 projects that should continue full steam ahead despite the delay. It’s a good list and worth sharing.

In general, the panel’s advice was to identify ICD-10 tasks that have collateral benefit for ICD-9 coding. These are the tasks that should be continued until such time as HHS makes another announcement regarding their plans, intentions, and deadlines.


Vendor and Payer Assessments

Continue checking with vendors and payers to see when systems will be ready for testing. Know what the ICD-10 upgrade will cost your organization, if anything. If your vendor simply can’t accommodate, start evaluating new systems to replace them. Conduct ICD-10 testing with your payers whenever and wherever possible to help reduce backlogs and denials upon go live.

Clinical Documentation Improvement

Any improvement in clinical documentation specificity and granularity will help support better, higher quality coding and reduce time wasted querying physicians. Coders can only code what is documented. This same core principle applies in ICD-10. CDI programs must be continued regardless of a delay.

Coder Biomedical Training

While educating coders in the finer nuances of ICD-10 coding can be postponed, strengthening their knowledge of the basics can’t. Many coders graduated from programs 10, 15, or 20 years ago. Medical science and our knowledge of anatomy, physiology, and disease processes has grown exponentially. Now’s the time to make sure your coders are brilliant at the basics. Anatomy and physiology training should continue to be conducted: online through a service provider or at a local community college.


Computer Assisted Coding (CAC) Technology

Coder productivity is predicted to drop by 50% during the implementation of ICD-10 and perhaps remain 10-20% below normal output for ICD-9 coding. CAC systems help offset this productivity loss by electronically “reading” the record and suggesting codes to the human coder. While CAC systems don’t replace coders, they do make them more productive and efficient. The delay provides more time for organizations to evaluate and implement this technology.

Assess and Refine Your Work Plan

Conduct a methodical step-by-step review of your initial plan. This process will identify which tasks can be pushed out and which cannot. The review will also uncover other tasks that have collateral benefit for ICD-9. For each task in your work plan, ask yourself, “Does the delay impact this task?”

Industry experts are already predicting the cost of an ICD-10 delay. Other experts are predicting lawsuits by providers to help recoup monies already spent. This expert simply suggests that you stay the course and keep working toward ICD-10 preparedness. We will all have to get there eventually. Better to be early than late on this one!

Torrey Barnhouse is CEO of TrustHCS of Springfield, MO.

 

Viva la CPOE!
By Daniela Mahoney


3-19-2012 7-08-23 PM

According to the HIMSS Analytics EMR Adoption Model , CPOE adoption remains steady at a rate of 13.2% for the past two quarters. And in recent months, many hospitals achieved the first stage of Meaningful Use. Congratulations to all!

 

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However, looking at the story behind CPOE implementations reveals that adoption struggles continue —regardless of the vendor system. Many community hospitals expend great effort and many dollars meeting Meaningful Use criteria, but additional time and money is also spent avoiding a full-blown revolution within their provider community because of CPOE implementation.

Technology is really only 15-20% of a CPOE implementation. Process, acceptance, culture, and constant transformation are the parts that truly define the difference between CPOE failure and success.

At the end of the day, technology’s golden purpose is to support the infrastructure: devices, performance, remote access, integration/interoperability, streamlined single-sign-on, and ease of navigation. But even when working flawlessly, it’s still an uphill battle capturing provider adoption on that much-needed “voluntary basis.”

I can always hear the physician protests, even when left unsaid: “Why should I use it?” “What is in it for me?” “Show me the money, Jerry.”

The question remains: why? Why won’t providers embrace new CPOE technologies and take advantage of the wonderful features, such as clinical decision support or evidence-based order sets that streamline the admission process?

Truthfully, there is nothing wrong with the providers’ feelings here. They simply know what’s at stake. And the odds are not in favor of CPOE, despite the benefits we may see through our own rose-colored glasses:  “Oh, how it benefits the patient! Why don’t you providers just snap out of it and embrace CPOE for the people, or at least for the children?”

Kidding aside, what a new CPOE system takes away from providers is TIME.

… at least for a while.

Time is a provider’s most precious commodity. A new system changes the way they work and takes time away from office hours and family. Time is irreplaceable and invaluable.

But the Meaningful Use mandates say “so what” and to just do it and accept it. CPOE is a reality and must be part of every provider’s future in the hospital or in the office. With that, I sympathize. Providers may have cause to rebel.

I spent some time researching literature while preparing this article, looking at provider efficiency with CPOE. Many studies are relatively old, done in the ‘90s or early 2000s. Not to dismiss their importance, but many issues experienced then have been since resolved with today’s systems. In retrospect, they really aren’t relevant.

But one thing overlooked then and now, to me, is the most important question: what is the right value proposition to the provider?

The answer? One that fits a provider’s community and meets their conditions to accept CPOE into their domain.

With 22 years invested helping providers through CPOE adoption , I found only one simple and effective system pitch. Be truthful and realistic. That’s what works. That’s what opens door and also ears.

For example, we can’t deny that it typically takes significant time to adopt and adjust to a new system, and that efficiency improves only with consistent use. Additionally, never overpromise that CPOE is faster than handwriting an order or checking boxes on a pre-printed order set. I can tell you, that approach doesn’t work.

Once providers are engaged, gather the value proposition’s building blocks by talking and listening to them –  eliciting their concerns, needs, and requirements — and also identify opportunities for compromise.

Usually during interview sessions, similar things are voiced. And believe it or not, it’s less about Meaningful Use (understanding the “benefit” of hospital reimbursement is typically demonstrated by only a few) and more about the direction of technologies in healthcare and reporting requirements and how it affects the way they practice medicine.

For example, for some it is important to have remote access, and not just to CPOE, but to also do other tasks, such as signing their charts. And from others, I often hear how they would prefer using their own laptops or iPads, so they do not need to compete for devices.

Here are some very telling interview quotes from providers about CPOE adoption:

  • “Access from outside of the hospital, home access would be great.”
  • “CPOE should be a resource for us. It should not make us work harder to accommodate it.”
  • “Ease to use and quicker order entry is most important.”
  • “Online view of medications administered would be a great value.”
  • “Reduces errors and provides clarity of medical orders. There must be a safety net if errors are made, especially with residents. Incorrect orders need to be stopped.”
  • “A quick-pick list for providers would be nice.”

In the end, the right value proposition delivers the commitment of the hospital’s leadership to respond to what providers say and need. It engages all providers and can convince them to fully adopt CPOE as part of their workflow—especially with respect to efficiency in daily operations.

Providers become very reasonable and willing to compromise if engaged and their voices heard. Realistically, you cannot fulfill every need, but it is still important to listen and respond. The hospital’s leadership must be proactive and have a solid communication plan to manage expectations at different levels before, during, and after implementation. The direction of CPOE within the organization must be clearly defined, from the adoption and training to the deployment strategy. Lastly, completing a cultural evaluation the provider community provides tremendous insight into defining the value proposition which is the foundation of your CPOE success.

Let them eat cake, because we’re having crepes …

3-19-2012 7-15-24 PM

Here is a simple but delicious nutella-banana crepe recipe enjoyed by our family. Bon appetit!

Daniela Mahoney, RN BSN is vice president of Beacon Partners of Weymouth, MA.

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March 19, 2012 Readers Write No Comments

HIStalk Interviews Brian Phelps, CEO, Montrue Technologies

March 14, 2012 Interviews 1 Comment

Brian Phelps MD is co-founder and CEO of Montrue Technologies of Ashland, Oregon. The company’s Sparrow EDIS for the iPad was the grand prize winner in the 2012 Mobile Clinician Voice Challenge, presented by Nuance Healthcare.

3-14-2012 7-02-41 PM


You’re an ED doc. Why did you develop Sparrow EDIS?

I’ve been in practice for 10 years. I’ve had the good luck — or bad luck, depending on your point of view — of being involved in a few software implementations. One of them failed spectacularly. I felt like I learned quite a bit about the good and bad of software in the ED. I thought about the culture of the companies that are offering software and how to make the culture better suited coming into that environment.

When the iPad came out, it was pretty obvious that that was the future for us. I assembled the team and here we are.

Is the iPad application just for presentation using other systems or is it a completely separate application?

It’s a native iOS application that communicates with the Sparrow Server that then integrates with the underlying EMR. It’s an abstraction on top of the underlying EMR, but as far as the user experience is concerned, they’re in a purely Apple environment.

Describe the product and how they’re using it.

The Sparrow Emergency Department Information System includes patient tracking, order entry, physician and nurse documentation at the bedside, discharge planning, and prescribing. They’re doing all that on the iPad at the bedside. You don’t have to interact with the PC workstations any more with our system.

Does everybody use it? Is using it mandatory?

We’re the whole product, so we come in with the devices as with the software. We’re in pilot phase now so there’s some details to be worked out, but the idea is that that we provide the whole solution, including white coats that have pockets big enough to hold it and the stylus if you want it. Doctors and nurses and registration all are using the devices. 

At HIMSS, I learned a lot and met a lot of great people. One of the themes that kept coming back was getting doctors on mobile devices and the “bring your own device” mentality, which I think is a symptom of a disease and not a cure. The disease is that consumer technology has so rapidly outpaced enterprise technology that it’s making end users crazy. They’re coming in with these personal devices and they’re demanding to connect. They’re using Citrix and whatever else they can and it’s not providing a very good user experience. 

