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Readers Write: EHR Ease of Use is Not Easy

February 4, 2015 Readers Write 3 Comments

EHR Ease of Use is Not Easy
By Lee Farabaugh

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Usability shows no signs of losing its luster as a buzzword in health IT. Coverage of a usability collaborative involving the efforts of the Electronic Health Record Association, the American Medical Association (AMA), and the American College of Physicians to improve user-centered design of EHRs in the context of the Meaningful Use program has certainly escalated. I

It’s no secret that EHR usability is, generally-speaking, pretty abysmal. There are standouts in the realm of interface design excellence – think of the award-winning PracticeFusion and athenahealth. But the overwhelming response to EHRs from the physician community is a groundswell of complaints over poor design, longer patient encounters, time-consuming documentation, and slow information retrieval response time.

The AMA recently published an article entitled “Improving Care: Priorities to Improve Electronic Health Record Usability” that identifies eight EHR usability principles, including supporting team-based care, promoting care coordination, and reducing cognitive workload through a user-centered design (UCD) approach. But even the AMA admits that while “some vendors have implemented user-centered design … their results have been inconsistent and many other vendors have not [even] implemented UCD.”

Apparently it’s not as simple as just applying the UCD process of user research, iterative design, and usability testing to the field of EHR design. Mary Kate Foley, VP of user experience at athenahealth, perhaps says it best: “Our industry has been talking about EHRs for years now, and if it were simple to make EHRs easy to use, we’d be done by now.”

EHR interface design is still subject to the design choices of individual interaction, visual, and user experience designers. While we’ve become used to the new flat UI convention on our iPhones, the vast majority of EHRs still look like snapshots from the past. In short, we don’t typically look to EHRs to be on the cutting edge, whether in terms of visual design conventions or adherence to UI design best practices.

The AMA calls for “the development of a common style guide – designed through collaboration between physicians and vendors – so physicians who practice in different care settings can move from one EHR to another.” But it’s not just physicians who stand to benefit. This type of common design framework frees organizations to make changes to their toolset because they don’t have to fear a steep learning curve for providers on a new interface.

How can we as designers support these efforts?

  • Remember that EHR design affects not only physicians, but patients, too. Patient tools, while separate from the EHR itself, both push information to and pull information from the EHR, making patients de facto EHR users by default.
  • Acknowledge existing efforts to reach a common design language in EHR interface design. Juhan Sonin, Jeff Belden, and Catherine Plaisant, among others, have created a nice start towards an EHR style guide for the industry at InspiredEHR.org. Their work includes medication lists, allergy lists, and drug alerts.
  • Continue to push forward with additional design patterns. One area where common design vocabulary is needed is the patient banner. EHRs should employ common conventions for elements such as patient name, gender, date of birth, allergies, etc. that typically appear in this space, and balance information communication with respect for screen real estate.
  • Educate our colleagues in industry about the importance of understanding and designing for the way real humans think and work. In my course on user-centered design for healthcare at UAB’s Masters Program in Health Informatics, my students (nurses, business analysts, and EHR vendors) are learning about how humans process information, think irrationally, and act according to behavior patterns that point the way towards more intuitive design.

EHR usability isn’t easy. It involves a complex interplay of care teams, workflows, the legacy of paper charts, and the promise of a design language we can all speak. But the need is real, and as the focus on “checking the box” for MU fades away, we’ll get down to the real business of not just using EHRs in a meaningful way, but in a delightful way.

Lee Farabaugh is chief experience officer at PointClear Solutions of Atlanta, GA.

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February 4, 2015 Readers Write 3 Comments

News 2/4/15

February 3, 2015 News 5 Comments

Top News

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Cerner completes its $1.3 billion acquisition of Siemens Health Services as announced in August. Cerner reiterated in the announcement that it will continue to support Siemens core systems for an unspecified period, with Soarian maintenance guaranteed for 10 years. Former SHS CEO John Glaser has joined Cerner as SVP and a member of the company’s executive cabinet. Julie Wilson, Cerner’s chief people officer, says Monday was “the biggest single hiring day in Cerner history” as its employee count jumped from 16,000 to 22,000 with the acquisition. CERN shares rose 0.57 percent Monday on the news, giving them a slightly better performance (blue, up 20 percent) than the Nasdaq as a whole (red, up 17 percent) over the past year.


Reader Comments

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From Lemmy: “Re: Athenahealth’s purchase of BIDMC’s WebOMR. Not sure why Athenahealth would be interested – WebOMR is a complete piece of crap being held together with gum.” I mentioned the acquisition in last weekend’s post as a rumor provided by reader InTheKnow, although I left out specific details since ATHN is publicly traded. More discussion follows below – I got details from John Halamka that go well beyond the announcement and invalidate some incorrect assumptions I had.

From Mr. Smith: “Re: national patient identifier. HHS and ONC are prohibited by law from even discussing anything related to an NPI even though they are acutely aware of the challenges posed by not having one. The legislative branch should address the issue, but HHS and ONC are trying to create a workable solution.”


HIStalk Announcements and Requests

Welcome to new HIStalk Gold Sponsor West Corporation and its healthcare practice. The Omaha, NE-based company processes billions of voice-related transactions each year. Its West Engagement Center drives patient engagement, care coordination, and provider collaboration using a variety of technologies (voice, text, email, mobile, contact center). Available solution sets include telehealth, patient access, prevention and wellness, and chronic disease management. It is used by providers, payers, and employers that are transitioning to value-based care, managing populations,  creating chronic disease care coordination programs, or adding patient engagement capability to existing population health management technologies. Sign up for an online tour here. Thanks to West Corporation for supporting HIStalk.

Here’s a YouTube video that shows how patients report their daily blood pressures using the West Engagement Center.

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We’ve received just a handful of requests from real-life patients who want to take advantage of our HIMSS15 conference scholarship ($1,000 in travel cash plus registration). We’re accepting applications through February 9 and will choose the five based on their patient stories and their writing ability. See Regina’s description and send entries to Lorre.


Acquisitions, Funding, Business, and Stock

Athenahealth makes its second recent  push into the inpatient EHR market by acquiring the WebOMR system that was developed by Beth Israel Deaconess Medical Center (MA). Terms were not disclosed. The company will integrate WebOMR with its AthenaNet system. The internal announcement from BIDMC CEO Kevin Tabb says that BIDMC will do a “trial implementation” of “some of athena’s current products” in “select areas of our network.” BIDMC’s only obligation to Athenahealth is to help its engineers understand how WebOMR works “so they can try to expand its use beyond our walls” as “the days of self-built information systems will not last forever.” Athenahealth acquired small-hospital EHR vendor RazorInsights on January 14. Athena shares ended the day up just over 1 percent, the same daily gain as the Nasdaq composite.

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I spoke to BIDMC CIO John Halamka, MD for clarification about the agreement:

  • BIDMC originally developed WebOMR as an ambulatory application, but it has been extended to include all BIDMC-developed automation – a certified inpatient EHR, OR management, oncology, laboratory, radiology, electronic medication administration record, and bedside barcoding. The only external dependency is First Databank for drug information. The only excluded module is the ED information system (which had been previously commercialized as Forerun) and the agreement doesn’t cover billing (which is performed by a McKesson application). BIDMC has done work with Google Glass and Apple Health and those components are included as well.
  • Athenahealth is buying BIDMC’s intellectual property, but it will not use BIDMC’s programming code, which was developed by a 25-member team using Cache’ and Cache’ server pages. Athenahealth will instead rewrite the entire product (or at least the parts they want to commercialize) using their own workflow, user interface, and business logic to create a new platform.
  • BIDMC will not act as Athenahealth’s development partner. What Athenahealth bought for an unstated cash investment is the intellectual property, one BIDMC FTE for two years to help them understand the applications, and access to an alpha site in BID-Needham, which has a 29-bed medical-surgical ward running Meditech (which will not be replaced there).
  • BIDMC gets a 20-year license to use the code that Athenahealth develops, but they do not have to move to Athenahealth’s version and are not precluded from replacing WebOMR with a commercial product, which Halamka says may happen at some point.
  • Halamka estimates that it will take Athenahealth 18 months to rewrite the product.
  • Athenahealth and BIDMC signed two agreements. The first covers the intellectual property as described above. The second is an agreement in which three practices within 38-site BIDMC Healthcare will begin phased implementation of Athenahealth’s ambulatory product, but BIDC has no further obligation to continue or extend the trial beyond those three practices that are participating in the trial.
  • Halamka says in a blog post that BIDMC won’t necessarily choose Athenahealth products when they consider replacing WebOMR since “we are a meritocracy and the best services at the lowest cost will win.” He adds, “Just as Mayo chose Epic to reduce the number of different IT systems, BIDMC will pursue a parsimony solution – the fewest moving parts possible. That might be one vendor, but hopefully it will not be more than two … While we want to continue to innovate, we know that commercial vendors will be able to leverage their knowledge and capabilities to build future platforms at larger scale.”

 

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Cerner rang Nasdaq’s opening bell Tuesday.

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Voalte lays off 25 percent of its staff, or around 40 employees, in a reorganization.

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Canada-based consulting and services vendor Accreon is acquired in a leveraged buyout funded by its management team, its founders, and Mansa Capital. As part of the deal, the company gives up its 49 percent ownership in Velante, which ran a controversial e-heath project in New Brunswick, and turns it over to the other partner, the New Brunswick Medical Society.


Sales

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Yale New Haven Health (CT) chooses Mobile Heartbeat’s clinical communications system.

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Boulder Community Health (CO) chooses Voalte’s smartphone caregiver communication for its newly expanded facility.

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Pocono Medical Center (PA) selects Authentidate’s telehealth solution.


People

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Murray Reicher, MD is named CEO of DR Systems, which he co-founded in 1992. He replaces co-founder Rick Porritt, who has retired.


Announcements and Implementations

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Vancouver, WA-based patient monitoring systems vendor OSTAR launches a cellular network-powered blood pressure monitoring system to reduce CHF readmissions.

Mediware announces CareTend, which combines its home care solutions into a single platform.


Government and Politics

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HHS Secretary Sylvia Burwell announces a $28 million ONC-funded HIE grant program, described as, “Grantees will address interoperability workflow challenges, technical issues, and improve the meaningful use of clinical data from external sources. Providers will be engaged from across the entire care continuum, including those who are not eligible for the Medicare and Medicaid EHR Incentive Programs such as long term care facilities, to be able to send, receive, find, and use health information both within and outside their care delivery systems.”

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ONC requests $92 million for its FY2016 budget, up from $60 million. ONC wants $5 million to establish a Health IT Safety Center that will go live in FY2016.

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This is a great quote from former National Coordinator David Blumenthal, MD, tweeted by ONC annual meeting attendee @PharmDJD: “It is cognitive dissonance to want cutthroat competitive markets but to expect healthcare players to share valuable data.” It would be great if hospitals, retail stores, quick lube stations, and hair salons shared customer information freely for the benefit of their shared customers, but only healthcare providers are being (unsuccessfully) shamed into doing so.

