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Readers Write: The Year is 2025…

June 5, 2013 Readers Write 4 Comments

The Year is 2025…
By Nick van Terheyden, MBBS 

6-5-2013 9-45-36 PM

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

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

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

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

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

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

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

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

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

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

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

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

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


Nick van Terheyden, MBBS is CMIO of Nuance.

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June 5, 2013 Readers Write 4 Comments

News 6/5/13

June 4, 2013 News 3 Comments

Top News

6-4-2013 11-24-49 PM

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


Reader Comments

6-4-2013 11-23-21 PM

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

6-4-2013 7-56-50 PM

6-4-2013 7-56-06 PM

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

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

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


Acquisitions, Funding, Business, and Stock

6-4-2013 11-26-05 PM

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

6-4-2013 11-26-58 PM

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


Sales

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

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

6-4-2013 11-30-10 PM

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

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

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

6-4-2013 11-31-36 PM

Ocean Beach Hospital (WA) chooses Healthland Centriq EHR.

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

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


People

6-4-2013 7-10-05 PM

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

6-4-2013 7-12-14 PM

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

6-4-2013 7-59-45 PM

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

6-4-2013 8-24-39 PM

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


Announcements and Implementations

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

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

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

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

Sanford Bemidji (MN) goes live on Epic.

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

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


Government and Politics

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


Innovation and Research

6-4-2013 11-34-53 PM

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

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

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

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

6-4-2013 10-20-58 PM

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


Other

6-4-2013 11-38-02 PM

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

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

6-4-2013 10-53-20 PM

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

6-4-2013 7-33-11 PM

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

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

6-4-2013 7-41-35 PM

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

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

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

 


Sponsor Updates

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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June 4, 2013 News 3 Comments

News 5/31/13

May 30, 2013 News 5 Comments

Top News

5-30-2013 8-38-04 PM

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


HIStalk Announcements and Requests

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

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

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


Acquisitions, Funding, Business, and Stock

5-30-2013 10-27-09 PM

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


Sales

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

5-30-2013 3-59-37 PM

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

5-30-2013 4-00-19 PM

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

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

5-30-2013 4-01-48 PM

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

5-30-2013 4-03-04 PM

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


People

5-30-2013 4-04-35 PM

AirStrip names OptumInsight CEO Bill Miller to its board.

5-30-2013 5-23-59 PM

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

5-30-2013 2-19-16 PM

Explorys appoints Cleveland Clinic CFO Steve Glass to its board.


Announcements and Implementations

5-30-2013 5-31-21 AM

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

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

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

5-30-2013 10-29-54 PM

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

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

5-30-2013 10-31-36 PM

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

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

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

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

5-30-2013 8-17-36 PM

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

5-30-2013 9-03-02 PM

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


Government and Politics

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

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

5-30-2013 8-03-47 PM

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

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


Other

5-30-2013 2-41-02 PM

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

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

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

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

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

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

5-30-2013 10-34-42 PM

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

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


Sponsor Updates

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

EPtalk – by Dr. Jayne

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

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

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

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

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

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


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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May 30, 2013 News 5 Comments

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

May 29, 2013 Interviews 8 Comments

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

5-29-2013 7-22-20 PM


Tell me about yourself and the company.

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

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

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

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

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

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

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

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

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

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

 

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

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

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

 

Who is your most significant competitor?

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

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

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

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

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

 

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

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

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

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

 

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

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

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

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

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

 

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

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

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

 

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

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

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

 

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

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

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

 

That would be unusual, right?

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

 

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

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

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

 

What research and development is the company working on?

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

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

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

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

 

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

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

 

Is that time-saving for them?

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

 

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

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

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

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

 

Do you have any final thoughts?

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

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May 29, 2013 Interviews 8 Comments

News 5/24/13

May 23, 2013 News 18 Comments

Top News

5-23-2013 6-21-30 PM

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


Reader Comments

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

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

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

5-23-2013 7-29-45 PM

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

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


HIStalk Announcements and Requests

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


Acquisitions, Funding, Business, and Stock

5-23-2013 11-07-30 AM

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

5-23-2013 11-20-36 PM

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

From the Quality Systems earnings call:

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

Sales

East Lansing Orthopedic Association (MI) selects SRS EHR.

