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News 5/8/13

May 7, 2013 News 8 Comments

Top News

5-7-2013 10-43-55 PM

McKesson reports Q4 results: revenue down 3.4 percent, adjusted EPS $1.45 vs. $2.09, missing expectations on both. In the earnings call, John Hammergren mentions that the company will exit its international technology and hospital automation business. I don’t know which product lines hospital automation includes, for instance whether that means the medication packaging and distribution systems business (ROBOT-Rx, AcuDose-RX, etc.) Technology solutions revenues were up 3 percent, but profit was down 16 percent, “well below our expectations.”


Reader Comments

From The PACS Designer: “Re: Windows 8. The unfriendly start menu for Windows 8 has Microsoft scrambling to fix the problem.” The company admits that its flagship product has a steep learning curve as it forced users to use its touchscreen-friendly tile-based graphical system instead of giving them the familiar Start button.

From Kaye: “Re: HIStalk sponsorship. This remains the best value we get for the money in advertising!” Thanks – that’s a nice comment and we appreciate it, especially coming from a company that has sponsored multiple HIStalk sites since 2009.

5-7-2013 10-45-46 PM

From Anesthesiologist: “Re: Google Glass. How can I partner with companies to develop applications that might be useful in the perioperative setting?” If you’re interested in working with this doc, e-mail me and I’ll forward to him.

From Arcane: “Re: Epic implementation. Do you know of a source for rollout and post-live support staffing numbers?” I have many readers and consulting firms that have implemented Epic, so please add a comment with your thoughts.


Acquisitions, Funding, Business, and Stock

5-7-2013 10-46-35 PM

Greenway reports Q3 results: revenue up 3 percent, adjusted EPS $0.01 vs. $0.08, beating earnings estimates of –$0.02  but falling well short of revenue expectations. The company blames a faster-than-expected shift to subscription-based pricing. Shares are near their 52-week low. President and CEO Tee Green also said in the earnings call that with HITECH in the rear-view mirror, buyer fatigue has set in over the past several quarters. Training revenue was also impacted, he said, by customers choosing train-the-trainer and pushing training back to after the quarter’s close.  He also said that Greenway’s participation in CommonWell hasn’t resulted in any sales (without expressing puzzlement at the analyst who apparently thought it might) but said more companies are signing on.

5-7-2013 10-47-20 PM

InstaMed raises $3.5 million in an internal round of funding.

5-7-2013 10-48-05 PM

Healthcare transaction processing firm MediSwipe signs a term sheet with a Chicago-based PE fund to receive up to $600,000 over the next nine months.

5-7-2013 10-48-35 PM

Vocera Communications reports Q1 numbers: revenue down 3.1 percent, EPS –$0.14 vs. -$0.08. CEO and Chairman Bob Zollars says the company saw an increase in new customer signings but did not complete several significant hospital deals.

Siemens Healthcare posts a 4.9 percent increase in Q1 profits, although revenues fell 2 percent.

5-7-2013 10-50-27 PM

Qualcomm Life acquires HealthyCircles, a startup that supports the secure sharing of patient data.

WebMD CEO Cavan Redmond, who has been on the job less than a year, will leave the company, along with CFO Anthony Vuolo.

Perceptive Software blames recent acquisitions for its decision to lay off about 40 employees, or three percent of its workforce.


Sales

5-7-2013 10-51-42 PM

Massachusetts General Hospital selects eHealth Connect Referral Portal from eHealth Technologies to support two-way communication between the hospital and its referring doctors.

East Kent Hospitals University NHS Foundation Trust chooses Harris Corporation’s Clinical Integration Platform to integrate data from six clinical systems across five sites. East Kent will also use Imprivata’s OneSign single sign- on technology.

Upper Peninsula Home Health, Hospice and Private Duty (MI) will implement the Procura for Hospice solution.

SCL Health System (CO) selects Leap-10 from Wolters Kluwer Health to streamline its conversion to ICD-10.

Amarillo Legacy Medical ACO (TX) selects eClinicalWorks Care Coordination Medical Record to advance its ACO objectives and coordinate care among its 100+ provider members.

Physical Rehabilitation Network will deploy NextGen Healthcare’s EHR, PM, PatientPortal, and NextPen products across its 100+ locations and use NextGenRCM Services for revenue cycle management.

Virtual Radiologic signs a five-year deal with Visage Imaging to implement Visage 7 Enterprise Imaging Platform for its 400 radiologists in a read-anywhere environment.


People

5-7-2013 10-38-08 AM

Ernst & Young names Intellect Resources President and CEO Tiffany Crenshaw a finalist for Entrepreneur of the Year 2013 in the Southeast region.

5-7-2013 11-09-04 AM

Former Cerner VP Ian Chuang, MD joins Netsmart Technology as CMO/VP of healthcare informatics.

5-7-2013 11-14-09 AM

Former National Coordinator Robert M. Kolodner, MD joins telehealth provider ViTel Net as VP/CMO.

5-7-2013 2-26-52 PM

Care Team Connect names Richard Popiel, MD (Regence BCBS) to its board.

5-7-2013 3-32-46 PM

Healthcare software solution provider MedicaSoft, LLC appoints Mike O’Neill (VA Center for Innovation) CEO.

5-7-2013 7-29-50 PM

Beebe Medical Center (DE) names Michael J. Maksymow, Jr. (Continuum Health Alliance) VP/CIO.

5-7-2013 10-27-30 PM 5-7-2013 10-28-38 PM

QPID hires Gary Zakon (ModelLogic) as VP of engineering and Caroline Smyth (Smyth Consulting) as VP of sales.

5-7-2013 8-31-06 PM 5-7-2013 8-31-57 PM

Eric J. Topol, MD is named editor-in-chief of Medscape. What’s most interesting to me is that his ongoing full-time employer Scripps Clinic apparently Photoshopped his black suit jacket to look like a white lab coat in the pictures above from their site.


Announcements and Implementations

Access is named as a Meditech Collaborative Solutions vendor, offering Meditech customers an integrated solution to capture and upload electronic signatures and data collected from clinical systems and medical devices.

5-7-2013 10-53-44 PM

Johns Hopkins Medicine integrates Epic with Hyland Software’s OnBase enterprise content management solution in its ambulatory and inpatient departments.

Philips launches Healthcare Transformation Services, a global business unit to provide consulting services to hospitals and health systems.

Trustwave introduces a mobile security practice to help enterprises with their BYOD strategies.

HCA MidAmerica Division equips seven hospitals and multiple physician offices in its Midwest region with Accelarad’s medical imaging solution.

Lifespan (RI) completes its rollout of the the TeamNotes electronic documentation system from Salar.

5-7-2013 8-07-30 PM

PerfectServe launches DocLink, a secure communications network for physician-to-physician communication.


Government and Politics

5-7-2013 10-21-35 AM

ONC publishes a governance framework for trusted health information exchange to help HIEs and other healthcare organizations understand ONC’s priorities and how to align with “national priorities.”

5-7-2013 10-54-20 AM

CHIME recommends in a letter to six Republican senators a one-year extension for Stage 2 MU before progressing to Stage 3. CHIME contends the extra year will give providers the opportunity to maximize their EHR technology to achieve the benefits of Stage 1 and 2 and give vendors time to “prepare, develop and deliver needed technology to correspond with Stage 3.”

5-7-2013 9-10-19 PM

Deputy National Coordinator Judy Murphy, RN kicks off National Nurses Week with a blog post on the role of nurses in healthcare IT and an invitation for nurses to share their stories.


Innovation and Research

5-7-2013 8-55-50 PM

UCSF creates the Center for Digital Health Information. It will be led by UCSF Medical Center CMIO Michael Blum, MD, who will assume the newly created position of associate vice chancellor for informatics and who will continue to lead its Epic implementation (physician leaders of the project are pictured above, with Blum on the left). Current projects include a team-based communications platform, an open source diabetes management system, a Web-based collaboration tool for virtual tumor boards, and a social media-based cardiovascular study.

Kaiser Permanente Center for Total Health will hold a Google Glass event in Washington, DC the evening of June 18.

5-7-2013 10-17-39 PM

South Carolina-based Iron Yard launches the Digital Health Program accelerator and incubator in the Spartanburg area.


Technology

Bloomberg TV covers the technology used by Palomar Medical Center (CA) and the "hospital of the future.” Palomar Health Chief Innovation Officer Orlando Portale is featured.


Other

An Imprivata-sponsored study finds that clinicians waste 45 minutes per day in using inefficient communication systems such as pagers.

Hospital IT leaders are focused on accommodating greater mobile and wireless connectivity to their networks and with ensuring the security of patient data in BYOD environments, according to a HIMSS Analytics study.

5-7-2013 8-13-09 PM

A Raleigh, NC clinic warns patients that it was scammed by a company that claimed it would digitize the practice’s old X-rays, but instead harvested their silver content and then destroyed the films.

5-7-2013 10-56-14 PM

University of Rochester Medical Center warns 537 patients that their PHI may have been compromised when a resident lost a USB drive containing quality improvement information. The hospital thinks it went to the laundry and was destroyed.

John Halamka reports on new Meditech 6.1 development after mixed response to Version 6: a cloud-hosted system based on standards, Web-centric and mobile-enabled, with both inpatient and outpatient capabilities, complete with analytics, a PHR, and care management tools. He says it will ship in 2014.

5-7-2013 9-01-55 PM

Drug chain CVS shuts down its drug company-sponsored refill reminder program because of limitations imposed by the new HIPAA Omnibus Rule on using patient information for marketing.

Weird News Andy refers to this story as “brain drain.” A man who thought his year-round runny nose was caused by allergies finds that it’s actually brain fluid leaking from a tiny hole. It’s been fixed and he’s fine. WNA also likes this story, in which researchers claim to have found the cause of graying hair (hydrogen peroxide buildup in the hair follicle) and a cure for both gray hair and vitiligo (a proprietary treatment involving a UV-activated enzyme).


Sponsor Updates

5-7-2013 10-36-38 PM

 

  • API Healthcare and The DAISY Foundation offer The Nurses Week Story Contest, with submissions from nurses due May 12.
  • McKesson releases version 13.0 of its Homecare solution.
  • Orion posts a video featuring Orion clients that have solved interoperability challenges.
  • More than 200 hospitals using CareWorks content management system from CareTech Solutions have received 32 Website awards in the past year.
  • Truven Health Analytics finds that healthcare spending is 20 percent higher for public sector employees than for the private employee population.
  • Passport Health Communications names Texas Health Resources, Trinity Medical Center (AL), and Kadlec Regional Medical Center (VA) winners of its Leaders at the Forefront of the Healthcare Experience contest for best healthcare access management practices.
  • Gwinnett Medical Center (GA) discusses how using RelayHealth services helped the hospital remove patient billing obstacles.
  • iHT2 hosts a May 29 Webinar on security, privacy, and compliance risks in a post-reform era.
  • Greenway Medical President and CEO Tee Green discusses the compatibility of innovation and other topics with PGA tour partner Jason Dufner.
  • Red Herring names Kony Solutions a finalist for its Top 100 North America award, which honors the year’s most promising private technology ventures.
  • EBSCO announces its intent to collaborate with the American College of Physicians to give ACP access to its DynaMed evidence-based clinical summary resources and literature surveillance.
  • Gartner names Health Catalyst to its list of Cool Vendors in Healthcare Providers 2013 and profiles Shareable Ink in its update on 2011 winners.
  • Greenway Medical releases agenda details for its PrimeLEADER 2013 user conference in Washington, DC August 22-25.
  • CommVault launches a customer education services program that includes customized user training and access to online training courses for its Simpana software.
  • ADP launches a Website to help clients and other employers plan for and comply with the Affordable Care Act.
  • Nuance names seven healthcare organizations winners of its Voice of the Customer award for improving quality of care, reducing costs, and accelerating EMR adoption using speech recognition and clinical language technology.
  • CCHIT extends EHR Module certification to the latest version of the Medseek Empower patient portal.
  • TELUS Health and McGill University enter a three-year joint venture to conduct research on how best to use technology to improve health and healthcare delivery for Canadians.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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May 7, 2013 News 8 Comments

Morning Headlines 5/6/13

May 5, 2013 Headlines 1 Comment

Two Cerner live sites go to tender

In England, two NHS hospitals release an RFP seeking a replacement for their Cerner systems.