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Health IT equities researcher Jamie Stockton of Wells Fargo Securities provides a slice and dice of CMS’s Meaningful Use Stage 2 data. Hospital attesters included 97 percent of eligible Epic users, 63 percent of Allscripts, and 60 percent of CPSI, with everybody else falling under that number (Medhost and NextGen trailed the pack at under 40 percent). Physician Stage 2 rates were predictably abysmal, with Athenahealth out front at 58 percent and Epic at 26 percent, but vendors such as Allscripts, Greenway, Cerner, NextGen, and McKesson (the latter at 0 percent) having less than 5 percent of users attesting. Obviously it’s dangerous to read too much into the vendor vs. the customer, especially given the mass EP Stage 2 bailout.


Privacy and Security

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Paper records from several New York City hospitals are lost when a Brooklyn document warehouse is destroyed in a seven-alarm fire that scattered charred patient charts over several blocks. Cleanup crews attempted to retrieve partially burned papers that contained patient clinical and financial information. New York City Health and Hospitals Corporation is among the organizations that stored documents in the warehouse, but says that as early EHR adopter, it expects no operational impact.

The creator of PGP encryption software (now owned by Symantec) says the Sony Pictures breach highlights the need for companies to redirect efforts from security to privacy by encrypting emails and documents and retaining less information online. “If you look at all the things that have been developed – firewalls, intrusion detection systems, all these things put in place to protect computers? They haven’t really hit a home run: they keep getting breached. But if you look at the Snowden material, the one thing that does seem to do well is strong encryption. Of all the things you see getting broken into, it’s conspicuously absent from that list … In the 90s, if you were using strong encryption, you’d have to defend yourself and justify what you were doing: ‘What, are you a terrorist or a drug dealer?’ Now, if you aren’t using strong encryption, you have to justify it. You’re a doctor? What do you mean you’re not encrypting your patient records? Or you left your company laptop in a taxi with 2,000 customer names on it? You better hope that data is encrypted or you’re in trouble.”


Other

Researchers at Penn State College of Medicine suggest 10 situations where it would be acceptable for doctors to Google a patient, boiled down to (a) if they suspect the patient is lying to them about their history; (b) if the patient could be a doctor-shopping drug user; and (c) if the patient seems to have the capacity to harm themselves.

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I received the email above from a well-known B2B spammer who apparently got an email list of HIMSS15 exhibitors and is offering to sell a database of full attendee details. The fraud clues are numerous: (a) the email purporting to be from “Tracy Nixon” was clearly not written by a native English speaker; (b) the company’s website is just a placeholder full of “lorem ipsum” text; (c) the domain owner’s name is blocked in its registration records; and (d) clearly a 7,500-record HIMSS conference attendee database is at best incomplete given the 40,000 or so attendees. The same company has scammed companies in other industries by selling them junk lists at high prices and then refusing to give refunds.

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Weird News Andy titles this story “Heaven Scent” and adds that the device should be worth the cost of at least 1,000 Fitbits. A smartphone-powered cancer detection system called the SniffPhone detects the odor of lung cancer on the breath with 90 percent accuracy


Sponsor Updates

  • SyTrue CEO Kyle Silvestro posts “The Secret Life of your Healthcare Data.”
  • Verisk Health’s HEDIS measures are certified by NCQA for 2015.
  • Nordic publishes a blog post titled “Optimizing My Birkie and Your EHR.”
  • Four Medicity HIE customers are named in “Survivor: Edition HIE"–Can Statewide HIEs Achieve Sustainability?”
  • Dan Hamilton, COO of Nor-Lea Hospital District (NM), writes an article titled “Handling the Demands of a Population Boom: Using RTLS to Improve Patient Care and Workflows” about its use of Versus Advantages Clinic RTLS.
  • ADP AdvancedMD asks, “Has the ICD-10 Delay Hurt Provider Preparedness?” in its latest blog.
  • Bottomline Technologies will exhibit at the NAMIC Claims meeting February 10-12 in Phoenix, AZ.
  • Divurgent offers a new white paper entitled, “From the Trenches: Leadership Strategies from the US Navy SEALs Applied to Healthcare.”
  • Clinical Architecture’s Charlie Harp posts the second installment of the company’s blog series on “The Road to Precision Medicine.”
  • Caradigm will exhibit at the iHT2 Health IT Summit February 10-11 in Miami.
  • Matt Patterson, MD asks “What stage of Meaningful interoperability are you?” in the latest AirStrip blog.
  • CareTech Solutions will exhibit at the Health Forum Annual Rural Health Care Leadership Conference February 8-11 in Phoenix.
  • Amber Harner blogs about her trip to Costa Rica to help build houses with Habitat for Humanity, courtesy of the CoverMyMeds 2014 CoverMyQuest competition.
  • Michael Passanante writes about the physician’s role in lowering hospital readmission rates in the latest Besler Consulting blog.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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February 3, 2015 News 5 Comments

Morning Headlines 2/3/15

February 2, 2015 Headlines No Comments

Cerner Completes Acquisition of Siemens Health Services

Cerner announces the completion of its acquisition of Siemens Health Services. The new merged organization has a combined customer base of 21,000 facilities and an annual R&D budget of $650 million.

Community Health Systems Professional Services Corporation and Three Affiliated New Mexico Hospitals to Pay $75 Million to Settle False Claims Act Allegations

For-profit hospital chain Community Health Systems will pay $75 million to settle False Claims Act charges with the DOJ. Three New Mexico hospitals are accused of making illegal donations to county governments. The funds were used to pay the state’s share of Medicaid payments to the accused hospitals, in an effort to drive up local spending and take advantage of a federal program that reimbursed New Mexico $0.75 for ever dollar spent on rural Medicaid services.

ONC Annual Meeting, February 2 – 3

ONC’s Annual Meeting kicked off in Washington DC today. Tomorrow morning Karen DeSalvo, MD will join the former National Coordinators for an hour long round table on the state of the HIT nation.

Cost Comparison Between Home Telemonitoring and Usual Care of Older Adults: A Randomized Trial

Researcher compare the total cost of care for 205 patients over the age of 60 and find that, over the course of a 12-month period, traditional care costs the same as care supplemented with remote patient monitoring services.

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February 2, 2015 Headlines No Comments

Cerner Closes Siemens Acquisition

February 2, 2015 News 4 Comments

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Cerner announced this morning that it has completed its $1.3 billion acquisition of Siemens Health Services as announced in August.

Cerner Chairman and CEO Neal Patterson said in a statement, “"By combining client bases, investments in R&D, and associates, we are in a great position to lead clients through one of the most dynamic eras in healthcare. Cerner remains focused on key development areas including population health, physician experience, open platforms, revenue cycle, and mobility. We see these as critical areas of investment to ensure providers can meet growing regulatory demands and control costs, while continuing to improve quality of care."

Cerner says its 2015 revenue will be around $5 billion, its employee count has increased to 21,000, and its annualized research and development expense will be $650 million.

Cerner reiterated in the announcement that it will continue to support Siemens core systems for an unspecified period, with Soarian maintenance guaranteed for 10 years. Former SHS CEO John Glaser has joined Cerner as SVP and a member of the company’s executive cabinet.

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February 2, 2015 News 4 Comments

Morning Headlines 2/2/15

February 1, 2015 Headlines No Comments

Interoperability Roadmap

ONC publishes a draft version of its 10-year interoperability roadmap. The 166-page document outlines a plan for deploying and maintaining an API-based interoperability framework over the next 10 years.

White House Details ‘Precision Medicine’ Initiative

President Obama’s recently announced Precision Medicine Initiative will send $5 million to ONC to develop an interoperability framework and data exchange standards.

CPSI Announces Fourth Quarter and Year-End 2014 Results and 2015 Guidance

CPSI announces Q4 and year-end results: revenue down 10 percent to $46.3 for the quarter and $204 million for the year, EPS $0.60 vs. $0.90. Share prices dropped 16 percent on the news.

Some Maine hospitals can predict your next trip to the ER: Here’s how

A local paper covers the population health analytics tool that Maine’s HIE HealthInfoNet is using to predict which patients are trending toward a stroke, heart attack, hospital admission, or ED visit.

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February 1, 2015 Headlines No Comments

Monday Morning Update 2/2/15

February 1, 2015 News 9 Comments

Top News

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ONC publishes a draft version of its 10-year interoperability roadmap that includes a short-term goal of taking actions that “will enable a majority of individuals and providers across the care continuum to send, receive, find, and use a common set of electronic clinical information at the nationwide level by the end of 2017.” ONC wants to create a governance framework to address the rules of the road for interoperability, improve interoperability standards, use “policy and funding levers” to reward organizations that share data, and clarify that HIPAA requirements don’t stand in the way of interoperability.

A significant portion of the plan addresses patient empowerment, such as the ability to download  health information and contribute information to the EHR. It says providers should offer online scheduling, refill requests, telehealth visits, incorporation of wearables data and patient-defined goals of care into the EHR, and shared care planning. ONC also proposes to write policies for “identifying and addressing bad actors” that don’t comply with interoperability guidelines. Public comments are being accepted through April 3.


Reader Comments

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From InTheKnow: “Re: [vendor name omitted]. Will announce Monday a strategic partnership with Beth Israel Deaconess Medical Center in Boston which involves their co-development of BIDMC’s homegrown WebOMR. In addition, BIDMC will implement the company’s products.” Unverified. I left out the vendor’s name for reasons that will become apparent should the rumor turn out to be true. WebOMR provides clinical results viewing, notes, problems, medications, order entry, patient lists, and integration with external references. Commercializing hospital-built systems of this scope usually fails, as McKesson can attest given its impending retirement of Horizon Expert Orders, a kludged, quick-to-market version of Vanderbilt’s WizOrder. Vendors usually discover that the product works well for the health system that wrote it, but contains odd technology dependencies and has hard-coded connections to other systems that have to be stripped out while not crippling the core product. BIDMC commercialized its ED software in 2006 under the company name Forerun, about which I’ve heard nothing for several years. Update: a second reliable source says the deal will indeed happen. There will be a lot to talk about once it’s announced.

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From HIT Pundit: “Re: ONC’s interoperability roadmap. I predict that the 2017 provider implementation date will be pushed out because of one impossible hurdle it doesn’t address: creating a unique national patient identifier. ONC wants providers to accomplish what Congress refused to deal with through a Rube Goldberg process of virtual and probabilistic patient ID methods and then measure for each provider via the Meaningful Use program the percent accuracy rate for proper patient identification. If our government was willing to deal with this ID issue head on, we could have true interop in six months. My suggestion is this: if a person wants a true health record with coast-to-coast portability, they agree to subscribe to a unique ID. If they want to maintain privacy, they opt out.” I like the idea since Congress refuses to consider a mandatory national patient ID. The government could offer a voluntary, secure patient ID number and then let providers do the job of selling its benefit to their patients.

From Katy Petri: “Re: Sunquest. Laid off 40 people on Friday.” Unverified by the company, but I was given some of the specific names.


HIStalk Announcements and Requests

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Twelve percent of poll respondents plan to buy a smart watch in the next year, with two-thirds of those expecting to own an Apple Watch. On the other hand, I recall my 2010 poll in which only 30 percent of respondents said the iPad would have healthcare impact, so I won’t underestimate Apple’s envy-creating marketing. New poll to your right or here: should the federal government issue a national patient identifier? Vote and then click the “comments” link on the poll to explain your position.

I’m getting a lot of inquiries about HIStalkapalooza. I haven’t opened up the “I want to come” page yet since I’m waiting to have a graphic designed. I decided to control the event myself this year, so I had to sign a contract with the House of Blues and the amazing Party on the Moon band way back in the spring before someone else booked the venue, meaning I was personally liable for $150,000 worth of expense (which covers only the HOB’s minimum buy-out charge and the band) without any guarantee that sponsors would step forward. I’m relieved that some great companies that I’ll highlight shortly are supporting the event, which means that, (a) I hopefully won’t go broke after all, and (b) I’ll be able to invite more people.