5-23-2013 11-21-55 PM

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


People

5-23-2013 6-14-27 PM

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

5-23-2013 12-26-07 PM

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

5-23-2013 10-16-53 PM

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


Announcements and Implementations

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

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

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


Government and Politics

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

5-23-2013 10-54-10 AM

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

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


Innovation and Research

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


Other

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

5-23-2013 11-25-09 PM

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

5-23-2013 11-31-20 PM

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

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

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

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

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

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

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


Sponsor Updates

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

EPtalk by Dr. Jayne

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

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

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

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


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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May 23, 2013 News 18 Comments

News 5/22/13

May 21, 2013 News 4 Comments

Top News

5-21-2013 7-35-19 PM

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


Reader Comments

5-21-2013 7-49-08 PM

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

5-21-2013 7-56-24 PM

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

5-21-2013 10-12-35 PM

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



Acquisitions, Funding, Business, and Stock

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

5-21-2013 9-03-24 PM

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

5-21-2013 9-35-25 PM

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

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


Sales

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

5-21-2013 12-47-20 PM

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

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

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

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

5-21-2013 10-17-52 PM

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


People

5-21-2013 3-43-25 PM

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

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

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

5-21-2013 3-50-02 PM

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



Announcements and Implementations

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

5-21-2013 11-17-00 AM

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

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

5-21-2013 7-44-22 PM

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

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

5-21-2013 9-11-45 PM

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


Government and Politics

5-21-2013 11-45-17 AM

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

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

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

5-21-2013 9-28-21 PM

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

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

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


Other

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

5-21-2013 12-09-06 PM

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

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

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

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

5-21-2013 10-19-35 PM

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

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


Sponsor Updates

5-21-2013 12-42-24 PM

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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May 21, 2013 News 4 Comments

News 5/17/13

May 16, 2013 News 12 Comments

Top News

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


Reader Comments

5-16-2013 8-31-28 PM

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

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

5-16-2013 7-50-36 PM

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

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


HIStalk Announcements and Requests

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

5-16-2013 7-24-53 PM

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

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

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

5-16-2013 8-04-07 PM

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


Acquisitions, Funding, Business, and Stock

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


Sales

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

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

5-16-2013 10-13-57 PM

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

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


People

5-16-2013 12-40-55 PM

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

5-16-2013 6-17-47 PM

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

5-16-2013 6-18-54 PM

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

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


Announcements and Implementations

5-16-2013 7-17-41 PM

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

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

5-16-2013 10-16-04 PM

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

5-16-2013 8-52-13 PM

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


Government and Politics

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

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

5-16-2013 8-21-37 PM

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


Innovation and Research

5-16-2013 9-07-42 PM

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

5-16-2013 9-11-20 PM

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


Other

5-16-2013 11-23-15 AM

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

5-16-2013 8-42-58 PM

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

5-16-2013 12-09-29 PM

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

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

5-16-2013 9-30-15 PM

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

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


Sponsor Updates

 

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


EPtalk by Dr. Jayne

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

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

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

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

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

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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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May 16, 2013 News 12 Comments

Readers Write: Hospital Pricing Data: Another Step Down the Rabbit Hole

May 15, 2013 Readers Write 6 Comments

Another Step Down the Rabbit Hole
By Data Nerd

On Tuesday, May 7 at 9:53 p.m., the Center for Medicare and Medicaid Services released a new open dataset to shed light on hospital pricing variations. The Times and The Washington Post (among others) published lengthy online articles (presumably overnight), complete with data visualizations to assist consumers in understanding the vast differences between what hospitals charge Medicare for their services. CMS released state and national averages a week later after The Washington Post published an article aggregating the data for comparison on the state level.

On the first day of its release, the dataset was downloaded over 100,000 times, displaying the large appetite that the public has for open healthcare pricing data. What is unfortunate is that this data set is fundamentally flawed for the purpose for which it was made public.

In the age of high(er)-tech journalism, I was disappointed to read article after article that overlooked the data documentation and went straight to the numbers and visualizations that could be concocted. Even HHS’s own chief technology officer got it wrong when he referred to the data as, “The actual prices that hospitals charge Medicare for the top 100 procedures across the country.”

The data given are not the top 100 procedures. They are the top 100 DRGs, which means that in any given claim, there could have been anywhere between one and 25 procedures performed (and they do vary, wildly.)

If the goal is to compare hospital’s charge rates, you need a normalized cohort. Or in layman’s terms, you need to compare apples to apples instead of kumquats to grapefruits. People with the same DRG suffer from the same diagnosis and often share similar courses of treatment, but wouldn’t a better analysis look at patients that all had the same procedures?

A DRG is a diagnostic related group, a very broad categorization of the primary diagnosis that the hospital is treating. A claim only has one DRG, but can have anywhere between one and 25 procedure codes. The data as it is currently presented is inherently incapable of pointing to charging discrepancies because a claim could be charging for one procedure or 25.

Personally, I think the move was more of an administrative muscle flex going into the healthcare exchanges set to open in October — fueled by the threat of public perception rather than an attempt to shed (non-refracted) light on the subject. A more accurate approach would have been to isolate claims where only one procedure was performed and provide the average charge or reimbursement data for those. Unfortunately, CMS charges nearly $4,000 for the data in a format that would allow this type of analysis.

This open dataset is another unfortunate example about our exuberance for “big data” giving way to our human propensity to under-analyze and take misinformed baby steps toward a greater goal, however noble it may be. As more and more data is presented for public digestion, its dissemination must be properly documented and cited if it is to be used to drive analytical outcomes.