AMA says EHRs create ‘appalling Catch-22’ for docs

Steven Stack, MD, chair of the AMA board of trustees. spoke at a CMS listening session on billing and coding within an EHR system. He questioned the government’s mandating the use of EHRs while simultaneously orchestrating a witch hunt over cut-and-paste fraud accusations associated with physician documentation. Sack points to the generic, nearly uniform output of EHR documentation systems for causing a false perception fraud.

TriZetto Corporation Announces Reorganization of Leadership Team

TriZetto announces an executive reorganization as CEO Trace Devanny departs immediately leaving an empty seat that will be temporarily filled by TriZetto board member Vicky Gregg. An executive search is underway for a permanent replacement for Devanny. Jude Dieterman, formerly EVP and COO, has been promoted to the newly created role of president.

Govt moves to roll out ambitious e-health plan

The health department in India has issued an RFP for its recently announced e-health plan, which calls for each citizen to have a health card to hold demographic data and an integrated EHR that will automate hospital processes and bring all information into a centralized state health information system.

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May 5, 2013 Headlines 1 Comment

News 5/3/13

May 2, 2013 News 2 Comments

Top News

5-2-2013 10-44-47 PM

A selectman and software developer from Edgecomb, ME blames MaineHealth’s decision to close a local ER on the health system’s $150 million Epic implementation. The selectman’s letter to the editor to the local newspaper notes that MaineHealth has charged “millions of dollars” to member hospitals, but has had “a real failure in its implementation,” resulting in unplanned operational costs with minimal benefit to the state. Meanwhile, in a memo to employees last week, Maine Medical Center’s CEO listed several causes for its $13.4 million loss in the first half of the fiscal year, including “unintended financial consequences” of its Epic rollout as well as incorrect charging. The organization has placed further Epic implementations on hold as teams from Epic and the hospital try to fix problems.


HIStalk Announcements and Requests

inga_small A few HIStalk Practice highlights from the last week: patients say the most bothersome aspect of doctor visits is unclear or incomplete explanations of problems. Health Texas Provider Network partners with MediMobile for its mobile charge capture solution. The number of physician office jobs for billers and medical record clerks has declined sharply over the last two years. Epocrates is the most popular mobile app among US physician app users. Athenahealth names St. Boniface Haiti Foundation the winner of its 2013 Vision Award. Physicians are generally making more money this year than last, but are also spending more time on paperwork. Most news items on HIStalk Practice are not mentioned HIStalk, so peruse HIStalk Practice regularly to stay current on the ambulatory HIT world. Thanks for reading.

On the sponsor-only Jobs Page: Regional Sales Director, Senior Director of Business Development, Senior Manager Engineering Development, Open Positions in Development.


Acquisitions, Funding, Business, and Stock

5-2-2013 10-45-35 PM

Merge Healthcare reports Q1 results: revenue up 4.3 percent, EPS –$0.07 vs. –$0.02, missing earnings estimates.

5-2-2013 10-46-12 PM

API Healthcare announces the signing of over 25 contracts in Q1 and bookings that were 25 percent higher than the same period in  2012.

5-2-2013 10-48-26 PM

MedAssets announces Q1 numbers: revenue up 15.3 percent, adjusted EPS $0.41 vs. $0.24, beating expectations on both.

5-2-2013 10-49-46 PM

Athenahealth announces Q1 results: revenue up 30 percent, adjusted EPS $0.38 vs. $0.17, beating on both but adjusting fiscal year EPS guidance to below consensus.


Sales

5-2-2013 10-51-29 PM

University of Nevada School of Medicine chooses GE Healthcare’s Centricity Business, Centricity Practice Solution, and Centricity PACS-IW.

Filmore County Hospital (NE) selects NextGen Healthcare’s Inpatient Clinicals and Inpatient Financials.

Baylor Quality Alliance (TX) chooses Humedica MinedShare from Optum to analyze administrative and clinical data from payers, various EHRs, and the Baylor Health Care System HIE.

Louisiana Specialty Hospital will implement ONE-Electronic Health Record from RazorInsights. 

5-3-2013 7-08-25 AM

MD Anderson Cancer Center (TX) chooses Epic as its vendor of choice, according to an internal memo forwarded by a reader. Other readers had reported that same rumor late last week, saying that Epic had beaten Cerner as VOC.


People

5-2-2013 6-25-04 PM

UNC Health Care (NC) interim CIO Tracy Parham, RN is named permanent CIO, where she will lead its Epic project.

5-2-2013 6-47-56 PM

Parallon Business Solutions names John Guevara (Allscripts ) as CIO.

5-2-2013 7-14-00 PM

Patient Privacy Rights names Adrian Gropper, MD (HealthURL Consulting) as CTO.

5-2-2013 7-48-03 PM

Stephen Collins (Allscripts) is named president of Austin-based behavioral charting system vendor ChartAssist.

5-2-2013 8-07-48 PM

The Advisory Board Company CEO Robert Musslewhite is named by Washingtonian as one of its 100 Tech Titans and is also profiled in a feature in The New York Times.

Galen Healthcare Solutions appoints Joel Splan (Northwestern Memorial Healthcare) as CEO.


Announcements and Implementations

Rockdale Medical Center (GA) implements Nuance’s PowerScribe 360 voice recognition software for the dictation of imaging reports.

5-2-2013 8-53-10 AM

PointClear will move its corporate headquarters from Huntsville, AL to Dunwoody, GA.

5-2-2013 11-02-55 AM

McKesson recognizes Peninsula Regional Medical Center (MD) as the 2013 winner of its Distinguished Achievement Award for Clinical Excellence for effectively using McKesson technology along with Modified Early Warning Scores to proactively identify patients at risk for a code blue.

Aprima Medical Software will interface its EHR/PM system with the Homecare Homebase platform.

LHP Hospital Group implements McKesson’s Paragon HIS at Portneuf Medical Center (ID), Seton Medical Center Harker Heights (TX), and Texas Health Presbyterian Hospital WNJ (TX).

Elsevier launches its third annual “Superheroes of Nursing” contest and is accepting nominations for applicants in the categories of Achiever, Protector, Educator, Validator, and Connector.

SCI Solutions adds text appointment reminders to its Schedule Maximizer scheduling solution.

Modern Healthcare has corrected its article about the State of West Virginia’s payments to Medsphere for implementing OpenVista. The originally reported figure was $8.4 million per year, but that was actually the total amount spent since the contract was signed in 2005. Current payments are just under $1 million per year.

5-2-2013 10-54-20 PM

Mount Sinai Medical Center (NY) announces that it has enrolled 25,000 patients in its BioMe program, which links DNA samples to its Epic EMR information to support targeted medical care and to provide de-identified data for research. 

First Databank announces ICD-10 for Saudi Arabia at the HIMSS Middle East conference.


Government and Politics

5-2-2013 6-30-10 PM

HHS names Lyfechannel the winner of its healthfinder.gov Mobile App Challenge for its myfamily app, which helps individuals manage their family’s health through customized prevention information for each family member.

Healthcare modeling and analytics company Archimedes collaborates with CMS to give users easier access to public payer claims data.

5-2-2013 3-29-16 PM

CMS announces that hospitals and EPs have been paid $13.7 billion through the end of March, with $8.5 billion going to 8,558 hospitals and $5.2 billion to 255,722 EPs.

FDA launches the redesigned FDA Patient Network, which will educate patients and their advocates about FDA and will invite them to attend and present at FDA meetings.

Farzad Mostashari was a panelist in a discussion of technology in healthcare put on by Politico last week. The 77-minute video is of very high quality and it’s an interesting mix of people and topics.

5-2-2013 11-08-05 PM

CMS gets criticism for removing information on hospital-acquired conditions from its Hospital Compare site. CMS says the information is flawed and is redundant, but patient groups say CMS is buckling to the complaints of low-performing, high-profile hospitals.


Innovation and Research

Vanderbilt University launches the Health App Challenge to transform clinical summaries into a more patient-friendly form. Entries are due August 1, with the winner receiving $10,000 and up to five finalists being awarded $2,000 or more each.


Technology

5-2-2013 9-43-07 PM

Former Google Health product manager Missy Krasner, now involved in startups and an advisor to Box, says Google Health was a good idea in theory, but “It was a very bumpy user experience for even the most super-charged, IT savvy consumer.” She says Box will take over where Google Health left off for storing personal health records that it supports HIPAA requirements. She concludes, “So here is my hope for the future. If most EHRs can currently export a Continuity of Care Document (CCD) via the Clinical Document Architecture (CDA), why couldn’t Box grab that clinical care summary format and stylize it in a way that made sense to other doctors or patients via its documenting previewing technology? This would help the interoperability and file transfer juggernaut get a whole lot easier.”

FastCompany profiles companies started by founders who were frustrated with existing products, among them Amazing Charts.


Other

5-2-2013 9-48-14 AM

KLAS reports on the post-acute care market, which is critical for managing outcomes and costs. HealthMEDX was named the top performer among long-term care vendors with 100 percent of its customers saying the company keeps its promises and that they would buy HealthMEDX Vision again.

Weird News Andy summarizes this article as “coming clean.” Piedmont Healthcare (GA) admits that for two years it improperly cleaned colonoscopy requirement at one of its ambulatory surgery centers, requiring it to notify 456 patients that they should be tested for hepatitis and HIV. Employees cleaned the equipment with soap, but missed the disinfectant step.


