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Monday Morning Update 12/23/13

December 20, 2013 News No Comments

12-20-2013 2-24-22 PM

From Kris Crinkle: “Re: Epic. The bells rang for a new contract signing. Southcoast Health System (MA). Replacing Meditech Magic, eClinicalWorks, athenahealth, and Cerner homecare. I’m an avid reader and love the format, especially Dr. Jayne.”

From JG: “Re: musical stocking stuffers, best of 2013. The Growlers, Dean Wareham, The Men. Thank you for everything you do!” I listened to all three bands and liked all three.

12-20-2013 1-23-27 PM

From The PACS Designer: “Re: all-digital solutions. A truly remarkable event took place at this year’s RSNA. Philips Healthcare introduced the world’s first all-digital diagnostic treatment solution in the form of a CT/PET Scanner. This event should be of great interest to Doctor Dalai as he’s been contemplating the purchase of such a system for quite some time.”

12-20-2013 10-09-07 AM

The vast majority of poll respondents think it’s time to retire the word “mHealth.” New poll to your right: is Karen DeSalvo a good choice for National Coordinator? Feel free to click the poll’s Comments after you’ve voted to explain why you think she is or isn’t.
12-20-2013 10-24-43 AM
Welcome to new HIStalk Platinum Sponsor DataMotion. The Morristown, NJ-based company offers easy-to-use solutions for email encryption, secure file transfer, and Direct-based secure messaging, allowing customers to cut costs and meet compliance and Meaningful Use requirements. DataMotion Direct makes secure messaging via Direct easy to implement and use, and the DataMotion Direct Developers Program provides vendors a quick, capital-free way to implement Direct messaging in their applications (EHRs, HIE, patient portal, interface engine) and to meet MU Stage 2 secure data exchange requirements. Give SecureMail a free trial, request access to their Sandbox,  or view the recorded Webinar, “HIPAA, Business Associate Agreements, and What You Need to Know.” Thanks to DataMotion for supporting HIStalk.
Here’s a DataMotion introductory video I found on YouTube.Here’s the complete list (not just AMIA members like the list I ran earlier) of the new diplomates in the Clinical Informatics subspecialty area.
Athenahealth will move its Bay Area office from a 20,000 square foot space in San Mateo to a 60,000 square-foot building in San Francisco.
Archbold Memorial Hospital (GA), San Francisco General Hospital and Trauma Center (CA), Virginia Hospital Center, and Western Connecticut Health Network select Perioperative Management from Surgical Information Systems.
An internal Marine memo reveals current inefficiencies in the transfer of medical records from the Navy to the VA. Currently the Navy prints service treatment records and mails them to the VA. At the same time the VA is in the process of scanning all paper files, which are saved electronically as PDFs. Depending on a the service member’s length of service and documented medical conditions, a single record can run thousand of pages.
Pharmacy benefit manager Prime Therapeutics contracts with CoverMyMeds.com for electronic prior authorization services.

A ProPublica investigation uses the federal government’s own Medicare databases to find evidence of rampant Medicare drug plan fraud, with organized groups either stealing the identity of doctors or bribing them to write prescriptions. Medicare’s process is so poorly managed that they rarely catch anyone. Example: Medicare paid $3.8 million in one year to fill the prescriptions of a psychiatrist, most of them for drugs unrelated to his specialty, when someone stole his identity. Pharmacies and insurers say they’re reporting suspicious behavior to Medicare but are being ignored. The series of articles concludes that newspaper reporters can easily detect fraud from Medicare’s databases, but the agency itself isn’t doing it.

Fraud rings use an ever-evolving variety of schemes to plunder the program. In one of the most popular, elderly, broke, disgraced or foreign-trained doctors are recruited for jobs at small clinics. Their provider IDs are used to write thousands of Medicare prescriptions for patients whose identities also may have been bought or stolen. Once dispensed, the drugs are then resold, sometimes with new labels, to pharmacies or drug wholesalers. In other schemes, investigators say, pharmacies are active participants, billing Medicare multiple times for prescriptions they never fill. Doctors can readily disavow the prescriptions as forged, investigators say. And because the schemes don’t always involve painkillers, a law enforcement focus, they can escape notice.


Weird News Andy delivers this story, which he titles “Yes C-Section, No C-Baby.” Doctors in Brazil perform an emergency C-section delivery after failing to hear the baby’s heartbeat, only to find that their patient wasn’t pregnant. The woman showed up with proof of her prenatal care and a protruding abdomen, but she was having a false pregnancy, her second of the year. The hospital suggested she seek mental care instead.


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

More news: HIStalk Practice, HIStalk Connect.


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December 20, 2013 News No Comments

News 12/20/13

December 19, 2013 News 7 Comments

Top News

HHS names Karen DeSalvo, MD, MPH, MsC National Coordinator for Health Information Technology. DeSalvo, health commissioner for the City of New Orleans, will start on January 13, succeeding Farzad Mostashari, MD, MsC. According to an internal email from HHS Secretary Kathleen Sebelius, “Throughout her career, Dr. DeSalvo has advocated increasing the use of health information technology (HIT) to improve access to care, the quality of care, and overall population health outcomes –including efforts post-Katrina to redesign of the health system with HIT as a foundational element.”

Reader Comments

12-19-2013 5-44-16 PM

From MC Scanner: “Re: Apple commercial. The video for ‘Misunderstood’ that will air on TV next week brought tears to my eyes. It’s amazingly powerful – even better than their ‘1984’ ad.” Maybe I’m just being a Scrooge, but it seemed to me like a lame, Microsoft-style attempt to make people believe that their lives are incomplete unless they experience it using consumer technology. This commercial features a kid who chooses not to participate in family holiday activities with everybody else, instead messing around with his phone and recording everything for the big reveal when he shows the edited video to the family on the big screen TV. The message appears apt for the self-obsessed Facebookers of the world who can’t turn their smartphones off long enough to participate in the world instead of documenting it in Kodak moments for public display. I was creeped out when the family stopped doing everything warm and loving about the holidays and instead stared at themselves on TV, suddenly overcome with affection for the kid who couldn’t relate to them otherwise (probably because he never stops staring into his phone). Here’s my alternative, non-Apple approved holiday message: put down your electronic pacifiers, spend time with people you love, forget the always-beckoning fantasy world of your phone for just one day, and live like a human instead of an online avatar.

From Unnamed: “Re: [company name removed]. Laying off US employees right before Christmas, moving jobs to India, cutting budgets by 25 percent, and disregarding outstanding financial commitments. Sounds like a HISsies ‘Stupidest Vendor Move’ category.” We had some financial problems with that company, too.

From Jack: “Re: Orion Health’s list of best healthcare reporters and blogs. I saw this and figured either your actual name was on here (gasp) or whomever wrote this doesn’t actually read HIStalk. But how in the world do you get left out of that list?” HIStalk gets left off quite a few of the “best HIT sites” lists for several reasons: (a) it competes with the interests of whoever created the list; (b) it’s based on an Internet metric like Alexa or Klout scores; (c) they can’t figure out whether to consider HIStalk a blog or something else; or (d) they think other sites are better, which is perfectly fine and maybe they’re right. I never look at those lists and I often haven’t heard of the sites they proclaim as the busiest or best, but all I know is that Orion Health sponsors HIStalk, which seems to indicate they think it’s OK even though it’s not on their “Five Healthcare IT Reporters You Need to Follow” or “Health IT Thought Leaders” list.

HIStalk Announcements and Requests

inga_small From HIStalk Practice in the last week: a few moonlighting suggestions for physicians. CMS offers informal reviews for EPs and group practices who will be subject to the 2014 eRx payment adjustment. CMS confirms that providers who assign their reimbursement and billing to a CAH under Method II are now eligible to participate in the MU program as EPs. A solo physician does a commendable job addressing a data breach. Salaried GPs in the UK face declines in compensation. My favorite gift, regardless of the holiday, is having new readers, so please take a moment and stop by. Thanks for reading.

Listening: The Honorary Title, a Brooklyn-based indie rock band that flamed out in 2009 without a lot of success. I’ve been obsessed with Nada Surf lately and they sound a good bit like them.

12-19-2013 6-15-33 PM 12-19-2013 6-21-15 PM

Welcome to new HIStalk Gold Sponsor (and HIStalk Connect Platinum Sponsor) CareSync. The Florida-based company offers a family health record and the mobile-based Visit Manager that provides access to a family’s medical records, organizes questions for providers, and stores to-do lists and notes, all to get family members organized before, during, and after their medical appointments. Information can be selectively shared with providers and family and friends who are helping with health needs. It allows tracking of health goals, prescriptions, emergency contacts, and providers. The company’s team of medical records specialists will even help assemble and organize the health information. It is reasonably priced and could make a nice Christmas gift for a family member. You probably know some of the industry long-timers who are involved – Travis Bond (Bond Technologies) and Amy Gleason, RN (Allscripts), to name two. Thanks to CareSync for supporting HIStalk.

I found this CareSync video on YouTube that explains it much better than I just did.


Mercy Health Physicians (OH) will implement PatientPoint’s patient engagement solutions.

Queen Elizabeth Hospital King’s Lynn (UK) selects iMDsoft’s MetaVision for its ICU.

Children’s Medical Center (TX) engages PCCI to build predictive analytical models to identify children at-risk for asthma crises and to develop an information exchange between pediatric and social services providers.


12-19-2013 12-42-34 PM

ClearDATA names Scott Whyte (Dignity Health) SVP for growth and innovation.

12-19-2013 8-39-01 AM

Ryan Donovan (Visa) joins Practice Fusion as VP of corporate communications.

12-19-2013 8-45-05 AM

CareInSync hires Cheryl Cruver (The Advisory Board Company) as SVP of provider solutions.

12-19-2013 9-13-32 PM

Rainu Kaushal, MD, who holds a number of roles including informatics at Weill Cornell Medical College and New York-Presbyterian Hospital, is named chair of the college’s Department of Healthcare Policy and Research.

Announcements and Implementations

Arch Health Partners, a medical foundation affiliated with Palomar Health (CA), deploys Phytel’s population health management platform.

Kansas HIE and the Lewis and Clark Information Exchange connect their networks.

University of Colorado Health migrates 17,000 mailboxes from three disparate healthcare organizations on multiple legacy email platforms into one single consolidated Microsoft Office 365 environment. The consolidation is expected to save the organization $13.9 million over 11 years.

Landesklinikum Amstetten (Austria), AZ Sint Lucas (Belgium), Hospital La Pitie-Salpetriere and Centre Hospitalier Regional De Metz-Thionville (France), and Medway Maritime Hospital (UK) go live with the iMDsoft MetaVision platform.

Wesley Medical Center, Cypress Surgery Center, and Surgery Center of Kansas go live on Anesthesia Touch from Plexus Information Systems.

Lehigh Valley Health Network (PA) implements Salar’s TeamNotes, which sits on top of GE Centricity EMR to facilitate ICD-10 compliant documentation.

Government and Politics

A report by the Senate Commerce Committee highlights minimally regulated data brokers that buy and sell patient data, including disease-specific patient lists and in one case, lists of rape and domestic violence victims.

The VA’s ongoing cybersecurity problems are the subject of a Federal News Radio series, which points out the material weaknesses listed in its financial statements. Among them: failing to revoke network access of terminated employees, failing to keep unauthorized software off the network, and improperly securing Web-based applications. An unnamed government official says the VA CIO’s office has developed a siege mentality against Congressional inquiries, concluding,

“I find it disingenuous in how they are responding to this and the degree of contempt they have in how they are approaching this. They feel it’s a witch hunt. There is a marked lack of respect for the committee by the IT leadership. How they are managing the process is indicative of the lack of respect for Congress and particularly the Veterans Affairs Committee. They think it’s a game so they will evade, obfuscate and they will basically come back with just the bare minimum so as not to be out of compliance.”

12-19-2013 10-20-31 PM

The Oregon government official in charge of the state’s trouble-prone health insurance exchange website resigns. The state had bragged that its marketplace would be one of the most advanced when it opened October 1, but it still can’t handle electronic applications and required hiring 400 workers to process paper forms. Carolyn Lawson, CIO of the Oregon Health Authority and Department of Human Services, stepped down Thursday for “personal reasons.”

12-19-2013 9-29-02 PM 12-19-2013 9-30-58 PM

Representatives Doris Matsui (D-CA) and Bill Johnson (R-OH) introduce the Telehealth Modernization Act of 2013, which would create a federal definition of telehealth based on an earlier California definition with the hopes of standardizing inconsistent state-level policies. It addresses patient-provider relationships, informed care,  provider documentation, sending documentation to other providers, and prescribing requirements.


Scripps Health launches a pilot of the Sotera Wireless ViSi Mobile vital signs wrist monitor, which measures ECG, heart rate, pulse,  oxygenation, and temperature.

MMRGlobal is awarded another patent, this time for just about everything a person can do to access health information on a mobile device.


The healthcare industry is making slow progress on preparing for ICD-10, according to a WEDI readiness survey. About 20 percent of vendors claim they are halfway or less complete with product development, while about half of providers have yet not completed an impact assessment. Meanwhile, about one-third of health plans have not initiated internal testing; two-thirds have not started external testing.

12-19-2013 5-12-32 PM

The Orlando newspaper profiles Automated Clinical Guidelines, which offers some kind of clinical pathway guidance product whose company-provided description is obfuscated by a writhing nest of unintelligible HIT-related cliches that marketing people dream about when you naively ask what a particular product does and 20 minutes you still have no idea:

ACG has developed an innovative healthcare ecosystem that is patient-centered, operates in real-time, is language-independent, and serves up evidence-based medicine for application on a worldwide basis. The ACG expert system represents a breakthrough in processing structured clinical information utilizing automated clinical guidelines. ACG software is a patented, smart, internet-based, and platform independent solution to the medical crisis in a demographically aging world faced with a severe shortage of physicians. ACG is NOT an EMR or an EHR product and in fact operates in a product space that is totally EMR/EHR independent. ACG revenue streams come from annual renewable institutional contracts, physician patient visits on a per click basis, and by medical products advertising. The ACG ecosystem is an elegant design that requires little or no training and guides the user by use of Symbolic and Boolean logic clinically correlated algorithms, as opposed to current attempts to use database centered templates and report writers.

12-19-2013 5-36-03 PM

The Houston newspaper writes up Decisio, which formats information from patient monitors into an electronic triage system. Says CEO Bryan Haardt, who was COO of Prognosis Health Information Systems until June 2013, “Today’s thermostats have more intelligence than most medical monitors.”

12-19-2013 7-36-34 PM

Cottage Health System (CA) discloses that the information of 32,500 patients was exposed when a vendor inadvertently opened up one of its servers to the Internet. As is nearly always the case, the problem was discovered by someone who found the information while Googling names. Surely there must be a monitoring service that can ping a supposedly secure server from outside the firewall and raise an alert if it gets in.

AMIA runs a list of its members who passed the first clinical informatics subspecialist exam in October.

12-19-2013 10-38-05 AM

inga_small A 66-year-old man files a lawsuit against Advocate Condell Medical Center (IL), claiming that hospital security guards threatened him, beat him, and bit him as he attempted to discharge himself from the ER. The main waited six hours for treatment of his TIA before trying to depart for another hospital, at which time he says seven security guards verbally and physically attacked him. Following the altercation, he claims he was injected with narcotics, strapped to a gurney, and kept in the hospital for six days.

12-19-2013 6-08-37 PM

Weird News Andy offers a list of items “for all the HIStalk techies in your life” from this article, cynically saying of an anesthesiologist robot, “What could go wrong?”

WNA will be sorry he didn’t see this first. A Chicago ED doc says he deals with sex-related accidents twice per week, enough to make him the star of a stupid new reality show (was that redundant?) called “Sex Sent Me to the ER.” Some of the cases he’ll cover involve people who fell on penetrating foreign objects (right), broken penises, and a 440-pound male virgin so focused on his first sexual experience that he pushed his girlfriend’s head through a wall. It looks stupid, sensationalistic, and poorly made, which of course means it will be an instant hit.

Sponsor Updates

12-19-2013 5-18-19 PM

  • Visage Imaging lists the top five trends it observed about enterprise imaging at RSNA 2013.
  • QPID releases some funny, holiday-themed training videos for its customers (1, 2, 3).
  • The MarketsandMarkets research firm ranks Perceptive Software’s Acuo VNA platform the world market share leader among all independent and PACS-affiliated VNA solution providers.
  • ICSA Labs awards CliniComp’s Essentris v213.01 software 2014 Edition Inpatient Modular EHR ONC Health IT Certification.
  • Deloitte includes Kareo on its Technology Fast 500 list of fastest growing technology, media, telecommunications, life sciences, and clean technology companies in North America based on its 797 percent growth over the last five years.
  • Gartner positions Informatica as a leader in its 2013 Magic Quadrant for Data Masking Technology report.
  • University College London (UCL) and Elsevier will establish the UCL Big Data Institute to explore innovative ways to serve the needs of researchers by providing analytical data for scientific content.
  • The Drummond Group certifies Alere Analytics Clinical Quality Measures Services version 2.1 and Public Health Electronic Laboratory Reporting and Communication Portal version 3.2 for ONC-ACB MU as Modular Inpatient and Modular Ambulatory solutions respectively.
  • T-System offers free T-Sheets flu documentation templates to hospitals and healthcare providers.
  • Greenway Medical Technologies wins the 2013 Intel Innovation Award for its PrimeMOBILE app for Windows 8.
  • Besler Consulting releases a review of the Hospital Outpatient Prospective Payment System 2014 final rule.
  • Experian integrates its identity proofing and risk-based authentication platform Precise ID for health care portals with Epic’s MyChart patient portal.
  • Impact Advisors principal Laura Kreofsky discusses HIT in 2014.
  • E-MDs Cloud Solutions v. Cirrus achieves ONC-ACB certification for MU Stage 1 and 2 and is compliant as a Complete EHR 2014.
  • Huntzinger Staffing Solutions expands its offerings to include Cerner staffing and sourcing services.
  • Carolyn Brzezicki, senior clinical specialist for Healthwise, challenges readers to behave as if they have Type 2 diabetes for one day.
  • Billian’s HealthDATA hosts a January 16 #HITchicks Tweet Chat.
  • HIStalk sponsors winning Fierce Innovation Awards include Health Catalyst for Best Problem Solver and Data Analytics; Patientco for RCM; QPID for Best Cost-Saver and Clinical Information Management; and CoverMyMeds in the HIE category and an overall award in Best in Show: Best New Product/Service.
  • Australia’s Adelaide Research and Innovation names Wolters Kluwer Health an Innovation Champion based on its ongoing partnership with Joanna Briggs Institute to bring evidence-based practice resources to healthcare institutions globally.

EPtalk by Dr. Jayne

I keep my eye on Twitter for interesting health IT items. A mention of “24 Outstanding Statistics on How Social Media has Impacted Health Care” caught my eye, mostly because of the use of the number 24. Usually articles will feature a top 10, top 20, maybe a top 25 but I thought going with 24 was an interesting choice. The statistics are drawn from some interesting sources from advertising and media firms to Mashable.

The first two numbers weren’t surprising: 40 percent of consumers say social media impacts how they deal with their health, 18-24 year olds are more likely than 45-54 year olds to use social media, and so on. The third did surprise me: 90 percent of those 18-24 said they’d trust medical information shared by others on their social media networks. This little tidbit doesn’t give me a lot of hope for humanity since my “official” practice persona is Facebook friends with a number of our patients in that age bracket. Let’s just say that most of the posts from that demographic are not exactly systematic literature reviews.

I wonder if they also buy into links for “one simple way to lose belly fat” or “avoid this one food to lose weight?” Behind the closed door of the exam room, I’ve heard a lot of things that 18-24 year olds say about health issues and can confidently attest that most of them have been bogus. Typically those conversations have been in the realm of reproductive health, which probably adds to the mystery of some of their statements, but I’m not sure I’d trust most of the advice these teens have been given by their peers.

Back when the Internet was all we had, I used to counsel patients that the Internet is like the world’s largest bathroom wall. There are a lot of things written on it and some of them are certainly true, but it’s hard to figure out which. The number and volume of sites, apps, and sources available now makes keeping track of the truth even more challenging.

Only 31 percent of healthcare organizations have written guidelines for social media, which I think is low, especially if the respondents were organizations of any size. A good friend of mine is a plaintiff’s attorney and regularly licks his chops at the prospect of litigating cases where medical advice was inappropriately given via social media or where patient-specific information was inadvertently released. Another statistic later in the piece states that 26 percent of hospitals participate in social media, so perhaps the relatively low rate of those online makes the guidelines percentage look a little better.