Nobody ever asked me to bring my Dell on wheels to the hospital. Ideally the hospitals will recognize that the users have spoken and these are the tools that they think are right for the job. That’s where we come in and deliver the right tools and the right software, all locked down in a secure environment.

How do you determine the success of the product if users can still use the underlying systems directly?

They can use the underlying systems to review records and place orders in the hospital information system, but we have order sets and a workload that is specific to emergency medicine. There are no longer paper charts when we come in. If they want to use the order sets that they have created, they would be using the iPad.

What tools did it require to create the iPad application?

It’s a lot. We have a server that runs SQLite. All of the devices run our application, which is in Objective-C for iOS. Our server and our iPads come in. There’s an interface that’s required to exchange data in HL7 with the inline EMR.

We have a strategic relationship with Nuance and they’ve really helped build out our product. Their SDK was very easy to use — it literally it took a few hours to get up and running. We have a relationship with LexiComp to do medication interaction checking and allergy checking on the devices and several other strategic business relationships that flesh out the product.

3-14-2012 7-14-59 PM

So it was easy to integrate speech recognition using the Nuance tools?

It was great how astonishingly easy that was. We had planned on speech integration from the very beginning. For all their wonderful qualities of iPads, the input mechanism for narrative is one of its minor weaknesses. We always knew speech was going to come into play. In fact, we built our application around it before we even knew that it was going to be technically possible. 

We had our eye on Nuance. When they released the mobile SDK, we snapped it up. The next day, we literally had a fully speech-enabled application.

Describe how the application uses speech recognition.

The thing about speech and documentation in medicine in general is that it allows you to capture the narrative. The patient’s story is really the heart of the patient-doctor relationship. There is no way that can ever accurately be captured by pointing and clicking. I can give you several examples of where template-driven documentation of the patient’s story led to harm. 

Building in speech recognition for the history of present illness and medical decision-making is really important. But we have to balance that with structured data to meet compliance and other measures, and also because there are some areas where structured data is perfectly appropriate. Medication reconciliation, for example, or even in our case we have templates for building physical exams and reviews of systems. 

Finding that balance between the unstructured narrative and the structured data input is what the iPad is ideal for, because as you’re sitting there with a patient, you basically can tap along and review their history and enter the important information. Then as you’re going to the next patient, you can speak in the parts of the encounter that are unique to that patient, namely their story.

What advantages does the user get from using an iPad application?

The biggest advantage is using the Apple navigation paradigm. We’ve been in a design relationship with Apple for about half a year. They’ve been advising us and getting it to be simpler and faster and more intuitive. The fact that it runs natively on the device means that it is incredibly fast and easy to use. Anyone who has used an iPhone or an iPad and used any of the native Apple applications knows immediately how to use our system.

It’s hard to overstate the importance of having something that sits in your lap while you’re engaging the patient. We’ve been speaking and poking at things for a million years as humans. We’ve only been pointing and clicking for 20. When patients are scared or in pain or feeling vulnerable, it’s almost cruel to turn away from them to click away on a QWERTY keyboard.

One of the themes that kept coming back at HIMSS was patient engagement. It means different things to different people, but in my line of work, I’m trying to engage the patient who’s sitting in front of me. I don’t think that you can engage patients with technology or with the latest application. You engage them by looking them in the eye and asking good questions and listening carefully and showing compassion.

Technology has only interfered with that process. The advantage of our system is that we get out of the way and allow doctors and nurses to interact with their patients in a way that they know how to do.

During your pilot phase, what are you measuring and what kind of response are you getting back?

We’re integrating the back end and we’re not live with patient data yet, so that’s coming up. When that happens, we’ll be measuring productivity, patient and physician and nursing satisfaction, and of course compliance with Meaningful Use.

Did you form the company just for this product or you have other products?

We formed the company with the goal of bringing mobile technology to emergency medicine. We had thought about strategy of having different sub-modules, but when it comes down to it, if you’re going to be successful in emergency medicine, you have to completely replace the three-ring binder. We spent two years building out every aspect of what had been a paper interface into our system. We are currently a one-product company and that’s our emergency department information system.

You said you designed the product around speech recognition even though it wasn’t available at the time. Do you think somebody could develop a comparable product without using it?

I think it could be done, but I think that the narrative input mechanism would be challenging. One possibility would be to have Bluetooth keyboards in each room and you pop the iPad in and type away your narrative, but I don’t see that it would be as effective. The combination of tappable templates plus speech for narrative on the iPad is really a match made in heaven.


At HIMSS there were companies at different stages of doing work on the iPad. What was your general feeling about where the industry is right now with the use of iPads? Did you expose your product to anyone to get a reaction?

We had an opportunity to present at the Venture Forum as well as on stage at the Nuance booth. We got lot of great feedback.

I think it’s very exciting what Epic is doing with their iPad interface. PatientKeeper has an excellent product. Nobody is doing exactly what we’re doing. We’re pretty thrilled that these other companies are demonstrating that there is a large, important market here. Beyond that, we take all that energy we might be thinking about competition and try to drive it back into our product and make it better.


Were you surprised that you were named the winner?

[laughs] I thought there was a pretty good chance we had a shot.

How will you use your prizes?

The best thing that came out of this was a deeper relationship with Nuance, who has been wonderful and supportive throughout. Just the recognition that that has brought to us has been phenomenal.

Assuming your pilot is successful, where do you go from there?

We’re making the product back end-agnostic, so any hospital that has an EMR that is struggling with workflow in their emergency department is a potential customer. There are at least 3,500 hospitals that meet that description. We’re pretty confident that as this wave of mobile devices washes into the mainstream, there will be a significant demand. The next step for us is to continue to make the product simpler and faster and more intuitive and then to connect with paying customers.

Typically that’s hard for a small company because it’s difficult to mount up a sales force. Do you see yourself selling directly into individual hospital emergency departments or partnering up with a specific vendor to make it an add-on?

We have been working on some channel partners. One strategy for us has been to look at the relationships we have with interface vendors to assuage the interoperability concern. We are pretty excited about the relationship that we built with Apple and we see a lot of ways that they — as part of their ambition to enter the enterprise space — could really be helpful for us getting in the mainstream market.

So far, our feedback from doctors and nurses has been fantastic. We’re pretty confident that we can leverage that groundswell of enthusiasm from end users to develop a relationship with their executives. To them, we will be focusing on our profound return on investment, which comes through improved charge capture.


I’m glad you mentioned that since I assumed the pitch would strictly be clinician satisfaction.

When software deployments fail, that’s the majority of the time due to physician rejection. Clinical informatics people really do have an incentive to make sure they’re finding a product their clinicians like to use. That’s one part of it.

The other part is that we capture charges just through the process of simple tap documentation. One of the commonly missed charges is IV start and stop times. Our system triggers the appropriate documentation, which we think will improve charges by about $40 per patient. There’s a thoroughly profound return on investment for executives as well.

The big challenge is that the gatekeepers tend to be the folks who have the least direct benefits from the application. Our goal now is to try as best as we can to understand what their needs are and meet those needs while still delivering a very usable product for these doctors and nurses.

Do you have any final thoughts?

This may resonate with you and what you’ve done with HIStalk, which has been phenomenal for me to learn about the industry over the last couple of years. When you really believe in something strongly as we do and you‘re willing to work at it, if you’re on the right track, doors start to open and more opportunities present themselves. That’s where we’re at with Montrue. We’re pretty happy that we’re on the right track and we’re excited about what’s to come.

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March 14, 2012 Interviews 1 Comment

Monday Morning Update 3/12/12

March 11, 2012 News 2 Comments

From N2InformaticsRN: “Re: Ed Marx and Jim Murry. Did a nice job discussing mobility in healthcare on CIO Talk Radio.” That’s pretty cool – the audio sounds like a real radio station.

3-11-2012 10-12-35 AM

From @Cedars: “Re: Cedars-Sinai CPOE go-live. As a consultant going from project to project, it’s easy to forget why I began to work in healthcare, but this weekend I was reminded of it. This means everything to our industry, as past failure is redefined forever. This project has been done right in every way. I was inspired by this note from CIO Darren Dworkin. Please, please interview him.” I think I’ve asked Darren before. The CPOE implementation and quick de-implementation at Cedars-Sinai years ago gives it an honored spot in the Healthcare IT Failure Hall of Fame, right up there with BIDMC’s massive network outage, Kaiser’s waste of $500 million hiring IBM to develop IT systems that were abandoned before completion to instead passionately mate with Epic, and El Camino’s near-shutdown after implementing a patient-endangering Eclipsys medication solution. Feel free to suggest new nominees since every one of these examples provided painful but valuable lessons for not just those involved, but also for the rest of us gawking at the smoking wreckage from the safe side of the “do not cross” yellow tape. All of those organizations learned from their mistakes and came back better than ever, although iterative learning isn’t necessarily a good thing for patients.

3-11-2012 2-23-14 PM

From Sinking Ship: “Re: GE Healthcare. Cancels the 2012 Healthcare Technology Symposium due to mounting budget pressures.” The reader provided a copy of what appears to be the announcement letter from VP/CTO Mike Harsh. UPDATE: I asked GEHC what this event is since I could find no reference to it. It’s an internal-only event, so it has no customer implications.

From Bed Manager: “Re: HIMSS13. They are pre-booking hotels and relatively few rooms are available in New Orleans. Did attendees wise up and book early, or are rooms being held back for exhibitors, or does New Orleans just not have enough rooms to handle the increased size of the HIMSS conference? Both hotels of my choice are sold out and they aren’t even in the HIMSS block.”