Sponsor Updates

  • T-System posts a photo gallery from its linkED 2013 Emergency Care Conference held in Dallas April 22-25.
  • Emdat posts a case study from Illinois Bone and Joint Institute, which reduced documentation costs by 50 percent by implementing Emdat’s transcription software and the company’s mobile documentation tool.
  • The Nashville Business Journal names Passport CEO Scott MacKenzie one of the most influential business executives in Middle Tennessee.
  • First Databank hosts a May 14 Webinar on the use of RxNorm within information exchange and clinical quality measures.
  • Kareo offers a May 16 Webinar that considers five activities to prevent a government audit.
  • Executives from Yale-New Haven Health System, Hartford HealthCare, and North Shore-LIJ Health System will share strategies to reduce readmissions at the iHT2 Summit in New York City on September 17-18.
  • Porter Research posts a presentation that provides insight into the trends, challenges, and benefits of engaging consumers in every stage of healthcare.
  • Capsule Tech will exhibit at the annual MUSE conference May 28-31 in Washington, DC.
  • Truven Health Analytics receives a five-year accreditation from the National Institute for Health and Care Excellence for its Micromedex Medication Management solution.
  • The National Committee for Quality Assurance certifies Verisk Health’s Quality Intelligence solution to support quality reporting for commercial and Medicare Advantage populations in the California P4P program.
  • As part of this week’s Medical Library Association Annual Meeting and Exhibition in Boston, Elsevier pledges to donate $1 to One Laptop Per Child for every ClinicalKey search made at Elsevier’s booth.
  • Allscripts releases details on its annual ACE client conference in Chicago August 21-23.
  • Liaison Healthcare launches its EHR Partner Program, which give participants access to orders and results connectivity to over 100 major lab and radiology service providers.

EPtalk by Dr. Jayne

HIMSS opens the call for proposals for the 2014 conference in Orlando with 24 topic categories. If you’re like many of us in the non-profit trenches, being selected as a presenter may be the only way to go to a meeting, so good luck!

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The hot topic in the physician lounge this week was HR 1701, the “Cutting Costly Codes Act of 2013.” Introduced by Representative Poe of Texas last week, it aims to block ICD-10 implementation. What surprises me most was the number of physicians who think the mere introduction of a bill will support their lack of preparation for ICD-10. News flash – if you haven’t started preparing, you’re already behind, and I certainly wouldn’t wait around to see if this becomes law before I get started.

It’s not health IT, but it’s my favorite story this week: “untethered microgrippers.” Engineers at Johns Hopkins are working on miniature devices to retrieve biopsy specimens. Although they’re not quite ready for human testing, they look cool and are promising as a mechanism to take multiple biopsies in hard-to-reach areas.

I almost missed this little tidbit in the Federal Register that would allow use of eight CMS record systems for emergency preparedness. The change would allow CMS to disclose individually identifiable records to “public health authorities and entities acting under a delegation of authority of a public health authority” for the purpose of providing health assistance in an emergency or disaster.

CMS issues a Call for Measures for potential Quality Reporting System items to be used in future rule-making years. CMS is focusing on measures that cover clinical outcomes, patient-reported outcomes, care coordination, safety, appropriateness, efficiency, patient experience, and patient engagement. Submissions must have strong scientific evidence, so I guess my “number of patients seen on time because they weren’t yakking on their phone when I entered the room” measure won’t make the cut.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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May 2, 2013 News 2 Comments

News 5/1/13

April 30, 2013 News 4 Comments

Top News

4-30-2013 7-09-06 PM

Greenway Medical announces that it will swing to a loss for the current fiscal year because of declining sales and deferred revenue. The company’s fiscal year earnings estimate of $0.10 to $0.17 on $145-$150 million in revenue was revised to a loss of $0.11 to $0.13 on revenue of $132-$134 million. The fiscal year ends June 30. Shares dropped from Friday’s $16.05 close to just above $12 by Tuesday morning, but had rebounded to $13.47 by Tuesday’s close. Above is the one-year GWAY share price (blue) vs. the S&P 500 (red).


Reader Comments

4-30-2013 10-18-31 PM

From Big Tex: “Re: Epic deals. St. David’s Healthcare in Austin and Methodist in Houston are both heading to Epic, though I don’t think either has officially announced yet.” Unverified.

From John: “Re: interesting comment from an FBR analyst covering Nuance’s poor earnings announcement. ‘While several industry/external (smart phone consolidation, transcription transition, EMEA weakness) factors have put pressure on mobile and healthcare growth, we believe the blame lies squarely around Nuance’s execution in the field, coupled with management’s feverish acquisition strategy over the last year, which has put onerous integration risks back into the Nuance story. While we believe potential activism could put a floor on Nuance shares and ultimately enhance shareholder value over time (e.g., management changes, split-up of the company, M&A path), we find it hard to remain positive on the Nuance story as the company goes through a challenging transition process in its business over the next six to nine months.’” Carl Icahn just announced that he’s loaded up on more shares, so the surprisingly poor results for both revenue and earnings help make his eventual argument that the company should be broken up or sold outright.

4-30-2013 8-17-49 PM

From Mr. Eko: “Re: HIMSS Middle East. Started Monday. Some American-based companies there are Cerner, GE, and Medicity. Judy Faulkner, CEO of Epic, was spotted yesterday morning eating breakfast in the Four Seasons hotel. Rumor has it they are pitching to the Ministry of Health for Saudi Arabia.”

From Giles: “Re: healthcare IT decision making. Interesting reader comments. What’s your opinion?” I agree with some of the comments that healthcare organizations are quicker to promote and retain executives who wouldn’t qualify for comparable jobs in most other industries based on their education and experience. However, healthcare is a different world, trying to balance the demands of an increasingly interventionist government, regulators, special interests, politicians, clinicians, community leaders, and giant insurance companies with the patients and families who are hardly typical customers. I’ve seen cases where hotshot IT people from allegedly more progressive sectors were brought in with near disastrous results, even though the IT shop looked like a showcase on paper. Some healthcare CIOs are not very good at strategic planning, management, and customer engagement, but they have a small domain with minimal clout and high operating and capital expenses due to decisions almost always made by someone else with more influence. Healthcare CIOs also aren’t given a lot of unilateral decision-making over anything other than infrastructure – everybody likes to suggest and approve massive change management projects that get incorrectly tagged as IT initiatives, but those folks disappear when their own lack of leadership ability starts sending the project down the drain due to poor user acceptance, lack of resources, and poor project decisions. My opinion, therefore, is that healthcare IT leaders aren’t empowered to make a lot of decisions on their own, are struggling to deal with the mess foisted upon them by their fellow executives and third parties, and are trying to deal with the squeeze of ever-increasing demand with an ever-decreasing budget. I’m fairly certain that swapping them out with fat-resume private sector CIOs wouldn’t make much difference on the plus side of the ledger, but would cause all kinds of unintended consequences to patient care. It’s easy to shoot the messenger, and with regard to many high-profile projects, that’s all the CIO is allowed to be. If nothing else, consider the high degree of CIO turnover – if all it took was new people in the chair, you’d be seeing wide swings in success from that alone and that’s not the case.


HIStalk Announcements and Requests

Nick van Terheyden, MBBS, CMIO of Nuance, posted the cool photo above on Twitter. If you’re traveling anywhere interesting, send a fun local photo with something that identifies HIStalk and I’ll run it here.

4-30-2013 8-00-00 PM

Welcome to new HIStalk Gold Sponsor Porter Research, A Billian Company. The company provides its clients with customized market intelligence and research insight that includes go-to-market strategy, focus groups, win-loss analysis, prospect profiling and lead generation, competitive analysis, customer and market analysis, and M&A research. Don Graham (GM of both Porter Research and Billian’s HealthDATA) and Cynthia Porter (president) have many years of industry experience with major healthcare IT firms. The company offers a brochure, case studies, a newsletter, and white papers that illustrate its expertise. Thanks to Porter Research for supporting HIStalk.


Acquisitions, Funding, Business, and Stock

4-30-2013 7-39-52 PM

Emdeon completes re-pricing of its existing senior secured credit facilities, securing lower interest rates on its term and revolving loans.

4-30-2013 7-38-31 PM

Nuance reports Q2 results: revenue up 15.9 percent, EPS $0.34 vs. $0.43, missing estimates on both and sending shares down 18 percent and increasing speculation that activist investor Carl Icahn will use his recently acquired 10.7 percent of the company’s shares to force a breakup.

4-30-2013 7-47-17 PM

USARAD.com launches SecondOpinions.com, which offers same-day medical second opinions. Radiology-related reports range from $29 for an X-ray to $99 for an MRI. The company also offers second opinions for primary care, surgery, dermatology, and other services.

4-30-2013 9-10-16 PM

Forms automation vendor FormFast opens a UK-based subsidiary.


Sales

Trinity Health (MI) signs a multi-year agreement with Explorys for data analytics solutions.

Saint Mary’s Regional Medical Center (NV), Renown Health (NV), and Chandler Regional Medical Center (AZ) select MRO Corp.’s ROI Online platform to manage release of information.

West Florida ACO will deploy Sandlot Connect, Dimensions, and Metrix from Sandlot Solutions for patient health information management.

Methodist Health System (NE) selects Wolters Kluwer ProVation Medical software for its gastroenterology procedure documentation and coding.

Amerinet contracts with Cornerstone Advisors Group to provide HIT advisory and implementation services to its group purchasing members.

Tri-State Orthopaedics (IN) selects SRS EHR for its 24 providers.

4-30-2013 10-35-53 PM

Saudi Arabia’s King Fahd University Hospital will implement Nuance Healthcare Dragon Medical 360 | Network Edition hospital-wide.

The Cleveland Clinic’s MyPractice Healthcare Solutions will provide project management and implementation assistance to Glens Falls Hospital (NY) as it deploys Epic at its physician and specialty practices.


People

4-30-2013 12-25-15 PM

MedMatica Consulting Associates appoints Jerry Howell (KPMG) CEO and a member of the company’s board of directors.

4-30-2013 12-33-30 PM

Thomas H. Lee, MD (Partners HealthCare) joins Press Ganey as chief medical officer.

4-30-2013 12-54-50 PM

CSI Healthcare IT hires Martin O’Neil (Charts In Time) as health information management practice director.

4-30-2013 1-23-24 PM

Meditab Software appoints Adele Nasr (WebMetro) VP of marketing.

4-30-2013 7-55-42 PM

A. John Blair III, MD, CEO of EMR consulting firm MedAllies, is elected chair of independent Direct community DirectTrust.org.

4-30-2013 8-19-02 PM

Christopher Mansueti, former VP of client services for RelWare, died Friday, April 26 of amyotrophic lateral sclerosis. He was 53.


Announcements and Implementations

VHA, Inc. adds physician dashboards to enhance its VHA IMPERATIV Advantage performance improvement solution, which leverages transactional-level data through Truven Health Analytics and UHC.

MDI Achieve, provider of the MatrixCare EHR for long-term acute care, will integrate with Homecare Homebase, a provider of homecare and hospice technology solutions.

Heywood Hospital (MA) streamlines clinician workflow following its implementation of Accent On Integration’s Accelero Connect integration platform.

4-30-2013 3-38-00 PM

Samaritan Albany General Hospital (OR) moves from Meditech to Epic this week.

Transylvania Regional Hospital (NC) goes live on Cerner.

Children’s Hospitals and Clinics of Minnesota implements wireless data transmission between Cerner’s EMR and CareFusion’s infusion pumps.

PeriGen recognizes its client Banner Health (AZ) for reducing unnecessary early-term deliveries by 22 percent, earning the health system a Showcase in Excellence Award from the Arizona Quality Alliance.

Florida Hospital Tampa implements the EarlySense bedside patient monitoring system.

