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Readers Write: The Art and Science of HIMSS Networking

March 1, 2013 Readers Write 1 Comment

The Art and Science of HIMSS Networking
By Jodi Amendola

3-1-2013 8-26-38 PM

By now you have scheduled your meetings, RSVP’d to all your party invitations, and if you’re a Type A personality, you’ve probably already packed your briefcase and most of your suitcase. But you still have some prep work to do if you want to maximize the benefits you receive from attending HIMSS, which remains the best annual forum for networking with prospects, customers, the media, industry analysts, and potential partners.

To achieve success with your networking efforts you must:

1) Know what you want to accomplish (e.g. networking, media interviews, intelligence gathering, lead generation, scouting new partners and/or business opportunities, etc.;

2) Be prepared; and

3) Follow up on your leads after the show.

Sounds pretty simple, right? But the key isn’t accruing a stack of business cards, reciting well-rehearsed talking points, or sending follow-up e-mails before your plane touches down at your local airport. Those activities will probably yield some results, but to achieve the greatest possible success you should think quality vs. quantity.

Just between us… the real secret for getting the most out of HIMSS is getting people to listen—not just hear—you, and to remember you and some of what you discussed. Ideally, you will provide at least one “light bulb” moment that resonates and sticks with your audience. And that’s not simple–or is it?

Below are my secrets for building relationships with the movers and shakers at HIMSS. Remember, you will be competing with lots of noise, hype, giveaways, competitors claiming they’re as good or better than your company, short attention spans, and overstimulated brains. Here’s some tips:

  • You never know where your next lead or opportunity will come from. While it might be a pre-planned meeting, you may meet your next business partner or client in the elevator, waiting for or sharing a taxi, or like one of my colleagues, waiting in line at Starbuck’s. Don’t be shy. Smile and take the opportunity to prospect, but do so in a friendly, conversational manner.
  • Industry pundits, analysts, and editors are overwhelmed with people and pitches. To break through the trade show tinnitus, you need to be different and compelling. That doesn’t mean you have to be a comedian, the ultimate social butterfly, or the next Steve Jobs. You do have to be you authentic and passionate in certain areas – no one wants to talk to a robot — but be concise and to the point. Why? Because, in reality, you are selling yourself first and your product or company second.
  • Get organized. Plan ahead and figure out what you want to say to the various types of professionals who attend HIMSS. You may want to stress different information and benefits depending on whether you’re talking to a CIO, a CMIO, the head of contracting services, or the vice president responsible for performance improvement. Remember you may only have 30 seconds to deliver your elevator pitch and capture someone’s attention so make it relevant. It’s okay to weave in humor if it feels natural, but don’t force it.
  • Explain what your company does in simple terms. No marketing fluff — just tell them what you offer and explain why they should care. Be specific about the pain points that your product or services address. This information, framed within a question and answer format, is often an effective means to capture their attention. “How much time do providers waste trying to reach patients about lab results? An average of six calls back and forth. In addition to that time drain, patients become frustrated as they wait for days to hear their diagnosis. With our solution, patients are instantly alerted with a text or e-mail the moment their lab results are available.”
  • To break the ice or establish a personal connection, learn and share something personal during your meetings. What’s their best stress reliever during HIMSS or their trick for enduring flight delays? If they are more reserved, start by sharing a story about you, such as how much you’re looking forward to your daughter’s nightly rendition of “If You’re Happy and You Know It” via Skype.
  • Try to include easy-to-understand metrics. “Our hospital clients have seen a 40 percent average increase in patient satisfaction within six months of implementation. Patients love it. Providers love it. It’s a win-win.” You can always follow up with more complex data after HIMSS.
  • Do some research to prepare for scheduled meetings. For example, if you have media interviews, review their 2013 editorial calendars for relevant future article topics and weave those specifics into your conversations. “Our Chief Technology Officer is deeply involved with helping our customers achieve Meaningful Use Stage 2 requirements. We’d be happy to provide her as a resource for your August Roundup on Meaningful Use or as a sidebar to your October article on EHRs.”
  • Express appreciation for their time, reiterate the calls to action, and leave them with a smile. “Thanks again, Bob. I’ll contact you next week regarding the August and October columns,” or, “Great to meet you Steve. I’m impressed with your commitment to ongoing performance improvement. I’ll be in touch next week to go over how we can help.” It’s always a good idea to let them know that, “If you ever need my help, just give me a ring or send an e-mail.” Remember, networking is a two-way street.
  • Fulfill your promises. Follow up with an e-mail within a week regarding the opportunities discussed. Don’t forget to mention at least one of the personal aspects that surfaced, such as, “Did you enjoy your tour of the Garden District as much as you expected?” or, “Were you able to get your Starbuck’s before your important meeting?” They’ll notice and appreciate that you cared enough to pay attention.

Truly connecting with people is both an art and a science, as any great leader will tell you, but it’s less daunting if you remember that you’ll mostly be relating to one or two people at a time. The important thing is to be yourself. Smile and they will smile with you. Networking doesn’t have to be a chore or intimidating. Showing up prepared with the right attitude can even make it fun as well as profitable. Have a great HIMSS!

Jodi Amendola is CEO of Amendola Communications of Scottsdale, AZ.

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March 1, 2013 Readers Write 1 Comment

Monday Morning Update 3/4/13

March 1, 2013 News 3 Comments

From HyWay: “Re: Costco. They sent an e-mail to customers who purchased Allscripts MyWay through Costco’s program saying they are working with Allscripts to ‘offer solutions for members who do not feel the move to Pro is right for them.’ In the mean time, Costco has initiated arbitration proceedings against Allscripts to make sure its users get the service they expected when they bought MyWay.” Unverified, but the forwarded e-mail appears to be authentic. Its tone was amicable.

From The PACS Designer: “re: iWatch. While we wait for the anticipated Apple iTV later this year, there’s something else to look forward to and that’s an Apple iWatch. TPD posted about the Pebble watch, and speculation is that the so called iWatch will be much more innovative and unique in its style and features. Apple has a patent requesting pending on a Amoled flexible wristband device to consider as the possible final product launch, or it could still be a traditional watch similar to the Pebble.”

I’m actually writing this Friday night since I’ll be traveling to New Orleans on Saturday, so don’t be confused when I also post on Saturday and/or Sunday and the days look goofy. Inga, Dr. Jayne, and I will be writing profusely from the HIMSS conference, and to avoid giving you inbox fatigue, I’ll collect the individual links into a single e-mail blast each day.

3-1-2013 2-33-25 PM

Speaking of New Orleans, only Dallas saved the city from a last-place finish in the locations respondents would most like to see HIMSS conferences held. All the southern cities fared poorly in the poll except Orlando, which is about as southern as Ohio and New Jersey in every way except location. The three-city rotation should be Orlando, Las Vegas, and overwhelming winner San Diego if HIStalk readers rather than HIMSS were choosing. Not only is this year’s host city nearly bottom ranked, but so is the 2015 one, Chicago. I’m glad to see I’m not the only one who misses San Diego, which HIMSS outgrew, but the convention center is planning a $500 million expansion that will place it back among the A-list. New poll to your right: is the industry experiencing an EHR backlash? You only get a yes/no choice, but the poll accepts comments in which you can further elucidate your position.

Lt. Dan had e-mailed me off the record about problems he’s having personally because of the lack of VA-DoD system integration. I suggested he write it up since he’s both a veteran and an HIT person, not to mention the author of HIStalk’s daily headlines and most of the posts on HIStalk Connect. I think his piece, Making the Transition: What the iEHR Failure Means for Veterans, paints a clearer picture of the problem than you’ll get from the agencies themselves.

3-1-2013 6-36-01 PM

Welcome to new HIStalk Platinum Sponsor Caristix, which offers HL7 software for interface lifecycle management. The company offers Cloak (HL7 de-identification), Pinpoint (interface troubleshooter), Conformance (interface specs development), and Test (complex interface validation and simulation). They will also help get you connected to the Mirth open source integration engine. You can download trials of everything from their site, and also the entirely free HL7 profile reader and an HL7 listener and router for recording and playing HL7 messages to validate connectivity. They have tools for providers and vendors alike. Interface folks will enjoy their HL7 Survival Guide, a no-nonsense guide to interface projects and technology. I featured the company in my Innovator Showcase just over a year ago, which included an interview with one of its customers and another with President Stéphane Vigot. Thanks to Caristix for supporting HIStalk.

My predictable YouTube cruise resulted in this Caristix video.

3-1-2013 7-08-30 PM

Welcome to new HIStalk Gold Sponsor eHealth Technologies. The company’s eHealth Imaging Solutions provide single-click access to diagnostic quality X-rays, CT scans, ultrasounds, ECG, etc. from an existing EHR or HIE solution. Clinicians gain the ability to view and collaborate using eHealthViewer ZF, a zero-footprint unified imaging platform that allows secure viewing of any image over the web. eHealth Imaging Solutions supports trauma and emergency access to images, allows transferring DICOM images between PACS locations so that radiologists can view outside exams, and provides cloud-based archival and disaster recovery solutions. Hospitals, IDNs, and HIEs can strength their referral networks, reduce the cost of physical media, meet MU Stage 2 image sharing requirements, reduce patient risk from unavailable images and radiation exposure from duplicate exams, and lower IT costs with the zero-footprint viewing platform that runs on all browsers and platforms (including iOS and Android). Thanks to eHealth Technologies for supporting my work.

Here’s a video I found featuring customers describing the benefits of eHealth Technologies for accessing images.

3-1-2013 3-12-21 PM

The Department of Defense chooses Health Language from Wolters Kluwer Health to provide terminology solutions to support enhanced documentation, population analytics, and business intelligence reporting across the Armed Forces Clinical Database.

3-1-2013 7-45-26 PM

TeleTracking will announce its Real-Time Capacity Management platform at HIMSS, with clients on hand in Booth #6619 to describe their experience with the company’s systems.

3-1-2013 7-46-23 PM

NextGen Healthcare will unveil NextGen Population Health at the HIMSS conference, which will help providers meet patient-centered medical home and ACO goals.

3-1-2013 7-48-09 PM

Vitera Healthcare Solutions releases Intergy v8.10, which includes enhancements for ICD-10, Meaningful Use, patient engagement, disease management, and performance-based reimbursement.

3-1-2013 7-53-04 PM

Covenant Health (TN) and Capital Region Health Care (NH) choose McKesson Paragon.

Hackensack Alliance ACO chooses Health Catalyst for care coordination, to be announced Monday. 

Patients whose hospitals or physician practices are customers of lifeIMAGE will be able to review their medical imaging results online using a free new service offered by the company, which also announces its support for Blue Button.

3-1-2013 7-53-51 PM

HIMSS Analytics will showcase the products and services of the recently acquired CapSite at the conference in Booth #4929, including the CapSite Database (pricing and contracts) and an expanded Consulting and Research & Advisory Services offering.

Optum will resell MModal’s Fluency Direct speech understanding solution as part of its documentation and coding systems.

Medical documentation vendor Command Health will use Clinithink’s CLiX natural language processing technology to turn physician narrative into indexed and tagged free text. Clinithink also announces that Health Evolutions Partners operating partner and former Microsoft Health Solutions Group VP Peter Neupert has joined its board.

3-1-2013 7-57-49 PM

Baystate Health (MA) chooses Awarepoint’s RTLS solution for asset management and capacity management in its three hospitals.

3-1-2013 3-53-35 PM

Vonlay has posted a page that displays photo-containing tweets that use the #HIMSS13 hashtag, which they also did during Epic’s UGM. It has several photos already but will surely blow up with tons of them come Monday (you’ll see a gazillion pictures of a microscopic Bill Clinton later in the week).

Quest Diagnostics, which includes Care360 and MedPlus, will host several speakers in its HIMSS theater, including HIStalk Connect’s Travis Good, MD.

We reported that Practice Fusion has discontinued its billing system partnership with Kareo based on the wording of an e-mail sent to Practice Fusion users that referred to the relationship in the past tense while announcing enhancements to Practice Fusion’s own billing system. According to Kareo, the business relationship continues and users of the products will continue to benefit from the integration.

3-1-2013 6-29-03 PM

I said from the beginning that Groupon’s business model was unsound for several reasons (low barrier to entry, discounting rarely earns businesses loyal customers) but I’ll give its now-fired 32-year-old CEO Andrew Mason kudos for writing the best executive resignation letter in history. Snips from it:

People of Groupon, after four and a half intense and wonderful years as CEO of Groupon, I’ve decided that I’d like to spend more time with my family. Just kidding – I was fired today. If you’re wondering why… you haven’t been paying attention … As CEO, I am accountable. You are doing amazing things at Groupon, and you deserve the outside world to give you a second chance. I’m getting in the way of that. A fresh CEO earns you that chance … For those who are concerned about me, please don’t be – I love Groupon, and I’m terribly proud of what we’ve created. I’m OK with having failed at this part of the journey … If there’s one piece of wisdom that this simple pilgrim would like to impart upon you: have the courage to start with the customer. My biggest regrets are the moments that I let a lack of data override my intuition on what’s best for our customers. This leadership change gives you some breathing room to break bad habits and deliver sustainable customer happiness – don’t waste the opportunity! I will miss you terribly. Love, Andrew.

3-1-2013 6-33-58 PM

Secure Threads introduces bring-your-own hospital gowns intended to prevent medical errors by having the patient’s name, blood type, allergies, age, medical conditions, and emergency contacts embroidered into the fabric.

Safe travels and an enjoyable and productive week for all those traveling to New Orleans. For those who aren’t attending, feel free to goof off all week while your boss is away.


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

More news: HIStalk Practice, HIStalk Connect.

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March 1, 2013 News 3 Comments

Making The Transition: What the iEHR Failure Means for Veterans

February 28, 2013 News No Comments

This article was written by Lt. Dan,who writes for HIStalk Connect and provides daily headlines on HIStalk.

After eight years of service — during which I traversed seven countries across three continents, lived in three states, and had the privilege of working alongside the very best, brightest, most dedicated, honest, and sincere men and women I have ever known — the time finally came in November 2009 for me to walk away. I signed my discharge papers on November 11 (Veterans Day), got in my car, and drove off base for the last time. I was sad, scared, and very excited.

Fast forward three months. I am sitting in a doctor’s office, about to have a physical from my new PCP. The office was clean; the staff was polite. This was nothing like sick call, where all ailments were treated universally with a prescription for Motrin 800 and a return-to-work slip. During the appointment. my doctor told me to send him my medical records from the Army.

I tracked down the clinic on the base I’d been assigned to and asked for my medical record. They told me it had been forwarded to the US Army Human Resources Command. I called them. They said that they didn’t have my records, didn’t know where my records were, were not responsible for processing requests to access said records, and suggested that I call the VA.

Undaunted, I did call the VA. They told me that US Army HRC was probably misinformed because they should have my records, but to be certain, I would need to fill out some forms, mail them in, and wait for an estimated 90+ days.

At this point, it was beginning to sound like my medical records were having a far worse go of it in civilian life than I was. I told them never mind, the whole thing seemed pointless since I knew everything that was in them and could just tell my PCP the history myself the next time I saw him.

When I went for my first civilian dental exam and was asked if I had a dental record, I was smart enough to just say no. To date, I still don’t have my military medical records and probably never will.

Transitioning out of the military is not easy. It’s moving long distance back to your home town and finding a new job. It’s changing the way you talk so you don’t accidently swear in a business meeting, or call a 22-year-old co-worker “ma’am.” It’s learning to make friends with people you don’t have something intimately in common with. It’s a good bit of doubting yourself and whether you are going to be good at this very different new life.

This stress is exacerbated by an estimated 35 percent prevalence of PTSD in returning veterans, and an estimated 20 percent prevalence of traumatic brain injury, which along with more traditional disabilities, has resulted in nearly 50 percent of departing veterans requiring disability services from the VA.

When that 50 percent of discharged veterans leave the military, their healthcare is transitioned from DoD facilities to VA facilities. The hope is that this will one day be seamless. For now, before the VA will provide services, soldiers submit a disability claim to receive approval to start receiving benefits.

Herein lies the problem. It takes an average of 277 days from the time a claim is submitted until the time a decision is made, much higher than the VA’s stated goal of 125 days. During this waiting period, veterans are left in limbo without access to services or entitlements. There is new policy in place that will allow a departing soldier to submit a disability claim with the VA prior to exiting the military, but currently they can only submit 180 days prior to their discharge date. Helpful, but another example of the needs of the veterans getting lost in translation with the policy makers.

The enormous disability claims backlog has made national news for more than a year now because it is larger than it has ever been in our nation’s history, approaching 1 million claims. Veterans who are leaving the service are usually dealing with a new job, a long distance move, and basic emotional transitions and simply do not have the energy to tackle another exhausting problem in their lives. But the VA’s disability claims process has become exactly that, an exhausting problem in the life of veterans who need services.

Over the last several years, the VA has put in place a plan to correct the disability claims backlog. It was a two-tiered technology implementation plan that involved developing iEHR, which would reduce the time it takes for veterans’ medical records to make their way to disability claims processors. A new disability claims automation system was expected to reduce the time and resources required to process a claim. These two projects were expected to solve the backlog, and so they were heavily funded and highly prioritized.

The disability claims system, called the Veterans Benefits Management System or VBMS, was a $500 million system that began its implementation this past summer. It hit the ground with a loud thud despite the fact that a significant portion of its allocated funding was spent.  The implementation has been mired in delays and functional issues that have repeatedly sent engineers back to the drawing board.

In June 2012, VA CIO Roger Baker acknowledged the issues in an interview, saying, “In mid-December, the volume of VBMS usage grew rapidly as users from the 18 [regional offices] were added. VBMS began to experience dramatic slowdowns in response time for some users, especially during peak usage hours. A root cause analysis determined that the issues were due to the way data is being read from disk storage. Since the impact was considerably more read/write work for each transaction, it had a greater impact as more users attempted to perform work on VBMS.” The initial recommendation was to halt any non-critical tasks, but the permanent fix will require a significant redesign.

VBMS was initially scheduled to complete its implementation across all VA processing centers by the end of 2012. At the close of 2012, just 5 percent of claims processors were using the new system. The implementation timeline has now been pushed out until the end of 2013.

iEHR was also conceived as a way of tackling the benefits backlog. The overriding goal of iEHR was to bring all stakeholders in the transition of veterans’ healthcare under one system to allow for a fundamentally more streamlined process for both soldiers and benefits processing for the VA. Summarized best by California House Representative Jeff Dunham during a recent hearing, “Those who have volunteered at a time of war … if they come home tomorrow, they ought to be in the (electronic-record) system tomorrow, knowing what benefits they will receive … and that it doesn’t take a 5-day or a 50-day system.”

iEHR was halted on February 5 after officials within DoD and the VA realized that the total cost to develop the system had grown to more than $12 billion, more than double the original $4-$6 billion estimate CIO Baker quoted at the onset of the program. Following the announcement, the VA and DoD went back and forth over whether it would be feasible for DoD to implement the VA’s VistA EHR as a Plan B that would allow both organizations to operate within one EHR and maintain the overall goal of a unified system that could streamline the transition process for veterans.

In response to this idea, the Assistant Secretary of Defense for Health Affairs said “The current VistA system is a generation 1-plus-2, in terms of how we look at electronic health records. Industry is already at a generation 3 and moving to a generation 4. We would need to assess what’s required for us to bring VistA over, modernize it, and (calculate) what the total cost of ownership would be over time." On February 8, DoD announced that it was launching a vendor search, ending any hope that iEHR would be revived.

