Home » Search Results for "search":

News 1/30/13

January 29, 2013 News 10 Comments

Top News

1-29-2013 6-31-49 PM

Medecision, which just announced plans to lay off 83 employees, acquires Cerecons, a provider of care coordination, population management, and quality outcomes and reporting applications for ACOs.


Reader Comments

1-29-2013 7-10-48 PM

From Greenway Rep: “Re: iPractice Group. During the last few days, we did learn that iPractice Group, one of Greenway’s resellers, ceased operations effective last Friday, January 25. This reseller represents a very small percentage of our provider base. We look forward to continue working with these sites, which will have the option to either transition to another Greenway partner or choose to work directly with us for implementation and/or support services.” Greenway confirmed that iPractice Group has ceased operations, as reported by reader Nasty Parts this past weekend. The company claimed to have almost 1,000 provider clients, so the impact to Greenway remains to be seen. The CEO of the three-year-old iPractice blamed its closure on poor Q4 sales. The company moved into a new headquarters building in October 2012 that was more than triple the size of its former location, increased headcount by 800 percent to 70 employees since 2011, and acquired a competitor in 2011. Greg Bolan, who runs the healthcare equity research arm of brokerage firm Stern Agee, credited HIStalk with the initial rumor in an investor flash note, also expressing concern about the impact on Greenway’s sales. Greenway was among the ten biggest percentage decliners on the NYSE Tuesday, with shares dropping 7.7 percent.

From Tom: “Re: [inpatient vendor name omitted]. Is laying off 75 percent of its staff. All IT staff gone, most implementation and some development staff gone.” Unverified, so I’ve left the vendor’s name off for now. Usually someone leaves a comment saying, “Yep, that’s my company and it’s true,” so we’ll see.

1-29-2013 9-52-49 PM

From Mrs. Te’o: “Re:  Joe Schmitt, previous CIO of Steward Health Care. Will be named new CIO of Brigham and Women’s.” Unverified, but the forwarded second-hand e-mail insists that’s the case.

1-29-2013 8-11-15 PM

From CIO Tracker: “Re: Barry Blumenfeld, MD, MS. Leaving as SVP/CIO of MaineHealth less than 60 days after bringing Epic live at the main hospital. The planned rollout to seven member hospitals is being pushed back while the main hospital consumes all resources. The CIO is a casualty of exceptionally wide scope without commensurate resources.” CIO Tracker provided a genuine-looking memo purporting to be Barry’s notice to staff that he’s leaving as of January 30, but I’ve heard that he actually left early. They’re looking for an interim CIO, rumors say.

From The Amish Avenger: “Re: GE/IDX. I want to pare back its use for scheduling and registration and use the EMR instead. I keep hearing that GE/IDX isn’t selling well and has had job cutbacks. What can I expect to see? Fewer code updates? Less support?” I’ll step aside and let readers chime in.

1-29-2013 7-29-58 PM

From Danbury Whaler: “Re: Norwalk Hospital. Getting swallowed up by Western Connecticut Health System. Rumored layoffs of 200+.” Norwalk signed the affiliation agreement last week. Layoffs weren’t mentioned, but are certainly likely.


HIStalk Announcements and Requests

1-29-2013 7-02-37 PM

The window for expressing interest in attending HIStalkapalooza is closing. Sign up now if you’re interested in a March 4 evening of food, drink, HISsies, bowling, and Zydeco music.

1-29-2013 7-53-01 PM

Welcome to new HIStalk Platinum Sponsor Dearborn Advisors, LLC. The Chicago-area professional services firm, founded in 2001, is a trusted advisor to clients who need help with clinical systems strategy, adoption, and deployment. Its services fall into three groups: strategy and value, clinical, and engagement and project management. All of those help clients maximize the return on investment of their clinical systems. The company’s consultants are experts in Allscripts, Cerner, Epic, GE, McKesson, Meditech, and NextGen, while the company maintains a close working relationship with Epic and Meditech. I’m impressed by the quality of their blog posts, such as this one on medication management. You surely know some of their executive team members if you’ve been around the industry for a while: Rick Mager, Jay Toole, Sally Akers, Bruce Bowers, John Brill, and quite a few more highly experienced people, with a significant number of them clinicians. Thanks to Dearborn Advisors for supporting HIStalk.


Acquisitions, Funding, Business, and Stock

1-29-2013 6-32-50 PM

Intuitive Health, which offers a platform that connects providers with at-home patients and their personal health devices, raises $3.8 million.

Informatica’s Q4 results: revenues up three percent; non-GAAP EPS of $0.41, down from $0.47 last year. The consensus EPS estimate was $0.37.

Roper Industries announces Q4 results: revenue up 10 percent, EPS $1.44 vs. $1.23, beating expectations on earnings while falling short on revenue. Chairman, President, and CEO Brian Jellison said the integration of Sunquest, which the company acquired this past summer, is on track, with Sunquest being a strong performer with high single-digit growth. The company’s CFO did note in explaining a tax rate adjustment, “Sunquest as a US-based company generates most of their earnings in the United States, which is the highest tax rate in the world.”

1-29-2013 10-06-41 PM

Lexmark announces Q4 results: revenue down nine percent, EPS $0.10 vs. $0.94. Its Perceptive Software unit was the bright spot, reporting revenue that increased by 40 percent over 2011.

1-29-2013 9-40-18 PM

Startup Ringadoc, which offers after-hours triaging of physician calls for $50 per month with no contract, raises $1.2 million in seed funding. I believe that’s a reflector thingy in its logo.

Philips announces that it will exit the consumer audio and video business to focus on home appliances and healthcare.

1-29-2013 10-08-03 PM

Margo Hendrickson, athenahealth VP of human resources, responded to our query about the company’s announced plans to lay off 36 employees of its Birmingham, AL office on March 6. That office is the site of the former care coordination platform vendor Proxsys that athenahealth acquired in July 2011:

“As a high growth company, we are always looking to apply efficiencies to the way we work. While it is incredibly difficult to let people go from what otherwise is a growing employee base, our intent and commitment to shareholders is to align investment with business growth opportunities. This focused set of employee restructuring will allow us to achieve several critical business scaling and financial objectives that otherwise we would struggle to meet. At athenahealth, we are committed to ongoing team growth; in the past year alone the Company has grown its US employee base 28 percent, adding a total of 473 new employees to its US total of 2,140.”



Sales

1-29-2013 2-55-23 PM

Sidra Medical and Research Center in Qatar selects Amcom’s emergency notification and call center solution and Omnicell’s G4 automated medication management system.

1-29-2013 6-34-33 PM

Scripps Health (CA) will implement Wolters Kluwer Health’s ProVation Order Sets software as its electronic order set solution.

Pioneer Medical Group (CA) signs an agreement with McKesson’s MED3OOO division to jointly own and operate an advanced management services joint venture.

1-29-2013 3-03-12 PM

Holyoke Medical Center (MA) expands its relationship with eClinicalWorks to include the eCW Care Coordination Medical Record for advancing ACO and PCMH objectives.

1-29-2013 3-04-18 PM

University of Virginia Health System will deploy MModal Fluency Direct and MModal Catalyst for Quality to speech enable its EHR systems.


People

1-29-2013 3-06-17 PM

HealthTech Holdings hires Tom Mitchell (MModal) as VP of marketing for its HMS, MEDHOST, and PatientLogic companies.

1-29-2013 3-15-34 PM  1-29-2013 10-26-32 AM

HIMSS recognizes James L. Holly, MD (UT Health Science Center) with its 2012 Physician IT Leadership Award and Robin S. Raiford (The Advisory Board Company) with its 2012 Nursing Informatics Leadership Award.

1-29-2013 6-39-08 PM

MedAssets appoints Keith L. Thurgood (US Army Reserve) president of its Spend and Clinical Resource management segment.

1-29-2013 3-22-52 PM  1-29-2013 3-24-36 PM

Streamline Health adds  Richard D. Nelli (OptumInsight) as SVP/CTO and Herb Larsen (Edifecs) as SVP of client services. Streamline also announces the resignation of SVP/COO Gary Winzenread.

1-29-2013 3-26-59 PM    1-29-2013 3-31-53 PM

HL7 appoints Joyce Sensmeier (HIMSS) and Walter Suarez, MD (Kaiser Permanente) to its advisory council.

1-29-2013 8-35-45 PM

Randy Gaboriault, VP/CIO of Christiana Care Health System (DE), is named by Computerworld as a 2013 Premier 100 IT Leader.

Former Barnabas Health (NJ) SVP/CIO Joseph Sullivan is named “client in residence” by management print services vendor Auxilio.



Announcements and Implementations

1-29-2013 3-33-16 PM

CPSI announces the formation of TruBridge, LLC, a wholly-owned subsidiary that will provide business services, consulting services, and managed IT services to rural and community healthcare organizations.

Intelligence InSites announces integration of its real-time intelligence platform with ScheduleAnywhere, an online employee scheduling software from Atlas Business Solutions.

1-29-2013 10-00-13 PM

Gottlieb Memorial Hospital (IL), part of Loyola University Health System, goes live with Epic.

TriZetto announces that BCBS of Tennessee is using its benefits solution to offer value-based insurance benefits to members.



Government and Politics

ONC publishes research to help providers putting HIEs in place, including findings on query-based exchange, HIE-driven notifications and subscription services, provider directory solutions, master data management, and consumer engagement and consumer-mediated exchange.

The operator of the leading cord blood bank settles FTC charges that it lacked policies and procedures to protect patient information in a 2010 breach involving unencrypted computer equipment stolen from an employee’s car containing the information of 298,000 patients. The company avoided a financial penalties by agreeing to improve IT security and to conduct a security audit every other year.


Technology

1-29-2013 10-09-18 PM

State auditors cite University of Iowa Hospitals and Clinics for not encrypting laptops. The hospital responded by saying it encrypts “where technically possible,” but the state official refused to back down, saying, “If it’s not technically possible, then they need to tweak the system a bit so that it is technically possible.”


Other

1-29-2013 7-41-27 PM

This patent troll story doesn’t involve healthcare, but it provides a good lesson. A fake company set up by a lawyer who bought some old patents and created a business based entirely on suing big companies for infringing on its claimed patent on online shopping carts finally gets its butt kicked, courtesy of online retailer Newegg. The company had shaken down big online retailers, demanding a percentage of annual revenues. Victoria’s Secret and Avon had already been ordered to pay $18 million and one percent of their annual online revenue, while Amazon had paid the patent troll an amazing $40 million. Newegg, which has vowed that it will never settle with a patent troll, successfully had the company’s patents invalidated on appeal. You have to admire Lee Cheng, Newegg’s chief legal officer (above):

”We basically took a look at this situation and said, ‘This is bullshit.’ We saw that if we paid off this patent holder, we’d have to pay off every patent holder this same amount. This is the first case we took all the way to trial. And now, nobody has to pay Soverain jack squat for these patents … Just think about the dynamic if you’re a juror … Everyone wants to go home. It’s not their money. Defense oriented jurors are more likely to compromise and say, ‘Maybe we’ll just split the baby. Maybe we’ll just give them $2.5 million and call it a day.’ … We’re competing with other economies that are not burdened with this type of litigation. China doesn’t have this, South Korea doesn’t have this, Europe doesn’t have this. Just in our experience, we’ve been hit by companies that claim to own the drop-down menu, or a search box, or Web navigation. In fact, I think there’s at least four that claim to ‘own’ some part of a search box … Then they pop up and say, ‘Hello, surprise! Give us your money or we will shut you down!’ Screw them. Seriously, screw them. You can quote me on that.”

1-29-2013 10-02-19 PM

Guam Memorial Hospital says a software bug introduced by its vendor NTT Data caused it to underbill drugs by $1.9 million since May 2012. It found the problem as part of a financial improvement initiative and says NTT Data has confirmed and fixed the bug.

Zoll Medical says it’s the first defibrillator vendor to promise that it will share patient data from its devices, providing tools that allow other vendors to share the information it collects for patient care, such as in emergency medicine.

A small town in Australia loses its Internet connectivity for the third or fourth time in a month, with some of the previous outages having lasted days. Merchants can’t charge credit cards, but the medical clinic brings up more pressing problems: “We receive all our pathology results, specialist letters and discharge summaries through the Internet. If a patient comes to us needing treatment after they have just been discharged from hospital and we don’t know what they need or what they’ve had done, that’s a real problem.”

HIT incubator Rock Health rolls out a single online employment and internship form for applying to work at any of its 49 portfolio companies.

Weird News Andy finds this story amazing: researchers at Texas Heart Institute are building replacement human hearts from pig hearts, saying animal organs “reanimated” with human stem cells can be used in emergencies. The lead scientist also predicts being able to reverse aging at some point, storing stem cells from patients while they’re healthy as replacements for when they aren’t. She says she’s regularly called Dr. Frankenstein.


Sponsor Updates

  • Intellect Resources offers tips for job seekers hoping to get the attention of online recruiters.
  • Infor Healthcare and NTT DATA host a February 13 webinar to discuss Lawson Financials and the effective interaction between legacy and new technology systems.
  • CommVault announces details of its fifth annual WTG Customer Seminar March 13 in Boston.
  • Truven Health Analytics hosts a January 31 Webinar highlighting coverage challenges under the ACA.
  • First Databank releases the FDB State and Federal Controlled Substances Module, which facilitates the e-prescribing, dispensing, tracking, reporting, and claims processing of controlled substances.
  • Vitera Healthcare Solutions will give practices using its Vitera Stat PM/EHR product access to DiagnosisOne’s CDS content and patient education materials at the point of care.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

View/Print Text Only View/Print Text Only
January 29, 2013 News 10 Comments

Morning Headlines 1/29/13

January 28, 2013 Headlines No Comments

Computer Programs and Systems, Inc. Announces Formation of TruBridge, LLC

CPSI announces the formation of TruBridge, LLC, a wholly owned subsidiary which will provide business services, consulting services, and contracted IT services.

Siemens Healthcare’s Q1 profits jump 38%

Siemens posted quarterly profits of $1.62 billion, or $1.89 per share, on sales of $24.15 billion.

Request for Information on Hospital and Vendor Readiness for Electronic Health Records Hospital Inpatient Quality Data Reporting

CHIME comments on CMS’s request for information on EHR-based quality reporting readiness, raising concerns over how discrete data should be extracted from narrative physician notes for reporting.

5 findings in ONC HIE research

ONC publishes new research highlighting the types of high-impact services that can sustain HIE organizations.

Health chief wants big telemedicine network across Georgia

Brenda Fitzgerald, MD, public health commissioner for Georgia, reports that every public health center across the state will be able to put patients in front of top specialists via telemedicine within three years, citing grant applications as the primary means of paying for the program.

View/Print Text Only View/Print Text Only
January 28, 2013 Headlines No Comments

Readers Write: In Defense of Copy-Forward

January 28, 2013 Readers Write 5 Comments

In Defense of Copy-Forward
By Lyle Berkowitz, MD

1-28-2013 6-34-06 PM

I’m part of the Association of Medical Directors of Clinical Information Systems (AMDIS), a group of 2,000+ physicians who are the experts in implementing and using EMRs. We have a pretty lively listserv discussion board, and I enjoy seeing what my colleagues are thinking, as well as posting my own thoughts. I especially enjoy posting when I feel like certain studies or comments by non-clinical researchers, administrators, or politicians make us start to question common sense.

One of my favorite topics recently came up — the fear and horror associated with actually reusing some of a previous note. This usually falls into the concept of "Copy-Forward" (when you copy forward the whole note and then edit for today’s visit), or "Copy-Paste" (when you select certain parts of a past note and just copy that part of it. I posted my reply and thought I’d share and expand a bit.

So as not to bury the lead, I think Copy-Forward of a note is a great tool and supports both efficiency and quality, when used appropriately. Turning it off is a classic throwing the baby out with the bathwater analogy. To clarify my biases, my thoughts and ideas are mainly from the perspective of an outpatient physician using Copy-Forward over the past decade, but much of this certainly can be applied to the inpatient world in various ways.

Also, the use of Copy-Paste has some similarities to Copy-Forward, but I agree Copy-Paste is not nearly as efficient and poses more quality issues since it does not have the automatic updating features you might see with Copy-Forward. Here are the points I would suggest we consider.

First, I am sick of these reports which say that things like, "We used plagiarism software to show that 60-80 percent of a doctor’s note is the same as their last one." Um, of course! Since when did progress notes become creative writing endeavors about coming up with different ways to document diabetes, hypertension, and obesity in the same patient visit after visit?