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May 15, 2013 Readers Write 6 Comments

HIStalk Interviews Benjamin Albert, CEO, Care Team Connect

May 15, 2013 Interviews 2 Comments

Ben Albert is founder and CEO of Care Team Connect of Evanston, IL.

5-15-2013 7-00-56 PM

Tell me about yourself and the company.

The company started officially in late 2008, but I took it on full time in early 2009. Prior to starting Care Team Connect, I worked in healthcare technology for my whole career, most recently in a services company, PatientKeeper, for the acute care setting, where we were pulling together data for hospitalists and the providers within the hospital to better coordinate and manage care within the hospital.

As a result of that and parallel to that, my grandfather had his second stroke. Seeing all the effort that was going into the inpatient setting and very little effort going into the community setting compelled me to start the company to better coordinate care in the community for high-risk patients.

 

Describe how care coordination should work ideally.

There’s a number of perspectives on that. In my opinion, the way care coordination should work is that patients should get a patient specific plan of care that encompasses all people who touch that patient so they’re singing off the same sheet of music. Making sure it considers psychosocial factors, patient history and patient risk, and the whole patient as the plan is assembled, so that everybody knows who is going to do what when for each patient. That will enable efficiency, lower costs, and higher quality.

 

What needs to happen to make the patient-specific plan of care ubiquitous, like medication reconciliation?

You need to have the right team in place in order to manage and coordinate a population’s care. While our technology will streamline it and allow you to do a tremendous amount more with the resources that you have than if you don’t have a platform like ours to power workflow and coordinate care, if you don’t have the people who are focused on it — and I mean truly focused on it, not tangentially focused on it — as soon as you determine that you need to establish a team that’s responsible for coordination, then you need to power that workflow and allow it to scale.

Where we see most of the initiatives fail is that people will make that decision, but then they won’t be able to get lift or scale around the population, because they end up managing just the highest of high-risk patients with a few part-time or full-time resources. That in itself isn’t a way to enable full, broad-scale care coordination.

You need a more systemic process around how you are going to manage the high-risk, moderate-risk, and low-risk patients. What things are you going to do specifically for each patient as they impact quality and cost? Then allow yourself to scale that through automated processes like our technology. But before you even get to technology, you need to talk about your program development and how you can scale,  which we also help our clients with.

 

How does your platform support that process?

The platform listens for data that would trigger action on a patient that’s being managed in a population. Truly managed, not any patient in the population. We’ll identify which patients need to be managed. We’ll reconcile actionable data, which could be a real-time admission alert from an ADT, it could be a new medication, it could be a change in a patient’s psychosocial status like a change in home setting.

Any number of these things can be a triggerable event in our system that would drive action. The system listens for that, weights it against the patient-specific information and the risk to the patient and the care program that that person sits in, i.e. what we need to do in the event this piece of data comes in for this particular patient at this risk?

It drives the specific tasks to the right people across the continuum. When I say that, I mean those right people can be a family member, a clinician, a nurse, and anybody who has a relationship to that patient. The system’s rule will tell you, OK, based on this patient, here’s where you fire this task to.

 

What integration is required?

The most common integrations we do are to either claims or attribution models from payers or a shared savings program or ACOs or however they have their attribution models in their claims from the payers. We’ll pull that in as the foundation for the population being managed. Then we’ll marry real-time data to that on the fly, which includes ADT, medication feeds, and visits to the physician office. Those types of pieces of data are real time, married to the attribution and patient-specific data.

It can be labs. It can be any number of data elements that will trigger action. Based on the population being managed, we build these programs and actionable events around the data that’s more pertinent to the population being cared for.

 

How would a typical customer connect to that data and what are they doing with the results?

I’ll walk you through a couple of customer scenarios. We work with medical homes, ACOs, health systems, and we’re starting to get into some more of the employee health types of things. In the ACO medical home scenario, we’ll take a client who is currently managing 120,000 lives across an entire state with 77 physician practices. They need to manage that care across all those lives, across all those demographics.

They take their attribution, and then they take some real-time ADT information from various places across the state, and the plan of care that’s been established for each of the patients based on their criteria. They marry that specific data, i.e. an admission for anyone in their 120,000-patient population will trigger a workflow for the care managers or care navigators supporting that population. That’s a very basic core workflow that prevents readmission, increases coordinated care, and truly establishes a workflow around it, a transitions of care workflow in particular. That’s one example.

Another example might be a pure preventable readmissions initiative with a specific client, who upon discharge, we receive just ADT information along with some other data to identify which patients are at risk of readmission. From there, we’ll drive a particular plan of care based on what type of patient it is, what type of follow-up needs to occur, and drive the tasks and the actionable plan around that in an automated fashion.