Within the past 30 days, CIO Baker along with VA CTO Peter Levin have been called before the Veterans House Services Committee multiple times to answer to outraged representatives over delays, cost overages, and systematic failures within both programs. For four years, the disability claims backlog grew with no improvement in the pace at which the VA processed new claims. Baker and Levin were the project owners for the two projects that were targeted to address the disability backlog issue. They drafted their plans, spent the money, the projects failed, and all that was left for them to do was resign, which is ultimately what they both did.

Now we have a growing disability claims backlog weighing down the VA. The proposed solutions have failed and the money is spent. Further complicating matters, the government is staring down the barrel of a federal budget sequester that is going to further limit the VA’s options to fix the disability claims backlog.

Meanwhile, a veteran population dealing with almost 10 percent unemployment and an unprecedented 22 suicides a day is going without disability benefits because the system that was designed to support them is fundamentally broken and programs intended to fix these problems are back to square one.

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February 28, 2013 News No Comments

News 3/1/13

February 28, 2013 News 2 Comments

Top News

2-28-2013 9-14-26 PM

A House panel, obviously fed up by the DoD’s cavalier attitude toward the VA’s VistA system compared to its own AHLTA EHR, demands to know why DoD won’t adopt the highly successful VistA. DoD says it’s looking at VistA yet again, but says it will evaluate it against commercial systems in attempting to “skate where the puck will be” and is concerned about multiple VistA versions and lack of conversion documentation. Congressman Jeff Miller (R-FL), as puzzled as the rest of us about whether VA-DoD will adopt a single EHR or try to cobble their respective systems to merely look like one, summarized as, “It sounds to me like we’re doing a U-turn and going back to the exact same thing again.” Outgoing VA CIO Roger Baker says estimates to develop the integrated system had doubled to $12 billion. One might assume that given Epic’s previous rumored involvement, its Coast Guard EHR experience, and its track record in large and diverse organizations, it might enter the picture in some fashion as the words “commercial systems” are uttered in polite company.

Reader Comments

From Jardone: “Re: Jardogs. A sale to Allscripts is imminent. Layoffs began yesterday, which appear to be across the board. Since Jardogs is owned by Springfield Clinic, no severance will be paid. Today is the last day for many, including myself.” Unverified. I e-mailed our contact at Jardogs inviting a response, but haven’t heard back. Jardogs, which offers patient engagement and health management solutions, is an Allscripts partner.

From Looking Deeper: “Re: MU Stage 2 requirements. Do your readers have tips for getting clarification for questions that aren’t resolved in the documentation? We would like to contact CMS. It’s a shame they don’t have an e-mail address or form.” A reader reports having successfully used this form, selecting “EHR Incentive Program” as the topic. She got a response in three weeks.

2-28-2013 9-18-23 PM

From Festus: “Re: coding issues. Jail time?” A 63-year-old cardiothoracic and vascular surgeon is serving a 10-month sentence for Medicare fraud, convicted for upcoding his cases. The US Attorney says his case sends a message to doctors, while professional organizations say that message is that doctors shouldn’t accept Medicare payment because nobody can comply with its complex requirements and now they could be imprisoned for making mistakes. According to the Association of American Physicians and Surgeons, “This precedent criminalizes false statements in a private setting without any proof of billing fraud and a greater interference with the day to day practice of medicine is difficult to imagine.” The doctor’s dictated reports from 10 years ago were found to have specified the wrong kind of graft in two of 2,400 operative reports. He says he was too busy to keep up with the reports and had been told to use a code that was similar if he couldn’t find the right one. AAPS says the irony is that he could have justifiably billed a lot more than he actually did even with the mistake. The charges say the surgeon did more than just choose the wrong CPT code – they say he also falsified his progress notes. It would be interesting to see if those were generated with computer assistance since that’s the only reasonable excuse.

From CEO: “Re: HIStalk. I start every day by catching up and reading HIStalk. It really is a wonderful source of content that helps me keep a good pulse on the industry. Thank you for serving so many of us!!!” Inga was happy to read this CEO’s e-mail in response to receiving his HIStalkapalooza invitation as one of few positive comments we’ve received lately, as most of our recent e-mails are from people complaining about not being invited to HIStalkapalooza because they didn’t register. I suppose I should be flattered that people care that much about attending.

2-28-2013 9-21-20 PM

From CatsEyes: “Re: three tidbits. Did you mention that Dr. Tonya Hongsermeier (above) left Partners CIRD to become CMIO of Lahey? Lovely and very smart person. And with Partners, Boston Medical Center, Lahey, and Lifespan all going to Epic. From New Haven to Mid coast Maine – Epic rules.” I left out Tidbit #1 since it involved a sales VP whose new job I couldn’t immediately confirm. I’m dating myself by admitting that when I hear Tonya’s name I still think of her being at Cerner, which she hasn’t been forever.

HIStalk Announcements and Requests

2-28-2013 9-10-58 AM

inga_small I took an unplanned three-hour field trip to the ER on Wednesday. Of course I asked the staff all sorts of questions about what technology they had in place (and why they were using so much paper.) Turns out I am just fine and my stress over selecting the perfect pair of shoes for HIStalkapalooza does not seem to be a contributing factor. Mr. H, however, thinks all the e-mails begging for last-minute HIStalkapalooza invites may have put me over the edge.

inga_small Have you stayed current with HIStalk Practice? If not, some of this week’s highlights include: only 60 percent of physicians are interested in participating in ACOs. ISALUS Healthcare introduces a new version of its OfficeEMR. Memphis Obstetrics & Gynecology Association goes live on MED3OOO’s InteGreat EHR. Practices have an increased need for population patient health tools. I love new e-mail subscribers, so take a moment to register for updates when checking out these stories. Thanks for reading.

2-28-2013 5-29-58 PM

Welcome to new HIStalk Platinum Sponsor Forward Health Group, located on Capitol Square in Madison, WI. The orange above looks juicy and that’s no coincidence – the company’s PopulationManager tool serves up QI and outcomes data to health systems that’s fresh, never frozen, squeezing it from your current systems, claims data, or administrative data. It’s accurate, actionable, complete, and timely, not to mention physician accepted at the individual patient level. The founders started out working in public health reporting back in 2004, meaning they had to figure out early on how to extract and aggregate data from a veritable science fair of disparate IT systems to create apple-to-apples measurements (that’s my second fruit analogy if you’re scoring at home.) It’s a fruit punch (fruit reference #3) of advanced informatics, population health best practices, and elegant visual explanations. They’ll set up a meeting or come to you at HIMSS or at HIStalkapalooza to tell you more – just e-mail them. Thanks to Forward Health Group for their berry (#4) much appreciated support of HIStalk. I have a feeling they’re a lot of fun, so you might be on the lookout for CEO Michael Barbouche or docs John Studebaker, MD and Sean Thomas, MD Monday night at Rock ‘n’ Bowl.

I found this Forward Health Group video that talks more about Fresh Data.


Thanks to Levi, Ray & Shoup, which not only issued a press release calling out my recent interview with SVP John Howerter, but used most of it to say nice things about HIStalk. I enjoyed talking with John because I consider myself something of an expert on print spooling-related problems in hospitals (having gotten myself hopelessly stuck in the middle of those problems many times over the years, unfortunately) so I was asking questions from my own experience.

2-28-2013 6-36-30 PM

Verisk Health is supporting HIStalk as a Platinum Sponsor. The company builds solutions for every payer type, including medical cost management, government reporting, payment accuracy, and revenue compliance. They can help identify risk, save money, and improve care. Providers interested in accountable care programs need tools for cost control, quality improvement, and population health management, and that also means you would probably benefit from getting a free copy of Verisk’s provider toolkit. Edward Hospital (IL), for example, is using PopulationAdvisor (through Premier) to monitor its clinical and financial performance, combining Premier’s comparative provider database with Verisk Health’s risk-based payer analytics to gain a better understanding of outcomes and cost of care provided both inside and outside the hospital. Verisk Health President Joel Portice has been around the industry for a long time, holding executive roles with Intelimedix, HCI, Enclarity, and Fair Isaac (not to mention that he’s also a novelist). Thanks to Verisk Health for its support of HIStalk.

HIMSS Conference and Social Events

inga_small Wen Dombrowski, MD, who tweets under @healthcareWenF, forwarded me this list she compiled of socials, Tweetups, and physician exec events. She is doing a Segway tour Saturday afternoon that sounds particularly fun.

2-28-2013 6-24-02 PM

I’m posting this shoe porn for Inga and Dr. Jayne, sent in by the (male) president of a new sponsor who clearly understands their fixation. Very hot.

2-28-2013 12-46-25 PM

inga_small The weather forecast for New Orleans looks pretty darned good. The mild temperatures suggest open-toed shoes as a viable option. Heavy coats can remain at home, or at least in the hotel room.

HIStalk’s Guide to HIMSS13
HIStalk’s Guide to HIMSS13 Meet-Ups
HIStalk’s Guide to HIMSS13 Exhibitor Giveaways

Acquisitions, Funding, Business, and Stock

Practice Fusion buys 100Plus, a startup co-founded by Practice Fusion CEO Ryan Howard that provides analytics-drive personalized health predictions.

Health Catalyst increases its Series B round by $8 million with participation from Kaiser Permanente Ventures and CHV Capital.

2-28-2013 7-49-14 PM

Revenue cycle solutions vendor Cymetrix Corp. acquires analytics vendor CareClarity.


2-28-2013 5-12-48 PM

Resolute Health (TX) selects Allscripts Sunrise Clinical Manager EHR and Allscripts Community Record for HIE and analytics.

Physician-hospital organization St. Vincent’s Health Partners (CT) chooses McKesson Population Manager and McKesson Risk Manager to manage the health of high-risk populations.

2-28-2013 3-21-03 PM

PeaceHealth will integrate Streamline Health’s AccessAnyWare enterprise content management solution with Epic ambulatory.

Evolution Health will deploy Greenway Medical’s PrimeSUITE across its national network of house call providers.

2-28-2013 9-24-44 PM

Northeast Georgia Health System (GA) will implement McKesson Paragon.

Daughters of Charity Health System will implement CliniComp’s Essentris Fetal mobile EMR in all of its hospitals. 


2-28-2013 5-14-12 PM

API Healthcare names Daryl Joslin (Defran Systems) chief marketing officer.

2-28-2013 5-15-29 PM

WorldOne, the parent company of Sermo, names Kerry Hicks (HealthGrades) chairman.

2-28-2013 5-16-25 PM

Press Ganey Associates adds Ralph Snyderman, MD (Duke University Health) to its board.

2-28-2013 8-11-21 PM

Beverly Bell (CSC) joins Health Care DataWorks as chief nursing officer and VP of implementation services and business performance management.

Announcements and Implementations

2-28-2013 3-30-39 PM

City of Hope (CA) implements Harris Corporation’s BI Practice Variation dashboards to identify opportunities for improving clinical outcomes, safety, and documentation.

Taylor Regional Hospital (GA) and Griffin Hospital (CT) complete activation of PerGen’s PeriCALM perinatal system in their labor and delivery departments.

Awarepoint makes its aware360 Suite for Workflow Automation services available on a cloud-based platform.

Wolters Kluwer Health introduces ProVation Care Plans powered by Lippincott’s Nursing Solutions, which provides tools for maintaining evidence-based interdisciplinary care plans.

First Databank announces new medication decision support tools that include interoperability mappings (linking RxNorm to FDB data, for example), enhanced AlertSpace functionality to reduce alert fatigue, and state and federal controlled substances information.

2-28-2013 9-26-16 PM

EHR vendor Practice Fusion announces that it has discontinued its relationship with billing system vendor Kareo due to “due to Kareo’s recent price hikes” while also acknowledging that “billing has not been our strongest feature.” The Practice Fusion announcement did not mention that Kareo announced its own free EHR last week. We invited both companies to respond and received this from Kareo:

Kareo is committed to delivering an open platform and supporting multiple EHR options driven by customer requirements, including partner-based solutions and Kareo EHR. Kareo will continue to work closely with our EHR partners to enhance and support our existing integrated solutions while adding new options over time. We believe this approach provides our current and future customers with the greatest flexibility to choose the best EHR for their specific needs. Kareo is proud of our reputation as a provider of intuitive and affordable solutions, and we are committed to delivering the highest value to our customers. The pricing plans for our customer base remain in place and have not changed in any way.

2-28-2013 9-27-22 PM

The iPad-powered Sparrow EDIS from Montrue Technologies becomes the first ED system to earn certification under the 2014 Meaningful Use criteria.

Allscripts will demonstrate award winners of its Allscripts Open App Challenge at the HIMSS conference, presenting $150,000 in prizes to 15 winners at Booth #3441 on Monday at 3:00 p.m. The company will also donate $5 to one of three charities (#AHA, #ACCS, or #JDRF) for tweets to @Allscripts answering the question, “What does Open mean to you” or “How have you benefitted by using Allscripts?”

Surescripts will announce Friday that electronic prescribing service NewCrop will connect to The Surescripts Network for Clinical Interoperability, which allows providers to securely share clinical information.

QuadraMed announces that Shands HealthCare (FL) will integrate the company’s AcuityPlus nurse resource management system with the Epic system that Shands is implementing.

VMware announces vCloud for Healthcare, which will allow healthcare IT customers to use a common cloud infrastructure inside and outside hospitals.

2-28-2013 8-27-39 PM

Sharp HealthCare (CA) and the Foundation for Health Coverage Education launch the for-profit PointCare Web-based eligibility software vendor, saying it will “change the tone of financial conversations with their uninsured patients.” Uninsured patients take a short quiz that identify the government programs that 80 percent of them are eligible for.


2-28-2013 12-04-01 PM

Athenahealth will invest up to $10 million and lease up to 60,000 square feet of office space in Midtown Atlanta for more than 700 employees.

A CHIME survey finds that the average base salary for healthcare CIOs in 2012 was $208,417, with respondents holding the EVP/CIO title averaging 50 percent more. More than half held a master’s degree, earning 10 percent more than those with a bachelor’s degree. Three-quarters of the CIOs reported receiving a raise of less than five percent in 2012.

2-28-2013 8-55-32 PM

The Nashville business paper profiles Shareable Ink President and CEO Stephen Hau. The 50-employee, 82-hospital software company relocated there from Boston in 2010.

Security researchers using CyberCity, a military-developed model city used to study cyberattacks, find that the city’s electronic medical records system is full of security holes. “OpenEMR from a security perspective is a disaster,” overlooking the fact that few if any US hospitals use that particular open source system.

I’ve gotten wind of an upcoming announcement from Michelle Obama’s Partnership for a Healthier America in which several EHR vendors that I won’t name (mostly the usual suspects, with some surprises) will pledge to add five anti-obesity features to their products at the March 6-8 PHA summit in Washington, DC. The features are BMI and weight classification percentiles, activity and dietary assessments, weight goal monitoring, referral to providers and community resources, and the ability to create a Healthy Weight Plan.

2-28-2013 9-32-23 PM

In Australia, Canberra Hospital will upgrade its ED system security after several employees were found to be altering patient data to make wait time statistics look more favorable. Most of the employees could not be identified because the EDIS was set up with generic user IDs like “nurse” and “doctor,” with managers claiming that the department could not function if users had to sign on and off individually. The upgrade will include quick logon/logoff. A server crash of the same EDIS caused the hospital to go on diversion Wednesday as the ED went back to paper.

In Canada, doctors in Nova Scotia complain of system crashes and response time problems with their $4 million Nightingale Informatix EMR, for which they were paid $10,000 each in government incentives to use. The company acknowledges software problems.

Cerner is among four dozen medical device and supply vendors that will pass along the new PPACA-mandated 2.3 percent medical device excise tax directly to their hospital customers.

Weird News Andy wonders if Meaningful Use statistics could be similarly fudged. The acting CEO of an English hospital resigns after an investigation finds that Royal Bolton Hospital coded its patient deaths due to septicemia at quadruple the expected rate, with interim findings indicating “cause for concern.” Hospitals get paid more for treating septicemia.

inga_small Researchers find that drinking red wine may protect against noise-induced hearing loss. When not drinking Hurricane Ingas, I will make a point of sticking to red wine when club hopping in the Big Easy.

Sponsor Updates

  • PatientKeeper will feature a number of hospital executives in Booth #2210 at HIMSS.
  • Wellcentive will join the Accountable Care Community of Practice.
  • Santa Rosa Consulting will feature The Honorable Tommy Thompson and Fred L. Brown at its customer and industry appreciation event at HIMSS next Tuesday.
  • Gates Hospitalists (MO) secures Medicare reimbursement using Ingenious Med’s PQRS Registry.
  • Nuance leases an additional 28,000 square fee of office space in Cambridge, MA to accommodate about 175 employees.
  • A local paper profiles Lyster Army Health Clinic (AL) and its use of RelayHealth’s secure messaging solution.
  • Iatric Systems adds CynergisTek as a reseller of its Security Audit Manager and Medical Records Release Manager solutions.
  • Lifepoint Informatics will sponsor the G2 Pathology Institute Conference February 28 – March 1 in Fort Lauderdale, FL.
  • CSI Healthcare IT spotlights Evan Ritter, its top sales performer of 2012.
  • University Health System (TX) reports a cost savings of over $13 million within a year of contracting with MedAssets for consulting, analytics, and process improvement services.
  • Covisint will integrate Milliman’s opportunity-based population analytics capabilities into its healthcare platform.
  • AT&T lists six questions to ask healthcare cloud vendors to ensure data security.
  • eClinicalWorks  shares details of how Coastal Medical (RI) achieved a 200 percent return on its original investment and improved care coordination utilizing the company’s EHR.
  • A Nuance Communications’ survey finds that 80 percent of US doctors believe virtual assistants will change how they interact and use EHRs and will benefit patients by making them more engaged in their own healthcare.
  • McKesson names the Bread of Healing Clinic (WI) the company’s first recipient of its Practice Choice EHR software as part of the McKesson Give Back initiative.
  • Impact Advisors Principal Rob Faix is featured in a podcast discussing PHI data breaches.
  • St. Luke’s Cornwall Medical Group (NY) shares how it increased cash collections by 17 percent utilizing Greenway’s PrimeRCM.
  • Mitochon Systems will integrate drug safety information from PDR Network into its Electronic Medical Office platform.
  • Merge Healthcare will bundle MModal Fluency for Imaging and MModal Catalyst for Radiology with its Merge PACS portfolio.
  • Signature Sleep Services, dba Sleep360, will market and integrate ZirMed’s RCM solutions with its platform of sleep medicine tools.
  • Georgia-Pacific Professional introduces the SafeHaven monitoring system, which combines Versus RTLS technology with Georgia-Pacific’s dispensers and skin care products. 

EPtalk  by Dr. Jayne


Several readers have asked Inga and me for HIStalkapalooza fashion advice. DO wear sassy bowling shoes or a cool retro bowling shirt. DON’T wear anything from MSN’s list of ugliest shoes of all time.


With HIMSS starting in a few days, my inbox is really filling up. If you’re exhibiting, that means you are a technology company of some kind or at least peripherally in the technology sphere. Up your game (and the chances that your message will actually be read) by proofreading your content and removing tags like that in the e-mail above prior to sending.