The creative parts of doctoring should involve being "House": figuring out the diagnosis, figuring out the best treatment plan, and artfully explaining it all to the patient. It should not be writing Edgar Allen Poe-like short stories to amuse our auditors or confuse our colleagues. Although, it could be fun, hmmm… what if I described a diabetic’s problems with hypoglycemia in Poe’s style: "Arousing from the most profound of slumbers (due to a glucose of 45), the patient states he feels as if he was in a gossamer web of some dream. Yet in a second afterward, so frail may that web have been, he claims to not remember that which he was dreaming."

Second, there are obvious efficiency benefits to Copy-Forward, but there are very real quality benefits as well. The most obvious is that this type of workflow makes it less likely that important diagnoses will be missed or forgotten over time. Additionally, many systems update certain pieces of data during the Copy-Forward process, so that you can see the most recent results (discussed more below). Obviously incorrect information can be duplicated, especially when a note is being authored by multiple providers over time, but this is where good training and leadership are needed to ensure every provider feels fully responsible for everything in their notes.

Third, getting rid of Copy-Forward or even Copy-Paste is certainly overkill, but we do need to use some common sense in designing technology, workflows, and processes that make it easy to do the right thing when documenting. In the ideal system, much of the critical data would either be updated automatically (e.g. the most recent lab would appear when a note is copied forward), or the system would date entries so it is clear what was done in the past versus today. To clarify, let me break down how an ideal progress note might look like when Copy-Forward is used:

Allergies, Meds, Problems

These update automatically, which is great, and means the note has the most recent data. I would hope all EMRs have this functionality already.

Past Histories (Social, Surgical, Family)

These copy forward and allow for easy editing in the note. Ideally, they could be managed in a widget external to the note and have them update from those profiles as well.

Physical Exam

Want to ideally be able to view old physical exams, and even reuse them when desired (except for vitals). In my current system, the full exam (sans vitals) does copy forward. So I usually just delete it and drop in a new macro and edit that. However, some patients have findings I want to compare from last time (e.g. size of a rash), or consistent findings (e.g. murmur) which I want to be reminded about

Labs/Studies

For labs (e.g. CBC, chem, chol profile) and certain studies (e.g. mammogram results, last ECG), we use macros which "auto-updatem" so when a note is copied forward, they update automatically to the most recent dates and values.

HPI/Impression/Plan

As some have heard me detail before, I use a form of "problem-oriented charting" in which I type out the history, impression, and plan for a diagnosis (e.g. diabetes) or system/problem area (e.g. "GI issues") all on one line. I also use a macro which includes the date of the entry and my initials.

  • Example for a diabetic patient. "01/19/13(LLB): Stable on Metformin 500bid, CS 100-120s before meals, no med side effects or other complaints. Impr: Stable DM, PLAN: CPM, labs, rtc 4 mos". No flourish is needed. The result is that when copied forward I can see the last time I addressed the DM and if I made any changes. In the same "area" for the problem, I would also have a list of relevant meds, labs, and testing results (e.g. ECGs and ECHOs for hypertension). This way I can see everything I need about a problem all in once place – which means I can make quicker and more accurate decisions.
  • Summarizing old entries over time. I will either retain the old entry, or can summarize over time (e.g. I might take four entries from 2012 and summarize into one line such as, "2012: Dx with DM 4/12, added Metformin 500qd, 6/12 incr to 500 bid and did well").
  • Multiple issues. Since I often address multiple issues in a given visit, I created a line which reads, "Problems below not addressed this visit" so that I can clearly demarcate what I did and did not address on a certain day. I think this method is extremely efficient and higher quality than the method of trying to document all the HPI about multiple issues at the top of a note, and then separating out the Impr/Plan at the bottom.
  • What is a SOAP note? Larry Weed, MD devised the concept of problem-oriented charting 50 years ago, but I think it’s fair to say we have over-complicated it over time. The SOAP note is supposed to be based around a problem. In other words, each problem should have a documentation area for Subjective, Objective, Assessment and Plan. Instead, we create one large SOAP note where we break away all the Subjectives into their own paragraph ("HPI"), thereby distancing your thinking about the complaint and what we are going to do about it. I hope we will soon see more EMRs going "back to the future" by embracing the true problem oriented charting philosophy.

Fourth, the outpatient world is different from inpatient, but there are similarities. I understand that inpatient notes can be more difficult to manage due to quickly changing problems, and especially multiple authors. Personally, I hope we put some more thought into the concept of an "Inpatient Wiki," a single type of inpatient note that can automatically pull in the relevant information for each specialty (e.g. different for medicine, OB, and various types of surgery). Then each author could see what they need to see – it would pull in the labs, tests, consult suggestions, or a nursing note – why make the doctor repeat this themselves every time?

The care provider would then be prompted to write what they are supposed to add, and the note would be a living document which flexes to the individual, but can be time-stamped for medico-legal purposes as well. It could have clear sections (similar to above), as well as an organ or system based areas (e.g. Cardiology issues, GI Issues, Neuro Issues, F/E/N issues) for documenting the SOAP note .

In summary, I would go as far as to say that we need to change our paradigm to "The Note is the Chart." The chart should no longer be a collection of distinct and incomplete notes, but rather the last note can really be the complete chart which contains everything a provider needs. If we do this, then we can reframe our expected workflow from, "You need to read every note ever written to understand the full patient" to, "You just need to read the last note".

The result: when a patient goes to the ER or sees another doc, those providers will find that the most recent note in the system will have all the info they need, so they won’t need to try and dig through 48 notes over 10 years (and let’s face it, they never do that anyway). Granted, the paper record allowed for a much easier way to flip thru past notes, but sooner or later we have to acknowledge that computerized systems have different attributes than paper. We can either keep trying to force the computer to act like paper, which never works out well, or we can start embracing the differences and truly take advantage of them.

Lyle Berkowitz, MD, FACP, FHIMSS is associate chief medical officer of innovation for Northwestern Memorial Hospital; medical director of IT and innovation for Northwestern Memorial Physicians Group; and co-founder and chairman of healthfinch.

View/Print Text Only View/Print Text Only
January 28, 2013 Readers Write 5 Comments

Monday Morning Update 1/28/13

January 26, 2013 News 12 Comments

1-25-2013 2-09-37 PM

From Optumized: “Re: Optum’s acquisition of Humedica. Confirmed by Lazard Capital Markets.” I appreciate that the update from Steven Halper, managing director of equity research, credited HIStalk as the original source (as I, in turn, should thank Embers and another couple of readers who tipped me off). A Boston Business Journal article says the acquisition is valued by an insider in the hundreds of million dollars. I interviewed Humedica President and CEO Michael Weintraub a year ago. I notice that the Boston paper is getting credit for breaking the news with its Friday afternoon article even though I ran and confirmed it Tuesday evening with the help of readers.

From False Positive: “Re: Farzad’s rebuttal that talks about ‘cynical critics.’ Who are they? How does he know that they don’t like paper?” The cynical critics, at least those constantly seeking attention, are easy to spot because they sing only one loud and sustained note. When I read an emotional, overwrought restaurant review on Yelp, I always click that person’s profile to see if they have a mix of positive and negative reviews and ignore them if not. Likewise, I twit filter the monotonic EMR whiners and cheerleaders alike, placing a lot more value on the 80 percent who don’t flaunt their blinders publicly. Farzad was right about the RAND study – they said their original projections about EMR savings were wrong because EMR adoption was less than expected and payment incentives are still screwed up. The job of EMRs is to support reform, not to create it. He’s also right that those cynical critics haven’t written smug and pedantic articles extolling the virtues of paper medical records, so they’re leaving us to breathlessly anticipate their suggested alternative. And if they’re intentionally avoiding EMR-using doctors and hospitals for their own care, they aren’t blowing that horn either. What they should be criticizing is the healthcare system that created the current batch of EMRs that conform precisely to its ridiculousness.

1-25-2013 3-41-10 PM

From The PACS Designer: “Re: TPD’s List. The recent update of TPD’s List of iPhone Apps that added a HIStalk Sponsors section has created new interest amongst them to recognize their iPhone apps. Vitera informed us about an app (above) that provides healthcare providers access to their Intergy EHR solution enabling anytime, anywhere access to schedules, tasks, patient records, and e-prescribing. Humetrix alerted us to several iBlueButton apps they developed with HHS. These new apps will be added to the next TPD’s List update.”

From Ear-Ground Continuum: “Re: MEDecision. Huge downsizing – they let 83 people go last month with another round this week and next.” Unverified. Recent comments on Glassdoor are certainly interesting. UPDATE: Verified by a reader’s link.

From Nasty Parts: “Re: Greenway reseller iPractice Group. Closed its doors today. Sources say cash flow problems despite strong sales, so the board pulled the plug.” Unverified. I e-mailed the company but haven’t heard back.

1-26-2013 11-44-38 AM

Speaking of the RAND study, more readers think it was naïve rather than biased (and yes, RAND should be capitalized, at least if you buy the idea that it’s OK to make up acronyms solely to create a conveniently pronounceable word, in this case Research ANd Development.) Anyway, new poll to your right: if you had to buy a vendor’s stock, which of the five listed would you choose?

Several readers (me included) expressed an interest in hearing more from Robert D. Lafsky, MD, whose guest articles always contain an impressive mix of medical knowledge, wry cynicism, and grammatical excellence (he always e-mails me when he finds my mistakes, and the threat of incurring his gentle wrath caused me to double-check the spelling of RAND). He has agreed to elevation to regular contributor under the nameplate The Skeptical Convert, with his first installment running this weekend.

Here’s a new Spotify playlist of what I’m listening to: new Aaron Neville, The Cardigans, 4 Non Blondes, Alabama Shakes, Imperial Teen, and a few more.

1-25-2013 5-25-24 PM

Welcome to new HIStalk Platinum sponsor The McHenry Group, an executive search firm focused entirely on the healthcare software and services vendor market. TMG’s team of search consultants averages more than 11 years with the company, having placed over 2,000 candidates since 1991. TMG has developed the industry’s largest candidate database of hard-to-find talent, including the hidden candidate market. The company conducts videoconference interviews with every candidate and forwards the videos of the strongest to the client for their review which moves things along faster and gives a better fit, enabling TMG to offer an extra-long 12-month replacement guarantee. TMG has filled positions for CEO, COO, CMO, CMIO, SVP, business development, sales VP, and informatics roles for companies such as RelayHealth, McKesson, Orion Health, and Health Language. They have conducted searches across the entire US as well as for non-US companies building their US operations. Featured business development stars are experts in clinical software, Meaningful Use, and payor technology, while project manager and implementation candidates are available in EMR, multi-hospital implementations, and client services. TMG provides well-screened candidates, ethical search consultants, and a promise to understand the client’s business needs. Thanks to The McHenry Group for supporting HIStalk.

Athenahealth files notice with the State of Alabama that it will lay off 36 employees at its Birmingham office on March 6. The company has not announced what types of workers are affected, although Birmingham was the location of Proxsys, the care coordination systems vendor athenahealth acquired in 2011 to boost its athenaCoordinator product.

Compuware turns down the $2.3 billion buyout offer of Elliott Management Corp and says it will instead spin off Covisint as originally planned.

1-25-2013 2-34-11 PM

Weird News Andy says this is better than die-alysis. A kidney patient in China who can’t afford dialysis treatments has lived for 13 years so far by dialyzing himself three times each week using a machine he built from kitchen tools and old medical equipment. He recently declined the Chinese government’s offer of free dialysis that was extended after his story was picked up worldwide, saying the hospitals are too far away and too crowded. He’s not worried that two of his friends died after trying a similar setup.

WNA also likes the RP-VITA iPad-controlled medical robot that just received FDA approval.

Farzad Mostashari can bask in the knowledge that he’s a big enough name to be featured in a CAP News parody (it’s like The Onion, but not as well done). I think they probably chose him randomly for the article Toilet Sizes Expand to Meet Needs of Obese Nation, quoting him in describing a new HHS standard called “Ass Cheek/Toilet Seat Ratio.”

1-26-2013 8-51-03 AM

Gartner says Big Data has reached the Trough of Disillusionment stage of its ingenious Hype Cycle, of which I’ve been a long-time fan. If the author is correct – and I would say she is – the previously Big Data-fawning press will start running negative articles, which is OK since once that negativity has been purged, it’s on to the Trough of Enlightenment, where organizations whose interest is more than fad-chasing start delivering results. A Wall Street Journal blog post on the Gartner item quotes Aurelia Boyer, CIO of New York Presbyterian Hospital, who says they’re using Hadoop with natural language processing to analyze millions of patient records to find, for example, how many of them have mentioned a gunshot wound.

A study looks at why patients may think doctors who use clinical decision support are less capable. Apparently patients worry more about doctors using non-human tools rather than having a doctor who seeks external advice.

New Hanover Regional Medical Center (NC) goes to paper downtime procedures for seven hours Thursday when its Epic system goes offline due to an AT&T regional outage.


An online publication HITECH article elicited interesting comments. Granted some of them veer into death panel nut job territory, but they’re still fun to read and some are insightful.
  • “EMRs encourage doctors and nurses to cheat and lie. EMRs have made medical records inaccurate and unreliable. When I read medical records nowadays, I often can’t tell what the hell happened.”
  • “In an EMR, every URI is an average URI.”
  • On the use of surgical case templates: “… worked out with the hospital risk management department to describe what should happen, and entered in the EMR with one click of a mouse. What actually happened? No one can tell.”
  • “The response calling this idiocy a step in the right direction apparently fails to get the point, which is that EMRs make crappy doctors look like decent ones by giving them the same well-written notes as the good ones.”
  • “It seems to me that this isn’t exactly the unintended consequences of EMR; it’s the unintended consequences of the government incentivizing bad EMR by incentivizing the wrong things:  the ACA encourages rapid adoption of immature or awkward technologies without clear benefits; medicare, medicaid, ACA, and the employer-provided health insurance tax exemption incentivize egregious billing practices. EMR and provider companies respond to the incentives; the problem isn’t the software per se, but the incentives. There’s no inherent reason why an EMR system should require more data entry on the part of doctors, or why the data entry should take longer than updating a paper chart. Systems could be designed that work better and provide consumer benefits, but they aren’t appearing because the system incentives really aren’t designed to serve the customer.
  • A physician on not customizing template-created notes: “I like to think most of us are pretty honest, and this doesn’t feel like a lie, more like the best that can be done with the time available and the limits of the EMR. I don’t know if I am only humoring myself about the honesty. I do know the job can’t be done except by the copy and paste method.”
  • “This article misses a key point. If they’re fine falsifying electronic records, why wouldn’t they be comfortable falsifying written records? Moreover, electronic records are easier to falsify, but they’re also easier to catch.”
  • “I think physician associations need to reemphasize that documentation by exception is not appropriate for physicians, perhaps even take it a step farther and officially declare it outside the standard of practice. The great potential benefit of EMR’s (along with the requirement that they be able to produce data in a standard format) is that medical charting will stop being primarily about stories and start being primarily about data. This will not only make treatment of patients more scientific, it will energize evidence-based medicine. Right now, about half of medical treatment is done despite no evidence of efficacy. Of course, if the data is unreliable, we have GIGO. So the use of charting by exception leading to bad data is a huge problem.”
  • “EMR’s are the vehicle for corporate and government direction of medical care. I predict that within 5 years, it will be illegal to provide medical care to a patient unless it is through an Electronic Medical Record … this idea will be advanced as important to preventing waste, fraud and abuse.”
  • “Simply put, doing a thing, and documenting the doing of a thing, are two separate, and not particularity related skills (I would figure that journalists would understand this better than anyone), and it is unlikely that a person who is good at the former is also good at the latter, and when we ask him to do both, this is what we get. Cheer up, we could get the people who do amazingly good documentation to do the surgery. I suspect that would be much worse.”

I’m scooping Weird News Andy on this story: a drunken Englishman is hospitalized after the paramedics he called found his frigid sexual partner dismembered in a snowy field. The partner was a snowman; the man’s injury involved frostbite of his manhood, which nearly required amputation.

It’s NextGen Part 3 from Vince this week as he covers Opus Healthcare Solutions.


Sponsor Updates

  • SimplifyMD is running cartoons and videos looking at the humorous side of medical practice at “Easy Street Family Practice.”
  • Nuance announces that the electronic medical records systems used by hospitals and clinics in the United Arab Emirates will be voice-enabled using Dragon Medical.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

View/Print Text Only View/Print Text Only
January 26, 2013 News 12 Comments

Collective Action 1/25/13

January 25, 2013 Bill Rieger 1 Comment

The views and opinions expressed are those of the author personally and are not necessarily representative of current or former employers.

Leader the Follow (Part 2) — Identity

Let’s see … where were we? Oh yes, talking about being a follower and the significance of that role. This is a follow up to the last Collective Action post on HIStalk.