I liked the statistic that 54 percent of patients are “very comfortable” with their providers using online communities to aid in treatment. It’s validating for me personally since I was once yelled at by a hospital VP after being quoted in a newspaper interview about using the Internet to search for information while seeing patients. He told me it was “unseemly” to admit that you didn’t know everything the patient needed you to know and would undermine confidence. I’ve always found patients appreciated the fact that I admit I don’t know everything and am willing to make sure I have the correct approach before I apply it to their situation.

Although 41 percent of people claim social media would impact their choice of a physician or hospital, I’d like to see the numbers if we asked which was more influential: social media or insurance coverage. I’m pretty sure reimbursement trumps reputation and quality much more often than most of us would like. Among resources used to health information, Wikipedia was at 31 percent. Since I personally use Wikipedia to validate information fairly often, that felt low to me.

I was heartened to learn that 60 percent of people trust physicians’ social media posts over any other group. In real-life clinical practice, it felt like I was often competing against Aunt Betsy or the neighbor up the street, so six out of 10 isn’t bad. Given this number in light of the statistic about the 18-24 year olds being so trusting of items seen on social media, I should probably start posting “safe sex” advice on my professional Facebook page. I’m sure my grandmother would be scandalized, but I can say I’m doing it in the name of science.

The final statistic mentioned is that Facebook is the most popular for hospitals that have an online presence. I must admit, my professional self no longer follows my hospital’s Facebook presence because I simply couldn’t take it any more. Rather than being a good source of health information and patient advocacy, it had become little more than a marketing vehicle. If I read one more congratulatory back-pat for earning some bogus “Top Whatever Hospital Center of Excellence Patient Choice Satisfaction” award, I was going to need anti-nausea medication.

What would Mark Twain think of the information age and its lies, damned lies, and statistics? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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December 19, 2013 News 7 Comments

News 12/18/13

December 17, 2013 News 6 Comments

Top News

The 2014 defense authorization bill, which has been endorsed by both the House and Senate, requires the DoD and VA to develop by the end of January “a detailed plan for the oversight and execution of the interoperable electronic health records with an integrated display of data, or a single electronic health record.” If the agencies miss the deadline they risk losing their ability to spend more than 25 percent of the estimated $344 million in funding needed for the project and will be required to notify military and veterans committees before dispensing any project funds in excess of $5 million. The system deployment deadline is end of 2016.

Reader Comments

12-17-2013 1-11-40 PM

inga From Lion: “Re: LinkedIn. OK, I’m curious. What is the deal with your profile picture?” There’s no faster way to peg yourself as a HIStalk Newbie than by asking Mr. H why a healthcare-related website features a smoking doctor or why I have hot shoes on my LinkedIn profile. I shared with Lion that I used to have the Inga avatar on my profile, but the LinkedIn police took it down, saying only photos were acceptable. I feel like such a renegade every time I see the sexy shoe photo on LinkedIn, though I’m now thinking it’s time to feature a new pair. Stay tuned.  

12-17-2013 6-32-42 PM

From Leaving T-System: “Re: big changes at T-System last Friday. Sunny Sanyal will leave the company in January, now looking for new CEO. Mikael Ohman, COO will be working on special projects only. Jim Mullen, SVP Sales is leaving to join Allscripts. Mark Horner is now SVP & GM over RevCycle+, already updated his LinkedIn page.” Varian Medical Systems has already announced that Sunny Sanyal will be taking over as SVP and president of its Imaging Components businesses as of February 7, 2014.  We appreciate T-System’s response to our inquiries:

It is with mixed emotions that we can confirm those changes are accurate. Sunny made the decision based on a personal need to work closer to his family and spend more time with his wife and three children. Sunny was very well-liked and respected at T-System and we will truly miss him. Sunny will remain as the CEO of T-System until the end of January. On a positive note, we have some additional, exciting changes that we would like to share with HIStalk readers. John Trzeciak, a long-standing board member and principal at Francisco Partners, will help with the transition and step in as the interim CEO of T-System while we search for a replacement. John has an extensive background in leading healthcare organizations and helping companies manage leadership transitions, and is already engaged in the T-System business through his role on the board. We are excited to announce that Tom Dunn has been named as Executive VP of sales and marketing. Tom had tremendous success as the sales and marketing VP at QuadraMed, helping the company achieve double-digit growth. We anticipate that he will drive further alignment of our new revenue cycle and documentation solutions. Jim is leaving to pursue new opportunities and we’re grateful for his contributions. Additionally, Mark Horner was promoted to senior VP and GM of our revenue cycle solutions while Steve Armond, T-System CFO, was promoted with additional responsibilities that include operations for client services and performance solutions.

12-17-2013 9-41-01 PM

From Dr. L: “Re: technology tip. I appreciated your review of the Asus MeMo Pad and the tip to find it on sale at Office Depot! I checked immediately and snagged the last one at my local store. I’m in a similar situation with an aging device, and it’s helpful to follow someone you trust to wade through the plentiful options. I was considering one of the new iPad Minis, but I agree the Asus delivers a lot of value and doesn’t feel like I’m skimping. You’d have a lot of grateful followers if you included a regular Personal Technology section on your blog. I recall a comment several years ago about your strategy to use your iPod Touch on WiFi instead of an iPhone, and I adopted that idea, too. Many thanks to you and your team for all you do each week. You’re the highlight of my day!” I appreciate those nice words and I’m still loving the Asus, especially for $120 (try playing this movie on it to appreciate the HD display.) I don’t buy a whole lot of technology, but I usually get excited about it when I do, because I’m a nerd, obviously, and a bargain hunter besides. It would be fun to have readers weigh in on their latest purchases and the deals they’ve found.

HIStalk Announcements and Requests

12-17-2013 6-48-04 PM

Welcome to new HIStalk Platinum Sponsor Lincor. The 10-year-old Nashville-based company’s patient engagement technology portfolio includes PatientLINC (touch-screen, in-room access to clinical information for caregivers and  patient tools, communication services, and entertainment such as on-demand video and games); ClinicalLINC (secure bedside EMR access via wall-mounted terminals);  MediaLINC (in-room patient access to educational materials and entertainment); and MobileLINC (patient access to medical information, educational materials, and entertainment on their mobile devices). All of these increase patient satisfaction and improve outcomes, helping hospitals meet Medicare-funded requirements for patient satisfaction, readmissions, and Meaningful Use. The company’s systems are used by 120 hospitals and 25,000 beds all over the world, and the world headquarters have been moved from Cork, Ireland to Nashville. Just this week the company announced another funding round, this time of $3 million, to expand in the US and EMEA. Thanks to Lincor for supporting HIStalk.

My YouTube cruise turned up this new and well-done video overview of Lincor’s LINC technology.

Acquisitions, Funding, Business, and Stock

12-17-2013 6-33-29 AM

HealthTech Holdings, which includes the HMS, Patient Logic, and Medhost brands, changes its name to Medhost and names Craig Herrod president. He previously served as president and CEO of the Medhost division.

Juniper Networks will acquire WANDL, a provider of software solutions for multi-layer networks, for $60 million. 


At Home Healthcare (TX) selects Procura Homecare software as its home and community care platform.

The Louisiana Senior Care Coalition chooses eClinicalWorks Care Coordination Medical Record as its population health management solution for advancing ACO objectives.

12-17-2013 6-22-19 PM

The VA St. Louis Health Care System will implement LiveData PeriOp Manager and integrate it with its existing VistA EHR.

Hospital Sisters Health System (IL) chooses Passport to provide RCM solutions and services to its 14 hospitals and network of affiliated facilities.

Intermountain Healthcare (UT) selects Elsevier ClinicalKey to provide electronic medical reference and knowledge-based information to its clinicians and medical libraries.


12-17-2013 10-48-26 AM

Medfusion names Vern Davenport (MModal) president and an equity partner.

12-17-2013 9-28-06 AM

Jack Redding (Mount Sinai Medical Center) joins Halfpenny Technologies as SVP of sales and marketing.

Oncologist Susan Desmond-Hellman, MD, MPH (UCSF) is named CEO of the Bill & Melinda Gates Foundation. One of her key policy recommendations to the National Academy of Sciences was creation of a knowledge network that would allow sharing patient data across research and clinical practice to tailor treatments to individual patients.

T-System appoints Tom Dunn (QuadraMed) EVP of sales and marketing.

12-17-2013 5-50-58 PM

inga Kathleen Sebelius announces the appointment of former Microsoft executive Kurt DelBene as senior advisor to lead and manage the Healthcare.gov project. DelBene was president of the Microsoft Office division, leading me to wonder if he’ll be typing many of his own memos in Word and if the memos will ever include the term “EHR.” Wouldn’t it be great if he were able to lobby his former employer to fix that annoying EHR/HER auto-correct issue?

Announcements and Implementations

HIMSS and HHS are recruiting for an “Innovator in Residence” to serve a two-year term to develop and implement a nationwide patient data matching strategy.

12-17-2013 6-18-02 PM

Susquehanna Health (PA) implements Summit Provider Exchange technology to provide bidirectional integration between its hospitals and physician practices running NextGen EMR.

Bay Area Medical Center (WI), which recently signed a letter of intent to partner with Aurora Health Care (WI), begins implementation of Epic, the platform already in place at Aurora.

The Illinois HIE and Missouri Health Connection will share clinical patient data.

12-17-2013 12-10-00 PM

Essentia Health-Virginia (MN) goes live on Epic.

Polk County Human Services (WI) adopts Forward Health Group’s PopulationManager to track and analyze the progress of patients with substance abuse disorders.

Palomar Health (CA) goes live with AirStrip ONE for remote EKG access, co-developed by the organizations based on Palomar’s MIAA (Medical Information Anytime Anywhere) platform that AirStrip acquired in mid-2012.

12-17-2013 7-50-09 PM

Oncology EMR vendor Altos Solutions and outcomes and analytics vendor COTA announce a partnership to sell value-based cancer care systems in the US.

In the UK, the Department of Health opens bidding to choose a new outsourcing provider for its Oracle HR management system, planning to replace McKesson after 13 years. The contract is valued at up to $730 million over six years.

12-17-2013 8-21-36 PM

UPMC’s Children’s Hospital (PA) will make its physicians available for second opinions to members of MDLIVE, which offers secure online access to physicians.

In England, NHS’s clinical research group uses QlikView to review clinical data quality and find unusual patterns.

Government and Politics

12-17-2013 6-19-56 PM

Medicare publishes a list of the 97 best and 85 worst hospitals for hip and knee replacements based on post-surgery complications and readmissions.

inga Congressmen Erik Paulsen (R-MN) and Jim Matheson (D-UT) propose legislation that would mandate the use of clinical decision support software by physicians receiving Medicare and Medicaid reimbursement when they order diagnostic imaging tests. The goal is to provide doctors with immediate feedback and recommendations for the appropriate tests to order. Sounds like a great idea that would likely create a few administrative nightmares.

Big pharma wants an independent investigation of the FDA’s computer security after a database containing clinical trial results and drug marketing plans submitted by drug companies was hacked last month. The drug companies are afraid their confidential information could end up in the hands of a competitor. FDA says the attacked system didn’t contain such information.


12-17-2013 9-05-13 PM

ReferralMD Founder and CEO Jonathan Govette, like others, says that EMRs will become unbundled the same way that a myriad of Craigslist features turned into much better individual platforms started by others. Above is how he sees that happening (click the image to enlarge). Tip from @ForwardHealthGP.

HIMSS will hold an mHealth Summit Middle East in Abu Dhabi in May 2014.

12-17-2013 9-54-13 PM

StartUp Health and AARP release a report on digital health in consumers over 50. Like much of what’s packaged as mHealth, it’s mostly aimed at investors rather than consumers.

Saint Francis Hospital (NY) says its Meditech implementation forced it into bankruptcy with $50 million in debt, but adds that it was the hospital’s own poor financial implementation and not Meditech that cost it “tens of millions of dollars” of uncollectible revenue. The hospital will sell itself once it exits bankruptcy.

A group of New York City parents files suit against the city and the Department of Education, claiming that disruptive 6- and 7-year-olds are being sent by ambulance to area EDs in violation of the Americans with Disabilities Act solely because the schools can’t handle them. According to one mom, “It has caused a financial and emotional strain for me and my entire family. I feel that they sent my son to the emergency room as an excuse to not do their job. If my child acts up at home I cannot send my son to the hospital emergency room.”

12-17-2013 10-39-45 PM

A California newspaper profiles 20-employee, Sebastopol-based E-Health Records, which develops EHRs primarily for use in developing nations. It runs on Android-powered tablets over Amazon cloud services.  

inga A former HHS investigator shares tips for preparing and responding to a fraud and breach investigation. The investigator says one of the biggest mistakes an organization can make during an on-site visit is to make the investigator wait. I’m guessing he’s never had to be on hold forever while trying to follow up on a Medicare claim. Now that’s waiting.

12-17-2013 7-46-39 PM

Weird News Andy summarizes this story as, “Makes it easy to put on socks.” Doctors in China reattach a man’s severed hand to his ankle for a month while he regains strength for hand surgery. I’m not entirely buying it – the story sounds suspicious and the picture looks a bit Photoshoppy.

WNA also notes this non-weird story, which describes November’s US hospital admissions as the lowest in a decade, with the survey sample of 98 hospitals reporting that admissions were down more than four percent.

Sponsor Updates

  • LRS releases the Mobile Connector for VPSX software, which allows users to print documents from any mobile device to any VPSX-defined output destination.
  • Athenahealth will integrate Merge Healthcare’s iConnect Network into its athenaClinicals EHR to allow users to receive and view exam results and diagnostic-quality images.
  • Wolters Kluwer Heath integrates its Health Language Provider Friendly Terminology with Epic EHR for mid-size to large practices and for hospitals.
  • Greenway Medical adds Digital Assent, a provider of patient satisfaction survey solutions, to its online Marketplace of value-added partners.
  • McKesson Episode Management releases 22 new episodes based on the PROMETHEUS Payment Evidence Informed Case Rate definitions, making it the first automated bundled payment solution to support the latest PROMETHEUS model.
  • InstaMed has grown to 1,000 providers and has processed over $30 billion in healthcare payments in 2013.
  • Razornsights employees celebrate the company’s Founder’s Day by building shoebox gifts in support of Operation Christmas Child.
  • Minnesota’s Office of the Commission of Health certifies Sandlot Solutions a health data intermediary, authorizing the company to provide HIE services in the state.
  • Maryland hires Optum/QSSI to provide project management and operational support for the Maryland Health Connection website.
  • A Nashville paper spotlights Lincor Solutions and the launch of its patient engagement technology for hospitals and health systems.
  • Health Catalyst board member and former Intermountain CIO Larry Grandia wins the 2013 Utah Governor’s Medal in Science and Technology.
  • Fujifilm demonstrated its Synapse products and the showed the MU Stage 2 capabilities of its Synapse RIS at RSNA
  • T-System authors a case study featuring its facility coding customer Memorial University Medical Center (GA), which boosted its ED revenues 20 percent through its coding initiative. 


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

More news: HIStalk Practice, HIStalk Connect.


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December 17, 2013 News 6 Comments

Monday Morning Update 12/16/13

December 14, 2013 News 11 Comments

12-14-2013 3-20-22 PM

From Epic Fail: “Re: Epic. During the Q&A portion of a talk by Bernard Tyson (Kaiser CEO) at Epic today, an Epic employee stood up in front of a full Epicenter and asked Mr. Tyson if he thought that Kaiser would consider selling insurance in the future.” I will generously assume that the interrogator was one of Epic’s youthful, perfect-SAT savants who performed a quick scenario analysis and was shrewdly suggesting to Mr. Tyson that Kaiser’s business model might need to adopt to ever-changing healthcare requirements by focusing on other aspects of the corporate portfolio beyond its extensive insurance offerings. Either that or it was the typical Epic 24-year-old philosophy graduate who knows nothing about healthcare, but who has gained unwarranted conversational confidence from telling hospital people how to run their businesses using knowledge obtained from reading software manuals.

12-14-2013 8-48-04 AM

From Sharing is Caring: “Re: Kaiser. I just got this and it is very interesting… revolutionary, in fact. We can now share patient information between any Kaiser and all of the major hospitals in the SF Bay Area that use Epic-Sutter, Stanford, UCSF, and Alta Bates.” Shared Epic information includes just about everything from the patient, encounters, and results, omitting only flowsheets, images, smart forms, and scanned documents.

12-14-2013 9-39-51 AM

From The PACS Designer: “Re: RSNA highlights. The 2013 RSNA featured an interesting shift in how radiologists can interact with patients. Aunt Minnie listed five areas that drew the attention from attendees. TPD was pleased to see informatics among the list of the top five categories presented in the list for radiologists to consider for adoption.” According to the writeup:

In the past, big iron scanner introductions drew the lion’s share of attention at McCormick Place. One of the defining characteristics of the “new normal” for the RSNA meeting, however, may be the continued prominence of imaging informatics software in the exhibit halls and the scientific program. Indeed, market interest in these technologies seemed to provide a rare sign of hope amidst the overall malaise that still seems to be plaguing much of radiology.

That radiology maturation seemed inevitable – it happened in lab, where the intelligence moved from the instruments to the software managing the information the instruments created. Imaging costs, radiation exposure, remote viewing, patient image sharing, and radiology efficiency are all key issues that smart software (rather than the latest and greatest scanner) can improve.

12-14-2013 7-48-50 AM

Even hospital people like HIStalk readers don’t pay attention to published hospital quality data when making medical decisions for themselves. New poll to your right: is the term “mHealth” obsolete or unnecessary? I think it’s not only meaningless (as is “digital health”) but also unnecessarily divisive as companies and people wall themselves off behind that label instead of jumping into the mainstream of just “health.” That’s not a criticism of the companies waving the mHealth banner – we’re having the same identity crisis in “healthcare IT” as well as it becomes clear that our horizons should be “health” and not just “healthcare” and we try to figure out how population health management and wellness fit among our stodgy billing and order entry episode-based applications. Somewhere among all of that self-imposed digital segregation are consumers-slash-patients wondering why we have to make everything so provincial, fragmented, and complicated.

My latest grammar pet peeve examples, provided without explanation since they are hopefully obvious: (a) I went away for a couple days; (b) So I read a new book; (c) I eat breakfast everyday in the backyard. I’m also still frustrated constantly by lame articles with supercharged headlines that make them sound useful and insightful when they clearly aren’t, leaving me to feel as though I wasted my time with the journalistic equivalent of trying to make a meal of air-filled Cheetos and instead ended up still hungry and with embarrassing orange gunk on my lips (I’m often led to those worthless articles by Twitterers and Facebookers who seem to love being the first to link to awful healthcare IT articles.)

12-14-2013 9-18-37 AM

Welcome to new HIStalk Platinum Sponsor Proximare Health. The 10-year-old Savannah, GA-based company improves the referral process, with 3,000 users processing 25,000 referrals per month through its clinical rules-powered IRIS (Internet Referral Information System). The result: referrals are made to the most appropriate service, the appropriateness is validated from the Web-based system, eligibility and authorization are verified, patients are prioritized by condition, clinical documentation is managed, and results are shared among a patient’s providers. IRIS was built with the help of clinicians from nearly every specialty at Cook County in Chicago, who were trying to solve access challenges by making sure referrals were clinically appropriate, with the referral process managed by (and supported by) clinicians instead of a non-clinical utilization management department. Cook County’s results: (a) referral processing time was reduced from three months to 5.5 days; (b) 22 percent of the referrals were rejected as inappropriate; (c) referral volume increase sevenfold with fewer employees needed to manage it. Check out the short  videos covering order entry, rules engine, scheduling, document and results sharing, patient messaging, appointment preparation, interoperability, and business intelligence. Thanks to Proximare Health for supporting HIStalk.

Proximare had lots of its own YouTube videos, but I found one created by Portland IPA on how it uses the IRIS referral management system.