A Modern Healthcare article covers the State of West Virginia’s VistA implementation. It’s paying Medsphere $8.4 million per year for support and an unspecified amount to InterSystems for Cache’ licenses. The state also added financial systems from NTT DATA to replace VistA’s minimal capabilities. Update: Modern Healthcare issued a correction to this article – Medsphere has been paid $8.4 million over the life of the contract (since 2005), around $940,000 per year.

4-30-2013 9-37-04 PM

The Pittsburgh paper profiles Omnyx, a five-year-old digital pathology systems vendor formed as a joint venture between UPMC and GE Healthcare.


Government and Politics

Arizona lawmakers pass legislation that will require health insurers to pay for telemedicine treatment for certain specific conditions for patients living in 13 rural counties.

Rep. Ted Poe (R-TX) introduces a bill that would prohibit HHS from mandating providers to switch to ICD-10 code sets, which Poe contends would cost about $80,000 for individual doctors and $250,000 for practices with five to 10 physicians.

4-30-2013 3-33-08 PM

A bipartisan group of 67 senators sends President Obama a letter calling for him to be more directly involved in the VA’s disability claims backlog situation. The senators note that the average wait time for first-time disability claims is around 316 days, with a delay of up to 681 days in certain parts of the country. Of 900,000 pending claims, more than 600,000 are over 125 days old.


Innovation and Research

4-29-2013 2-10-36 PM

A peer-reviewed article published by the CDC finds that the interface technology of Intelligent Medical Objects is superior to population classification techniques as a disease surveillance tool. The findings are based on a study that showed IMO terminology service was 32 to 42 percent more accurate in identifying coronary heart disease compared to algorithms using reimbursement coding and classification techniques in identifying coronary heart disease.


Technology

AirStrip Technologies settles its patent dispute with MVisum, Inc., a competitor it accused of infringing on its patent for real-time viewing of patient data on mobile devices. MVisum agreed not to offer infringing products that include “streaming or displaying real time or near real-time patient physiological data.”

NextGen Healthcare launches Comparison Utility, a proprietary ICD-9/ICD-10 comparison tool that is available a no charge to its customers.

4-30-2013 9-04-40 PM

Healthcare Holdings Group acquires the exclusive rights to 3D-Practice’s patient education graphics technology, which it will embed in its ChartZoneMD EHR.


Other

Athenahealth and MIT’s H@cking Medicine host a May 4-5 Hack-a-Thon aimed at at bringing about disruptive and meaningful solutions to healthcare challenges.

4-30-2013 7-24-51 PM

Anthony Weiner, the former Congressman who resigned after admitting to sending sexually suggestive text messages and photos to several women, is making big money as a corporate consultant. One of his clients is EMR vendor CureMD.

4-30-2013 8-15-35 PM

Here’s Imprivata’s latest HIT cartoon.


Sponsor Updates
  • DrFirst publishes a white paper highlighting the 428 percent growth in e-prescribing for controlled substances.
  • Medseek holds the inaugural meeting of its Clinical Advisory Council , formed to enhance patient engagement.
  • MedAptus highlights three customers and their seamless integrations between the MedAptus charge capture solution and their EHRs.
  • GetWellNetwork recognizes 12 hospitals and individuals for improving clinical care and outcomes through the use of IPC technology.
  • Inland Northwest Health Services releases its 2012 Community Report.
  • Martin’s Point Health Care (ME) discusses how its use of PopulationManager by ForwardHealth Group has improved its ability to respond to patient needs, identify gaps in care, and make systemic changes based on performance.
  • Imprivata hosts May 9 Webinar introducing the benefits of OneSign for healthcare.
  • Nuesoft hosts a May 8 Webinar on  using technology to improve revenue cycle.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 30, 2013 News 4 Comments

Advisory Panel: Surprise Projects for 2013

April 29, 2013 Advisory Panel No Comments

The HIStalk Advisory Panel is a group of hospital CIOs, hospital CMIOs, practicing physicians, and a few vendor executives who have volunteered to provide their thoughts on topical industry issues. I’ll seek their input every month or so on an important news developments and also ask the non-vendor members about their recent experience with vendors. E-mail me to suggest an issue for their consideration.

If you work for a hospital or practice, you are welcome to join the panel. I am grateful to the HIStalk Advisory Panel members for their help in making HIStalk better.

This question this time:  What "surprise" IT or informatics projects have come up recently that you didn’t expect to have to deal with in 2013?


We’re about four months away from a pretty big EHR rip-and-replace go-live. The surprise for me has been the steady drumbeat of “business as usual” requests: a new POC lab system, new offices, clinics and moves, interfaces to the legacy system that will be replaced 30 days after go-live, etc. I guess I shouldn’t be surprised — just a little freaked out.


When we began the fiscal year in October, we had not planned on applying for a CMS Shared Savings ACO. The learning curve was steep on this, and now that we were awarded one in January, we are being cautious to make the right decision on an IT platform to support the ACO.


Not sure that it’s a surprise, but the increased focus on meeting regulatory demands have shifted the focus of IS. Even though the organization focuses well on our EHR and Meaningful Use progress, it is difficult to find the funds to refresh our infrastructure and deliver the smaller application needs of the organization (food management and employee health are recent examples that come to mind). Our average age of infrastructure continues to creep upwards while our MU efforts monopolize most of the IS capital. On top of that, there is renewed focus on patient access and experience that have impact to the IS "pot o’ gold" (and for my organization it’s not really much of a pot to begin with – maybe a cup is more accurate). I have had to redirect money away from the non-regulatory projects and leave organizational needs unmet. Old equipment and unhappy customers create uncomfortable CIOs. Not a complaint really, just a reality of the job. These demands on capital make it more critical for IS to be able to tell the story on how we are
going to decrease costs, increase revenues, avoid penalties, etc.


The surprise projects are currently getting planned for 2014 in our organization. Many of them are focused on Meaningful Use – both for 2014 Stage 1 and Stage 2. From our organization’s perspective, it will probably late 2014 or 2015 before we can focus on any significant IT project that isn’t driven by a regulation or a dependency for a project that is.


Multiple instances in my organization where a doctor or department had spent time and money to build out an application for their use and want to now commercialize it. Who knew there would be so much entrepreneurial spirit going on under our hood? Begs the question – should we better create an atmosphere and infrastructure to support these projects, and what is the best way to support them moving forward (e.g. do we help to spin them off into new companies to help create a way to sustain them?) And of course we
have to work through the IP issues as well.


A couple of large HR system and outpatient business analytics projects competing for resources with ICD-10 and Meaningful Use Stage 2 prep projects.


Replace our software for calculating month end reserves. Replacing software for electronic claims submission.


I’m not sure I would call these a complete surprise, but what has surprised me is the volume of good, value-added ideas that are coming up related to using our EMR to further improve quality, safety, efficiency. Multiple IT-enabled optimizations using our EMR and analytic tools to help further reduce readmissions, provide an early warning on septic patients, reduce catheter -associated urinary track infections, and the like. In addition to ensuring readiness for Stage 2 Meaningful Use, we are spending much effort and energy on optimizing our EMR.


No real surprise projects. What is creating unrest is BI, ACO support, and keeping up after we cut our staff by 20 percent.


Interestingly, most surprises here are due to our operational need to jettison existing partners, in my case, in rad onc and imaging. This was primarily due to the relationships going south fairly quickly. Standing up linear accelerators et al, as well as a new PACS, was definitely not even on the radar. Both are significant projects.


HIMSS Healthcare Transformation Project.


Major modifications to our revenue cycle system and the interfaces to our insurance companies, based upon changes to reimbursement policies, particularly capitated payments. Still reeling.


We have a solid strategic plan that’s updated each year. We also have an engaged IT Governance group. I can’t think of any surprises, but we are only halfway through the fiscal year. My mindset is that IS should expect them and not overreact. This is where you can see what your team is made of. Also, surprises provide teaching and growth opportunities.


We have to go through three major code upgrades before February 2014, rather than just two. And we have to implement our EHR vendor’s HIM module upgrade, to our surprise, because none of the vendor’s new functionality works with our current HIM module. That turns out to be a major project, and a prerequisite that has set several other projects (such as physician documentation) back by nearly a year. Lastly, our pharmacy had been trying to "skate by" the MU Stage 2 regs by only implementing bar-coding for IV meds, but we realized after some calculations and CMS FAQs that still wouldn’t hit our required 10 percent. We’re going to have to do a full medication barcode implementation under very tight time frames.


Most surprises have been in the realm of infrastructure upgrades (additional storage and additional wireless capability). Under the heading of wireless capability, the organization chose many years ago to implement a guest wireless network. Our administration wanted to bring their own devices — they balked at having to give permission to sign on to the guest network even with something as simple as an acknowledgement. Because of this, our guest network is regularly exceeding its connection limit. We are working to create a third network for employees and their devices.


New hospital process reengineering projects that will have IT implications.


There is possibility of squeezing in (at least the beginnings of) more inpatient EHR implementations during the latter part of the year than anticipated as we get ever closer to Stage 2 requirements kicking in.


Not a total surprise, but our physicians and our key ambulatory vendor are very rapidly moving toward multiple mobile solutions as well as patient centric solutions. More quickly than we had anticipated, we are learning to support the iPad EMR version, iPhone  apps, and patient portal.  The vendor is providing new cloud computing solutions and we’re learning how to implement and support these very rapidly.


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April 29, 2013 Advisory Panel No Comments

News 4/26/13

April 25, 2013 News 8 Comments

Top News

4-25-2013 7-33-10 PM

Cerner posts Q1 results: revenue up 6.1 percent, EPS $0.62 vs. $0.51, beating adjusted earnings estimates but falling short on revenue. A 12 percent decline in system sales was balanced by a 16 percent increase in support, maintenance, and service revenues. From the conference call, the company announced one win over Epic in the quarter, talked up its international business, and touted its population health management efforts. Neal Patterson participated, finishing up with, “You can see from the CommonWell Alliance that we use our leadership position in the industry for the greater good, but also to basically highlight where basically we have bad actors around subjects such as interoperability.”


Reader Comments

From Med Student: “Re: Meaningful Use Stage 3. If you could change anything in Stage 3, what would you include or cut out?” I’m curious about that myself, so please leave a comment with your thoughts.

From Herky: “Re: warm-blooded. Spotted at TEDMED last week, riding the bus together from the Kennedy Center to GWU for Great Challenges Day: Allscripts CEO Paul Black and former CEO Glen Tullman. I guess all those rumors about bad blood between the two were ill founded.”


HIStalk Announcements and Requests

inga_small Some hot news you may have missed this week on HIStalk Practice: compensation for medical directors is increasingly tied to quality metrics, as are job responsibilities. Advice for physicians engaging in Web-based messaging services. Details on athenahealth’s emergency response process, which was activated during last week’s manhunt for the Boston Marathon bombing suspects. EMR adoption by primary care physicians in Canada has doubled from 23 percent in 2006 to 56 percent in 2012. Rather than sell out to hospitals, practice management consultants offer alternate alignment models for consideration. Dr. Gregg puts his spin on the phrase that pays and playing in the healthcare sandbox. Take or moment or three to catch up on the latest ambulatory HIT news and sign up for e-mail updates while you are there. Thanks for reading.


Acquisitions, Funding, Business, and Stock

4-25-2013 7-30-54 PM

Hill-Rom Holdings reports Q2 results: revenue up three percent,  EPS $0.37 vs. $0.43.