I don’t follow many people on Twitter, but I’m starting to unfollow those who: (a) post local weather and police updates; (b) share their couch-based hero worship of athletic teams and participants; and (c) live tweet events that didn’t interest me in the first place. Maybe Twitterers should have two accounts (one personal, one professional) or Twitter should add categories that could be suppressed by people looking for health IT insight rather than fervent sports victory prayers.


Last Week’s Most Interesting News

  • CMS announces plans to reduce the 2015 Meaningful Use reporting period from 365 days to 90 days.
  • ONC releases new Meaningful Use Stage 2 numbers that show only 15 percent of eligible EPs have attested as the deadline draws near.
  • Several large health systems collectively agree to move 75 percent of their business to value-based payment by 2020.
  • HHS announces that it expects to tie 30 percent of Medicare payments to alternative payment models by 2016.
  • The OpenNotes project announces pilot sites for its next phase, OurNotes, in which patients can add their own notes to the electronic chart.

Acquisitions, Funding, Business, and Stock

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Surescripts will spin off its population health business into a separate company that will operate under the Kryptiq name. Surescripts acquired Kryptiq in 2012 and will keep its secure messaging, e-prescribing, and portal technologies. Surescripts will maintain a minority ownership position in Kryptiq, which will be run by the former Kryptiq management team.

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CPSI announces Q4 results: revenue down 10 percent, EPS $0.60 vs. $0.90, sending shares down 16 percent as the Nasdaq’s fourth-largest percentage loser for Friday. Above is the one-year price chart of CPSI (blue, down 26 percent) vs. the Nasdaq (red, up 13 percent). The company said in the earnings call that hospital EHR penetration is close to 100 percent and sales will have to come from displacements, also showing some concern about increased competition from Epic in the small-hospital market and Athenahealth’s acquisition of RazorInsights. Chairman and CFO David Dye said when pressed by stock analysts to consider reducing headcount in response to lower sales, “We’ve never had any layoffs in the history of the company … we will continue to always think long-term … we’re a hell of a long way from thinking about anything like that.” 

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Orion Health shares drop on lower than expected sales that the company blames on the “iPhone 6 effect” as its customers wait for new product announcements in April. Orion Health’s shares, which are listed on New Zealand’s NZX, are trading below their November IPO price.


People

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Omer Awan (Memorial Hermann Health System) is named VP/senior regional CIO of Eastern Maine Healthcare.


Announcements and Implementations

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Drug maker Roche will use Qualcomm Life’s medical device data capture network to connect chronic disease patients with their providers.


Government and Politics

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New York legislators propose a one-year delay in implementing the I-STOP law that requires all prescriptions to be transmitted electronically by March 27, 2015, saying that the DEA moved too slowly in certifying vendors to transmit controlled substance prescriptions.

President Obama will propose a $215 million precision medicine initiative that includes $5 million for ONC to develop interoperability standards and privacy requirements for secure data exchange.

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The FCC leaves no doubt that it is seriously angry at Marriott for trying to force its hotel guests to buy its Wi-Fi service by blocking their personal hotspots. Marriott had to pay $600,000 to settle with the FCC, but still brazenly pushed the agency to rule whether hotspot-blocking is illegal. The FCC’s response was abundantly clear.


Technology

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Several hospitals are installing  Sky Factory photo or video technologies in walls or ceilings to provide a relaxing, nature-like view even in basement rooms. I almost rigged something similar years ago for my office in the hospital basement, where I was going to mount an LED monitor in a window-like frame and pipe in video from a outside webcam.

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A Maine newspaper covers the use of predictive analytics to identify people likely to require an ED visit to support early intervention. The program is run by HealthInfoNet, which collects EHR data from 32 of the state’s 36 hospitals and 300 outpatient facilities. The software and algorithms provided by HBI Solutions, which was founded by former Eclipsys executives and clinicians from Stanford University, logged a 74 percent accuracy rate in predicting ED visits.


Other

Weird News Andy asks, “Who you gonna call?” in referring to a decision by one of England’s NHS trusts to ration its overloaded ambulance service by downgrading 999 calls (their equivalent of 911) from patients known to be terminally ill or who had signed “do not resuscitate” requests. The since-rescinded policy was in effect for two months, during which time 57 patients died after their emergency calls were changed to low priority.


Sponsor Updates

  • TeraMedica’s Evercore VNA is named a KLAS category leader in “VNA/Image Archive.”
  • Victor Lee, MD writes about “Health IT and Care Coordination” in a Zynx Health blog post.
  • ZirMed will exhibit at the 2015 Combined Sections Meeting of the American Physician Therapy Association February 4-7 in Indianapolis.
  • Huron Consulting employees logged over 5,500 hours of service and participated in more than 100 philanthropic events in 2014.
  • Voalte Technical Writer Ashley Murphy asks “Is There a Voalte Solution for First-Time Parents?” in the latest company blog.
  • Verisk Health features “Three Questions for the CMS Star Ratings Expert” Melanie Richey in its latest blog.
  • Forbes interviews TransUnion Senior VP Julie Springer about the company’s new brand launch.
  • TeleTracking Technologies VP/GM Josh Poshywak writes about fighting infection with RTLS for Health Management Technology.
  • Stella Technology expands its corporate headquarters in a move to Sunnyvale, CA.
  • Sentry Data Systems will exhibit at the 340B Coalition Winter Conference February 4-6 in San Francisco.
  • Amy Krane recaps how Partners Healthcare eliminated prior authorization using Qpid Health technology.
  • Nordic wraps up its “I Heart Cupid” video series on Epic’s cardiovascular information system.
  • MEA/NEA’s Lindy Benton writes about the “Return of the RACs.”
  • The New York eHealth Collaborative will participate in the eHealth Initiative 2015 Annual Conference & Members Meeting February 3-5 in Washington, DC.
  • Patientco Marketing Specialist Patrick Creagh offers “7 Things You Need to Know About Your Patient Payments.”
  • Porter Research President Cynthia Porter offers insight into “Thought Leadership and Credibility Content in Healthcare B2B.”
  • PMD offers “PQRS Solutions for the New Year.”
  • Nvoq offers SayIt 9.3 with new features that simplify use and enhance organizational productivity.
  • Passport Health will exhibit at the Athenahealth Marketplace Fair February 3-4 in Boston.
  • Orion Health EVP of Healthier Populations David Bennett shares his thoughts on population health
  • Navicure’s Jeff Wood covers “How Answering Patient Questions can Boost Your Practice’s Revenue.”
  • The local business paper highlights the success Lexmark has had since acquiring Perceptive Software.
  • NTT Data opens an operations center in Bangalore, India.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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February 1, 2015 News 9 Comments

Morning Headlines 1/30/15

January 29, 2015 Headlines 3 Comments

CMS intends to modify requirements for Meaningful Use

Following months of growing pressure from industry groups, CMS announces that it will reduce the 2015 Meaningful Use reporting period for from 365-days to 90-days.

Best in KLAS & Category Leaders 2014

KLAS publishes its annual “Best in KLAS” awards, with Epic winning top spot for: Acute Care EMR, Ambulatory care for practices over 10 providers, HIE, LIS, Billing, Surgery Management, and Patient Portal. MEDITECH 6.0 wins Best in KLAS for community hospital EHRs, and Wellsoft wins best stand-alone EDIS.

This Medical Supercomputer Isn’t a Pacemaker, IBM Tells Congress

IBM has been lobbying Congress to push the newly introduced 21st Century Cures bill through to ensure that its Watson supercomputer is protected from FDA oversight.

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January 29, 2015 Headlines 3 Comments

News 1/30/15

January 29, 2015 News 7 Comments

Top News

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CMS announces plans to shorten the 2015 EHR reporting period to 90 days and to change hospital reporting to be calendar year in a new rule it expects to be approved in spring 2015.


Reader Comments

From Information Dirt Road: “Re: Practice Fusion. Earlier this month they interfered with all lab results traffic during peak business hours and now are having another outage. All who work with PF are cursed by the absurd spectacle of PF being the clueless center of their own special universe.” They have a scheduled weekly maintenance window of Thursdays from 9 p.m. to 1 a.m. Pacific, which seems sensible to me. I followed the link to their EHR status page, which appears to be rarely updated.

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From HIS Junkie: “Re: HX360. I thought this was supposed to get people going on a new interoperability phase of HIT, but HIMSS has created a new meeting program for it right in the middle of its conference. It’s amazing how fast HIMSS jumped on this to make another buck.” I’m not a fan of co-located conferences, but you can watch a just-posted interview with HX360 CEO Roy Smythe, MD for more on what they’re doing. The HX360 exhibit hall is included with normal HIMSS15 registration, the full track is an extra $225, and the executive sessions are invitation-only.   

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From Deli Meat: “Re: electronic signature pads. Thanks for an amazing website. We are trying to reach Topaz Systems about problems with their signature pads that we use in registration with Epic. Emails are bouncing, phone calls aren’t returned, and their website seems to be down. Please assist with any insider information you may have.” The website is up for me and I got a live salesperson when I called their number, so I passed along your email address and said you needed help as a live customer.


HIStalk Announcements and Requests

I forgot to include a link to the the now-separate Dr. Jayne post in the email update, but it’s right here.

If your company sponsors HIStalk and didn’t receive our email in which we’re taking RSVPs for our HIMSS sponsor networking event and collecting information for our HIMSS guide, contact Lorre. Sometimes the information we have for contacts is incorrect or even missing entirely.

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We’re still accepting applications through February 9 from real patients who want to attend the HIMSS conference with a $1,000 scholarship and registration provided. These are for non-healthcare IT folks who have a compelling patient story to tell and who want to attend the HIMSS conference and write about their experiences on HIStalk afterward. Email Lorre with your story and why you want to attend – we’ll judge on both motivation and writing ability.

This week on HIStalk Practice: Telehealth takes over the headlines, with state licensing issues and vendor compliance making the news. GE Ventures looks to HIT to the potential tune of $40 million. Community Eye Center Optometry goes with VersaSuite. Doximity offers interactive physician salary data by state. Premedex launches new chronic care management solution for physician practices. Clinicient secures $7 million. Customer satisfaction with government services reaches a new low. Google Fiber heads southeast.

This week on HIStalk Connect: Google partners with Biogen Idec in a multi-year project focused on researching multiple sclerosis. The FDA approves the first smartphone-connected continuous glucose monitors, technology that diabetics have been demanding for years. Researchers from the University of Pennsylvania find that Twitter data analytics can be used to create highly accurate maps depicting the prevalence of heart failure at the county level. 

Welcome to new HIStalk Gold Sponsor CenterX. The Madison, WI company’s next-generation e-prescribing network improves medication adherence by closing the physician-pharmacist loop. It offers enterprise medication authorization, formulary management, pharmacy benefit eligibility, and medication profiles. Doctors are notified when the prescription is picked up and flat rate pricing eliminates the per-transaction penalty that discourages communication. Physicians benefit from electronic refill requests and automated prior authorization. Only about 40 percent of patients nationally pick up their prescriptions and use them correctly, but CenterX users have up to 90 percent adherence. The company just announced that it has fully integrated its Enterprise Medication Authorization solution with Epic. Thanks to CenterX for supporting HIStalk.