12-14-2013 8-32-16 AM

My first-generation iPad is getting long in the tooth to the point it can’t run newer versions of apps. I don’t use it enough to justify spending $499 on an iPad Air or even $299 for an iPad mini, so I did my research and instead bought an Asus MeMo Pad HD 7 for $119 from Office Depot on Friday. It’s amazing how much technology you get these days for so little money and in a thin, 10-ounce package: a high-definition display, super fast performance with 1 GB of DDR3 memory, front and rear cameras, dual speakers that sound really good, 10-hour battery life, highly responsive touch, 16 GB of storage, and a Micro SD card reader slot for cheap storage expansion. A seven-inch screen is plenty big when you have an HD display — even tiny text is crisp and playing a YouTube HD movie will just about take your breath away (I’ll use it to watch movies on planes, I’m sure.) Picking up my old iPad now is like hefting a yellowed, weighty encyclopedia volume from 1970. The MeMo Pad feels every bit as satisfying and well designed as my iPhone and Android is just as easy to use as iOS. Thank you, Google, for developing an economical and powerful alternative to the OS wares of Apple and Microsoft.

12-14-2013 8-06-25 AM

Cerner announces a $217 million share repurchase program. As a review, those programs involve companies using their cash to buy their own shares (which they often consider undervalued) on the open market. Or at least that they’ve announced plans to do so – companies don’t always follow through. Those purchases take shares off the market, which increases earnings per share even though overall earnings haven’t changed. They also increase executive bonuses tied to earnings per share at the expense of reduced cash that might have been spent on R&D or acquisitions. In other words, share repurchase programs don’t mean a thing despite the feel-good message that “we love our stock so much that we’re buying it ourselves.” Above is the five-year performance of CERN vs. the Nasdaq.

12-14-2013 8-10-17 AM

Jamie Stockton of Wells Fargo Securities provides the above slice-and-dice of hospital Meaningful Use attestations through 10/31/13. Meditech leads by far in total and net number of attestations, while Epic, Cerner, and McKesson have the highest percentages of clients successfully attesting. Trailing the pack in client percentages are Healthland, Siemens, and Allscripts.

12-14-2013 3-26-42 PM

Duke University Health System goes live with Strata Decision Technology’s StrataJazz for capital and long-range financial planning. 

12-14-2013 3-16-40 PM

A former IT director of The Advisory Board Company pleads guilty to defrauding his employer of $100,000 by approving the payment of invoices to a sham company he created for that purpose.

12-14-2013 3-28-52 PM

Barron’s says athenahealth’s stock drop late last week was due to concerns raised at the company’s investor meeting: (a) CEO Jonathan Bush announced that he will take a two-month leave next year; (b) the company guided next year’s earnings expectations down; (c) the company’s use of flattering but unusual financial measures that have given it a “thin-air valuation” of $5 billion; (d) athenahealth’s statement at the investor meeting that it will double its market opportunity by selling inpatient clinical software to hospitals and by doing so will “undermine the foundations” of Cerner and Epic; (e) the company has little choice for selling to hospitals because they are acquiring its practice-based customers and replacing athenahealth’s products. Athenahealth’s hospital plans apparently involve pre-certification and referrals.

Weird News Andy titles this story as “Now that’s what I call a gestation period,” although he notes that “the train never left the gestation.” Doctors find that an 82-year-old woman with stomach pain has a 40-year-old fetus inside her.

Here’s Vince’s Christmas edition of HIS-tory.


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

More news, HIStalk Practice, HIStalk Connect.


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December 14, 2013 News 11 Comments

News 12/13/13

December 12, 2013 News 1 Comment

Top News

12-12-2013 7-22-35 PM

Athenahealth lowers FY14 guidance, projecting EPS of $0.98-$1.10 vs. analyst expectations of $1.38, sending shares down 14 percent Wednesday.

Reader Comments

From Norm: “Re: HHS Office for Civil Rights. I’m not surprised the OCR had issues with their internal security practices based on my past interactions. I’ve been through a couple of OCR audits and my staff and I spent almost as much time educating the auditors on the MU requirements and the meaning of various measurements as we did compiling the reports for the actual audit. I’m curious if that is also the experience of other HIStalk readers.” Readers are welcome to weigh in.

12-12-2013 8-47-43 PM

From Bobby Orr: “Re: Lifespan (RI). Having to borrow another $50 million during bad financial times to buy Epic may not have been the best idea.” Lifespan’s net earnings dropped from $41 million to a loss of $5 million in the most recent fiscal year excluding a one-time gain. The health system blames the “unique dynamic in play nationwide.” It paid its CEO $7.88 million in 2011.

HIStalk Announcements and Requests

inga_small In you’ve gotten behind on your ambulatory reading in the midst of the busy holiday season, here are a few highlights: MGMA requests end-to-end ICD-10 testing with physician offices. CMS will develop guidelines for the practice of copying and pasting in EHRs. Private physicians office are predicted to net profit margins of 12.7 percent for 2013. Only 17 percent of Medicaid EPs are meaningful EHR users, though 76 percent have been paid an EHR incentive. An autism module added to an EHR’s clinical decision support system improves screening. Brad Boyd of Culbert Healthcare Solutions considers the value of EHR optimization. Dr. Gregg wonders if health IT cares. If you take a moment to sign up for the HIStalk Practice email updates it will be like buying a Christmas present for your BFF (in this case me) and getting a present for yourself at the same time (come on, you know you’ve done that.) Thanks for reading.

On the Jobs Page: VP of Product Management.

Acquisitions, Funding, Business, and Stock

12-12-2013 10-36-18 PM

Streamline Health Solutions reports Q3 results: revenue flat, EPS -$0.50 vs $0.18.

12-12-2013 7-25-08 PM

Doctor on Demand, which offers $40 video chats with US-licensed doctors, closes $3 million in seed funding. Investors include athenahealth’s Jonathan Bush, Venrock, and Google Ventures.

12-12-2013 7-27-18 PM

Toronto startup Figure 1, which offers a photo-sharing app for physicians, raises $2 million in seed money.

12-12-2013 8-37-59 PM

Cerner will take a Q4 earnings charge of up to $0.19 per share (vs. expected earnings of $0.35) after an arbitrator rules in favor of Trinity Medical Center (ND). The value of the settlement wasn’t announced, but the hospital had sought $240 million, claiming that the Cerner Pro-Fit financial system it bought in 2008 was dysfunctional. CERN shares closed down 1 percent Thursday.


12-12-2013 7-28-50 PM

Estes Park Medical Center (CO) selects Summit Healthcare to integrate its Meditech HCIS and MEDHOST EDIS.

12-12-2013 7-29-40 PM

Butler County Health Care Center (NE) selects Access electronic patient signature and e-forms solutions to complement its Meditech rollout.

Springhill Medical Center (AL) chooses Allscripts Sunrise Surgical Care to manage the perioperative care process.

The 16-bed Crook County Memorial Hospital (WY) contracts with RazorInsights for its ONE-Enterprise Edition.


12-12-2013 7-31-58 PM

Alere appoints former US Surgeon General Regina M. Benjamin, MD to its board.

12-12-2013 9-14-10 PM

MidMichigan Health names Dan Waltz (University of Michigan Health System) as VP/CIO.

12-12-2013 9-26-02 PM

Joe Craver, president of the health and engineering sector of Leidos, resigns. The parent company of the split-up SAIC announced this week that it lost $7 million in the most recent quarter vs. a profit of $100 million year over year. Revenue in Health and Engineering dropped 20 percent, which the company attributed to completed projects, less new business, and shrinking hospital budgets. That division includes SAIC’s healthcare consulting acquisitions, Vitalize Consulting Solutions (July 2011, price not disclosed) and maxIT Healthcare (July 2012, $473 million.)

Announcements and Implementations

CommonWell Health Alliance will launch its interoperability services in early 2014 in Chicago; Elkin and Henderson, NC; and Columbia, SC.

12-12-2013 7-34-24 PM

Cerner will offer KidsHealth pediatric-specific discharge and after-care instructions within the Cerner Millennium Patient Education Content.

Practice EMR vendor drchrono releases an API that will allow developers to extend and enhance its platform.

Government and Politics

HHS Secretary Kathleen Sebelius reports that 365,000 individuals had selected plans from the state and federal marketplaces by the end of November, with November’s enrollment in the federal marketplace four times greater than that of October. Sebelius also reveals that the IT costs for the website totaled $677 million through the end of October.

12-12-2013 7-16-39 PM

HHS launched the Spanish version of the marketplace website last weekend.

12-12-2013 8-33-04 PM

Texas Medical Association urges CMS to extend the MU Stage 2 deadlines for another year.

A Kentucky doctor announces closure of his practice, erroneously blaming Obamacare (rather than ARRA) for requiring him to adopt electronic medical records. He says the change would be too expensive and would require thousands of hours of work to convert his paper records.

12-12-2013 10-21-08 PM

An OIG report on fraud prevention safeguards in hospital EHRs recommends that hospitals:

  • Turn on EHR audit logging at all times (ONC responded that it will make this a certification requirement for vendors)
  • Revoke permissions for users to delete or edit the audit
  • Use audit logs to detect fraud, not just monitor for HIPAA violations
  • Develop policies for using EHR copy-paste capabilities, issue warnings to users copying and pasting, and capture copy-paste activity in the audit log (CMS responded that it will develop guidelines on copy-paste use)

ONC will discuss findings from its patient matching initiative next week in Washington, DC.

Innovation and Research

12-12-2013 7-35-55 PM

Kaiser Permanente’s use of data analytics is helping to lower hospital mortality rates, according to CMIO John Mattison.

HIE data can identify ED frequent flyers better than a single hospital’s records, according to a Health Affairs-published study of 10 hospitals participating in the New York Clinical HIE.

Researchers at Johns Hopkins University are working with a Belgium-based technology company to developed a nanotechnology-based “lab on a chip” that would allow diagnostic testing to be performed anywhere.


In England, an NHS-funded patient safety project replaces paper charting of vital signs with automatic recording via an iPad app, which also calculates an Early Warning Score. Project developers Oxford University Hospitals was also awarded a grant to develop a system that links the EHR to the pharmacy packaging robot so that take-home meds can be prepared and delivered automatically, decreasing discharge delays.


12-12-2013 1-26-26 PM

The Fire Department of NYC sends a medical bill, addressed to “unknown Asian” to The New School of New York, a 10,000 student college.  A spokesman for FDNY says their billing contractor is fixing the problem.

HIMSS names MedPeds (MD) a 2013 Ambulatory HIMSS Davies Award of Excellence winner for its use of EHR to improve the healthcare delivery process and patient safety while achieving a demonstrated ROI.

12-12-2013 9-19-17 PM

Horizon Blue Cross Blue Shield of New Jersey notifies 840,000 customers that their personal and clinical information has been exposed after two unencrypted laptops are stolen from its offices. 

Healthcare app platform vendor Happtique, which sells services to app vendors intended to improve provider confidence, suspends its certification program when an outside developer finds that apps in the first group Happtique certified two weeks ago store usernames, passwords, and data as easily exposed plain text.

A tweet by UCSF physician Bob Wachter, MD says that each ICU patient triggered an average of 1,156 alarms per day, leaving nurses with 2.5 million alarms to deal with in one month.

Weird News Andy suggests redefining “never.” In England, NHS reveals that 150 patients were harmed in six months by “never” events that included performing heart surgery on the wrong patient, removing a woman’s fallopian tube instead of her appendix, and 69 cases in which surgery implements were left inside patients.

Sponsor Updates

  • Market research firm Radicati Group names AirWatch a “Top Player” in the Enterprise Mobility Management Market Quadrant.
  • Cornerstone Advisors Group chooses three client-related hospital projects to support from its Cornerstone CAres charitable program funded by the company and its employees.
  • The Orange County Register names Kareo a top workplace in the mid-sized company category.
  • Clinithink wins the 2013 MediWales Innovation Judges Award for the development of innovative technology and outstanding contribution to the life science sector.
  • Business NH Magazine names Bottomline Technologies to its Best Companies to Work For Hall of Fame for 2013.
  • The HROToday Forum names Aspen Advisors and its big data platform Pando the Top Technology Innovator for 2013.
  • Forward Health Group CMIO John Studebaker,  MD discusses the transition to value-based care in an MGMA on-demand webinar.
  • Halfpenny Technologies discusses how access to actionable and complete lab and clinical results data enables health insurance organizations improve care management.
  • DrFirst presents a case study profiling Edward Sobel, DO and David Krasner, DO and and their transition to e-prescribing.
  • Craneware sponsors a December 17 HFMA webinar featuring Lake Regional Health System’s (MO) development of an audit management process. 
  • The Boston Globe names Imprivata one of the city’s best places to work for 2013.
  • Porter Hills Retirement Community Services and Home Care shares how it found flexibility and time savings through the use of the HealthMEDX Vision solution. 
  • Liaison Healthcare predicts six 2014 trends that will make an impact on the healthcare and life sciences industries.
  • Laura Kreofsky and Jason Fortin of Impact Advisors provide commentary on the recently announced extension of Stage 2 and Stage 3 MU deadlines.
  • Lincor Solutions launches a portfolio of products for delivering patient engagement to hospitals and health systems.
  • Truven Health Analytics releases MarketScan Oncology EMR Database for oncology-focused research studies.

EPtalk by Dr. Jayne

I enjoyed reading Rebecca Sutphen’s piece on bringing up family health history during the holidays. Not only is it important for individuals to understand their family history for genetic purposes, but it’s good for the younger generations to be aware of conditions their older relatives may be treating. Knowing that Uncle Sal is diabetic may be helpful if he starts acting funny on Christmas Eve and he hasn’t been hitting the eggnog.

It can also be important to understand relatives’ end-of-life plans. I encourage everyone to discuss their wishes with family, especially if they don’t have an Advance Directive in place. The holidays may be the only time families get together and talk about these important issues. Good information on talking points can be found at FamilyDoctor.org.

I’ve received a lot of correspondence regarding Monday’s Curbside Consult discussing the CMS changes to Stage 2 and Stage 3. I got quite a few questions about the three years of Stage 2 for those practices that started Meaningful Use in 2011 or 2012. At this time, participating providers and hospitals will have to complete all three years and there won’t be any skipping allowed. All of the CMS materials will need to be updated, but I’m sure they will be clarifying this.

As CMS tries to use information from Stage 1 and Stage 2 to inform Stage 3, a reader shared John Halamka’s recent blog (written before the announcement) about rethinking certification. Make no mistake, the recent timeline shift does not do anything to delay the need for hospitals and providers to have their certified 2014 software live so that they can attest in 2014. I agree with his assessment that the certification criteria are “overly burdensome…. And disconnected from the attestation criteria.” Some of the certification criteria have also forced vendors to modify functionality in ways that fracture provider workflows and make it more difficult to provide care.

Since I use several different big-name products, I know that there are some nuances in the ways that vendors implement these requirements, but some of them are particularly difficult to implement with good usability in a way that actually supports clinical care. I visited one of my providers the other day and listened to what can only be described as a tirade against all the bells and whistles that don’t do anything to help him provider better care to his patients. I agreed, but also pointed out that it’s bigger than Meaningful Use and EHRs, though – there are many things that have happened in medicine during the last few decades that do little to improve patient care.

E&M coding rules, draconian audit methodologies, Medicare RAC hit squads, pre-payment audits, and the rise of defensive medicine have done little to improve care. In my experience as a patient, I think that patient portals are the best thing since sliced bread. I enjoy being able to use secure communications to take care of issues without having to take phone calls at work or schedule time off.

However, in looking through communications with my physicians over the last two years, not a single question has been medical. I don’t think it’s because I’m a physician and am making my own medical judgments. My clinical history looks very similar to most women in my age group and it’s not that complicated. Looking at the topics of communication across a couple of practices reveals: requesting a mammogram order with a wet signature for no good reason other than the imaging center wants one because it’s afraid of an audit; dealing with wacky insurance rules that require me to reschedule a visit because it’s one day earlier than the insurance plan allows; requesting to have a prescription rewritten with specific directions because my pharmacy benefit manager disagrees with one that meets all of the Surescripts guidelines for correct and accurate prescribing; and dealing with a co-pay issue because the office didn’t understand that I don’t pay one for preventive visits. There are more, but the theme is the same.

My fear (which I think is well founded) is that things are only going to get more complex. To make things more interesting, like many Americans, I have brand new health insurance starting after the first of the year. Now I get to figure out all the nuances that took me years to figure out with my previous carrier. At least we can all sympathize. It’s looking like 2014 is shaping up to be a very interesting year indeed.

A shout-out to my friend Dr. Doug Farrago of the Authentic Medicine Gazette for sharing this quote of the week which sums up my recent challenges as a CMIO:


I never did give anybody hell. I just told the truth and they thought it was hell.


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

More news, HIStalk Practice, HIStalk Connect.


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December 12, 2013 News 1 Comment

News 12/11/13

December 10, 2013 News 6 Comments

Top News

12-10-2013 5-23-25 PM

Practice Fusion closes a $15 million Series D round led by Qualcomm Ventures, bringing the company’s total funding raised to date to $149 million.

Reader Comments

12-10-2013 5-53-48 AM

From Lorre: “Re: mHealth. So many people were coming up to me asking if I was Inga that I finally had to make this sign. I am going to get a well-made one for HIMSS. At one point today I showed someone my shoes and he said, ‘Yeah, you’re not her.’” Lorre was holding court at our little HIStalk booth at this week’s mHealth conference. I’m going to recommend that she not only get a better sign for HIMSS but step up her shoe attire, just to confound suspicious readers.

From Helen: “Re: mHealth Summit. I met Lorre – she rocks!” Lorre enjoyed meeting those (few) readers who attended the conference this week. I’m not sure it was relevant enough for a return next year, but we’ll see.

From ASMD: “Re: floppy disks. New York Times or Dilbert?” An article points out that government is not the most sophisticated technology user, noting that The Federal Register often receives submissions from federal departments via 3.5” floppy disks.

Acquisitions, Funding, Business, and Stock

12-10-2013 5-26-09 PM

HealthLoop, which offers an automated patient follow-up solution, raises $10 million in Series A funding led by Canvas Venture Fund. The company’s CEO is Todd Johnson, the former CEO and president of Salar.

IMS Health, a big data firm that aggregates and sells large databases of de-identified healthcare data, acquires Pygargus, a Swedish health analytics firm. Bloomberg, by the way, reports that IMS Health is considering an IPO in 2014 and  may seek a company valuation of at least $8 billion.


The Indiana HIE selects AT&T’s healthcare Community Online information exchange platform for clinical messaging and medical record sharing.

12-10-2013 1-49-05 PM

Crystal Run Healthcare (NY) selects the Health Catalyst data warehousing and analytics platform.

12-10-2013 1-48-17 PM

UF Health Shands (FL) contracts with Besler Consulting for its Transfer DRG recovery services.


12-10-2013 1-50-04 PM   12-10-2013 1-53-47 PM

HMS Holdings names Joel Portice (Verisk Health) divisional president of government solutions and corporate strategy and Douglas M. Williams (Aveta) divisional president of commercial solutions.

12-10-2013 1-54-45 PM

Teleheatlh solution provider AMC Health appoints Lisa J. Roberts (Viterion Corporation) SVP of its government market division.

12-10-2013 11-54-26 AM

Juan Diaz (Association Capital Resources) joins The HCI Group as SVP/general counsel.

12-10-2013 4-37-04 PM

Bobbie Byrne, MD is named SVP/CIO of Edward-Elmhurst Healthcare, created by the merger of her former CIO employer Edward Hospital and Elmhurst Memorial Healthcare. She will also have responsibility for the facilities and construction departments at Edward as well as the two locations of the Edward Cancer Centers.  

Next Wave CONNECT names Doug Cusick (HP/IBM), Robert Cothron (Singing River Health System), Becky Heflin (IBM), John McDowell (Oslo’s), and Sherry Reynolds (HHS) to its community management team.

Announcements and Implementations

12-10-2013 8-21-45 AM

St. Mary’s Health Care System (GA) makes the Epic MyHealth portal available for hospital patients.

Billings Clinic (MT) implements Omnicell automated dispensing cabinets integrated with Cerner Millennium EHR via the CareAware iBus.

Mercy Medical Center (MD) deploys BridgeHead Software’s Healthcare Data Management for the protection of its Epic system data.

PA eHealth, eVantage Health, and Caradigm will complete the pilot for their HIE project in early 2014.

The Mount Sinai Health System (NY) will use $5 million in funding from the NYC Economic Development Corporation to establish the Mount Sinai Institute of Technology. The Institute will initially focus on digital health technologies, biologically integrated technologies, and prescription technologies.

Government and Politics

The FDA, ONC, and FACC will release a report early next year outlining strategies and recommendations on an HIT framework that promotes innovation, protects patient safety, and avoids regulatory duplication.

Do as I say, not as I do: the OIG finds that the HHS Office of Civil Rights failed to comply with certain federal cybersecurity requirements for the IT systems used to store HIPAA-compliance investigation data. The OCR says all deficiencies have now been corrected.