4-25-2013 7-31-34 PM

Streamline Health’s Q4 numbers: revenue up 49 percent, EPS –$0.63 vs. $0.00.

4-25-2013 7-32-28 PM

Lexmark subsidiary Perceptive grew Q1 revenue 47 percent to $44 million.

4-25-2013 9-05-02 PM

Informatica reports Q1 results: revenue up 9 percent, EPS $0.16 vs. $0.24.

4-25-2013 9-08-55 PM

Qlik Technologies announces Q1 results: revenue up 22 percent, adjusted EPS –$0.09 vs. –$0.03, beating expectations on both.

Nuance seeks the advice of Goldman Sachs following the acquisition by activist investor Carl Ican of 9.3 percent of the company’s shares.


Sales

The Michigan Health Information Network partners with Surescripts to allow users of Surescripts’ Clinical Interoperability network to send electronic health information to the State of Michigan’s public health reporting system through the HIN and the Michigan Department of Community Health.

Presence Health (IL) awards Harris Corp. a three-year contract to create a private HIE.

4-25-2013 7-35-58 PM

The University of New Mexico Health Sciences Center purchases MDaudit Professional billing compliance software from Hayes Management Consulting.

Syracuse Community Health Center (NY) selects NextGen Healthcare’s Ambulatory EHR, PM, and Electronic Dental Record solutions for its 16-location FQHC.

MModal signs seven new hospitals and imaging centers for its Fluency for Imaging radiology workflow technology.

4-25-2013 7-35-00 PM

Fisher-Titus Medical Center (OH) selects Wolters Kluwer’s ProVation Order Sets.

UC Davis Medical Center (CA) selects TriZetto’s ClaimLogic as its claims processing solution, where it will integrate with Epic.


People

4-25-2013 6-17-53 PM

The Patient-Centered Outcomes Research Institute hires Bryan Luce (United BioSource Corporation) as chief science officer.

4-25-2013 6-18-33 PM

Interactive patient care system provider Skylight Healthcare Systems names Lisa Romano (TeleTracking Technologies) chief clinical officer.

Cleveland Clinic Innovations names its current GM of IT Commercialization Gary Fingerhut as the organization’s interim director, taking over for founding executive director Chris Coburn, who is heading to Partners HealthCare to lead innovation efforts.


Announcements and Implementations

Atlantic General Hospital (MD) implements Allscripts Sunrise.

Physicians’ Alliance of America launches iMedicor SocialHIE, giving its 34,000 physician members the ability to electronically exchange clinical information.

4-25-2013 9-57-08 PM

Athenahealth announces its marketplace for third-party solutions.

4-25-2013 8-24-52 PM

HCS, which offers the Interactant suite, launches a new logo and website.

UMass Memorial Health Care deploys MedAptus Technical Charge Capture.

4-25-2013 8-11-18 PM

Patient Logic launches its physician documentation system at three small hospitals. Its sister HealthTech companies are HMS and Medhost.

Children’s Specialized Hospital (NJ) launches GetWellNetwork’s GetWell Town interactive patient system, funded by a grant from L‘Oreal USA.

The physician informaticist who heads up MedAppLab in Germany says diagnostic or prescriptive smartphone apps present too many possible sources of error to be recommended for use, including the quality of peripherals such as headphones.

4-25-2013 8-54-16 PM

Online storage vendor Box says its product is now HIPAA compliant, also announcing 10 partner applications that include the drchrono EHR, in which Box has taken an undisclosed equity position.

Lott QA Group and HRS announce an ICD-10 testbed for coding and clinical documentation.

4-25-2013 7-37-03 PM

John Halamka says in his blog that Beth Israel Deaconess Medical Center will go live on its homegrown electronic medication administration record in June. He says it’s Web-based, mobile-friendly, and integrated into existing systems. It will support the use of iPhones for viewing, iPads to verify orders at the Omnicell cabinets, and wall-mounted computers with bar code readers for verification.


Government and Politics

CMS proposes raising the maximum reward for reporting Medicare fraud from $1,000 to $9.9 million; denying Medicare enrollment to providers affiliated with an entity that has unpaid Medicare debt; and denying or revoking billing privileges to individuals with felony convictions.



ONC revokes EHR certification on EHRMagic-Ambulatory and EHRMagic-Inpatient following notification that the products did not meet the required functionality and should not have passed certification. InfoGard Laboratories, which certified the products originally, retested them after reviewing additional information and gave them a failing score. Above is the reaction of Candid CIO Will Weider.

AHA tells CMS not to add additional HIE requirements for providers, but instead focus more on implementing current HIT initiatives.

4-25-2013 3-49-10 PM

Meanwhile, the founding members of the CommonWell Health Alliance tell CMS they are committed to collaboration with HIT suppliers, adding that they will use existing standards and supplement them only when needed. Members also emphasized the importance of creating an open forum for secure patient data exchange and removing data access barriers.

4-25-2013 8-04-04 PM

A North Carolina Senate panel approves a bill that would require hospitals to create easily understood bills that include definitions for any medical terminology. State Senator Jeff Tarte, a former hospital CIO via a stint with Ernst & Young, says transparency is tough to solve and just creating nicer bills isn’t going to fix the problem.

A federal grand jury convicts the former medical records director of a Florida-based partial hospitalization program for leading a scheme that submitted $63 million in fraudulent Medicare and Medicaid claims. The therapy provided to the severely mentally ill patients involved watching Disney movies and playing bingo.


Other

4-25-2013 7-24-03 PM

A new KLAS report says that patient accounting systems are the next hot thing in 200+ bed hospitals because of accountable care needs, the tapering off of Meaningful Use system selections, and the impending transition to ICD-10. Integration is a priority, leaving Epic and Cerner as the only inpatient billing systems that also cover ambulatory billing, with Cerner still scoring low but trending up. Update: KLAS says my summary is misleading, so here is their exact wording: “Epic and Cerner are the only vendors whose inpatient billing systems are integrated with both their inpatient EMR and ambulatory billing systems.”

4-25-2013 7-52-13 PM

A solo family physician in rural Colorado says he “gave up on healthcare in America,” sold his practice to a hospital, and moved to Australia because of the 2 percent Medicare penalty he would have been charged in 2015 for not adopting an EHR that he couldn’t afford anyway. He says in Australia people love his American accent, he gets a lot of time off, and he makes $250,000 a year for a light schedule vs. the $100,000 he was making for being overworked in Colorado. “Primary care is highly respected here. That’s not the case any more in America. In the United States, health care has become more about the business of making money. The personal side of medicine is going away.”


CommonWell, challenged directly on Twitter by Terry Bequette, state HIT coordinator for the State of Vermont, says “all HIT developers” are welcome to join.  

WakeMed (NC) creates a video celebrating its 52 years and touting its new $100 million Epic system, which it is implementing along with nearby Triangle-area academic medical centers Duke University Hospital and UNC Health Care.

Truven Health Analytics reports that 71 percent of ER visits made by patients with employer-sponsored insurance coverage are for conditions that did not require immediate attention or could have been prevented with outpatient care.

Medhost files a lawsuit against Health Management Associates, claiming the hospital operator continues to use its ED software despite not having paid the third installment of $4.5 million last year.

4-25-2013 10-13-15 PM

Henry Ford Health System (MI) reports a 15 percent decrease in net income, primarily due to an increase in uncompensated care and the $36 million it spent to implement Epic. According to the CEO, “We knew that 2012 and 2013 would not be easy years for the system because of the Epic costs.”

A court orders UPMC to allow employees to use its computers and e-mail system for union-organizing activities.

Weird News Andy says this is like a reality show for doctors. Utah pediatricians trying to relate better to their teen patients hire acting students to simulate clinic visits and act out medical scenarios. The students are enjoying it so much that they have volunteered to continue after school is out.

WNA also likes this story, in which Seattle police are investigating reports that a nurse imposter entered patient rooms at Swedish Medical Center and cut the IV lines of patients to steal what sounds like narcotic-containing PCA cartridges.

4-25-2013 11-13-38 AM

inga_small In patient fashion news, Henry Ford Health System introduces a new double-breasted hospital gown that closes in the back, uses snaps instead of ties, and is made of thicker fabric than traditional gowns. One of the gown designers notes that, “By creating a hospital gown that is safe, stylish, and comfortable, we’ve made the patient feel more at home, like they’re wearing their own garments." Kind of makes me want to schedule some elective surgery just to try one out.


Sponsor Updates
  • Aprima Medical Software, Greenway Medical Technologies, and Allscripts forego interface fees as preferred partners for Greater Houston Healthconnect’s regional HIE.
  • Elsevier issues a brief that identifies the need for and potential impact of evidence-based medicine.
  • Wellsoft will participate in next month’s 2013 Emergency Medicine Update conference in Toronto and the e-Health 2013 conference in Ottawa.
  • Barb White, director of healthcare solutions for AT&T, discusses cyber attacks and security breaches in healthcare. 
  • MedAssets’ Sandy Hoffman co-hosts the Fifth Annual Mouse Races for MS in Cape Girardeau, MO on April 27.
  • Laura Kreofsky, principal advisor with Impact Advisors, discusses how EPs are spending their Meaningful Use incentives.
  • Prognosis suggests topics to discuss with current or potential vendors to avoid EHR dissatisfaction.
  • Penn State makes the DynaMed clinical reference database available to all students and staff. 
  • Boston Children’s Hospital Chief Innovation Office Naomi Fried and Carnegie Mellon University professor Alan Russell will provide the keynote addresses at the iHT2’s Health IT Summit in Boston May 7-8.
  • ADP AdvancedMD hosts a May 8 Webinar on engaging patients in their healthcare. 
  • NextGen Healthcare hosts a May 1 Webinar on effective claims processing.
  • Stuart Long, Capsule’s chief marketing and sales officer, discusses the benefits of medical device integration and how it works in a hospital.

EPtalk by Dr. Jayne

ONC issues the Apps4TotsHealth Challenge to encourage integration of the TXT4Tots message library into new or existing platforms. The library includes evidence-based messages focusing on nutrition and physical activity and is targeted to parents and caregivers of children 1-5 years old.

The National Institutes of Health is using IT to boost energy savings. Maneuvers that would benefit healthcare entities include forcing computers to go on standby at the end of the day and software to aggressively manage environmental systems.

Children’s National Medical Center is using video games as a way to measure and manage chronic pain. Applications are used for physical therapy as well.

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Overheard in the physician lounge: two of my colleagues were discussing slick new carts that have appeared on the floors. I’m happy to note that they are from HIStalk sponsor Enovate.

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I received a HIMSS e-mail regarding the annual conference experience and asking me to take a brand survey on my “emotional connection” to HIMSS. I was asked to select images that fit attributes for the HIMSS brand on “touch, taste, scent, sight, and sound.” Maybe I’m too much of a literal person, but I found the concept odd. It also didn’t fit my screen without scrolling, making it a non-starter.

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Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 25, 2013 News 8 Comments

Morning Headlines 4/25/13

April 24, 2013 Headlines 1 Comment

FDA Device Surveillance to Tap Phone App

The FDA Adverse Event Reporting System will be revamped in part by launching a smartphone app for streamlined adverse event reporting by physicians.