Acquisitions, Funding, Business, and Stock

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Lexmark turns in anemic Q4 results, but its Perceptive Software business books a solid quarter.


Sales

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Penebscot Community Health Care (ME) chooses Forward Health Group’s PopulationManager and The Guideline Advantage.

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St. Joseph Health (CA) selects Clinical Architecture’s Symedical for terminology management, semantic normalization, and interoperability.


People

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St. Tammany Parish Hospital (LA) promotes Craig Doyle to VP/CIO.

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Impact Advisors promotes Jenny McCaskey to VP.

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Richard Holada (IBM) joins Truven Health Analytics as chief data and technology officer.


Announcements and Implementations

First Databank announces GA of FDB Cloud Connector, an Amazon Web Services-powered web API solution that reduces development time and IT overheard required to deliver FDB’s drug knowledge. Meditech was an early adopter, and interestingly, the company mentions that future pharmacogenomics decision support may be impractical to deliver by traditional means.

Medsphere announces OpenVista Population Health, a Windows-based enhancement developed by the Indian Health Service for its RPMS ambulatory EHR version of the VA’s VistA. The company signed a $15 million contract in 2011 to support and enhance RPMS.

Epic wins Best in KLAS 2014 for overall software suite, acute care EMR, HIE, patient accounting, patient portal, surgery management. Epic Beaker beats the best-of-breed LISs as the #1 lab system (although one might argue that Epic Care Everywhere as the #1 HIE is equally surprising). Epic also wins best physician practice vendor and several EHR/PM categories. Athenahealth wins for practice management in the two larger practice size categories (11 docs and up), while Impact Advisors takes the top spot in overall IT services and clinical implementation principal.


Government and Politics

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New ONC Meaningful Use Stage 2 numbers show that 88 percent of hospitals that are MUS2 eligible have attested so far with an April 2015 due date, with 25 percent of those using the Flexibility Rule. EP attestations are much less robust, with only 15 percent of MUS2 eligible providers attesting so far with a February 28 due date and nearly half of those using the Flexibility Rule.


Privacy and Security

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The psychologist who pioneered the study of facial expressions in the 1970s fears that companies will use his work to infringe on privacy. Software can measure consumer reaction to ads, but is being extended to detect shoplifters and to interrogate suspects, leading him to worry that facial expression algorithms will be used in public spaces without consent. On a positive note, the technology is being testing for measuring post-operative pain and to detect stress levels.


Technology

A New York Times editorial by a Mayo Clinic anesthesiologist warns that despite President Obama’s call for heavily funded research for precision medicine, it won’t make most people healthier. He says that genes can’t predict the most common and expensive chronic diseases, but we can already do that with simple tests, while the treatment is decidedly non-technical: eat better, exercise more, and don’t smoke. He concludes that “moonshot medical research initiatives” such as the “war on cancer” usually fail and that efforts would be better directed to studying human behavior.

Bloomberg Business says IBM has lobbied Congress for two years to pass the 21st Century Cures bill that would keep Watson-powered medical capabilities free of FDA oversight. The bill, which also includes the Software Act and addresses several health IT issues, was drafted by the House Energy & Commerce Committee, whose Democrat members just pulled their support of the bill.

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AliveCor’s smartphone-powered heart monitor earns FDA approval for new algorithms that assess an ECG as normal and that warn users that interference makes the ECG unreliable. The just-introduced third generation model costs $75, creates readings from a two-finger touch, and includes an algorithm to detect atrial fibrillation.


Other

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A group of health systems – including Advocate, Ascension, Atrius, Dartmouth-Hitchcock, Dignity, OSF, Partners, Providence, and SSM — and other healthcare players unite under the name Health Care Transformation Task Force in committing to put 75 percent of their business into value-based payments by 2020.

A NEJM study suggests that while the Affordable Care Act prohibits insurance companies from excluding coverage for pre-existing conditions, they may be using high drug co-pays to keep people with expensive diseases such as HIV from signing up in the first place.

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The bonds of Einstein Healthcare (PA) are downgraded due to financial losses that are partly attributed to a drop in employee productivity caused by its Cerner EHR.

Massachusetts General Hospital (MA) used telemedicine virtual visits during the recent snowstorm when clinics closed.

A physician’s editorial in NEJM called “Death Takes a Weekend” ponders the age-old question of why — in this age of high-acuity admissions and fast discharges — hospital services shut down on weekends. “It seemed callous on the hospital’s part — expecting very sick patients and very worried family members to understand that the doctors’ convenience had to come first. They need the weekend off, so you’ll have to wait till Monday. Even in good hospitals, weekends had a decidedly makeshift feel, with a constant refrain of ‘I’m just cross-covering, we’re short-staffed, the person you need will be here Monday.’”

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Weird News Andy researches scam online medical journals that charge authors to publish their work. A doctor tests their editorial review process by submitting an article composed of randomly generated phrases titled “Cuckoo for Cocoa Puffs?” with primary authors Pinkerton LeBrain and Orson Welles. Seventeen of 37 journals accepted it within the first two weeks and offered to publish it upon submission of a processing fee. One of the journals shares an address with a strip club. I checked out Global Science Research Journals, which publishes dozens of journals such as “Global Journal of Neurology and Neurosurgery” and “Global Journal of Pediatrics” and charges a $500 per article fee. The Nigeria-based publisher’s US office is in a Brooklyn apartment.

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Another WNA find he calls “My Doctor the Car”: Mississippi’s medical board investigates an 88-year-old doctor whose practice consists only of house calls, saying they don’t like the idea that he writes prescriptions from his 2007 Camry. In the TV station video, a guy walks right up to the car window to explain his medical issues. WNA proposes a solution: he should upgrade to an RV.


Sponsor Updates

  • Named as KLAS Category Leaders for 2014 are Sentry (340B management inpatient), SIS (anesthesia), Merge (cardiology hemodynamics), Zynx Health (CDS care plans), Wolters Kluwer (CDS order sets), Premier (CDS surveillance), Optum (computer-assisted coding), Strata Decision (decision support business), Emdeon (eligibility enrollment), NextGate (EMPI), Allscripts (global acute EMR, Northern America), Encore (go-live support), GetWellNetwork (interactive patient systems), Capsule (medical device integration), Nuance (medical records coding, quality management), Ingenious Med (mobile data systems), Nordic (other implementation), TeleTracking (patient flow), Iatric Systems (patient privacy monitoring), Craneware (revenue cycle charge capture), SSI Group (revenue cycle claims management), and GE Healthcare (staff/nurse scheduling, time and attendance).
  • Named Best in KLAS 2014 are Merge (cardiology), ZirMed (claims and clearinghouse), Impact Advisors (overall IT services, clinical implementation principal), Wellsoft (emergency department), Streamline Health (enterprise scheduling), McKesson (ERP), Allscripts (global acute EMR), CareTech Solutions (IT outsourcing extensive), Orchestrate Healthcare (technical services).
  • Logicworks publishes the eighth installment in its DevOps Automation series, entitled, “Improving the End User Experience with Amazon Web Services.”
  • Orion Health earns accreditation as a HISP.
  • William Seay of Lifepoint Informatics writes a new blog entitled, “Get Your Laboratory & Anatomic Pathology Results in Real-Time, When You Want, How You Want & Where You Want.”
  • LifeImage’s Mike Murphy blogs about saving time, increasing referrals, and improving orthopedic patient care via medical image sharing.
  • PDR will exhibit at the NACDS Regional Chain meeting in Naples, Florida on February 2-4.
  • Ivenix Medical Advisor and anesthesiologist Matt Weinger, MD shares his views on infusion pump technology at the Association for the Advancement of Medical Instrumentation’s blog.
  • Kathleen Aller writes about looking for meaning in mounds of data in the latest InterSystems blog.
  • HealthMEDX offers insight into its full EHR implementation at Lexington Health System (KY).
  • Jim Blanchet, associate management consultant at Greencastle, blogs about “The Valley of Despair” and asking yourself the right questions.
  • The HCI Group offers five tips on meeting the ICD-10 implementation deadline.
  • Pepper McCormick writes about the four healthcare trends that will shape 2015 in the latest Healthwise blog.
  • Greythorn will exhibit at this weekend’s Geek Wire Startup Day in Seattle.
  • Health IT Outcomes profiles e-MDs and its work to exchange provider data directly with the new Kansas infectious disease registry.
  • DocuSign announces that over 50 million people in 188 countries now use its technology.
  • The Healthfinch team offers a new blog on healthcare IT assumptions versus reality.
  • Cynthia Ethier of Hayes Management Consulting offers advice on how to create an ACA front desk.
  • HDS takes a look at the growing phenomenon of walk-in clinics at local malls in its latest blog.
  • Ingenious Med Mobile Product Manager Brannon Gillis posts a new blog entitled, “Useful and Usable: Basic Mobile Development Philosophy in Action.”
  • ICSA Labs participates in the IHE North America Connectathon today in Cleveland.
  • Extension Healthcare will exhibit at the Association of California Nurse Leaders Conference in Anaheim from February 1-4.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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January 29, 2015 News 7 Comments

EPtalk by Dr. Jayne 1/29/15

January 29, 2015 Dr. Jayne No Comments

The physician lounge was buzzing this morning with discussion of HHS secretary Sylvia Burwell’s newly-announced goals for the Medicare program. The plan is to move 90 percent of Medicare fee-for-service (FFS) payments to a quality-based system by 2018 and to move 50 percent of FFS payments into “value-based alternative payment models” on the same timetable.

Although we’re pretty far along with the quality-based payments, we’re nowhere near that far with alternative models (such as ACOs). When you consider the number of providers who have failed to join (or dropped out of) ACO programs, that’s a pretty audacious goal. The general tone among my colleagues is this: they’re supportive of quality, but would like to see other institutions (especially the Medicare and Medicaid bureaucracies and Healthcare.gov) held to the same standards.

I didn’t watch the State of the Union Address to hear about the President’s “Precision Medicine Initiative” but have been asked a couple of times what I think about it. Although it is very sexy, precision medicine is also very expensive. I surfed around for some quote from the Address and the Initiative purports “to give all of us access to the personalized information we need to keep ourselves and our families healthier.” It reminds me a little of end users who refuse to use the EHR because it doesn’t have one sexy feature or another. I have to talk them into using it to get the benefits it actually has rather than worry about what it doesn’t have. We need to figure out how to better encourage patients to take advantage of the general (but very effective as well as inexpensive) medicine advice we already have: eat less, move more, make healthy choices. Alas, daily exercise and delayed gratification aren’t as exciting as the idea that technology will fix all that ails us.

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As a CMIO, I spend a fair amount of time listening to what physicians don’t like about our software. It’s always interesting when we perform an upgrade, and while some users like it, others consider it a “downgrade.” Sometimes the complaining is justified, but it always feels more acute when it’s a problem with the EHR rather than consumer software. I was interested to see a software firm other than Microsoft or Yahoo make a blunder recently. Intuit is under fire for realigning the features of its popular TurboTax product. Since I’ve already spent a couple of hours this week preparing all my documentation, I’m glad I saw this letter to customers that explained that the version many of us have used for years will no longer meet our needs. They’re trying to make it up to users with a $25 rebate. That’s about 50 percent of the purchase price of the version in question. Extrapolate it for what we pay for medical software and that could get interesting for a vendor who wanted to make good on a dodgy software release.