Almost 76 percent of the largest not-for-profit senior living organizations are implementing EHR technology and 83 percent are implementing point-of-care systems.

12-10-2013 12-25-49 PM

KLAS finds that despite vendor claims of the importance of technology differentiation, providers find that technology platforms do not accurately predict EMR capabilities or clinical success.

12-10-2013 12-45-36 PM

Also from KLAS: StatRad, Rays, and TRS earn top scores for overall customer satisfaction in a report on teleradiology in the ED.

12-10-2013 12-33-20 PM

Thanks to Brian Ahier for forwarding an updated graphic that clarifies the newly proposed timeline changes for MU. Brian notes, “I think the important point here is that although there will very likely be more changes to come, healthcare organizations and providers should not count on any delay or changes but prepare for plans to proceed under this current current regulatory framework.”

Further thoughts on the MU Stage 2 extension: the Stage 2 timeline is unchanged, as Brian’s graphic depicts. Just because Stage 3 has been pushed back a year doesn’t mean that ONC is ignoring concerns about Stage 2 as CHIME and other groups seem to assume by their ballistic reaction to the Stage 3 announcement. ONC’s decision-making process has been thoughtful, participative going back to when Farzad was named National Coordinator. ONC announced the Stage 3 decision Friday and mentioned this week that it will offer a public comment period for the regulatory strategy being worked on with HHS and FDA when that report comes out in in early 2014. Those events show show that nothing has changed just because Farzad has moved on – ONC is listening and won’t blindside anyone with salvos of dictatorial imperatives. The pundits are also missing another important point – decoupling product certification from MU gives vendors more predictable certification updates and the change to give input. Vendors can deliver what the market wants (usability and patient safety features, for example) instead of chasing certification checkboxes.

A Massachusetts man spends about $10 and 20 minutes to make a prosthetic hand for his 12-year-old son on a 3D printer using plans he found on the Internet. The estimated cost for a traditional prosthetic hand is $20-$30,000.

Sponsor Updates

  • API Healthcare reports that more than 250 hospitals and other healthcare providers have chosen its ShiftSelect to automate staffing and scheduling processes.
  • HMS will integrate Medi-Span Controlled Substances Drug File from Wolters Kluwer Health into its Prescriber Eligibility solution.
  • Visiongain includes AT&T and Airstrip on its list of Top 20 Mobile Health Companies for 2014.
  • Anthelio Healthcare Solutions and Encore Health Resources align to promote economies of scale and expand available services.
  • Certify will participate in next month’s IHE NA Connectathon 2014 in Chicago.
  • Caristix posts a white paper on managing predictable outcomes and margins with  HL7 integrations.
  • Iatric Systems hosts a December 12 webinar on integrating EHRs with Welch Allyn vitals.
  • Billian’s HealthData shares its list of the five most popular health market reports for 2013.
  • Twenty-nine percent of patients participating in the 2013 Connance Consumer Impact Study rate their most recent hospital billing experience with top satisfactions scores, though 19 percent express full dissatisfaction.
  • PeriGen hosts a December 11 webinar featuring the company’s chief clinical officer Thomas Garite, MD and a discussion on problems with Category II fetal heart rate problems.
  • KLAS gives 3M Health Information Systems the highest overall performance score among vendors for the 360 Encompass System, 3M’s inpatient CAC technology.


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

More news: HIStalk Practice, HIStalk Connect.

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December 10, 2013 News 6 Comments

Monday Morning Update 12/9/13

December 7, 2013 News 8 Comments

12-7-2013 7-45-29 AM

From Beyond the Legalese: “Re: revised Stage 2 timelines announced late Friday. What exactly does this delay mean? If we are a hospital that must attest to Stage 2 by end of fiscal year 2014, does this mean we now have until end of fiscal year 2015 for our first MU2 attestation year?” My impression is that the Stage 2 start date hasn’t changed, only the end date, so it’s not really a “delay” as much as it is an “extension” to make Stage 2 a three-year program. In that regard, I’m not sure the extension is cause for universal celebration since the 2014 dates remain unchanged for Stage 1 and Stage 2 – it’s really only Stage 3 that has been delayed. Feel free to leave a comment. CMS and ONC “announced” the change in a potentially obscure blog post late on a Friday without making supporting material available to clarify, but I expect they will provide more details. CHIME is already complaining that the 2014 start dates haven’t changed as it and other organizations wanted (nobody feels guilty about looking the taxpayer gift horse in the mouth, apparently.)  

From The PACS Designer: “Re: smartphone overview. With the holiday season upon us, TPD thought it would be useful to post features of the smartphones currently available from various sources. As smartphones get more integrated into everything we do daily, it’s important to match the intended use with the right smartphone features, whether it be iOS or an Android system.”

12-6-2013 3-46-17 PM

Respondents are split on whether the FDA should regulate clinical software to any degree. New poll to your right: have you made a personal medical decision based on published hospital quality data in the past one year? I’ll admit that having worked almost my entire adult life in hospitals, I’ve never looked at the published quality data of local hospitals, including my own (although I’ve also never been hospitalized, so I had little motivation.)

I’ll be writing from the mHealth Summit this week. Drop by the microscopic HIStalk booth (#1305) and say hello if you are so inclined. The event has more than doubled in attendance since the last time I attended in 2010 and I’m hoping that the conference logistics have improved after HIMSS took it over from the National Institutes of Health.

12-6-2013 4-39-53 PM

Welcome to new HIStalk Platinum Sponsor Juniper Networks. A secure, reliable network is mandatory for EMRs, HIEs, telemedicine, PACS, high definition video, remote patient monitoring, real-time wireless location, and mobile clinicians. Juniper’s Healthcare Network Solution provides clinician access from any mobile device, secure access to patient records, a single user policy for all network points, and reductions in cost and risk via a unified wired and wireless infrastructure. Juniper’s WLAN solution provides the highest levels of reliability, scalability, management, and security to meet the needs of a mobile healthcare workforce. See “Top 10 Reasons Healthcare Prefers Juniper Wireless.” A case study quote from Juniper customer Lurie Children’s Hospital (IL): “We need to broker the complex relationship between stability and speed. We want to be able to put new applications on the network and adjust the network to meet the need. But on the other hand, we want to retain a stable network. We need a network that has very predictable behavior.” Juniper powers 60 percent of the world’s Internet transactions. Thanks to Juniper Networks for supporting HIStalk.

I found this new Juniper Networks video on YouTube.

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

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Medicaid fraud is too common to be newsworthy, but not when foreign diplomats are involved. Among the 49 people charged with defrauding Medicaid of $1.5 million are dozens of Russian diplomats and their wives, who federal prosecutors say misstated their income to get Medicaid to pay their medical bills and then used the money for luxury vacations and helicopter rides. The government, of course, didn’t blame itself for happily paying the bills of non-citizens.

12-6-2013 7-59-11 PM

Nashville-based healthcare IT consulting firm eMids raises $13 million in funding.  

12-7-2013 6-52-41 AM

Emory University Hospital (GA) uses IBM InfoSphere Streams real-time analytics and data acquisition software from Excel Medical Electronics to analyze ICU patient data in real time. If you want to play around with stream computing, there’s a free download of InfoSphere Streams.

12-7-2013 7-50-25 AM

Huntsville Hospital Health System (AL) chooses Caradigm Health Information Exchange to connect its affiliates. Caradigm signed a partnership deal earlier this year to market Orion Health’s HIE product.

A former Epic employee files a class action lawsuit against the company, claiming he and hundreds of other Epic quality assurance employees should have been paid overtime wages over several years. Epic disagrees, saying federal law is clear in classifying QA people as salaried rather than hourly.

12-7-2013 7-05-04 AM

Keith Seaman (Department of Veterans Affairs) joins VMware as chief technology executive for healthcare.

Saint Francis Health System (OK) chooses Epic.

Norton Healthcare (KY) reports that it has earned $12 million in HITECH payments in the third year of its $200 million, five-year Epic implementation.

Houston Methodist Hospital reports that a laptop containing the information of 1,300 transplant patient was stolen last week, but as is rarely the case when these announcements are made, the laptop was encrypted.

12-7-2013 7-40-39 AM

A 22-year-old woman sues a doctor, Northwestern Memorial Hospital, and the Feinberg School of Medicine (where the doctor is a pain management fellow) after he posts pictures of the woman drunk in the ED on Facebook and Instagram. The doctor also posted a Facebook invitation to join him for cocktails near the ED while waiting for the woman to recover from alcohol poisoning. He wasn’t actually her doctor – he came to the ED at the request of a mutual friend – and the hospital now claims he inappropriately accessed the patient’s medical records.

Illinois chiropractors consider going off the insurance grid and making patients pay cash due to high patient deductibles, medical coding issues, and the cost of software. According to one chiropractor, “The Affordable Care Act will make deductibles so high that people will soon be paying out-of-pocket for chiropractic medicine anyway. So why not go cash-only? This way, I can get rid of the headache of dealing with insurance companies, bring costs down for my patients, and get back to spending more time helping people.”

Ed Marx got a lot of responses to his “Identity and Leadership” CIO Unplugged post last week and has decided to delve deeper into the topic in the specific areas of titles and physical appearance. Watch for his next post.

The last 100 directory assistance operators in Connecticut will lose their jobs in February due to smart phones, which caused 411 calls to drop by 70 percent in the last three years.

12-7-2013 6-41-08 AM

Congratulations to those physicians (Dr. Jayne among them) who received notice Friday that they passed the exam to become board certified in clinical informatics.


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

More news: HIStalk Practice, HIStalk Connect.


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December 7, 2013 News 8 Comments

News 12/6/13

December 5, 2013 News 8 Comments

Top News

12-5-2013 8-03-31 PM

Healthcare Informatics owner Vendome Group acquires The Institute for Health Technology Transformation (IHT2), which offers executive health IT conferences, webinars, and research reports.

Reader Comments

12-5-2013 8-52-52 PM

From Quilmes Boy: “Re: Medseek. Underwent another round of layoffs this morning. My role was one of them.” Medseek CEO Peter Kuhn provided this response to our inquiries: “Over the past 12 months, Medseek has developed a significant offshore development operation, adding almost 150 personnel in India to accelerate product development and enable us to respond quickly to changing market dynamics and evolving customer requirements. In addition, weeks ago we funded the acquisition of Madison, WI-based Symphony Care, a leading population health and care management solution provider. Today, the company initiated a planned restructure to take full advantage of these recent investments. Medseek has retained all key personnel to deliver on customer commitments and deliver on near and long-term strategic goals.”

HIStalk Announcements and Requests

inga_small Some recent goodies from HIStalk Practice include: McKesson may close its Seattle office. Physician EMR adoption in the US is up but still lags behind many countries. Texting while doctoring could negatively impact patient care and safety. CMS finalizes the 2014 Medicare Physician Fee Schedule, which includes a 24 percent pay cut if the SGR formula is not amended. Patent data from EHRs provide reliable measures of the process of care and the patient-centeredness of a primary care practice. A gastroenterologist finds pleasure in his move to a low-tech office. Lab ordering rates among primary care physicians decline with providers have a real-time display of cost information within their EMRs. Dr. Gregg takes a trip back to the future. Thanks for reading.

On the Jobs Page: Program Manager – Healthcare Resellers.

Upcoming Webinars

December 17

How to Drive ROI in Your Healthcare Improvement Projects,” presented by Bobbi Brown and Leslie Hough Falk, RN, MBA, PMP of Health Catalyst. Sponsored by Health Catalyst. Tuesday, December 17 at 1:00 Eastern. At a time when average hospital’s margins are stagnating, executives should be asking tough questions about the ROI of "indispensable" technologies. Will new technologies prove their worth or drive them further into the red? How do you measure and track ROI?

December 10


Paperless Practices: Harnessing EHR Value by Improving Workflows with Electronic Data,” presented by Jay Ward of Kryptiq, Mike Kelly of DocuSign, and Sam Clark of  Asheville Head, Neck, & Ear Surgeons, P.A. Sponsored by DocuSign. Thursday, December 10 at 1:00 Eastern. During this Webinar, panelists will discuss how industry and market trends have aligned to rationalize the adoption of e-signature in healthcare. They will also review primary, practical considerations such as legality, security, and mobility. Finally, panelists will highlight case studies and relevant examples of organizations that have successfully jumped onto the “path to paperless”.

December 11

Audit Readiness: Three Simple Steps to Protect Patient Privacy,” presented by Mark Combs of WVU Healthcare System and Rob Rhodes of Iatric Systems. Sponsored by Iatric Systems. Wednesday, December 11 at 2:00 Eastern. Join us for this insightful Webinar to learn what you can do to keep your healthcare organization safe from unauthorized access to patient data.

December 12

Looking Behind the Curtain: Value Based Care’s Impact on the Revenue Cycle ,” presented by Karen Marhefka, MHA, RHIA of Encore Health Resources. Sponsored by Encore Health Resources. Thursday, December 12 at 1:00 Eastern. This webinar provides a basic understanding of value-based health care, or accountable care, explain why value-based reimbursement may not impact the core revenue cycle components immediately, discuss the key focal points for change needed to maintain profitability in a value-based reimbursement model, review why organizations will be pressured to consolidate revenue cycle systems, list the type of tools that are being introduced or are changing with the move to value-based reimbursement and name the major changes that will be required from organizations to move to value-based care and reimbursement.

December 17

The Power of Doctor Happiness: Why The Ideal Patient Experience Needs to Start with the Ideal Provider Experience,” presented by Lyle Berkowitz, MD, FACP, FHIMS (DrLyle). Sponsored by HIStalk. Thursday, December 17 at 2:00 Eastern. Hear from a "Doctor Happiness Guru" who describes how to think innovatively about using healthcare IT in ways which can automate and delegate care, resulting in time savings to doctors as well as improved quality and efficiency for patients.

Acquisitions, Funding, Business, and Stock

12-5-2013 5-49-33 PM

ClearDATA Networks closes a $14 million Series B funding round.

Accelera Innovations will pay $4.5 million in cash for Behavioral Health Care Associates, a billing and PM provider.

12-5-2013 6-48-07 PM

The College of American Pathologists (CAP) confirmed with Inga that it will shut down its CAP Consulting business over the next few months, concluding that, “The Board decided to exit the CAP Consulting business, our division located in our Lake Cook Road office that provides terminology and clinical information consulting services. CAP Consulting has made steady progress against its business objectives over the past several years; the services it provides are incredibly important and valuable. But with current fiscal constraints, the CAP is not able to continue to invest at the level needed to sustain and grow the business.” Employees were told on November 21. CAP hopes to place those affected in open positions, but also recognizes that the vendors it works with may have an interest in hiring them. CAP will continue to support existing products such as Electronic Cancer Checklists and Electronic Forms and Reporting Module.

12-5-2013 9-50-01 PM

Carl Icahn raises his stake in Nuance to nearly 19 percent of the company’s shares. NUAN shares rose around 6 percent in the past week.


St. Luke’s Hospital (TX) will add Craneware’s Pharmacy ChargeLink.

San Diego Orthopaedic Associates Medical Group (CA) selects SRS EHR.

12-5-2013 5-54-24 PM

Marin General Hospital (CA) engages MedAssets to support the optimization of clinical support resources through cost and operational management improvements.

Baptist Health South Florida will implement the Medseek Empower enterprise patient portal and integrate it with its existing Siemens and NextGen EMRs.

12-5-2013 7-25-07 PM

Banner Health selects Wolters Kluwer Health’s Health Language solutions to navigate the ICD-10 conversion process.

University Physicians of Brooklyn-Anesthesia (NY) will implement OpenTempo’s staff scheduling and case management solutions.


12-5-2013 3-59-33 PM

Experian names Jennifer Schulz (Visa) group president of its vertical markets group, which includes the company’s healthcare business. Its healthcare-related acquisitions include SearchAmerica (December 2008), Medical Present Value (June 2011), and Passport Health Communications (November 2013).

12-5-2013 8-24-11 PM

The National Association of Professional Women names Trudy Easton, RN, senior clinical consultant with McKesson, as its Professional Woman of the Year.

MedSynergies hires Doug Hansen (Accelion Health) as CFO.

Announcements and Implementations

12-5-2013 9-52-27 PM

Homecare and medical staffing company Interim HealthCare implements Procura Home Care Software across 47 locations.

Pediatric genetic testing laboratory Claritas Genomics will implement Cerner’s Millennium Helix solution, join Cerner’s Reference Lab Network, and collaborate with Cerner to develop a laboratory solution for molecular diagnostics. Cerner Capital has also invested in Claritas, closing the company’s Series A round.

Impact Advisors completes a feasibility analysis for Sutter Health (CA) that consider the possibility of Sutter sharing its EHR platform with a community hospital.

Healthix and the Brooklyn HIE (NY) complete their merger and will combine their separate technology platforms over the next year. The organization will retain the Healthix name.

PerfectServe introduces Clinical Event Push, which automatically informs physicians of important clinical events as they occur.

Coastal Healthcare Consulting announces Fusion, a solution to help healthcare organizations achieve peak performance from their EMR investment.

12-5-2013 9-21-07 PM

Mediware releases the MediLinks WTS workload solution for respiratory therapist staffing. 

Government and Politics

ONC’s HIT Policy Committee votes to urge HHS to abandon a proposed requirement for providers to give patients reports showing who looked at their EHR data. Though patient advocacy groups support the requirement, opponents claim the option would be technically impractical and administratively burdensome.

CMS reports that 85 percent of eligible hospitals have received a MU incentive payments through the end of October and 60 percent of Medicare EPs are meaningful users. Agency representatives also note that 89 percent of EHs have attested to Stage 1 MU using a primary vendor that had any 2014 edition product, while 70 percent of EPs used a primary vendor that had any 2014 edition product.

12-5-2013 1-35-14 PM

Rep. Scott Peters (D-CA) introduces the Health Savings Through Technology Act, which would create a commission to investigate how digital health technologies could help reduce healthcare costs and how they could be integrated into federal healthcare programs.

Innovation and Research

Researchers find that physicians who receive email notifications of lab results for tests pending at the time of patient discharge are significantly more likely to be aware of abnormal test results. Authors of the AHRQ-supported study suggest that widespread use of such automated systems could improve patient safety.

When it comes to HIE adoption, physicians are more influenced by other physicians with whom they interact and have common patients than by geographical proximity or other factors, according to a study published in the Journal of the American Medical Informatics Association,


12-5-2013 9-50-31 AM

inga_small Microsoft researchers develop a smart bra prototype embedded with sensors that flash smartphone warnings when the wearer’s mood suggests they might be about to eat too much. Enterprising hackers would be well advised to seek fast food chains willing to underwrite lingerie infiltration activities to redirect consumers’ dietary choices.

12-5-2013 7-01-41 PM

A study of 19 healthcare systems using the Philips eICU ICU telemedicine system finds that mortality and length of stay were reduced, adding that patients were 26 percent more likely to survive their ICU stay and were discharged from the hospital 15 percent faster. The study also identified the most important criteria in delivering patient care and cost benefits from an tele-ICU program:

12-5-2013 7-00-32 PM

I spoke to principal author Craig M. Lilly, MD, professor of medicine, anesthesiology, and surgery at the University of Massachusetts Medical School and director of the eICU program at UMass Memorial Medical Center (MA), who told us, “All of the things we found made sense." The most important factors affecting patient outcome and cost were:

  • Having a remote or local intensivist review the patient and care plan within an hour of ICU admission
  • Reviewing the results of the program regularly
  • Responding faster to patient alerts and alarms
  • Following ICU best practices
  • Conducting interdisciplinary rounds
  • Running an effective ICU committee

Lilly clarified that the organizations studied were hospitals which had not outsourced their intensivists to a for-profit company.

I asked about previous vendor-supported studies that claimed benefits from tele-ICU programs that independent studies rarely validate. He emphasized that no commercial ties existed in this study. "Any meta-analysis that’s done going forward will definitely show improvement whether you include or whether you exclude the studies that were done by the commercial manufacturers."

Several health systems have shut down their tele-ICU programs due to cost and questionable benefit, most recently MaineHealth, and I asked Lilly about that. He said, "The MaineHealth outcome is really interesting. They had withdrawn it from about 35 community hospital intensive care beds and those folks actually signed up with another vendor. Even though MaineHealth wasn’t going to support it or subsidize it — and they were providing a pretty darned good subsidy, I can tell you, to have it in these community hospitals, which I think is when it became financially unviable and that was one of the reasons they wanted to cut it down — these other community hospitals absolutely saw the value in it for their patients and also for their financial outcomes.They signed up with another vendor and paid a lot more money to do so."