Last time I asked for input from readers about what kind of leader you would follow. I received several responses and I will include some of them at the end of this article. Thank you to all who provided feedback — it was insightful and entertaining. 

The key to studying followers is similar to the key to studying leaders. It is not about characteristics of a leader or follower. To me, the key is identity. How you see yourself determines your effectiveness. 

I agree we need to talk about Meaningful Use, business intelligence, ACOs, and what the next great innovation in healthcare will be. But none of those things can happen without  a focus on both leaders and followers and teams they lead.

As I was researching this topic of identity, I came across an interesting term: “metaperceptions.”  This is not how you are perceived, but rather how you perceive others perceive you. The difference is slight, but profound. 

I have a great example of this from a recent presentation I gave. I was speaking to a crowd of about 100 people here at our hospital at a recent event. It was an EMR project-related event that we themed “Finish Strong,” where I and others presented concepts from Dan Green’s book Finish Strong

I consider myself a good communicator. I believe I have a gift that allows me to write and present well. As I was presenting, someone in the audience dozed off. I thought right then that her perception of me was that I was a lousy presenter. Instead of continuing as I should have, I got thrown off. I thought they had lost interest and I started rushing through the rest of the presentation, not giving some of the more impactful parts ample time. 

Afterwards, I spoke to her and asked her how she liked the event and presentation. She said that she loved it, but had a new baby and was very tired. She made some comments about what was said and how it impacted her. I was blown away. My metaperception was wrong, but that didn’t matter, it impacted my effectiveness.

The root of our identity is only partially based on what others think. It is mostly based on how we view and think about ourselves. Here are some interesting statistics regarding how we think about ourselves. 

According to Daniel Amen, MD, a renowned psychiatrist and brain imaging specialist, we have about 60,000 thoughts per day — one every second while we are awake. Ninety-five percent of those thoughts are the same ones we had yesterday (a broken record!) For the average person, 80 percent of those thoughts are negative. 

That is incredible. Every day, the average person working in your department or your hospital or living in your home has 45,000 negative thoughts. Whether you are a leader or a follower, whether or not you care about what others say about you, you can do enough damage to yourself to keep yourself from fulfilling your destiny.

How do we combat this? How do we help those around us combat this? If you don’t think this is true about yourself, then you are probably not average, but you know someone who is. While it may not directly impact you, it impacts you in some way.

Let me offer something to you that is a bit unorthodox, but that has literally changed my life. I got this from the late Zig Ziglar, who says that how you see yourself is everything. A part of his program, called Self Talk, includes a laundry list of positive attributes: honest, intelligent, organized, responsible, committed, teachable etc. He offers several paragraphs with affirmations and instructs everyone he works with to say this list of affirmations in the mirror, morning and night, for at least 30 days. 

When I first heard this, I thought it was ridiculous, much like what you are likely thinking now. When I tried it, I thought it was stupid and embarrassing. I would not tell my wife. I locked the bathroom door and went through it as fast as possible. 

A peculiar thing happened after a couple of weeks. First of all, I finally told my wife, but I also started to become less embarrassed. I started to see that I really was some of these things, and some of them all the time. Other characteristics were just seeds and needed watering. 

At the end of 30 days, although I did not count, I literally sensed the number of daily negative thoughts decreasing, being replaced with thoughts that were empowering. Dare I say, I started to believe that I was just scratching the surface of what I thought I could accomplish in life. There is a lot more to that story, but it is for another post.

Besides how we talk to ourselves, there are additional factors in our life that impact those 60,000 thoughts. In Darren Hardy’s book The Compound Effect, he dedicates a chapter to influences. He says that everyone is affected by three kinds of influences: input (what you feed your mind), associations (the people with whom you spend time), and environment (your surroundings). These external forces are very powerful and dramatically affect how we think and feel about ourselves, our choices, behaviors, and our habits. In this book, he offers suggestions on how you can govern these forces so they can support and not derail your journey towards success.

To help deal with this on a corporate level, we have been walking our team through a couple of things to help positively reinforce who they are and where they are going.

The first was we helped everyone on our team develop a brand statement for themselves and complete a professional bio. This exercise forced them to take a look inside and actually write down what they have accomplished and really who they are as a person and a professional. 

The second thing we did was have everyone complete Clifton’s Strengthsfinder assessment. The result of the assessment was a list of your top five strengths, which most everyone, including myself, has posted on their door or cubicle wall. 

We review these things in team meetings. We try to use them to better align teams. Although we have a long way to go to really perfect this, the attempt alone at trying to deal with this has had a positive effect in the department.

Follower or leader, both are important roles, and while healthcare goes through rapid transformation, we need the best and brightest operating in their gifts with full confidence. If you struggle with this or know someone who does, you can be a resource in their life, and in turn, in this industry. The answer to how to improve healthcare will come from the people within healthcare, and we need these people thinking they can affect change. 

While this topic may not seem relevant, I believe it is at the root of advancement. Whether leader or follower, even this little bit of knowledge about your identity and how you see yourself can help you and help you help others. This is your destiny!   


Responses

The first response came from a popular HIT blogger who reached out via Twitter (@SmyrnaGirl) and said, “I would follow a leader who wouldn’t be afraid to impart wisdom and one day let me lead in their place.” 

Not all followers share this sentiment. An anonymous person shared the following. “When my personal convictions are strong and clear, others may agree and choose to follow, but they do so on their own. On the other hand, if my convictions happen to align with those of others before me, then I may seem to be a follower, but in reality I am going my own way. Either way is fine with me. I will never follow or lead just because someone thinks I should, and I have no inherent desire to fill either role.” After a few more comments, he went on to answer the question directly. “For me, I would have to first decide if it was my battle. If so, then I’d follow the plans and directions of the one who seemed most aligned to my own thinking.”  

A practice administrator in Jacksonville, FL had this to say. “This organization thus  far has given me almost free reign on how and where I am taking our primary care network, with the expectation that I do it within cultural norms and corporate guidelines. After 10 months, I am happy to report that this is a comfortable position for me.” 

A quality management informatics analyst sent an e-mail saying, “One of the best leaders I had was a supervisor who openly said that he ‘had my back.’ When business events happened that threatened to undermine my authority or the scope of my work, he would respond by protecting me and promoting my interest in the situation. As a result, I felt a lot of loyalty and trust toward him and tried even more to meet his expectations.”  

The final comment came from a chief operating officer of an HIT vendor. He provided some great comments about leadership and following in general. We had an e-mail dialogue that really gave me some great insight into leadership. He said, “Inspirational leadership is great, but good execution combined with it is rare. Find a CEO or president who is a visionary and the matching CEO or COO who has the power of execution to make it happen. Typically, the inspirational people are not good at actual execution, but they need to let go to have others execute.” It sounds like he would be willing to follow someone who in addition to being able to recognize their strengths,they can recognize their weakness and bring someone in who can help bridge the gap.

Bill Rieger is chief information officer at Flagler Hospital of St. Augustine, FL.

View/Print Text Only View/Print Text Only
January 25, 2013 Bill Rieger 1 Comment

News 1/25/13

January 24, 2013 News 9 Comments

Top News

1-24-2013 9-15-30 PM

Quality Systems (NextGen) reports Q3 results: revenue up two percent, EPS $0.26 vs. $0.36, missing analyst estimates on both. The company reported a 29 percent drop in system sales revenue as operating expenses rose six percent. The earnings call transcript is here. The results were announced before Thursday’s market open, with shares closing down only 0.16 percent by the market’s close.


Reader Comments

1-24-2013 5-53-24 PM

From Kojak: “Re: Intuit Health changes. Medfusion founder Steve Malik is retiring in June and Sanjiv Waghmare is taking over as Intuit Health’s new GM.” The e-mail announcement was attached. Malik (above) was named president of the Intuit Health Group when Intuit purchased Cary, NC-based portal vendor Medfusion for $91 million in 2010. Waghmare is a VP of product marketing.

From WHIMSSical: “Re: booth demo stations. PowerPoint or video? Should vendors use PPT since nobody can hear the video?” I say video and/or a live demo backed by a credible and engaging demonstrator, but perhaps also a fast-paced and highly graphical looping PowerPoint on a big projection screen as a billboard to grab attention as attendees streak by. Readers, what would get your attention?

From Doc Tari: “Re: Allina. Did know if you heard Allina having a bit of restructure. CMIO Shrift left to Cleveland and now CIO over all the IS areas.” 

1-24-2013 6-34-08 PM 1-24-2013 7-18-27 PM

inga_small From Carrie Prejean: “Re: HIStalkapalooza. What exactly does one wear to HIStalkapalooza this year? Bowling shoes? I want to come prepared because I am determined to win the ‘Inga Loves My Shoes’ contest!” When I first heard that this year’s bash was going to be in a (very cool) bowling alley, I was also perplexed on the proper attire. We are fine-tuning things, but suffice it to say that just about anything will go. We will once again have a red carpet, so arriving in stiletto heels and sequins will be totally acceptable. Alternatively, if you own a vintage bowling shirt, this could be the time to pull it out of the back of the closet. The shoe contest will include categories for those partial to high fashion as well as those who choose to adorn more functional bowling shoes. We will also be crowning a HIStalk King and Queen based on their total fashion package. Winners will be awarded amazing prizes, so don’t show up in your “straight off the exhibit floor” attire, especially if the look includes a company logo’d tee shirt.

1-24-2013 6-43-11 PM

From RFP: “Re: MD Anderson. Posts an EHR RFP.” The RFP strongly suggests that prospective bidders attend the pre-proposal conference on Wednesday, January 30 just in case you want to thrown your electronic hat into the ring.

From Slim: “Re: Optum. I read your update confirming that Humedica was bought by Optum. Wouldn’t it have to be announced since Optum is part of UnitedHealth Group, which is publicly traded?” I’m not an expert, but I believe SEC disclosure requirements cover only “material events,” meaning companies must file an 8-K form only if a merger, loss of a key customer, or policy change could reasonably be expected to impact share price in the company’s subjective judgment. UnitedHealth Group’s market cap of $58 billion and annual revenue of $111 billion would make all but a huge acquisition non-material.

1-24-2013 7-41-12 PM

From Bill O’Plenty: “Re: SB 1275. Crazy law introduced in Virginia.” Virginia State Senate Bill 1275, introduced January 14, would prohibit any organization that stores electronic medical information from (a) participating in the Nationwide Health Information Network; (b) performing analytics on multiple patient records for diagnosis, treatment, or population health management; and (c) processing medical data within Virginia if most of the patients represented live out of state. It also mandates that providers cannot be penalized for refusing to implement EHRs, that patient consent for electronically storing their information is valid only for healthcare coverage purposes, and that the state is prohibited from starting or operating an HIE. I e-mailed the office of the bill’s sponsor, Republican Senator Stephen H. Martin, to ask what he’s trying to accomplish with the bill, but I haven’t heard back. Senator Martin is running for lieutenant governor, which could ironically pit him against Democrat Aneesh Chopra, former White House CTO and advocate for all the items that the bill would prohibit, so perhaps he’s just trying to pick a fight.

From Wearing Dad’s Suit: “Re: Epic’s non-compete. Does it cover this?” Applicants for the head football coaching job posted on the University of Wisconsin’s HR website include a Walgreens pharmacist whose only relevant experience was as a season ticket holder, a Fedex driver who said he’d take $60K to lead the Badgers, and a financial analyst with Epic whose college athletics experience consists of having been a practice player for Tulane’s basketball team. I give our young Epic friend credit for trying even though he lost the $2 million job to a more experienced candidate who responded to the online posting, Utah State Coach Gary Andersen.


HIStalk Announcements and Requests

The latest highlights from HIStalk Practice include: Epocrates says its app has helped clinicians avoid more than 27 million adverse drug events. Farzad Mostashari, MD highlights some of the ONC’s 2012 achievements. Pharmaceutical companies and other businesses embrace advertising opportunities within cloud-based EMRs. E-visits may be as effective as in-person office visits for uncomplicated ailments. Dr. Gregg describes a day in the office in the Year 2063 (quite fun.) You know the drill: catch up on all the latest ambulatory HIT news, click on a few sponsor ads to find a goodie or two that might improve your life, and sign up for the e-mail updates. Thanks for reading.

On the Jobs Board: Cerner Experienced Providers, Product Marketing Manager, Healthcare Strategy Communications Specialist, Project Specialist.


Acquisitions, Funding, Business, and Stock

1-24-2013 5-56-29 PM

Healthcare social networking site iMedicor acquires iPenMD, which offers a digital pen solution to capture clinical data. iPenMD apparently bought the intellectual property of nextEMR this past July per a reader’s rumor report.

1-24-2013 6-03-35 PM

Merck Global Health provides $6 million in growth capital to eHealth Technologies, a provider of continuity of care solutions.

1-24-2013 6-04-22 PM

Praesidian Capital invests second lien debt capital in eTransmedia Technology to replace debt and fund growth.

1-24-2013 8-34-24 PM

Revenue cycle systems vendor Recondo Technology receives a $20 million growth investment from private equity firm Bregal Sagemount.

1-24-2013 6-25-07 PM

Healthcare Growth Partners releases its 2012 HIT Market and M&A review that summarizes capital markets, M&A, and capital raising activity for the healthcare IT and services sector.


Sales

1-24-2013 4-02-46 PM

Tampa General Hospital (FL) selects Merge’s CTMS for Investigators solution for enterprise management of clinical trials.


People

1-24-2013 3-50-34 PM  1-24-2013 3-51-42 PM

Huron Consulting Group adds Jim Agnew (Navigant Consulting) and Jeffrey McLaren (VHA, Inc.) as managing directors in its Huron Healthcare practice.

1-24-2013 3-53-51 PM

HIMSS promotes Thomas M. Leary to VP of government relations, taking the place of Dave Roberts, who was elected to the San Diego Board of Supervisors.

1-24-2013 1-39-04 PM

Iatric Systems promotes Frank Fortner from SVP of software solutions to  president.

1-24-2013 6-09-34 PM

The Northeast Business Group on Health honors Truven Health Analytics president and CEO Mike Boswood at its 18th Annual Tribute to Leadership.

1-24-2013 3-56-46 PM

Clinical data integration provider Apixio hires Jonathan Murray (Aetna) as chief business development officer.

1-24-2013 6-12-51 PM   1-24-2013 6-14-16 PM

Intellect Resources announces triple-digit growth in 2012 and announces several promotions and hires, including the promotion of Eileen Dick to VP of technology and Cindy Orr to VP of go-live services.

1-24-2013 9-11-26 PM

Robert Rowley, MD (Practice Fusion) is named medical advisor for personal health care vendor LifeNexus.


Announcements and Implementations

CareCloud and HealthTronics partner to combine CareCloud’s PM product with HealthTronics’ UroChart EHR and meridianEMR urology-specific EHR platforms.

1-24-2013 9-22-42 PM

Fletcher Allen and Dartmouth Hitchcock Medical Center (above) announce the creation of OneCareVermont, the nation’s first statewide ACO that includes 13 hospitals and hundreds of primary care physicians. We announced their plans in September.

Three Ontario hospitals go live on PatientKeeper Physician Portal, Mobile Clinical Results, and NoteWriter, including Alexandra Marine & General Hospital and two hospitals in the Huron Perth Alliance.

The RFID in Healthcare Consortium and Intelligent Hospital.org recognize six organizations for their advanced use of healthcare technology solutions.

GE Healthcare introduces Centricity Practice Solution 11.


Other

Winthrop Resources is conducting a survey on cloud solutions and bring-your-own-device practices. If you’d like to take about 10 minutes to help them out, the survey is here.

HIMSS finds yet another way to offer preferential treatment for its higher-ranking provider members whose purchasing influence makes its vendor members salivate. Healthcare Transformation Project offers “exclusive access” to services, meaning of course that someone has to be excluded (like the rest of us dues-paying members). For example, invitation-only HTPers get “up-front VIP seating at the HIMSS13 Keynote Address by President Bill Clinton” (I was going to insert a cigar joke, but decorum prevailed). The Transformers who are willing to spend $295 of their employer’s money to attend its annual forum at the HIMSS conference get to hear a bizarrely HIT-unrelated group of political speakers – former Florida Governor Jeb Bush, Democratic political strategist Donna Brazile, and former Nixon speechwriter Pat Buchanan. HIMSS says that “participants will make commitments that will translate goals into meaningful and measurable results in their own organization or community,” so we can all look forward to seeing how those work out for patients. Meanwhile, HIMSS offers vendors a bunch of expensive ways to get in or near those decision-making faces, with $50K buying you a podium speaking slot and free tickets for prospects who would be impressed by Pat Buchanan.