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Speaking of vendors, I have a couple of physician friends who work in the vendor space. If you’ve ever wondered why they’re not spending all their time creating usable new features that physicians need and want, take a look at the test procedures they have to follow in order to get the product certified. If you’ve never seen them, let’s just say they make CMS billing regulations look like a pre-K reader.

Researchers at the University of Pennsylvania have harnessed Twitter to predict rates of coronary heart disease. Analyzing the content of tweets by county, “they found that expressions of negative emotions such as anger, stress, and fatigue in a county’s tweets were associated with higher heart disease risk.” Although there is no expectation of privacy when using Twitter, I couldn’t help but think about the documentation needed to do this kind of human studies research. Maybe Twitter should add something about it to their terms of service.

Another interesting twist on their work is the comment by one researcher that, “You’ll never get the psychological richness that comes with the infinite variables of what language people choose to use.” This is exactly what EHR-using physicians have been saying for years – that it’s impossible to get the “flavor” of the patient’s story through checkboxes and templates. I’m looking forward to the day when I can go back to dictating my notes and letting voice recognition and natural language processing do the heavy lifting of turning it into something appropriate for coding, billing, and interoperability.

The research team has experience with linguistic analysis, showing it can be as effective as questionnaires in assessing personality characteristics. I hope they’re not looking at my tweets, because given their recent infrequent nature, they would likely determine that I’ve become reclusive.

What does your Twitter history say about your personality? Email me.

Email Dr. Jayne.

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January 29, 2015 Dr. Jayne No Comments

Morning Headlines 1/29/15

January 28, 2015 Headlines 2 Comments

Major Health Care Players Unite to Accelerate Transformation of US Health Care System

A large group of private health care systems and payers have formed a coalition with a goal of migrating 75 percent of their business to value-based arrangements by 2020. Called “The Health Care Transformation Task Force,” the new organization is comprised of 16 health systems, including: Ascension Health, Dignity Health, and Partners Healthcare.

Internet of Things: Privacy & Security in a Connected World

The FTC is taking flack over recommendations made in a new data security report that addresses the coming “Internet of Things.” The report calls for updates to HIPAA that would expand its consumer protection standards to apply to any consumer-facing products that capture patient health data. The report also champions the notion of data minimization, the idea that businesses should redesign their processes with the goal of capturing and retaining less data, an idea with few fans in healthcare.

Data Analytics Update: Health IT Standards Committee Meeting

During yesterday’s HIT Standards Committee meeting, ONC reported that only 15 percent of eligible professionals scheduled to attest for Stage 2 MU have done so. Further, nearly half counted among the 15 percent that have successfully attested did so by securing a hardship exemption.

Committee releases to-do list to help medical industry

A group of bipartisan lawmakers introduced a 400-page draft proposal titled  “21st Century Cures” which would cut red tape from FDA approval processes, increase access to telemedicine, and invest in research to improve the security of medical devices.

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January 28, 2015 Headlines 2 Comments

News 1/28/15

January 27, 2015 News 8 Comments

Top News

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HHS Secretary Sylvia Burwell announces an ambitious plan to tie 30 percent of Medicare provider payments to alternative payment models by 2016 and 50 percent by 2018, and also to link 85 percent of Medicare fee-for-service payments to quality and value by 2016. The announcement was received positively, although with guarded enthusiasm due to the lack of details and the mixed results of early adopters.


Reader Comments

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From Nihilist: “Re: BJC. Rumor is that the Epic install will be run out of a yet-unnamed holding company as a partnership with Washington University School of Medicine, which employees the academic hospital faculty. That’s why no job postings have appeared.” Unverified.


Acquisitions, Funding, Business, and Stock

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Huron Consulting will acquire Pensacola, FL-based, healthcare leadership consulting firm Studer Group for $325 million. The 235-employee company was founded by former hospital CEO and author Quint Studer in 1999 and was reported to have had 2013 revenue of $67 million.

China-based Alibaba Group, one of the world’s most valuable technology companies, partners with a medical software company to develop cloud-based services for physician practice, payment systems, e-prescribing, and drug tracking.

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Roper Industries reports Q4 results: revenue up 7 percent, adjusted EPS $1.85 vs. $1.65, falling short on revenue expectations but beating on earnings. Chairman, President, and CEO Brian Jellison says the company will be making at least one more Q1 acquisition that relates to its Sunquest business. He adds that Roper paid $140 million for Strata Decision Technologies, which has $30 million in annual revenue, but Roper gets an immediate $40 million in tax benefit because the company was operating as a limited liability corporation.


Sales

Eastern Idaho IPA chooses Valence Health’s vElect contract administration system to allow physicians to compare fee schedules to Medicare benchmarks in selecting and declining payer contracts.

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Two hospitals in Dubai will use Oneview Healthcare’s interactive patient engagement and clinical workflow system.  

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University Medical Center Health System (TX) extends its agreement with Cerner.

MedConnect chooses clinical interface terminology from Intelligent Medical Objects for its EHR.


People

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Biotechnology company Biogen Idec hires Naomi Fried, PhD (Boston Children’s Hospital) as VP of medical information, innovation, and external partnerships. She was Kaiser Permanente’s VP of innovation and advanced technology from 2006 to 2009.


Announcements and Implementations

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Georgia’s GRAChie HIE – founded by Cerner, GRHealth, and Navicent Health — reports increased numbers of data sources and system usage.

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The DEA approves EHNAC as the sole certifier of applications for electronic prescribing of controlled substances.

The Anesthesia Quality Institute recognizes Shareable Ink’s newly released ShareQuality mobile quality capture product as Quality Clinical Data Registry ready, allowing practices to use CMS’s preferred reporting mechanism.

CoverMyMeds announces that its electronic prior authorization system has been integrated with Epic.

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Decisio Health earns FDA marketing approval for its EHR-powered bedside clinical decision support and triage dashboard that was beta-tested by Memorial Hermann Hospital (TX).  

The Apple Watch will begin shipping in April.


Government and Politics

An HHS OIG report says CMS should coordinate its multiple quality improvement programs to reduce duplication of effort and to make it easier to attribute results, adding that CMS awarded Quality Improvement Organizations a new $4 billion contract just after spending $500 million to roll out two other programs.  


Privacy and Security

St. Peter’s Health Partners (NY) warns that a manager’s stolen, unencrypted cell phone contained emails with patient scheduling information for its physician practices. I think I read that iOS 8 encrypts everything on the iPhone by defauult.


Innovation and Research

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Samsung engineers create a smartphone-powered early warning stroke detection headset that analyze brain waves, expressing hope that the sensors may also be useful for other brain-related conditions. The engineers add that while the prototype model is a headset, the rubber-like sensors could be attached to less-obtrusive eyeglass temples.


Technology

Logitech announces a $500 portable videoconferencing solution for medium-sized rooms, which might be interesting for remote teams and IT meetings. ConferenceCam Connect works on any device that has a USB port and includes both battery and AC power.


Other

Weird News Andy says it’s like deja vu all over again. A doctor describes his patients’ constant deja vu as being trapped in a time loop. “As he walked in, he got a feeling of deja vu. Then he had deja vu of the deja vu. He couldn’t think of anything else.”

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Western Missouri Medical Center’s COO gives its Meditech-to-Cerner conversion a B+ grade, saying that continuity, integration, and data collection improved markedly, but getting data from Meditech was hard. They say they “never new when upgrades are coming” with Meditech.

Weird News Andy says it’s like deja vu all over again. A doctor describes his patients’ constant deja vu as being trapped in a time loop. “As he walked in, he got a feeling of deja vu. Then he had deja vu of the deja vu. He couldn’t think of anything else.”


Sponsor Updates

  • Nordic suggests five areas that should be part of a 2015 health IT plan.
  • Beacon Partners explains Business Intelligence Competency Centers and how to implement them.
  • PatientSafe Solutions CNIO Cheryl Parker, PhD, RN publishes “Smartphone-Based Mobility for Nurses.”
  • Besler Consulting participates today in the HFMA Florida Chapter Mid-Winter Conference and the Tri-State Winter Institute in Mississippi from January 28-30.
  • Caresync CEO Travis Bond asks, “What’s it Really Going to Take to Have Personalized Medicine?” in the latest company blog.
  • Brian Mitchell of CommVault, asks if “2015 is the Year of Data Dystopia?”
  • Clockwise.MD is nominated as a finalist in the inaugural Georgia’s Top Startup Awards.
  • AirStrip’s Alan Portela writes about “The Healthcare Dinner Party” at the company’s Mobile Health Matters blog.
  • Craneware lists the “Top Five Reasons for Denials” in a new blog post.
  • Awarepoint posts a new article, “The ROI in RTLS for Hospital Asset Management.”
  • Divurgent writes about “The ABCs of Ambulatory EMR Training and Acceptance.”
  • Clinical Architecture’s Charlie Harp writes about “The Road to Precision Medicine” in a new company blog.
  • Jaffer Traish of Culbert Healthcare Solutions writes about data sharing.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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January 27, 2015 News 8 Comments

Morning Headlines 1/23/15

January 23, 2015 Headlines No Comments

 EHR Certification Improvements

A large cohort of medical associations lobby to ONC to focus MU3 certification on usability, interoperability, and safety.

NHS disregards patient requests to opt out of sharing medical records

The NHS confirms that it has disregarded tens of thousands of requests by patients to opt out of a new national medical record sharing program, citing concerns that patients did not understand what they were opting out of.

Pew Submits Letter to Health and Human Services Regarding Unique Device Identifier Capture in Electronic Health Records

Geisinger Health Systems, Intermountain Healthcare, and a number of industry groups send a letter to ONC asking that implant medical device tracking be included as a required feature for EHR certification.

ONC adds chief health information officer position

ONC hires Michael McCoy, MD, to its newly created position of chief health information officer. 

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January 23, 2015 Headlines No Comments

EPtalk by Dr. Jayne 1/23/15

January 22, 2015 Dr. Jayne 1 Comment

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While everyone is waiting for the Meaningful Use Stage 3 shoe to drop, let’s not forget we are only eight months away from ICD-10. CMS announced that those organizations that participated in their January end-to-end testing event have already been registered for the upcoming testing week in April. If you missed out on the fun, you can volunteer through your Medicare Administrative Contractor. The chosen few will be announced by February 13. Don’t miss out on this exciting pre-Valentine’s Day gift — volunteer today!

CMS has also released an enhanced version of its Open Payments data search tool, allowing users to view summary information about physicians such as total dollar value of all payments and total transactions. I looked up a couple of friends and am wondering exactly what kind of “Informational Meal” one of them enjoyed for $2.68. I’m guessing that the colleague who enjoyed the $168.72 “food and beverage” line item might have had a better time.

I’m behind on email, but wanted to comment on the recent article in JAMA titled “Wearable Devices as Facilitators, Not Drivers, of Health Behavior Change.” I agree with its conclusion that having a device in and of itself isn’t going to change behavior, but putting strategies around use of the device could help reinforce behavior. They mention improving the design of feedback loops as a way to get wearers to continue, specifically lottery-based designs and the concept of “anticipated regret.”