In summarizing his study, Lilly told me, "It didn’t matter whether you had in-house intensivists or didn’t and a lot of these places did. They still got better when they added this layer on. Even though they had somebody in house, that person couldn’t be everywhere they needed to be when they needed to be there. Because while they were dealing with the emergency in Bed 1, the patient in the the ICU three floors above them in Bed 7 was really getting sick and they didn’t know about it. This technology allowed hospitals with good intensivists and great bedside nursing to get the right expertise when they needed it, where it needed to be there because they were able to get on the alerts and alarms in less than three minutes and they couldn’t before."


Allscripts India opens a new and expanded office in Vadodara to house 275 existing employees and to accommodate up to 400. Allscripts has 2,000 employees in India, up from 850 in 2010.

A psychiatrist warns peers about blanket authorizations that patients sign to get their insurance companies to pay for their care, with an example of a subsidiary of Quest Diagnostics requesting the complete paper file on one of his patients. He found that the company mines prescription data and sells it to life insurance companies to consider when deciding whether to issue policies. Psychiatric News, which ran the story, said, “Steven Daviss, MD, chair of the APA Committee on Electronic Health Records, told Psychiatric News that health information exchanges (HIEs), which connect different sources of patient health care data for the use of practitioners caring for patients, can also be an unexpected source of sensitive information. In Maryland, for example, the HIE contains information on hospital treatments, laboratory and radiology data, diagnoses, and medications. ‘This is valuable information that improves the continuity of care, but states have different policies regarding access to these data beyond treatment purposes,’ he said. ‘Most states have mechanisms that allow one to opt out of the HIE and to see who has accessed your information.’”

12-5-2013 10-02-58 PM

Boston Children’s Hospital (MA) reports a substantial drop in medical errors with the introduction of more standardized communication during patient handoffs, including a structured handoff tool within the EMR that self-populates standard patient information.

Vendors, beware: lawsuit-happy MMRGlobal is awarded its tenth healthcare IT patent entitled “Method and System for Providing Online Records,” which covers prescription and appointment reminders as well as e-prescribing.

12-5-2013 7-43-28 PM

A New York Times opinion piece by Pulitzer-winning writer Tina Rosenberg says hospital quality data is inconsistently reported and hard to understand. She says, “But at times it seems as if hospitals aren’t trying very hard. They like to report process measures on which they score well. But with 440,000 deaths from hospital error per year, their record is poor on key safety outcomes. This somewhat dampens their enthusiasm for public reporting. And what hospitals want matters a lot.”

12-5-2013 7-52-42 PM

A study finds that hospitals have a median of two employees assigned to manage population health, with mid-level managers being the most likely to be involved. It concludes that hospital population health approaches are inconsistent and poorly integrated.

In Europe, big drug companies are enlisting patient groups to lobby against legislation that would require them to publish all results of clinical trials, not just favorable ones, so that independent researchers could validate their conclusions. The two drug company trade associations want patient advocates to protest the release of such data by expressing concerns that it would be misinterpreted by non-experts. According to a trade group SVP, “EMA’s proposed policies on clinical trial information raise numerous concerns for patients. We believe it is important to engage with all stakeholders in the clinical trial ecosystem, including the patients who volunteer to participate in clinical trials, about the issue. If enacted, the proposals could risk patient privacy, lead to fewer clinical trials, and result in fewer new medicines to meet patient needs and improve health.”

Adoption of core medication MU elements reduces adverse drug event rates with cost savings that recoup 22 percent of IT costs, according to a study published in the American Journal of Managed Care.

12-5-2013 6-40-22 PM

An op-ed piece in New England Journal of Medicine reviews the OpenNotes initiative that calls for patients to have access to the notes made about them by their clinicians, citing previous studies showing that most patients read the notes and reported improved understanding, medication adherence, and feeling of control, with the vast majority of both patients and clinicians urging that the program continue. However, the article finds that while electronic medical records created the opportunity, they also complicate it:

Early adopters are learning that implementation means more than simply mailing notes or visit summaries or having patients log on to a portal. For starters, the knowledge that patients (and often their families) will have access to records affects the intent and sometimes the content of clinical documentation. Writing accurately about a suspicion of cancer, for instance, can be difficult for clinicians who don’t want to worry patients unnecessarily, and addressing character disorders or cognitive dysfunction in ways that are useful to patients, consulting providers, and others who use the records requires carefully considered words. These challenges are compounded by today’s electronic records, in which the story weaving together social, familial, cultural, and medical contributors to the patient’s health and illness often disappears, obscured by templates. A boon to billers, quality assessors, and researchers, such records can become formulaic and susceptible to data-entry errors. Moreover, they’re often filled with copied-and-pasted information that buries the essential narrative under voluminous repetitive text.

You may think you possess an unnatural ability to speak Siamese Thai when watching this video from Bumrungrad International Hospital in Thailand that describes its planned January go-live with inpatient nursing documentation using Medicomp’s Quippe.

12-5-2013 7-34-04 PM

Weird News Andy racked his brain to come up with “From Doobies to Boobies” as his working title for this article, which describes the potential for marijuana smoking to cause gynecomastia in men (i.e., moobs). WNA also likes the story of Ben Taub Hospital’s ED director (above), who is charged with breaking into the home of another female physician and using red lipstick to write “whore” and “homewrecker” on her bathroom mirror, presumably for reasons not involving emergent care.

Sponsor Updates

  • Clinical insights platform vendor QPID is named a finalist for a publisher’s innovation award, as chosen by a panel of hospital CIOs and other executives.
  • Greythorn conducts a market survey for HIT professionals to analyze compensation, benefits, job satisfaction, hiring trends, and industry participation. Greythorn will donate $1 to the Boys and Girls Clubs of Bellevue and Chicago for every submission.
  • MedcomSoft partners with Liaison Healthcare to connect its Record EHR platform to more than 120 labs and imaging centers integrated within the Liaison EMR-Link Lab Hub.
  • Aprima Medical integrates DMEhub into its EHR, allowing physicians to write orders for durable medical equipment directly from their Aprima EHR.
  • First Databank begins publishing the National Average Drug Acquisition Cost pricing file from CMS.
  • Aspen Advisors spotlights Baystate Health’s (MA) EHR optimization efforts following Aspen’s review and analysis of the organization’s EHR options.
  • API Healthcare highlights the top 10 interview questions to ask nurses.
  • The Indiana HIE details its work with Predixion Software to develop predictive analytics healthcare solutions at this week’s National Readmission Summit.
  • Truven Health Analytics extends its contract to use Post-n-Track’s cloud-based web services platform for the exchange of eligibility data.
  • AT&T launches EverThere, a wearable device that connects to a 24/7 call center if it detects that the wearer has fallen.
  • Impact Advisors principal Laura Kreofsky discusses the sharing of patient data between hospitals.
  • Quantros launches Quantros Member Center, a customer portal that provides immediate access to support cases, training videos, release notes, and user groups.

EPtalk by Dr. Jayne

From The Grey Goose: “Re: RSNA. Booth traffic felt like it was up. The temps were much warmer than last year (except they dip to the 20s later this week) so that probably helped improve the moods. All the big anchor exhibitors continue to improve their booths – more flash, more high tech, better organized space – so people wouldn’t get log-jammed in the middle. Lots of focus on moving data to HIPAA-compliant clouds and being able to access it securely on any device, anywhere. Folks not looking at that seem to be in the minority now which is a big shift from a year or two ago. People want to be more efficient to drive down costs in the land of Obamacare.” Thanks for sharing your experience. It’s great to have roving reporters fill us in on the meetings we’re not able to fit onto our busy dance cards.


From Converse All-Star: “Re: your Thanksgiving column. Mentioning readers sending photos of shoes brought to mind a pair of shoes that my lovely wife possesses. As you might expect, she saves them for special occasions and they also occupy a place of honor in our closet at home.” I’ll let our readers guess what state they represent. The coordinating scarf definitely puts these over the top! Is this the beginning of a 50-state themed challenge? Or better yet, perhaps we could convince The Walking Gallery’s Regina Holliday to branch out into shoes?

Dr. Jayne’s HIMSS Registration Update


More fun and games on the HIMSS website this week. After the HIMSS14 registration site couldn’t figure out how to charge my membership, I decided to go to the HIMSS main website to try to update my membership first so I wouldn’t have to do that step on the conference page. No luck – this critical error message was all I received. The site also refuses to recognize my MD and I can’t figure out how to update that part of my demographics (although it does refer to me as “Dr.” so it’s even more confusing).

I tried it again a couple of days later. I didn’t get the critical error, but when I tried to renew my membership, it adjusted the expiration date by a month since I’m renewing before mine expires, making it effectively only good for 11 months. At that point I was just glad my housing reservation was successful. I gave up for the night.


I decided to go back to the conference website and try it again that way. I am still receiving an alert that it can’t find the pricing for a membership renewal, but at least it has my expiration date in the wrong year. For those of you who are not familiar with the concept of positive pessimism, that’s an example: following up a negative statement with another negative statement to take the edge off the current problem. You’ll learn more about it if you are actually able to register for HIMSS and stay until Thursday to hear Erik Weihenmayer speak. He’s one of the best motivational speakers I’ve heard.


I tried to do it again without the membership renewal (thinking I’d try to do it on the main HIMSS site in January) and got this great new alert. Unfortunately it doesn’t tell me what to do with “please note” rather than “error” or “warning.” Perhaps we could use this as a testing scenario for next year’s Clinical Informatics board exam. Is anyone else having these issues? Or is it as I suspect and half the attendees are either vendors or media so they have a different registration process entirely and no one has complained yet?

I finally broke down and called because I didn’t want to miss the Early Bird discount. I was directed into a phone queue that didn’t have an option that applied to my scenario. Unfortunately the best advice the live agent could give was, “log out and log in again” and we all know how much end users love to hear that. I explained that I had been trying to register using multiple browsers on multiple different devices over many days, so I didn’t think logging out would help.

I asked if they could manually register me. She had to ask a supervisor. Ultimately the blame was placed on the data file that HIMSS sent with the incorrect expiration date, although they said they had no access to the file to try to verify the correct dates. After roughly half an hour of back and forth, they were able to shadow me in their system and bypass the problematic steps, so I suppose now I’m good to go. Inga and I are well into planning our social schedules, so please keep those event invitations coming.


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

More news: HIStalk Practice, HIStalk Connect.


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December 5, 2013 News 8 Comments

News 12/4/13

December 3, 2013 News 4 Comments

Top News

12-3-2013 6-04-00 PM

Hearst Corporation will acquire 85 percent of Homecare Homebase, the #1 KLAS-ranked software provider for the homecare and hospice market. Hearst’s other healthcare IT companies include First Databank, Map of Medicine, MCG, and Zynx Health.

Reader Comments

From N2InformaticsRN: “Re: CAP Consulting. The College of American Pathologists is dissolving CAP Consulting, its informatics consulting practice. This is the group that was doing exceptional work in terminology and standards with a deep understanding of the information needs and challenges faced by providers across the health care delivery and laboratory spectrum. More recently they developed an effective framework to assess and tackle health information management.  The team has unique skill sets and helped us ensure ontological correctness by developing a terminology roadmap. It will be interesting to see who picks these folks up or whether they form a consulting group on their own.” Unverified. We have a call scheduled for Wednesday with CAP Consulting to learn more.

HIStalk Announcements and Requests

12-3-2013 6-53-05 PM

Welcome to new HIStalk Platinum Sponsor Physician Technology Partners. The physician-owned and led consulting company offers provider-to-provider services that make Epic-using physicians more productive. Its physician champions hold ASAP and EpicCare Ambulatory certifications. PTP’s six-phase approach to building to optimize for quicker ROI includes strategic planning, implementation, build and validation, training, go-live support, and optimization. They’ve done it for customers that include Ohio State, UCSF, Sutter, Exempla, Texas Children’s, Providence, University of Miami, and a bunch more names you would know. PTP’s expertise also includes making Dragon speech recognition work optimally in an Epic environment. Thanks to Physician Technology Partners for supporting HIStalk.

I have an interesting challenge with HIStalkapalooza. Jonathan Bush has a conflict and, for the first time since the inaugural HIStalkapalooza in 2008, we may need to find someone else to present the HISsies awards (travesty, I know.) I need someone who has commanding stage presence, a wicked sense of humor, and a cynical view of healthcare IT (extra points for being able to swig large-format bottles of high-gravity beer while uttering a non-stop stream of one-liners during the otherwise august proceedings.) Let me know if you’ve seen anyone who can approximate JB’s on-stage magic since otherwise Inga’s going to have to get up there and she will be terrified.


Acquisitions, Funding, Business, and Stock

12-3-2013 6-06-47 PM

Post-acute care software provider Brightree acquires MedAct LLC, a developer of home medical equipment and DME software solutions.

12-3-2013 6-07-45 PM

Entrada, a developer of workflow products that are integrated with EHRs from athenahealth, Allscripts, Greenway, and NextGen, raises $1.12 million in new equity.

12-3-2013 6-16-06 PM

Shareable Ink closes $10.7 million in Series C financing and names former Allscripts CEO Glen Tullman to its board.

12-3-2013 6-16-57 PM

Lexmark will consolidate four acquired businesses — Pacsgear, Saperion, Twistage, and Acuo Technologies — under its Perceptive Software subsidiary.


12-3-2013 9-21-02 PM

AnMed Health (SC) will implement technology from Iatric Systems to integrate multiple hospital and departmental systems.

The Metropolitan Chicago Healthcare Council selects HIE technology from Sandlot Solutions.

Children’s National Medical Center (DC) will deploy Streamline Health’s OpportunityAnyWare business analytics software suite.



12-3-2013 7-47-10 PM

Kristina Greene (Proxicom) joins Lucca Consulting Group as RVP.

12-3-2013 8-14-35 AM

Acusis names Richard Simonetti (Horiba Medical) VP of strategic business solutions.

12-3-2013 8-35-54 AM

Kareo hires Amyra Rand (HireRight) as VP of sales.

12-3-2013 8-34-56 AM

Perigen appoints Chip Long (Merge Healthcare) SVP of growth and development.

12-3-2013 6-11-55 PM 12-3-2013 6-12-47 PM

RCM service provider MedData appoints Paul Holland (QuadraMed) VP of sales and Carl Naso (Aleris International) corporate controller.

12-3-2013 6-14-43 PM

Stephen Bernard (Accretive Health) joins Connance as VP of professional services.

12-3-2013 12-51-06 PM    12-3-2013 12-50-27 PM

Valence Health names Nathan Gunn, MD (Verisk Health) VP of population health and Dan Blake (AirStrip Technologies) SVP of software product development.

KLAS names six members to its first-ever imaging advisory board: Mark Christensen (Intermountain Healthcare), Karen McGraner (Exempla St. Joseph Hospital Denver), Eugene V. Pomerantsev (Massachusetts General Hospital), Peter S. Rahko (University of Wisconsin Hospital), Pablo Ros (University Hospitals HS Cleveland), and Brian Wetzel (Our Lady of Lourdes Memorial Hospital Binghamton.)

Announcements and Implementations

Pro-Laudo, a teleradiology practice in Brazil, implements eRAD PACS with integrated reporting and speech recognition.

12-3-2013 8-53-08 AM

PeaceHealth Medical Group in Longview, WA goes live on Epic.

Hospitals and skilled nursing facilities in California’s Santa Clara county will deploy CareInSync’s Carebook platform to coordinate care transitions.

12-3-2013 9-24-47 PM

Cheyenne Regional Medical Center (WY) converts patient information and data from seven legacy systems into a single platform integrated with Epic using Hyland Software’s OnBase ECM solution.

More than 50 Adventist Health/Central Valley Network (CA) facilities go live this week on Cerner.

12-3-2013 6-19-51 PM

Martin Health System (FL) deploys the RightPatient iris biometrics patient identification system from M2SYS Healthcare Solutions.

Providence Health & Services (WA) opens a clinic without a waiting room in its first go-live of RTLS from Versus Technology.

UCLA Health System (CA) opens the Lockheed Marking UCLA TeleHealth Suite and Lockheed Martin Outpatient Recovery Suites for Wounded Warriors of Operation Mend, which were made possible by a $4 million gift from Lockheed Martin.

GE Healthcare launches Centricity 360, an online clinical collaboration tool that provides real-time sharing of data.

3M Health Information Systems releases 3M ChartScriptMD Software for Radiology, a reporting application that allows radiologists to create, sign, and distribute complete reports and communicate diagnostic findings from a single, integrated system.

12-3-2013 7-33-20 PM

Congratulations to Tampa General Hospital (FL), which VP/CMIO Richard Paula tells me has earned HIMSS EMRAM Level 7 with its $90 million Epic system.

Innovation and Research

Researchers from NORC at the University of Chicago will study how Cerner employees respond to cost transparency tools from Change Healthcare. The RWJF-funded study will assess the impact of price, quality, and engagement approaches on consumer choice of healthcare.

Researchers at the University of Pittsburgh create a publicly searchable digital database of infectious diseases cases dating back 125 years.



12-3-2013 9-47-33 AM

The Leapfrog Group publishes its annual list of top hospitals based on quality of care.

Carolinas HealthCare System launches analytics capabilities that integrate data for evidenced-based health management, individualized patient care, and predictive modeling. The health system’s in-house analytics group built the data analytics models and are using de-identified clinical and financial information from 10.5 million patient encounters. I interviewed SVP/CIO Craig RIchardville in September.

Happtique certifies 19 health and medical apps, which requires them to meet privacy, security, and operability standards and pass clinical content testing.

WEDI, EHNAC, and DirectTrust partner to promote and accelerate the adoption of a national accreditation program for information “trusted agent” service providers.

12-3-2013 1-46-45 PM

inga_small The New York Times highlights the insanity of US hospital charges, including pricing that is often arbitrary; wide variations in pricing for the same service across different facilities and regions; and, heavily inflated prices for routine supplies and services. For example, the average cost of treating a cut finger in an ER ranges from $790 in New England to $1,377 in the Pacific. Also noted: the hefty incomes of many executives in non-profit health systems, including 28 Sutter Medical Center officials who each make more than $1 million a year.

12-3-2013 1-31-36 PM

inga_small A tone-deaf boy in Denver suffers a concussion playing lacrosse, recovers, and develops the ability to play 13 instruments. His physician theorizes that the musical talent was “latent in his brain and somehow was uncovered by his brain rewiring after the injury.” Sort of gives new meaning to the term, “one-hit wonder.”

Crain’s Chicago Business points out that despite the hoopla around the 34 hospitals MetroChicago HIE has announced as members, it has failed so far to sign at least three of the biggest ones: Northwestern, University of Chicago Medicine, and NorthShore.

Weird News Andy finds himself thankful for piercings after reading this story, which describes a joystick-like device implanted as tongue piercing that allows paralyzed people drive their wheelchairs by flicking their tongues.

WNA may have a new competitor, as a reader provided this toothsome morsel of prose. A Swedish prisoner escapes two days before his scheduled release to have a tooth fixed, having been denied service by the prison dentist. He has the tooth removed and then returns to his cell. The prison gives him an oral warning and extends his stay by 24 hours to make up his time.


Sponsor Updates

  • Administrators from Nemours Children’s Hospital (FL) explain how Rauland-Borg Corporation, Versus Technology, and GetWellWork integrated their technologies to inform patients about their doctor or nurse as they walk into a patient room.
  • Mike Silverstein and Kasey Fahey of Direct Recruiters, Inc. interviewed 21 healthcare IT executives about trends and predictions.
  • Capsule Tech joins the Continua Health Alliance.
  • Greenway Medical Technologies will integrate data analytic tools from Inovalon into its PrimeSUITE EHR platform.
  • AirWatch develops app reputation scanning technology for its platform in support of corporate-owned and BYOD deployments.
  • Vital Images showcases clinical enhancements to its VitreaAdvanced software at this week’s RSNA meeting.
  • MedAssets shares a video case study highlighting how it helped the Texas Purchasing Coalition achieve $60 million in cost reductions and increase efficiencies.
  • Culbert Healthcare Solutions hosts a December 13 webinar on the ICD-10 impact of revenue cycle operations and clinical workflows.
  • Quantros offers a December 11 webinar on quality reporting requirements for inpatient psychiatric facilities.
  • Nuance adds speech recognition accuracy and workflow enhancements to the PowerScribe 360 platform.
  • Beacon Partners publishes a white paper outlining best practices when connecting affiliated physicians to the health system.
  • Merge Healthcare releases iConnect Network, an imaging network for the secure electronic exchange of imaging information.
  • FUJIFILM Medical Systems introduces Synapse VNA technology and demonstrates Synapse RIS EHR solution at this week’s RSNA meeting.