Electronic health records key to patient care quality improvement

In England, a survey of physicians reveals that 94 percent believe that patients should have at least some access to their electronic medical records, but only 34 percent like the idea of full access. Physicians also overwhelmingly support allowing patients to update standard sections of their own electronic records, including demographics, family history, allergies, and home medications.

Patient-Centered Outcomes Research Institute to Invest Up to $68 Million to Develop a National Patient-Centered Clinical Research Network

PCORI has committed $68 million in funding to support the development of a national infrastructure to advance patient-centered clinical research that enables efficient participation from broad patient populations.

athenahealth Marketplace Brings Shopping to Health Care IT

athenahealth launches a marketplace of bolt-on pfferings for its cloud-based practice solution from a variety of vendors, including Experian Healthcare, InHealth Clinical Documentation Solutions (ICDS), NHXS, iTriage, and Entrada.

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April 24, 2013 Headlines 1 Comment

HIStalk Interviews Elizabeth Holland, Director HIT Initiatives Group, CMS

April 24, 2013 Interviews 8 Comments

Elizabeth Holland is director, HIT Initiatives Group, Office of e-Health Standards and Services for CMS.

4-24-2013 1-33-51 PM

Describe the scope and process for the Meaningful Use audits for hospitals and EPs.

It’s really two pronged now, because we started last year. We started a post-payment audit program and now we are also doing pre-payment audits as well. 

When I say audits, it’s mainly the audits that are being done on the Medicare side. Medicare is actually handling the audits for all the Medicare eligible professionals and then all the Medicare hospitals as well as the Medicare dual hospitals, the hospitals that can get Medicare and Medicaid. But the Medicaid audits of the eligible professionals are being done by the individual states. 

Our audit are looking at Meaningful Use. We’re looking at providers to validate that they are using certified EHR technology. Secondly, we’re looking at them to see if they have the documentation and can justify that they are in fact Meaningful Users.

 

Will all attesting providers be audited in some fashion or will it be a random selection?

It’s actually a little of both. Certainly not all will be audited, but we are looking and refining our ability to make selections. Some selections are totally random and others are more targeted. We’re using a combination of both.

Some of the targeting is really crude and basic, like we had people who wrote a numerator and denominator to get 100 percent on every single measure. That flagged them for audit.

 

Like IRS audits, where you have a chance of being randomly audited, but there are certain red flags that you may or may not publicize?

Exactly.

 

Will the audits be strictly desk audits or will there be field audits?

There may be some field audits, but so far they’ve all been desk audits.

 

The question I’m asked most often if it will be like IRS forms that tell you how long it will take you to provide the information. Do you have an idea of how much time providers will need to set aside?

I don’t have a feel for that. The audit process becomes very individualized. We’re using the same contractor for pre-payment and post-payment. They send an initial request letter asking for certain things.

What I’m told is that it varies by practice how quickly they can pull that stuff together. Some providers have it all together because they pulled it together  when they did their attestation, so it’s very easy for them to pull it together. Others, it takes more time.

I believe the initial request gives them two weeks to pull everything together. However, if they need more time, we’re very flexible. All they need to do is contact the contact names on the letter they received. We’ve been giving everybody who’s requested it additional time.

 

What criteria were used to select the audit contractor?

That I honestly don’t know. The selection wasn’t done in my office, so I don’t know how.

 

Will the auditors, either the individual auditors or the auditing firm, be financially rewarded for identifying fraudulent attestations so that they’re encouraged to find problems?

I don’t believe so. I think they’re paid by the audit. We’re not looking for fraud so much. We’re wanting for people to tell the truth, but so far the only thing happens if you’re found not to be a Meaningful User is that you return your incentive payment. That goes right into the Treasury. It’s not like the whole practice and all your Medicare claims billings are being looked at. That’s not the way these audits are working.

 

I  assume that a lot of what you may find wrong, like on tax forms, are honest mistakes rather than intentional fraud.

Exactly.

 

How will you determine intention if you’re only doing desk audits? It would seem like you would need to have a direct conversation.

It has varied. We have sent audit letters and people have returned checks without sending in any documentation. What does that mean? I don’t know. I’m just telling you that’s a fact.

This is not really meant to be a gotcha. If you attested to a particular measure and the standard for that measure was 50 percent and what you told us is you had 90 percent … if we go back in and see you only had 80 percent, that’s fine. You’re still a Meaningful User. We’re not going to say gotcha.

We’re really looking to validate Meaningful Use. if it’s like a percentage off on one measure, we’re not going to die on our sword for that. It’s just if you have repeated measures where what you told us is massively different than the documentation that you’ve shared with us, that’s when you may have more of an issue.

 

How many audits have been done so far?

All we’re saying right now is that we’re aiming for 5 to 10 percent of the people who received incentive payments.

 

Based on experience and what you’ve learned so far, do you have any feeling for what the percentage might be that you will find not in compliance that will have to return their check?

I don’t have the feeling for that yet. Part of it is when they first started doing the audits, there were a lot of things that the auditors weren’t totally clear on. My policy staff has worked with them very closely to try to clarify things. That’s part of why we put out some of the guidelines that we put out, so that everybody can be more clear about what documentation they need to save, what they need to be attached to, all sorts of things like that, so that everybody’s nearly well aware of what the requirements are.

I think in the beginning there was just a lot of cloudiness and now we’re trying to make everything much clearer for the auditors and for the providers as well.

 

Will it be a phased approach where they’re looking at a random sample over a fixed time period, or will it be a big swoop of people …

It will be ongoing throughout the program. What will probably happen — and I don’t know this for sure — but my sense is that if you are audited and you pass, the likelihood of you being selected in the next year will be lower than if you did not pass and you participate in a subsequent year.

 

Going back to the model of financial audits or IRS audits, there’s usually a thoroughly documented step-by-step process that has every procedure down pat so that the audit person doesn’t have to use a lot of judgmental analysis. Does that exist for Meaningful Use audits, and if so, is it publicly available?

Very close. Any time there is any call for judgment, it comes to my staff. If there’s anything that’s not clear, we make the decision.

 

Since providers are being held to those audit standards, would they have access to see what those standards are other than the obvious about how the process will work?

I’m thinking we’re going to be putting out a lot more information on that. But yes, they should know what the standards are, and part of that is what the definition of Meaningful Use is.

The goal of the program from my perspective is to get people to switch from paper to electronic, and then once you’re using the EHR, to use it in a meaningful way. We’re not trying to scare people. We’re not trying to get people to return to paper. But then again, we’re also paying out an incredible amount of money. We want to make sure that taxpayers are getting what they expected — that people are really switching to electronic health records.

We have a really strong fiduciary responsibility, so we’re trying to balance that to make sure people know that we’re serious. You should have documentation that backs up your attestation, but it’s not going to be like a “surprise, gotcha” thing. It will be things that you know about.

 

If the provider is judged to have not been in compliance, is there an appeals process?

At this point, we are still deciding that.

 

But from what you said, the auditors won’t hold the sole authority on any decision …

That’s the thing. The appeal process is run by my office. If we’ve already weighed in back and forth on the audit, then there’s no need for us to weigh in again.

 

Let’s say a provider fails the audit and blames their certified vendor. Will there be any push to then evaluate the vendor as well as the user?

We’re talking to the Office of the National Coordinator a lot about that. Honestly, a lot of providers are concerned about their products. But what we’ve said is if the product produces a report and you rely on that report for your attestation, that gives you documentation, and if the tool itself is not calculating accurately but you have reports that document what you attested to, then you’re fine.

There have been lots of instances that the EHR is not calculating things correctly and patches going out and providers being really scared.

 

If that occurs and it turns out the vendor software has made a mistake of some sort, will there be repercussions to that vendor?

I don’t know if there will be, but we’ve certainly known of several instances with different vendors about patches they’ve put out. We made the auditors well aware of those things so that they don’t penalize the providers.

 

Much of the documentation involves EMR-generated reports with the vendor’s name on them. It seems like it would be pretty easy for someone to just Photoshop those.

That’s one of the things we’re working on.

 

Doctors are telling me that there is definitely fraud occurring under the Medicaid program Adapt, Implement, and Upgrade where providers claim to be customers of a vendor and the vendor has never heard of them. Is there ability or an interest in checking to see that if a customer claims that they’re using a particular vendor software that by simply contacting the vendor to find out if they really are or not?

Each state is handling that differently, but before they pay, they’re supposed to have in various standard of validation comes before they pay. In a way it’s like a pre-payment audit where you have to give a bill of sale and things like that to justify your payment.

 

I don’t want to suggest even though I used that Medicaid example that the possibility is limited to Medicaid. Under the Medicare audit, it could be the same issue, where someone has attested and says, “I use NextGen,” but NextGen says, “No, they’re not a legal user of our software.”

Some of the things that we ask for in the audit are screen shots and things like that. We’re talking about trying to get some sort of automatic … like you have to send an e-mail from the EHR to us so we can validate that they’re actually using the tool. But I think for Medicaid, it’s because you don’t have any measures to do. You are just adapting, implementing, or upgrading. You don’t have to be using. You can just get these tools. I think it’s harder to validate. At this point, the number or people we have participating is so large that I don’t know how we would call all the vendors to find out.

 

Will the results of the audits be made publicly available in any form?

Yes, but I don’t know when that will be. We have a lot of people who are wanting that.

 

That wouldn’t name providers, I assume.

I don’t believe so, no. It could certainly go after like provider type, like  large or small eligible professional or hospital. I think from my understanding right now we’re doing a lot more audits on EPs just because there’s more of them. The hospitals are doing really well. The EPs have more issues, but that’s mainly based on sheer numbers.

 

Audit notices are going out by e-mail. In the experience so far, have there been providers who just didn’t get the e-mail or just ignored it hoping it would go away?

I don’t know that if they ignored it to would go away, but I think if they don’t respond then we send them a letter, like a mail letter. That’s just the first. Just because they don’t respond doesn’t mean they’re off the hook. Good try.

 

There’s been a lot of attention paid to the group of Republican senators who are challenging the Meaningful Use program. Do you see that the nature or the scope of the audits will be adjusted in any way to appease the folks who want to see it made tougher?

Quite honestly, I think that was an interesting letter. And I think we’re actually, despite what the letter says … a lot of what they want us to do is already included in Stage 2 of Meaningful Use. I believe we’re on the path that they want us to be, but also in the letter they told us to slow down to Stage 3. Stage 3 would be an additional push to do more, but they asked us to … they were happy that we were delaying the rulemaking. 

We’re definitely going to have more conversations with them to clarify how we’re moving forward. We believe we’re really in alignment. We just have to make a better case for ourselves, I think.

 

One of the most misunderstood aspects from the beginning is that you didn’t have to buy anything to qualify for the incentive. Do you think that people understood that you didn’t necessarily have to invest? Do you have a feel for how many people did invest to earn the payment versus those who are already pretty much in compliance already?

My understanding is that every EHR system out there had to be tweaked. Some were major tweaks and some were minor tweaks, so depending on what kind of system you had, they had to be certified, but in that most cases like the vendors would take care of that. Then you had to make sure you got whatever upgrade or whatever and made sure that it was certified. 