If I go back to that first scenario for a second, I failed to talk about one core piece of data that is a differentiator. The population health analytics companies who today are doing a great job of identifying gaps in care and managing the data around the population that also in case of truly managing the health of a population, that data is valuable in addition to the real-time data, in addition to the attribution to trigger the right plans of care based on the patient’s attribution, risk, gaps, and beyond.

 

Many companies are involved in analytics and population health management. How do you see your offering fitting and who do you consider to be your competitors?

In the population health analytics space, we look at their data as great triggerable events married to all the other things we’re doing with the population. We like to work closely with them, especially if our clients decide to go in that direction and feel the need is strong enough for their population to identify gaps and do that analytics.

We really don’t feel like we’re competitors to the analytics companies. It’s more as a partner, where we can leverage their data to truly drive workflow and action, which seems to be a pretty big gap in the market right now that we’re filling.

 

Is it difficult for people to understand what you’re offering and how it fits in?

It can be, until the market understands the difference between care coordination and care management and population analytics, which we’re charged with helping the market understand. There’s a huge difference. It can get gray in terms of the client’s perception of what we do versus what those solutions provide.

But as soon as a client really digs in and says, OK, how are we actually going to manage the population? Not how are we going stratify and identify the population, but how are we actually going to manage the population and all of these care coordinators we’re hiring now? How are we going to power their workflow in a way that we’re sure that they are going to follow the right patients and that we’re going to get the yield out of the initiative that we anticipated getting?

It’s the next step. People recognize that as a major need. We sit on front of it to make it all happen. But until there is that understanding of what analytics is really built around — and it’s really built around crunching the data and what we do, which is built around workflow and coordinated care — I think the market does get confused until they understand the difference.

 

It sounds so obvious that there should be a patient-specific plan of care. Describe how it gets created and maintained and what the end result looks like.

It is somewhat of a new concept in the way in which we approach it, but I think there had been a lot of folks after the longitudinal plan of care for a patient. They are often templated and disease based, much as disease management companies or groups like that have approached the market in the past.

What we do is much different. There are elements of disease-based plans of care, but it’s really about the patient themselves, the psychosocial data, meaning what is their mental health, what is their home status? A number of those other elements which can help dictate how to follow up and manage that patient. Essentially, how much do I need to do to support this patient as opposed to how much can they do on their own without my involvement?

Our approach takes that data, which changes over time, and marries it to the real-time data. The plan is always changing. It’s a living, breathing plan of tasks and documentation to support that patient. As data changes from a real-time perspective and there is a profile change for a patient, the plan morphs along with the patient to make sure that it’s always providing the right level of support and efficiency around that patient’s care as required.

That’s really a big difference for us. It’s by no mean a single-threaded plan of care. This is a living, breathing plan of care based on the data coming in to the system and the patient’s needs, which really hadn’t been done before, not in this way, anyways.

It seems to be getting a lot of traction in the marketplace as a result, because our clients don’t have all the resources in the world and that’s not going to change. How are you going to truly manage this population of patients and help our community members who are collaborating with you in this ACO or in this shared risk initiative to support the population in real time? That’s how we help it happen.

 

A typical example would be where there is a primary care provider and a hospital relationship that integrates specialists and therapies. They’re potentially with an admission or an ED visit and there might be a specialist involved and there might be therapies of some sort. The resulting plan integrates all that into a single single source of truth that everybody agrees and understands that is taking care of that patient.

Absolutely. You’ve got it. That plan is driven by the individual or group that is responsible for the population. The ACO group may create that source of truth through our platform, or the hospital. It really depends on where is the risk is. They’ll drive that plan based on the automated routines.

 

The new brave new world of ACOs has put together some bedfellows that may not be comfortable with each other, as in hospitals and practices. 

You can add the health plans into that mix as well, in terms of all the groups who are participating in these initiatives and how well they work together in a way that makes sense for everybody.

I suppose the answer to you is that’s initiative by initiative, community by community. In some cases, like in Battle Creek where we are working, everybody is collaborating really well. It’s actually the practices who are leading the initiative, supported by the health systems and other folks in the community organizations and the community.

In the hospital-driven initiatives, it can be very effective. For example, we’re working with a health system in the Northeast. They are powering all their skilled nursing facilities through our platform. Upon discharge, one of the skilled nursing partners will get all their detailed plans for a heart failure patient that’s being discharged to them. Not in the placement type of variety, which I know is probably the next question, but more on, what’s the plan of care for this patient?

Those people are engaging and wanting that type of information because they aren’t armed with that data in a way that makes them successful. They want that type of collaboration. They know in the future it’s all going to be shared, and if they are not lining up to collaborate well with the health system today, it’s going to be a big problem for them in the future.

 

Everybody thinks about physicians and hospitals when they think about care coordination or ACOs, but in this model that you’re describing, it sounds like there is an important role for a nurse.