RSNA Impressions

12-3-2013 7-12-28 PM
Deborah Kohn checks in with a high-level reaction to RSNA.

Based on my observations of RSNA 2013’s multitude of imaging informatics products, radiology (and other image-generating “ology” or department) PACS continue to be “deconstructed”.

For example, the “A” in PACS (for Archiving) remains the focus of many Vendor Neutral Archive (VNA) system products. No noteworthy independent (of PACS vendors) VNA products are being introduced this year, and most of the PACS vendor VNA products are trying to catch up to the independents by highlighting new functionality. This year’s newer focus centers on enterprise viewers, which consolidate provider organizations’ large number of disparate clinical system viewers, such as those of the multi-modality PACS (DICOM), Enterprise Content Management (non-DICOM), and even EHR system viewers.

Also moving to the enterprise level are the image share / image exchange capabilities, which include the taking-along of key clinical content down/uploaded from/into the EHR. An impressive Johns Hopkins Medicine work-in-progress at IHE’s Image Sharing Demonstration included Face Time/Skype-like (yet HIPAA secure) video conferencing for consultations and/or second opinions. The remote providers collaborated on diagnostic-quality views of DICOM images with side-by-side, structured EHR data and unstructured text reports – all in one view at the click of a button.

In summary, traditional PACS functionality continues to be siphoned off into other, more robust and often enterprise components, leaving traditional PACS as the important workflow engines for the modalities.


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

More news: HIStalk Practice, HIStalk Connect.


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December 3, 2013 News 4 Comments

Monday Morning Update 12/2/13

November 30, 2013 News No Comments

11-30-2013 6-37-29 PM

From The PACS Designer: “Re: Splunk for data. Splunk has an app library for developers of data solutions and uses Hadoop and XML to easily craft viewing platforms for various data solutions. By using basic Simple XML concepts you can experiment and find a data viewing solution for critiquing by your user groups.”

11-30-2013 11-53-52 AM

Two-thirds of respondents say they’re OK with entertaining new job possibilities at the HIMSS conferences. New poll to your right: should the FDA regulate clinical software in any way? Vote and then use the poll’s comment link to elaborate.

Listening: Feeder, somewhat obscure (in the US anyway) radio-friendly British rockers who’ve been around for 20 years.

News is slow as it always is over Thanksgiving weekend. I hope your holiday (for those celebrating) was memorable in positive ways. It’s barely more than three weeks until Christmas, believe it or not.

11-30-2013 6-29-26 PM

I’ll be writing daily from the mHealth Summit in the Washington, DC area next week. If you’re going, drop by the our first-ever HIStalk booth (#1305) and say hello. Ours will be the nearly bare one because it’s really expensive to furnish a booth. My impression from the last time I attended was that not many hospital folks attend, but the event has grown to 5,000 attendees since HIMSS bought it and may have outgrown its governmental and public health roots.

11-30-2013 6-35-27 PM

In Canada, Children’s Hospital of Eastern Ontario announces that it will implement Epic in its hospital and 80 clinics. The budget was reported at $7.7 million, which is surely incorrect except possibly for the clinics only.

11-30-2013 7-59-53 PM

MetroChicago HIE will be announced this week and launched early next year, reports say, with 34 area hospitals (listed here) participating initially. The HIE was originally planned in 2009 and announced in April 2011 but stalled when hospitals balked at paying to participate.

Palomar Health (CA) releases a mobile app built with Extension Healthcare that locates patients and lets caregivers communicate.

Speaking  of Palomar Health, here’s a video from the November 5 SoCal HIMSS CIO Forum featuring Chief Innovation Officer Orlando Portale speaking about hospital innovation. He says that only 5 percent of hospitals are innovative; the rest are followers.

11-30-2013 7-53-25 PM

University of Washington Medicine (WA) says that information on 90,000 patients was accessed in October 2013 when an employee opened a email attachment that contained malware.

Weird News Andy extends his Thanksgiving best wishes with a story about what he calls “a chip that makes you lose weight.” It’s genetic rather than potato, nacho, or chocolate — an arm-implanted computer chip releases a hormone that sends an “I’m not hungry” message when the implantee has eaten enough.

Vince continues to put a personal face on the confusing string of McKesson acquisitions in this week’s HIS-tory, which covers CyCare.


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

More news: HIStalk Practice, HIStalk Connect.


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November 30, 2013 News No Comments

News 11/27/13

November 26, 2013 News 2 Comments

Top News

11-26-2013 7-24-25 PM

Nuance Communications reports Q4 results: revenue up less than 1 percent, adjusted EPS $0.30 vs. $0.51. Unenthusiastic company guidance sent shares plummeting 18 percent Tuesday; they’ve sunk 41 percent in the past year. Above is the one-year price graph of NUAN (blue) vs. the Nasdaq (red).

Reader Comments

11-26-2013 3-42-24 PM

From BR549: “Re: Health Care DataWorks. Laid off 35 percent of its workforce last Wednesday.” HCD CEO Jason Buskirk provided this response to our inquiries: “We do not share specific statistics, but the percentage that you quote is incorrect. Based on feedback from our clients, we are realigning the organization to be laser focused on our software, KnowledgeEdge. HCD will continue to hire the best and brightest technical talent in the industry.” Buskirk was announced as CEO on September 18, replacing founder Herb Smaltz, who had held the CEO position since 2008 but remains on the company’s board.

11-26-2013 12-51-59 PM

inga_small From TomT: “Re: holiday wishes. It’s that time of year when we should take a moment to give thanks for for all 141,000 new ICD-10 codes coming our way. I hope you and the rest of the HIStalk gang avoid any of these turkey-related injuries and have a wonderful Thanksgiving.” Yet another reason to buy the frozen Butterball. Many thanks to TomT and all the other readers who have sent us holiday greetings!

HIStalk Announcements and Requests

11-26-2013 3-13-32 PM

Welcome to new HIStalk Platinum Sponsor Medfusion. The Cary, NC-based company enhances the patient-provider relationship by providing new ways for them to communicate, improving patient engagement and allowing providers to meet MU Stage 2 requirements. The former Intuit Health’s patient portal allows providers to spend more time on patients through the efficiencies gained from online messaging, appointment scheduling, bill payment, payment plans, refill management, and results sharing. Medfusion’s portal also integrates with popular EHRs and provides patients with mobile access. See for yourself – you can test drive the patient portal instantly with no signup required just like I did. I interviewed founder Steve Malik, who bought the company back from Intuit in August 2013. Thanks to Medfusion for supporting HIStalk.

11-26-2013 4-07-10 PM

I’ll have details about our HIMSS activities (including HIStalkapalooza) after New Year’s, but here’s something fun: we’ll be having an HIStalk sponsor networking reception Sunday evening, February 23 from 6:30 until 8:30 (an easy walk from the HIMSS opening reception, which runs from 5:00 to 7:00). Sponsor executives always enjoy the chance to lay aside their competitive armor in renewing old acquaintances and making new ones in a relaxed setting, so this should be a fun evening in which business will be inevitably conducted as well. Lorre will be hosting and I’ll provide great food and drinks. Watch for your invitation.

Acquisitions, Funding, Business, and Stock

11-26-2013 9-21-29 AM

Patient engagement and education provider PatientPoint completes the acquisition of publishing assets from American Hospitals Publishing Group International, a developer of customized patient guides and communication tools.

11-26-2013 10-51-41 AM

Genophen, a developer of a health management platform and clinical support tool, raises $2 million in a third round of funding.

11-26-2013 4-10-12 PM

Streamline Health Solutions prices its secondary stock offering of 3 million shares at $6.50 per share for net proceeds of $17.1 million.

11-26-2013 6-11-00 PM

Cumberland Consulting Group acquires life sciences implementation firm Mindlance Life Sciences

11-26-2013 7-01-17 PM

PM/EMR vendor CureMD acquires medical billing company AviaraMD.


11-26-2013 9-22-31 AM

AtlantiCare (NJ) selects MedCurrent’s OrderRight Radiology Decision Support system, which will be integrated with AtlantiCare’s existing Cerner PowerChart platform.

Madera Community Hospital (CA) will implement Passive Incident Management software from RGP Healthcare.

UK Healthcare (KY) will implement medical image sharing services from lifeIMAGE.

Allina Health (MN) expands its use of MedAssets Contract and Episode Management solutions into outpatient settings.

Bone marrow donor center DKMS chooses registry software from Remedy Informatics.


11-26-2013 9-33-17 AM

Brigham and Women’s Health Care (MA) names Cedric J. Priebe, MD (Care New England Health System) CIO.

11-26-2013 11-16-35 AM

Michael Dal Bello, managing director of Emdeon’s parent company Blackstone Group, resigns from Emdeon’s board.

11-26-2013 12-50-23 PM

The Pennsylvania eHealth Partnership Authority appoints Michael Fiaschetti (Highmark) to its board.

11-26-2013 6-03-02 PM

Outpatient specialty care software vendor Net Health hires Mary Mieure (Greenway) as VP of training and implementation.

Announcements and Implementations

The Kansas HIN and the Lewis and Clark Information Exchange agree to connect their HIEs, allowing the networks to keep $1 million in federal funding.

Huntsman Cancer Institute (UT) deploys the NLP-based I2E software platform from Linguamatics to extract discrete data from unstructured texts in clinical notes.

ProHealth Care (WI) becomes the first healthcare system to use Epic’s Cogito data warehouse tool, which combines patient data from Epic with information from other EMRs and data sources.

Government and Politics

11-26-2013 3-08-55 PM

Several industry organizations ask the House Ways & Means and Senate Finance Committees to ensure that MU Stage 3 includes interoperability requirements for EHRs and remote patient monitoring systems.

Vermont Governor Peter Shumlin reprimands Health Access Commissioner Mark Larson for lying to state representative earlier this month when Larson was asked directly if the state’s insurance exchange had experienced any security breaches. Larson failed to disclose an October incident in which a user pulled up the personal information of someone else due to a reassigned username.

Seven Democratic senators call on the President to name a CEO of the Healthcare.gov website who would report directly to the White House instead of to HHS.

Innovation and Research

Researchers find that rural ED physicians are less likely to make medication administration errors when using telehealth technology to consult with specialists.


11-26-2013 3-10-31 PM

The AHA urges CMS to ensure Medicare contractors and state Medicaid agencies  begin end-to-end testing on ICD-10 by January in order to prepare for the October 1, 2014 deadline.

11-26-2013 8-04-17 PM

Epic will build two laboratory installations of its EpicCare EHR at Oregon Health & Science University for medical informatics and research purposes. On the research side, the University will have access to Epic’s source code. 

Weird News Andy notes breaking news from Good Shepherd Medical Center (TX), where a male suspect is being held in the Tuesday morning stabbing death of a female nurse in the hospital’s ambulatory surgery center. Another employee and three visitors were also injured.

An Idaho state senator video chatting with her son on her iPhone on Face Time has a stroke, which her son notices from seeing her confusion and facial drooping . He rushes her to the hospital in time for speedy treatment and she’ll make a full recovery. She says, “I’ll always be a dedicated fan of the iPhone,” while her son adds, “If you have adults that live away, you need an iPhone for ‘em. I’m serious, that’s huge. … Seeing their face, you can actually see if something’s amiss.”

USA Today talks up the promise of analyzing large healthcare databases to its audience of hotel guests and airport travelers,  although the article wanders around with a few unrelated facts and no real conclusion other than “it’s coming.” It did contain one interesting factoid: a study found that diabetic hospital readmissions weren’t dominated by older patients who had forgotten to inject their insulin, but rather young female diabetics who had intentionally skipped their dose trying to lose weight.

Sponsor Updates

  • Nuance Communications announces the general availability of Dragon Medical 360 l Network Edition 2.0, which allows clinicians to document using multiple devices and provides an accuracy level of 98 percent or higher out of the box.
  • E-MDs Solutions Series 8.0 achieves Complete EHR 2014 certification for Stage 1 and 2.
  • MModal integrates radiology report measurements from PACSGEAR’s ModLink with MModal Fluency for Imaging Reporting.
  • Merge Healthcare will showcase iConnect Access Version 5.0, its universal viewing and imagine sharing solution, at next week’s RSNA meeting in Chicago.
  • Iatric Systems announces that Meaningful Use Manager with Clinical Quality Measures Version 3.0 has earned ONC 2014 certification as an EHR Module.


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

More news: HIStalk Practice, HIStalk Connect.


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November 26, 2013 News 2 Comments

Monday Morning Update 11/25/13

November 23, 2013 News 13 Comments

From HIT Newbie: “Re: Jonathan Bush of athenahealth. Here’s his recent interview at Duke’s Fuqua Distinguished Speaker Series. Great stuff.” It’s very interesting even for non-athena fans and less manic (but still as full of quotable sound bites) as his shorter-form interviews. It’s hard to stop watching once you start.

From The PACS Designer: “Re: Android’s coming up fast. The latest information available on shipping volumes for mobile platforms shows the Android platform beating everyone else easily. While the healthcare space is benefiting from the huge volume of available Apple apps, it won’t be long before Android development expertise grabs the opportunity to offer solutions for big data applications which are sorely needed by researchers and practitioners.”

11-23-2013 9-01-21 AM

Our field involves technology and health, but only about half of respondents use apps to monitor or improve their own health. New poll to your right, inspired by Dr. Jayne: if you’re going to the HIMSS conference, will you be open to the possibility of finding a new job?

Healthcare IT news is always slow in November and December unless some company decides to do a year-ending acquisition, so don’t think a shorter HIStalk post means you’re missing anything. It’s not a magazine with an incentive to pad out the issue with non-newsworthy junk. As I always say, 90 percent of my job is deciding what “news” to ignore. I hate reading stories with attention-getting headlines and cleverly written prose that turn out to be a complete waste of time.

11-23-2013 6-54-31 PM

Sunquest forms The HIT Group, soliciting member companies that agree with its position that the FDA should regulate healthcare IT, with particular emphasis on patient safety and software development practices. I wouldn’t expect many companies to join except those who, like Sunquest, are already regulated by the FDA, but it would be a bold move for vendors to encourage regulation and use their influence to make it reasonable rather than waiting for the FDA to spring a potentially vendor-unfriendly surprise. As a patient, it’s hard to argue against external oversight of systems that are becoming more influential in how care is delivered. I’m not quite sure why the announcement letter capitalizes words and phrases that don’t require it, such as “patient,” “health information technology,” “government,” and “patient safety.”

The New York Times finds that Healthcare.gov was doomed from the start by an unbroken string of bad decisions: the White House’s infatuation with creating a dazzling site, its inflexibility on an October 1 go-live that required ill-advised shortcuts, White House meddling that caused weeks of delay in answering simple software engineering questions such as whether the user should be required to enter their Social Security number, CMS’s decision to use the NoSQL database despite warnings from contractor CGI that not many people know how to program against it, CMS deciding to act as its own systems integrator instead of hiring an experienced company, and putting a CMS official in charge without giving him the authority to make decisions without first contacting the White House. The gist of the article is that White House arrogance combined with CMS incompetence created a disaster that everybody saw coming but nobody could stop.

Encore Health Resources will present an HIStalk Webinar, “Looking Behind the Curtain: Value Based Care’s Impact on the Revenue Cycle” on Thursday, December 12 at 1:00 Eastern.

11-23-2013 6-57-50 PM

Health Canada apologizes to 40,000 medical marijuana users when it mails an information update with a privacy-torching return address of the Marijuana Medical Access Program.

Block Island Medical Center, a two-doctor practice in Rhode Island, reports frustration with its conversion to an unnamed EMR in its quest to collect HITECH incentives. The executive director says “it takes hours to enter records” and one of its doctors reports, “What used to take minutes to write in is now taking hours. The other night I was here until midnight.” A board member says the EMR is “totalitarian,” while the board president said they should have had an implementation person or guide.

The western Montana region of Providence Health & Services lays off employees to offset the cost of new positions required to support Epic.

11-23-2013 6-59-44 PM

Virginia-based gastroenterologist Michael P. Jones, MD (who, interestingly enough, also holds a degree in dentistry) writes a Los Angeles Times opinion piece on EMRs, saying it takes doctors more time to document procedures than to actually perform them and that the main role of EMRs is to create “a bill of sale” to get insurance companies to pay for services. He’s not a fan of the healthcare system in general, either:

My job is to listen and observe, to figure out who really does have something bad going on and who may simply be feeling the effects of life’s wear and tear. There’s a huge difference between that and the healthcare industry, which is more about industry than health or care. Third-party payors don’t really care what happens in an exam room. The visit that you, as a patient, have been anxiously waiting for could just as easily be shoes or oranges or pork bellies to these folks. It’s just a commodity. It’s just data. And now the industry wants it documented in a format that works for billers and statisticians but not so much for doctors: the electronic medical record.

Sponsor Updates
  • Prominence Advisors is named as a “National Best and Brightest Companies to Work For” for 2013.
  • Infor announces enhancements for its MediSuite system for hospitals in Canada, including workflow enhancements, the addition of care models, and improved physician integration.


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

More news: HIStalk Practice, HIStalk Connect.


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November 23, 2013 News 13 Comments

News 11/22/13

November 21, 2013 News 9 Comments

Top News

11-22-2013 12-23-38 AM

HIMSS names Children’s Medical Center (TX) its 2013 Enterprise HIMSS Davies Award of Excellence winner.

From Ricky Roma: “To shag or not to shag… Please weigh in to help with our HIMSS 2014 booth decision, as our team is split along gender lines this year. Do we go with the high shag, ‘flooring equivalent of a peacock’s tail’; or the low shag, ‘it’s apparently easier to endure if you’re in heels’ booth carpet? What’s a sales leader to do?” I will solicit the collective knowledge of the HIStalk readership to answer this very important question.

HIStalk Announcements and Requests

inga_small A few HIStalk Practice highlights from the last week include: AMA continues to push for an ICD-10 delay. I share my recent experience with physician rating websites. The majority of physicians express dissatisfied with their ambulatory EHRs. A reader offers a music review from the NextGen UGM. A New Jersey practice manager shares details of her office’s EMR selection and implementation and discusses how the EMR has help improve the quality of care for patients. Thanks for reading.

Acquisitions, Funding, Business, and Stock

Catalyze.io, which offers a platform to accelerate the development of mobile health apps, secures a Series A financing round. The CEO of Catalyze.io is HIStalk Connect’s own Travis Good, MD.

Experian completes its acquisition of Passport Health.


Healthconnect HIE (TX) selects Surescripts services to make prescription and medication fill data available to hospitals.

11-21-2013 1-58-44 PM

Children’s Hospital of Wisconsin will implement Health Catalyst’s Late-Binding Data Warehouse and Analytics platform.

11-21-2013 2-00-16 PM

Inland Imaging (WA) will expand its use of MModal products to include MModal Fluency for Imaging and MModal Catalyst for Radiology.

11-21-2013 2-01-29 PM

Christiana Care Health (DE) selects grants management software from Huron Consulting Group.

11-21-2013 2-03-10 PM

Texas Health Resources will implement patient engagement technology from Emmi Solutions.


11-21-2013 2-05-07 PM

Huron Consulting Group names William T. Foley (Vanguard Health Systems) managing director of its healthcare practice focused on public healthcare systems and academic medical centers.

11-21-2013 9-34-48 PM

Randy Fusco (Microsoft Health & Life Sciences) joins Emdeon as SVP/CIO for revenue cycle services.


St. Luke’s Health System (ID) promotes CMIO Marc Chasin, MD to VP/CIO.

Announcements and Implementations

Clinovations launches the Clinovations Center for Population Health Management to help stakeholders design and implement infrastructures and operating models to support population management and value-based care delivery systems.

11-21-2013 6-58-02 AM

Children’s Hospital & Research Center Oakland (CA) completes the first phase of its $89 million Epic implementation.

Michigan Health Connect delivers diagnostic-quality images to its HIE member hospitals using the eHealth Connect Image Exchange platform from eHealth Technologies.

Visage Imaging implements its Visage 7 Enterprise Imaging Platform as part of vRad’s RG2 radiology operational management solution.

Roskilde Sygehus in Denmark goes live with iMDsoft’s MetaVision in its ICU, NICU, OR, and PACU.