Cerner and Sporting KC take heat for failing to keep their promise to build a $35 million youth soccer complex in return for the $200 million in taxpayer-funded incentives they received to build their professional soccer stadium and Cerner office buildings. The youth fields were supposed to in use by now, but work hasn’t started.

1-24-2013 8-41-55 PM

Spain’s leading newspaper says it was duped when it ran a fake photo of Venezuelan President Hugo Chavez in his hospital bed, which the paper was told had been taken illicitly by a hospital nurse. The image, widely panned as unconvincing, turned out to be a screen shot of a YouTube surgery video from 2008 featuring an acromegaly patient being intubated.  

The local TV station covers the use by Georgetown University Hospital (DC) of the iPad-based patient data collection system from Tonic Health that replaces paper forms in the doctor’s office. The story says other Tonic users include Mayo, UCLA, the VA, and Kaiser. The company says the product integrates with EHRs via HL7 or can send a CCD record. It offers a free version with limited functionality. Founder and investment information is here.

1-24-2013 9-28-26 PM

As tweeted by @Cascadia: a Virginia medical practice charges patients for using its patient portal, billing $125 per year for Gold access to make appointments and refill requests, while the $250 per year Platinum plan adds three electronic visits. That’s the opposite of every other industry, where free online services encourage customers to do it themselves without tying up an expensive employee. This is like banks offering free teller service but charging for ATM access, or maybe McDonalds adding a drive-through surcharge.

A Texas judge orders the deposition of two partners of a CPA firm accused by a medical practice of failing to secure the accounting system it installed in the practice, which the practice says allowed an employee of the practice to embezzle $1 million over five years.

Weird News Andy says this man wears his nose on his sleeve, also wondering if he will pick his nose in public. British scientists are using a man’s own cells to grow a new nose to replace the one he lost to cancer. They have two noses underway (“just in case someone drops one,” the researcher said) and the patient will chose one of them to be implanted under the skin of his arm until it’s ready to transplant.

I had a feeling where WNA’s story was going when I saw his best-ever headline, “Nothing like having a cold one after work,” but I still nearly choked on my soda when I saw the story, in which a male hospital nurse is arrested on suspicion of having sex with the body of a deceased patient.


Sponsor Updates

  • Nuesoft Technologies CEO Massoud Alibakhsh discusses data security and Nuesoft’s technology platform in the video above.
  • Awarepoint celebrates its tenth anniversary and recaps key successes.
  • GetWellNetwork Founder and CEO Michael O’Neil delivered Thursday’s keynote address on interactive patient care technologies at the IPC Symposium at Hasbro Children’s Hospital (RI).

EPtalk by Dr. Jayne

Your tax dollars at work. On Tuesday, the US Supreme Court rejected an attempt to reopen Medicare claims that are more than two decades old. The hospitals assert that CMS miscalculated payments between 1987 and 1994 that were intended to compensate their treating large numbers of low-income patients. Based on the fact that it took my local academic medical center over a year to settle the bill for a routine eye care visit, it doesn’t surprise me that it takes years for hospitals to figure out they’re missing money.

Attention vendors: Mayo Clinic releases a new list of the top reasons for visiting US health care providers. Maybe you should use this as a starting point for your primary care office visit templates rather than some of the bizarre things I sometimes see on your screens. Granted the data is from Olmsted County, MN, but it looks surprisingly similar to my clinic roster this week except for the absence of “flu” and “freaking out that spouse has the flu.”

I received my first HIMSS-related mailing today. It was so underwhelming I can’t even remember who it was from. When I went to dig it out of my recycling bin, I couldn’t find it – which means it was nondescript as well. Great job, marketing team!

A wise man once told me to always spend a small amount of time “looking for your next gig” because things are constantly shifting in the world of medicine. For those of you who think the same way, ONC is looking for a policy advisor “who knows meaningful use policy backwards and forwards.” I was curious, so I checked out the link and got the best laugh of the day. The low end of the salary range is $123,758. Leave it to the federal government to specify it down to a bizarre dollar amount.

I had lunch with four of the smartest women in the world today. Three have been my boss in the past while the fourth who taught me everything I know about billing. Here’s a shout out for leaders who not only know their fields but “get it” as far as motivating employees to excellence. Thanks for keeping me grounded and reminding me that although I currently work in chaos, I can always count on your listening ears. And your unbiased opinions when I text you pictures of shoes I’m thinking of buying. And your assistance with crafting the “Typhoon Jayne” cocktail for HIStalkapalooza. Salud!

Print



Contacts

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

More news: HIStalk Practice, HIStalk Connect.

View/Print Text Only View/Print Text Only
January 24, 2013 News 9 Comments

Morning Headlines 1/23/13

January 22, 2013 Headlines No Comments

Missouri, Kansas and Nebraska Connect via Direct Secured Messaging

The Nebraska Health Information Initiative, Kansas Health Information Network, and Missouri Health Connection announce that they are now connected and able to exchange Direct secure messages across state lines.

Naperville’s Edward Hospital to merge with Elmhurst Memorial

Edward Hospital & Health Services of Naperville, IL and Elmhurst Memorial Healthcare announce plans to merge, forming a three-hospital health system with revenues of more than $1 billion.

Providers Get Help From Clinical Decision Support Evidence Vendors but Still Face Obstacles

KLAS evaluates clinical decision support strategies and roadblocks for providers and concludes that third-party order sets, care plans, and drug dictionaries lead the pack in CDS plans but notes that a lack of integration with EHRs is hindering the utilization of these tools.

King Saud University Signs a Strategic Agreement With Cerner for Two Major Hospitals in Saudi Arabia

King Saud University signs with Cerner to implement EHRs for two academic facilities in Saudi Arabia.

View/Print Text Only View/Print Text Only
January 22, 2013 Headlines No Comments

News 1/23/13

January 22, 2013 News 5 Comments

Top News

The Nebraska Health Information Initiative, Kansas HIN, and Missouri Health Connection connect their exchanges to share Direct secure messages across state lines.


Reader Comments

1-22-2013 10-01-20 PM

From Embers: “Re: Humedica. Being bought by Optum, I’ve heard. I wonder what will become of the Allscripts deal that frankly brought Humedica some business, but also had them running in circles (true for anyone dealing with Allscripts in the past few years)? Also, the new Optum research center in Cambridge is gathering steam and they are putting together a nice team to be a healthcare think tank. Hope you had a nice few days off – my imagination puts you on the podium with Obama and not sipping drinks by the pool.” A couple of readers told me they’ve heard that clinical data vendor Humedica has been acquired, one of them specifically saying it happened last week with no public announcement planned. Wednesday morning update: I’ve confirmed via a reader that the company has been sold to Optum. I’m happy to say that my mini-vacation consisted of the latter and not the former, as I took Mrs. HIStalk out of the country for some magnificent and rare downtime sprawling under 80-degree blue skies, swaying palms, and very small paper umbrellas that didn’t protect our white-to-red skin but did make our tropical drinks look even more fetching. I’m paying for the break today after getting home in the early morning, heading off to work just five hours later, and now sitting here with no break or bedtime in sight after 17 hours of non-stop catching up.

1-22-2013 6-57-28 PM

1-22-2013 6-55-10 PM

From EHR Watchdog: “Re: MedLink. See attached. Unfortunately customers can’t reach the company as its top two executives are being investigated by the SEC. The company’s EHR is certified and customers are no doubt trying to figure out what to do. One physician has a contractual requirement that records for his 6,000 patients will be available digitally, but he’s having to go through them one by one to either print or save to an external device as he shops for another EHR after spending thousands of dollars on MedLink.” The reader attached the SEC’s October 2012 complaint against Medlink and its two executives, Ray Vuono and Jameson Rose. It claims the company filed a Form 10-K audit report bearing the name of an auditing firm that had in fact not audited the company’s books, with that same SEC form bearing the electronic signature of one of the company’s directors who had not reviewed the form or authorized that his signature be attached. Lastly, the SEC claims an investor asked to have his check returned, but the company deposited it instead. In the SEC’s words, MedLink “purports to be a healthcare information technology company” and Vuono is “a recidivist securities law violator.” I know what that word means because Raising Arizona is one of my all-time favorite movies.

1-22-2013 7-23-52 PM

From Iconic Reader: “Re: Allscripts. The smoking doc, at least the reflector part of his attire, is apparently the model for the isolation icon in an Allscripts product!” I give them the nod for going old school, with a doc sporting a reflector thingy and a nurse wearing a starched white cap with a red cross on it.

From Pinky Toe: “Re: vendor shakeup. The vendor is Allscripts. Major reorg in the development group, which includes product management and testing, in which 200+ remote employees are being required to move to Raleigh, Chicago, or Burlington VT or face termination. This move not initiated by Paul Black, but he has sanctioned. This is a RIF, but instead of calling it a RIF, management is calling it a consolidation of resources to ‘centers of excellence.’” More convincing (but also unverified) were reader declarations that the vendor referenced in a reader’s earlier comment about employee layoffs is in fact NextGen, but I don’t have confirmation on anything since companies rarely announce or confirm personnel actions.

From Ben Dover: “Re: NextGen. Cutting personal days for employees, sent out the week of January 16 but backdated to January 1, which means employees who took personal days for the holiday will be back-charged for vacation.” Unverified, but the source is non-anonymous and has a copy of the internal communication. The backdating, which adds a bit of sting to the slap in the collective employee face, seems indicative of either an impulsive management decision or inability to get the corporate act together.

1-22-2013 10-03-32 PM

From THB: “Re: Edward Hospital & Health Services. Merging with Elmhurst Memorial Healthcare to create a $1 billion system that would be among the largest in the Chicago area. Edward is going through an Epic implementation.” Verified in a Tuesday announcement. I interviewed Edward VP/CIO Bobbie Byrne a year ago. Edward seems to be the dominant would-be partner, so I expect the Epic implementation will continue and Elmhurst will drop Meditech.  

From Idol Observer: “Re: Greenway’s announcement of meeting ONC 2014 criteria as an EHR Module. According to the announcement, they only met two criteria, a safety-enhanced system and a quality management system. The first requires the vendor to simply name their testing methodology for the features already required by the 2011 feature – no programming is required. The second is to just identify the quality management system being used, with no programming required there either. In other words, it’s just meaningless PR that will get physicians even more confused.” I get lost in all the certification minutiae, so I’ll defer to Frank Poggio.

From Rand Reader: “Re: the recent Rand report. It said EMRs remain costly without good outcomes because doctors haven’t re-engineered their workflows to accommodate electronic systems. Why would they want to do that when the change could be averse to safe care? Just an idea for your next poll.” My opinion is that many doctors will never accept EMRs because to do so would implicitly accept the idea of process standardization and repeatable processes everywhere, and doctors are trained to be confident in their individual abilities and wary of any process that doesn’t involve their own brains and hands. Patients are usually on the side of doctors since everybody likes to think they’re getting extra-special treatment and not being managed by a corporate algorithm. I don’t know that either side has proved its point convincingly.

From Just Wonderin: “Re: ONC’s HIT Safety and Surveillance Plan of December 21. The ‘public comments’ solicited by HHS are not so public after all since they are not being presented for the public to see. Is it because HHS and ONC don’t want the public to see the comments offered by the Cerner and Epic ilk?” It appears that comments can be submitted only via e-mail.


HIStalkapalooza 2013, Sponsored by Medicomp

1-22-2013 8-02-29 PM

1-22-2013 7-56-06 PM

1-22-2013 7-55-27 PM

1-22-2013 8-59-24 PM

HIStalkpalooza will be Monday, March 4, 2013 at Rock ‘n’ Bowl, New Orleans, LA. Medicomp CEO Dave Lareau, one of the coolest guys I know, wanted to bring you some real New Orleans flavor for Medicomp’s return as HIStalkapalooza sponsor. He’s ably assisted by the ultra-professional crew who engineered the 2011 event: Patrice at bzzz productions, Shannon and Cindy from Thomas Wright Partners, Anthony from Istrico Productions, and of course the Medicomp stars like Roy and James that you saw on the stage and at the Quipstar event on the HIMSS show floor.

Medicomp sponsored the 2011 event at BB King’s in Orlando (video is here, although I doubt anyone has forgotten that bash). They said then they wanted to return this year, so naturally I’m super happy to have them back and expecting them to rise to the challenge of a superb 2012 HIStalkapalooza in Las Vegas courtesy of ESD (I still play their video every now and then because it’s so cool).

Rock ‘n Bowl is equal parts bowling alley, dance hall, live music venue, and old-school Cajun-Zydeco shrine, which sounds kind of low-brow until you notice that it has earned a 4.5 average review on both Yelp and Tripadvisor. Beats the heck out of a cookie cutter hotel ballroom or a Disney-like fake Cajun place. It’s a big place even though the layout makes it hard to tell in pictures. Some details:

  • Buses will take HIStalkapaloozans from the convention center to Rock ‘n’ Bowl and back to the key hotels.
  • You’ll be offered the chance to once again execute your perfect red-carpet strut while having an Ingatini thrust into your parched palm and being surrounded by industry glitterati.
  • You will have the option to sip (or guzzle) the aforementioned Ingatinis and Typhoon Janes, not to mention just a lot of drinks in general. The ladies are providing guidance on how they want their namesake potions prepared (I’ll bet there’s a lot of alcohol involved), so details on those will come later.
  • You’ll be entertained by Brian Jack and the Zydeco Gamblers, with instructors leading you in Zydeco dance lessons if you so choose.
  • You’ll be fed you authentically and well with red beans and rice, jambalaya, crawfish etouffee, and retro bowling alley food like pizza, wings, and fried seafood. No tray-passed mini-quiches or two-per-person drink tickets here, folks.
  • Inga will be overseeing our usual shoe and attire contests, best bowling shirt judging, and some other categories I’m not privy to but that I expect will result me spending excessive money on beauty queen sashes and prizes. She can chime in later on the particulars.
  • The inestimable Jonathan Bush will once again preside over the not-to-be-missed HISsies awards at 7:30, the role he created at the first HIStalkapalooza in 2008 and has held since. I have it on good authority that the people you chose for all of the important and serious awards (Industry Figure of the Year, Lifetime Achievement Award, etc.) will be there, which would be quite an assemblage of industry talent.
  • There will be a fun bowling tournament, but since I haven’t bowled since college (translation: I’ve never bowled sober nor seen any reason to) I’ll let Medicomp explain how that will work later. I know some of Medicomp’s partner companies will be hosting individual lanes, so I’m sure we’ll have some fun folks there.
  • You will have networking opportunities like crazy given the remarkable number of CEOs, VPs, investment bankers, press, and lower-ranking but generally amiable grunts like me who’ll be hanging around and lowering their guard to conduct frank and possibly slightly slurred conversations. Deals will be made, jobs will be offered, and a variety of propositions will be extended and considered. A good time will be had by all.

The registration page is now open. Since demand always exceeds supply, registration puts your name on the “I want to come” list. If we have enough capacity, everybody on the list will get an invitation in mid-February. If not, then I’ll have to channel my velvet rope bouncer technique in choosing who gets an invitation (providers and long-time HIStalk supporters get picked first, then I just try to make it interesting by employer and role). Every HIStalk reader is important to me, so I sure hope we can squeeze everybody in since it’s your night.



Acquisitions, Funding, Business, and Stock

1-22-2013 10-10-31 PM

Kareo raises $20.5 million in series F funding led by Stripes Group.

1-22-2013 10-09-55 PM

Shares in Scotland-based revenue software vendor Craneware jump after the company said it expects half-year revenue to increase by seven percent.

1-22-2013 10-11-09 PM

Compuware reports Q3 results: revenue up two percent, EPS $0.12 vs. $0.10. The company says its Covisint HIE business grew 30 percent. The board says it will make a decision shortly about an unsolicited takeover offer of $11 per share, equal to the current share price.


Sales

1-22-2013 6-23-52 AM

King Saud University in Saudi Arabia contracts with Cerner to provide Millennium to two of its hospitals.

Lowell General Physician Hospital Organization (MA) selects HDS, athenahealth’s healthcare data management service for population-based cost and quality data analysis and reporting.

The New Mexico Health Information Collaborative will implement Orion Health’s HIE platform for its statewide exchange.

1-22-2013 3-09-01 PM

Henry Mayo Newhall Memorial Hospital (CA) selects Accent on Integration’s Accelero Connect platform to integrate its Philips IntelliVue patient monitors with its Meditech HIS and EDM solution.

Hong Kong and Tsuen Wan Adventist Hospitals select First Databank’s International Drug Knowledge.