Even with a relatively full inbox, it’s a slow news week as everyone saves up their big news to announce at the show. You don’t have to make a big splash at HIMSS to be a success. Vendors are quietly certifying their products for Meaningful Use 2014 and I salute them.

I’ve had a lot of questions about what I’ll be looking at during the show. Rest assured I’m making my list and checking it twice. I plan to spend plenty of time in the far reaches of the exhibit hall looking for the next big thing, so stay sharp because you never know when we might come by your booth.

I’m off to the Crescent City tomorrow and will bring you the news and happenings of HIMSS. For those of you unable to attend, thank you for keeping the availability high, the loads balanced, and the issue resolution times low. We’ll raise a glass in your honor at HIStalkapalooza. Laissez les bons temps rouler!


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

More news: HIStalk Practice, HIStalk Connect.

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February 28, 2013 News 2 Comments

News 2/27/13

February 26, 2013 News 2 Comments

Top News

2-26-2013 9-07-23 PM

Telus Health will acquire MD Practice Software, which will make Telus the largest EMR vendor in Canada. The deal is scheduled to close Monday.

Reader Comments

2-26-2013 7-26-23 PM

From Spell Checkeroff: “Re: HIPAA. The Miami Herald did something you don’t see often – spelled out the law’s name correctly, then derived an incorrect acronym!” I’ve noticed that as newspapers continue their slow swirl down the toilet, they keep losing their better people who might be able to actually investigate a story, proof read, or write editorials that express original thoughts. About all they’re good for now is sports scores, Hollywood gossip, and funny stories with zero news value. On the other hand, that’s about all their declining audience wants to read anyway.

From NoPhone: “Re: Booth etiquette. Last year you ran an article about HIMSS booth etiquette and we would love to share it with our sales team.” The Readers Write by Rosemarie Nelson offers tips for vendors on the trade show floor.

2-26-2013 7-20-48 PM

From Moe Money: “Re: PQRS submissions. See forwarded e-mail.” Above.

HIStalk Announcements and Requests

2-26-2013 6-28-53 PM

Welcome to new HIStalk Platinum Sponsor Ping Identity, also known as “The Identity Security Company.” Its identity and access management platform provides one-click access to any application from any device, with over 900 enterprise customers including 45 of the Fortune 100. The company’s health solutions make it easier to run cloud-based applications and to meet compliance requirements, offering single sign-on to improve user satisfaction. They also provide a seamless, secure platform for internal and external collaboration and customer engagement. Ping Identity’s solutions help protect PHI and allow users of federated applications to be quickly disabled in the event of a breach. A free trial of PingFederate is available for download. Pay them a visit at HIMSS Booth #2470 and tell them you read about them on HIStalk. Thanks to Ping Identity for supporting my work.

My YouTube hunt was successful, turning up this educational Ping Identity video on Identity Management 101. It’s a really good and easily understood overview.

HIMSS Conference and Social Events

inga_small I have been hunting for a HIMSS mobile app that includes the schedule and meeting rooms. Has anyone seen one?

inga_small If you signed up to attend HIStalkapalooza before registration closed on Monday, February 11 and did not receive an invitation by e-mail, drop me a note by Thursday and I’ll check your status. Otherwise, we are totally full even though Medicomp doubled capacity to 1,000 this year, which means we unfortunately can’t invite you even if you’re one of the folks who are pleading that your HIMSS experience might be a bust if you are unable to participate in the “Inga Loves My Shoes” contest, drink Hurricane IngaTinis and Typhoon Janes, and hobnob with the coolest folks in HIT.

2-26-2013 3-59-46 PM

inga_small For those who received HIStalkapalooza invitations, here is transportation information:

  • The good folks at Medicomp have put together a pocket-sized card with transportation details. You can pick it up from their Booth #3068 on Monday or get one from one of the human directionals that will be in the main hallway of the convention center starting at 5:30 PM on Monday. Look for the HIStalk/MEDCIN Engine tee shirts and signs.
  • Buses will leave convention center for HIStalkapalooza from 6:15 p.m. through 7:00 p.m.
  • If you are driving, Rock ‘n’ Bowl is located at 3000 S. Carrollton Avenue and has plenty of free surface parking.
  • Return bus service to specific downtown hotels starts at 9:00 p.m.
  • Bus service is complimentary, as is coat and bag check at the venue.
  • A Transportation Concierge will be located at the front of Rock ‘n’ Bowl to answer any questions. They can help you get a taxi if you’re in a hurry to leave and don’t mind paying.

Inga, Dr. Jayne, and I (Mr. H) will be covering HIMSS in great detail starting this weekend. Let us know if there’s anything you would like is to report on beyond the obvious (booth snark, making fun of people who deserve it, spilling the dirt we overhear in coffee lines and restrooms, and our jaded assessment of what’s important and what clearly isn’t). We intentionally avoid one-on-one appointments and demos since those are usually a waste of time, preferring to do our reporting from the ground as regular, anonymous attendees. Contact us from there if you run across anything interesting.

HIStalk’s Guide to HIMSS13
HIStalk’s Guide to HIMSS13 Meet-Ups
HIStalk’s Guide to HIMSS13 Exhibitor Giveaways

Acquisitions, Funding, Business, and Stock

2-26-2013 9-50-22 PM

Shares in Accretive Health drop 20 percent in after-hours trading Tuesday after the company announces that it will delay reporting Q4 and FY2012 results while it evaluates its revenue recognition policies for its revenue cycle management agreements. Any change might require restating prior-period financial statements, management added.

Cerner announces that it will acquire PureWellness, which offers a health and wellness platform for corporate wellness programs and insurers, strengthening its position in the population management market.

2-26-2013 9-08-19 PM

Craneware reports half-year profit of $0.12/share compared to $0.10/share a year ago. Revenues were up seven percent.

2-26-2013 9-08-56 PM

OCHIN, which operates Oregon’s REC, acquires the Oregon Health Network, a non-profit focused on improving quality and access of healthcare through HIT and other initiatives.

Informatica acquires process automation company Active Endpoints.


Graham Hospital (IL) selects Merge Healthcare’s iConnect Enterprise Clinical Platform and Honeycomb Archive solution.

2-26-2013 9-10-14 PM

Summit Healthcare Regional Medical Center (AZ) chooses Ingenious Med’s impower charge capture solution to improve documentation and communication.


2-26-2013 11-07-27 AM

Vocera Communications appoints Sandra Miley (Juniper Networks) VP of corporate marketing.

2-26-2013 6-18-13 PM

Elsevier names Jim Nolin, MD (Ascension Health) editor-in-chief of InOrder,  an Elsevier order set solution that’s scheduled to launch in March.

2-26-2013 6-57-58 PM

Beacon Partners promotes Kevin McKittrick (above) and Scott Freeman to principal.

2-26-2013 7-32-25 PM

Cornerstone Advisors Group names Kristi Lane (Stage 7 Consulting) VP of talent management.

Charles C. Corogenes (Toshiba) joins ChartWise Medical Systems as VP of sales and marketing.

Announcements and Implementations

Kansas HIN transmits immunization data from the Community Health Center of Southeast Kansas to the Kansas Immunization Registry through the ICA CareAlign HIE platform.

Rockcastle Regional Hospital (KY) goes live as the first user of Patient Logic’s physician documentation system.

2-26-2013 8-01-23 PM

You might think managed services vendor ClientFit would spell the name of its new partner athenahealth correctly in its press release announcing that relationship. You would be wrong, although I might be inclined to side with them because their version is at least properly broken out into separate words and capitalized correctly. I grit my teeth and follow The Associated Press Stylebook, which says to use the company’s made-up lower case version except when athenahealth begins a sentence, in which case capitalize it even if they wish you wouldn’t.

Albany Medical Center will become the first healthcare provider in New York to utilize Direct Messaging through the Healthcare Xchange of NY.

2-26-2013 9-28-32 PM

QuadraMed announces that Avita Health System (OH) attested for Stage 1 Meaningful Use through its use of the company’s QCPR EHR that the health system implemented last year.

Winona Health (MN) says its implementation of Cerner’s revenue cycle solutions for acute and ambulatory services fueled a 25 percent decrease in clinic coding turnaround time and consolidation of hospital and clinic billing.

Legacy Data Access introduces LegacyCompleteClinicalView and LegacyRemitBank to enhance clinical and revenue cycle functionality for retired healthcare applications.

Jardogs releases version 1.5 of its FollowMyHealth universal health record.

CommVault launches Simpana 10, which offers an open, scalable platform and advances in data and information management.

LDM Group’s ConnectSys 3.0 achieves 2014 Edition Ambulatory and Inpatient EHR Module Certifications by ICSA Labs.

McKesson announces that more than 90 percent of physician users of its iKnowMed oncology EHR have successfully attested for Meaningful Use.

2-26-2013 7-00-56 PM

McKesson and Cerner will announce their unspecified collaboration (presumably related to cooperative interoperability in trying to derail the Epic juggernaut) from HIMSS on Monday, March 4 at 11 a.m. Central.

2-26-2013 9-16-01 PM

Microsoft-GE joint venture Caradigm will announce next week its selection by Continuum Health Partners (NY) to provide tools that will support the health system’s care coordination and population health strategy. Caradigm’s products include the Caradigm Intelligence Platform (the new version of Amalga), applications from both Caradigm and third parties for population health management, Caradigm Health Information Exchange, and identity and access management solutions.

MMRGlobal, featured in my interview with CEO Bob Lorsch, will launch a health and wellness app at the HIMSS conference that will work with its MyMedicalRecords PHR. The company also says it has started notifying mobile healthcare app vendors that their products appear to infringe on its patents.

MModal and 3M Health Information Systems collaborate to link MModal’s voice-enabled clinical documentation platform with the 3M 360 Encompass computer-assisted coding system.

VitalWare files a provisional patent for Sherpa, a physician documentation ontology engine that automatically presents physicians with clinical concepts and their related categories at the point of care.


2-26-2013 8-14-31 PM

An India-based startup announces Uchek, a urinalysis app for smartphones. You pee in a cup, not on the phone, and then take photos of dipped chemical strips to monitor diabetes, UTIs, and kidney and bladder problems. I might be concerned that its display shows “keytone” since I get nervous when medical software contains misspellings.

I mentioned the Android-only Swiftkey on-screen keyboard and medical dictionary ($3.99) that gets rave reviews for clinical documentation. The company announced Tuesday that it will launch a healthcare-focused typing app for the iPad. Apparently the new BlackBerry 10’s all-touch keyboard runs Swiftkey, although neither company will confirm.


inga_small Massachusetts General Hospitals offers its 22,000 employees a $250 bonus for watching an 11-minute video on customer service. About 98 percent of the employees thought it was worth $22 per minute to score some cash, meaning the hospital shelled out more than $5 million to teach them how to be nice. 

2-26-2013 9-23-26 PM

The Robert Wood Johnson Foundation awards PatientsLikeMe a $1.9 million grant to create the first open-participation research platform for the development of patient-centered health outcome measures.

2-26-2013 7-48-02 PM

I mentioned in introducing new sponsor MediQuant in the Monday Morning Update that I was enjoying the Legacy System Blues song on its site. Apparently I caught it early — a new press release just announced it, also mentioning that the band is led by MediQuant Founder and President Tony Paparella, who has had the track pressed on vinyl 45 RPM records.

Security volunteers who find an unnamed hospital’s data exposed on the Web are perplexed when their phone calls, service desk ticket, and e-mail to the hospital’s CEO are all ignored and nobody has taken the data down. A technician at the hospital’s outsourced help desk told them he doesn’t have an e-mail address. The group suggests that hospitals include a dedicated, monitored e-mail address and telephone number on their home page so they can be notified quickly of security problems.

Weird News Andy says he bet the surgeon was heard to say, “Awww, nuts” in this story of a patient suing a British hospital after surgeons removed the wrong testicle. Surgeons performing the cancer surgery realized their mistake 40 minutes in and “tried to correct the mistake in an emergency procedure,” but it was too late.

Strange: police in India arrest the son of a hospital CEO after he threatens to post to the Internet a homemade sex video featuring himself and his wife unless she agrees to pay for the hospital’s new trauma center. Also in India, 35 specialty physicians protest their hospital salaries by threatening to kill themselves.

Sponsor Updates

2-26-2013 9-33-54 PM

  • The Johns Hopkins Hospital and Levi, Ray & Shoup discuss the simplification of document management processing in Webinars March 12 and 14.
  • Hyland Software validates integration between its OnBase enterprise content management and Nuance Communications’ eCopy ShareScan scanning and workflow solutions.
  • The AMA and McKesson agree to a licensing arrangement that allows for the mapping of molecular diagnostic testing codes in McKesson’s Diagnostic Exchange software to the AMA’s CPT code set.
  • Greenway Medical Technologies achieves PCMH 2011 Prevalidation status from NCQA for its PrimeSUITE EHR platform.
  • Wolters Kluwer Health adds a Patient Safety Programs File to its Medi-Span solution.
  • MedAssets CEO and President John Bardis will ring the NASDAQ closing bell February 27.
  • Bottomline Technologies announces the GA of Logical Ink 4.6 and MedEx 4.0.
  • Marion McCall of Surgical Information Systems reviews considerations when selecting perioperative analytics solutions.
  • Santa Rosa Consulting adds Clearwater Compliance’s HIPAA-HITECH compliance tools to its portfolio of services.
  • Truven Health Analytics releases its annual list of 100 Top Hospitals based overall organizational performance.
  • CTG Health Solutions announces that it increased revenues 18 percent from 2011 to 2012 and expanded its IT consulting team.
  • Direct Recruiters, Inc. offers an interview called “Hiring Game Changers.”


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

More news: HIStalk Practice, HIStalk Connect.

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February 26, 2013 News 2 Comments

Curbside Consult with Dr. Jayne 2/25/13

February 25, 2013 Dr. Jayne No Comments


I’m fairly addicted to Twitter, mostly because some of the people I follow provide a humorous break from reality. I recently saw a tweet about a hospital bill for childbirth. The year: 1951. Ever since I was an intern, I’ve found the history of maternity care in the US to be fascinating (most likely due to all the long hours spent on the labor and delivery floor). I’ve delivered a couple hundred babies and know what charges look like today, so decided to see what this bill would look like in 2013 dollars.

The good people at Dollar Times offer a nifty inflation calculator that helped me with the “today’s dollars” numbers for this five-day hospital stay:

Delivery Room: $91.84
Anesthesia: $91.84
Laboratory: $18.37
Dressings: $32.14
Medicine: $92.30
Formula: $2.76
Circumcision: $18.37
Room and Board: $482.16
Baby Care: $137.76
Telephone: $22.96

Of course, you can’t truly compare apples to oranges against a modern hospital bill, because there is no way you’d be allowed to stay for five days for a normal, uncomplicated delivery. Most commercial payers in my area require patients be discharged no later than 48 hours after a non-surgical delivery and many encourage only a 24-hour stay.

You also can’t compare apples to oranges because payment was made on the day of discharge. No billing or insurance was involved. Paying this bill at discharge would be equivalent to asking a patient to pay nearly $1,000 today and most patients would balk even at that. We’ve become dissociated from the true cost of medical goods and services to the point where if it costs more than a $20 copay or $500 deductible, we can’t fathom paying it.

What do cash patients pay today? A quick Google reveals a two-day labor and delivery package at Tucson Medical Center for $2,300, but only if paid in advance. My hospital offers a similar package that’s priced about the same. Still, that’s more than double the expected price given inflation alone.

Incidentally, while researching this, I learned that my hospital refuses to accept cash as a form of payment. That’s a sad commentary on modern life. Of course there’s a theoretical risk of counterfeiting and you have to have cash-handling policies, but I’d rather have that than the risk of a bounced check or have to bill patients who don’t have credit cards.

I don’t want to get into a debate about natural childbirth here, so let’s assume you’re a patient who wants a “standard” hospital birth. When you consider the modern technology associated with today’s labor and delivery experience, it doesn’t look like such a price hike. In 1951, the anesthesia used at our hospital was Twilight Sleep and was likely to result in maternal amnesia and infant breathing problems.

Today, patients who want it can have continuous fetal monitoring, epidural anesthesia, and highly skilled nurses who are experienced with challenging deliveries and resuscitating depressed infants if needed. Laboring mothers can move from bed to shower to chair to bathtub to labor ball rather than just lying on a gurney. Whole families can share in the delivery experience and babies are able to instantly bond with their mothers.

How then do we translate this to the exorbitant bills we’re seeing from hospitals today? The key difference (besides patient care technology) is the rise of the insurance company and our resulting detachment from the cost of the care we’re receiving. Hospitals and offices must maintain armies of coders, billers, processors, and all manner of clerks, insurance follow-up representatives, patient accounts representatives, etc. just to stay in business. This in turn drives up costs and perpetuates the hamster wheel on which we run.

I have a few good friends who have gone to cash-only practices. I’m not talking about “concierge” or “retainer” practices where the patient pays an annual fee for access to the physician. I’m talking about physicians that know the true cost of their services and what income they want to achieve and charge accordingly.

It’s surprisingly affordable, with office visits in the $40-$50 range. They’re bringing home good money with a higher quality of life. Payment is required at the time of service and no bills are generated. One of my colleagues does provide a copy of a superbill for the patient to submit to insurance, but the others do not. One has a nurse, one has a medical assistant, and the other has no staff at all.

Interestingly, despite being “off the grid,” all three have electronic health records and demonstrably high quality of care. They use their EHRs to enable their workflow rather than to count bullet points and participate in regulatory nonsense.

I’d love to spend some time looking at the true cost of hospital care and modeling what it would look like if third-party payers (and the resulting bureaucratic bloat) were out of the mix. Patients would be closer to the actual costs of procedures and would be better able to determine if it’s worth it to keep grandma in the ICU for her last weeks or whether it would be better to spend a fraction of the money on a hospice nurse tending her in her own bed.

Of course, there would be those crying out that we’re refusing to care for the poor or elderly if we did that. I would argue that some of our high tech interventions aren’t done so much in the name of “care” as much as “because we can.” I’m not arguing that we should deny care to those who can’t afford it, but merely suggesting that if patients (and facilities) were more in touch with the actual cost of care that we’d be in a very different situation than we are now.

As a family physician is wont to do, I’ve told the patient’s story from cradle to grave. I’m interested to see what the tale looks like for the next generation.


E-mail Dr. Jayne.

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February 25, 2013 Dr. Jayne No Comments

Monday Morning Update 2/25/13

February 23, 2013 News 7 Comments

From Grizzled Veteran: “Re: Stark Act/Anti-Kickback Relief. It’s scheduled to expire on 12/31/13. What are the thoughts on it being extended or not? What happens to hospitals and practices if it isn’t?” The floor is now open. Feel free to leave a comment stating and perhaps defending your opinion.

From CPAhole: “Re: CMS. Has anyone raised the issue of the CMS PQRS site being down for days at a time just when everyone is trying to submit and there is a 72-hour turn on submissions? CMS is trying to come up with a Plan B to fix their system.” Unverified.

2-22-2013 10-56-38 PM

From The PACS Designer: “Re: mobile ECG Monitor. TPD is intrigued by AliveCor’s FDA-cleared Heart Monitor & AliveECG app for the iPhone. An iPhone app that can benefit both the patient and the physician brings health monitoring to a new level of care. This app will be added to TPD’s List of iPhone Apps with the next update.”