The US Patent and Trademark Office issues SCI Solutions a patent for its method and systems used for secure online patient referral and ordering.


11-21-2013 12-51-41 PM

inga_small I’m thrilled to have found the perfect Christmas or Hanukah gift for all my favorite  clinicians (you know who you are, so just skip down to the next item if you don’t want to ruin the surprise.) Struck by Orca includes dozens of illustrations that depict artists’ visual interpretations of their favorite ICD-10 codes. I’m impressed that many of the illustrators are healthcare professionals and I thought the $20 price tag sounded reasonable. One of my favorites (because I’ve had this injury numerous times) is the above work by Sarah Bottjen, an Epic project manager.

Forbes profiles Cedars-Sinai Medical Center’s (CA) implementation of Voalte One technology combined with Epic.

Weird News Andy titles this article “Unconventional Therapy.” A Florida doctor uses whips and blindfolds to perform sadomasochistic acts in attempt to cure a female patient of depression. He wasn’t charged because the relationship was consensual, but he may lose license.

Sponsor Updates

  • Wolters Kluwer Health launches an enhanced web application within ProVation Order Sets.
  • Awarepoint is named the seventh fastest growing medical device company in North America in Deloitte’s 2013 Technology Fast 500.
  • RelayHealth Financial announces that all its financial connectivity solutions meet the current ICD-10 standards and that ICD-10 testing is available at no cost to its customers.
  • Troy Group and LRS install tamper-proof prescription printing capabilities at a North Carolina hospital.
  • Ping Identity introduces PingAccess, an identity gateway that combines web access management with mobile and API access management.
  • The Huntzinger Management Group reports that this year the company has increased its managed and advisory services and launched Huntzinger Staffing Solutions, a healthcare staffing company.
  • Perceptive Software’s Records Manager product is certified against Chapters 2 and 5 of the DoD 5015.2 standards for records management.
  • Intelligent Medical Objects highlights the integration of IMO’s Problem and Procedure solutions with Aprima EHR, which gives users on-demand access to over 180,000 medical terms from within the Aprima application.
  • MedDirect releases its upcoming conference schedule.
  • iHT2 interviews Wesley Valdes, DO, the medical director for telehealth services at  Intermountain Healthcare.
  • Vital Images will participate in the Image Sharing demonstration at next week’s RSNA meeting in Chicago.
  • UnitedHealth Group and Optum offer a free emotional support help line for people affected by recent tornados in the Midwest.
  • Liaison Healthcare wins four Gold, three Silver, and three Bronze awards at the Golden Bridge Awards ceremony. 
  • WisBusiness.com discusses the growth of HIT in Wisconsin with Nordic Consulting CEO Mark Bakken.
  • Bonnie Cassidy, Nuance’s senior director of HIM innovation, offers some key questions to consider when evaluating the efficacy of an ICD-10 coding program.
  • A Washington neurologist explains the benefits of the Virtual Lifetime Electronic Record, which uses technology and services from INHS.
  • The Business Application Research Center ranks QlikView first in collaboration and performance satisfaction among large international vendors offering BI software products.
  • HIMSS Analytics and The International Institute for Analytics launch DELTA Powered Analytics Assessment to allow healthcare provider organizations to evaluate and benchmark their analytical maturity relative to their peers.

EPtalk by Dr. Jayne


Readers who follow me on Twitter @JayneHIStalkMD may have seen me kvetching about problems with the HIMSS registration sit. I tried it multiple times on Firefox over a multi-hour period and even tried Internet Explorer. Previously it just said “something went wrong” but now it’s displaying a specific error. HIMSS did respond and offer to help me get squared away. If it’s not working in the next few days I might have to call. It’s expensive enough without missing the early bird registration and particularly so since my hospital no longer pays for anyone to attend.

Speaking of HIMSS, I was looking at last year’s “HIStalk Ladies Social Schedule” and it’s not too early to ensure your party makes it onto the Inga and Jayne must-see list. Email Inga inga@histalk.com or me drjayne@histalk.com and let us know why your event should make the cut. I’ll be arriving a little early to relax before the exhaustion of sessions, the exhibit hall, and of course HIStalkapalooza. I should probably take a few days off on the tail end of the meeting however my boss (probably assuming no one would actually pay his or her own way to HIMSS) scheduled a leadership retreat for Thursday and Friday so that’s not going to happen. Let’s hope it gets canceled or bumped.

I’m looking forward to HIMSS as a time to meet up with old friends and perhaps to explore some new opportunities. I’m starting to become a little leery of how our hospital is planning to tackle MU2 and various other initiatives. Several key members of our leadership have fallen victim to vulture-like consultants that have been circling. (Incidentally, did you know a group of vultures is called a committee? Makes perfect sense to me.) After dozens of hours of assessments the consultants have determined that our fairly conservative approach to Meaningful Use is overly strict and that we need to relax a little bit.

I know for a fact that I don’t look good in either black and white stripes or prison orange so some of the things they have suggested we do are downright frightening. They’re fairly cavalier in their interpretation of some of the rules and I’ve already made enemies by printing out specific CMS FAQ items and bringing them to meetings. I know the consultants think they’re impressing us by showing how much money we could be collecting (since we already ruled out a good chunk of providers as likely to not be able to attest) but it seems to be a shell game to me. Given the all-or-none nature of the Meaningful Use program it doesn’t seem like cooking the books even a little bit is a good idea.

They’re also pushing hard that we reorganize our employed medical group so we can start doing provider-based billing. I find it a fundamentally offensive approach to charge patients more a) just because you can, and b) just because everyone is doing it. We dabbled in this a couple of years ago with laboratory billing and the backlash from patients was overwhelming. It seems we are doomed to repeat the mistakes of the past.

Watching this happen is just one symptom of the growing dysfunction within the organization. It’s not easy to admit that you’re working at a place that is allowing its values to slip away in pursuit of profit (despite being a non-profit entity). I’m all for efficiency and streamlining, but there is a difference between that and cutting corners. We had a pretty significant layoff earlier this year and people genuinely fear for their jobs so what used to be a fairly transparent team-oriented workplace is rapidly becoming factious and paranoid. Many of the most talented analysts and team leads have already left with a fair amount of them going to work for either competing hospital systems or for vendors.

I’m not sure what I think about working for a vendor having been in non-profit health care for so long but sometimes it looks pretty good. On the other hand, I’ve seen how our CIO behaves towards some of our vendors and I wouldn’t want to be on the receiving end of that kind of treatment. I’m watching him pit two vendors against each other for a large rip-and-replace project and it reminds me of the movie “Gladiator.” It’s unpleasant yet I am still tugged by loyalty to an organization that I’ve been with a long time. Regardless, I’ll be dusting off my curriculum vitae (why can’t physicians just call it a resume?) and seeing what’s out there. What do you think about job hunting at HIMSS? Email me.


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

More news: HIStalk Practice, HIStalk Connect.

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November 21, 2013 News 9 Comments

News 11/20/13

November 19, 2013 News 2 Comments

Top News


A Johns Hopkins-led study published in JAMA concludes that the major factors driving healthcare costs up are consolidation of hospitals and practices that increase pricing power, high drug and medical device costs, and heavy IT investment with questionable value. It notes that costs are not visible to doctors or patients, which prevents healthcare from functioning as an efficient market.

Reader Comments

From Flash: “Re: AMIA. Perhaps the biggest news at AMIA so far is the non-news that CMS probably won’t delay Stage 2 MU. That’s essentially what the ONC’s Jodi Daniel said during a session Monday.” At this stage in the game, it would be more surprising if CMS did consider changes or delays.

Upcoming Webinars

DocuSign will present “Paperless Practices: Harnessing EHR Value by Improving Workflows with Electronic Data” on Tuesday, December 10 at 1:00 p.m. Eastern. “Audit Readiness: Three Simple Steps to Protect Patient Privacy”, presented by Iatric Systems, will be presented on Wednesday, December 11 at 2:00 Eastern. More information on both programs is on the Webinar page.

Acquisitions, Funding, Business, and Stock

CareFusion will acquire respiratory care and anesthesiology medicine manufacturer Vital Signs from GE Healthcare for $500 million.

11-19-2013 10-15-57 AM

Acupera, developers of population healthcare and coordination workflow management technology, secures $2 million in bridge financing.

MDS Medical, Greenway Medical’s top-producing channel partner, acquires the assets of EHRsolutions, Greenway’s second largest reseller.

Carl Icahn, who owns 4.7 million shares of Apple and a 16.9 percent stake in Nuance Communications, tells participants at an investment summit that he will not push Apple to buy Nuance.

Truven Health Analytics provided this comment related to its recently released 10-Q forms that a reader commented about in the Monday Morning Update:

Truven Health Analytics has performed well in 2012 and through the first three quarters  of 2013, with steady increases in revenue and robust margins for adjusted EBITDA.  Reported losses are due to accounting changes stemming from our divesture from Thomson Reuters and one-time costs associated with the migration of our data center from Thomson Reuters onto a standalone platform, neither of which affects ongoing operating performance.



The 25-bed Van Buren County Hospital (IA) selects McKesson Radiology and McKesson Study Share.

MModal adds new customers for its MModal Fluency for Imaging product including Coastal Radiology (NC), Coosa Valley Medical Center (AL), Greensboro Radiology (NC), Maricopa Integrated Health System (AZ), and Radiology Associates (OR).

Avera Health selects Craneware InSight Medical Necessity for 28 of their 33 hospital organizations.

11-19-2013 9-37-37 AM

King Khaled Eye Specialist Hospital in Saudi Arabia will implement InterSystems TrakCare. The hospital, by the way, is part of a compound that includes six five-story apartment buildings, 22 villas, a community center, tennis courts, playgrounds, a cinema, a supermarket, and a mosque.

Ophthalmology Associates (WI) selects SRS EHR for its six providers.

Avera Health (SD) chooses Craneware’s InSight Medical Necessity. 


11-19-2013 3-15-47 PM

The Georgia HIN names eHealth Services Group CEO Denise Hines executive director.

11-19-2013 3-19-47 PM

Recondo Technology appoints Lori Prestesater (McKesson Provider Technologies) chief growth officer.

11-19-2013 3-22-30 PM

Verisk Health promotes Nadine Hays from EVP of sales, marketing, and strategic partnerships to president, replacing Joel Portice who is leaving to pursue other interests.

Nuance extends the existing employment agreement with its CEO Paul Ricci through November 11, 2015 and agrees to pay him a base salary of $800,000 plus annual performance bonuses of up to $1.2 million.

MediTract, a provider of automated contract management solutions, names David F. “Buddy” Bacon (Meridian Surgical Partners) CEO.


Announcements and Implementations

eClinicalWorks will invest an additional $50 million over the next 12 months in addition to the $25 million it had already committed to enhance and expand population health solutions and patient engagement tools under its Health & Online Wellness business unit. Part of the funding will be used to hire an additional 100 software developers.

Southeaster Overread Services (NC) implements eRAD PACS with integrated speech recognition technology from MModal.

11-19-2013 10-47-26 AM

Parrish Medical Center (FL) expands its use of products from Strata Decision Technology with the implementation of  StrataJazz Decision Support.

11-19-2013 11-14-47 AM

Florida Governor Rick Scott joins iSirona employees to announce the company’s plan to create 300 new jobs over the next three years at its Panama City headquarters.

HIMSS Analytics and The International Institute for Analytics announce the launch of a service that will allow hospitals to assess the maturity of their analytics capabilities and benchmark against peers.

The Boston Globe names Meditech as one of the Top Places to Work in Massachusetts.

iMDsoft integrates the Electronic Whiteboard from  Intelligent Business Solutions into its MetaVision AIMS solution.


Government and Politics

House lawmakers introduce legislation that would create and expand physician reimbursement of telehealth services to active-duty service members, their dependents, retirees, and veterans.

Sen. Rob Portman (R-OH) proposes a bill that would extend MU incentive payments to behavioral health providers, including psychiatric hospitals, substance abuse facilities, and psychologists. The legislation would also address EHR-related adverse drug reporting to patient safety organizations, clarify that EHRs are not subject to the Food, Drug and Cosmetics Act, and limit electronic discovery in EHRs.

Medicare will cut reimbursements by as much as 1.25 percent to 1,451 hospitals next year as a result of their performance in CMS’s value-based purchasing program. An additional 1,231 hospitals will see payments increase by as much as 1.25 percent based on their performance across quality indicators.


The American Academy of Ophthalmology unveils the IRIS Registry, the nation’s first eye disease and condition patient database. The registry is designed to interface with any EMR system and will handle data on more than 18 million patients by 2016.

11-19-2013 8-22-44 PM

Three young programmers create HealthSherpa.com, which one-ups Healthcare.gov by allowing consumers to quickly get insurance prices by entering only their ZIP code. It took them only three days to develop and test the site. I tried it and had insurance prices and details in less than five seconds.

Weird News Andy finds this story to be strange but true. Researchers find that patients with a wide range of red blood cell sizes are more likely to have depression.


Sponsor Updates

  • Greenway Medical releases Intergy v9.00, which includes a dashboard to track the progress of a practice’s transition to ICD-10 or MU attestation.
  • The Drummond Group certifies Allscripts dbMotion 5.0  as an ONC-ACB 2014 compliant EHR Module.
  • Lifepoint Informatics announces the details of its March 13, 2014 user conference in Orlando.
  • National Decision Support Company, Montage Healthcare Solutions, and Nuance Communications collaborate to bring Imaging 3.0 tools to radiologists.
  • Medical Staffing Network (FL) completes their companywide implementation of API Healthcare’s solution suite.
  • Aspen Advisors raises $2,300 for Florida’s Health First health system during the company’s annual retreat in Ft. Lauderdale.
  • The Detroit Free Press names CareTech Solutions the top workplace in the large-company category based on employee satisfaction.
  • Surveys from Porter Research and Imprivata indicate that healthcare is beginning to trust cloud technology for the storage of PHI.
  • Emdeon discusses the challenges and opportunities of CPOE under Stage 2.
  • Sagacious Consultants launches Sagacious Connect to support hospitals extending their EMR software to independent practices and hospitals.
  • T-System’s Tonda Terrell offers seven considerations for payer contracting in the healthcare reform-era. The company’s Elizabeth Morgenroth also provides communication tips for a successful ICD-10 implementation and conversion.
  • Imprivata earns a spot on the Boston Globe’s Top Places to Work 2013 in the medium company category.


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

More news: HIStalk Practice, HIStalk Connect.

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November 19, 2013 News 2 Comments

Monday Morning Update 11/18/13

November 17, 2013 News 8 Comments

11-17-2013 11-13-49 AM

From Concerned: “Re: Truven Health Analytics. Its Q3 2013 SEC 10-Q says 2012 was an earnings disaster, and so far this year the company has lost $26 million and is increasing debt to pay bills.” I took a quick glance over the form, but I’m not an accountant and most of it glazed me over. Revenue took a big jump year over year and the net loss dropped as expenses were held fairly steady through the acquisition of the Thomson Reuters healthcare business in June 2012. As of September 30, the company appeared to be running a monthly loss of around $3 million and had $8 million in cash. The long document full of numbers is confusing because of the acquisition, but it appears that the company lost $8.4 million in the quarter vs. $20 million a year ago, so the situation may be improving. I found it depressing that Truven has 225 pending lawsuits against it filed by people who claim they were harmed by the drug Reglan and are suing the company because its patient education materials didn’t warn them of that possibility.

UPDATE: Truven provided this clarification: “Truven Health Analytics has performed well in 2012 and through the first three quarters  of 2013, with steady increases in revenue and robust margins for adjusted EBITDA.  Reported losses are due to accounting changes stemming from our divesture from Thomson Reuters and one-time costs associated with the migration of our data center from Thomson Reuters onto a standalone platform, neither of which affects ongoing operating performance.”

11-17-2013 11-14-48 AM

From FormerHHSIntern: “Re: HIE. Secondary consequences of poor Healthcare.gov rollout. Impending implosion over failed $600 million HHS/ONC Health Information Exchange grant program. At least one senior ONC leader will leave in next two weeks.” Unverified.

From Ken Dahl: “Re: paper vs. EMR for physician data entry. There’s a big difference on that score for inpatient vs. outpatient. For inpatient care, EHR is much better – for purposes of rounding, orders, med rec, and keeping track of care plans. Outpatient clinics are a bit more difficult because of the amount of charting required on EHR is overwhelming, and leads to a lot of MDs typing while talking which sets up an uncomfortable dynamic for the ‘therapeutic’ interaction. But there’s  always a tradeoff – either you chart with the patient or you chart at the end of the day and you lose an hour or two of time with your family that night. That is a reason MDs are becoming less interested in having a clinic practice.” General practice and some specialist physicians are, for the most part, vastly overtrained for seeing office patients. They are wasting most of their day looking at the same old problems that an extender could handle, playing EMR stenographer, and chatting with patients whose chronic disease requires no new diagnosis or treatment. Doctors (and healthcare in general) could learn from my dentist. Usually there’s just one dentist on duty, but a stable of hygienists and techs keeps several rooms full of patients undergoing everything from cleanings to denture repairs to crown and cavity work. He flits between rooms to oversee everything, speaks to every patient to hear any concerns, and shows up just in time to perform procedures on the fully prepped patients. He does not touch the practice’s fully electronic dental record and imaging system that I’ve ever seen, complete billing documentation, or handle referral or absent-from-work forms. We need to separate out the tasks that truly require a physician’s extensive education and experience and turf everything else off to cheaper and more readily available positions. One might argue, however, that physicians created the current state because they, until recently, were happy to collect big paychecks in return for underusing their skills.

11-16-2013 9-33-53 AM

From The PACS Designer: “Re: Apple’s curved screen iPad. As Apple continues to innovate in the PC space, they will be offering an edge to edge curved screen with the iPad 6 in 2014. Other rumored improvements are the replacement of the current screen material called Gorilla Glass with the indestructible sapphire material which is currently in the camera and fingerprint button.” The curved glass (image above from TechCrunch) would be mostly a cosmetic enhancement, but Apple is supposedly working on technology that will allow its mobile devices to detect the amount of pressure of a fingerprint touch and react accordingly. The current iPhone touch accuracy has been tested and found to be dramatically inferior to that of the Samsung Galaxy S3, so it’s time for the House That Two Steves Built to get on the ball.

11-16-2013 7-46-42 AM

Hospitals should stop fantasizing about big data and instead use the data they already have (and often ignore) to make improvements, the clear majority of poll respondents say. New poll to your right: do you use any mobile apps to monitor or improve your health? You can interpret what that means to you – apps for exercise, diet, medically related reminders, or health tracking.

11-17-2013 2-53-52 PM

Welcome to new HIStalk Platinum sponsor Connance. The Waltham, MA-based company was founded in 2007 to offer cloud-based predictive analytics and rule-driven workflow technologies that improve the financial performance of healthcare providers. Programs include self-pay maximization, commercial revenue optimization, performance benchmarking, charity and outreach, A/R valuation, revenue leakage detection, managed care contract enhancement, preventable readmission management, and consumer engagement. St. Joseph’s Hospital of Atlanta reported a 13:1 ROI, Florida Hospital saw a 20 percent increase in cash collections, and Children’s Hospital and Medical Center saw a 45 percent increase in charity dollars and a 40 percent decrease in bad debt expense (more case studies are here). I interviewed CEO Steve Levin in October 2013 and we covered some interesting topics: the changing nature of self-pay patients, the hit hospitals take on their patient satisfaction scores that are due to lack of financial service excellence, and ACA-triggered changes in charity classification. Some fun facts from its site: 40 percent of self-pay accounts generate 90 percent of the cash; 30 percent of accounts assigned to bad debt should be charity; and 20 percent of denials cost more to pursue than they will generate in cash. Thanks to Connance for supporting HIStalk.

11-16-2013 9-50-34 AM

Travis from HIStalk Connect and I will be reporting live from the HIMSS-produced mHealth Summit in the Washington, DC area on December 8-11. They’re offering a $75 registration discount to HIStalk readers (use code HISTalk). We’ll have a tiny HIStalk booth in the exhibit hall, staffed by my newest team member and the non-anonymous face of HIStalk, Lorre. I think she’s bringing some little giveaway items, hoping to distract from the fact that our booth will have all the charm of a rental storage unit because the furnishings were out of our price range (I may begrudgingly get her a chair to sit on, but I’m thinking about bringing one of those $10 folding camp chairs from the local Walmart). Lorre is getting a crash course in all things HIStalk without having met any actual readers or sponsors, so stop by and say hello so she doesn’t think I made it all up. You can email her to say hello if you like.