El Camino Hospital (CA) chooses data warehouse and analytics solutions from Health Care DataWorks.


People

1-22-2013 3-24-15 PM  1-22-2013 3-25-26 PM

Mobile health provider Glooko hires Rick Altinger (Intuit Health) as CEO and Dean Lucas (Epocrates) as VP of product development. Glooko, which Dr. Travis included in a recent review of tools for diabetics, just received FDA 510(k) clearance for its mobile logbook device.

1-22-2013 3-27-40 PM

Amplion Clinical Communications names Tom Stephenson (Health Management Systems) president and COO.

1-22-2013 5-40-06 PM

Wendy Penfield (RealMed) joins Intellect Resources as VP of consulting services.

1-22-2013 3-31-25 PM

The Carroll County Chamber of Commerce (GA) names Greenway Medical founder W. Thomas Green as its 2012 Entrepreneur of the Year.

1-22-2013 9-23-59 PM

Rich Boehler, MD (MedeAnalytics) is named president and CEO of St. Joseph Healthcare (NH).


Announcements and Implementations

HIMSS awards 10 scholarships to students enrolled in HIT and management system degree programs.

1-22-2013 9-15-06 PM

Kansas City area hospitals form the Cerner-hosted Lewis and Clark Information Exchange (LACIE), originally created by Heartland Health.

Wheeling Hospital (WV) deploys PeriGen’s PeriCALM Plus in its obstetrical department.

1-22-2013 3-38-03 PM

UNC Health Care’s Rex Hospital (NC) implements Merge Hemo to automate cath lab processes into its EHR.

1-22-2013 3-39-57 PM

UPMC Beacon Hospital (Ireland) implements BridgeHead Software’s integrated backup solution for Meditech.

Neighborhood Health Plan and Partners HealthCare (MA) will provide $4.25 million in grants to 49 community health centers to expand HIT systems, train on Meaningful Use and medical coding, and train and build capacity for performance improvement.

HealthSparq launches its consumer health shopping platform (patient reviews, cost estimator, provider search, and social media forum) to health insurers.

1-22-2013 9-28-57 PM

The Government of Cantabria, Spain will deploy the initial phase of a European-wide e-health service from Texas-based Prodea Systems.


Other

Brian Ahier and a couple of privacy experts will discuss the new HIPAA rules in a Google Hangout streaming video session on Wedneday, January 23 (which is “today” for most readers) at 2:00 p.m. Eastern.

1-22-2013 5-46-13 PM

KLAS looks at clinical decision support tools and finds that more providers are turning to third-party order set and care plan vendors. Key findings:

  • Almost half of providers using third-party products previously tried to build a solution from scratch.
  • Among providers using third-party order sets, half use for reference content only because of an inability to move built pieces into the EMR.
  • Most providers would like more ability to customize medication alerts.

Sponsor Updates

  • SRS reports a 94 percent increase in revenues from 2011 to 2012 and the addition of 56 new employees.  
  • AT&T Healthcare’s Christine Furjanic will speak at the Western Physicians’ Alliance (NV) January 29 seminar on accountable care.
  • Orchestrate Healthcare expands and relocates its corporate headquarters to Carbondale, CO.
  • Greenway Medical Technologies, Inc., announces that Greenway PrimeSUITE 2014 (17.0) is compliant with the ONC 2014 Edition criteria and has earned certification as an EHR Module.
  • Shareable Ink reports 300 percent year-over-year growth and a twofold increase in employees since January 2012.
  • PatientPay CEO Thomas Furr offers advice on managing practice A/Rs and cash flow in a guest articl.
  • API Healthcare announces a 60 percent increase in year-over-year sales bookings and record bookings in the fourth quarter of 2012.
  • T-System will offer the PayRight Health Solutions patient collection system with its RevCycle+ solution.
  • CynergisTek and managed security service provider Solutionary partner to offer outsourced security monitoring.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

View/Print Text Only View/Print Text Only
January 22, 2013 News 5 Comments

Morning Headlines 1/21/13

January 20, 2013 Headlines 1 Comment

athenahealth and MedOasis to Provide Comprehensive, High-Value Anesthesia Billing Solution for Hospital Departments and Independent Practices

athenahealth and MedOasis will partner to provide an anesthesia-specific billing solution that combines athenahealth’s claims processing solution with MedOasis’ anesthesia coding, charge-entry, contract management, and compliance capabilities.

UCSF Medical Center throws a great outside curve ball, keeps EMR rollout under wraps

The local paper profiles University of California San Francisco’s $160 million Epic implementation, which quietly reached its completion one year overdue and $100 million over budget. In May of 2011, then CIO Larry Lotenero was shown the door after implementation costs ballooned to three times expectations.

Identifying Personal Genomes by Surname Inference

A group of fifty men who anonymously donated DNA to genome research have been positively identified by scientists who were able to identify the patient, their address, and their relatives by taking the little demographic information maintained on the donors, and supplementing that with the wealth of information extracted from the donors genome.

Allscripts to Announce Fourth Quarter and Full Year 2012 Financial Results on February 19

Allscripts announces that it will report year-end financials during a February 19 investor call.

View/Print Text Only View/Print Text Only
January 20, 2013 Headlines 1 Comment

Morning Headlines 1/18/13

January 17, 2013 Headlines 1 Comment

New rule protects patient privacy, secures health information

HHS announces modifications to HIPAA that substantially expand privacy, security, enforcement, and HITECH breach notification rules. The final rule is effective March 26, 2013 and is expected to require an initial economic cost of $114 million to $225 million.

Department of Veterans Affairs Selects HP to Help Improve Operations, Healthcare Services

HP wins a 5-year, $543 million contract to implement RTLS across 152 VA medical center.

Hospital Board Discusses Grade Change By the Leapfrog Group

The Leapfrog Group has retracted the "F" grade it gave 25-bed Texas County Memorial Hospital after an investigation found that the research methodology used was questionable and relied on inaccurate data sources.

A centralized research data repository enhances retrospective outcomes research capacity: a case report

Researchers at Columbia University find that using a data repository to conduct outcomes research significantly enhances overall workflow efficiency.

View/Print Text Only View/Print Text Only
January 17, 2013 Headlines 1 Comment

News 1/18/13

January 17, 2013 News 4 Comments

Top News

1-17-2013 8-57-34 PM

HHS Secretary Kathleen Sebelius announces the final omnibus rule that substantially changes HIPAA regulations for the first time in 15 years. It (a) expands HIPAA’s reach to business associates such as contractors who will now be directly liable; (b) increases penalties to a maximum of $1.5 million per violation; and (c) clarifies the HITECH breach notification requirements. Patient provisions include (a) the right to request their own information in electronic form; (b) allowing cash-paying patients to instruct providers to not share their treatment information with their insurance company; and (c) limiting the use and sale of a patient’s information without their permission. The 563-page document has considerable detail including a discussion of feedback received, so feel free to leave a comment with nuggets you run across.


Reader Comments

From Digital Probe: “Re: headline. One of the rags ran a headline all day saying Health Information Exchange over a story about health insurance exchanges.” Indeed they did, and they’ve since quietly corrected their mistake, I see. I’m slightly mystified by their confusion, but even more so at their running a lengthy article on health insurance exchanges in an IT publication intended for a provider audience who I can’t image cares one iota about them.

From Android Powered: “Re: TPD’s list of iPhone apps. Anybody want to share their list for Android?”

1-17-2013 5-51-39 PM

From Boy Gary: “Re: Anthem CA Blue Cross. Their electronic eligibility system is down, so they e-mailed providers telling them to e-mail subscriber and patient information to check eligibility. They’re asking for the subscriber’s Social Security number to be sent by unsecured e-mail.” That’s such a bad idea that I’ll overlook their less-egregious omission of the apostrophes in the possessive occurrences of “subscriber’s.” They get credit for at least putting a manual step in place to help providers get paid.

From The PACS Designer: “MakerBot at CES. An addition to MakerBot’s product line that TPD posted about was introduced at the Consumer Electronics Show in the form of a 3D plastic design system. The MakerBot Replicator 2X 3D printer uses melted plastic to form objects based on available 3D pattern software. So, for example you want a new coffee mug, you use your pattern design software to create the desired result. Maybe one of our adventurous readers will buy the Replicator to design a new shoe for Inga!” Pretty fascinating – the $1,749 device can replicate household hardware parts, antiques, and who knows what else.

From Lumpy Rutherford: “Re: former NextGen President Pat Cline. He has resigned from the QSI board effective immediately and on his LinkedIn page lists himself as CEO of newly incorporated Delaware corporation Lightbeam Health Information Systems. I don’t know the connection, but I suppose you could draw conclusions.” Indeed you could. I was interested in the corporation’s other officers, but couldn’t turn them up on Delaware’s corporations page (at least not without paying).


HIStalk Announcements and Requests

1-17-2013 2-58-51 PM

inga_small My inbox has been filling up with inquiries about HIStalkapalooza. Here’s what I can share for now. We will post a link to the invite sometime in the next couple of weeks, so keep reading HIStalk. We will again have the Inga Loves My Shoe contest as well as a crowning of the HIStalk King and Queen for best attire. Translation: if you needed a legitimate excuse for splurging on a new outfit, you now have one. However, you might want to wait for more details on the event because it may influence your final selection. The date again is Monday, March 4 at 6:30 p.m.

inga_small The latest goodies from HIStalk Practice include: the HIStalk Practice Advisory Panel discusses the various resources they use when purchasing HIT system to compare vendors and products. Bruce Henderson of Aetna Accountable Care Solutions suggests some factors that practices should consider before committing to an ACO model. Rob Drewniak of Hayes Consulting Management overviews and defines data governance. SRS CEO Evan Steele expresses concern about the future of the EHR incentive program. Proposed legislation would provide SBA loan guarantees for the purchase of clinical IT systems. A study suggests that projected primary care physician shortages could be eliminated if practices used EHRs and shifted more care to non-physician providers. EHR adoption by family physicians is expected to exceed 80 percent by the end of 2013. Most physicians don’t find online physician ratings helpful, though the vast majority believe their own ratings are at least partially accurate. Thanks for reading.

I’m taking a short beach break, leaving Miss Inga in charge of the Monday Morning Update. You can occupy your time by (a) connecting with us via our non-Catfished social not-working profiles; (b) porting intently and clicking methodically over the ads to your right from the folks who underwrite your HIStalk habit, if such a thing exists for anyone but me; (c) signing up for spam-free e-mail updates; (d) reviewing more in-depth sponsor information and filling out a two-minute form to solicit consulting help; and (e) evangelizing to your colleagues who won’t see our slick marketing campaigns and ads since we don’t have any. Seriously, you are the best.

On the Jobs Board: Product Marketing Specialist, Expert Solution Consultant – Revenue Cycle Specialist, Healthcare Vertical Solutions Director, Sr. Applications Engineer – EMR.


Acquisitions, Funding, Business, and Stock

1-17-2013 9-07-11 PM

PE firm Primus Capital Funds invests in Emmi Solutions, a provider of patient engagement solutions.

MIT Media Lab spinout Atelion Health will commercialize one of the lab’s project, a care coordination system that’s being tested at Boston Medical Center, Joslin Diabetes center, and Mayo Clinic.

1-17-2013 8-16-40 PM

Cleveland-area data archiving vendor MediQuant, which says its revenue is growing at 45 percent per year, moves into a larger space for its 40 employees and the 10 additional it plans to hire this year.

A hedge fund shareholder of Compuware criticizes the company for “intentionally dragging your feet” by not yet responding to a $2.3 billion December 18 takeover offer from Elliott Management Corp. Just after it received that offer, Compuware announced plans to conduct an $200 million IPO of its Covisint HIE business unit by the end of March.


Sales

Centra Health (VA) selects Wolters Kluwer Health’s ProVation software for cardiology procedure documentation and coding.

HP Enterprise Services announces that it has been chosen by the VA for a $543 million, five-year, 152-hospital RTLS contract, being issued the bid again after competitor protests of last year’s award. Subcontractors are CenTrak, Intelligent InSites, and WaveMark.


People

1-17-2013 5-19-49 PM

The Society of Health Systems and HIMSS award Dean Athanassiades, senior director of software customer services for Philips Healthcare, the 2012 SHS/HIMSS Excellence in Healthcare Management / Process Improvement Award for leadership in implementing synergies between the process improvement and IT professions.

1-17-2013 5-22-01 PM

Symphony Health Solutions names Frank Lavelle (Siemens Medical Solutions, Medquist) CEO.

1-17-2013 5-22-53 PM

Doug Cusick (HP, IBM) joins Clinovations as a partner, tasked with leading the expansion of the company’s payer, life sciences, and technology service lines.

1-17-2013 6-23-14 PM

Dann Lemerand is promoted to EVP of strategic alliances for The HCI Group.


Announcements and Implementations

Greenway Medical Technologies unveils its interactive Developer Portal and API to facilitate creation of apps that interoperate with Greenway’s EHR and PM platform.

Siemens Healthcare offers consulting services for value-based purchasing, preventable readmissions, and healthcare-acquired conditions.

1-17-2013 9-13-14 PM

A Dell-sponsored study finds that the family medicine residency program of Tallahassee Memorial HealthCare (FL) saved $600,000 and enhanced productivity by implementing the company’s Mobile Clinical Computing solution, which includes desktop virtualization, single sign-on, and strong authentication.


Government and Politics

1-17-2013 5-28-23 PM

ONC selects four winners of its Health Design Challenge to develop patient-friendly designs for printed health records to help patients better understand and use their EHRs. The winners shared $31,000 in prize money.

ONC publishes several reports on HIEs.

1-17-2013 8-44-01 PM

In the UK, Secretary of State for Health Jeremy Hunt calls on NHS to become paperless by 2018, making it “the most modern digital health service in the world.” The physician’s union replied, “The biggest challenges to making the NHS paperless by 2018 are down to funding, resources, prioritization, and the choice of systems in secondary care. Although there may potentially be some efficiency savings, technology will not necessarily create huge cost savings. As well as ongoing hardware and software funding, sufficient resources will be required to support evolving training, IT support and admin support.” Other goals the Secretary set: (a) every patient will have online access to their own records by March 2015; (b) referrals will be paperless; (c) patient records held in different locations will be linked; and (d) records will follow patients throughout NHS and social care.


Technology

1-17-2013 8-11-40 PM

A NIH-funded University of Pittsburgh study of four skin lesion apps finds that three of them weren’t very good at diagnosing a test set containing 53 images of lesions known to be cancerous. The apps incorrectly concluded that 30 percent of the lesions weren’t cancerous. The fourth app, which sends the image to a dermatologist for review, missed only one of the samples. The conclusion is to not trust unregulated apps with important medical decisions.


Other

The Leapfrog Group retracts the “F” grade it gave to Texas County Memorial Hospital (MO) after the hospital complains that its score was based on incorrect data. The 25-bed hospital opted not to participate in Leapfrog’s survey because it did not have the resources required to complete the 80-page questionnaire. It says Leapfrog applied “questionable methodology” and used information that was not confirmed by NQF or independently assessed for reliability and validity. The hospitals has retained legal counsel. 

Siemens Health Services CEO John Glaser, who served as an ONC senior advisor helping craft Meaningful Use in 2009 while still VP/CIO at Partners HealthCare, agrees with several member organizations in calling for a slowdown of its rollout. He says, “The pace is too damned high. People are just cramming this stuff in.” Johns Hopkins Vice Provost for IT/CIO Stephanie Reel says the “one size fits all” approach is causing headaches for specialists and the Meaningful Use program needs to be evaluated for effectiveness, saying, “To keep moving ahead with such an aggressive strategy strikes me as foolish. We don’t know what’s working and what’s not working.” Obviously pushback is escalating.

1-17-2013 7-20-08 PM

Sporting Kansas City, partly owned by Neal and Cliff of Cerner, parts ways with its charity partner, Lance Armstrong’s Livestrong. ESPN says Livestrong cancelled the stadium-naming deal because the soccer team owed it money, while Sporting KC takes advantage of the Dope Pedaler headlines by loudly announcing the breakup with perfect timing. Livestrong’s name gets yanked down from the Livestrong Sporting Park sign and it loses its percentage of the gate, worth $8-10 million over six years.

An article in a security magazine says Australian security researcher have found “dangerous, unpatched flaws” in the Philips Xper cardiovascular imaging system that allow them free access to patient information. The researchers said they weren’t able to connect with someone at Philips, so they got in touch with the Department of Homeland Security and the FDA instead. They claim Homeland Security told them the agency was taking over all aspects of software vulnerabilities related to medical devices and software. Philips says the flaw is present only in old versions of its software. The researchers also played around with an iPad-based patient monitoring and found problems.