From Marrioutta Here: “Re: HIMSS hotel. Just got a call from Marriott. There was an error in their website and they are overbooked. Moving folks 35 miles away and paying for the rooms.” At least when HIMSS e-mailed this week to tell me I was bumped out of the hotel I had booked in September they put me in another one that’s a little bit closer, a little bit cheaper, and newly added to the shuttle route. I don’t like the rooms as much from the description, but it’s walkable to the convention center and closer to restaurants. Some hospitals force employee groups traveling together to share rooms or pay the different for a single room themselves, which would probably greatly reduce the number of rooms required since it’s like a commuter highway – single occupancy is the rule.

2-22-2013 8-55-48 PM

The majority of poll respondents say they’re getting too much HIMSS-related vendor contact, although a solid 36 percent are happy with the volume and a disappointed 12 folks wish they’d get more. New poll to your right: what city would be your choice for holding the HIMSS conference?

2-22-2013 9-02-59 PM

Welcome to new HIStalk Platinum Sponsor MediQuant of Brecksville, OH. MediQuant offers Data Transition Management Solutions. Almost every healthcare organization keeps orphaned systems running just because someone might need access to the data they contain at some point. MediQuant’s DataArk active archiving solution allows those systems to be decommissioned with savings of up to 80 percent (using their data center or yours), providing ongoing easy access to clinical, financial, or ERP data. It’s always a pain to work down patient accounts after a system conversion and balance-forward conversions are notoriously risky (why junk up your new system with iffy data?), but DataArk customers can still bill those accounts, post payments, add notes, defend audits, and produce itemized statements with even easier access than the retired system offered. Clinical systems conversions are equally tricky with legacy data and chances are you’re not living in a “no lawsuits after discharge” bubble that allows walking away from years’ worth of patient data, so DataArk allows moving that historical information to its clinical repository module. Turn off the old system and the cash drain required for its upkeep. Other MediQuant products include FirstComply and AccuRules for medical necessity/ABN compliance. The company’s client base includes more than 700 facilities (examples: UPMC, Baptist Louisville, Dignity Health, Kettering Health Network, and West Virginia University Healthcare.) I’m rocking out to their Legacy System Blues by The DeCommissioners on their home page. Drop by Booth #5649 at HIMSS and say hello and thanks to MediQuant for supporting HIStalk.

On the Jobs Page: Demand Generation Specialist, Sales Effectiveness Consultant, Healthcare ECM Sales Executive, Account Manager – Government.

Listening: new from Nick Cave & the Bad Seeds, lush and powerful brooding from one of music’s most tortured geniuses. New live concert video here.

2-23-2013 1-36-36 PM

Want to win a $25 Amazon gift card and be sashed on stage at HIStalkapalooza? Tell us why you have a crush on Inga, Dr. Jayne, or Mr. H. We’ll pick the best entry for each crushee and recognize them on stage with an Inga’s Secret Crush, Dr. Jayne’s Secret Crush, or Mr. H’s Secret Crush beauty queen sash as a token of our mutual affection. Speaking of “crushed,” Inga is exactly that so far because all of the entries have been for me (Mr. H). I’m on standby to pledge my affection for her and Dr. Jayne if need be. Mrs. HIStalk assembled and packaged the sashes when they came in the mail last week and was less than thrilled when she got to the “Mr. H’s Secret Crush” one. I told her it was Inga’s idea.

Encore Health Resources will announce this week its Value-based Performance Improvement (VPI), an analytics software and services program developed with Catholic Health Initiatives that includes Meaningful Use reporting, population analysis, clinical analytics for care coordination, and financial analytics. The company says the program will transform EHR data to help organizations focus on quality and performance data at a low cost of entry. Components that can be implemented individually or fully include an analytics engine, an ETL tool, and dashboards.

2-23-2013 7-34-32 AM

Georgia Regents Medical Center (recently renamed from Georgia Health Sciences Medical Center) selects Besler Consulting’s BVerified – Transfer DRG tool to identify and recover transfer DRG underpayments. It automates the required review of the Medicare Common Working File and creates workflow tasks that guide the provider through follow-up steps.

Yavapai County, AZ admits that its printing of death certificates was delayed by more than a week due to computer problems following a software upgrade.

2-23-2013 1-39-44 PM

The longest article ever published in Time magazine is this week’s cover story on high healthcare prices, Bitter Pill: Why Medical Bills are Killing Us. The basic conclusion is that the US needs to set healthcare rates in a Medicare-type national system instead of letting the so-called free market do so. Most of the criticism is aimed at hospitals, so it’s worth a read even for those of us who working in them even though we were numbed long ago to $2 Tylenol tablets and $300 chest x-rays. The fact that the author couldn’t come up with recommendations less invasive or more likely to succeed than simply letting the government run all healthcare as it does the wasteful, political, and fraud-riddled Medicare program is a bit of a letdown.

2-23-2013 2-19-19 PM

Medical practice plaintiffs who filed a class action lawsuit against Allscripts for its decision to not enable the MyWay EHR for future MU stages or ICD-10  will learn Tuesday whether they can continue with their suit or will instead be forced to accept binding arbitration. If the complaint is certified as a class action, Allscripts will be required to provide the names of all MyWay customers to the plaintiff’s attorneys, who say all 5,000 MyWay physician users would then be automatically included in the suit. Attorneys for Allscripts have filed a motion to block the suit, arguing that the doctors signed a contract requiring their differences to be settled by binding arbitration. Some of the specific complaints, remembering of course that they represent only one side of the argument:

  • ”Our EHR is a piece of crap,” said an anesthesiologist and “buggy” according to others involved with the lawsuit, each of which paid up to $40,000 per physician to implement what they claim is a defective system.
  • Anesthesiologists claim they were promised a pain management module that was never developed.
  • A client who bought MyWay in June 2012 was assured by their Allscripts sales rep that the product would be enhanced to meet MU Stage 2 and ICD-10 requirements, with the company announcing otherwise four months later.
  • Users say MyWay, originally developed by iMedica as a client-server product, was sold by Allscripts as a cloud-based offering that performed poorly.
  • The lawsuit says that a “free upgrade” to the Allscripts Professional EHR isn’t an upgrade at all since it’s a different product and requires a complicated and costly conversion.

Facebook apologizes to a 104-year-old woman who found that she could not enter her real date of birth on her page. The company changed its date edits to allow birth years before 1910.

Robert Lorsch, chairman and CEO of PHR vendor MMRGlobal, briefs members of a congressional subcommittee on HITECH payouts and what he says is its failure to ensure standardization, interoperability, and PHR access. He demonstrated his company’s PHR product, telling the audience that it could be made available to all Americans for less than the money one large hospital would spend on an EMR. MMRGlobal has sent infringement letters to healthcare IT vendors and hospitals in the US and elsewhere claiming that they are violating the company’s patents that cover a variety of online services.

2-23-2013 7-50-04 AM

Vermont’s smallest hospital will lay off 15 employees, 10 percent of its work force, blaming cost pressures created by the Affordable Care Act and its new ACO relationship with OneCare Vermont. Officials with the 19-bed Grace Cottage Hospital defended spending $2 million on an EMR, saying ARRA money paid for it and it needed the system to participate in the ACO.

MedSnap releases an iPhone app for medication reconciliation that allows the provider to place a patient’s pills on a tray and use the phone’s camera to take a photo, which the app then analyzes to display the name and strength of each drug along with drug-drug interactions, drug-disease contraindications, and allergies based on the patient’s medical records. I would characterize this as brilliant. Future offerings include medication reminders and caregiver monitoring. The company is looking for volunteers for its Pill Mapping Project, whose submissions will improve its recognition database. Co-founders Patrick Hymel, MD and Stephen Brossette, MD, PhD founded MedMined, the infection surveillance software company acquired by Cardinal Health in 2006.

MModal and Intermountain Healthcare will jointly develop a speech-powered CPOE app for iOS devices. The app’s vocabulary will recognize terms related to the ordering of meds, labs, imaging, and nursing. They say it will be completed by fall.

2-22-2013 9-31-14 PM  2-24-2013 3-52-11 PM

Supporting HIStalk at the Gold level is ReadyDock. Everybody’s walking around hospitals carrying tablets these days, which means they’re also giving a free ride to microorganisms to spread from one patient to another. ReadyDock:UV is the world’s first solution for one-step disinfecting, charging, and securing of tablet PCs and iPads. It’s UV powered, which means no messy wiping down with disinfectant (and no voiding the manufacturer’s warranty by fluid contact). Tablets are often part of normal workflows and charging and disinfecting them needs to be equally user friendly. The device takes up a lot less space than a standard docking station, frees up power outlets, and eliminates a tangle of wires. You can see it yourself at HIMSS in Booth #3879. Thanks to ReadyDock for supporting my work.

I found this brand new ReadyDock video on YouTube featuring Louise-Marie Dembry, MD, MS, MBA, infectious disease professor from Yale-New Haven Hospital.

Thanks to a rumor report from reader Smarty Marty, we reported on February 13 that Aetna was rebranding its health and technology unit (ActiveHealth Management, iTriage, and Medicity) as Healthagen. The official announcement went out Friday.

2-22-2013 10-01-51 PM 2-22-2013 10-02-31 PM

First Databank promotes Bob Katter and Charles Tuchinda, MD to EVP following the recent promotion of Gregory Dorn to EVP/deputy group head of Hearst Business Media.

Wired profiles stealth startup Smart Scheduling, which identifies patients who are likely to be no-shows for their appointments based on past behavior. The company went through Healthbox’s accelerator program and connected with athenahealth to fine tune its algorithms. The application is being piloted by Steward Health, which uses athenahealth’s scheduling system. The software suggests the optimal time slot for a given patient based on the likelihood they won’t show up. Steward says the program is 95 percent accurate, allowing them to schedule around possible no-shows to hit their overall patient targets.

A mini-study in a Letter to the Editor in NEJM finds that about 12 percent of US physicians have attested to Meaningful Use under the Medicare program, making it likely that many practices will face financial penalties starting in 2015. Specialists have about half the adoption rate of primary care providers. Physicians working with Regional Extension Centers have only a slightly higher attestation rate at 16 percent.

2-23-2013 2-22-33 PM

The e-mail system of Ohio State University’s Wexner Medical Center was down for 42 hours through Friday morning, with “replaced infrastructure” identified as the culprit.

UCLA’s medical school is the subject of a snarky Los Angeles Times article that criticizes its cozy relationship with nutritional supplement manufacturer (and accused scam multi-level marketer) Herbalife, which donates a lot of money to the school and drops the school’s name at every opportunity to give its products the scientific credibility that nutritionals sorely lack. UCLA’s cellular and molecular nutrition lab is named for the company’s founder, or as the article says, “The lab is named after Herbalife’s founder, who died in 2000 after a four-day drinking binge — not the greatest advertisement for healthful, active living.” Several medical school faculty members serve on the company’s board, with one of them being paid $17.8 million over 10 years through his consulting firm in return for product endorsements that include his signature on the label. Both he and the company can make almost any exaggerated claim they want since nutritional products escape FDA oversight. The article concludes, “When torrents of cash fall upon people like Heber and Ignarro — especially when the payments promote interests fundamentally in conflict with their responsibilities for thorough, objective research — it’s proper to ask whether the recipients should be viewed primarily as university professors with an income source on the side, or as agents of industry exploiting their academic titles for show.”

Vince wraps up NextGen’s HIStory this week. He starts the long history of Meditech next time and welcomes your contributions.

HIMSS Conference

HIStalk’s Guide to HIMSS13
HIStalk’s Guide to HIMSS13 Meet-Ups
HIStalk’s Guide to HIMSS13 Exhibitor Giveaways

Sponsor Updates

2-22-2013 10-27-56 PM

  • At the HIMSS conference, HITPC member Gayle Harrell will present a session titled “Leading Change through Health Information Technology” on Monday, March 4 at 2:00 p.m. at Sunquest’s Booth # 911.
  • Edward Fotsch, MD (CEO, PDR Network) and Douglas Gentile, MD, MBA (CMO, Allscripts) will present “Turning Patient Portals into Major EHR Assets” on Wednesday, March 6 at 8:30 a.m. in Room 288 of convention center. The session will also be streamed live.
  • PatientPay is named by PYMNTS.com as a finalist for a 2013 Innovator Award in the Best Debit category.


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

More news: HIStalk Practice, HIStalk Connect.

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February 23, 2013 News 7 Comments

Readers Write: What Would Steve Jobs Say?

February 22, 2013 Readers Write 3 Comments

What Would Steve Jobs Say?  
By Tom Furr

2-22-2013 6-50-05 PM

When you purchase a song on your iPhone, do you have to search for it in one application then toggle over to a different application to pay for the tune and then toggle over to another application to listen it? The answer is no. The brilliance of iTunes is that you can do it all within that one application. It is a single application that performs multiple tasks.

What iTunes is and how it works did occur to me while at a conference on “healthcare innovation.” All the speakers there talked about how users would have to exit out of or toggle from the practice management software to log into a payment portal after having downloaded data.

I wondered what Steve Jobs would say about the user experience in healthcare? I imagine it would not be favorable. I asked my fellow attendees this very question. The standard response was, “This is just how healthcare works.” To me, this is just unacceptable.

There are about 300 vendors offering practice management software. I suspect most of those applications require users to toggle out to access a partner’s application. All this raises the question: why don’t practice management software vendors make the user experience a selling point?

A little reconnaissance will show that your users do not like to toggle from application to application. Case in point: moving from your practice management software to a billing application or a clearinghouse portal and then to a reconciliation spreadsheet. Toggle. Toggle. Toggle. Users want to see and do everything on one screen within the practice management software. Have it all in one place.

If you’re not attuned to the usage preferences of those dealing with your software every day, you are putting your long-term viability at risk. A kludgy user experience puts vendors at risk with the rise of new, innovative vendors willing to address design and usability as Steve Jobs did religiously.

Usability is what differentiates and provides an edge when competing for users and market share. I would suggest you look at how BlackBerry is doing today versus Apple or Samsung to see just how much value your consumers place on ease of use.

Like Apple has done, how do you keep your current customers fiercely loyal to your product, attract new ones, and drive your competitors crazy trying to keep up? Keep their experience with your product in mind at all times and move quickly to embed all functions of their day into your practice management software and eliminate the need to toggle. You create a unified user experience, put up significant barriers to switching, and drive greater revenue as your customers become your greatest salespeople. Just like Apple.

It’s worth noting the words of Steve Jobs: “Innovation distinguishes between a leader and follower.” It’s time for you to be the innovator.

Tom Furr is CEO of PatientPay of Durham, NC.

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February 22, 2013 Readers Write 3 Comments

The HIT Productivity Paradox — It’s Gonna Be OK

February 21, 2013 DrLyle 4 Comments

The New York Times publishes another article about how spending money on EMRs is a waste since the benefits are not obvious. Like so many media cycles, they build you up (HIT is great) and then tear you down (HIT is a waste of money). 

Fair enough. Are EMR’s worth it? Was MU worth it?

I’ve said before that I don’t think I would have spent the $30-40 billion that way (remember, they use the $19 billion figure because they assume $10-20 billion in savings). I would have focused on mandating standards and trying to push for a uniform data model platform upon which vendors could then build their more external facing products.  

However, I will happily admit that MU has done its job. It has stimulated the adoption of EMRs. It won’t be the 80+ percent they were hoping, but it still got a lot of people off their asses and moving.

Next question: will EMRs provide all the great things we are hoping for?

Certainly we’ve got some issues. EMRs are still not mature, nor is our understanding on how to best use them. But no technology, from cars to computers, started out perfect.  

I’ve been reading "The Signal and the Noise." Very early on, it reminds readers of "the productivity paradox," which helped explain why the early computer age (1970s-1990s) actually saw a lower productivity as everyone was figuring out how build them well and how to use them. Sound familiar?

From Wikipedia:

The productivity paradox was analyzed and popularized in a widely-cited article by Erik Brynjolfsson, which noted the apparent contradiction between the remarkable advances in computer power and the relatively slow growth of productivity at the level of the whole economy, individual firms, and many specific applications. The concept is sometimes referred to as the Solow computer paradox in reference to Robert Solow’s 1987 quip, "You can see the computer age everywhere but in the productivity statistics." The paradox has been defined as the “discrepancy between measures of investment in information technology and measures of output at the national level.” It was widely believed that office automation was boosting labor productivity (or total factor productivity). However, the growth accounts didn’t seem to confirm the idea. From the early 1970s to the early 1990s there was a massive slow-down in growth as the machines were becoming ubiquitous. (Other variables in country’s economies were changing simultaneously; growth accounting separates out the improvement in production output using the same capital and labour resources as input by calculating growth in total factor productivity, AKA the "Solow residual.")

If and how can this best be applied to healthcare IT? It turns out that some smart authors actually addressed this exact issue in a June 2012 NEJM article entitled. “Unraveling the IT Productivity Paradox — Lessons for Health Care.” The authors explain that sure, we are seeing problems with HIT, but it is as expected, just like every other new industry has to evolve. They conclude with the following paragraph:

The resolution of the original IT productivity paradox suggests that current conclusions about the value of health IT investments may be premature. Research suggests three lessons for physicians and health care leaders: invest in creating new measures of productivity that can reveal the quality and cost gains that arise from health IT, avoid impatience or overly optimistic expectations about return on investment and focus on the delivery reengineering needed to create a productivity payoff, and pay greater attention to measuring and improving IT usability. In the meantime, avoiding broad claims about overall value that are based on limited evidence may permit a clearer focus on the best ways of optimizing IT’s use in health care.

Clearly we are not at perfection. HIT can affect efficiency and quality in both good ways and bad.  But rather than try to create some artificial polarization that it is all good or all bad, let’s continue doing our job (for the medical informatics professionals reading this) to keep making HIT better serve our providers and patients, while educating those who get freaked out every time a new stat or story comes out pointing out its imperfection. 

2-21-2013 10-49-19 PM

Lyle Berkowitz, MD is associate chief medical officer of innovation, Northwestern Memorial Hospital; chairman of healthfinch ("The Doctor Happiness Company"), author of the Change Doctor blog, and editor of the new book, Innovation with Information Technologies in Healthcare, which has a whole bunch of good stories about organizations who have succeeded with EMRs and healthcare IT by thinking innovatively about the best way to use them in their settings.

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February 21, 2013 DrLyle 4 Comments

News 2/22/13

February 21, 2013 News 3 Comments

Top News

2-21-2013 10-18-36 PM

An article in The New York Times called “A Digital Shift on Health Data Swells Profits an an Industry” takes direct shots at the HITECH act, particularly emphasizing the “behind the scenes lobbying” that Allscripts, former CEO Glen Tullman, and other unnamed vendors employed to get it passed. It points out that Tullman was health technology advisor to the Obama campaign, a personal donor of $225,000 to Democratic political candidates, and a seven-time White House visitor after Obama took office. Cerner doubled its lobbying dollars to $400,000, with almost all of it going to Republicans.

Athenahealth’s Jonathan Bush weighed on “the Sunny von Bülow bill” that he says kept his stagnant competitors “alive for another few years.” In a seemingly random quote, the ED chair at UCSF Medical Center said Epic is “mediocre” on a good day but “lousy” most of the time, while a counterpoint from UCSF’s CMIO saying that most doctors there like it receives less-sensationalized coverage. The article also points out that Neal Patterson’s stake in Cerner is worth $1 billion and mentions that a letter from Steve Lieber of HIMSS urged President-elect Obama to set aside at least $25 billion to increase EHR adoption.