From Epic Employee: “Re: Farzad Mostashari. Will be speaking at Epic on April 24. Pretty cool.”

3-11-2012 5-36-55 PM

From John: “Re: HIMSS conference exhibit layouts. The problem was because it was at the Sands Expo Center instead of the Las Vegas Convention Center, which has high ceilings and a long hall. I heard that the conference was supposed to be in Chicago but fell through at the last minute, leaving the Sands as the only alternative. HIMSS missed revenue since it sold out the Sands space weeks before the show, although I liked the Sands because it involved less walking and easy access to the Strip.” I don’t know if HIMSS planned to return to Chicago after what I would consider a predictably terrible first and only trip there (snowstorms even after screwing up the schedule by moving the event back, surly union workers in the hall, wildly overpriced hotels), but I thought they originally announced a permanent rotation of only Orlando, New Orleans, and Las Vegas. I don’t think that plan lasted long since they’ve been to Atlanta since then. New Orleans was OK last time, but that was right after Katrina when hotels and restaurants really didn’t have enough employees to keep things running smoothly. I’ll still hold out for San Diego as my favorite HIMSS experience and I heard they were expanding the conference center to handle the huge annual comic book convention.

3-11-2012 3-54-12 PM 

From VA Doc: “Re: digital pens. The VA puts out an RFI for the technology, which has matured to the point where it makes sense to move beyond case studies.”

3-11-2012 3-59-11 PM

From MT Hammer: “Re: Clinical Documentation Industry Association. Ceasing operations, annual conference in Baltimore cancelled, financial pressures cited.” CDIA was a trade association for clinical documentation services, basically transcription. HIMSS could have possibly taken it over given a few familiar names among its dwindling list of members: Acusis, Arrendale, Diskriter, MD-IT, MedQuist, M*Modal, Nuance, and Verizon. The former Medical Transcription Industry Association (MTIA) rolled out its new name at the HIMSS conference in 2011, but a year later, both the organization and the conference are defunct.

From Sagacity: “Re: International Society for Disease Surveillance. Seeking comment on syndromic surveillance guidelines for the ambulatory and inpatient settings, targeting potential application for Meaningful Use Stage 3. The organization did the same thing for emergency and urgent care in the past, which led to MU Stage 1 specs.” Information here.

3-11-2012 4-51-26 PM

From Just a HIT Guy: “Re: WellStar. Moving off McKesson, NextGen, and GEMMS Cardiology, going to Epic. Internal memos released this week.” I’ll list this as unverified because I agreed to wait for a formal announcement as a courtesy to WellStar, but as usual, the organization’s long list of inpatient Epic job listings tell you everything you need to know anyway.

From EMR_Guru: “Re: WellStar. Announced to physicians they are scrapping NextGen and going with Epic. Wellstar has acquired a large number of physician practices over the last several years, Imagine getting bought and deploying NextGen only to be told a few months later that you have to scrap it and go with Epic.” That’s one of many risks involved in deciding to work for a hospital instead of for yourself.

From Prevailing Winds: “Re: Allscripts. You mentioned a vague acquisition rumor about Allscripts and IBM, but here’s something I’ve heard mentioned that I should say is completely unsubstantiated but potentially related. I’ve heard rumors of a potential buyout of Xerox/ACS by IBM. Allscripts remote hosting is outsourced to Xerox/ACS, so maybe the rumors refer just to that business instead of the whole company. Just rumor mill grist that may or may not mean anything.”

From Bony Moroni: “Re: HIMSS evaluation survey e-mail. It contained confusing instructions, misspellings, and a splash screen apologizing for errors in the e-mail. And we wonder why our industry is the butt of jokes by non-healthcare people. Here’s a crazy thought for an IT association in an industry known for sloppy work: test the damn e-mail merge program first. Not only was the merge done incorrectly, the ‘brief survey’ has a million questions on 11 pages, a status bar instead of an idea of what’s to come, and a pointless listing of the name and company of each recipient apparently just because they could. Obviously this is a contracted vendor, but does HIMSS really want this shoddy effort being the last thing people remember about the conference or the quality of work that HIMSS puts out?”

I’m back and rested after a week off out of the country, woefully behind, facing 500+ e-mails in my inbox, and regretting the loss of an hour due to springing forward since I’m already re-immersed into chaos even before I get back to my “real” job at the hospital. Actually I’m not that well rested since I got only four hours’ sleep Saturday night after downing my first-ever Red Bull to stay awake until  getting home at 3:00 a.m. Still, I’m happy to be back in my multiple saddles even though the horses tend to take off in different directions most of the time. Thanks to Inga for  keeping the HIStalk fires burning in my e-mail free absence. I’m sure I’ll repeat some items she’s already mentioned in trying to catch up, but that should be a one-time occurrence before things get back to normal with Tuesday’s news.

Thanks sincerely to everyone who completed my annual reader survey. It helps immensely and I’ve already made a to-do list for the next year based on the results. Obviously I almost cheated on my no-Internet vacation pledge to Mrs. HIStalk, but rationalized it to her by explaining that it took only seconds to download the results, even if I did spend several frowning and chin-stroking hours thinking about them and furiously taking notes. The preponderance of supportive comments was touching, although I probably won’t run them all here since that seems rather vain (as does re-reading them repeatedly, but at least I keep that particular vanity to myself.)

3-11-2012 8-55-10 AM

Readers grade ONC’s MU Stage 2 performance as maybe a D+. New poll to your right: does your PCP document your encounters in an electronic medical record? Mine does, even though the system he uses is about to get the boot in a hospital-mandated EHR replacement.

How did your Daylight Saving Time switchover go? Let me know if you had problems at your hospital. I’m always curious since vendors (some at my hospital, anyway) still haven’t worked out the bugs and punt by just suggesting shutting everything down for a couple of hours. Most of the problems are in the fall, when the “fall back” causes the 2:00 a.m. hour to be repeated, driving some badly designed systems crazy.

My Time Capsule editorial this week happens to be maybe my favorite one (at least until next time): Want to Anger a Nurse? Make Smug Comments about Grocery Store Barcoding. A desensitization dose: “They would buy Doritos by the bag, but would have to repackage and label individual chips and then track every chip – who bought it, who ate it, and whether they ate it in an appropriate quantity and with only complementary foods and according to dynamically calculated nutritional needs. ”

3-11-2012 8-51-51 AM

Fujifilm Medical Systems donates $25,000 to a laid-off radiology tech to save her foreclosed home, as seen on the Ellen show. 

3-11-2012 9-08-31 AM

Former HHS CTO and athenahealth co-founder Todd Park is named CTO of the United States, replacing Aneesh Chopra. Who would have put their money on the first HIT’er in the White House not being Allscripts CEO Glen Tullman?

3-11-2012 9-22-27 AM

Doug Stacy is named CIO at Labette Health (OK.) He was previously CIO at Coffeyville Regional Medical Center (KS.)

3-11-2012 3-50-22 PM

Dean Marketti, previously with BCBS, is named the first CIO of Morris Hospital & Healthcare Centers (IL.) I almost gave up trying to figure out what state the hospital is in given the common small-town newspaper website practice of not giving their location, apparently convinced that if you don’t already know, you couldn’t possibly care. Which I’ll concede is pretty much the case. 

Scott & White Healthcare names Matthew Chambers as CIO. I’m guessing he was interim while working for KPMG since his LinkedIn profile says he’s had the job since July 2011.

Holon Solutions (solutions for telepharmacy, order entry, results reporting, and the CollaborNet data sharing solution) names industry long-timer Mike McGuire as CEO. He was previously with MET-test.

3-11-2012 9-32-27 AM

Cincinnati Children’s Hospital (OH) and the local technology incubator launch QI Healthcare to commercialize the hospital’s quality improvement software that analyzes EMR data to identify improvement opportunities. I’m a bit skeptical about how easy it will be to commercialize any EMR data analysis application given the inconsistency in how each product and user stores and uses data, but hopefully they will figure out how to make that giant leap from Customer #1 to Customer #2. It took forever to find the startup’s Web page, which appears to be due to a combination of (a) lack of search engine optimization and Web content (just a leering stock art doctor on a GoDaddy parking page,) and (b) a poor choice of names that’s always going to give unrelated Google results. I continue to be amazed that new companies still choose names that won’t stand out in an Internet search.

It’s old news since I’m catching up, but First Databank mentions HIStalk (“the influential industry blog”) in the announcement of its rebranding, which I think is the first time a large, respectable organization has mentioned the name of this small, not all that respectable one in a significant announcement. I was impressed.

In the UK, Lord Carter of Coles, who heads up an NHS group to ensure fairness to its suppliers, is pressured to resign after the newspaper belatedly realizes that he’s also chairman of the UK division of McKesson (which he clearly disclosed when he took the job) and is part of an investment group that owns chunks of several healthcare companies. NHS pays him $90K per year for his two-days-per-week job, while McKesson pays him $1.25 million. Not surprisingly, nobody is suggesting that he quit the McKesson job.

Here’s Vince’s Part 2 of the CliniCom story.

The local paper covers the implementation of McKesson Paragon by McLaren-Bay Region (MI.) I think that’s actually McLaren Health Care, which makes a lot more sense.

A study at Minneapolis Heart Institute finds that surveillance software was able to retrospectively detect problems with implantable cardioverter-defibrillator devices long before the routine monitoring performed by the device manufacturers. The problem, of course, would be in collecting data in near real-time from the universe of patients in order to capitalize on the lead time.