Lurie Children’s Hospital of Chicago sues a web design firm, seeking the return of the $859,000 it paid the company to design a site to promote its new $915 million hospital.

1-17-2013 7-42-26 PM

The Dallas paper profiles Robert Abbate, DO, who started One Touch EMR, an iPad-based EMR.   

A reader once swore she would never read HIStalk again if I mentioned the term “fecal transplant” again, so here’s a sad but necessary wave goodbye to her from Weird News Andy, who subtitles the story “May I borrow some Grey Poopon?” A study finds that the unsavory procedure works better than antibiotics for treating diarrhea due to C. Diff. WNA adds, “When they figure out how to put them in a pill, maybe,” which I might argue is even more disturbing.


Sponsor Updates

1-17-2013 9-18-44 PM

  • Columbia Valley Community Health (WA) chooses Access Evolution for creating and managing paperless forms and workflow.
  • Craneware offers VP-and-above healthcare finance executives a chance to win a $250 Amazon gift card if they answer a 10-question Executive Industry Survey by February 5.
  • HMS will participate in the HFMA Region 11 conference in Las Vegas January 27-30 and the THA 2013 Annual Conference February 13-14 in Austin.
  • dbMotion shares the agenda for its February 7 seminar in Dallas on connected healthcare.
  • Emdat adds Carmichael Business Systems, Northland Business Systems, and Integrated Data Technology as resellers of its digital dictation software.
  • The Advisory Board Company offers an infographic  that addresses accountability gaps and best practices for improving teamwork among frontline staff.
  • The City of Springfield (OH) renews its contract with MED3OOO for EMS billing services through January 31, 2014.
  • The US Army Network Enterprise Technology Command issues CommVault a Certificate of Networthiness for its Simpana 9 data and information management software.
  • Santa Rosa Consulting’s Carl Jaekel discusses issues practices will need to consider to accommodate PCMHs in a blog post.
  • T-System offers its T Sheets flu documentation template free to hospitals to help EDs manage the national flu epidemic.

EPtalk by Dr. Jayne

Every day is a good day to be anonymous, especially for the HIStalk team. Sometimes I marvel that I haven’t been outed at the office. I and am grateful that apparently I have enough of a filter so that my superhero identity isn’t revealed. I do have to be especially vigilant to ensure I’m logged into the correct Facebook and Twitter accounts so I don’t inadvertently post as the “wrong” me.

I’m just one of thousands of physicians using social media and was excited to see this article in the Annals of Internal Medicine. The authors sent hypothetical social media situations to various state medical boards to evaluate whether there was consensus on which situations might lead to a disciplinary evaluation. Not surprisingly, the riskiest posts included misleading clinical or credentialing information, using patient images without permission, and inappropriate contact with patients such as contacting them on dating sites. There was low consensus for sharing clinical anecdotes (as long as confidentiality was maintained) and for “showing alcohol use without intoxication.”

clip_image001

I do have some latent Victorian sensibilities, so I’m not sure photos of anyone drinking belong on Facebook. I have been friended by some of my colleagues and I think that either they have forgotten that their posts are visible to the workplace or perhaps they simply don’t care. Working for a conservative non-profit, I’d be a little concerned that those posts could someday be an issue (if not for the current workplace then for a potential or future employer.)

Many organizations have social media policies or codes of conduct, but it’s not a bad idea to find out if there are “informal” policies in play as well. Is it frowned upon for subordinates to “friend” their supervisors? Is there a difference between connecting on Facebook and connecting on LinkedIn? What about posting to social medial during typical business hours? Depending on an employee’s role and career goals, some of these are less than appropriate.

Having TMI (Too Much Information) seems to have become the norm. I’m not advocating for a return to the days of inkwells and quill pens, but I do miss having a little mystery in the world. I don’t need a photo of your lunch every day, unless of course if includes an awesome martini. If you have pictures of those, feel free to e-mail me.

Jayne125


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

View/Print Text Only View/Print Text Only
January 17, 2013 News 4 Comments

News 1/16/13

January 15, 2013 News 9 Comments

Top News

1-15-2013 8-26-57 PM

AMA submits comments to ONC urging that Meaningful Use Stages 1 and 2 be evaluated before committing to a Stage 3. It says its members most often express five concerns: (a) passing requires a 100 percent score; (b) the core measures are inflexible with regard to practice patterns and specialties; (c) the program needs to be independently evaluated; (d) EHR certification should place more emphasis on software usability; and (e) healthcare IT infrastructure barriers prevent data sharing. AMA wants three years between stages to give EHR vendors time to prepare – one year for making the rules, one for product development, and one for implementation.


Reader Comments

From EHR You Experienced?: “Re: Johns Hopkins Epic motivation for clinicians. Funny.” It is, but I can’t for the life of me figure out why people keep writing Epic in all capital letters. It’s just plain wrong.


HIStalk Announcements and Requests

Need a new Spotify playlist? Here you go. Beach House, Christian Mistress, Young the Giant, The Maldives, and others ranging from popular to obscure (mostly the latter since I strenuously resist musical monotony).

125x125_2nd_Circle

Just for you Smokin’ Doc fans, I’ve had the old logo turned into smaller ones of various sizes and shapes featuring just the doc himself, which I’ll be using regularly here and there. I may even place him permanently at the top of the page since people keep lamenting his apparent demise, which is simultaneously endearing and disturbing. However, just to be clear: (a) I don’t smoke a pipe or anything else and never have; (b) he doesn’t look like me; and (c) you won’t find many doctors wearing reflector thingies on their heads unless you time travel back to the 1960s – they’ve gone electronic.


Acquisitions, Funding, Business, and Stock

1-15-2013 7-09-32 PM

Twelve-employee Flatiron Health raises $8 million in a Series A funding round led by Google Ventures. The company, which is running a private beta of its oncology analytics platform, was started by the two founders of media buying platform vendor Invite Media. They sold that company to Google for $81 million in 2010.


Sales

Primary Partners (FL) contracts with telemonitoring provider AMC Health for remote monitoring of discharged patients using biometric devices.

1-15-2013 5-05-06 PM

Springhill Medical Center (AL) selects Omnicell for automated medication solutions and business analytics.

Holland PHO (MI) chooses Wellcentive Advance for aggregating and analyzing patient information from multiple EMRs and systems into a central repository to meet BCBS Michigan’s OSC program guidelines.

HealthEast (MN) chooses RelayHealth to power an enterprise HIE that will help coordinate care across its four hospitals and 14 clinics.

Health Services for Children with Special Needs (DC) selects care and claims systems from TriZetto.

1-15-2013 8-29-03 PM

Norwegian American Hospital (IL) chooses revenue cycle solutions from HealthWare Systems.

Aetna and Centene Corporation choose readmission predictive analytics software from Predixion Software.


People

1-15-2013 5-06-41 PM  1-15-2013 5-07-30 PM  1-15-2013 5-08-35 PM

KLAS appoints John Halamka (Beth Israel Deaconess Medical Center), Wright Lassiter (Alameda Medical Center), and Denni McColm (Citizens Memorial Hospital) to its advisory board.

1-15-2013 5-09-22 PM

Kareo hires Rob Pickell (Strategy for HireRight) as its first chief marketing officer.

1-15-2013 5-10-33 PM

HIMSS and the American College of Clinical Engineering recognize Paul H. Frisch (Memorial Sloan Kettering Cancer Center) with the ACCE-HIMSS Excellence in Clinical Engineering and Information Synergies Award for demonstrating leadership in promoting synergies between IT and clinical engineering.

1-15-2013 5-12-09 PM

Merge Healthcare Chief Medical Officer Cheryl Whitaker, MD leaves the company to pursue new ventures.

1-15-2013 5-57-07 PM

Mike Quinto (Quantros) joins PatientSafe Solutions as regional sales VP.

1-15-2013 7-26-29 PM

Former consultant and National Quality Forum SVP/COO Laura Miller joins HP as client principal in the public health sector.


Announcements and Implementations

1-15-2013 2-41-49 PM

Optum and Mayo Clinic launch Optum Labs, an open, collaborative research and development facility focused on improving patient care. Participants in the project will have access to Optum and Mayo’s information assets and technologies, including de-identified clinical and claims data.

White Plume Technologies adds AccelaPQRS, powered by Wellcentive, to its solutions suite. Its smart workflows and customized rules capture eligible encounters that allow users to transmit their denominators and numerators to Wellcentive’s registry.

An independent study finds that PeriGen’s PeriCALM Patterns can accurately screen fetal monitoring strips in real time, with its findings matching that of three experts from National Institutes of Health 97 percent of the time. Clinicians can also use the software retrospectively to test new hypotheses on stored fetal heart rate information. I interviewed CEO Matt Sappern in September.

1-15-2013 6-13-54 PM

Here’s a new cartoon from Imprivata.

1-15-2013 7-19-28 PM

US Rep. Tom Price (R-GA) visits Roswell-based revenue cycle vendor MediStreams.

MModal announces a partner certification program for vendors using its Fluency Direct speech recognition and natural language processing technologies.

Henry Schein MicroMD enhances its PM/EMR automated solutions line with tools for dashboards, patient marketing, data backup, electronic payments, statements, websites, PDR information, and third-party collections.


Government and Politics

 

CMS expands the MU program to include physicians who assign their reimbursement and billing to critical access hospitals.

1-15-2013 6-28-05 PM

William Zurhellen MD, a solo practice pediatrician in the New York City area, petitions the White House to move EHR strategy away from facilitating payment to a national approach for improving outcome and costs. His petition has 123 signatures so far of the 25,000 needed to put it in front of the President. We interviewed him on HIStalk Practice three years ago, where he explained why he wrote his own Unix-based EMR and why he’s not a HITECH fan. “The entire ARRA is a trade for information. We’ll give you money to put in records, but in return, we want you to supply us with performance data. Performance does not equal quality.” A reader reports that a recent CCHIT meeting, he received applause from at least half the audience when he announced, “Certification should focus on improving care. Anything else is a waste of time.”


Innovation and Research

Joe Kiani, founder and CEO of patient monitoring systems vendor Masimo, launches a patient safety conference and calls for fellow vendors to share their monitor information. He envisions a “superhighway of patient data” that can be analyzed by algorithms to provide an early warning of patient problems that will reduce 200,000 preventable deaths that occur under a provider’s care. Promising to share were Circuit Board, GE, Cerner, Smith Medical, SonoSite Fuji, Surgicount Medical, and Zoll Medical. Other solutions discussed were patient checklists, medical mistakes, and hospital overuse of blood from blood banks. Bill Clinton delivered the conference keynote and patient safety expert Peter Pronovost, MD, PhD also presented.

1-15-2013 7-56-57 PM

Conor Delaney, MD, a surgeon at University Hospitals Case Medical Center (OH) is profiled in an article about Socrates Analytics, which he founded to develop a system for University Hospitals that analyzes hospital information to support quality improvement efforts.


Other

1-15-2013 5-52-30 PM

The Raleigh-area business paper covers the departure of Diane Adams, VP of culture and talent of Allscripts. We detailed her severance package here when it was first filed, but the paper recaps: a year’s salary in cash, her annual target bonus in cash, a year of health benefits, partial accelerated vesting, and other potential bonuses. She gets an extra year’s salary if the company sells out within the next year. She made $1.9 million in 2011 for her job, described as “building a values-based, high-performance environment where people, learning, and fun are the priorities.” It would be interesting to hear from those people whether they enjoyed $1.9 million worth of learning and fun.

1-15-2013 3-10-04 PM

HIMSS Analytics reports that in the last five quarters, the number of US acute care hospitals achieving EMRAM Stage 5 or Stage 6 has increased more than 80 percent and the number reaching Stage 7 has grown 63 percent, suggesting that HITECH has spurred the increased implementation and meaningful use of EHRs.

A routine compliance audit by Samaritan Medical Center (NY) uncovers what it says is illegal activity by a sheriff’s department RN who was authorized to review the electronic medical records of inmates, but who was found to be checking out the records of other patients as well.

Pennsylvania’s Department of Vital Statistics warns parents to check the birth certificates of their newborns after a vendor’s newly implemented records software was found to be pulling in incorrect names for the father.

1-15-2013 8-09-18 PM

Northwestern University (IL) will spend $1 billion to replace its women’s hospital, planning to tear down an existing structure that preservationists are trying to have designated as a protected landmark.

1-15-2013 8-35-21 PM

Weird News Andy finds this story odd: the VA hospital in Buffalo notifies hundreds of patients from 2010 to 2012 that they may have been exposed to HIV or hepatitis because nurses misused insulin pens by correctly discarding the used needles, but re-using the same pen on multiple patients.

Strange: a Washington psychiatric hospital loses its accreditation because of an unsecured karaoke machine. State inspectors said the cord presented a patient safety hazard, no doubt remembering an event from a month before in which one patient at the hospital strangled another in karaoke-unrelated incident.


Sponsor Updates

  • HealthMEDX customer Asbury Methodist Village (MD), which recently won an award for its use of technology to improve care transition from long-term care to other settings, is featured in a video from Leading Age and the Center for Aging Services Technologies.
  • John McCullough, associate VP of clinical applications for Wake Forest Baptist Medical Center (NC), reviews his organization’s partnership with Intellect Resources, which provided Wake Forest with strategic planning services prior to its go-live.
  • Steve Besch, senior systems analyst for Ingenious Med, discusses PQRS and the need for program participation in 2013 to avoid penalties in 2015 in a blog post.
  • TrainingWheel introduces its mobile solution for automating help desk issues and support tracking.
  • TrustHCS offers advice for the C-suite on preparing for ICD-10 and Meaningful Use in a blog post.
  • Velocity Data Centers breaks down how it builds data centers in 90 days and publishes a time-lapse video documenting the start-to-finish process.
  • VersaSuite will participate in the Rural Health Care Leadership Conference in Phoenix February 10-13.
  • Arian Bichsel, director of client support for Allscripts, shares strategies to reduce hospital readmissions.
  • API Healthcare discusses the use of payroll and HR software to drive down the cost of care, boost efficiencies, and improve clinical outcomes.
  • Infor recognizes NTT DATA as its 2012 Infor Lawson Service Partner of the Year based on its 250+ successful implementations of Lawson’s ERP software.
  • Informatica sponsors GovernYourData.com, a vendor-neutral online community and resource center for data governance.
  • ICSA Labs and IHE USA partner to provide industry-accepted certification to complement existing testing of IHE integration profiles.
  • The Colorado Health Insurance Cooperative selects Emdeon subsidiary HTMS to provide strategic planning and operational roadmap for the development of a consumer-owned health insurance plan.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

View/Print Text Only View/Print Text Only
January 15, 2013 News 9 Comments

Morning Headlines 1/14/13

January 13, 2013 Headlines No Comments

2014 Testing and Certification

ONC announces that certifying agencies may begin testing EHRs for MU Stage 2 certification.

In Second Look, Few Savings From Digital Health Records

The New York Times covers the recently published RAND study that acknowledges a lack of evidence for calling EHR implementations a cost-cutting initiative.

US Health in International Perspective: Shorter Lives, Poorer Health

The Institute of Medicine, in conjunction with the National Research Council, publishes a study measuring overall population health and concludes that the US is dead last of the 17 developed nations and that, among many problems, our healthcare IT is categorized as "worse than average.”

Blue Health Intelligence Creates an “Informatics Center of Excellence” Through Acquisition of Intelimedix

BCBS acquires Intelimedix, a data analytics company specializing in employer group reporting, mass customized communications, and medical cost containment. BCBS manages care for 110 million patients.

View/Print Text Only View/Print Text Only
January 13, 2013 Headlines No Comments

Monday Morning Update 1/14/13

January 12, 2013 News 15 Comments

From The PACS Designer: “Re: TPD’s list. The latest update of my iPhone apps lists is online. In addition to many new apps is a new section highlighting the apps of HIStalk sponsors.” TPD’s list is here. He’s always up for additions to it.

From Frank Poggio: “Re: Meaningful Use Stage 4.  At the January 8 HIT Policy Committee meeting, Farzard Mostashari, ONC director, waxed eloquently about MU Stage 4. Hey, wait a minute — the original playbill said this was to be a three-act play! Does he think we can stay in this claustrophobic theatre all day and night? How many more acts will there be? One thing for certain — the bonus money will run out long before the last act, but you can be sure the ‘penalty’ clauses will not. This MU theatre of the absurd must be in the Hotel California… you can check in, but you can never check out.”

1-11-2013 8-46-11 PM

From Green Space: “Re: Judy Faulkner’s new company to generate electricity for Epic. Search the Wisconsin Department of Financial Institutions for Galactic Wind. Here’s a photo of the wind farm, about 15 miles north of Epic’s main campus.”