In other words, the article is all over the place. The only new material appears to be a handful of quotes that were allowed to run unchallenged, with everything else looking more like a set of Google search results than a thoughtful and balanced piece. Its conclusion is hardly startling: the federal government wastes enormous amounts of taxpayer dollars in scratching special interest backs and a few people get really rich as a result (fun fact: Glen Tullman is now running his solar energy company, reaping the benefit of another big federal spending program.) Far more interesting than the article itself are the reader comments:

  • My impressions of the vendors can be described in two words: Welfare Queens. The systems are glorified billing and scheduling systems. Vendors were "certified" before they actually created the upgrades that supposedly met MU criteria.
  • Regardless of how much customization you do to the form and how many drop-boxes there are for entering data, the result is medical records which look very similar from patient to patient, and omit nuances and details which are specific for individuals.
  • It is interesting that so many commenters complain about a lack of privacy (signing my life away on consent forms!!), while others complain because not all providers in the country have easy, fast access to their medical records.
    You must realize that these things are at odds, and affected more by HIPAA than limitations of technology.
  • EMR 1.0 = islands of information, designed for billing and documentation. EMR 2.0 = system of engagement – Key information summarized and shared. Saves time for the users. It’s coming!
  • Try telling countries like Canada, New Zealand, Netherlands and Japan that they should give up all of the EMR systems that are unusable despite the fact that the majority of their docs are using EMR systems today. Just because a few people in an article determined a system to be unusable doesn’t make it so.
  • The EHR has become the patient. It is sicker than you and more complicated, taking more time. You, the real patient, can just lay there waiting in a state of abject neglect.
  • There is a lot more to this movement than this article suggests — and it is good. "The clear winners are big companies" — yes, in some ways, but the even bigger winners are patients and the doctors who care for them. In my family, this record-keeping already has resulted in a life-saving developments.
  • In our office we have had three over 50 early retirements due to the EPIC system.
  • Think if America had as many electric outlet types as Europe (free markets!) This mishmash of EMR will take a generation to unravel and cries out for a centralized system & format.
  • I’m a primary care physician working at Kaiser Permanente. We’ve been using the Epic system for years. While it isn’t perfect, I’d never go back to paper … the real reason this system works for us is because we are an integrated system. If we weren’t, it wouldn’t work well at all. The real problem is lack of integration in US medicine.
  • Banks and many other industries already embrace efficient and effective computerized systems. Where your life is at stake, wouldn’t you want your doctor to have the same advantages as your bank?
  • This is a very one-sided article, and almost reads like a smear in some places.

For a counterpoint, see DrLyle’s post, The HIT Productivity Paradox — It’s Gonna Be OK.

Reader Comments

inga_small From Ms. HIM: “Re: X-Rays. Inga, did you report to someone at the facility that you were able to see the patient data in the hallway?” Ms. HIM is referring to my recent visit to a radiology practice that had patient data prominently displayed on several monitors in common areas. I did e-mail the CIO and included my stealthily-taken pictures. No response yet.

From Disappointed: “Re: HIStalkapalooza. I want to give kudos to Shannon at Thomas Wright Partners. I am unable to attend HIMSS due to a family thing, but she promptly and cheerfully changed my confirmation to my boss who had neglected to sign up (what can I say?) She also said if things changed and I was able to attend, she personally would ensure I would get in and gave me her cell phone number. What great service!!!” Medicomp is working with the same team (Thomas Wright Partners, Bzzz Productions, Istrico Productions) that brought you HIStalkapalooza 2011 in Orlando. They are indeed efficient and responsive. I had no qualms about putting my name on the event and leaving the details to them.

2-21-2013 9-25-51 PM

From Letter of the Law: “Re: Allscripts Meaningful Use Guarantee. Doesn’t sound like MyWay will meet Stage 2 MU or get 2014 ONC certified as a Complete EHR. Does this mean MyWay clients get a 12-month support credit or refund? Seems like the guarantee was written to be purposefully vague and has now mysteriously disappeared from the Allscripts site (convenient) except in the Investor area.” Allscripts told us they would respond, but they haven’t so far.

2-21-2013 9-31-51 PM

From Tom: “Re: Epic. An electrophysiologist wrote a satirical post about Epic and used screenshots to convey the problems he experienced. He says Epic contacted his hospital administrators and asked him to take the screenshots down. He is now concerned about legal ramifications.” It should be noted that the doctor sells software on the side, although it costs only a few dollars and is specific to electrophysiology. Still, Epic has made it clear in the past that it won’t tolerate posting screen shots, documentation text, or almost anything else publicly. I’m thinking I remember (but could be wrong) that they warn UGM presenters not to post their slides publicly if they contain anything that Epic might deem proprietary. Says the doc (with some of his preachy indignation removed):

I’m just a physician who uses their software … No software is perfect however and I think the Epic bosses should be more interested in using feedback and criticism from health care professionals to improve the program rather than spending their time worrying that a screenshot of their user interface is available on the web … these massive companies who have benefited enormously from our tax dollars have the nerve to threaten those who criticize their software and publish a few bland screenshots. Unfortunately though, with their cash reserves and cadres of lawyers, there is little that EP Studios (cash reserves = $0) can do to stop their bullying.

2-21-2013 10-04-37 PM

From Say What?: "Re: HIMSS in Cleveland. Surely you jest. What is moving 345 miles from its Chicago base going to do for HIMSS? At least Nashville made sense from a different geographic, cultural, and transportation point of view, as would Phoenix, San Francisco, or Seattle.”

From Richard: “Re: HIStalk. Thanks for one of the most concise, relevant online healthcare IT publications out there. Your work is an excellent balance of current news, pertinent insight, and subtle (or sometimes hot so subtle) humor. Please pass on my compliments to the entire HIStalk crew for their excellent contributions. P.S. I admire your team’s ability to present a meaningful contribution and at the same time party like college freshman at HIMSS.” I did indeed pass along your much-appreciated comments to the crew, which got me trapped in the e-mail crossfire as Inga and Dr. Jayne tried to one-up each other with their claimed partying capacity beyond freshman level. I stopped reading once they escalated to grad school.

HIStalk Announcements and Requests

inga_small This week on HIStalk Practice: MGMA introduces a Web-based tool that allows organizations to benchmark themselves against peers using national MGMA data. The RI REC offers EHR adoption assistance to specialists. Researchers devise an AI tool that may outperform physicians in making cost-effective clinical decisions. Michigan lawmakers consider legislation requiring a single universal prior authorization form for prescriptions. PCMHs deliver slightly better patient satisfaction and preventative care but may not result in cost savings. Dr. Gregg shares details of the meeting between Focus and Byproduct … heck, it’s a great story, so give it a read. Greenway Medical CEO Tee Green discusses the company and industry and makes some predictions for the future. Thanks for reading.

Maybe I’m the only one who didn’t know: Word, going back to the 2007 version apparently, has a “Save as PDF” option that’s easier than PDF print driver products like CutePDF or PDF995. And in another Andy Rooney meets Larry King kind of non sequitur, I heard programmers repeatedly pronounce two words oddly in a meeting today: DISplay and REfresh. I am monitoring further accent-switching occurrences.  

I got an e-mail today that HIMSS has kicked me out of my reserved hotel and put me in a lower-rated one because of “an oversold situation,” adding that they “wanted to inform you before you arrived in New Orleans.” How thoughtful, especially considering that I booked in September.

2-21-2013 8-54-49 PM

Welcome to new HIStalk Gold Sponsor Greythorn, whose healthcare IT practice places candidates in the specific high-demand market segments of Epic, Cerner, and ICD-10. Greythorn has offered specialty IT staffing solutions for more than 30 years. Check out their LinkedIn Epic and EHR Professionals group, or seek their folks out at HIStalkapalooza since they told me they’re going and I sense they’re a fun bunch. For clients, expect nice people, a big pipeline of candidates including international ones, and a zeal for understanding your business and your needs. Job candidates should read their Resume and Interview Tips document (“Questions to Be Prepared For” contains just about all of the HR-mandated behavioral interviewing questions I’ve ever asked). Stop by Booth #5358 at the HIMSS conference and pass along my thanks to Greythorn for supporting my work.

Here’s a “Working at Greythorn” video I found on YouTube.

HIMSS Conference Social Events

2-21-2013 1-05-34 PM

inga_small If you registered in advance, your official HIStalkapalooza invite should have hit your inbox Wednesday (check those spam folders!) Make sure you’ve arranged your schedule to be there in time for the Inga Loves My Shoes contest and the crowning of the HIStalk King and Queen. The highly coveted beauty queen sashes and prizes will return.

inga_small Speaking of sashes, we decided to give readers a chance to win one, along with stage recognition and a $25 Amazon gift card. All you have to do is declare Inga, Dr. Jayne, or Mr. H as your secret crush and explain why. We’ll choose the most convincing entries, so feel to free to lay it on thick and shamelessly in an obvious appeal to our vanity. Winners (who must be at HIStalkapalooza) will be sashed on stage with "Inga’s Secret Crush," "Dr. Jayne’s Secret Crush," or "Mr. H’s Secret Crush" as a token of our reciprocation.

Aventura is participating in a booth block party at the conference on Tuesday from 4:00 until 6:00 p.m., with beer and margaritas.

2-21-2013 6-33-14 PM

Speaking of Aventura, they’ve sent the best e-mail promotion so far with their serious-sounding “HIT Survival Handbook” that includes some dry humor. I forwarded the e-mail home from work just to run it here.

I always scan down the HIStalkapalooza attendee list to see who’s coming and what titles they hold. Eyeballing it, it looks like over 100 presidents/CEOs, 200 VPs, 24 CIOs, 13 CMIOs, and eight financial and equities people. That’s a fraction of the total invitations, so obviously many other titles were represented.

Here’s a list of our HIMSS-related pages and their downloadable/printable PDF equivalents that will tell you what our sponsors are doing at the conference:

HIStalk’s Guide to HIMSS13
HIStalk’s Guide to HIMSS13 Meet-Ups
HIStalk’s Guide to HIMSS13 Exhibitor Giveaways

Acquisitions, Funding, Business, and Stock

2-21-2013 10-29-21 PM

Shareholders of PSS World Medical approve the company’s agreement to merge with McKesson, clearing the way for a Q1 closing.

2-21-2013 10-28-51 PM

GetWellNetwork reports 30 percent growth in revenues and a 90 percent increase in orders from 2011 to 2012.

2-21-2013 10-30-07 PM

MedAssets reports Q4 results: revenue up 4.5 percent, adjusted EPS $0.27 vs. $0.32.


The New Hampshire Health Information Organization selects the Massachusetts eHealth Collaborative to provide executive director management services for the implementation of its statewide HIE, which will utilize Orion Health’s technology backbone.

2-21-2013 3-56-46 PM

NYU Langone Medical Center contracts with Accenture to support its ICD-10 implementation process.

Intelligent InSites wins a $543 million contract to implement to RTLS at 152 medical centers, as reported here previously. We interviewed President and CEO Margaret Laub last week.

2-21-2013 3-58-09 PM

Numera selects AT&T to be the wireless network and location services provider for Numera Libris, a mobile home health management and personal emergency response system.

2-21-2013 3-59-23 PM

Banner Health expands its portfolio of 3M products to include the 3M 360 Encompass System for computer-assisted coding and clinical documentation improvement.

2-21-2013 4-02-04 PM

Memorial Sloan-Kettering (NY) chooses Orion Health’s Rhapsody Integration Engine for communication and data sharing between the hospital’s different IT applications.

2-21-2013 4-03-30 PM

Phoenix Children’s Hospital (AZ) selects Allscripts Sunrise Financial Manager, Sunrise Ambulatory, and Allscripts Community Record.

Mid-Valley Hospital (WA) selects e-forms and electronic electronic patient signature solutions from Access to use with its Meditech Scanning and Archiving system.

2-21-2013 10-31-08 PM

Fairview Health Services (MN) will implement Strata Decision Technology’s StrataJazz for decision support, operating budgeting, strategic planning, and capital planning.


2-21-2013 6-04-10 PM

Avere Systems appoints Michael McMahon (CommVault) as VP of business development.

2-21-2013 6-05-43 PM

Tom Giannulli, MD (Epocrates) joins Kareo as CMIO.

2-21-2013 6-06-38 PM

VA CTO Peter Levin, who led the Blue Button initiative, announces his resignation.

2-21-2013 6-50-40 PM

As reported here last week. Health Catalyst names Brent Dover (Medicity/Aetna) as president.

Wolters Kluwer promotes Kevin Entricken from CFO of the Wolters Kluwer Health division to CFO of the parent company.

Harris Interactive names Matt Knoeck (TNS North America) SVP of healthcare and Sharon Albert (TJ Sacks) VP of marketing for its healthcare group.

Announcements and Implementations

The Rochester RHIO partners with area ambulance companies to allow physicians to see critical patient information gathered in the field during ambulance calls.

Medical equipment provider Skytron upgrades six of its customers to CenTrak’s clinical-grade RTLS technology.

SuccessEHS connects with MyHealth Access Network HIE (OK) to send clinical care documents from its EHR.

Aker Eye/Vision Source (FL) implements RTLS from Versus Technology.

The Joint Commission begins offering a PCMH certification for accredited hospitals and critical access hospitals.

2-21-2013 10-33-07 PM

SCI Solutions launches Readmission Minimizer to track and monitor post-discharge processes.

The Utah Health Information Network offers Direct secure messaging labeled as cHIE Direct, using technology from Secure Exchange Solutions.

2-21-2013 9-59-07 PM

Enovate announces two new products, the e5000 telemedicine cart and colorful peds-oriented Emagination Stations.

2-21-2013 10-34-16 PM

Humetrix introduces cross-platform capability for its iBlueButton app that allows consumers and patients to exchange clinical information at the point of care regardless of which smartphone they use.

2-21-2013 10-35-08 PM

Kareo launches a free cloud-based EHR that can be used as a standalone application or integrated with the company’s PM and billing services. It was developed using technology acquired from Epocrates, which exited the EHR business a year ago. Kareo notes that the EHR is “advertisement free” and says it will provide support and updates at no charge. The company hopes that the free EHR offering will attract more clients for its PM and billing service products.

Government and Politics

2-21-2013 10-36-08 PM

ONC is accepting applications from those interested in serving on a new workgroup, the HITPC Food and Drug Administration Safety Innovation Act Workgroup,  that will provide recommendations for a risk-based HIT and mobile device regulatory framework.

2-21-2013 10-37-00 PM

Worth a read: The Advisory Board Company publishes “How Stage 2 Raises the Bar on Stage 1 Organizations.” Like everything Advisory Board, it’s fluff-free and to the point.

Innovation and Research

Researchers from the University of Cincinnati find that physicians using an EMR are more likely to order routine screening tests for women.

Processing a prescription drug order through a CPOE system decreases the likelihood of error with that order by 48 percent according to a study supported by AHRQ. Researchers say the findings suggest CPOE can substantially reduce the frequency of medication errors in the inpatient setting, but it is unclear whether that translates into reduced harm for patients.

2-21-2013 9-46-43 PM

Christiana Care Health System is awarded a $10 million grant from CMS’s innovation grant program for its Bridging the Divides program that uses predictive analytics to target patients who would benefit from intervention. CMIO Terri Steinberg, MD, MBA (above) tells me that analytics can be run against the patient’s entire data set even if it originates from a different health system. I may follow up for more information.


2-21-2013 1-40-54 PM

Healthgrades says Dayton, OH, Phoenix, AZ, and Milwaukee, WI have the lowest risk-adjusted hospital mortality rates in its list of America’s Best Hospitals 2013.

Express Scripts sues Ernest & Young and one of its former partners for stealing trade secrets and corporate data to boost E&Y’s healthcare business. The lawsuit claims Donald Gravlin, who was working on the Express Scripts-Medco merger, entered an Express Scripts facility several times  to forward confidential company e-mails to his personal account.

Black Book Rankings releases the results of a survey to identify the top hospital EHR vendors based on client satisfaction. Winners include:

  • CPSI (under 100 beds)
  • Cerner (100-249 beds)
  • Epic (academic teaching hospitals and major medical centers)
  • Cerner (healthcare systems, hospital chains, integrated delivery networks)
  • Picis (ED)

UnitedHealth Group announces the creation of 1,000 new jobs in North Carolina by its UnitedHealthcare and Optum businesses.

2-21-2013 6-49-09 PM

Weird News Andy waxes poetic on the news that Cornell researchers have created a realistic 3-D printed human ear. WNA says, “Poems are make by this fool right here, but only Cornell can make an ear.”

WNA finds this item both odd and sad: a suspended Johns Hopkins gynecologist accused of secretly taking photos of hundreds of his patients using a pen camera commits suicide.

Sponsor Updates

  • Aspen Valley Hospital (CO) shares how it increased front office payments and cash on hand and reduced administrative time and costs by using InstaMed solutions in a case study.
  • Covisint extends its cloud identity services to include small and medium-sized organizations.
  • US Secret Service Special Agent Erik Rasmussen and Trustwave SVP Nicholas Percoco will lead a keynote address on cybercrime at next week’s RSA conference.
  • Halfpenny Technologies adds Altosoft’s BI dashboard to its ITF-Hub solution for clinical laboratories. 
  • API Healthcare offers a Webinar series focused on effective employee recruitment and retention.
  • HealthMEDX expands its support of LeadingAge, a non-profit committed to providing care and services to the aging.
  • eHealth Technologies releases a zero-footprint, Web-based image viewer that uses the eUnity platform of Client Outlook.
  • Informatica releases Cloud Spring 2013, the latest release of its integration and data management applications, and will hosts a February 25 Webinar to introduce its features.

EPtalk by Dr. Jayne


Clinicians can now diagnose leprosy (Hansen’s disease) more than a year before patients are symptomatic. The new test uses a smart phone, a test strip reader, and a single drop of blood. Each determination will cost $1 or less.

This week President Obama announced an initiative to map the human brain, citing the Human Genome Project as a precedent. The brain is a fascinating thing and I’m excited about the role that information technology will play in making it a reality. Even better was the adrenaline rush I got since I read the announcement while I was hopped up on cold medicine watching “The Bourne Legacy.” Hopefully the CIA isn’t waiting in the wings to create neurologically engineered killers with the resulting data.

I’ve enjoyed the reader comments about travel arrangements for HIMSS. I apparently waited too long to book my hotel room (silly me for thinking three months in advance was enough) so I am arriving a day later and leaving a day earlier than I’d have liked. The idea of having to split between two different hotels to cover the entire stay was not very appealing. The comments about venues for future HIMSS meetings are spot on as well. I mentioned the HIMSS rotation to a dental colleague today and learned that there IS something worse than HIMSS returning to Chicago: The Chicago Dental Society Midwinter Meeting, which is held every February in the Windy City. The schedule of events lists a Fashion Show Luncheon. I wonder if they feature parkas, boots, and mittens?

Twitter served up an item from @ONC_HealthIT celebrating a physician who built his own EHR in response to budget cuts. A read of the actual article reveals that “eventually he turned to Cerner.” Unfortunately Meaningful Use has stifled grassroots innovation like building a custom EHR for your practice. I also like the line about practice administrators scanning paper test results into the EHR. If they actually have practice administrators feeding the scanner, I can recommend some additional overhead cost cutting for them.