What we don’t have good intelligence on are how many people, especially with the early adopters, were already electronic and just had to do Meaningful Use to get a payment and how many people were nowhere. They just decided, oh, here’s an opportunity to go electronic — you can get some compensation for it. We’re trying to look more into that data.

There’s misinformation out there thinking that there’s a mandate that they must go to electronic health records. That’s not true, although it is true if they’re not Meaningful Users for Medicare, they will get a payment reduction starting in 2015. It’s sort of like the carrot or the stick, any way you can get people to switch to going electronic, because one of the big goals is having interoperability but if you have half the EPs still on paper, reaching true interoperability is going to be really hard.

 

I don’t mean to harp on this question, but I have a lot of vendor readers. Do you see any reaction to the results of the audits that would impact vendors, such as some changing of the certification criteria?

The certification criteria are already changing for 2014. That was all in rulemaking, so there’s nothing else we can do for Stage 2 at this point. We had to do the rulemaking so early without, in my opinion, enough data to really know what the main issues were with Stage 1.

What we heard anecdotally from vendors is a lot of them have many different tools and that there’s going to be some sort of consolidation as they move to Stage 2. Not necessarily a merging of vendors, but a vendor may have 10 tools that he may only get six or something like that certified for Stage 2 or the 2014 certification. Hopefully that means that vendors are concentrating on certain products and trying to make those products as good as they can possibly be.

 

Any final thoughts?

From my perspective, we’re trying really hard to educate providers, but we’re also trying really hard to educate the vendors. We have a new vendor work group that we have called with the vendors, working through issues that they’re having. My staff are the people who wrote the Meaningful Use rules, so that we go into in depth explanations about what we mean about each of the Meaningful Use objectives and measures. 

We’ve had a much more collaborative process as we’re moving through Stage 2, mainly because there were a lot of misinterpretations of Meaningful Use measures at the beginning of Stage 1. This time we’re trying to be more proactive as we move forward. The providers have been appreciating that and the vendors have been very appreciative.

We have a really large group of vendors that is participating with us. Hopefully that will lead to a more unified determination for programming of the Stage2 EHRs so that the EHRs will just do better work. They’ll work for providers better.

The main thing that I keep saying to people that I talk to is you shouldn’t be worried about the audits as long as you have told the truth. I know there’s some panic out there, but if you’re honest and you’re telling the truth, you have really nothing to worry about.

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April 24, 2013 Interviews 8 Comments

News 4/24/13

April 23, 2013 News 4 Comments

Top News

4-23-2013 8-43-50 PM

Nextgov uncovers a scathing internal Pentagon memo that says DoD’s plans to acquired commercial off-the-shelf software fly directly in the face of the President’s call for a joint DoD-VA EHR based on open standards.


Reader Comments

4-23-2013 9-46-12 PM

From Wesley: “Re: Encore Health Resources. They have laid off multiple people in recent weeks.” I asked Encore CEO Dana Sellers, who provided this reply:

Encore continues to experience strong, healthy growth thanks to wonderful clients and the best consultants in the industry. As a result, we’ve done some realignment of our Client Services organization over the past few weeks to better position Encore to execute our strategy: the delivery of a full life cycle of consulting solutions with a focus on business intelligence and performance improvement. In fact, to meet our increasing business demands, we are actively recruiting for Client Services Executives in Nashville, Florida, Colorado, and California. Send some great folks our way, would you?

From John Porta: “Re: Advisory Panel CIOs not finding value in the HIMSS conference. Who does find value, the marketing VPs? Sales employees think it’s the biggest waste of their time in the pipeline, which is why they spent their days on their phones while ignoring the giveaway seekers and non-buyer IT staff. Why do vendors spend an average of probably $250K to be there preaching to the choir? Maybe just  companies trying to justify their marketing existence. I believe the HIMSS conference is an ongoing, self-perpetuating, ad-selling, marketing come-on. Few companies have the balls to pull out.”

4-23-2013 9-46-55 PM

From Iggy: “Re: MModal. Debtwire said that on April 3, executives told their debt holders that they fell out of compliance in the period ending March 31 and One Equity will ‘cure’ this. Is this routine?” I asked Ben Rooks, who writes HIStalk’s “Healthcare IT from the Investor’s Chair,” who with help from his friends at investment bank Houlihan Lokey provides this explanation:

Loans such as the one that allowed One Equity to borrow money to purchase MModal (the Leverage in the term LBO, or Leveraged Buy Out) have certain ongoing requirements with which the company must comply (known as “covenants”). In this case, there was actually only one such covenant, but it allowed for a maximum amount of net leverage (how much debt each dollar of EBITDA — earnings before interest, taxes, depreciation, and amortization — must support). This metric rose since the deal closed, reaching 6.43x at the end of last year in contrast to the 5.35 that was projected. Interestingly, it was set at 6.5 in Q1, then drops sequentially by .25 until it reaches 5.75 in Q1 2014 (presumably as the company both pays down its debt and grows its revenues and EBITDA). According to Standard & Poor (the debt rater in this case), “MModal has seen its revenue weaken as a result of a slower-than-expected transition to its new products strategy and competitive pricing pressures” and it downgraded the debt a notch. Realizing that these things can happen, however, the loan agreement allows the sponsor (One Equity) to cure the problem, typically by adding more equity dollars or else guarantying part of the loan. Incidentally, M*Modal might not be public, but its debt is, so this was, in fact, disclosed publicly, just not as loudly as in the case of public companies.


Acquisitions, Funding, Business, and Stock

4-23-2013 9-47-45 PM

LifeIMAGE closes a $15 million Series C round of financing.

Henry Schein, Inc. secures $300 million of committed financing with The Bank of Tokyo-Mitsubishi UFJ, Ltd. based on the securitization of its A/R.

4-23-2013 9-48-31 PM

CTG reports Q1 results: revenue up five percent, EPS $0.24 vs. $0.20. CTG attributes its growth on increased demand for EMR and other health information technologies.

4-23-2013 9-49-11 PM

Healthcare learning platform vendor HealthStream announces Q1 results: revenue up 25 percent, EPS $0.07 vs. $0.05, beating earnings expectations and sending shares up 16 percent Tuesday.

Israel-based medical social data mining vendor Treato raises $14.5 million in funding. The company’s platform extracts patient comments from blogs and discussion forums, applies natural language processing and other analytics, and provides an overview of patient comments about drugs and conditions. According to the company’s CEO, “Until now, everyone wanted to hear the doctor’s voice. Now, because of social changes and even legislation, everyone wants to hear the patient’s opinion. Regulation no longer pays for the doctor to treat, but for the patient to heal.”


Sales

Nightingale Preventive Care, a provider of healthcare services in Kmart stores, selects HealthFusion’s MediTouch EHR.

4-23-2013 9-50-47 PM

Riverside Health System (VA) chooses HealthMEDX Vision for EMR and billing for its Lifelong Health and Aging Related Services division.

Orange Accountable Care (FL) selects Halfpenny Technologies to provide a lab data interface for referring physicians using risk management services from Orange Health Solutions.

Scott & White Healthcare (TX) contracts with KPMG LLP to assist with its Oracle PeopleSoft v0.2 Human Capital Management reimplementation project.

Ardent Healthcare will expand its use of Infor’s human resources and financial management suites.


People

4-23-2013 9-40-49 AM  4-23-2013 9-42-41 AM

Huron Consulting Group hires Todd Christiansen (IBM Global Business Services) and Joseph Gaetano (Siemens Medical) as managing directors in its healthcare practice.

4-23-2013 7-15-38 PM

Anthony Caponi (Maxim Healthcare Services) joins Direct Consulting Associates as VP of sales.

4-23-2013 7-19-35 PM

MediRevv hires Randy Blue (Resource Corporation of America) as director of sales.

4-23-2013 9-02-49 PM

VC firm Polaris Partners names Tim Kilgallon as CEO in residence, focusing on consumer-directed digital health opportunities. His healthcare IT experience includes stints with Pointshare Corporation and Medaphis.

4-23-2013 9-07-37 PM

Health program and population health management software vendor Aegis Health Group promotes Bill Walker to CTO.

4-23-2013 9-33-06 PM

Mobile applications platform developer Kony Solutions, announcing 90 percent year-over-year growth, names Abhay Parasnis (Oracle) as president and COO.

Gary Peat (Council Capital) joins eDoc4u as SVP of corporate and business development.


Announcements and Implementations

The Patient-Centered Outcomes Research Institute will fund up to $68 million to support organizations focused on the advancement of comparative clinical effectiveness research.

Hamad Medical Corporation in Qatar will implement Cerner Millennium across its primary care centers and eight hospitals.

Allscripts releases Allscripts Care Director to enable care coordination across all care settings.

4-23-2013 7-25-45 PM

Emmi Solutions wins a communication award from The Center for Plain Language for its Heart Failure Transition multimedia series.

4-23-2013 9-55-07 PM

Gwinnett Hospital System (GA) adopts the ChartWise:CDI clinical documentation system.


Government and Politics

HHS considers amending the HIPAA Privacy Rule to allow states to report information on potentially dangerous mental health patients to the National Criminal Background Check System, the database that houses information on individuals prohibited by law from possessing firearms.

4-23-2013 11-42-37 AM

CHIME calls on HHS to extend certification requirements to include the HIE market.

CMS and ONC will convene a May 3 meeting on appropriate coding using EHRs from 9:00 a.m. until 2:00 p.m. in Baltimore. The session will also be streamed online.

A bipartisan group of senators unveils a discussion draft of a bill to create a nationwide electronic system for tracking the distribution of prescription drugs. The proposed measure would require every entity in the prescription drug supply chain to provide electronic transaction information when there is a change of ownership, plus shift the country from a lot-level drug tracing system to a unit-level tracing system.

4-23-2013 2-40-32 PM

CMS and ONC post a joint fact sheet that breaks down the progress made since the passage of the HITECH Act that also includes the latest numbers on EHR adoption, e-prescribing rates, and the increased emphasis on interoperability and exchange.


Technology

Medical device company Smiths Medical will develop connectivity between its infusion systems and Epic using IHE standard profiles to establish communication between the systems.


Other

A small-scale Johns Hopkins study finds that first-year residents in academic medical centers spend just 12 percent of their time interacting with patients, while computer duties take up 40 percent of their hours. Patient time has been significantly reduced since a similar 2003 study, suggesting that mandatory reduced hours may have caused an undesirable balance of work duties. The researchers say better EMR systems would reduce some of the computer time required. The study’s senior author, a hospitalist, concludes, “All of us think that interns spend too much time behind the computer. Maybe that’s time well spent because of all of the important information found there, but I think we can do better.”

4-23-2013 9-56-36 PM

The Kansas Department of Health and Environment will officially take over the Kansas HIE effective July 1. The HIE board acknowledged in September that it financially unsustainable and voted to relinquish its functions to the state.

John Halamka reflects on hospital lessons learned from last week’s Boston Marathon bombings in his “Life as a Healthcare CIO” blog. Among them: making sure systems can support working from home, limiting data center access, increasing on-screen warnings to staff about looking up patient information, and improving HIE capabilities.

A review of CEO salaries of non-profit Chicago hospitals finds 20 who made at least $1 million in total compensation in 2011, with the CEO of Northwestern Memorial HealthCare leading the pack at $4.6 million.