1-11-2013 8-50-50 PM

From Dragovitz: “Re: Peake Healthcare Innovations. The image sharing joint venture between Johns Hopkins Medicine and Harris Computer appears to be defunct. Rumor has it they found it hard to differentiate themselves from PACS vendors and underestimated the risk of trying to use MINT, a protocol that would have displaced DICOM.” Unverified. The JV was created on March 2011 and their “new approach to medical image management” was rolled out at HIMSS last year.

1-12-2013 7-29-39 PM

Sixty percent of us have used a patient portal offered by our PCP. New poll to your right: was the 2005 RAND study naïve, biased, decent but not useful for justifying EMR subsidies, or possibly accurate once more time goes by? Pick the best answer since you get only one.

Thanks to the following sponsors, new and renewing, that have recently supported HIStalk, HIStalk Connect, and HIStalk Practice. Click a logo for more information. 

1-11-2013 8-31-29 PM
1-11-2013 8-30-26 PM
1-11-2013 8-39-37 PM
1-11-2013 8-22-57 PM
1-11-2013 8-38-37 PM
1-11-2013 8-11-00 PM
1-11-2013 8-32-50 PM
1-11-2013 8-24-20 PM
1-11-2013 8-12-09 PM
1-11-2013 8-13-04 PM
1-11-2013 8-27-51 PM
1-11-2013 8-14-49 PM
1-11-2013 8-41-28 PM
1-11-2013 8-29-41 PM
1-11-2013 8-25-12 PM
1-11-2013 8-34-45 PM
1-11-2013 8-36-27 PM
1-11-2013 8-21-40 PM
1-11-2013 8-26-37 PM
1-11-2013 8-40-38 PM
1-11-2013 8-33-55 PM
1-11-2013 8-28-41 PM 

1-12-2013 11-07-49 AM

1-12-2013 11-09-28 AM

A new report commissioned by the National Research Council and the Institute of Medicine finds that despite the largest per-capita healthcare spending of all countries, the US ranks dead last among 17 developed nations in health. Most surprisingly, it’s not our also legendary number of poor and uninsured residents who are dragging our average down – our unhealthiness is equal opportunity by income and education. If you want your child to live to 50, move to another of those 16 other countries because they’re a target here for being murdered, dying in a car wreck, and not even living long enough to attend pre-school (we’re #1 in all those categories). We’re lucky that one other country beat us in the percentage of people dropping dead of heart problems and lung disease. We’re dead last in the percentage of doctors in primary care, and the graphic above shows IT as one of the “worse than average” items (the others being coordination of care, medical errors, patient dissatisfaction, and miscommunication). No single cause was identified, but it says a lot of the problem starts with being fat, overusing legal and illegal drugs, shooting each other, and wrecking cars, not to mention a healthcare non-system that’s superb at Rambo-style interventions but really bad at almost everything else. The authors found no silver bullet other than spending a lot of taxpayer money, which is another not-so-great #1 they didn’t bring up (the largest national debt at $16 trillion with the lead widening by the minute). Being rugged and self-determinant individualists, we’re not real big on public health programs in the US, so it’s ironic that excellent schools crank out thousands of public health stars who immediately head off to Africa or South America to find work despite a target-rich environment here.

1-12-2013 10-22-59 AM

ONC announces that Authorized Certification Bodies are now authorized to test and certify EHRs using the 2014 Edition Standards and Certification Criteria.

1-12-2013 9-35-05 AM

My guilty pleasure is reading John Halamka’s “Building Unity Farm” posts on his Life as a Healthcare CIO blog. I skim his other IT-related posts on occasion, but I never miss an episode about how he uses his engineering and IT background to approach building a gentleman’s farm, like Oliver Douglas on Green Acres except he knows what he’s doing. I find myself fascinated by what kind of guinea fowl he favors, his hardwood management plan, and what was on his vegan Christmas menu.

The Illinois Department of Financial and Professional Regulation, the state’s overseer of physicians, will lay off 18 of its 26 medical unit employees next week because of a $9.6 million budget shortfall.

An interesting Alabama Supreme Court ruling allows patients who claim injury from a generic drug to sue the manufacturer of the brand name drug they didn’t take. The court ruled that generic drug makers are required to use the approved labeling of the patented drug, so a lack of warnings isn’t their fault. Alabama high-end real estate values will probably benefit as out-of-state trial lawyers shop second homes there.

Academic Ranking of World Universities, assembled by researchers at a university in China, ranks the world’s best clinical medicine and pharmacy universities, with US schools taking all but four spots in the Top 20, counting ties. In order, Harvard, UCSF, University of Washington, Johns Hopkins, Columbia, UT Southwestern, UCLA, Stanford, University of Pittsburgh, University of Michigan, University of Minnesota, Mayo Medical School, University of North Carolina at Chapel Hill, MD Anderson, Yale, and Vanderbilt.

1-12-2013 9-48-08 AM

BCBS’s Blue Health Intelligence acquires Tampa, FL-based Intelimedix, which offers employer and payor analytics from its medical claims database covering 110 million patients.

1-12-2013 9-55-19 AM

Miami Children’s Hospital receives a hospital association’s marketing award for sending urgent care wait times via text messages. The hospital uses a service from ER Texting.


RAND Corporation’s admission in a Health Affairs article that its own 2005 study predicting vast savings from EHRs was dead wrong gets major space in The New York Times, even scoring a quote from original National Coordinator David Brailer, MD, PhD, who now says HITECH was a “colossal strategic error” that encouraged providers to earn government checks by buying EHRs quickly and worrying later about actually using them for anyone’s benefit. The new analysis says the original vendor-funded report was “enthusiastically embraced,” but that now “critics of the RAND team’s analysis can claim a measure of vindication.” Some quotes from the new article:

  • Lack of interoperability means systems function “less as ATM cards, allowing a patient or provider to access needed health information anywhere at any time, than as frequent flier cards intended to enforce brand loyalty to a particular health care system,“ with the huge amount of information stored by Kaiser and the VA “essentially useless if the patient seeks out-of-network care.”
  • EHR adoption is still arond 40 percent instead of the 90 percent threshold RAND said was needed despite billions of HITECH payouts, which it described as, “Most of the action is concentrated among facilities that were already planning to implement or upgrade their health IT systems. Federal incentives have not yet closed the health IT gap between small, rural, and nonteaching hospitals and larger, urban, and academic ones.”
  • Patients share the blame, with few of them even signing up to view their electronic records and most of those never actually looking at them.
  • “Considering the theoretical benefits of health IT, it is remarkable how few fans it has among health care professionals.” The article says market forces aren’t working to demand more usable systems since comparative system information is not readily available and HITECH encourages just buying whatever’s out there anyway.
  • The “do more, bill more”healthcare payment system provides no incentives to use IT to reduce costs or improve outcomes.
  • The article concludes, “The optimistic predictions of Hillestad and colleagues in their 2005 analysis of the potential benefits of health IT have not yet come to pass. This is not because of shortcomings in their analysis but rather because of shortcomings in the design, implementation, and use of health IT in the United States. When the preconditions these authors posited are finally realized, the benefits they predicted will be realized as well.”

I bet most readers saw this coming when the exuberant 2005 study started putting stars in the eyes of vendors and the federal government. People who put their hopes in a tool rather than tool users are usually wrong, and it’s almost always true that those tool users will do whatever it is that they’re paid to do, like cranking out procedures, stealing each other’s profitable patients and doctors, and buying EHRs quickly without a lot of thought or commitment.

My take is that the original article was more naïve than biased. The new article, however, puts a lot of the blame on HITECH — which wasn’t implemented until four years after the original article — and not enough blame on a screwed up healthcare system whose technology reflects that unfortunate reality. A vendor could easily develop a usable, interoperable, patient-centered EHR if they didn’t have to deal with mountains of billing rules (most of them coming from the same federal government that’s complaining about complex systems), insurance companies, regulators, and market-force competitiveness, following the specifications of users dedicated to a framework of standardized and repeatable processes. They would, however, have no customers. That’s why only the VA has done it, and they developed their own VistA system having the luxury of a vacuum to work within.

The worst thing about the original RAND study is that it was quickly co-opted by special interests as validation for spending billions of taxpayer dollars to subsidize fast-tracked sales of systems to providers who had already declined to buy them with their own money. We have good providers, good electronic systems, and good patients — we just can’t seem to put the policies in place to move the needle on the marginal ones.


Vince has a great look-back this week, getting some first-hand history of Sphere Healthcare Information Systems as it eventually became NextGen’s financial system.


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

View/Print Text Only View/Print Text Only
January 12, 2013 News 15 Comments

News 1/11/13

January 10, 2013 News 2 Comments

Top News

1-10-2013 8-39-19 PM

The VA launches a Medical Appointment Scheduling System challenge to replace its VistA scheduling module. Up to three entrants will win up to $3 million each.


Reader Comments

1-10-2013 7-17-31 PM

From TV’s Frank: “Re: Intermountain Healthcare. Finally dumping GE Healthcare.” An e-mail from Intermountain CIO Marc Probst to IT employees says the still-incomplete system it’s been building with GE is deficient in clinical documentation, CPOE, and integration with coding and billing. As a result, Intermountain has evaluated GE’s future EMR strategies and decided not to renew their contract, instead considering three options: (a) keep building their homegrown EMR without GE’s involvement; (b) buy Epic, Cerner, or Siemens; or (c) buy best-of-breed and try to integrate. I’ve panned the GE-Intermountain deal since it was announced in 2005, skeptical that dumping a few hundred million dollars and GE’s questionable expertise was going to ever yield anything tangible, which apparently is exactly the case seven-plus years into the 10-year deal. Or as I described it in 2011, “GE-Intermountain screwing around that never seems to provide any real, marketable products (are those Intermountain-led Carecast enhancements just about done?)”
1-10-2013 6-46-44 PM

From Jerry Aldini: “Re: Geisinger Health System (PA). I contacted you a while back with the rumor that they were developing a commercial solution for accountable care enablement. It was announced at JPMorgan last week. Announcement attached.” I haven’t seen announcement hit the wires, but it says that Geisinger is launching xG Health Solutions, a for-profit spinoff that will commercialize its intellectual property. On the list: consulting services, population health analytics, care management, healthcare IT optimization, and third-party administration services. Geisinger EVP Earl Steinberg, MD, MPP (above) is named CEO and former Alere Chief Innovation Officer Gordon Norman, MD will be chief medical officer.

From PolishingMyResume: “Re: Allscripts. Preparing for relocations and layoffs in the software development organization for development people who work remotely or outside the seven core offices of Boston, Bangalore, Burlington, Chicago, Raleigh, Pune, and Vancouver.” Unverified. Seems like a smart strategy to me. The problem with indiscriminate acquisitions is that you have people strung out all over the place who understandably don’t want to move, limiting your opportunity for the synergy or culture management that Allscripts could use quite a bit of right about now (not to mention expense reduction, ditto). One of quite a few bad decisions by Eclipsys before Allscripts overpaid to buy the company was hiring CEOs who refused to relocate and instead occasionally jetted a few time zones over when the troops needed demoralizing, so I assume that lesson was learned and Paul Black will work out of the Chicago office. 

1-10-2013 8-07-46 PM

From Joan Hovhanesian: “Re: Howard University Hospital. Went live on Soarian clinical documentation on January 7.” Congratulations to the folks there. That’s a gutsy move going live immediately after the holidays. I still think of Joan as being with FCG and later VP/CIO of Shands Healthcare, so I’m out of touch – she’s with Program Advisors now.


HIStalk Announcements and Requests

inga_small HIStalk Practice highlights from the last week include: only 16 percent of providers met PQRS requirements in 2010. Primary care physicians are more likely to demonstrate improvement on measures of care when they have had sustained and extensive technical assistance. A billing service and four pathology groups agree to pay $140,000 to settle allegations that they improperly disposed of thousands of medical records found in a public dump. Job opportunities for physicians will continue to rise in 2013. The AMA and other professional medical organizations urge CMS to stop the implementation of the ICD-10 code set for outpatient diagnosis coding. Galen Healthcare releases a plug-in for Allscripts Enterprise EHR that sends providers EHR task updates to their PC or smartphone. It’s a new year and I hope your 2013 resolutions include not only a commitment to good health, but also a vow to expand your HIT ambulatory knowledge by faithfully perusing HIStalk Practice. Thanks for reading.

On the Job Board: Marketing Manager, Senior Applications Engineer – EMR.

1-10-2013 6-10-34 PM

Welcome to new HIStalk Gold Sponsor HTTS (Health Technology Training Solutions). For you vendors out there, this is my theory: customers often slam your product on KLAS surveys when their problem is really inadequate user training, not your software. The last thing you want customers to experience before go-live is a hastily thrown together set of PowerPoints and talking head demos put together by someone who knows the application but has no knowledge of instructional design and adult learning theory. You’ll hear an earful afterward, but not just on your training evaluation forms – users will under-use your systems, overload your help desk, and badmouth your product on reference calls. The HTTS team of healthcare IT and instructional design experts can help eliminate those problems by reviewing your training strategy, conducting a training needs analysis for new products or releases, and developing your training content using state-of-the-art learning techniques. Check out the testimonials of vendors who have engaged HTTS to optimize their training experience. If you’ve experienced professionally designed software training (both online and instructor-led), it’s easy to distinguish it from the more typical variety assembled by well-meaning amateurs. Now’s a good time to arrange a HIMSS conference connection to learn more. Thanks to HTTS for supporting HIStalk.


Acquisitions, Funding, Business, and Stock

7 Medical Systems closes on its acquisition of HealthLink Minnesota Management Group, a provider of administrative and IT services to clinics.

1-10-2013 5-12-29 PM

ManTech International completes its acquisition of CMS contractor ALTA Systems.

1-10-2013 5-11-29 PM

EBSCO Publishing expands its evidence-based pediatric content with the acquisition of PEMSoft, a pediatric point-of-care clinical information library and multimedia decision support system.


Sales

1-10-2013 2-25-22 PM

Saint Luke’s Health System (MO/KS) expands its use of Perceptive Software solutions to include integration with Epic.

CalHIPSO contracts with ClearDATA Network to offer cloud hosting, offsite backup, and disaster recovery services to CalHIPSO provider members.

Emergency Medicine Physicians selects athenaCollector and athenaCommunicator for its 800-physician group. athenahealth also announces that Prospira PainCare with deploy athenaClinicals, athenaCollector, and athenaCommunicator.

1-10-2013 2-27-24 PM

Children’s Mercy Hospitals & Clinics (MO) selects GE Healthcare’s Centricity Business as its enterprise-wide RCM solution.

1-10-2013 5-15-44 PM

Straith Hospital for Special Surgery (MI) chooses the ONE EHR from RazorInsights.

1-10-2013 2-30-01 PM

Flagler Hospital (FL) contracts with Surgical Information Systems for Sunrise Surgery.

1-10-2013 5-17-46 PM

Doylestown Hospital (PA/NJ) subscribes to the CapSite Database to assist with the capital planning and purchasing processes.

Lincoln Orthopaedic Center (NE) selects SRS EHR for its 14 providers.

1-10-2013 8-42-32 PM

Vanderbilt University Medical Center will use event-driven software from Tibco to support its clinical decision support capabilities.

1-10-2013 3-12-54 PM

Rainbow Babies & Children’s Hospital (OH) will encourage non-emergent ED patients to instead use HealthSpot telemedicine kiosks staffed by medical assistants and equipped with monitoring instruments. Also announced: telehealth provider Teladoc will offer HealthSpot’s kiosks.


People

1-10-2013 5-18-39 PM 1-10-2013 5-19-37 PM

MedSys Group names Steven Heck (First Consulting Group) president and Luther Nussbaum (First Consulting Group) chairman of the board.

1-10-2013 5-21-44 PM

URAC President and CEO Alan P. Spielman announces his resignation.


Announcements and Implementations

1-10-2013 3-09-43 PM

Sentara Healthcare (VA) begins implementation of Morrisey Associate’s Concurrent Care Manager software across its 10 hospitals and 100 medical facilities.

The dbMotion-powered ClinicalConnect HIE (PA) expands its reach to 1.3 million patients.

1-10-2013 5-26-19 PM

South West Medical (KS) and Rems Murr Kliniken in Germany go live on iMDsoft’s MetaVision platform.

1-10-2013 8-30-21 PM

Hospital messaging services vendor Critical Alert Systems partners with Mobile Heartbeat, which provides hand-held messaging and alarms, to create an enhanced nurse call solution.

3M Health Information Systems opens an innovation center in Silver Spring, MD that will showcase its offerings.