As part of the annual conference this year, HIMSS is promoting the “HIMSS 15 Wellness Challenge.” Registrants can either purchase a Misfit Shine device or use their own. I was initially enthused and registered, but when presented with the fine print, had a case of actual regret. Winners will be announced at the Connected Patient Learning Gallery throughout the conference but must be actually present to win. I’m pretty sure by the end of each day I’m going to just want to put my feet up.

Usually I don’t read JAMA, but this week’s table of contents was a winner. They must be taking their headlines straight from the tabloids. For a moment I thought I was reading The Onion:

  • The Implications of Marijuana Legalization in Colorado
  • Improving Long-term Psychiatric Care: Bring Back the Asylum
  • Navigating the Rise of High-Deductible Health Insurance: Childbirth in the Bronze Age
  • Flamed on the Net

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Because nothing says professional like addressing a c-level as “Hey %%FirstName%%”: I’m begging HIMSS to please engage some proofreaders. As many teachers have said over the years, “Hey [sic] is for horses.”

I’ve had a tremendous amount of feedback on Monday’s Curbside Consult. Based on some of the responses, it looks like the industry might be having a collective mid-life crisis. I haven’t had a chance to respond to everyone but appreciate your support. We always love hearing from readers, so keep the comments coming. I’ll share some of them in my next Curbside. Until then, I’ve got a hot date with a cup of cocoa, a handmade afghan, and some Netflix before I head back to the office.

Email Dr. Jayne.

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January 22, 2015 Dr. Jayne 1 Comment

News 1/23/15

January 22, 2015 News 3 Comments

Top News

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A group of medical associations that curiously includes CHIME but not HIMSS urges ONC to refocus EHR certification on usability, interoperability, and safety and to disconnect EHR certification from the Meaningful Use program. They add concerns that ONC isn’t paying enough attention to how ATCBs certify EHRs for privacy and security, such as not requiring complex passwords or insufficiently logging user privilege changes. Apparently the groups don’t think the free market is working since the implication is that the EHR vendors they keep buying from are ignoring their customers and won’t change without government intervention. Vendor priorities were so much more straightforward before Meaningful Use. 


Reader Comments

From JustAsking: “Re: Allina-Health Catalyst deal. Lots of headlines about a $100 million ‘valuation’ but no mention of additional equity, yet Allina now owns a piece of the company that investors sunk $40 million into last year. Was the customer unhappy? The Allina CEO took pains to say that it’s not an exclusive arrangement.” Unverified. I agree that the highly touted $100 million figure is meaningless since no details were provided about what that number represents, so I think the company overemphasized that just to add some sizzle (although the press seems to have accepted it without question). I don’t get the sense that Allina is unhappy with Health Catalyst at all – they seem to be thrilled with the information they’re getting. Most of Health Catalyst’s board members are from investment firms who would make sure to protect shareholder value, so I’m assuming the deal makes good business sense. The only downside for the company is that whatever impressive results Allina announces won’t be entirely credible given that they’re now a part owner.

From Hawaiian Charlie: “Re: Scripps. I heard Cerner dropped out before demos start next week.” Unverified. The semi-insider I know wasn’t aware of anything new.

From Just a CEO: “Re: our national user conference. I’m looking for a speaker and one name came to mind – Mr. HIStalk! We can give you a mask or burka.” I’ll pass, but I will instead ask readers: have you heard a really good keynote-type speaker lately, especially one with credibility in the ambulatory world? Let me know and I’ll pass it along.

From Pure Power: “Re: fitness trackers. Their allure is fading fast.” As it should. It’s fun for a couple of days to count steps, but the novelty fades fast as most people don’t really want to be reminded to do something they don’t enjoy (and whether fitness trackers change long-term exercise patterns is questionable). Wearables that can make a different in healthcare will need to: (a) measure something medically actionable; (b) contain enough smarts to figure out when data patterns – rather than a single reading – are meaningful, customized down to the individual patient; and (c) communicate those results quickly and perhaps silently to clinicians who are committed to act on them (probably without much hope of getting paid). Infrastructure will also need to be in place for clinicians to monitor what’s coming in, like those people who sit in burglar alarm monitoring centers who decide whether to dispatch police. Wearables won’t do much for healthy people, but with adequate sensors could help with chronic disease management, provided that those sensors aren’t unpleasant to wear. From a business perspective, steer clear of wearables that diagnose new conditions since nobody wants to pay for new medical problems – focus instead on reducing the costs of managing existing, expensive conditions. We diagnose people pretty well – it’s their care management that’s killing us (and them).


HIStalk Announcements and Requests

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Teach for America teacher Mrs. DiPaula sent over photos of her low-income Idaho first graders using the math games we HIStalk readers bought them a few months back via DonorsChoose.org. She adds, “Thank you from the bottom of our hearts!” I funded a bunch of grant requests using the proceeds from the top-of-page ads that I ran right before the HIMSS conference last year and I’ll do the same this year if companies buy those spots.

This week on HIStalk Practice: Auburn University Medical Clinic rolls out new electronic immunization record-keeping system. Wake Emergency Physicians launches RelyMD telemedicine business. Security divas scrutinize the current state of cyber threats. ARcare selects new pop health tech. Ringly raises a new round. Kaiser makes it official with the NBA.

This week on HIStalk Connect: the FDA issues clarifying guidance on general wellness apps. Stride Health raises $2.4 million to scale up its Healthcare.gov-like insurance shopping app. A team of Harvard and MIT scientists launch InnerAge, a mail-away blood test used to predict lifespan and provide personalized nutritional recommendations to extend life. 

Welcome to new HIStalk Platinum Sponsor Anthelio. The Dallas-based company has been a single-source provider of healthcare-only technology solutions for 15 years, offering a long list of services (outsourcing, application hosting and management, data protection, data warehouse and analytics, service desk, EHR implementation and optimization, HIM outsourcing, revenue cycle optimization, clinical documentation improvement, population health management, legacy system archiving, and ICD-10, among many others). Products include a population health management platform, patient portal, patient-facing mobile app, and a physician coding improvement collaboration tool. You probably know industry long-timers CEO Asif Ahmad (formerly of Duke and McKesson) and SVP Gary Trickett. Thanks to Anthelio for supporting HIStalk.

I always head over to YouTube to look for videos about new sponsors, so here’s an intro to Anthelio I found there.


Acquisitions, Funding, Business, and Stock

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Quality Systems (NextGen) reports Q3 results: revenue up 13 percent, adjusted EPS $0.16 vs. $0.11, beating estimates for both.

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Private investment firm Veronis Suhler Stevenson gets FTC approval to sell Strata Decision Technology to Roper Industries, which owns Sunquest. Stratus founders Catherine Kleinmuntz, PhD and Don Kleinmuntz, PhD moved on not long after selling the company to VSS in 2011. Roper also acquired post-acute care analytics vendor Strategic Healthcare Programs in August 2014 and already owned hospital dietary software vendor CBORD, so it’s liking the healthcare software business.

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Device and wearables Integration technology vendor Human API raises $6.6 million in venture funding.

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The Advisory Board Company announces a $200 million add-on public offering. Above is the one-year share price of ABCO (blue, down 29 percent) vs. the Nasdaq (red, up 15 percent). The company’s market cap is $1.6 billion.


Sales

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Sixteen-bed Jerold Phelps Community Hospital (CA) chooses Healthland Centriq for clinical and financial systems.

University of Texas MD Anderson Cancer Center selects Capsule Tech’s SmartLinx to integrate information from 2,000 medical devices with Epic.


Government and Politics

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Several industry groups request that Meaningful Use and EHR certification require that EHRs be capable of electronically tracking implanted medical devices. They want EHR users to be able to scan the device’s bar code (which contains an FDA-assigned unique identifier) to update the patient’s record for outcomes tracking, adverse event reporting, and recall management. They add that the information could also be used by the EHR to trigger patient-specific device warnings.

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ONC hires Michael McCoy, MD for the newly created position of chief health information officer. He’ll report to Karen DeSalvo and will lead ONC’s interoperability efforts. He ran a two-person consulting firm (Physician Technology Services) and has spent time as a CMIO and working for vendors such as DigiChart and Allscripts.


Privacy and Security

In England, NHS admits that it has ignored all of the thousands of requests it received from patients who don’t want their records shared, saying that those who opted out may not have understood that they wouldn’t have been notified of preventive services such as cancer screening.

SplashData studies 3.3 million leaked passwords from 2014, with the top 10 most used (and thus the worst ones to choose) being:

  1. 123456
  2. password
  3. 12345
  4. 12345678
  5. qwerty
  6. 124567890
  7. 1234
  8. baseball
  9. dragon
  10. football

Innovation and Research

The Center for Integrated Diagnostics at Massachusetts General Hospital (MA) is performing genomics research using InterSystems HealthShare, using the population information it collects for personalizing treatments.


Technology

Microsoft announces the HoloLens, an eye-worn appliance that blends holograms with vision. If nothing else, it should nudge Facebook to bear down harder on its Oculis Rift virtual reality headset. The company also announced that Windows 10 will be released later this year as a free upgrade for users of Windows 7 or 8 if they upgrade in the first year. I like Windows 8 just fine, but a free upgrade offer means plenty of users don’t.


Other

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It’s interesting to read Mayo Clinic’s history as it prepares to implement Epic and its “one patient, one record” philosophy. Henry Plummer, MD created the concept of a centralized medical record at Mayo in 1907, replacing ledger books kept by each of its clinics. Mayo built a pneumatic tube system to move records from location to another. It looks a lot like the ones still used by bank drive-through tellers. Most of the hospitals I’ve worked in considered the tube system or dumbwaiter to be their central nervous system – computers work fine for information, but not for objects. I once convinced one of my tiny co-workers to climb into the dumbwaiter so I could send her up to third floor, where she popped out and terrified a nurse who was waiting for something to be sent other than a mischievous, perky blonde.

New York gun rights activists file an injunction to strike down the state’s two-year-old SAFE Act, saying that it gives authorities access to protected health information that is used to confiscate the firearms of people who seek mental health treatment. The tough gun control law was passed a month after the Sandy Hook shootings of December 2012.

Early bird pricing for HIMSS15 ends January 26, so members will save $100 by registering now instead of later (or even more for the real procrastinators who’ll pay $1,145 if they wait until March 17). Attendees also get free online access to the session recordings, which is a nice benefit  — I used to always buy the CDs to review later.

I was reading an interesting legal case that involved an EHR. A patient being treated by a physician practice for insomnia found that his wife was having an affair and then killed her and then himself. The man’s estate sued the practice, claiming that the doctor failed to diagnose his depression and should have referred him to psychiatric help. The doctor testified that he asked the patient about suicide even though the pre-populated EHR checkbox didn’t say so. The plaintiff’s attorney used that discrepancy as an argument that the physician was practicing “point and click medicine” and wasn’t listening to the patient, arguing that the EHR interfered with the physician’s thought process. The jury found the practice liable for $8 million. The interesting aspect is that the jury’s deciding factor was conflicting, auto-generated EHR entries.

Hospitals in Vietnam report that thieves are posing as the family members of patients in order to steal jewelry or money (inpatients usually have cash because hospitals there require upfront payment for each service). In one case, a guy posing as a doctor convinced a woman in the OR waiting room to pay him for her husband’s perioperative blood transfusion, after which he he printed her a receipt from his iPad then took off with her money.