In addition to the paper mail and tchotchkes enticing me to various booths at HIMSS, I’ve started receiving e-mail invitations to focus groups. Today’s gem promised to “present 4 innovative clinical strategies that leverage technology to reduce cost and improve all quality metrics.” Wow! They improve all quality metrics? That’s impressive. Even more impressive is the honorarium offered: a “Personalized tour of Walgreens Flagship Location – TBD.” Sheesh.



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

More news: HIStalk Practice, HIStalk Connect.

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February 21, 2013 News 3 Comments

News 2/20/13

February 19, 2013 News 16 Comments

Top News

2-19-2013 7-43-22 PM

Allscripts reports Q4 numbers: revenue down 10 percent, EPS –$0.14 vs. $0.14. The company’s reported revenue of $350.9 million fell short of expectations of $368 million on weaker sales and a deferred revenue provision, while the loss of $0.14 per share missed expectations of a positive $0.20 per share. President and CEO Paul Black says both the quarterly and annual results “did not meet our expectations.” Shares are up 6 percent in after-hours trading due to higher-than-expected bookings. From the conference call:

  • Reception to the MyWay to Professional program “has been strong.”
  • Two Sunrise acute care agreements have been signed so far this year, one of them with an existing client.
  • The four key areas of focus are client alignment, unlocking competitive advantage, reducing costs, and reporting consistent financial results.
  • Two-thirds of developers will be located in either Raleigh, NC or Boston after office consolidation.
  • The company plans to expand its hosting business.

Reader Comments

From UAHN Rocks: “Thanks for all the great work you to.  I am writing to share a video made by patients, clinicians, and executives from The University of Arizona Health Network’s Diamond Children’s hospital to celebrate the amazing work that they do to improve the lives of children in the community. UAHN is in the midst of an enterprise implementation of Epic, covering Diamond Children’s as well as all of our adult and outpatient facilities, with a go-live later this summer.” The video contains a medley of music, so keep playing, including a big finish with the magnificent Electric Light Orchestra at 3:00.

2-19-2013 8-26-57 PM

From HIMSS Bound and Gagged: “Re: flights to New Orleans. Costs are out of control, causing us to scale back our attendees. Have you heard anything?” According to Travelocity, the round-trip cheapest flights are $1,767 (Chicago), $1,142 (Atlanta), $1,582 (Los Angeles), and $1,687 (New York). Those include some really crappy connections as well, like going through Denver from New York. I seem to recall that the HIMSS post-Katrina booking of New Orleans in 2007 had similar problems, where flights were not sufficient to get people in and out. HIMSS was supposed to have narrowed down its conference cities to just three – Orlando, Atlanta, and Las Vegas – if I’m remembering right from a few years ago. All three are easy to get to, cheap, and have endlessly available hotels, restaurants, cabs, service workers, etc. Then came the charitable addition of New Orleans (whose infrastructure clearly wasn’t up to the challenge despite the HIMSS pitch) and the hometown reach-around to Chicago (where everything, especially union member surliness, cost twice what it would have in those other three cities and it was cold and snowy besides). Both were HIMSS low points in my opinion, yet here we are going back to New Orleans this year and Chicago in 2015. The best city (San Diego) and the cheapest (Dallas) were dropped from the rotation years ago. I’m pretty sure that if HIMSS actually listened to its members, or even asked them for that matter, they would not favor returning to New Orleans or Chicago even though those cities are perfectly fine for personal travel. I booked my flight on January 23 and was griping about paying $300 and now it’s over $1,300. If you don’t already have a flight, aren’t within driving distance, and aren’t a fan of Amtrak or Greyhound, you’re screwed.

HIStalk Announcements and Requests

inga_small In case you missed it we published the HIStalk Guide to HIMSS13 over the weekend. More than 130 vendors (all of whom happen to be HIStalk sponsors) provide details on the products and services they will be featuring this year. We also created HIStalk’s Guide to HIMSS13 Meetups, which includes contact information on about 30 vendors that are not exhibiting but happy to schedule meetings with interested folks. Finally we developed HIStalk’s Guide to Exhibitor Giveaways to help you find the best swag.  When you chat with these vendors, please tell them thanks for supporting HIStalk.

2-19-2013 3-15-25 PM  2-19-2013 3-14-20 PM

inga_small I accompanied a family member to get X-rays yesterday and stood outside in the hallway during the actual scan. While waiting, I was able to read all sorts of patient-specific information on two different monitors, as well as on the computed radiography reader (Mr. H tells me that’s the name of the thingy on the left.) Why worry about privacy, right?

2-19-2013 7-13-45 PM

Welcome to new HIStalk Platinum sponsor Legacy Data Access of Marietta, GA. It’s refreshing that the company’s mission is not only easy to describe, but is even contained in its name. Legacy Data Access provides customers with access to all of that data that’s locked away in their retired legacy applications. The company eliminates the hassle and cost of keeping the old app running solely for occasional lookups or reports. Clients don’t need to pay apps vendors for support, maintain aging servers, chew up big chunks of their disaster recovery plan, and tie up high-level talent keeping an abandoned system running after Legacy has moved data from that old system to a shiny new database and given users a slick Web-based front end and extemporaneous reporting tool for their inquiries. Think of LDA as a retirement home for apps, which might include revenue cycle systems (clients still get receivables functionality), PM/EHR, nursing documentation, and ancillaries. LDA can even provide a Legal Medical Record. Some of the company’s customers are UCSF, Parkland, Stanford, Trinity Health, and others that are so recognizable that it would be just name-dropping on my part to continue reciting them. If your IT stroll down memory lane includes Carecast, Invision, STAR, MedSeries4, Series 2000, ESI, Premis, EMstat, Midas, or others whether they’re on LDA’s list or not, they can help. Once an app is ready for full retirement, LDA will move everything to its LegacyVault, where information will be available indefinitely (like in the case of a lawsuit). Move on to your new-system life by letting LDA help you move gracefully away from the old one. Thanks to Legacy Data Access for supporting HIStalk.

HIMSS Conference Social Events

2-19-2013 3-41-24 PM

inga_small At least in my mind THE social event of HIMSS is HIStalkapalooza. Here are a few vital details for those attending:

  • Invitations will go out starting Wednesday. Make sure to check your spam filters. We’re inviting twice the usual number of folks, so the odds of getting an invitation are favorable.
  • Medicomp is once again sponsoring HIStalkapalooza and they know how to throw a party, as those of you who attended the 2011 event at BB King’s in Orlando can attest. Guests will be greeted on the red carpet and handed a Hurricane Inga or Typhoon Jane. How’s that for hospitality?
  • The Inga Loves My Shoes contest is back by popular demand, so pack your best zapatos. Since HIStalkapalooza is at the Rock ‘N’ Bowl, we will have a category for Best Bowling Shoes, as well as Hottest Men’s and Women’s Shoes.
  • We will again crown a HIStalk King and Queen for the best-dressed guests, so bring your bling. We’ll also recognize the Best Bowling Attire for those opting for the ten pin look. If you haven’t figured out what to wear, here is a tip: nothing says sexy like a bowling shirt, except maybe sequins and a tux. I expect to see plenty of stilettos and Farzad-inspired bow ties. Feel free to leave your company-logoed shirt in the hotel room.
  • The party starts at 6:30 and the contests (followed by the HISsies) will begin about 7:30. Our esteemed judges will begin selecting contest finalists as soon as the doors open, so don’t be late.
  • After the HISsies, the Zydeco band and the fast-paced bowling tournament get going. Bowling teams currently include keglers from athenahealth, Bumrungrad International Hospital, CareCloud, Clinical Architecture, Northrop Grumman, Orion, SuccessEHS, and Vitera.
  • The party goes on until 11:30, so join us late after your fancy dinner at Emeril’s.

Acquisitions, Funding, Business, and Stock

2-19-2013 7-44-04 PM

Liaison Technologies acquires Ignis Systems, a provider of clinical data integration solutions for lab and radiology orders and results.

Allscripts discloses in a regulatory filing its plans to close 12 offices and implement other changes to reduce costs associated with product development. The company estimates that it will spend $10 million for employee severance, $16 million for relocation costs , and $3 million for lease exit costs.

2-19-2013 7-44-52 PM

Merge reports Q4 results: revenue up 1 percent, adjusted EPS –$0.13 vs. $0.04, missing consensus earnings estimates. The company also announced that its board has unanimously rejected the valuation placed on the company in strategic alternatives proposals and will instead continue to execute its own plan. In the conference call, the company pointed out strongly increased bookings, increasing subscription revenue, increased acceptance of its iConnect enterprise archive, and growth in specialty areas such as cardiology and orthopedics.

2-19-2013 7-04-07 PM

Social network platform vendor iMedicor acquires HITS Consulting Group (HITS CG) and the data mining firm ClarDIS. The company also appointed HITS CG CEO Henry Denis president and ClariDIS Founder and President Joshua Brimdyr as COO.

Clinical research services vendor Quintiles announces plans for a $600 million IPO. The company was taken private by Bain and TPG in 2008 for $3.8 billion and is $2.4 billion in debt. The founder, Bain, and TPG each own shares worth around $500 million.


Triad Healthcare Network (NC) will implement Alere Accountable Care Solutions for its HIE.

Cardiovascular Care Group selects McKesson’s Paragon HIS for use at its Bakersfield Heart Hospital (CA) facility.

2-19-2013 10-05-45 PM

Pioneers Memorial Healthcare District (CA) will deploy Medseek’s self-service portal tools.


2-19-2013 1-56-31 PM

Kimberly Labow (NaviNet) joins ZirMed as VP of marketing.

2-19-2013 5-08-38 AM

Clinithink appoints Russ Anderson (Availity) VP of product management.

2-19-2013 5-11-27 AM

Roland L. Surprenant (Allscripts) joins Patient Safe as a regional VP.

2-19-2013 8-44-45 PM

Hal Andrews (Mainland Morgan & Co.) joins nTelagent as CEO, replacing founder Earl Winter, who remains on the board.

The SSI Group names Terry Pefanis (Healthtech Holdings) as CFO and promotes Mary Hyland to VP of regulatory affairs/chief privacy officer.

Brian Graves (Picis) joins Connance, Inc. as VP of marketing and communications.

HCA Gulf Coast Division (TX) names Carl Vartian, MD to the additional role of CMIO. He will continue as chief medical officer of Bayshore Medical Center (TX).

Alan Huffman (Healthcare Management Systems) joins Shareable Ink as VP of engineering.

Announcements and Implementations

2-19-2013 6-54-40 PM

Benjamin Russell Hospital for Children (AL) goes live on the Versus Advantages Asset Tracking solution, which includes two-way HL7 integration to Four Rivers Total Maintenance System.

2-19-2013 9-01-11 PM

Data analytics and natural language processing vendor Health Fidelity is awarded a National Science Foundation grant to develop technology to identify patient cohorts using EHR data. 

Government and Politics

2-19-2013 6-56-21 PM

HHS names Marshfield Clinic Research Foundation the winner of its Million Hearts Risk Check Challenge for its Heart Health Mobile app and awards the Foundation $100,000 for maintenance and updates.

2-19-2013 9-40-49 PM

CDC releases Solve the Outbreak, a free iPad game.


2-19-2013 7-50-22 PM

Palomar Health will announce this week that it’s the first customer of a new wireless vital signs monitor for tablets and smartphones. The phone-sized, wrist-attached ViSi Mobile by Sotera Wireless will send continuous information on heart rate, blood pressure, and oxygen levels directly to the electronic medical record, allowing non-invasive monitoring from any hospital location.

2-19-2013 9-18-40 PM

Bayada Home Health Care issues 4,000 Samsung Galaxy Tab tablets to its professionals following a 20-person pilot project. They’re using SwiftKey Healthcare ($3.99), which speeds up documentation with an on-screen keyboard, terminology dictionary, and auto-fill capability. More than two-thirds of Bayada’s nurses who use SwiftKey said they would rather document on the tablet instead of on the laptop or on paper. It doesn’t work on iOS devices, though, since Apple doesn’t permit third-party keyboards.


HIMSS will lease 25,000 square feet in Cleveland’s Global Center for Health Innovation (just renamed from Medical Mart at the request of its tenants) to be used for exhibition, education, and demonstration as well as the HIMSS Innovation Center, presumably replacing its planned presence at the defunct Nashville Medical Trade Center project.

2-19-2013 7-58-47 PM

I think I remember a reader’s earlier question about Epic’s Meaningful Use Stage 2 certification status (it involved a claim that they wouldn’t be ready, as I recall). Both EpicCare Inpatient and Ambulatory are now listed on CCHIT’s site as being certified for the 2014 criteria.

2-19-2013 10-10-14 PM

A bomb scare-triggered lockdown this week at Natividad Medical Center (CA) proves the value of its electronic medical record in an emergency. According to the hospital assistant administrator, “We have an electronic medical record, so we are able to see where the patients are and what kind of service they need.”

A Black Book Rankings provider poll finds that up to 17 percent of physician practices may be planning to change EHRs in the next year, which it blames on vendors who are too busy selling and implementing their products to address unmet client needs. Of those practices contemplating a change, more than half said they would prefer a hosted solution. Specialists expressed strong dissatisfaction with their current systems, with more than 70 percent of ENT, immunology, orthopedics, gastroenterology, ophthalmology, urology, and nephrology practices saying their current EHR doesn’t meet their needs.

A trauma center in India implements a new system that eliminates readability issues with physician documentation and reduces the time required to document 30,000 accident cases per year. The self-developed, template-based new system is solely for “medico-legal cases,” i.e. it’s not for patient care, but rather to document cases that may eventually initiate a lawsuit.

Sponsor Updates

  • SCI Solutions adds 93 hospitals in 2012, achieves sequential sales growth of 37 percent, and maintains an attrition rate below two percent.
  • Ping Identity showcases its next-generation cloud and mobile identity management solution during next week’s RSA conference in San Francisco.
  • Greenway’s PrimeSUITE (V17.0) receives 2014 ONC HIT certification as a complete EHR. The company will also integrate the Physicians Interactive eCoupon voucher and coupon distribution system into  the system.
  • Covisint releases its Direct solution that provides secure, scalable point-to-point email-like messaging. 
  • ICA selects Health Language from Wolters Kluwer Health to support its HIE platform.
  • MedAptus VP of Client Services Rick Little shares details of MD Anderson Cancer Center’s use of MedAptus for charge capture.
  • NIH experts validate PeriGen’s fetal heart rate interpretation, which was presented this week at the Society of Maternal Fetal Medicine in San Francisco.
  • Aspen Advisors becomes a Premier CHIME Foundation member.
  • iSirona will be featured in the Interoperability Showcase at the HIMSS conference after passing the interoperability requirements at IHE North America Connectathon.
  • Beacon Partners will offer a session entitled “Habits of Highly Meaningful Users” at the HIMSS conference on March 6.
  • Healthpac will embed PatientPay’s online bill management services into its practice management system.
  • ICA and Futurix Health partner to offer payers, ACOs, and providers enhanced data analytics and benchmarking tools coupled with ICA’s interoperability and informatics platform.
  • DynaMed and Isabel Healthcare partner to allow mutual customers linkage from Isabel’s differential diagnosis tool to DynaMed’s evidence-based clinical information resources.
  • An Iatric Systems video describes the company’s vision for comprehensive healthcare IT integration.


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

More news: HIStalk Practice, HIStalk Connect.

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February 19, 2013 News 16 Comments

Morning Headlines 2/19/13

February 18, 2013 Headlines No Comments

Speech Recognition Tools Look to Play a Crucial Role within EMR

KLAS reviews front-end and back-end speech recognition systems including Nuance, Agfa, Dolbey, and MModal. The latter saw a significant increase in satisfaction with its back-end solution, but a significant decrease in satisfaction of with its front-end solution.

Obama Seeking to Boost Study of Human Brain

The Obama administration is planning to announce plans for a decade-long scientific effort to build a comprehensive map of the human brain, seeking to do for the brain what the human genome project did for genetics.

A sensational breakthrough: the first bionic hand that can feel

Researchers announce a prosthetic hand that will receive command instructions from the brain and send back tactile information about the environment in what will be the first prosthetic capable of bi-directional communication with the brain.

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February 18, 2013 Headlines No Comments

Curbside Consult with Dr. Jayne 2/18/13

February 18, 2013 Dr. Jayne 3 Comments

In the last several months, I’ve been involved in a lot of conversations around the concept of unique patient identifiers. A considerable amount of it has been due to our hospital’s participating in an accountable care organization.

We have a very good master patient index (MPI) in place, as well as other tools that allow most of our applications to use CCOW to share patient context as well as user context. Now the ACO is requiring us to tightly integrate with providers external to our owned facilities and employed medical group. That is giving a lot of people in our organization a fair amount of heartburn.

During nearly a decade of practice acquisitions and mergers, I’ve seen how people in various practices may (or may not) correctly identify patients. I’ve seen people perform patient searches using: the first three characters of both first and last name; first name, last name, and Social Security number; first initial, last name, and phone number; and various combinations of name, address, and date of birth. In consulting work, I’ve seen clients with both pristine MPIs and those clogged with duplicates.

The health of the MPI depends on not only the actual data integrity, but how the information is governed. The logic of the matching algorithm also plays a major role in minimizing erroneous matches or missed matches. If person merges are not performed in a timely manner (or if users don’t know how to request a merge when they find a duplicate patient) patient safety can be in jeopardy. In large health systems that have let their MPIs get out of control, it can take months to years for a cleanup effort to be successful.

Our organization is all too familiar with what happens when data isn’t as tightly governed as it is within our MPI. We’ve dealt with the pharmacy intermediaries that use ZIP codes for matching, which is a challenge for our transient patients. We’ve dealt with Sandy vs. Sandie vs. Sandi when the patient’s legal name is Sandra. We’ve dealt with marriages and divorces and the ensuing claim denials that result when names may not match.

There has been a lot of debate in the past about a national patient identifier. As fiercely independent Americans, we seem to fight it as an intrusion into our privacy. However, we willingly submit to a government identifier in order to pay taxes or receive government benefits (the Social Security number) or when we want to drive a car (the state-issued driver’s license number) or go to the Caribbean for spring break (the passport). Yet for the most personal situations (and possibly life-saving or life-threatening, depending on how you think of it), we resist a unique identifier.

I have to have a National Provider Identifier number if I want to receive anything other than a cash payment for my professional medical services. It took time and effort to update clinical, administrative, and payer systems with fields to track the NPI, but somehow we all survived. The same type of update would be needed to track a patient identifier, but the demands of Meaningful Use have proven that vendors can and will update systems based on government regulations.

There would also need to be a new government infrastructure created to issue identifiers and maintain the information. Meaningful Use has also demonstrated a willingness to accept additional layers of bureaucracy in the name of intended reform, so why not for a patient identifier?

Having a unique patient identifier would certainly make interoperability easier. It would also provide significant benefits to patient safety by reducing the possibility of duplicate or conflicting charts. Knowing exactly who we’re treating can also assist in preventing drug diversion and reducing healthcare and insurance fraud.

The original HIPAA Act of 1996 allowed for the creation of unique patient ID numbers, but Congress quickly blocked funding, citing privacy concerns, existing numbering systems, and concerns about government involvement in health care. A decade and a half later, however, those trains have long left the station. It’s time to reconsider.