A huge role for a nurse and family and community partner. If you fall in to the trap of this is only a physician-led or hospital-led initiative, you’re not going to change things the way that they need to be changed in order to really coordinate care.

You need to infiltrate that with a care navigator-type nurse function that supports the population and also understands what it means to truly work with community members, Meals on Wheels, various partners in the community, family members, adult caregivers. All these people who can play a role for you. 

I’ve got all this work to do for this population. I know I need to do to support the population well. I have a handful of resources to make it happen. There are community resources out there willing to do this and they just need to be armed and ready to go. If you put that process in right, you are actually solving a much bigger problem by truly supporting the community and the population as a whole.

 

Where do you see that company being in five years?

That’s a great question. I get it often. The way I answer that is, I’m not sure where the company will be in five years. We just keep delivering value week to week, month to month, year to year basis, and keep listening to what our clients are telling us. Making sure we understand where the market is going and keep driving and building a successful organization that has value and purpose.

We try very hard not to focus on our five-year plan, but to focus on execution, action, value, and purpose as an organization. The rest will take care of itself.

 

Any final thoughts?

The company is doing tremendously well. I’m sure this is consistent with what everybody says, but the company is truly doing great. We recently signed our largest client to date. I think Care Team Connect is very, very well positioned for the foreseeable future. We’re just excited to continue to read your blog and hopefully show up there more and more with good news.

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May 15, 2013 Interviews 2 Comments

Morning Headlines 5/13/13

May 12, 2013 Headlines No Comments

Cash-strapped hospital bosses employ American IT expert on a salary of £25,000 A MONTH…and even picked up his bar tab and his laundry bill

In England, Rotherham NHS Hospital is being criticized for spending $40,000 a month on consultants in hopes of salvaging a struggling $60 million Meditech implementation.

District Medical Group Partners with Medical Scribe Program to Optimize Electronic Medical Record

Phoenix, AZ-based District Medical Group hires scribes to support physician documentation in its transition to an EMR. The scribes has improved physician workflow and eliminated transcription costs.

UPMC Q3 operating income down by half

University of Pittsburgh Medical Center reports a nearly 50 percent drop in Q3 revenue compared to the same time last year. The drop-off would have been closer to two-thirds lost had UPMC not picked up a $53 million return on its 2006 investment in dbMotion, which sold to Allscripts this March for $235 million.

Tampa Stakes its Claim to Lead Healthcare into the Future

In an effort to attract jobs, Tampa is developing a city-wide program to embrace technology and best practices to reduce overall healthcare costs, generally the second highest cost for businesses after payroll. The program is being offered in lieu of the traditional tax breaks offered as an incentive by most cities.

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May 12, 2013 Headlines No Comments

Readers Write: Managing Total Medical Expense While Improving Health Outcomes

May 10, 2013 Readers Write No Comments

Managing Total Medical Expense While Improving Health Outcomes
By Michael Gleeson

5-10-2013 8-53-34 PM

As our healthcare system evolves and payment reform expands, providers are forced to deliver higher quality care at a lower cost to curb explosive growth in national expenditures seen in past decades. As a result of this paradigm shift, the industry is responding.

In order to accommodate the incentives and priorities set forth by the Affordable Care Act (ACA), health systems must elevate the importance of primary care. This care model is shifting, with many adopting a patient-centric “Medical Home” approach to patient management. This new model emphasizes cross-provider care coordination, risk-stratified patient management, and proactive, preventative care.

Organizations are also using data more effectively. Increased adoption of electronic health records (EHRs), has led to valuable clinical data that can be mined and analyzed to inform health plans and providers on both their patient population as well as clinician behavior. However, the problem is that it isn’t being mined correctly. By integrating claims and clinical data, building trust and acceptance by care delivery professionals, and reorganizing care teams around actionable information, health systems will start demonstrating reductions in medical costs while improving patient outcomes.

So where should you start?

The four key pillars for success outlined below focus on improving health outcomes and managing total medical expense as critical elements in achieving lasting change within the practice.

Building Trust and Sharing Data

Despite significant investment in technology and data sharing by health systems, health plans and most primary care providers still have no visibility into their patients’ activity outside the four walls. And some health systems are hesitant to share data and/or performance with their counterparts, so as a result, it’s important to do the following when integrating with the network:

  • Create data governance policies. It is important to have a policy that dictates the use and exchange of shared data.
  • Establish role-based security and blinded data policies. This is a good rule for those who are apprehensive to share information. Not everything needs to be shared in order to drive change.
  • Data validation. Assessments to ensure that the data presented to the practice accurately reflects the activities at the point of care is critical to building trust.

Patient Attribution and Outreach

Quality improvement programs are often hindered by the challenge of accurate patient designation. If you can’t accurately identify who is responsible for a patient, you can’t improve the care rendered to them. Health plans often provide member rosters, but these can be large, burdensome to work with, and are often wrong.