3-11-2012 2-35-37 PM

The founder of SAP backs MolecularHealth, which offers software that matches the genomic data of individual patients to scientific evidence to suggest optimal cancer treatments. The application, which the company calls clinical decision support for oncologists, is being refined at MD Anderson.

Inga ran an anonymous reader’s rumor suggesting that GE Healthcare’s Centricity Perinatal could be on the sunset list. Not true, according to GEHC, and I’m sorry we ran that without asking the company for verification. GEHC is really fast and courteous about getting answers to my questions or rumor reports and I would have asked them for confirmation before running it. Inga doesn’t know the contact and probably figured she wouldn’t get a response.

3-11-2012 5-44-21 PM

Mrs. Dennis Quaid #3, the mother of the twins who were overdosed on heparin at Cedars-Sinai four years ago that were the subject of Dennis Quaid’s 2009 HIMSS conference keynote speech, files for divorce from the actor.

BCBS of North Carolina rolls out a mobile website that lets patients view claims, check their plan benefits, find a doctor, get a treatment estimate, and comparison shop drugs and insurance plans. The site, developed by Kony Solutions, supports Android and Apple platforms.

3-11-2012 3-38-57 PM

Philip White, historian and PR manager of electronic forms management vendor Access, appeared on Fox News last week after the release of his book about Winston Churchill’s Iron Curtain speech in Missouri in 1945. They asked him whether the lessons learned from the previous cold war still apply in situations related to Iran’s nuclear capabilities.

3-11-2012 3-51-39 PM

The local paper covers Oakwood Healthcare System’s (MI) $80 million Epic project, to be kicked off in August.

3-11-2012 4-26-51 PM

A fun Bloomberg BusinessWeek article discusses the joys of attending a conference in Las Vegas. It contains interesting mentions of the HIMSS conference, including four Craigslist “casual encounters” ads targeting HIMSS attendees like the one above.

A Kaiser Health News/Fortune article profiles Farzad Mostashari and HITECH. A quote:

Remarkably, in an era of partisan government, Mostashari’s program enjoys bipartisan support — or, at least, bipartisan tolerance. While only three Republicans voted for the stimulus bill in 2009, which provided the program’s funding, few have spoken out against it. The fact that the information technology industry is a big supporter — giants such as IBM, Microsoft, General Electric, Hewlett-Packard and a host of smaller health-care specialty technology companies — doesn’t hurt. The $27 billion will flow their way, and plenty of high-priced lobbyists are working hard to keep it flowing.

The New York Civil Liberties union criticizes the state’s privacy and security policies, saying HIEs should require patient consent to access their records and that the all-or-nothing approach to privacy means doctors see a lot of confidential information they don’t need to do their jobs.

3-11-2012 6-30-30 PM

Utah Business names Amy Rees Anderson, CEO of HIE technology vendor MediConnect Global, as its CEO of the Year.

3-11-2012 6-32-10 PM

State auditors discover that 269-bed Salinas Valley Memorial Healthcare System (CA), which earned scathing headlines last year when auditors found that its retiring CEO was paid over $5 million, did $21 million of business over a five-year-period with firms in which its executives held a financial interest.

A woman whose pending Supreme Court lawsuit argues that the federal government can’t force individuals to carry health insurance files bankruptcy after the family car repair business fails. Among the debts she’s petitioning the federal court to allow her not to pay: several thousand dollars owed to hospitals and physician practices. She had opted not to purchase health insurance.

E-mail Mr. H.

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March 11, 2012 News 2 Comments

News 3/9/12

March 8, 2012 News 4 Comments

Top News

National Coordinator for HIT Farzad Mostashari, MD takes issue with the recently published report that found doctors with online access to patients’ charts ordered more tests. Mostashari disputes the study, which raised questions as to whether or not EHRs cut costs. Mostashari’s contends that the study was based on 2008 data and before the start of the Meaningful Use program and thus does not address certified EHRs’ capabilities for data exchange and clinical data support.


Reader Comments

From EFMHead “Re: OB data management. Rumor has it that GE Centricity Perinatal is to be discontinued and that CPSI is auctioning off its OBIX product. Thoughts? If true, this signals an odd and sudden exodus of two major players from the OB data management market space.” Unverified. UPDATE: per GE Healthcare, the Centricity Perinatal rumor is not true.

3-8-2012 5-29-50 AM

From CW “Cake. Here’s a picture of the cakes that were prepared for Vada’s retirement. She was also presented with a quilt that reflected all the company names and colors over the last 24 years.” The cakes were prepared in honor of the retiring Vada Hayes, a longtime Allscripts/Misys/Medic support supervisor.


HIStalk Announcements and Requests

3-7-2012 2-10-35 PM

inga Highlights from HIStalk Practice this week include: a handy two-page summary of Stage 2 for EPs, prepared by two e-MD physician users. US physicians charge two to three times more than their French and German peers and achieve similar outcomes. MGMA urges Secretary Sebelius to consider adding due diligence to the ICD-10 timeline and limit required adoption to hospitals. A survey finds that 30% of physicians have implemented an EHR that meets MU criteria, 14% will in the next three years, and 17% have no plans to do so. Check out the rest of the goodies on HIStalk Practice and be sure to sign up for the email updates. Thanks for reading.

3-8-2012 6-42-37 PM

HIStalkapalooza’s  own singing Elvis is seeking  music video contributions for “Gimme My Damn Data,” as debuted at HIStalkapalooza last month. Dr. Ross D. Martin, MD encourages anyone wishing to promote access to their electronic health information to submit a video clip by March 26th. Check out the video clip – fun stuff.

Mr. H will be back in front of his computer this weekend, following his week-long get-away with Mrs. H. Of course I’m ready for him to be back at the helm, especially since he is the one most likely to feign amusement by my witty e-mails. He did a pretty good job staying off the Internet this vacation, meaning his inbox is likely overflowing; no doubt he’ll immediately be back to his workaholic ways.


Acquisitions, Funding, Business, and Stock

3-8-2012 7-10-24 PM

Medivo, a provider of decision support and analytics software, acquires WellApps, a developer of mobile disease management applications for chronically ill patients.


Sales

The 150 physician Holston Medical Group (TN) selects Humedica MinedShare as its clinical intelligence solution to be used in a joint venture with over non-Holston 1,300 physicians.

3-8-2012 10-14-26 AM

WellStar Health System (GA) selects PerfectServe’s clinical communication platform.

3-8-2012 7-12-04 PM

University Health System (TX) expands its Allscripts portfolio with the selection of Allscripts Community Record, powered by dbMotion, to share data across its 24 locations.

3-8-2012 7-13-05 PM

Watson Clinic (FL) selects MedAptus’ Professional Intelligent Charge Capture for its 294 multi-specialty providers.

Oakwood ACO (MI) contracts with Wellcentive to provide its the Wellcentive Advance healthcare intelligence solution suite for Oakwood ACO physicians.

3-8-2012 7-14-13 PM

Fairview Health Services (MN) chooses Amcom Software’s communication solutions, including smartphone-ready encrypted messaging and nurse call alerting on mobile devices.

3-8-2012 7-15-05 PM

Brattleboro Memorial Hospital (VT) selects Unibased’s ForSite2020 solution for enterprise scheduling.

CSC signs a nonbinding letter of intent with the NHS to move forward with additional implementations of the Lorenzo patient records system, beyond the 10 that have already been rolled out.


People

3-8-2012 7-16-08 PM

The Cal eConnect board of directors appoints Ted Kremer as president and CEO. Most recently Kremer served as executive director of the Rochester Health Information Organization.

3-8-2012 7-17-08 PM

Former Nuance Communications executive John Shagoury joins Eliza Corp. as president. Shagoury replaces company co-founder Alexandra Drane, who takes over as chairwoman and chief visionary officer of the patient engagement company. Shagoury is the former president of Nuance’s healthcare division.

3-8-2012 7-18-13 PM

Physicians Interactive, a provider of mobile and Web-based clinical resources, names Gautam Gulati, MD (Digitas Health) as CMO and SVP of product management and Joe Caso (King Pharmaceuticals, Pfizer) as EVP of new business development.


Announcements and Implementations

Datawatch Corporation partners with HIT consulting firm Jacobus Consulting, enabling Jacobus to incorporate Datawatch’s Monarch Report Analytics platform into its client offerings.

Bayscribe partners with Health Fidelity to integrate Fidelity’s NLP platform into BayScribe’s clinical documentation solutions.


Government and Politics

The Stage 2 proposed rules for Meaningful Use were officially published in the Federal Register Wednesday, marking the start the 60 day commentary period. CMS is accepting feedback through May 7th.


Other

Solo and small practices are now outpacing larger practices in EHR adoption, with single-doctor office adoption growing from 31% to 37% for the second half of 2011. Overall EHR adoption rates remain higher as the number of physicians practicing at each site rises.

Moody’s Investor Service predicts even more consolidation among hospitals over the next few years as institutions look for ways to enhance efficiencies, improve competitiveness, and drive higher payments from insurers.

3-8-2012 6-26-39 PM

Forbes profiles Epic founder and CEO Judy Faulkner, whom it dubs “healthcare’s low-key billionaire.” The magazine estimates her net worth at more than $1.5 billion, making her the only woman to reach the rank of billionaire by founding her own technology company.

3-8-2012 6-58-17 PM

Weird News Andy checks in with a few goodies, including a story of a three-year-old who ingested 37 Buckyball magnets. The magnets snapped together in the child’s intestine, tearing holes in the intestine and stomach. WNA says, “No MRIs, please.”