There is significant support among the professional community. The American College of Cardiology has a nice position statement. Many other organizations cite the 2008 RAND Corporation study titled “Identity Crisis” in calling for support.  The RAND study also discusses the need to use both statistical matching and a unique identifier during the implementation process or if participation is voluntary.

Correct patient identification is essential for effective health information exchanges. There’s a lot of discussion around the Direct protocols for Meaningful Use Stage 2. Privacy rights advocates are pushing for patient-defined identifiers where patients can choose different identifiers in different situations depending on what data they want shared. Although this may allow some data to remain siloed in an effort to protect privacy, it also prevents creation of a true comprehensive patient record.

I support the ability of patients to receive care anonymously, but when patients do so, they should not be surprised that physicians and caregivers may not have the full picture of the patient’s health. Physicians and hospitals should not be held liable for negative outcomes when information is sequestered by the patient. For the rest of us, however, who want to ensure that our physicians have our entire health history present so we can receive the best care possible, this can’t happen too soon.

What do you think about a national patient identifier? E-mail me.

E-mail Dr. Jayne.

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February 18, 2013 Dr. Jayne 3 Comments

HIStalk Interviews Margaret Laub, CEO, Intelligent InSites

February 18, 2013 Interviews No Comments

Margaret Laub is president and CEO of Intelligent InSites of Fargo, ND.

2-15-2013 5-44-50 PM

Tell me about yourself and the company.

Intelligent InSites is 10 years old. I think about us as being the operational intelligence platform that essentially leverages real-time data from both EMRs and other HIT systems as well as sensory tags. Our goal is to increase the efficiency of health systems while improving care.

I joined Intelligent InSites in August. I have a background in healthcare services and technology for the last 15 or so years. I spent some time at McKesson, where I ran the “not the distribution business” and “not the hospital technology systems”, but what I call the “all other businesses.” Everything there has a technology component to it and a services component to it.

I’ve been in technology and services in healthcare for a long time. I grew up in the accounting field. I was an accountant back in the day with Coopers & Lybrand, which is partly what really interests me in Intelligent InSites and operational intelligence.

One of the reasons I’m here is to see the value of knowing what’s going on within your hospitals. Really seeing what’s going on and being able to make immediate decisions about those activities that can provide value from the standpoint of improving satisfaction, saving money, meeting compliance regulations, or improving quality. Back in the day when I was growing up, I did things like activity-based costing, which is essentially looking up what’s going on in your business, applying inputs and outputs to those things, and being able to make decisions about how better to improve your processes.

When I saw Intelligent InSites and the fact that we were a platform that was looking to accumulate data from a number of different data sources — sensory tags and/or HIT systems — and actually apply it at the point of service as well as being able to look at data providers over a period of time, I got very excited. I said, “Wow, that’s a great thing for me to do.” I’m here and very excited about helping us create this market.


It doesn’t seem that long ago that an RFID project involved expensive door frame sensors and passive tags. You got just enough software to turn out a primitive tracking log and maybe saved some money by tracking equipment instead of renting it. What’s the current state and how did we get here?

Many things coalesced. They all came together at one time. The population and customers probably started demanding more service. I don’t want to be treated like the old days, where I had to go to an old hospital and have things done to me. I would like to know what’s going to be done. I would like to be part of that process. I would like to comment on the value of the service I got. There is the whole consumer quality driving aspect to the environment that we didn’t have 10 years ago.

New reimbursement models are coming down, both from the standpoint of the regulatory environment as well as just the fact that populations are growing and everybody needs to use their resources in a much more efficient way. There are fewer physicians. There are fewer nurses. There are fewer dollars to be spent on things. All of these things are coalescing all at the same time, which is going to cause folks to say, “Wait a second. I really, really, really have to look at how I’m operating the business.” 

More importantly, as the volumes of patients or services are being provided, every single thing has to be done for an individual. Healthcare is individual. Each one of us is going to be treated a bit differently, and yet we’re going to have to find ways to treat people consistently and in a standardized way just because we’re going to have to do it from a financial standpoint.

That’s what’s changed. People need to get insight and visibility into how to do that. It’s not just about the hard dollars any more. It’s not just about finding pieces of equipment. It’s how are we using an equipment, to whom are we applying that equipment, why are we doing it, for how long are we doing it, is there a different way to do it? All of those things need to be looked at, because all these influences are coming together at once.

Certainly accountable care has even moved that far up. Meaningful Use, accountable care, all of those things are just driving it. Hospitals and IDNs really do need to start thinking of themselves in a bit of a different way. I think it’s the larger IDNs, the ones who are leading, who have done the EMRs, and who have taken big steps in looking at the clinical side of the business. Now we’re going to start looking at, how do I take the clinical piece and how do I integrate that into my operation so it’s not only clinical delivery that’s efficient and effective and valuable and satisfactory, but it’s also how I actually deliver it?


Many times people find creative uses for a technology once the infrastructure investment has been made. Do you have some examples of some high reward type customer projects?

One of our customers has used our technology to do their workflows in a very different way. In clinics generally and in hospitals, the patient goes to where the services are. One of our clients has changed the way they deliver the service. They take the services to the patients. The workflow has changed. It gets more efficient. It gets more effective. 

What they’ve been able to do with our enterprise platform as well as one of our workflow apps that we’ve worked with them on is change the way that that service is delivered. Instead of the serial nature of it, essentially the services are going to the patient. That’s very, very different. I think they’re one of the folks that won an award or will be winning an award at HIMSS in the near future.

The other I think that’s very innovative is what we’ve done with the VA. We recently — along with our partner HP — were awarded the VA national contract. They will be doing a couple of things. They will be using our enterprise software, a platform across all of their hospitals. They will have one unique view across the 152 sites that they have, as well as have that unified view at the hospital level. It’s a very innovative use. It’s not just a point solution. It’s not just being used in one department or for one hospital. It’s being used across the whole entire enterprise.


The VA’s announcement was, in my mind, a turning point for RTLS. It suddenly was not only validated, but being deployed in a widespread implementation by an organization that’s been good at changing around their technology. What did the VA have in mind when they decided that RTLS was the way to go?

The VA’s ultimate objective, and they very clearly stated it, is better care for the veterans. They looked at it as yes, there is value as that relates to tracking hardware and patients and where they are, but ultimately what they’re looking at is how do we deliver better care to the veterans?. Their decision, at least from our understanding, was based across a couple of things. How can I see that across everything that I’m doing, and more importantly, how do I plan for the future when there are many things that I don’t even know that I’m going to use down the road? What kind of platform do I need that will grow with me, that I know is not going to be something that I’m going to be replacing in five years? What kind of platform can I get that can integrate with the systems that I currently have, including VistA, which they’ve talked about and we will be integrating with them. How can I use all of those things? 

They are really forward thinking in terms of not just thinking of it as RTLS software, but as  software that allows them to collect data from a number of sources, apply some contextual information to it that will come out of their VistA system, and be able to translate that into better care at the point of service.


Some of the more promising projects in the early days involved tracking employees, which got a lot of pushback. Are those projects still off the table?

I haven’t run into that in my tenure here at this point. In fact, one of those other examples that I didn’t give you before was that we have a client who is a family medical clinic. They are using badges to track translators at the clinic that supports a customer base of 25 or 26 different languages that are spoken. When someone comes into the door, rather than wasting time in searching for that person, they can use the badge to track down the appropriate translator and get that translator right to that patient and as soon as they walk in the door.

In the VA, it’s not even a question at this point to my knowledge. It’s something that they’re a bit concerned about, but I don’t think it’s something that’s causing them major issues right now. They do have unions and they’re going to be working through that, but we haven’t heard that being a major problem. The customer that I referred to before that’s using a new process in the clinic, I do think they are badging some their folks. They’re just saying, “Hey, when can I get badged?” because it actually helps them in their processes. I’m not saying that that is not an issue that is going to be dealt with, but I don’t believe that’s going to be a bigger issue as it might have been even 10 years ago.

Even some simple things where you take pieces of information out of an EMR. If a patient has an allergy and if you can give that information real time to a nurse when they are in the room and they can make sure that there is not something that they might be inadvertently doing that would cause a problem in allergy, all of a sudden what you’re doing is you’re actually helping that nurse do their job rather than worrying about, “Gee, was she in the room for a period of time?” I think most caregivers are in the business for care giving, and if we can show them both kinds of values rather than “Hey, we’re trying to figure out if you went out and had a cigarette and went to the ladies’ room or whatever you did, you didn’t punch in or punch out” or whatever it is — I think that that’s going to change the acceptance of it.


Some of that information has to come from a traditional EMR. Do you find a happy coexistence with EMR vendors?

EMRs are a great source of the contextual information that we need to leverage. Over time, they’re going to be willing to share pieces of information. Are they going to open up their whole entire databases to folks like us? No, but I do believe over time, as we say, “Hey, can we just have pieces of information? Can we get that from you?” they’re going to be willing to do that.

Probably more importantly, what we can do is give them back automatically collected information. Instead of a physician or a nurse keying in when something happened — it happened at this point in time, the person went from this process to that process — if we can, use tags and locating information to automatically update the EMR, that makes the EMR itself much more useful and valuable. Again, this is not something that’s happening right now,  but I think over time as these pressures are applied from all angles, from the client, from external sources, to maybe make some of that information available.


Who are your main competitors and how do you differentiate yourself from them?

We are purely an enterprise software and services company. We are focused exclusively in healthcare. Because we’re only focused on providing real-time operational information and we can take it from a number of sources, we’re neutral. We can take it from all the different tag providers, we can take it from databases, we can take it from anywhere. It’s really hard to say who a traditional competitor might be. I don’t know that there’s anybody that does exactly what we’re doing right now.

That being said, we do tend to be to get grouped with the other RTLS vendors even though RTLS is only a component of what we do. If they are looking for somebody, they probably find us more through the RTLS. But if we do get grouped in with the RTLS, it’s probably Stanley at this point in time from their acquisition of AeroScout. Even then I’m not sure that is a fair comparison because we have an open platform. We’re totally focused in healthcare and again, we are neutral as it relates to any not only RTLS or sensory system, but also any other kinds of databases.


Where does the company go from here?

I hope that maybe five years from now we are no different than a CRM system, than a lab system, than a scheduling system. We’re just a component of what every IDN does. We are their operational intelligence platform. We’re the folks that notify when things go not as planned. Healthcare is individual. Every person is unique. Everybody wants to be treated appropriately, yet we have to have a consistency of how we deliver.

Hopefully we’re the ones at that point in time who are giving the alerts at the point of care that something different needs to be done here. An action needs to be taken. We’re the value provider in that sense. We will continue to be in healthcare. We will not be external to healthcare. We will always be a healthcare-focused company.

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February 18, 2013 Interviews No Comments

Monday Morning Update 2/18/13

February 16, 2013 News 20 Comments
2-16-2013 10-33-57 AM

From Man Show: “Re: VA CIO Roger Baker. Resigning, just heard it on a conference call.” Verified, although not by the VA, which didn’t respond to my inquiries Friday. An internal memo says he’s resigning for unspecified reasons at an unnamed date. We could take bets on which government contractor will end up hiring him, like his previous employers Dataline and General Dynamics. He’s done a good job and will be hard to replace.

2-16-2013 12-47-37 PM

From Friend of ONC: “Re: RECs. Innovative shift from government seed capital to sustainable operating models. ONC is starting to work with the 62 RECs to co-develop sustainability models, business plans, and new service lines for the post grant-funded era and the 140,000 providers they work with.” Weaning organizations (and citizens, for that matter) off free taxpayer money has been a challenge, most notably with HIEs. It will be interesting to see if the same problem arises with HITECH-motivated medical practices since everybody assumes that once you’re on an EMR, you won’t go back to paper, although the Medicare penalty stick may provide the necessary motivation after the MU carrot has been consumed.

From Joshajust: “Re: [vendor name omitted]. In contract disputes with multiple hospitals in South Carolina over the failure of their computer-assisted coding module, which doesn’t appear to work.” It wouldn’t be fair to run the company’s name without some kind of proof of the specific disputes. If you have any, please send it over.  

From LinkedIn Stalker: “Re: premium membership. I was grandfathered in with a lower-cost premium membership which allows me to see who’s viewed my profile, as well as an expanded range of searches. As a sales and marketing executive, I find it invaluable as a means of research and connecting to people of interest, although I am always sure to personalize my connection request.” LinkedIn has had more luck than most freemium sites in getting users to pony up for optional services. Facebook seems to be losing the attention of its users to some degree, so while it waits to be marginalized by a trendier newcomer like MySpace before it, it could always use LinkedIn’s model of charging people to see who’s checking out their Facebook, which might be a lot more lucrative given its higher population of psychotic former lovers, stalkers, and narcissists.

From Telluride Tom: “Re: your day job. Why don’t you quit? You’ve done it long enough. Sponsors and consulting could offset.” I like working for an academic medical center and I really believe that patient outcomes would be at least a zillionth of a percentage point less positive if I left. I would also be loath to leave the playing field to join the healthcare-inexperienced commentators blabbing endlessly from the safety of the announcer’s booth. I don’t know that I could make HIStalk better by devoting even more time to it since I already have people who help me, but I would if I needed to. I’ve been doing what I enjoy doing for 10 years without regard to workload, money, etc. and it’s mostly working OK except it doesn’t make very interesting obituary material.

From LabRat: “Re: University of Iowa. Rumor is their Epic Beaker LIS install isn’t going well so far. Beaker needs a big win in a complex academic environment for market credibility.” Unverified. Epic seems to have been forthright in identifying appropriate candidates for Beaker, which if it follows the trajectory of all previous Epic modules, will quickly move up the food chain from barely usable to top rated as Epic sends in its cadre of youthful ground troops to earnestly learn from early adopters. Lab is probably the toughest market to crack given well-established workflows, FDA oversight of instrument interfaces, and the department’s full use and utter dependence on its technology, all of which have been well served for decades by best-of-breed LIS vendors and long-perfected interfaces. Lab also covers broader territory than outsiders appreciate, including microbiology, anatomic pathology, molecular diagnostics, cytology, blood bank, outreach, transfusion, and a host of activities that I don’t claim to understand. Folks frustrated with sketchy usage and questionable benefits of other hospital systems should visit the lab to see what can happen when you combine a small group of motivated, analytical, and focused employees performing repetitive tasks using purpose-built technology that achieves both increased task efficiency and improved patient care. When it comes to improving patient care with technology, the showcase hospital departments are always lab, pharmacy, and radiology. Those areas are small in number, focused in mission, and are not only accepting of technology but fans of it.

UPDATE: UI Health Care CIO Lee Carmen provided a response:

Regarding the reported rumor of issues with Epic Beaker install at University of Iowa Hospitals and Clinics. I am the CIO for UI Health Care, and I can report the project is proceeding as planned. There are a few aspects of this project that Epic has not dealt with at other Beaker sites, but we have a positive, constructive dialogue underway and I am confident we will find a way to meet the needs of our laboratory operations and have a successful Beaker install.

2-16-2013 8-42-52 AM

From HIMSSGoer: “Re: HIMSS vendor propaganda. Today HP sent me 45 M&Ms in a large Fedex box.” Funny you mention that — the same box was dropped on my doorstep, and before I read your e-mail, I also took a photo and counted the M&Ms. My photo above hardly does justice to HP’s massive waste of packaging and carbon. Inside the large Fedex box was an expensive-looking inner box, shrink wrapped and packed with air pillows. Inside that was a pill bottle, and inside that was a tiny bag of HP-imprinted M&Ms that was so resistant to opening that I had to use the same knife I needed to hack through the shrink wrap. Mrs. H did a double-take at the kitchen table full of junk as though I had just opened a package containing a human ear. I bet the whole matryoshka doll-type package cost HP at least $30 to send out, which is a lot for a small bag of M&Ms that bled blue ink over my fingers since imprinted M&Ms don’t have the usual “melts in your mouth, not in your hand” waxy coating. The subject of the pitch was the new ElitePad, an alternative to the iPad that (a) costs more; (b) runs Windows 8; and (c) is made by a famously struggling company that yanked its consumer tablet off the market six weeks after its launch in 2011. All three factors will probably reduce consumer interest to near zero, but maybe HP will sell a few to Apple-phobic IT shops willing to support Windows 8. If so, I don’t think it will be because of the M&Ms.

I’ve been too busy to do a music playlist lately, so I’ll recommend just one band this time: The Thermals, highly listenable and tight indie punk from Portland, OR. Kudos to the three-member band for recording live straight to tape and directly mastering from it instead of screwing around with computers and overdubs. My legs are doing faux kick pedal drumming as I listen to their excellent KEXP videos on YouTube and every one of their 60 or so tracks on Spotify. Best music I’ve heard in some time.

HIMSS Conference Social Events

Omnicell will offer beer and wine in Booth # 8141 Monday and Tuesday from 4:00 to 6:00. Betsy told me she can’t comment on the quality of the beer, but she says the price is right.

2-16-2013 7-07-18 AM

Three-quarters of poll respondents say the government should issue a national patient identifier, although few of those respondents have ever sought the votes of wary constituents. New poll to your right: is the amount of HIMSS-related vendor contact you’re getting too little, about right, or too much?

For the HIMSS vendor contact, I’m going to go with “about right” since it’s easy for me to toss mail-out cards without even looking at them, which I’ve done with every one of them that have arrived. I always toy with the idea of choosing some vendor at random from the HIMSS list who’s exiled to a tiny booth in the Siberia part of the exhibit hall and then imploring my readers to show up there at a designated time just to give them hope. Every year I purposely walk those seldom-trod paths and chat with the untouchables, although in many cases they’ve already given up and either left their booth unattended or repurposed it as a place for their reps to sprawl back and play with their phones. Inga, Dr. Jayne, and I are good mystery shoppers, telling you the good and the bad booth behaviors we observe during the conference.

2-16-2013 7-35-21 AM

Welcome to new HIStalk Platinum sponsor InstaMed. The Philadelphia-based company’s integrated healthcare and payments network has been chosen by 400 hospitals and 60,000 practices who wanted to collect more patient payments, get paid faster, and reduce the time and complexity involved in collecting what’s owed to them. Everything from eligibility to claims can be managed on the company’s cloud-based portal, while patients get their own portal for receiving electronic statements, making payments, and setting up payment plans. Other tools include eligibility, a patient payment estimator, converting scanned checks to eChecks, claims management, remittance management, and electronic remittance. A just-issued case study describes the experience of Aspen Valley Hospital (CO), which used InstaMed to increase front office payments by 124 percent over five years and reduce payment processing administrative time by 65 percent. Good Samaritan Hospital (IN) cut statement costs by 25 percent and reduced administrative time in handling credit card payments by 90 percent. Lots of testimonials, including names, are here. Thanks to InstaMed for supporting my work.

England’s Rotherham NHS Foundation Trust halts new go-lives of Meditech, citing “persistent serious issues” that include “clinician and staff acceptance and usability.” Overseers say The Rotherham is falling short on financials because the system can’t book appointments effectively, also saying they can’t trust Meditech’s coding, case mix, and activity data. The trust went live last year two years behind schedule, expecting to spend $62 million over 10 years on Meditech as one of the first trusts to bypass NPfIT-provided systems in choosing their own. Excellent reporting by eHealthInsider.