It’s important to implement a system that will absorb the membership files from multiple plans, sync this data with the EHR and Practice Management data, and generate a list of members who are inaccurately attributed. The upkeep on this process, once it’s started, can be done monthly and will only take a couple of hours. With the attribution problem solved, the practice can reach out to the non-engaging patients it was responsible for and re-immerse them in primary care.

Fast, Accurate, and Actionable Data

In the whirlwind of external data feeds and complex EHR data structures, finding meaning can be a long process. Utilizing a flexible, transparent and vendor-agnostic data warehouse system allows information from multiple EHR feeds and claims files to aggregate on a nightly basis. This data is merged into a simple, patient-centered data model for reporting and analytics use. A focus on the EHR’s clinical data ensures near real-time analysis and greater relevance to the providers and care teams, resulting in more accurate and efficient patient results that can be monitored accordingly.

Transforming Clinical Care Teams

Even with access to timely and accurate data, practices can still struggle to improve outcomes because of inadequately aligned care teams. Providers are burdened with excessive documentation requirements in poorly optimized clinical systems. When a PCP is spending 10+ hours a day documenting in their EHR, they do not have the time and energy to consume the relevant information to drive proactive care management and move the needle on patient performance measures.

Arranging these roles appropriately within the care team maximizes resources and is critical to successful patient care. Medical Assistants should become the primary consumer of reports and act as a quarterback for the team, beyond their role of taking vitals. Using pre-visit planning reports, they should identify care gaps and coordinate with the RN and care manager to ensure the right actions are taken before the patient arrives. This will enhance the interaction and allows all current and potential problems to have the time to be addressed.

The inevitability of healthcare reform is forcing practices nationwide to shift how they view, plan and deliver care. While there is a renewed focus on managing quality and cost containment, this requires health systems of all sizes to master their data assets and align care team roles around the right tools and mandates.

As noted earlier, this charge is not easy. However, many organizations are currently rising to and conquering this challenge by utilizing these four pillars of success. By meticulously positioning themselves in line with this industry transformation, and keeping their goals and attention keenly on improving patient care and dissolving excessive costs, real improvements are being identified in the current health environment.

Michael Gleeson is senior vice president of product strategy for Arcadia Solutions.

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May 10, 2013 Readers Write No Comments

News 5/10/13

May 9, 2013 News 7 Comments

Top News

5-9-2013 7-31-07 PM

Allscripts reports Q1 results: revenue down 4.8 percent, EPS –$0.07 vs. $0.03, missing estimates on both.


Reader Comments

From IT Exec: “Re: HIStalk. Thanks for everything you do. My day wouldn’t be complete without spending a few hours on there.” Thanks. Mine either.

From PCP Doc: “Re: athenahealth. Just got back from their user conference. Jonathan Bush did not mince words on stage, just like in their earnings call, when talking about ‘companies of Epic proportions.’ Athena going to Haiti to install an EMR in a rural clinic that treats spinal injury patients was a noble touch.”

From Green Lantern: “Re: CMIO searches. I am aware of a couple of hospital systems that restarted their search rather than make an offer to an existing applicant. Does that happen often with CMIO searches vs. other C-level corporate officers? Are there enough applicants, or are hospitals being unreasonable?” Your thoughts are welcome.


HIStalk Announcements and Requests

inga_small Highlights from HIStalk Practice this week: the AMA’s board of trustees chair criticizes the federal government for mandating the use of EHRs under threat of monetary penalty while simultaneously accusing providers of cloning documentation. Frederica Krueger responds to the AMA’s complaints in a “Nightmare on EHR Street” Readers Write post. DigiChart changes its name to Artemis. American Medical News reviews the status of various lawsuits against Allscripts since the company announced plans to stop regulatory development of its MyWay product. CMS creates a timeline for aligning quality measurement and reporting for multiple initiatives. Dr. Gregg considers patient engagement and patient empowerment from both the provider and consumer points of view. Get your fix of ambulatory HIT news and sign up for the email updates while you are there. Thanks for reading.

On the Jobs Page: Open Positions in Development, Senior Manager Engineering Development, Clinical Analyst.


Acquisitions, Funding, Business, and Stock

5-9-2013 7-31-44 PM

HealthTap raises $24 million in series B funding led by Khosla Ventures.

5-9-2013 7-32-33 PM

Alere reports Q1 results: revenue up 10 percent, EPS $0.09 vs. –$0.05, beating expectations on both. The company also acknowledged that an investment firm that is a major shareholder will launch a proxy fight.

5-9-2013 10-04-47 PM

The Advisory Board Company reports Q4 results: revenue up 19.1 percent, adjusted EPS $0.33 vs. $0.31, beating analyst expectations for both.

5-9-2013 7-29-59 PM

Canada-based vertical software vendor Constellation Software acquires Quantitative Medical Systems of Emeryville, CA, which offers dialysis-specific revenue cycle and EMR software.