WNA wonders how much the living received in overpayments, after an audit finds that Washington, DC paid nearly $700,000 in Medicaid payments for dead people, including one nearly nine years after the patient’s death.

And in an overachieving moment, WNA adds the story of a Texas dialysis nurse, accused of injecting bleach into the dialysis tubing of patients, killing five.



Sponsor Updates

  • API reports it added 38 contracts with new and existing clients between Q4 2011 and Q1 2012 to date.
  • BCBS North Carolina launches a mobile version of its member web portal that is based on Kony Solutions’ mobile technology
  • States and regional HIE’s drive demand for technology from Medicity, Axoloti, and Orion.
  • Gwinnett Medical Center (GA) launches MedGift, an online gift registry powered by RelayHealth.
  • Pathology Service Associates, a division of MED3OOO, prepares to move into a new, $5.5 million 32,000 square foot headquarters in Florence, SC.
  • Health 2.0’s Matthew Holt chats with Kareo CEO Dan Rodrigues about the current state of the one to four physician market.
  • iSirona releases DeviceConX 4.0, its latest version of connectivity software.
  • Hayes Management Consultant’s Anita Archer, CPC, provides recommendations for preparing for ICD-10.
  • Vitalize Consulting Solutions ranks third in the 2011 Best in KLAS Awards for software and services. Apparently KLAS inadvertently left VCS off the original report published in December.
  • The Advisory Board reports that nearly 50% of hospital CIOs will hire consultants to help achieve MU.

EPtalk by Dr. Jayne

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Nuance announced plans to drop $300 million in cash to acquire Atlanta-based medical transcription and speech editing vendor Transcend Services. The move is aimed at expanding Nuance’s customer base in the small- to mid-size hospital market. We’ll have to see if employees still embrace the “It’s better here” motto after the dust settles.

In other acquisition news, CareFusion will PHACTS LLC. CareFusion hopes that by adding PHACTS to its existing Pyxis products, pharmacies can better manage inventory, manage drug shortages, and of course improve the bottom line.

IBM has named nine members of the Watson Advisory Board to “focus on medical industry trends, clinical imperatives, regulatory considerations, privacy concerns, and patient and clinician expectations around the Watson technology and how it can be incorporated into clinician workflows.” Seven of the nine are physicians, including family doc Douglas Henley MD who is CEO of the American Academy of Family Physicians. I learned at HIMSS that family docs can be a lot of fun so I’m excited to see him on the Board.

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ONC is seeking public comment on how health care providers and health systems user mobile devices to access, store, and transmit health information. Laptops, PDAs, smartphones, and tablet computers were specifically called out but storage devices were excluded. Comments are being accepted through Friday, March 30th.

CMS will be releasing new online billing statements intended to help seniors find bogus charges. The “consumer-friendly format” goes live Saturday on Medicare’s secure web site. Features include larger type and explanations of medical services in plain language. Revised paper statements are coming next year. I cruised the site looking for samples but couldn’t find any, so I’ll use my next best research source: grandma. I definitely want to see one before patients bring them to me to discuss. Apparently the site also allows beneficiaries to check claims status and use an online appeals form. It also includes the Blue Button.

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HIMSS released its online photo gallery in case you want to purchase photos of your favorite ONC, CMS, and HIT crushes. Although it’s not from the official HIMSS site, I’ve been told this pic depicts the response of a certain someone when informed that he missed the chance to dance with the ladies of HIStalk at HIStalkapalooza.

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No, that’s not a sample of the tattoos that Inga and I had done while we were in Las Vegas – but one of my favorite readers did send an article about the growing phenomenon of medical tattoos. It’s low tech but does make a point for patients with health conditions or who want to make sure first responders understand an individual’s wishes for resuscitation. The tattoo chosen by the reader in question: “afraid of needles.”

Have a question about voice recognition, clinical decision support, or just want to share what you’d choose as your medical tattoo? Email me.

drjayne


Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

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March 8, 2012 News 4 Comments

Nuance to Buy Transcend Services for $300 Million

March 7, 2012 News No Comments

3-7-2012 8-36-15 AM  3-7-2012 8-38-16 AM

Nuance announces Wednesday morning a definitive agreement to acquire Transcend Services, a provider of medical transcription and speech editing services, for $300 million, net, in cash. The acquisition accelerates Nuance’s expands the company’s presence in the small- to mid-size hospital market.

Janet Dillione, EVP and GM of Nuance’s Healthcare business said, “The acquisition of Transcend will expand the delivery of our innovative voice and Clinical Language Understanding solutions especially to small- and mid-size hospitals. With Transcend, we will drive change and improvement to the way these hospitals capture and leverage clinical information. The acquisition is a natural extension of Nuance’s existing healthcare business, and will strengthen our solution and services portfolio, as well as enhance our profitability.”

Transcend acquired electronic clinical documentation provider Salar in August of 2011.

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March 7, 2012 News No Comments

News 3/2/12

March 1, 2012 News 4 Comments

Top News

3-1-2012 7-03-49 PM

The Defense Department appoints former Harris Corp. VP Barclay Butler to serve as director of the Defense Department/VA Department Interagency Program Office to manage the development of an integrated EHR for both departments.


Reader Comments

inga_small From HairClub: “Re: Shafiq Rab. The CIO at Orange Regional Medical Center is taking the VP/CIO position at Hackensack University Medical Center.” Unverified.

inga_small From Free Lunch: “Jason DeSantis. Joining Zanett’s healthcare division as executive director of business development.” Unverified. He’s division CIO at University Hospitals in Cleveland.

mrh_small From Last Man Standing: “Re: GE Healthcare. Layoff today of 5% targeting services and support.” Unverified. Many of the GEHC rumors I get are somewhat true but exaggerated, so if the company provides an update (which companies usually don’t for HR-related issues) I’ll run it here.

3-1-2012 8-10-06 PM

mrh_small From Printgeek: “Re: Epocrates. Laid off their entire EMR staff on Tuesday and are shutting down their EMR project. The BOD lost patience, as crazy sales expectations were set by previous CEO and CFO. They expected to sell 1,500 docs in 2011 with an uncertified system that was release in July. This exec team did a good job hiring talent, but failed to listen to their feedback on what it takes to actually sell EMR and the subsequent expectations.” I think there’s a lesson to be learned here: if selling EMRs was easy, everybody would be doing it, and HITECH has accelerated the polarization of the successful and unsuccessful vendors. If Epocrates, which has an impeccable brand recognition in healthcare and was seemingly doing all the right things, struggled to meet sales numbers for its EMRs, clearly the age of the mom-and-pop EMR is over. Actually, there’s an even more applicable lesson here: publicly traded companies may say all the right things about being dedicated to healthcare, but quarterly numbers can send them fleeing for cover almost instantly. Whatever docs just bought their EMR are now finding out what it means to be on the wrong side of their vendor’s “core business.” The one-year share price chart doesn’t inspire much confidence that a steady hand on the tiller is what’s needed – shares are down almost 60% in the past year.

3-1-2012 9-01-37 PM

mrh_small From HIT Student: “Re: Connected Care Challenge. I thought some of your readers might be interested.” Janssen is offering $250K in awards for easily adopted, low cost technology solutions that can improve information sharing among hospitals, patients, caregivers, and community physicians, with the goal of improving post-hospital care and lowering the cost of unnecessary readmissions. Submissions are being accepted through March 25.

mrh_small From Non-Sequitur: “Re: SNOMED. Here are examples of the proposal to require SNOMED in Stage 2/2014 Edition. In the 45 CFR Part 170 Standards Companion, see Pages 45 (cancer registry), 52 (problem list MU objective), 58 (summary care record MU objective), and 90 (lab results to public health agencies MU objective.)” Thanks. I know several readers are interested in the potential requirement to use SNOMED.

3-1-2012 9-12-09 PM

mrh_small From I Was There: “Re: HIStalk sponsor lunch at HIMSS. Great location, great food, a nice mix of heavy hitters and rising stars, and great networking with lots of cards being passed and commitments for follow-up discussions. Art Glasgow’s talk was very well received, talking about how HIStalk plays a part in his daily activities as Duke University Hospital CIO, how vendors and providers should help spread the word about it, and the shifts he made going from the vendor world at Ingenix to Duke. The focus was on the three of you as people were trying to figure out who you are and checking out Inga’s shoes. I thought the event was great.” It was really cool that 100+ folks from our sponsoring companies took time away from a very busy first day of the HIMSS conference to let us say thanks to them for supporting what we do. Naturally Inga, Dr. Jayne, and I felt simultaneously ridiculous and vulnerable appearing in disguise, but we did our best. Most of our sponsors understand that we’re going to objective and fair to sponsors and non-sponsors alike and, to their credit, they support us even when what we say isn’t going to be popular back in their offices. If you were there, thank you very much.

mrh_small From Judy Judy Judy: “Re: Epic consulting firm. Last week Judy F. of Epic met with executives of [consulting firm name omitted] about their violation of Epic’s non-solicitation clause. An Epic client turned them in to Epic after the firm poached a handful of the client’s employees. Epic banned the firm for a year (which was ‘negotiated’ to a shorter term) from selling to or doing business with any new Epic customers. Seems like a slap on the wrist based on recent discussions with Epic Consulting relations personnel and their stringent expectations for consulting partners. Why not take away their preferred certification program as well?” Unverified, so I’ll leave out the company name for now.

mrh_small From MD Informaticist: “Re: digital pen technology – mightier than the mouse? Are they really making an impact on usability and clinical documentation? I would be interested in your opinion of the Verizon and other digital pens and clarify for us: can this technology re-energize a dormant innovative industry?” What I’ve seen of them seems pretty cool, but I’m interested in hearing from readers about who is actually using them and what results they are getting.

mrh_small From Mark Schmidt: “Re: HIMSS. It’s become such a large event that the Booth Crawl brought back feelings of those early days when it was possible to spend time with just about every vendor. I learned a lot and heard the latest from Sunquest, which has not been sitting still as the industry has progressed!” Mark, CIO of SISU Medical Systems of Duluth, MN, won a Sunquest-provided iPad last week. He and I have swapped occasional e-mails going back to early 2008.

mrh_small From Just a Fan: “Re: 5010. Anyone else having issues with a claims clearinghouse not being ready? Our cash on hand is taking a beating because our claims have been sitting at the clearinghouse and are only just now starting to trickle out to payers, which are requesting information required on 4010 but deleted in 5010. And the enforcement delay was good why?” We keep hearing anonymous rumblings with no specific examples. Give us details and we’ll see what we can find out.