Two former patients of Glens Falls Hospital (NY) file a class action lawsuit against the hospital and its contractor Portal Healthcare Solutions after the medical records of 2,300 patients are left on an unprotected computer network for four months.

Microsoft will sponsor an April 25 panel discussion on Unintended Consequences: Patient Perspectives on the HIPAA Omnibus Rule at the Microsoft Innovation & Policy Center in Washington, DC. Panels will include Iliana Peters (OCR), Corinne Cary (New York Civil Liberties Union), Deborah C. Peel, MD (Patient Privacy Rights), and Hemant Pathak (Microsoft).

4-23-2013 8-49-10 PM

Baltimore-based Healthify, a new startup led by Johns Hopkins University graduates and students, develops a free electronic waiting room questionnaire that can screen for health determinants such as psychosocial risks, nutritional status, housing, education, and substance abuse, all of which significantly increase the odds of an individual requiring hospitalization.

No-frills clinics in India say they can offer heart surgery for $800 by operating in prefabricated buildings that have air conditioning only in the OR suites and that require family members of patients to help care for them. The company’s founder, a noted heart surgeon, says that while Stanford Hospital is spending $600 million to build a 200-300 bed hospital and a new London hospital will cost $1.5 billion, the clinic can build and equip a hospital for $6 million and have it up and running within six months.

Weird News Andy says this might make sense. In England, NHS is considering sending recovering elderly patients to “hospital hotels” run by private hotel chains. It’s modeled after a similar program in Scandinavia and would relieve “bed blocking,” where local councils have cut funding for home health and residential services, leaving patients stuck in expensive hospital beds they don’t really need.

4-23-2013 7-37-54 PM

WNA also likes a story that he titles “A different kind of Brazilian close shave.” A Brazilian fisherman accidentally fires a foot-long harpoon into his skull, then decides to go home to sleep it off. His aunt calls the fire department 10 hours later. He’s in ICU and has permanently lost sight in one eye.


Sponsor Updates

4-23-2013 7-29-06 PM

  • Infor will donate $5 to charity for each attendee of Monday night’s Infor Healthcare party, held in conjunction with Inforum in 2013 in Orlando.
  • Greenway Medical will add RemitDATA’s comparative analytics solution into its PrimeDATACLOUD Remittance Intelligence service, giving practices reimbursement and productivity insights and performance benchmarking.
  • Jill Farnsworth and Mike Grisaffee from Encore Health Resources  will participate in educational sessions at the HIMSS Texas Regional Conference May 14-15 in San Antonio.
  • Healthcare Anytime offers a June 4 Webinar on surviving the avalanche of patient data.
  • Bottomline Technologies donates $2,500 to a memorial fund for Joshua Krantz, a recently deceased employee.
  • The Denver Post names Ping Identity Top Workplace for the second consecutive year.
  • InstaMed launches the InstaMed Healthcare Payments Account, which helps providers get paid faster and through more channels.
  • Visage Imaging releases version 7.1.3 of the Visage 7 Enterprise Imaging Platform, which incorporates over 1,000 enhancements and product fixes.
  • T-System will deploy the NextGen PM solution for its RevCycle+ solution clients.
  • Craneware showcases enhancements to its Bill Analyzer and InSight Audit solution during this week’s HCCA 17th Annual Compliance Institute in National Harbor, MD.
  • eClinicalWorks offers a series of Webinars in April and May on its upcoming eBO Version 6 release.
  • Henry Johnson, MD, VP and medical director for Midas+, a Xerox company, discusses value-driven analytics and the best big data trends for healthcare.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 23, 2013 News 4 Comments

HIStalk Interviews Keith Figlioli, SVP Healthcare Informatics, Premier

April 19, 2013 Interviews No Comments

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

4-15-2013 7-07-13 PM

Give me some background about yourself and your job.

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

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

 

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

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

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

 

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

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

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

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

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

 

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

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

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

 

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

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

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

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

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

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

 

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

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

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

 

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

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

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

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

 

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

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

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

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

 

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

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

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

 

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

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

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

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

 

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

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

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

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

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

 

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

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

 

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

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

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

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

 

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

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

 

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

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

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

 

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

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

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

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

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

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

 

Do you have any concluding thoughts?

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

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

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April 19, 2013 Interviews No Comments

News 4/19/13

April 18, 2013 News 7 Comments

Top News

4-18-2013 6-10-27 PM

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


Reader Comments

4-18-2013 6-44-17 PM

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

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

4-18-2013 7-02-08 PM

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

4-18-2013 7-29-50 PM

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

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


HIStalk Announcements and Requests

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

4-18-2013 7-35-27 PM

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

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

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


Acquisitions, Funding, Business, and Stock

4-18-2013 8-29-48 PM

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


Sales

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

4-18-2013 4-09-36 PM

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

4-18-2013 4-08-20 PM

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


People

4-18-2013 8-31-05 AM

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

4-18-2013 8-05-01 PM

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

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

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


Announcements and Implementations

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

4-18-2013 4-12-04 PM

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

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

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


Government and Politics

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

4-18-2013 8-19-51 PM

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


Technology

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


Other

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

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

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

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

4-18-2013 8-41-31 PM

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

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

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

4-18-2013 8-57-38 PM

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

4-18-2013 9-04-56 PM

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

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


Sponsor Updates

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

EPtalk by Dr. Jayne

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

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

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

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

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

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


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 18, 2013 News 7 Comments

HIStalk Interviews Farzad Mostashari, MD, National Coordinator

April 17, 2013 Interviews 7 Comments

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

4-17-2013 7-05-05 PM

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

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

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

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

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

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

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

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

 

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

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

 

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

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

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

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

 

Is there an endgame to Meaningful Use stages?

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

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

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

 

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

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

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

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

 

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

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

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

 

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

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

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

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

 

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

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

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

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

 

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

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

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

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

 

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

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

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

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

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

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

 

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

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

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

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

 

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

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

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

 

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

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

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

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

 

Do you have any concluding thoughts?

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

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

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

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

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

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April 17, 2013 Interviews 7 Comments

News 4/17/13

April 16, 2013 News 4 Comments

Top News

4-16-2013 9-28-53 PM

4-16-2013 9-34-13 PM

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


Reader Comments

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


HIStalk Announcements and Requests

4-16-2013 6-51-38 PM

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

4-16-2013 8-15-22 PM

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


Acquisitions, Funding, Business, and Stock

4-16-2013 9-00-49 PM

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

4-16-2013 9-24-32 PM

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


Sales

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

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

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

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


People

4-16-2013 3-50-19 PM

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

4-16-2013 6-23-59 PM

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

4-16-2013 2-48-32 PM

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

4-16-2013 8-32-21 PM

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

4-16-2013 7-59-29 PM

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

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

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

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


Announcements and Implementations

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

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

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

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

4-16-2013 10-49-13 PM

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

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

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

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

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

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


Government and Politics

4-16-2013 3-23-17 PM

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


Innovation and Research

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


Other

4-16-2013 10-52-40 PM

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

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

4-16-2013 10-51-19 PM

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

4-16-2013 8-56-03 PM

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

4-16-2013 9-10-46 PM

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

4-16-2013 9-14-19 PM

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

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

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


Sponsor Updates

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 16, 2013 News 4 Comments

News 4/10/13

April 9, 2013 News 14 Comments

Top News

4-9-2013 10-40-32 AM

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


Reader Comments

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

4-9-2013 7-33-51 PM

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

4-9-2013 7-43-59 PM

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

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

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


HIStalk Announcements and Requests

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

4-9-2013 7-45-43 PM

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

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


Acquisitions, Funding, Business, and Stock

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

4-9-2013 10-32-34 PM

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

4-9-2013 10-33-14 PM

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


Sales

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

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

4-9-2013 10-34-01 PM

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

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


People

4-9-2013 6-04-33 PM

Versus promotes Kevin Jackson to VP of technology.

4-9-2013 6-11-33 PM

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

4-9-2013 6-10-41 PM

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

4-9-2013 9-39-25 PM

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


Announcements and Implementations

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

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

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

4-9-2013 1-50-38 PM

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

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

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

4-9-2013 6-53-07 PM

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

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

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


Government and Politics

4-9-2013 10-38-15 PM

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


Technology

4-9-2013 10-39-35 PM

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

4-9-2013 7-18-09 PM

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

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


Other

4-9-2013 11-22-30 AM

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

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

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

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

4-9-2013 6-24-06 PM

Here’s the latest cartoon from Imprivata.

4-9-2013 8-20-57 PM

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

4-9-2013 8-25-10 PM

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

4-9-2013 7-40-24 PM

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


Sponsor Updates

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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April 9, 2013 News 14 Comments

Curbside Consult with Dr. Jayne 4/1/13

April 1, 2013 Dr. Jayne 2 Comments

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

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

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

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

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

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

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

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

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

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April 1, 2013 Dr. Jayne 2 Comments

News 3/29/13

March 28, 2013 News 7 Comments

Top News

3-28-2013 10-09-06 PM

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


Reader Comments

3-28-2013 10-10-32 PM

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

3-28-2013 10-11-45 PM

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


HIStalk Announcements and Requests

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

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

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

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


Acquisitions, Funding, Business, and Stock

3-28-2013 7-47-11 PM

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

3-28-2013 9-08-33 PM

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


Sales

3-28-2013 10-14-59 PM

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

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

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

3-28-2013 10-16-16 PM

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


People

3-28-2013 6-40-34 PM

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

3-28-2013 11-34-52 AM

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

3-28-2013 7-21-23 PM

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


Announcements and Implementations

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

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

3-28-2013 10-17-51 PM

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

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

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

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


Government and Politics

3-28-2013 12-17-15 PM

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

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


Other

3-28-2013 10-19-06 PM

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

3-28-2013 10-20-04 PM

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

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

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

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

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

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

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

3-28-2013 8-28-32 PM

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


Sponsor Updates

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

EPtalk  by Dr. Jayne

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

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

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

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

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

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

Print


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 28, 2013 News 7 Comments

News 3/27/13

March 26, 2013 News 6 Comments

Top News

3-26-2013 9-45-15 PM

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


Reader Comments

3-26-2013 6-55-16 PM

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

3-26-2013 6-57-46 PM

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

3-26-2013 6-53-16 PM

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

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

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

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


HIStalk Announcements and Requests

3-26-2013 6-26-43 PM

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

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

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

3-26-2013 7-02-09 PM

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


Acquisitions, Funding, Business, and Stock

3-26-2013 7-38-24 PM

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

3-26-2013 9-07-04 PM

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

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


Sales

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

3-26-2013 4-59-37 PM

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

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

3-26-2013 5-05-00 PM

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


People

3-26-2013 3-25-04 PM

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

3-26-2013 6-51-39 PM

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

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


Announcements and Implementations

3-26-2013 5-13-15 PM

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

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

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


Government and Politics

3-26-2013 9-06-53 AM

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

 

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


Innovation and Research

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


Technology

3-26-2013 3-50-00 PM

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

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


Other

3-26-2013 3-51-28 PM

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

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

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

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

3-26-2013 12-45-22 PM

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

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

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

3-26-2013 5-43-42 PM

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

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


Sponsor Updates

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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March 26, 2013 News 6 Comments

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