Sales

5-9-2013 6-16-19 PM

The Mount Sinai Medical Center signs a multi-year agreement for Cureatr, a mobile app designed by one of its residents that offers HIPAA-secure group text messaging for care coordination.

Chicago Health System ACO (Vanguard Health Systems) selects Care Team Connect’s integrated care management platform.

SSM Health Care – St. Louis (MO) selects the EDCO Health Information Solutions day forward medical record scanning services for use at its seven area facilities.

Quality Health Solutions, formed to support the virtual network of seven healthcare systems and Medical College of Wisconsin, chooses population health management and clinical integration solutions from Valence Health.


People

5-9-2013 9-14-13 AM  5-9-2013 9-17-38 AM    5-9-2013 1-21-59 PM
Culbert Healthcare Solutions adds Jason Faaborg (Dell), Tom Gurdak (CSC), and David Howe (Public Consulting Group) as VPs of sales.

5-9-2013 6-25-26 PM

Forbes profiles Imprivata CEO Omar Hussain in an article on leadership.

5-9-2013 7-22-43 PM

Adventist Midwest Health names Thomas Schoenig (Wyoming Medical Center) as regional CIO.

5-9-2013 8-40-57 PM

Care collaboration platform vendor CareInSync names Steve Curd president and CEO. The company also announced a follow-on investment from California HealthCare Foundation’s Health Innovation Fund.

NCPDP names First Databank’s VP of Health Policy and Industry Relations Tom Bizzaro to its board of trustees.

Mike Vandiver (SecureWorks) joins Ingenious Med as CFO.

Charlie Ditkoff (Bank of America Merrill Lynch) joins Cumberland Consulting Group’s board.


Announcements and Implementations

5-9-2013 9-37-23 AM

Royal Philips and Al Faisaliah Medical Systems open Philips Healthcare Saudi Arabia, a 50-50 joint venture to market and sell Philips solutions and services in the Kingdom of Saudi Arabia.

5-9-2013 10-04-50 AM

Geisinger Health System (PA) will give patients access to their doctors’ notes in its RWJF-funded OpenNotes program, in which 82 percent of participating patients opened up at least one EMR note.

5-9-2013 7-39-33 PM

Martin’s Point Health Care will present at the AQA meeting in Washington, DC on May 13. They use Forward Health Group’s PopulationManager at all nine sites and 70 provider panels for micro and macro reporting.

API Healthcare and TeleTracking Technologies enter into a strategic partnership to offer API’s workforce optimization solutions and TeleTracking’s workflow automation offerings.

Project MIST takes first place in an athenahealth and MIT H@cking Medicine-sponsored hack-a-thon for its glaucoma eyedrop spray canister.

Lake Tahoe Regional Hospitalists (NV) and Shasta County Hospitalists (CA) deploy MedAptus for inpatient charge capture.

5-9-2013 10-09-07 PM

Rochester General Hospital (NY) implements EDCO Health Information Solutions’ point of care batch medical record scanning solution.


Government and Politics

HHS releases data on inpatient charges that shows significant variations in pricing, such as joint replacement that ranges from $5,300 to $223,000.


Innovation and Research

5-9-2013 9-49-26 PM

Healthfundr launches its equity-based crowdfunding platform for health startups, open to accredited investors only and working with more established companies.


Technology

 

Epic gives VMware Horizon View “Target Platform” status for EMR delivery through a virtual clinical desktop, quoting Metro Health CIO William Lewkowski as saying the move is saving his organization $1.6 million per year.

 

 


Other

5-9-2013 10-12-15 PM

Fletcher Allen Health Care (VT) will lay off 40 staff members and outsource its transcription services to Nuance Communications, which will offer jobs to 35 affected transcriptionists.

5-9-2013 6-32-04 PM

The Leapfrog Group finds in its spring update that hospitals have made only incremental progress in addressing errors, accidents, injuries, and infections that kill or hurt patients. Sixteen hospitals received an “F” grade.

Gila Regional Medical Center (NM), struggling with uninsured patient volumes, downgrades employees, halts an expansion project, and postpones implementation of a new hospital information system.

Keynote speakers at the MUSE conference May 28-31 in Washington, DC will be Farzad Mostashari and George Will.

5-8-2013 3-03-08 PM

A Surescripts report finds that 69 percent of office-based physicians actively e-prescribed last year and nearly half of patient visits generated an electronically-delivered medication history, 31 percent more than in 2011.

Allscripts will add 350 new jobs over the next five years in Raleigh, NC as it consolidates its US engineering centers. State officials will extend up to $5.35 million in incentives if Allscripts meets investment and hiring goals and maintains its 1,266 jobs in Raleigh.