HIStalk Announcements and Requests

inga_small This week on HIStalk Practice: Dr. Gregg pulls a double shift in an an attempt to diffuse last week’s “mournful silence” on HIStalk Practice while I was busy drinking IngaTinis and walking my high heels off at HIMSS. Dr. Gregg missed HIMSS this year, but still offers some fun HIMSS musings. A proposed rule would require physicians to return improper Medicare payments within 60 days of  notification and allow auditors to investigate 10 years of records. Most physicians believe EHR use is valuable for improving quality and managing patient care, but less convinced that EHR improves diagnosis accuracy or treatment planning. Black Book Rankings announces its ambulatory EHR vendor rankings. Athenahealth CEO Jonathan Bush likens his company to a “snippy kind of overconfident Chihuahua jumping up and trying to nip at the tails of the Dobermans.” By the way, we are conducting a reader survey on HIStalk Practice that is in addition to the HIStalk version; we’d love readers to take a moment to  have a  to provide input. Thanks for reading!

3-1-2012 7-24-23 PM

mrh_small I appreciate the support of Levi, Ray & Shoup (specifically LRS Output Management) for supporting HIStalk as a Platinum Sponsor. The company’s expertise is in document solutions for hospitals, so let’s use a typical Epic shop as an example. Maybe your big Epic print jobs fail; you need centralized capability to monitor and reprint jobs without re-running them on Epic; you are maxing out out your Windows print queues or the Windows print spooler; or you’d like to save print costs by allowing users to preview reports before printing and automatically route large reports to more economical printers. With the LRS solution, you gain centralized control, you can implement load balancing, you avoid installing multiple print drivers on each workstation, and you get rid of the unreliable science fair of printing solutions (UNIX to JetDirects, multiple printer types, a mix of Epic text and ERTF documents, etc.) and you can even require users to verify their identity before printing patient documents to an unattended printer. It doesn’t matter how cool Epic is if the tangible, patient-critical label or report it creates as an end product is hanging out there in the ozone because of a cobbled-together print solution that is far less enterprise grade than the system that drives it. One hospital with four FTEs handling printing issues cut back to just one after implementing LRS Output Management, which can handle anywhere from hundreds to thousands of printers. And while Epic is a good example, the solution works with any application (Lawson, SAP, etc.) Check out their case studies from Carilion, Hopkins, UVA, etc. Thanks to Levi, Ray & Shoup for supporting HIStalk.

3-1-2012 7-42-29 PM

mrh_small Liaison Healthcare Informatics is supporting HIStalk as a Platinum Sponsor. The Atlanta-based integration and data management company has over 9,000 customers all over the world, including more than 600 in healthcare. The company’s cloud-based data integration solutions provide a platform for the secure exchange of data among providers, payers, patients, and HIEs. Some of the pain points it addresses are HIPAA, HITECH, DEA Form 222, Safe Harbor qualification of encrypting PHI data at rest, electronic file transfers, and avoidance of data breaches. Its Liaison Protect solution makes sure you are securing your databases, integrating encryption, tokenization, key management, and logging. Its Liaison Exchange managed file transfer software suite allows cost-effective management of ever-increasing volumes of file transfer exchanges both inside and outside the organization. If you need to accelerate your HIE or ACO efforts, securely share patient information with other organizations, or gain control over risky and poorly monitored file transfers, give their offerings a look. Thanks to Liaison Healthcare Informatics for supporting HIStalk.

mrh_small Inga mentioned the reader survey — you have one last chance to provide input that we’ll use to plan the next year of HIStalk. Thanks. It really does help us given that we work largely in a vacuum and have to pick and choose our projects since we have limited time to get things done.

mrh_small For our numbers-obsessed reader(s), we had a record-breaking 125,867 visits in February, along with 196,565 page views. The e-mail blasts go out to 7,935 subscribers, while Dann’s HIStalk Fan Club has 2,268 members (OK, I admit that we’re not entirely comfortable with the idea of having fans, but it’s slightly satisfying to reflect on that fact during our frequent bouts of feelings of inadequacy and lack of accomplishment.) You can move our emotionally needy needles by (a) subscribing to the updates; (b) connecting with us on Facebook, LinkedIn, and Twitter; (c) supporting the sponsors who support us by poring over their ads, clicking those of interest, checking out their Resource Center pages, use the Consulting RFI Blaster to quickly solicit consulting help; (d) sending us news, rumors, guest articles, or anything else that would interest your fellow readers; and (e) feeling the positive thoughts Inga, Dr. Jayne, and I are beaming your way for supporting what we do in whatever form that support takes, which means a lot to the ladies and me.

mrh_small A reader asked about WellStar’s ambulatory EMR project. I have the information, but agreed to sit on it for a few days. Stay tuned.

3-1-2012 9-34-42 PM

mrh_small The overachievers at API Healthcare, not content to simply mail Gabe Davis (right) of Texas Health Partners his iPad prize from the recent Booth Crawl after he had to leave the HIMSS conference early, sent VP Kyle Allain (left) to his office to hand-deliver “the famous HIStalk iPad” personally. This was Gabe’s first trip to HIMSS and he had nice things to say about HIStalk and API’s support of it. His 16-year-old son will get the iPad and is apparently pretty stoked about it, and rightfully so because iPads are darned cool even if you aren’t an Apple fanboy.

On the Jobs Page: Financial Systems Consultants, Meditech CPOE Go-Live Support, Epic Certified Builders. On Healthcare IT Jobs: Senior Health Information Technology Specialist, Implementation Consultant, Project Manager CMIO Informatics, McKesson Paragon Consultants.

mrh_small I’m taking a little break to escort Mrs. HIStalk to somewhere warm and sunny where laptops are as rare as bathing suit tops (OK, I’m kidding on that one) so the eminently capable Inga and Dr. Jayne will be holding down the fort as I try to fight the urge to stay off e-mail (I’m rarely successful.) I don’t know about you, but I’m really tired after all the HIMSS-related activities over the past few weeks and I want to see what it feels like to sleep more than five hours in a single night.


Acquisitions, Funding, Business, and Stock

Teledermatology provider Iagnosis raises $1 million from 11 investors.

3-1-2012 10-33-58 PM

Accretive Health releases its Q4 numbers: profit of $13.2 million ($0.13/share) compared to last year’s $5.5 million ($0.06/share.) Net services revenue grew 53% to $260.1 million.

HP Enterprise Services notifies the State of Wisconsin that it will be eliminating 157 Medicaid program jobs in Madison and Milwaukee.


Sales

DR Systems announces six new contracts for its Unity platform totaling more than $2.07 million.

3-1-2012 10-34-51 PM

Cancer Treatment Centers of America signs an agreement to deploy Unibased Systems Architecture’s ForSite 2020 application suite across all its facilities.


People

3-1-2012 7-02-42 PM

Beacon Partners appoints Christina Bertsch (EMD Serono) VP of human resources.

3-1-2012 7-04-48 PM

The National Quality Forum board of directors announces that President and CEO Janet Corrigan will resign as of June 2012.

3-1-2012 7-05-52 PM

HHS Office for Civil Rights names attorney Juliet K. Choi (American Red Cross) as chief of staff and senior advisor.


Announcements and Implementations

3-1-2012 10-37-56 PM

Four Lakeland Healthcare (MI) hospitals go live on their $50 million Epic system.

T-System licenses its clinical terminology to Prognosis HIS, allowing Prognosis to incorporate into its ChartAccess EHR more than 200,000 clinical phrases.

MED3OOO chooses Macadamian to help develop a new product that it says will expand the usability and adoption of its ambulatory systems.

Shareable Ink incorporates Pentaho Business Analytics to create a data analytics platform for healthcare.

Michigan Health Connect wins second place in an IT innovator awards contest for its electronic referrals solution app, powered by Medicity’s iNexx, that was rolled out to nearly 1,000 physicians over 28 counties. 


Government and Politics

The Advisory Board Company does a nice high-level summary of the proposed Meaningful Use Stage 2, nice for CIOs prepping peer execs for what the IT agenda will look like.

In England, two NHS trusts seek a supplier to take over their IT help desk and infrastructure in what would be the first outsourcing contract of its kind. The deal is valued at  $50 million.