Weird News Andy says he could understand if it were pediatrics, but OB/GYN? Police responding to a hospital’s call about a “young black male who appeared to be a child was dressed as a doctor” find find a fully garbed 17-year-old in an exam room with a doctor and a patient. The teen, who had been hanging around the hospital for weeks, wasn’t charged since his mom says he’s under unspecified medical treatment and refuses to take his meds.


Sponsor Updates

  • The Sandlot Connect clinical interoperability platform from Sandlot Solutions earns ONC-ACB certification.
  • T-System announces the five winners of its client excellence awards and will make a charitable donation on behalf of each.
  • Pat Adamiak of Liaison Technologies writes a new blog on “Making Your Big Data Project Successful.”
  • Influence Health opens registration and speaker abstract applications for its Influence 2015 Client Congress, taking place in St. Louis May 3-6.
  • Impact Advisors post two new blogs: “When an IT Project Isn’t an IT Project” and “Meaningful Use 2014: Lessons Learned and Looking Ahead.”
  • Hayes Management Consulting Director of Informatics Pete Rivera offers insight into “What You Need to Know About Hiring Veterans.”
  • Healthwise wins gold and silver Web Health Awards for its health education videos.
  • HealthMEDX participates in the Georgia Health Care Association 2015 Winter Convention taking place today in Atlanta.
  • Amanda Randall blogs about the “5 Benefits of Working at Healthgrades.”
  • Healthfinch posts a new blog entitled, “A Nod to Nature: Building a Balanced Healthcare Ecosystem.”
  • E-MDs CEO David Winn pens a new article entitled, “Time to Let the Air Out of the Tires on ICD-10.”
  • Healthcare Data Solutions offers a new blog on content-marketing strategy.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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January 22, 2015 News 3 Comments

Morning Headlines 1/22/15

January 21, 2015 Headlines No Comments

Precision Medicine: Improving Health and Treating Disease

The White House releases details on the new precision medicine program President Obama announced during his State of the Union Address. The program will work to individualize treatment plans through advances in genetic research, medical imaging, and health information technology.

Survey finds physicians being forced to switch EHRs

The American Academy of Family Physicians releases survey results from physicians who have recently switched EHRs. The majority reported that the switch was an organizational choice and not their own. 61 percent of those that had a say in which EHR was selected reported being happy with the new system, versus a paltry 19 percent approval rating from new EHR users that were not involved in the selection process.

Doctors Choose the Best Health Apps of 2014

HealthTap, an online Q&A site where doctors respond to anonymous medical questions, publishes a list of the top 100 mHealth apps based on voting by its contributing doctors. The top three were all calorie counter apps, and there were no medication reminder or chronic disease management apps within the top 10.

Cerner Collaborates With VFW to Help Improve Lives of Service Members During and After Their Service

Cerner announces a virtual veterans job fair that it will co-host with the VFW on February 18, and a new conversion tool on its recruitment page that will convert a military job code to an ideal job at Cerner.

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January 21, 2015 Headlines No Comments

Startup CEOs and Investors: Michael Barbouche

Why I’m Happy That I Did Not Go to the JPMorgan Conference (Or, You Can Go Back to College)
By Michael Barbouche

10-9-2013 11-34-07 AM

Now in the sixth year of my entrepreneurial journey with Forward Health Group, one thing is abundantly clear—I don’t watch TV. No, really. I know nothing. “Breaking Bad?” That’s my email inbox. Many things in my world come down to the wire, but not “The Wire” [1]. About the only thing I do try and sneak into the mix is college football. [2] Fall Saturdays are my day. Social media? The only social texting in my life involves my beloved Badgers and occasional jabs at impostors. [3]

Now that the college season has ended, I will miss many things:

  • Tailgating.
  • The University of Wisconsin Marching Band, the best college band, ever, in Intergalactic [4] History.
  • SEC-on-SEC cannibalization.
  • The games that immediately follow Notre Dame’s annual 7-0 start.
  • Dish Network’s kangaroo-imbued commercial (you know, the one with Heath Shuler, the pretty boy from USC, and The Boz!)

I was reminded of Dish’s fluffy kangaroo as I read Marty Felsenthal’s very entertaining (and accurate) post last week. Having attended JPM last year, let me be the first to share the secret with my struggling peers. Yes, you can go back to college! JPM is nothing more than a return to your freshman year—cluelessness, social awkwardness, and the occasional spilled beverage.

Let’s begin.

 

Cluelessness

The first thing you need to know is that the JPMorgan folks must be pretty powerful because even the Google can’t point you to the conference registration page. Try a search right now. Here’s what no one tells you—JPMorgan is like that blowout fraternity party you didn’t attend during your first week on campus. If you don’t have an invite, well, sorry, you’re not going to the actual party.

And, as a matter of record, freshmen just don’t get invited. Those are the Rules. I spent three days hoofing up and down the hills of San Francisco and never once saw your typical conference nametag. No lanyards were spotted. I would ask people, “Hey, where is the conference — you know, the actual JPMorgan event?” None of the folks I met could give me the answer.

Cunningly, JPM is setup just like your college class schedule. But for the first couple of days, you are the only person that doesn’t know how it works. Soon, however, you begin to understand the cryptic system. Meetings are scheduled on the hour, every hour. The meetings really can’t last more than 40 minutes because you need to sprint to your next meeting. Invariably, you are late to every meeting, and as you the entrepreneur stare at the clock, the fear of outright missing the next appointment overcomes your consciousness. Like the phantom fear of missing a final exam, you begin to sweat for no good reason.

 

Social Awkwardness

Imagine a square drawn around Union Square—four blocks by four blocks. Think of this as a human dog park. There are people running all over the place with no particular destination in mind (how else to describe the same people running the opposite direction four minutes later?) [5] The entire reason you are in San Francisco is to engage in brief, repeated sniffing sessions. After your fifth pitch session (of the day), you begin to figure out a few of the signals. [6] By Day Two, you have the routine down:

Savvy Investor (in his 43rd pitch meeting of the week): “What were your revenues last year?”

Struggling Entrepreneur: “We had a pretty good year. We did [$x]! We are really excited about this year—we think we can do [$4x], which is really great.”

Savvy Investor: “That is great. Wow. I must say, however, that our minimum investment for this fund is [$15x]. We have invested in companies as low as [$10x], but that’s atypical.”

[two minutes of awkward stumbling and rambling comments by Struggling Entrepreneur …]

Savvy Investor: “We definitely want to stay in contact with you to monitor your progress. Is it OK if we follow up with you later in the spring to see how you’re doing?”

Struggling Entrepreneur: “Sure. And thanks for the bottle of water.”

 

Occasional Spilled Beverage

On that Tuesday morning of JPM week, you are filled with excitement. The reason you are in San Francisco in the first place is because all of the analysts [7] at VC firms use the exact same Salesforce install with the exact same auto-email template. Beginning in late November, the auto-email template updates to include this sentence:

“Also, wanted to set a time to meet with you at JPM.” [8]

As you scan your full roster for the day, you see that the first discussion lists “2317 HYATT” as the meeting location. You are six blocks away from Union Square and you realize that there is a plurality of hotels named “HYATT” in San Francisco-proper. [9] When you get to the correct Hyatt, your native instinct is to look for the conference rooms. Oddly, when you get off the escalator, the conference rooms are named after landmarks — no numbers. A few minutes of elevated heart rate leads to a discovery—23rd floor! You get off on the 23rd floor, and, again, look for conference rooms. No such luck. You walk down the corridor of hotel rooms. Whoa, room 2317. Could it be? Seriously? You knock. The door opens. There are numerous men dressed [10] in those flat-front, skinny lapel suits that only the “I’m training for an Iron Man right now but I’m doing a half in April” triathlete crowd wears. This is your meeting location.

Think of the scene in the hotel room like the pre-party before the house party hosted by the older brother of your new college roommate’s friend’s cousin. You “know” only one person in the room—the analyst guy who emailed you to setup the meeting. There are not enough chairs. The bed has been moved into the corner to serve as a sectional sofa. The coffee table is in the corner serving as a buffet table /business card holder [11] / collection point for half-emptied water bottles. There are more butts than there are flat surfaces. Someone will be standing the entire meeting.

The hotel room door opens often as new people in skinny suits enter the room and current participants exit gracefully. That is, until one of the bed-sitters has to be excused for another meeting. This is what triggers the coffee or juice or soda spill. Thankfully, the beverage vessel is usually half-empty [12] and your analyst friend quickly jumps in with a bathroom towel to avoid a dry cleaning situation.

Though I did not attend JPM this year, I have few regrets [13]. If you are an entrepreneur and you are contemplating JPM in 2016, make your hotel reservations [14] soon. Your email invitation from that analyst is already in the queue.

Michael Barbouche [15] is founder and CEO of Madison-based Forward Health Group. At the 2014 JPM, Michael had dinner with Marty Felsenthal in the Wednesday evening 7:00 PM-8:00 PM slot.

[1] Note for Millenials–this is a reference to an HBO program that has not aired in years. You should be able to stream from your parent’s HBOGO account.

[2] True confession—I TiVo “College Gameday” to watch Lee Corso put on the headgear.

[3] Yeah, I’m talking to you, Goldy Goopher fans.

[4] Unclear if Epic has exclusive use of this term in the health IT space, so thought it was prudent to footnote. Further research needed on specific citation required.

[5] See below for explanation.

[6] If someone refers to you as “Jugdish, Sidney, or Clayton,” and that is not your name, the investors are likely to be working their iPhones before you have even finished your intros.

[7] The people who email incessantly to set up a call to pump information out of you.

[8] If you want to spend $145, you can verify with your lawyer—this simple inquiry is not the legal equivalent to a court-issued summons.

[9] During JPM, it is not uncommon to hear numerous exclamations that contain the phrase, “F*#@%ing Google Maps!”

[10] Ties are strictly prohibited. Obviously.

[11] At one of my meetings in 2014, there were business cards (face up) from two of my direct competitors.

[12] For the record, I view the vessels as half-full.

[13] I’m overdue in connecting with Ben Rooks and Michelle. Guys, we should chat soon!

[14] www.hotwire.com

[15] When I was in college, adding footnotes to your paper was complete pain in the ass. Now, it is so simple.

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January 21, 2015 Startup CEOs and Investors 1 Comment

News 1/21/15

January 20, 2015 News 6 Comments

Top News

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Mayo Clinic chooses Epic, as I mentioned a few days ago from a reader’s rumor report. Cerner gets a double whammy – not only do they lose the Mayo bid, some of their systems will be displaced as they (along with GE Healthcare) are the Mayo incumbent. Actually, there’s one more Cerner insult: former Mayo CEO Denis Cortese, MD sits on Cerner’s board.


Reader Comments

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From Banned in Boston: “Re: McKesson Horizon. The attached letter verifies its sunsetting on March 31, 2018. The event has passed with little fanfare since Horizon has become increasingly obsolete.” The letter, signed by McKesson EVP Pat Blake and President Jim Pesce, says the company will issue a Meaningful Use Stage 3 update and thanks Horizon users for their “partnership,” a trite, vendor-created synonym for “sending checks as a customer.”

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From Jose Francisco: “Re: Scripps Health. Will be moving to Epic. Impact Advisors led the system selection – Cerner never had a real shot. Decision will become public in 30-60 days.” Unverified. Scripps chose GE Healthcare’s Centricity Enterprise in 2007 and Allscripts Enterprise for its outpatient clinics in 2009. Assuming the rumor is true, EMR critic and Scripps cardiologist and author Eric Topol, MD will become an Epic user – it will be interesting to see what he says about it among all of his smartphone infatuation. Update: I reached a non-anonymous source who says that Scripps hasn’t yet made a decision as far as he or she knows.