Meta Healthcare IT Solutions announces customized versions of its clinical documentation, CPOE, pharmacy, and medication administration software that meet the requirements of Canada-based customers.


Government and Politics

The FCC announces it will make available up to $400 million in annual funding to healthcare providers to spur development of broadband networks for telemedicine.

HHS Secretary Kathleen Sebelius announces the formation of 106 new Medicare ACOs.

Former CMS administrator Don Berwick, MD says he is strongly considering running for Massachusetts governor in 2014. He says healthcare experience gives him sensitivity to issues, adding, “I get more and more excited about the idea of Massachusetts as a model.”


Technology

1-10-2013 6-57-49 PM

Panasonic announces an expanded line of Toughpad enterprise-grade tablets that include a 10-inch model running Windows 8 Pro ($2,899) and 7-inch ($1,199) and 10-inch ($1,299) Android versions.

HL7 releases a CCD to Blue Button Transform Tool that allows organizations using the CCD format to allow patients to download information as ASCII text.


Other

1-10-2013 8-00-53 PM

A heavily recruited professor couple at University of Minnesota’s School of Public Health, one of them director of the ONC-funded University Partnership for Health Informatics (UP-HI), quit amidst charges they were double-dipping by simultaneously being paid by another university employer. The State of Georgia handed down felony indictments against Julie Jacko in 2011 after finding that she and Francois Sainfort were collecting full-time paychecks from both UM and Georgia Tech, but dropped charges in return for a plea agreement, restitution payments, and probation by Sainfort. Jacko ran the UP-HI project, funded by a $5.1 million ONC grant.

A California judge refuses to grant Kaiser Permanente access to the PCs and e-mail accounts of a couple whose small document storage business it hired to manage paper patient records. The state health department found last month that Kaiser put medical records at risk by turning them over to the small company without a signed contract. Kaiser claims it picked up the paper records, but the couple didn’t return everything.

Vermont’s Department of Financial Regulation scolds Porter Hospital for overrunning the $4.3 million budget of its Meditech-MedHost EMR project by 63 percent. The hospital undertook the project to earn HITECH money and to participate in Vermont Blueprint for Health. The hospital’s VP of public relations said, “The Meditech folks would hand you a box and say, ‘Good luck, do you have any questions?’” The hospital admits that during the physician practice rollout, all of its practices stopped accepting new patients for an unstated period, with the article ironically concluding, “Porter found that the productivity of doctors took a big hit each time the software was rolled out at a new practice … Officials said it has not been unusual for a doctor who normally saw 20 patients an hour to be able to see only 10 or 12 once the productivity-enhancing software was introduced.”

Weird News Andy finds this story a HIPAA stretch. Police confiscate the cell phone of a man filming an arrest on a public street, with a deputy telling him, “If I end up on YouTube, I’m gonna be upset.” The man was charged with obstruction and disorderly conduct, with the deputy claiming it was a HIPAA violation. A Stanford law expert opines the obvious: “There’s nothing in HIPAA that prevents someone who’s not subject to HIPAA from taking photographs on the public streets. HIPAA has absolutely nothing to say about that.”

1-10-2013 9-14-16 PM

It’s not an April 1 gag: the iPad-ready children’s iPotty debuts at CES. My only surprise is that the adult model wasn’t rolled out first.


Sponsor Updates

  • Jim Stilley, director of clinical workflow consulting for Versus, will discuss the use of RTLS to improve patient flow and efficiency at the 2013 Patient Flow Management Congress January 28-29 in Las Vegas.
  • The Advisory Board Company offers a February 14 Web conference on the inpatient value-based purchasing program.
  • MedHOK earns full 2013 NCQA HEDIS software certification for its 360Measures v2.56.
  • Bill Bithoney, MD of Truven Health Solutions discusses innovative and targeted approaches for reducing costs by improving care quality for better patient outcomes in a blog posting.
  • Medicity publishes a white paper discussing how to build patient centeredness into the ACO model. 
  • iMDsoft highlights some of its 2012 milestones, including successful implementations in Canada and the Czech Republic, 60 critical care and anesthesia projects, and go-lives of MetaVision in 17 countries.
  • Prognosis HIS doubles its client base for the second consecutive year and announces that all of its eligible clients exceeded baseline requirements to complete Stage 1 MU attestation using ChartAccess EHR.
  • Beacon Partners defines population health management and its relation to ACOs in a January 18 Webinar.

EPtalk with Dr. Jayne

CMS is seeking comments from hospitals, EHR vendors, and “other interested parties” on its electronic quality reporting. Starting in 2014, the Hospital Inpatient Quality Reporting (IQR) program requires use of the Quality Reporting Document Architecture (QRDA) standard. According to the e-mail, “CMS wants to increase efficiency and reduce the burden for providers…” If that’s true, I have some other suggestions for them as well. The comment period closes January 22, so sharpen those pencils and fire up those keyboards.

Speaking of CMS, don’t forget that if you completed your 2012 reporting period on time, you only have until February 28 to attest for Medicare. Those attesting with Medicaid should check for their specific state deadlines.

One more CMS deadline-related item and then I’ll quit, I promise. The comment period for ONC’s Health IT Patient Safety Action & Surveillance Plan is open until February 4. Goals of the plan include making it easier for clinicians to report patient safety events, engaging vendors to “embrace their shared responsibility for patient safety,” and incorporating health IT safety in post-market surveillance of certified EHRs. It’s only 40 pages, considerably shorter than most ONC reads.

From Follow Up Fred: “Re: sticky workplace problems. Good topics for discussion! One solution I’ve successfully employed for years is this. If I need a prompt response to a question or request communicated by voicemail or e-mail, I always end the message by asking for a response by a certain date and time. Typically, “Hey Jane, I’d appreciate it if you’d get back to me by close of business Thursday, January 10.” I then flag the e-mail or voicemail follow-up date on phone in the event the requested deadline is missed. I’ve found it very effective for myself but also the recipient, who in turn can prioritize the return response.” An excellent point, especially in a workplace where people won’t do anything until they’re absolutely up against a deadline.

The AMA continues to play Chicken Little with their ongoing pleas for CMS to halt implementation of ICD-10. Citing the cost and administrative burden, they ask that it not simply be delayed again, but to call on “appropriate stakeholders to assess an appropriate replacement for ICD-9.” There has already been significant expense to prepare for implementation and I know many people will be aggravated at the lost time, money, and effort if they’re successful. Do I sense an HIStalk poll in the making?

clip_image002

Inga and I are hard at work designing the beauty queen sashes for HIStalkapalooza. Thanks to some virtual BFF shoe shopping (via camera phone and text message), I’m ready for HIMSS. Do you have your shoes picked out and your accessories coordinated? E-mail me.

Print


Contacts

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

More news: HIStalk Practice, HIStalk Connect.

View/Print Text Only View/Print Text Only
January 10, 2013 News 2 Comments

Morning Headlines 1/10/13

January 9, 2013 Headlines 1 Comment

Primary Care Physician Shortages Could Be Eliminated Through Use Of Teams, Nonphysicians, And Electronic Communication

Analysis from this month’s issue of Heath Affairs concludes that the anticipated primary care physician shortage could be resolved by moving to a team-oriented care model and expanding the use of non-physicians. The study was conducted jointly by Columbia and Wharton Business Schools and included no clinicians on the research team.

Benefits Consulting Firms Form Acclaim Health Analytics, LLC

Consulting firms Peel & Holland, Silberstein Insurance Group, and Virtus Benefits create a jointly owned data analytics company called Acclaim Health Analytics, which aims to aggregate health data to identify actionable health risks.

LifeBridge Health Names Tressa Springmann Chief Information Officer

LifeBridge Health, a Baltimore-based three-hospital health system, names Tressa Springmann as CIO.

Hottest IT jobs are in health care

Healthcare ranked as the fastest growing segment of the IT jobs market in 2012 and looks to repeat in 2013. Insurance and finance also outperformed the overall IT jobs market.

 At CES, staying healthy the high-tech way

The Boston Globe covers the growth of health IT startups representing the industry at this week’s CES tradeshow.

View/Print Text Only View/Print Text Only
January 9, 2013 Headlines 1 Comment

Readers Write 1/9/13

January 9, 2013 Readers Write 3 Comments

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

The views and opinions expressed are those of the authors personally and are not necessarily representative of their current or former employers.


Why Medical Practices Must Manage A/R Better … Now
By Tom Furr

1-9-2013 6-46-10 PM

“I didn’t go to med school to be an accountant.” How many times have we heard those words being muttered from a physician’s mouth?

Until now, that’s been an acceptable sentiment for any doctor. Today such thinking is financially dangerous if not downright disastrous. Even doctors in practice for as little as 10 years kept their focus on the insurance company, the source of 85 to 95 percent of their income. That almost predictable cash flow made reviewing accounts receivable reports — universally known as A/R — barely necessary.

Today, looking at A/R is an absolute requirement because of four letters that are having a huge impact on medical practices of all sizes and types – HDHP, which stands for High Deductible Health Plans.

These insurance plans have sent a loud and clear message to doctors across the United States: the game has changed. Simply stated, those practices that adjust quickly and wisely will be better able to survive. Those that don’t will be at risk of needing to sell out to hospitals or suffer serious issues with cash flow that could threaten the survival of their practices.

According to the annual report of America’s Health Plans, the number of U.S. residents using HDHPs rose nearly 20 percent in the past year. In 2013, 70 percent of larger employers will offer HDHPs, noted a Tower and the National Business Group of Health study. While the growth rate of this type of plan varies from region to region, no practice can think it won’t affect them soon.

The new reality is deductibles as a percent of contracted rates are about 50 percent. The days of the $25 co-pay are gone. Now practices are tasked with securing half the service bill’s balance from the patient. Unfortunately, physicians today don’t know the amount due until weeks after service, making it a priority to get the patient bill out as soon as the claim is adjudicated by the insurance company. That’s especially the case at the start of a calendar or plan year.

No one is suggesting doctors turn in their white coats and stethoscopes for green eye shades and a handful of sharpened pencils. However, they must become more attuned to the state of their practices’ financial condition. If a system is not embedded in their practice management software to manage patient bills and balances as well as produce insightful A/R reports, the doctor and his/her office manager should identify one and put it into place. Even if a new practice management system has just been deployed, that doesn’t mean you don’t need to ask the questions immediately of how to capture patient balances and post them automatically.

In the HDHP environment, everyone in the practice has a role to play, from front desk personnel to physicians. Each member of a practice should be educated on the new reality of HDHPs and how patients understand this new reality. However, it is also the responsibility of the practice to provide patients a simpler way to meet their financial obligations to the practice and continue to keep their healthcare relationships sound. If patients understand and have easy ways to remit payments, the physician keeps a sharp focus on the practice of medicine, secure in the fact that the A/R is being managed.

However, make no mistake, there is a limit on how much delegation a doctor or his/her office manager can allow. The tough calls need to be made by those individuals leading the practice. Decisions of the sort that most medical professionals could never have conceived of during their internships, like “firing” a patient.

Think about it:  with HDHPs, the shift from patient to deadbeat can occur in a matter of weeks if close attention is not paid to A/R.

Tom Furr  is CEO of PatientPay of Durham, NC.


NLP and Physician Workflow: An End to Physician Resistance?
By Chris Tackaberry, MB, ChB

“I hate all the EMRs out there, including the one our practice just bought. Notes that come from an EMR have so much extra stuffing in them that it takes me forever to figure out what you guys really had to say about the patient I referred to you. I have to wade through lines and lines of empty verbiage to finally find a meaningful sentence or two that tells me what I need to know.”

While the promise of the EHR/EMR remains as great as ever for healthcare providers, so too does the issue of physician resistance, as evidenced by this doctor’s comment, part of a conversation highlighted in a MedPageToday online article. Since EHRs came on the scene decades ago, physicians have remained slow to adopt the technology, even with the promise of improved workflow automation, enhanced care quality, rapid data exchange, and increased efficiencies. While the issue of physician resistance is certainly not new, it becomes an ever-more important concern as many hospitals continue to struggle to achieve Meaningful Use requirements.

There may be several reasons why physicians remain slow to come on board, but the most obvious is simply that doctors want to spend their time caring for patients, not struggling to use technology that introduces foreign, cumbersome tasks into their workflow. The truth is, even with today’s best systems, EHR data remains, on the whole, insufficiently descriptive or lacking in clinical context. Complete patient details often reside within historical notes embedded deep inside the EHR, and manually reviewing them for each and every patient, if a physician can access them, is incredibly time consuming and cumbersome.

Even with the technological advancements EHRs have seen over the years, physicians still have to spend tremendous amounts of time describing patient problems, medications, allergies, etc., in cumbersome forms or templates. As my colleague Tielman Van Vleck, PhD, Clinithink’s director of language processing, recently stated: “There is an intrinsic inefficiency in this process because so much of this information must be documented in the clinical notes repeatedly. As a result, there has been significant physician pushback against EHRs, despite their potential to improve both the quality and efficiency of physician-delivered care.”

NLP effectively embedded into an EHR has shown remarkable promise when it comes to minimizing the negative impact EHRs have on physician workflow. Rather than burdening physicians, NLP delivers more efficient and intuitive documentation of patient information in a manner already natural to the traditional physician workflow.

This is an important concern for providers dealing with Meaningful Use requirements, particularly Stage 2 and ICD-10, where capturing patient problem lists with unfamiliar coding terminology is another big deterrent to physicians. The good news is that NLP within an EHR can automatically tag all the problems referenced in a patient note, which in addition to facilitating analytics and clinical decision support not previously possible, can also support the capture of medications and allergies, saving physicians time associated with filling and maintaining these lists.

Physician resistance to EHRs won’t end tomorrow. But with the advent of Natural Language Processing and the manner in which this technology compliments physician workflow and will ultimately improve care quality, the light at the end of the tunnel may be considerably closer. Dr. Van Vleck recently noted, “NLP isn’t just a bigger hammer to build better widgets. If we do this right, we can improve medicine, helping people lead healthier, longer lives; we can simplify healthcare delivery and involve patients more; we can even help researchers make medical discoveries or respond to new diseases. There are a million ways that NLP can be leveraged in healthcare.”

It would seem tough to find a physician who could resist that scenario.

Chris Tackaberry, MB, ChB is CEO of Clinithink of London, England.


Vendor Resolutions for 2013
By Vince Ciotti

I tried to go to the gym today, but couldn’t get in. Too many people making New Year’s resolutions to exercise! So I went back to the office early and wrote this piece on New Year’s resolutions for our top 13 vendors, listed in order of their annual revenue.

  1. McKesson. So big (over $3B in annual revenue) that they made two: (a) find jobs for the 200+ well-paid Horizon veterans they laid off last year, all with 15+ years experience in healthcare, programming, etc., and (b) hire 200+ new employees for the expanded Paragon line, following the Epic model of young, inexperienced, and cheap.
  2. Cerner. Kick Paul Black’s butt.
  3. Siemens. Use the excellent marketing materials and RFP responses for Soarian financials to start the design and programming soon.
  4. Allscripts. Make Neal Patterson sorry he ever let Paul get away.
  5. Epic. Find a NYC bank with a high interest rate on CDs.
  6. GE. Sell something to somebody, somewhere, sometime, somehow …
  7. Meditech. Start the design work on Release 7.
  8. NextGen. Integrate the brochures, proposals, and PowerPoints for Opus, Sphere, and IntraNexus.
  9. CPSI. Sell a large hospital (over 25 beds).
  10. QuadraMed. Take a Quantim leap backwards.
  11. NTT/Keane. Optimize their disparate product lines.
  12. HMS. Get ready for Primus time.
  13. Healthland. Rearrange their various products in Concentriq circles.

Vince Ciotti is a principal with H.I.S. Professionals LLC.


View/Print Text Only View/Print Text Only
January 9, 2013 Readers Write 3 Comments

Founding Sponsors


 

Subscribe to Updates

   

Search


Loading

Tweets

Report News and Rumors

No title

Anonymous online form
E-mail
Rumor line: 801.HIT.NEWS

Archives

Sponsor Quick Links

Platinum Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gold Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Follow

Reader Comments

  • Oxymoron?: I think you mean Redundant! Have you ever been to the User Group Meeting?...
  • morethan insurance: There's certainly a great deal to know about this topic. I love all the points you have made....
  • Mobile Man: What a great interview! I love how he lays it out there. Right on target....
  • a patient too: Allen K - Well said!! Pre-visit price transparency should be at the top of that list. I cant think of how many time...
  • Allen K.: Mr. Biehle makes a lot of good points here, but I think some illustration might be valuable. Dignity and clear communic...

Text Ads