5-9-2013 3-52-39 PM

An eight-country survey of physicians finds that 93 percent of US physicians report using an EMR. E-prescribing rates were highest (65 percent) among US providers, as were rates for entering patient notes into EMRs (78 percent.) While the majority of doctors in all countries report EMR and HIE have had a positive impact on their practice, US doctors were the least likely to report that their use reduced organizational costs.

Ken Roberts, MD and Jim Granfortuna, MD sing about EHRs in “Our Song of Epic Proportions.”

5-9-2013 8-06-59 PM

Weird News Andy wonders, “What is it with Brazilians and harpoons lately?” A couple of weeks ago a Brazilian guy accidentally shot a harpoon into his own head. Now a Brazilian man cleaning his spear gun in the living room accidentally shoots off a spear that goes through the mouth of his wife, who was in the kitchen at the time. She’ll recover fully. And in another incident, a Brazilian teen fishing in the Amazon River mistakes his brother for a fish, shooting a harpoon into his face and then paddling 195 miles in a canoe to take him to the hospital.

WNA also ponders this story, in which a South Florida plastic surgeon is arrested for using waterboarding-type torture on his girlfriend for 16 hours after being angered by her Facebook post.

 


Sponsor Updates

5-9-2013 7-02-12 PM

  • Consulting firm Virtelligence and its client Cone Health (NC) donated 400 tree seedlings via the Arbor Day Foundation to the Guilford County School System, whose students planted the trees around the Triad. The company tracked the number of pages printed during the Epic implementation and used an online program to estimate the number of trees required (361) to manufacture it.
  • NTT Data moves its North American corporate headquarters to Plano, TX.
  • EClinicalWorks releases agenda details for its 2013 National Users Conference October 11-14 in San Antonio.
  • Holon Solutions hosts a May 15 Webinar introducing the value of building an HIE.
  • Sandlot Solutions Director Rosalind Bell discusses how recent emergencies highlight the need for HIEs.
  • Billian’s HealthDATA releases its Provider Portal benchmarking database, which gives hospitals and health systems data for competitive analysis.
  • In a company blog post, Patientco addresses the growing patient payment problem.
  • Red Herring names Awarepoint, InstaMed, and Kony Solutions finalists for its 2013 Top 100 North American Award, which honors private technology ventures.
  • Aspen Advisors consultants will co-present at two sessions during next week’s Texas HIMSS Conference in San Antonio. Aspen’s Director of Clinical Informatics Mark Van Kooy, MD will participate in a panel discussion during an executive summit in San Francisco May 15-17.
  • Kathy LePar, VP of strategic services for Beacon Partners, offers recommendations for healthcare organizations for creating an integrated, holistic approach to strategic enterprise initiatives.

EPtalk  by Dr. Jayne

Georgia Governor Nathan Deal signs the State Physician Shield Act, which is aimed at preventing use of Affordable Care Act provisions to establish standard of care in liability cases. Supporters want to ensure that payment guidelines aren’t used to define care standards to the exclusion of individual patient factors or other clinical standards.

CMS releases Medicare provider charge data for the top 100 most frequently billed discharges across 3,000 hospitals. The variation across some procedures is as much as tenfold.

CNBC recently ran a piece on bad habits demonstrated by younger job-seekers. There are certainly a lot of relatively young workers in IT departments, but I’ve found that regardless of age, behavior is becoming more boorish. I may not be Emily Post, but I’d like to offer some etiquette tips for the age of social media:

  • Learn how to put your phone on silent. Practice this skill often.
  • Texting or checking e-mail on your phone while in face-to-face meetings is just rude.
  • Choosing “Darth Vader’s Theme” as your supervisor’s ringtone is not a career-advancing move, especially if you haven’t learned to put your phone on silent.
  • If you’re hosting a Web-based meeting and sharing your desktop, turn your instant messenger and e-mail notifiers off. I’m tired of seeing embarrassing, unprofessional, and distracting messages come across while I’m trying to work with you.
  • If you’re attending a meeting by conference call, don’t multitask unless you have the skills to pull it off. Asking, “Can you repeat that? I was on mute.” makes no sense and brands you as inattentive and illogical.
  • If you join a meeting late, don’t waste the group’s time with excuses. Say “I’m sorry” then sit down and get to work.
  • Lock your Facebook page down like Fort Knox unless you can keep your mouth shut. Do you really think it’s smart to advertise to your co-workers that you accepted prime hockey tickets from a vendor and thereby violated corporate policy?
  • Learn how to use Scheduling Assistant, Busy Search, or whatever tools your company uses when inviting people to meetings. If an attendee is already booked and you make them “required,” have the courtesy to discuss it and obtain approval first.

clip_image002

Speaking of meeting etiquette, it’s been a rough week, so I was happy to see a tweet for The Ridiculous Business Jargon Dictionary. I think I’m going to try “acluistic” in a meeting I have scheduled for tomorrow and see if anyone figures it out.

Print


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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May 9, 2013 News 7 Comments

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

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