Also in England, Royal Berkshire Hospital is reported to be close to shutting down Cerner Millennium because of higher-than-expected ongoing cost and productivity losses that have frustrated staff and bottlenecked patients. The hospital expected ongoing costs of $2.5 million per year, but the actual annual run rate of the $46 million system is $8.5 million. Patient delays have been so extensive that the hospital offers them parking discounts, free refreshments, and quizzes with which to amuse themselves while waiting.

Our Investor’s Chair guru Ben Rooks weighs in on why companies adopt a majority voting policy for their directors as Allscripts did last week:

This is actually quite shareholder friendly and has become much more common in corporate governance. In contrast to the way boards typically were retained (plurality voting), this says that if most shareholders don’t actively want the director to serve, they need to resign. In effect, inertia and indifference cease to become as powerful forces in retaining directors. I’d view both this step and the expiration of the shareholder rights plan as positive for MDRX shareholders.

2-16-2013 12-42-37 PM

The recently reopened Bellevue Hospital Center (NY) diverted trauma patients for 90 minutes Thursday evening when an electrical problem shut down its computer systems for several hours.

Covisint will announce next week an out-of-the-box solution to connect with the Direct Project, which will include Web services APIs to manage message routing, administration, and a secure inbox. Covisint Direct will be market to hospitals, states, RECs, and EMR vendors as a quick way to create a Direct solution for sending CCDs, care gaps, and alerts.

2-16-2013 11-48-14 AM

The newly appointed president of the Allegheny County Medical Society (PA) says doctors are spending too much time completing electronic medical records, also noting that her own plastic surgery practice has been forced to change EHRs three times. 

A Zimbabwe family’s home remedy of treating wounds with sugar is being tested in British hospitals with some degree of success. Weird News Andy says they use the same sugar on both left and right limbs … because it’s ambidextrose (I won’t rain on WNA’s pun parade by pointing out that table sugar is sucrose rather than dextrose). It’s also not a new practice – hospitals I’ve worked in have used sugar on wounds on rare occasion, sometimes in conjunction with Maalox. Unlike most treatments, at least these are cheap and cause no harm even when they don’t work.

Sponsor Updates

  • Intermountain Healthcare will feature TeleTracking’s RTLS solutions in an interactive hospital patient room display in HIMSS Booth #1810.
  • HFMA member Dan Mandy of Winthrop Resources is featured in a peer-reviewed HFMA article that describes funding options for IT capital expense.
  • Philips Healthcare CMIO/CTO Joseph Frassica, MD will speak at the HIMSS Interoperability Showcase on Tuesday, March 5 at 11 a.m. I interviewed him last August.
  • Intelligent InSites is chosen by en-Gauge as the locating solution for its fire extinguisher and medical oxygen monitors.
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February 16, 2013 News 20 Comments

Morning Headlines 2/15/13

February 14, 2013 Headlines No Comments

QPID Launches EHR Search Engine

QPID, an EHR search engine, analytics, and real-time reporting tool for EHRs, launches appropriately enough on Valentine’s Day. The venture is a Massachusetts General Hospital spinoff and will be led by CEO Mike Doyle, formerly of Medsphere.

North Memorial Health Care Reduces Unnecessary Early-term Deliveries by 75 Percent with Adaptive Data Warehouse from Health Catalyst

North Memorial’s use of Health Catalyst technology reduces its rate of elective pre-39 week deliveries by 75 percent in just six months, from 1.2 percent to 0.3 percent of all births.

TeraMedica Signs Agreement with Vanderbilt University Medical Center for its Evercore Vendor Neutral Architecture

Vanderbilt University Medical Center will implement TeraMedica’s Evercore Clinical Enterprise Suite to archive radiology and cardiology images across the health system.

PeriGen, Inc. Names American Journal of OBGYN Editor-In-Chief Thomas J. Garite MD, Chief Clinical Officer

Perinatal clinical decision support vendor PeriGen appoints Thomas J. Garite, MD as chief clinical officer. He is editor-in-chief of the American Journal of OBGYN.

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February 14, 2013 Headlines No Comments

News 2/15/13

February 14, 2013 News 12 Comments

Top News

2-14-2013 9-55-50 PM

Massachusetts General Hospital spinoff and EHR query platform vendor QPID chooses a timely Valentine’s Day launch. I interviewed President and CEO Mike Doyle earlier this week about the company.

Reader Comments

2-14-2013 10-12-54 AM

inga_small From DrLyle: “Re: LinkedIn. Looks like I have more stalkers than you.” DrLyle and a few other folks sent me notes saying they were among the millions in the top five or even one percent of LinkedIn users with the most viewed profiles in 2012. DrLyle, by the way, posed an interesting question: is there value in paying LinkedIn for one of the professional versions? I defer to readers since I have no interest in paying $20 to $75 a month for premium options.

inga_small From Geographically Challenged: “Re: HIMSS13. Will you be attending this year’s HIMSS13 Annual Conference in Las Vegas from March 3-7?” Note to vendors and PR firms pitching for media time: messaging is far more effective when you get the name of the city correct. Not to mention that we already suspected that HIMSS13 would be held this year. Maybe it was a trick question.

2-14-2013 7-49-34 PM

From Skunk Baxter: “Re: Stanford Hospital CIO. She is out.” Carolyn Byerly’s LinkedIn profile shows that she just started a new job as managing partner with Platinum Advisory Services, LLC.

HIStalk Announcements and Requests

inga_small A few highlights from HIStalk Practice over the last week: CMS provides guidelines for EPs for avoiding the 1.5 percent PQRS penalty in 2015. CVS dominates the retail medical clinic market. Athenahealth earns a spot on FastCompany’s list of the World’s Top 10 Most Innovative Companies in Healthcare. SRS CEO Evan Steele discusses Thoma Bravo, EHR usability, and Meaningful Use. Thanks for reading.

inga_small Coming soon: HIStalk’s Guide to HIMSS 2013, which includes essential details on over 100 vendors, all of which in a remarkable coincidence happen to be our lovely sponsors. You won’t want to miss it if you need the scoop on who to contact to schedule meetings or where to find the best booth giveaways.

2-14-2013 6-28-12 PM

The always-creative folks at Vonlay steered me to a humorous Dear Abby-type blog post they’re running in honor of Valentine’s Day, but I was more amused by the graphic on their main page.

I’ve been getting several calls at the hospital each day from vendors pitching their HIMSS presence, more than I remember in previous years. They’re easy to spot on Caller ID, so I just let them go to voicemail and delete them later. Today a company (I’ll be nice and not name them) left a lengthy voice mail, with the rep (badly) reading a canned script that ended with, “we’re scheduling meetings with people” (nothing like making a prospect feel special). Worst of all, she was reading it over her speakerphone. I pictured her as a bored phone sex operator.

2-14-2013 8-18-45 PM 2-14-2013 8-26-44 PM

Welcome to new HIStalk Platinum Sponsor Halfpenny Technologies. The Blue Bell, PA company specializes in data interoperability, such as laboratory information systems communicating with EHRs, health plans, or each other (reverse reference labs). Point-to-point interfaces push data around inefficiently and without normalization, making them a sitting duck for Halfpenny’s ITF-Hub, which serves as air traffic controller to manage the flow of orders and results among all participants (hospitals, independent labs, HIEs, health plans, practices, and public health). Everybody knows you can’t do much of anything for a patient without lab results. The company has been around since 2000, having worked with more than 200 EHR vendors since then and embedded its technology into some of their products as well. They offer portal and mobile access, which of course makes docs happy, especially the ones who aren’t using EHRs. Their CMIO will tell you how Meaningful Use Stage 2 affects the clinical lab. Drop by HIMSS Booth #5223, tell the folks you read about them here, and drop subtle hints about signing you up for some swell prizes. Thanks to Halfpenny Technologies for supporting HIStalk.

On the Jobs Board: Project Manager – Government, Business Intelligence Architect, Software Product Development Manager, Requirements Engineer.

HIMSS Conference Social Events

Send us your event details if it’s a good one (i.e, free food and drinks at minimum) and you promise that all HIStalk readers are welcome to attend, even if they work for your most hated competitor as a given reader might well do. Don’t blame us if throngs eat you out of cocktail weenies and tortilla roll-ups. I would be especially interested in companies serving really good beer as I ran across a couple of conferences ago.

2-14-2013 6-03-40 PM

Jardogs will host a happy hour on Monday, March 4 and Tuesday, March 5 from 5:00 to 6:00 pm in Booth 4659. Dr. Jayne and Inga have noted this in their schedules.

Acquisitions, Funding, Business, and Stock

Allscripts adopts a majority voting policy for directors and announces that its annual stockholder meeting is set for May 21. We’re not astute financial analysts who actually know what that accomplishes, so Ben Rooks of the Investor’s Chair has promised to render his opinion.


2-14-2013 11-50-52 AM

Vanderbilt University Medical Center (TN) will implement TeraMedica’s Evercore Clinical Enterprise Suite for vendor neutral archiving. 

SCL Health System selects the technology platform of Lumeris for its accountable care initiatives.

Community Memorial Hospital (CA) contracts with Cymetrix for revenue cycle services.

2-14-2013 5-58-55 PM

DeKalb Health (IN) selects e-MDs Solution Series for its 19 providers.

2-14-2013 6-00-03 PM

Bali Royal Hospital in Indonesia selects Wolters Kluwer Health’s UpToDate as its evidence-based clinical decisions support system.

2-14-2013 6-01-29 PM

Mee Memorial Hospital (CA) will use Access-eforms on demand and e-Signature technology with its Meditech Magic Scanning & Archiving system .


2-14-2013 6-04-31 PM

PeriGen names Thomas J. Garite, MD (American Journal of OB/Gyn) chief clinical officer.

2-14-2013 8-04-55 PM

Nancy Ham (McKesson / MedVentive) is named CEO of Aetna’s Medicity subsidiary. She replaces Brent Dover.

2-14-2013 8-07-17 PM

Brent Dover (Aetna / Medicity) is named president of Health Catalyst, which will announce his hiring on February 19. Brent says the irony isn’t lost on him that he left an HIE company to lead an analytics vendor, while Nancy Ham left an analytics vendor to replace him at the HIE company.

Announcements and Implementations

2-14-2013 6-16-08 PM

Baylor University Medical Center (TX) goes live on Allscripts Sunrise Clinical Manager.

North Memorial Health Care (MN) reports a 75 percent reduction in unnecessary early-term deliveries using Health Catalyst’s Adaptive Data Warehouse technology.

2-14-2013 6-18-03 PM

Integration and data management services provider Liaison Technologies announces that its healthcare division grew 83 percent and its headcount more than doubled in 2012.

The CalHIPSO Regional Extension Center launches service offerings that include Meaningful Use tracking, EHR readiness, and eligibility registration attestation.

Cleveland Clinic (OH) signs up for the CliniSync HIE, joining the previously announced University Hospitals Health System.

Perceptive Software announces an upgrade to its Perceptive Search applications, the first since it acquired the technology last year. It searches documents, e-mail, websites, intranets, databases, social networking sites, and local computers.

Government and Politics

2-14-2013 10-09-38 PM

President Obama calls out patent trolls in a Thursday afternoon Google Hangout session dubbed Fireside Hangout. “They don’t actually produce anything themselves. They’re just trying to essentially leverage and hijack somebody else’s idea and see if they can extort some money out of them.”

Innovation and Research

2-14-2013 6-24-26 PM

NeuroCare Tech launches BrainAttack, a $5.99 decision support app for evaluating ED stroke patients as candidates for tPA.

2-14-2013 7-47-20 PM

The free Qpid.me service allows potential romantic partners to share their sexually transmitted disease status directly from the medical records of their doctors. Concerns about the site are that practices won’t have the time to send patient records if it really takes off, not to mention that once those records arrive at the company’s servers, patients are no longer protected by HIPAA.


Four Rivers Total Maintenance Systems integrates Versus Technology’s RTLS within its asset management software.

A study’s questionable conclusion claims that Microsoft’s Kinect videogame controller could reduce healthcare expenses by $30 billion by replacing expensive telemedicine systems (which of course Skype and other video chat tools can do for free). Kinect’s advantage is that it can be used hands-free in a sterile field, but I haven’t seen a lot of telemedicine originating in the OR. One of the study’s two authors works for Microsoft.


Patient Privacy Rights provided links to its federal Form 990 for 2010 and 2011 in response to the inquiry from Alert Reader. They’ve been there all along on the “Why Donate” page. UPDATE: my mistake, they apparently were just added from the reader’s inquiry. I didn’t see any smoking guns if that was the expectation – the organization took in around $105K in donations in 2011 (half what it received in 2007-2009), spent a small amount on its one FTE, and the rest went to professional fees and office and travel expense. Deb Peel was paid nothing.

2-14-2013 10-12-25 PM

Froedtert Health (WI) warns that a virus that penetrated an employee’s computer may have exposed the information of 43,000 patients to unknown parties.

2-14-2013 9-46-05 PM

A San Diego publication profiles Chris Van Gorder of Scripps Health, a former beat cop turned hospital security guard and now CEO who is determined to reduce unnecessary variation to cut costs. According to the article, “Van Gorder trusts that sharing financial information, especially on costs, along with data on treatment and outcomes, will usually lead doctors to the best-outcome-at-lowest-cost decisions.”

People always send me funny stuff because they know I’m a sucker for it, and the video above from customer engagement and total cost of ownership services vendor PeerIntel is good one, with the smarmy doc playing it straight all the way. I notice the hospital name is actually that of the company’s R&D VP, described on its site as a “scruffy Armenian.” The other bios are pretty funny, too, with the marketing guy’s saying that he came to the company due to “a series of (now-broken) promises” by the top guys. The company used to be called Katalus Advisors. I interviewed Chairman Jeremy Bikman in October 2011.

A laid off MedQuist director shares her experience in “losing my job to technology” as speech recognition technology replaces transcriptionists.

2-14-2013 8-12-27 PM

The second spokesperson for Heart Attack Grill in Las Vegas dies of, you guessed it, a heart attack. He weighed only 180 pounds, a wisp compared to his 575-pound predecessor. The restaurant fries in pure lard, sells beer and cigarettes, offers a 10,000 calorie burger, and  provides free meals to patrons weighing over 350 pounds. Their employees are scantily clad “nurses” that critics say places it in the Hooters-created category known in the trade as “breastaurants.”

I see that passengers on the Carnival Triumph are suffering bad food, long lines, and rude fellow passengers. Sounds about like our experience on a week-long cruise on Triumph a few years back, except ours was just a normal cruise. Everybody’s fretting about underfed passengers, but nobody seems worried about the 1,000 foreign crew members working around the clock in miserable conditions trying to keep passengers safe, comfortable, and norovirus-free for their princely wages of maybe $150 per week, not to mention that tips will be few this time. As the ambulance chasers and sensationalistic news reporters line up to prod the vacationers into a state of righteous indignation (even though they’re already receiving a nice package of reparations from Carnival), someone should raise some money to help the crew, who will probably get nothing for what they’ve been through.

Scotland’s NHS hospital employees, like ours, share passwords, post questionable information in Facebook, curse in e-mails, and install unauthorized software on their hospital devices, according to disciplinary records.

Weird News Andy says this woman really did have a HERnia, in the form of a baby girl. A 44-year-old woman complaining of bloating is X-rayed by hospital doctors, who are startled to find a full-term baby in her womb. They did a C-section and she’s now a first-time mom.

Sponsor Updates

  • NextGen Healthcare adds ITelagen as a VAR.
  • VersaSuite participates in this week’s Rural Health Care Leadership Conference in Phoenix.
  • TrustHCS representatives will speak on ICD-10 readiness during the April AHIMA ICD-10 CMS/PCS and CAC Summit in Baltimore.
  • SuccessEHS sponsors a February 28 Webinar on the patient-centered EHR and quality improvement.
  • CIC Advisory offers suggestions on implementing and adopting a health IT safety program.
  • CardioNet and AirStrip partner to develop and co-market an integrated solution for mobile patient monitoring.
  • Agilum Healthcare Intelligence publishes a case study on business intelligence strategies for small and mid-sized hospitals.
  • AdvancedMD offers a guide to improve patient experience with EHRs.
  • Intellect Resources posts a  Gotye parody video about recruiters.
  • Imprivata adds Aura Healthcare as a VAR to resell its single sign-on solution.
  • Best of Staffing recognizes CSI Healthcare for its outstanding reviews from clients and job-seekers.
  • Data Trade Solutions will offer nVoq’s SayIt speech recognition technology to its physician clients.
  • NorthWise Services (UK) partners with Merge to offer clinical trial services.
  • Wellcentive participated in the 2013 IHE North America Connectathon earlier this month.

EPtalk by Dr. Jayne

The Workgroup for Electronic Data Interchange survey remains open through next Wednesday. Any individual associated with health care organizations (vendors, health plans, providers, etc.) may participate. I’m a little offended that they listed providers last and even after health plans, but I took the survey anyway.


Speaking of surveys, a senior at Washington University in St. Louis conducted one on hip replacement prices. As part of a research project on healthcare costs, Jaime Rosenthal called 100 hospitals (two in every state) and asked for cash prices for a hip replacement surgery for her fictional grandmother. Despite pushes for transparency, only half the hospitals could provide an estimate and those that did ranged from $11,000 to $125,000.

A related commentary discusses the disparities in “sticker price” of health care and tells the story of the automobile window sticker, stating, “A 2013 hip replacement looks a lot like a 1954 Buick.”

2-14-2013 6-35-00 PM

Just when I thought I had seen it all, Dr. Mostashari’s bow tie opened its own Twitter account yesterday. You can follow its exploits @FarzadsBowtie while “Putting the Bow-Tie in Health IT.” I’ve had crushes on some famous people, but never on one whose apparel had its own social life. What’s next: @IngaHistalksShoes?

Speaking of shoes, Inga beat me to the punch with the chocolate shoes, but they’re too good not to mention here as well. My favorite is the red stiletto with the dark chocolate filigree, although the pink with white polka dots is cute too. Maybe a certain someone will take the hint.


If not the shoes, I’m definitely liking this lovely ring from MF Jewelry, created from your own EKG tracing. 

2-14-2013 6-37-44 PM

Considering my recent piece on handwritten thank you notes at the hospital, Inga sent over this ER doctor’s note that’s been circling the Internet. Now this is meaningful use of a handwritten note. Kudos to New York Presbyterian’s fine and caring staff member.

I’m starting to put together my serious (i.e. “non-cocktail party”) agenda for HIMSS. I was a little bitter to see that Inga and I were not invited to the #HITchicks Tweetup event on Monday. I can’t think of more fun #HITchicks than us. I’m hoping to see some new and innovative things rather than more of the same. Have something that I shouldn’t miss? E-mail me.



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

More news: HIStalk Practice, HIStalk Connect.

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February 14, 2013 News 12 Comments

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Reader Comments

  • Jay Alicea: A great and timely read....
  • Stephanie Marlowe: I'm interested in the future that Google is promising. It is interesting that they over all have the biggest say in tech...
  • : Judy is not happy that there is a negative perception about Epic’s technology that is creating market pressure for the...
  • C Harris: Re: ONC. A "steady ship" can also be one that is lying at the bottom of the ocean. ONC reportedly has over 150(!!) emp...
  • Kathy L.: Very wise words - as always. Wish that more execs understood this way of thinking. ;)...

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