From Lips Pursed: “Re: HISsies voting. It’s just a popularity contest and the ballot choices are stupid.” Of course it’s a popularity contest, just like the Presidential election – what did you think it was? Readers (few of whom are stupid) make the nominations and vote for their choices as they’ve done since 2008, with the most-nominated entries appearing on the ballot. Having people who didn’t nominate anyone complain now is like moaning about the Presidential candidate chosen by your more responsible peers in that primary election voting you skipped.


HIStalk Announcements and Requests

The results of my reader survey are always interesting and useful. Thanks to those who responded.

Some nice point-counterpoint commentary was generated by CommonWell’s answers to HIStalk reader questions and a reaction article by Brian Weiss of Carebox. The comments are getting interesting as Brian suggests that (a) HIStalk readers vote as consumers on the approaches of the respective organizations, and (b) that the organizations consider developing a prototype for exchanging information securely and under the control of patients, driven only by their email address. They are also discussing patient-controlled health record banks.

Welcome to new HIStalk Platinum Sponsor Oneview Healthcare. The Dublin, Ireland-based company (with US offices in San Francisco and Pittsburgh) offers a Microsoft-powered customizable interactive patient care system that’s accessible by smartphone, tablet, or in-room TV. Patients get education, entertainment, communications services, messaging, scheduling, way-finding, meal ordering, nurse rounding, and remote consultation, while clinicians use it to access electronic medical records and other point-of-care applications. Two big reference clients are the newly built Chris O’Brien Lifehouse in Sydney, Australia (they have a patient experience focus and every patient interacts with the Oneview system) and UCSF Mission Bay (a three-hospital campus opening in a couple of weeks). Maimonides Medical Center (NY) SVP/CIO Walter Fahey says, “The capability that the Oneview solution can deliver is second to none and it will transform the healthcare experience, not only for our patients, but for our healthcare teams and hospital managers.” Thanks to Oneview Healthcare for supporting HIStalk.

I found this overview video of Oneview Healthcare on Vimeo.

Listening: Gary Lewis and the Playboys. Like most of America, I can’t understand how the unattractive, minimally talented son of the annoying Jerry Lewis could have become a 1960s pop star, at least until his career was waylaid when he was drafted and shipped off to Vietnam in 1967. I’ve seen him live a couple of times –he’s good natured (he’s 68 now) and he had some massive songwriting and production firepower behind his records. I have a strong need to hear “This Diamond Ring,” “Palisades Park,” “Everybody Loves a Clown,” “Save Your Heart for Me,” and “Little Miss Go Go “ every few years. Trivia: there were no actual Playboys on the records – it was all Gary and some studio musicians, heavily overdubbed and recorded using the opportunity created by his mom’s money and his dad’s name.


Acquisitions, Funding, Business, and Stock

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Xconomy profiles nonprofit Wisconsin investor BrightStar, which funnels charitable donations of around $200,000 to complete funding rounds for early-stage companies that are creating state jobs. It quotes Forward Health Group CEO Michael Barbouche, who says working with BrightStar is painless and easy.

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Patent troll MMRGlobal challenges recent court rulings in which its infringement lawsuits against Allscripts, WebMD, and others were rejected. Above is an illustration from one of its 13 patent applications from its 300 open lawsuits. MMRGlobal’s penny stock shares (literally: its shares are listed at $0.01 on the pink sheets) have dropped 59 percent of their value in the past year. Founder Bob Lorsch and his spokesperson/president wife were featured in a 2012 TV show called “Interior Therapy with Jeff Lewis” in which they are portrayed as emotional hoarders of a crammed houseful of stuff. I interviewed him a couple of year ago and found him charming and his product interesting, although the endless lawsuits overshadow all of that. He made one of his fortunes selling 976 telephone services in the 1980s, including a Santa Claus hotline (he sued a phone sex company for using a number similar to his) and running a children’s 976 phone service as a fundraiser for museums in which he kept $1.75 from each $2 call.

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The Washington Post profiles hCentive, a software development company started by a guy who in 2009 downloaded a copy of the Obamacare bill the Senate was then debating and saw opportunity. The Affordable Care Act was signed into law nine months later and the three-person company now has 700 employees and $50 million in annual revenue after building four state exchanges and being signed by the federal government to build a small business site after it fired CGI for the failed Healthcare.gov rollout.


Sales

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Wheaton Franciscan Healthcare (WI) chooses Epic in a $54 million, five-year project.  

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Southeastern Health (NC) chooses eClinicalWorks Care Coordination Medical Record.

Aetna selects HealthEdge’s rules-powered health management system for payors.


People

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Randy Carpenter (Omnicare) joins Stoltenberg Consulting as SVP of strategic services.

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Xerox Government Healthcare names Scott Bennett (Siemens Healthcare) as SVP of sales.


Announcements and Implementations

PeriGen announces a doubling of its customer base in 2014, with 140,000 births to date supported by its PerCALM Tracings electronic fetal monitoring system.

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St. Maarten Medical Center says it will be the first hospital in the Caribbean to use a fully electronic system when it completes its implementation of CPSI, which replaces a Siemens MedSeries4 system that was “no longer reliable and nearing a system failure.”

GE Healthcare and NextGen earn EHNAC’s first practice management system accreditation.


Government and Politics

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Computer scientist Kathy Pham, a new employee of the United States Digital Service, attended Tuesday night’s State of the Union address as one of 22 guests invited by the White House. She has been a healthcare informatics researcher, a software engineer for Harris Healthcare Solutions, and a healthcare consultant with IBM. She also serves as a patient advocate for her mother, who has acute lymphoblastic leukemia.

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A report by HHS’s Office of Inspector General finds that CMS’s work on Healthcare.gov was sloppy, hurried, and poorly overseen, awarding no-bid contracts worth hundreds of millions of dollars without reviewing past company performance or having firm requirements defined. As has been widely reported, CMS hired 33 companies to work on the site, but didn’t name any one of them to be in charge, although they just assumed that CGI Federal was running the project. The agreements also didn’t cap payments and allowed overbilling with minimal documentation, so some companies were paid up to three times their bid amount. CMS originally estimated the value of six key contracts at $464 million, but has paid $824 million so far.


Privacy and Security 

A security company finds that Healthcare.gov connects in the background to dozens of private websites, including Facebook, Google, and Twitter, raising concerns about cybersecurity exposure and whether user information is really private.


Innovation and Research

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A new research article describes how Kaiser Permanente analyzed its EHR information to identify neighborhoods with a low rate of childhood vaccinations, allowing it to mount outreach efforts to five areas. One private school had a 50 percent rate of “personal belief exemption.”


Technology

in England, the medical director of NHS says wearables will play a vital part in future health in allowing people to be monitored at home for irregularities in heart rhythm, breathing, and edema. He adds that NHS will push a “huge rollout” of those technologies.

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Bizarre: Airbnb-inspired Airpnp lets app users in need of a bio break rent bathrooms in private homes. The founders were inspired by a New Orleans decision to ban street-located Porta-Potties during Mardi Gras. It’s hard to fathom that sellers would allow a stranger into their homes (and bathrooms) for a dollar or two. It sounds like a spoof to me, but then again it’s sometimes hard to tell if a startup is serious. Perhaps the same skepticism applied early on to Uber, however, which just announced that its San Francisco revenue alone is $500 million per year – nearly four times the entire taxi market there — and is growing 200 percent per year.  

Microsoft patents user-configurable technology that can automatically dim and silence a smartphone when the phone’s GPS detects that the user has entered a theater, when it senses darkness and quiet, or when so instructed by the Wi-Fi system being used.


Other

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An epidemiologist with New York City Department of Health and Mental Hygiene tells the Health IT Policy Committee that fast outbreak identification and control requires better integration between EHRs and its disease surveillance system. She envisions EHRs sending real-time data for surveillance and then receiving back prompts for additional information, such as patient demographics.

A North Carolina OB-GYN says doctors should use computers and not vice-versa, urging his peers to look at the patient instead of the screen. “The folks who sold us these systems talked about all the wonderful things EMR can do … One might assume the EMR would excise the tumor, lower the blood glucose and stop the hallucinations. The problem is that the EMR really should not ‘do’ anything. Patients tell us their concerns. Practitioners do their best to listen and perform the appropriate evaluation, with or without technology … everything we need to know about our patients is in their face, in their voice, and in their eyes.”

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Forbes India profiles India-based Narayana Health, whose first non-India hospital opened in the Cayman Islands a year ago in a partnership with Ascension Health. Founder and cardiac surgeon Devi Shetty got the idea for his medical tourism hospital from a friend who mused, “The most profitable hospital in the world is the one which is built on a ship and parked outside US waters because it gets to serve American patients and yet stays away from its jurisdiction.” The hospital has implanted an artificial heart for what Shetty says is less than half of the $1.2 million US hospital price. He’s working with two US-based health systems on new hospital software (I’d be curious to learn more about that) and is talking about starting a Caymans medical school.

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Weird News Andy likes the glucose-monitoring temporary tattoo on the left better than the diabetes-hating one on the right, although I’ll add that both might illustrate diabetic monitoring assuming there’s a Diastix right above the word “diabetes.”  


Sponsor Updates

  • Zynx Health VP Guillermo Ramas writes about attaining the impossible in the company’s latest blog.
  • Frank Myeroff of Direct Consulting Associates interviews Denver Health CIO Jeff Pelot.
  • Huron Consulting Group will exhibit at the AHLA 2015 Legal Issues Affecting Academic Medical Centers and Other Teaching Institutions conference in Washington, DC from January 22-23.
  • Voalte Product Manager Anthony Mitchell blogs about the smart use of smartphones in the latest company post.
  • ExitEvent highlights Validic and its relationship with digital health startup Qardio.
  • T-System Clinical Systems Engineer Deon Melton, RN shares “Life Lessons Learned in the ER” in a new blog.
  • Caradigm Director of Product Marketing Scott McLeod pens a new blog, “All Signs Point to Population Health Management.”
  • AtHoc President and CEO Guy Miasnik writes about the role AtHoc technology played in protecting Gritman Medical Center from an active shooter.
  • The local business paper highlights the venture capital funding raised by CareSync in Q4 2014.
  • CareTech will attend the January 28 MCACHE event on “Building a Leadership Team for the Healthcare Organization of the Future.”
  • AirWatch’s Noah Wasmer offers five end-user computing technology predictions for 2015 in a new blog.
  • ADP AdvancedMD offers tips on leveraging practice data to view key performance indicators in a new blog.
  • Besler Consulting offers advice on how to increase Medicare EHR incentive payments.
  • Aventura will exhibit at the IMN Health Impact Conference of the Southeast in Tampa on January 23.
  • CitiusTech achieves the ISO 13485 quality management system standard for medical devices.
  • CoverMyMeds shares a moment with Account Coordinator Josh Campanella in the latest installment of its “Hey, You!” blog series.
  • ABCNews.com lists Clockwise.md amongst other companies making a name for themselves developing online booking software.
  • CommVault launches new endpoint data protection to secure, support, and back up mobile enterprises.
  • Craneware lists its goals for 2015 in a new blog post.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

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January 20, 2015 News 6 Comments

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