3-1-2012 10-39-00 PM

mrh_small I liked Doug Fridsma’s post on HHS’s blog about the Interoperability Showcase at HIMSS. He says Farzad Mostashari showed up there by surprise and challenged the participants to demonstrate impromptu interoperability with another participant with whom no relationship existed. He gave them one hour to make it happen technically, which involved overcoming challenges such as authentication certificates, vocabularies, and firewalls. The result: NextGen sent a C32 to Allscripts, EXCITA HIE and Medical Informatics Engineering exchanged a transfer of care document in ER discharge summary format, and Enable Healthcare sent a CCDA discharge summary to Verison to create a new patient chart. That’s pretty cool.


Other

3-1-2012 10-42-49 PM

Ochsner Health System (LA) announces that its neurologists recently completed their 1,000th patient consult as part of Ochsner’s  telehealth stroke treatment program.

KLAS reports that some providers are concerned with a number product gaps and weaknesses in the McKesson Paragon product and wonder if Paragon can scale to larger hospitals, especially those with more than 400 beds.

Jackson Health System (FL) announces the layoff of more than 1,000 people in an effort to save the organization $69 million.

Trinity Health’s Michigan hospitals sign an agreement with University of Michigan to explore ways the organizations can work together to coordinate care, with one of the areas of discussion being information technology. 

3-1-2012 10-40-27 PM

A physician’s assistant who sued her former employer, Mercy General Hospital (CA), for sexual harassment is awarded $167 million.

3-1-2012 8-21-57 PM

mrh_small The folks at MED3OOO asked Inga and me to choose and announce a winner from the six finalists in their contest to create the best video testimonial. They offered to pay for our time, but we said it either had to be (a) free to them because they’re a sponsor, or (b) if they really wanted, they could donate whatever amount they wanted to a charity of our choice. Thanks to MED3OOO for their donation to Best Friends Animal Society, a highly rated charity whose mission is “to bring about a time when there are no more homeless pets.” And congratulations to the winner, Kyle Adkins, administrator of Golden Valley Medical Clinics of Clinton, MO (he’s in Interview 1 on the finalist page) which implemented the InteGreat browser-based EHR from MED3OOO. My favorite quote: “You don’t ever make this decision well the second time or a third time. You may make a better one if you’ve made the wrong decision, but there will be someone else making the decision.” Great job, Kyle, and for that you win an all-expense paid trip to MED3OOO’s 2012 National Healthcare Leadership and Users Conference in St. Thomas, US Virgin Islands in October.


Sponsor Updates

3-1-2012 9-06-36 PM

  • World Wide Technology is sponsoring Geek Day 12 in Washington DC, April 11-12, complete with showcase labs, breakouts, and birds of a feather session divided by industry focus. The event is free and so is lunch.
  • API Healthcare partners with Presagia Software to offer Presagia’s workforce absence management solutions to API clients.
  • ProHealth Care (WI) goes live with iSirona’s connectivity technology to deliver patient data from anesthesia monitors into Epic EMR.
  • A survey by BridgeHead Software finds that most hospitals want vendor neutrality with more control over their image data.
  • Black Book names Quest Diagnostic’s Care360 EHR the best EHR for single physician practices and for e-prescribing. It was also ranked eighth on Capterra’s most popular EMRs.
  • Alexander Orthopaedic Associates (FL) selects White Plume Technologies’ AccelaSMART resolution engine to bridge the gap between its Exscribe EHR and ADP’s AdvancedMD’s PM system.
  • MEDSEEK and BrightWhistle partner to offer a search and social media marketing solution.
  • Lawson Software enhances its Cloverleaf Secure Courier and Global Monitor for its Cloverleaf Integration Suite to increase speed and provide greater connectivity.
  • New York-Presbyterian Hospital goes live with Awarepoint’s RTLS at its Columbia University Medical Center campus.
  • Aventura will participate in the World Congress Inaugural eHealth Innovation Conference this month in Cambridge, MA.
  • Santa Rosa Consulting advisor Matt Wimberley  discusses confidentiality, integrity, and availability in the HIPAA security rule.
  • Bruce Friedman MD, emeritus professor of pathology at University of Michigan Medical School, keynotes at the Lifepoint Informatics User Conference 2012.
  • Evergreen Healthcare (WA) shares how API Healthcare’s Time and Attendance and Staffing and Scheduling technology helped the organization get its productivity and costs under control.
  • MedAptus launches a revenue cycle reporting and performance analytics module for its Professional solution.
  • Coastal Cardiovascular Consultants (NJ) will implement the SRS EHR at two locations for its six providers.

EPtalk by Dr. Jayne

The American Journal of Preventive Medicine recently published an article about cybercycling. It shows that riding a stationary bike which hooked up to interactive videogames could increase brain function in older adults compared with a standard exercise bike. Elderly study participants who took 3D tours and raced computer generated avatars showed better memory, attention, and problem-solving abilities. Not surprisingly, some reported knee and back pain as well as “frustration with interacting with a computer.” Now we just have to wait for a vendor to allow the cybercycling data to flow through the patient’s PHR into their EHR charts.

Shades of Eliot Ness: Even without federal approval, Illinois is getting tough on Medicaid fraud. The state will start matching Medicaid patient data with the state driver’s license database to make sure only Illinois residents are receiving benefits. Applicants would also have to show additional proof of income to maintain benefits. Even without federal blessing, this seems like a reasonable idea – recently 6% of Medicaid cards were returned as undeliverable or having an out-of-state forwarding address.

It looks like there might be another way for vendors to expand their offerings. The Department of Health and Human Services recently announced plans to look as far back as 10 years when auditing Medicare overpayments. I forsee a whole new subset of vendors offering data archiving and retrieval specifically for Medicare billing. As Medicare goes, so go the rest of the payers, so it’s only a matter of time before providers are forced to maintain massive amounts of data. And we thought seven years for the IRS was bad.

For those of you who work directly with providers, it will be interesting to see how upcoming changes to the Medical College Admission Test (MCAT) affect the physician pool. The test is being updated to gauge “knowledge of the psychological, social, and biological foundations of behavior” as well as critical thinking skills. The goal is to “better prepare students to be doctors in today’s changing health care system.” It will be interesting to see if this really makes a difference in patient care, but I do hope it will also make a difference in being able to intervene with colleagues who are ripping their hair out due to the continuous onslaught of ever-changing federal and payer regulations.

USA Today reports that Hawaiians rank at the top for residents having the best overall sense of well-being. Don’t attribute it all to the sunlight and tropical breezes though – North Dakota, Minnesota, and Alaska also made the top ten. West Virginia finished last. Gallup gathered the data by calling 1,000 people daily for all but 15 days of 2011.

I’m still poring over all the Stage 2 documentation that’s coming across my desk (and phone, and e-mail, and the water cooler) and for better or worse, it seems like I’ve become comfortably numb as far as finding something noteworthy to discuss. Have a thought about your interpretation of those 455 pages of bliss? E-mail me.

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Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

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March 1, 2012 News 4 Comments

News 2/29/12

February 28, 2012 News 1 Comment

Top News

2-28-2012 8-12-15 PM

2-28-2012 6-12-17 PM

mrh_small Epocrates reports Q4 numbers: revenue up 9%, EPS –$0.18 vs. $0.01. The company reduced 2012 revenue estimates and says it will seek strategic alternatives for its EHR, which includes a native iPad version, since “the effort has hindered our ability to aggressively pursue such [physician network] opportunities.” Maybe that list of EHR mistakes is of theirs.


Reader Comments

2-28-2012 7-57-00 PM

mrh_small From BeenThere: “Re: WellStar. Shutting down its ambulatory rollout of [vendor name omitted].” I’m looking for confirmation and will provide more details if I get them.

mrh_small From Non-Sequitur: “Re: SNOMED. My manager attended Dr. Mostashari’s session and is able to substantiate what you wrote down about SNOMED and the problem list. He captured the talk on a Flip and we just listened to that segment talking how ‘we now have a standard for this or that’ ontology. Here’s specifically what he said regarding problem lists: ‘There is now a single standard for problem lists: SNOMED.’ I concur with the other people who have commented there is no mention of a requirement for SNOMED in the currently released document. We’ll see if what is published in the Federal Register provides additional detail.“ Thanks! I was hoping I hadn’t dreamed that part so early in his talk.

mrh_small From Jockey: “Re: Allscripts. Curious if you’ve heard rumors of an acquisition by some big non-healthcare guys.” Two anonymous readers have said that IBM (and possibly Oracle) might be making a move, but I have nothing substantial to back that up.

2-28-2012 8-03-03 PM

mrh_small From BrazosKid: “Re: KC area eClinicalWorks user group meeting. Surprise guest was CEO Girish. Said a few words and took some questions, made time for anyone who wanted to talk to him. A very personable and approachable CEO. You should interview him.” I have, actually: in 2006, 2008, and 2009. Girish Kumar Navani is one of my favorite people to talk to: honest, logical, and insightful, not to mention fun and an excellent businessman.

2-28-2012 7-58-48 PM

mrh_small From Phil: “Re: HIStalkapalooza. The flipbook with Elvis was the highlight of the memorabilia I brought back!” Those were cool. Check them out in the video if you haven’t already. I may need to make Elvis a fixture at future events since he was fun.

mrh_small From Kathy Wheatley: “Re: thanks for the Booth Crawl iPad from T-System. Coincidentally, some of our facilities use T-System and love it. Paper T’s in the past, but the electronic version is very easy, fast, and reliable. Thank you T-System for sponsoring HIStalk. I get my information from HIStalk, HIStalk Practice, and HIStalk Mobile, pull out applicable info, and copy it in another e-mail for our leadership team. My boss told me not to stop sending them – he was getting a lot of good market info from them. You have a great knack of pulling together applicable and trend information to hand it to your readers with a great synopsis and links to the full articles, which I have used often. I appreciate the writings of Inga, Dr. Jayne, and Dr. Gregg as well, and I enjoy reading Ed Marx – so spot on. Thanks for being the glue that holds this together.” Thanks for those nice comments from Kathy from HCA, for which I’m sure I’m speaking for T-System as well. I also got  nice e-mail from Jason Blunk, who won his iPad from MedPlus and said he enjoyed checking out booths he would have missed otherwise.

mrh_small From Sagacity: “Re: Meaningful Use Stage 2 references. Along with the bookmarked version of the NPRM, here is a bookmarked version of the ONC Standards, Implementation Specifications, and Certification Criteria. It comes with the added bonus of clickable MU Objective links, which take you back to the CMS MU objective being referenced in the CMS document. (Just be sure to save both in the same folder).” Thanks for sending the links.

mrh_small From The PACS Designer: “Re: iPad 3. When the iPad 3 is released next month, you’ll find that the majority of changes will be inside, since rumored details indicate that there will be no change in the size of the screen. One new upgrade coming is better High Definition, where the number of pixels will double by using a 4×4 matrix instead of 2×2 currently in the iPad 2.”


HIStalk Announcements and Requests

mrh_small If you’ve completed my once-a-year Reader Survey, thanks. If not, I’d appreciate your input.


Acquisitions, Funding, Business, and Stock


2-28-2012 5-01-15 PM

Halfpenny Technologies secures $2.25 million in VC funding co-led by Vital Financial and Emerald Stage2 Ventures. The company also announces that it has won approval as the first pilot by the Laboratory Results Interface Pilots Work Group.

2-28-2012 5-01-56 PM

T-System acquires Clinical Coding Solutions, a provider of technology for facility and professional charge capture and coding for EDs, observation, urgent care centers, and outpatient clinics.

2-28-2012 5-02-54 PM

Hello Health raises $10 million in a combination of common and preferred shares and issuance of convertible debentures through its parent company Myca Health.


Sales

2-28-2012 2-33-47 PM

CentraState Healthcare System (NJ) chooses Cognizant to develop its ICD-10 transition strategy.

2-28-2012 2-35-34 PM

Trinity Health (MI) selects Quest Diagnostics’ ChartMaxx Enterprise Content Management solution.

LifeCare Hospitals (TX) chooses Meta’s integrated HIM and CDI software suite for abstracting/coding and clinical documentation for its 27 long-term acute care facilities.

CMS awards SAIC a contract to provide enterprise remote identity proofing and multi-factor authentication credential services. The total contract value is $78 million, assuming all contract options are exercised.

HMO Simply Healthcare (FL) selects MedHOK’s care management, quality, and compliance software for quality improvement initiatives.

2-28-2012 2-39-10 PM

Sacred Heart Health Systems (FL), Piedmont Healthcare (GA), and Orlando Health (FL) sign contracts with QuadraMed for its identity management solutions.


People

2-28-2012 5-05-51 PM

KPMG appoints Richard Bakalar (Microsoft Health Solutions Group) to its Global Healthcare Center of Excellence.

2-28-2012 5-09-32 PM

CORHIO Executive Director Phyllis Albritton announces that she will step down at the end of March after four years of leading the organization.

2-28-2012 5-12-58 PM

Cape Cod Healthcare (MA) promotes Jeanne M. Fallon to VP/CIO.

2-28-2012 5-14-07 PM

CareCloud appoints John Hallock, formerly with athenahealth, as VP of corporate communications.

2-28-2012 5-15-29 PM

Siemens Healthcare names David Fisher, formerly with the Medical Imaging & Technology Alliance, as VP of healthcare policy and strategy.


Announcements and Implementations

2-28-2012 2-49-53 PM

Ochsner Health System (LA) standardizes on the Informatica platform for HIE, BI, and other IS initiatives.

2-28-2012 2-51-58 PM

Sentara Princess Anne Hospital (VA) implements EXTENSION’s clinical workflow solutions for nursing staff in its neonatal ICU.

2-28-2012 6-09-28 PM

Oakwood Healthcare Dearborn (MI) will go live with an $80 million Epic project in August.

Midwest Orthopaedis at Rush goes live with SA Ignite’s MU Assistant, which documents EHR usage in preparation for assessment.

Delaware Health Information Network announces that all of the state’s acute care hospitals and skilled nursing facilities are participating in its statewide community health record, making it the first state to have all hospitals involved.

2-28-2012 8-06-05 PM

New York eHealth Collaborative is accepting presentation proposals through March 23 for its 2012 Digital Health Conference to be held in October.

Shareable Ink announces partnerships with Greenway, NextEMR, and VoiceHIT for its handwriting recognition technology.


Government and Politics

In England, a hospital pilots an analytics service in which drug companies can use the hospital’s de-identified and aggregated data directly from its databases to perform queries and data analysis.

The VA orders worked stopped on its $103 million enterprise service bus that would connect external products to the EHR it’s developing with the Department of Defense. CIO Roger Baker also says the VA is looking for less-expensive alternatives to Microsoft Office, but has no immediate plans to switch.

CMS credits its fraud detection technology for the indictment of a Texas physician and six other people who it claims bilked the government for $375 million of unnecessary home health services. CMS says the physician certified more Medicare beneficiaries for home health service than any other US medical practice, claiming that he recruited them via door-to-door solicitations and visits to the local homeless shelter.


Other

2-28-2012 2-53-34 PM

Novant Health (NC) is hiring 150 people with clinical and computer experience as it transitions to Epic.

Weird News Andy extends this story on cosmetic leg-lengthening surgery, which he captions, “Men, grow six inches.” WNA also likes this ink on medical tattoos, including “No CPR” emblazoned on a man’s chest, although the wording WNA suggests for breast implants is not family friendly.

Nuesoft is conducting a survey on attitudes about the transition to ICD-10 and ANSI-5010.

An article in the Minneapolis paper covers the local VA’s use of a virtual ICU to cover hospital ICUs in multiple cities from a single location, which an intensivist there likens to air traffic controllers watching from afar.


Sponsor Updates

2-28-2012 8-09-16 PM

  • DIVURGENT and Bon Secours Kentucky Health System publish a white paper on implementing an EMR.
  • Covisint partners with Anvita Health to add Anvita’s Smart Problem List to its HIE platform.
  • Comanche County Memorial Hospital (OK) will migrate from McKesson’s Horizon Clinicals to Paragon HIS.
  • ZirMed introduces VeraFund Manager, an end-to-end automated patient/payer solution for healthcare providers.
  • CommunityHealth IT (FL) partners with RelayHealth for its HIE.
  • Allscripts and MyCareTeam launch a diabetes management system that integrates the MyCareTeam application with Allscripts Enterprise EHR.
  • Beacon Partners launches Pillars Project Planner, a Web-based project management and implementation tool that provides organizations real-time access to their projects.
  • Nuance introduces two clinical language understanding solutions, Dragon Medical 360 | M.D.Assist and Dragon Medical 360 | QualityAnalytics.
  • eClinicalWorks announces Community Analytics, a data analytics solution for communities and ACOs that provides reporting, alerting, and messaging capabilities to manage population health.
  • UC Health (OH) expands its use of Streamline Health Solutions in three of its hospitals.
  • Central Alabama Health Image Exchange selects MEDecision to deliver its DICOM images and clinical information solution to seven of its hospitals.
  • Healthland partners with Imprivata to resell Imprivata’s single sign-on and access management technology.
  • Concentra (TX) selects Allscripts EHR to deploy in its 310 urgent care locations across the country. CVS Caremark’s MinuteClinic will transition from its proprietary EMR to AllscriptsMyWay EHR.
  • HFMA grants Surgical Information Systems the “Peer Reviewed by HFMA” designation.
  • LTC provider NuVista Living (FL) implements the Intelligent InSites RTLS solution as part of its Living Smart Room.
  • Trenton Health Team (NJ) selects Covisint as its HIE provider.
  • GetWellNetwork says it gained 25 new hospital customers and a 35% increase in live beds for its interactive patient care solution in 2011.
  • Healthcare Management Systems (HMS) and Certify Data Systems partner to make Certify’s HIE solution available to HMS customers.
  • Microsoft selects Health Language to map patient data within Microsoft Amalga platform.
  • Practice Fusion wins top honors for customer satisfaction in the primary care division of the Black Book Ratings
  • Imprivata introduces CorText, its secure texting application.
  • T-System introduces care coordination technology at the Emergency Nurses Association Leadership Conference.
  • PatientKeeper introduces the latest release of its medication reconciliation software.
  • Brown & Toland IPA (CA) selects Humedica MinedShare as its analytics platform to assist its 1,500 physicians with Pioneer ACO requirements.
  • CynergisTek partners with Iatric Systems to offer Iatric’s Security Audit Manager and Medical Records Release Manager solutions.
  • Quest Diagnostics announces a 30-day EHR implementation guarantee to enable bi-directional data exchange between hospitals and ambulatory physicians using the Care360 EHR.

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

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February 28, 2012 News 1 Comment

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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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.

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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.

More news: HIStalk Practice, HIStalk Mobile.

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February 2, 2012 News 6 Comments

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