The AMIA 2013 Annual Symposium started Saturday in Washington, DC. I’ve never been to one (I’m not a member, although I once was, and I had a conflict this week) but I like the topics – it’s like a more academic and less commercial HIMSS conference from what I can tell. I decided to run tweets from the conference in the right column just in case you want to see what’s going on there.

11-17-2013 10-46-40 AM

AMIA announces at the leadership dinner of its conference the Stead Award for Thought Leadership, which will be awarded to recipients whose vision influences the use of informatics to improve healthcare. It honors Bill Stead, MD, associate vice chancellor for health affairs and chief strategy and information officer at Vanderbilt University Medical Center. Above are Stead with the members who recommended creation of the award: Nancy Lorenzi, PhD (VUMC); Bill Stead; Ed Hammond, PhD (Duke Center for Health Informatics); and Kevin Johnson, MD, MS (VUMC). The award’s colors will be Duke blue (where Stead was a student under Hammond), Vanderbilt gold, and AMIA crimson. I was amused that AMIA, like others regularly do, confused in the announcement its own journal’s name (JAMIA) with that of JAMA, saying that Bill was the first editor of the Journal of the American Medical Association, which if so means his informatics research has turned up the Fountain of Youth since JAMA’s first issue rolled off the presses in 1883.

ONC announces that it will develop interoperability standards that will allow EHRs to exchange information with state-run prescription drug abuse databases, updating pharmacy records in near real-time and helping prescribers identify potential abusers directly from order entry. An HHS task work group created the plan in 2011, final recommendations were issued in August 2012, and pilots were completed this year.

The Metro Atlanta Chamber names patient payments platform vendor Patientco its 2013 Healthcare IT Startup Company of the Year. I interviewed CEO Bird Blitch a month ago, including a question about Georgia healthcare IT companies.

11-17-2013 11-24-37 AM

Knowledge management solutions vendor Streamline Health announces a secondary stock offering to finance the acquisition of two small, unnamed software vendors. Company A offers patient scheduling and access solutions, has 29 clients, and will be acquired for $6.5 million in cash. Company B offers financial and operational analytics to its 35 clients and will be acquired for $13.75 million in cash and stock. I interviewed CEO Bob Watson in August 2013. I observed then that STRM shares had jumped from $1.50 in early 2012 to $7 at that time; they’re at $7.60 now.

Eleven Canada-based startup healthcare IT vendors will demonstrate their products in Philadelphia on Tuesday as part of a collaboration program between the city and a Canada-based health IT accelerator. On hand will be Caristix (HL7 integration), Hospitalis (clinical pathways and interventions), Infonaut (infection control surveillance), Memotext (patient adherence), Pulse InfoFrame (analytics), Sensory Technologies (homecare management), HandyMetrics (hand hygiene auditing), Impetus Healthcare (online communities), Interfaceware (HL7 integration), MetricAid (ED efficiency), and Phemi Health Systems (analytics).

11-16-2013 8-13-44 AM

The board of Cover Oregon, the state’s health insurance exchange, places its executive director on notice because of website problems that have resulted in zero enrollments for coverage that begins January 1. The board expressed displeasure with Oracle, which it says missed deadlines and provided marginally skilled employees. The exchange has asked the federal government to loan it seven people to help.

11-17-2013 11-34-00 AM

CMS Deputy CIO Henry Chao did his best to rally the troops this summer to get Healthcare.gov ready, but his patience for missed deadline excuses and demands for more money (especially from contractor CGI) was obviously wearing thin by mid-July. According to a July 12 email, “they [CGI] need about $38 million more to get them through Feb. 2014 … the $38 million does not include the approximate $40 million we have in the budget for this contract.”

11-16-2013 8-19-59 AM

Steve Larkin (maxIT Healthcare) joins ESD as regional VP.

11-16-2013 9-19-46 AM

Marc Winchester (Intuit Health) takes a sales and marketing role with supply chain systems vendor Aperek, previously known as Mediclick.

11-16-2013 7-54-35 PM

Robert Marcus, MD (NextGen) joins TrustHCS as a physician consultant.

11-16-2013 8-05-57 PM

Richard Tunnell (UMDNJ) is named CIO of University Hospital (NJ).

11-16-2013 8-17-15 AM

Fargo-ND-based Intelligent InSites employees wore tee shirts Friday to support United Way. The hats are from the company’s user group meeting held this summer, and since they invited me but I couldn’t attend, they’ve got one with my name on it.

If your HIS-torical memory includes names such as McAuto, SAINT, IBAX, and Amex, then you’ll enjoy Vince’s chapter this week in his continuing analysis of the confusing and sometimes incestuous McKesson HIT family tree.


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

More news: HIStalk Practice, HIStalk Connect.


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November 17, 2013 News 8 Comments

News 11/15/13

November 14, 2013 News 7 Comments

Top News

11-14-2013 11-32-20 PM

Moses Cone Memorial Hospital (NC) sees its credit rating downgraded from stable to negative after spending $90 million to implement Epic, with plans to spend another $40 million and to add another 90 employees to support it over the next three years.

Reader Comments

From Head Scratcher: “That Allscripts announcement about implementing Sunrise at two newly acquired Montefiore hospitals comes just days after Montefiore announces the signing with Epic. Interestingly, Jack Wolf is not leading the Epic install.” Unverified.

HIStalk Announcements and Requests

inga_small Are you current with all the latest HIStalk Practice news? Some highlights from the last week include: “better-performing” practices use patient-satisfaction surveys to evaluate and improve practice operations. Doctors blame EMRs for slowing them down and reducing productive face-time with patients. Emdeon reports a Q3 loss of $16.2 million and a nine percent increase in revenues. Practices charge for online access to patient portals. Dr. Jayne’s personal physician shares impressions from NextGen’s User Group Meeting, including a review of the NextGen Patient Portal solution. Thanks for reading.

On the Jobs Page: Director of Business Development, Solution Sales Executive, Sales Excellence Manager.

Acquisitions, Funding, Business, and Stock

RightCare Solutions, a provider of decision support and transition of care technology developed by a University of Pennsylvania Nursing professor, raises $5 million in a Series B funding round.

11-14-2013 10-45-11 AM

Healthcare messaging company docBeat secures $1.1 million in a pre-Series A round.


Signal Health (WA) selects HealthUnity’s HIE, analytics, and PHR platform.

11-14-2013 11-36-12 PM

Albert Einstein Medical Center (PA) will integrate MedCurrent’s OrderRight radiology decision support system Cerner Millennium.

Wentworth-Douglass Hospital (NH) selects PatientKeeper Charge Capture and PatientKeeper Sign-Out solutions for its hospitalists and intensivists.


11-14-2013 4-04-26 PM

The Care Continuum Alliance appoints ICA CEO Gary Zegiestowsky to its board.

11-14-2013 10-47-47 PM

An internal McKesson email indicates that Kevin Torgersen, president of Imaging & Workflow Solutions, resigned this week for personal reasons. IWS will be reorganized under the acute care product line and several personnel changes were announced to employees.

11-14-2013 10-52-53 PM

Kevin Brown (athenahealth) is named VP of West Coast sales for CareCloud.

Announcements and Implementations

Accenture and The Phoenix Partnership deliver the first phase of an EHR across nine NHS systems in Southern England.

11-14-2013 11-26-55 AM

Virtual Radiology releases its free Radiology Patient Care benchmarking metrics.

Orion Health launches Rhapsody 5.5.

pMD announces ICD-10 Converter, which automates ICD-9 to ICD-10 conversion.

Government and Politics

11-14-2013 12-44-49 PM

CMS releases the Virtual Research Data Center, a data sharing tool that provides researchers access to Medicare and Medicaid data from their own workstations for performance analysis and data manipulation.

The Obama administration won’t require insurance companies to upgrade existing individual plans to meet ACA requirements for 2014 as long as the insurers notify consumers what ACA protections their plans don’t include and of the additional options available through insurance exchanges. The announcement comes a day after CMS revealed that 106,185 individuals had selected plans in the first period of open enrollment, only 26,794 of them through the federal exchange.


11-14-2013 1-00-29 PM

inga_small Even if I talked on the phone more I don’t think I would be an early adopter of this technology. Google files a patent for an electronic skin tattoo that sticks to your neck and serves as a hands-free microphone for your cellphone. The tattoo could also carry a lie detector that would detect skin response caused by nervousness. To be clear, I was a “no” before the lie detector part was mentioned.


In Oregon, a university-based pediatric intensivist remotely diagnoses a baby’s life-threatening bacterial infection using a telemedicine workstation controlling a robot-like device. The mother says the telemedicine technology “is the greatest thing ever invented” and does not think her daughter would be alive without it.

11-14-2013 10-39-54 AM

A KLAS report finds that no single vendor leads in the population health management tools market, though early leaders are emerging based on their portfolio breadth, experience, and ability to deliver. Those vendors include The Advisory Board Company, Conifer Health, Explorys, Healthagen, Optum:Humedica, i2i Systems, McKesson, Optum: Care Suite & Impact, Phytel, Premier, and Wellcentive.

Three US organizations win the 2013 Malcolm Baldrige National Quality Award, including Baylor Regional Medical Center at Plano (TX) and Sutter Davis Hospital (CA).

Steven Brady, SVP for administration at SUNY Upstate Medical University, resigns after the university discovers that he received outside income without permission from its affiliate MedBest Medical Management, which has a $22 million contract with the university to implement a PM/EMR system.

Sponsor Updates

  • Gartner positions CommVault in the leaders quadrant of its Magic Quadrant for Enterprise Information Archiving.
  • Kareo launches Kareo Marketplace, a solution center to help private practices identify cloud-based applications and services to optimize their operations.
  • VMware announces it will provide HIPAA business associate agreements to its customers.
  • Visage Imaging will demonstrate new features for its Visage 7 Enterprise Imaging platform at RSNA December 1-5 in Chicago.
  • The ICA-powered Kansas HIN reaches the connectivity milestone of providing access to more than one million patients.
  • Great River Health Systems (IA) shares how Encore Health Resources provided contract review and pre-implementation assistance while transitioning to Cerner.
  • EDCO Health Information Solutions recommends three point-of-care record scanning articles.
  • ICSA Labs offers five tips for keeping enterprises safe from mobile app threats.
  • Wolters Kluwer Health is providing a free emergency resources portal to Philippine hospitals and healthcare institutions in support of typhoon disaster relief efforts.
  • HIStalk sponsors named to Deloitte’s Technology Fast 500 list for 2013  include AirWatch, Awarepoint, Kareo, InstaMed, Etransmedia Technology, Allscripts, Liaison Technologies, SRSsoft, Greenway Healthcare, Halfpenny Technologies, Imprivata, Valence Health, Vocera Communications, and VMware.
  • Impact Advisors principal Laura Kreofsky discusses MU audits at next week’s Oregon & SW Washington Healthcare, Privacy & Security Forum.
  • Elsevier launches Elsevier Adaptive Learning study solution for improved learning and memory retention for healthcare professionals.

EPtalk by Dr. Jayne

I’ve been digging through provider quality reports this week and it’s so tiresome. I have to know which physicians are in jeopardy of missing their bonus targets so that when they call screaming at me that the reports are wrong, I can be prepared. It’s surprising how badly some of them are doing. They receive a package of reports monthly so that they can see where they are, and our chief medical officer works with those that are underperforming to institute changes in the practice to try to increase their success. There’s only one month left in the year, however, and unless providers are only under their targets by a fraction of a percent (or see small numbers of patients), it’s not likely that they can turn things around now.

What kills me is that some of the measures they fail to hit seem to be no-brainers. Our EHR has tons of prompts to make sure that certain services are done – both passive alerts (icons, exclamation points) and “in your face” type modal window popups that they cannot get past without acknowledging. We have standing orders available that providers can print, sign, and institute in their offices (and in the EHR) so that their clinical staff can administer vaccines without individual patient orders. We have signage available reminding diabetic patients to remove their shoes and socks so the providers can examine their feet. Inevitably, though, providers miss the mark.

Sometimes I really wish I had gotten a psychology degree instead of a chemistry one – it would have been much more useful in figuring out what makes my colleagues tick. Why wouldn’t you want certain services to be on autopilot? Why would you want to have to give individual verbal orders (or heaven forbid ,enter them into the EHR yourself) for flu shots or tetanus shots? And what makes some providers very eager to get on board with these kinds of clinical protocols when others dig in their heels? If I could crack this code I could retire early.

Maybe it’s being afraid of “cookbook medicine” or just not wanting to be told what to do by others. In some cases, it’s being in denial of the clinical evidence that shows that standing orders prevent disease and disability. Maybe it’s just feeling beaten down by what the healthcare system has become. Another one of my friends just made the decision to leave clinical medicine – she finished her MBA and is off to work for one of the major health IT vendors.

I’m looking forward to 2014 as a chance to reset. Those providers that missed the mark can start over. We only have to attest for 90 days instead of the full year, so that will reduce some stress, although our impending EHR upgrade and some other payer initiatives are adding to the overall tension. I suspect that CMIOs at other hospitals and health systems are feeling the same kind of pressure, but there is not a lot we can do about it since the forces are largely external.

For me, it’s back to the quality reports. But first, another NextGen User Group special report from our roving reporter. Inga shared comments from my personal physician about the NextGen User Group this week in Las Vegas. Here’s her second installment:

NextGen UGM Update

The customer appreciation parties thrown by vendors on Monday were a lot of fun. My favorite was IMO’s elegant cocktail party held in a suite with a balcony overlooking the strip. They had Monday Night Football showing on the balcony’s big screen TV (that’s the way to live!) and an excellent wine assortment, although rumor was the MGM wouldn’t let them serve reds due to the all-white décor of the suite. The buzz on the street was that Navicure’s party was best and had nearly 1,000 attendee at the Hard Rock. I’m just a little PCP, though, so didn’t score an invite.


I noticed this display appear on Day 2, near the escalators where you enter the conference center. Only in Las Vegas can you get walk-in IV hydration and a B12 shot. It’s a cash practice with no insurance billed, so of course they can do whatever they want. One young IT guy I overheard in a session said he took advantage of it after a night of too much fun. He mentioned that the nurse who administered his IV normally works in a pediatric ER and loves working the “spa” because the patients have big veins.

There were many good educational sessions on ICD-10, Meaningful Use Stage 2, and how to improve revenue cycle and clinical documentation. A fair amount of continuing medical education credit was offered as well. The MGM did a great job with logistics for 5,000 people. This was my first User Group and the build-up to the Tuesday client event was huge. They always keep the entertainment a secret and past musical acts have included Sammy Hagar, Styx, Foreigner, Huey Lewis and some other well-known groups. The first act turned out to be the Brian Setzer Orchestra, which would have been good if the acoustics weren’t so distorted. The second was Big and Rich, which provoked a mass exodus. I was among the scattering crowd so I can’t report after that. Wednesday was a little more low-key with only two education sessions and I suspect many people left early to avoid the chaos that is the Las Vegas airport.


I forgot to send this picture earlier in the week, you have to love an airport with a liquor store in baggage claim. I relaxed on the plane on the way home reading the Twitter feed for the event and some of my favorite tweets were:

  • Either I’m in ICD-10 hell or they have the heat on in room 309

Followed by:

  • Do you know the ICD-10 code for burning up like you are Lucifer’s step sister?

And then:

  • Depends on whether burning is via a coal- or wood-fired oven, nuclear meltdown, etc. Please consult CMS GEM mappings.

You have to make fun of ICD-10 or you’d cry, so I found it particularly funny.

All in all it was a successful meeting. I got some CME, heard some great speakers, and learned some things that should make my EHR documentation quicker and easier. I’ll definitely be back next year!

I’m glad she got to go and I was able to live vicariously through her – I’ve only been to my own vendor’s meeting. I’d love to see how the grass looks on the other side of the fence. Maybe that’s an idea – we could auction off a chance to have Dr. Jayne attend and review your user group meeting (under an assumed name, of course). Proceeds could go to charity. What do you think? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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November 14, 2013 News 7 Comments

News 11/13/13

November 12, 2013 News 21 Comments

Top News

11-12-2013 5-49-15 PM

AMIA announces in an email to members that Kevin Fickenscher, MD will step down as president and CEO on November 30, 2013 to return to industry. He took the position for 20 months ago. The search for his replacement will start immediately.

Reader Comments

11-12-2013 7-57-05 PM

From Pitiful: “Re: U. Arizona Health System. More than 9,500 glitches in its Epic EHR, claims to have solved more than 6,000. The health system is financially precarious.” Unverified. They were scheduled to go live November 1.

Acquisitions, Funding, Business, and Stock

11-12-2013 3-22-35 PM

Vocera reports Q3 results: revenue flat, adjusted EPS -$0.02 vs. $0.13, missing earnings estimates.

11-12-2013 3-26-09 PM

Alan Dabbiere, chairman of mobile device technology vendor AirWatch, expresses an interest in acquiring BlackBerry’s services division and integrating the Blackberry server technology into its device management technology to provide corporate customers a single dashboard for all devices.

Long-term care EHR provider PointClickCare acquires Meal Metrics, the developers of a web-based nutritional management solution.

11-12-2013 7-45-41 PM

AuthentiDate announces a $2.46 million private placement from unnamed investors. The company offers telehealth, referral management, and discharge management solutions, with the VA as a notable customer.


11-12-2013 1-42-31 PM

Star Valley Medical Center (WY) selects Access E-forms on Demand to eliminate paper forms.

11-12-2013 1-40-41 PM

ValleyCare Health System (CA) will implement CareInSync’s Carebook mobile communication platform for care team coordination.

The 11-provider Ocean Eye Institute (NJ) selects SRS EHR.

11-12-2013 1-38-41 PM

Denver Health (CO) selects Besler’s BVerified Screening and Verification solution.

The Nevada HIE will deploy the Orion Health HIE.

Montefiore Health System will upgrade its newly acquired hospitals in New Rochelle and Mount Vernon to Allscripts Sunrise, including EHR, Analytics, Radiology, and Laboratory and implement the FollowMyHealth patient engagement platform.

SummaCare (OH) selects Wolters Kluwer Health’s Health Language to convert ICD-9 codes and DRGs to ICD-10.


11-12-2013 1-55-25 PM

PaySpan names Cheryl King (First Data) CFO.

11-12-2013 1-50-27 PM

Candace Smith (Medline Industries) joins Voalte as CNO.

11-12-2013 3-53-30 PM

The VA appoints Arthur L. Gonzalez (TISTA Science and Technology Corp.) deputy CIO for service, delivery, and engineering.

11-12-2013 4-02-05 PM

Direct Recruiters, Inc. promotes Dan Charney to president.

11-12-2013 6-50-31 PM

Scotland-based Craneware appoints Colleen Blye (Catholic Health Systems of Long Island) to its board.

Announcements and Implementations

Nextgen introduces NextGen Share, an interoperability solution based on the Mirth HIE platform that facilitates clinical data exchange and referrals from within the NextGen EHR.

11-12-2013 1-56-46 PM

CSI Healthcare IT completes a Cerner activation at the University of Tennessee Medical Center.

Merge Healthcare will exit the consumer medical information kiosk business, which reportedly accounted for $10 million of the company’s $250 million in sales last year. Merge, which spent $2.8 million on 500 of the kiosks last year with an ultimately failed plan to roll them out throughout Chicago, said technology upgrades were too expensive and it agreed to get out of the business following a patent infringement lawsuit. The kiosks made up one of 11 deals between Merge and companies owned by its chairman and largest shareholder, Michael Ferro, who stepped down in August 2013.

Westmed Medical Group (NY) reports that its ACO program with UnitedHealthcare and Optum improved nine of 10 health quality metrics, increased patient satisfaction, and reduced costs since its establishment in mid-2012.

DrFirst launches the Patient Advisor Report Card, a medication adherence alert system that provides a physician with medication adherence rates for each patient.

NextGen announces NextPen Voice, a pen that accepts either voice or written input depending on user preferences and activities. It uses digital pen technology from Sweden-based Anoto, which announced three weeks ago that it couldn’t survive another 12 months without issuing new stock rights.

Four large Boston-area organizations – Dana-Farber, Brigham and Women’s, Boston Children’s Hospital, and Broad Institute – form the Joint Center for Cancer Precision Medicine, which will study the genetic characteristics of tumors to choose the best chemotherapy drug treatments for individual patients.

Government and Politics

inga_small The Wall Street Journal reports that fewer than 50,000 people signed up for health insurance through Healthcare.gov during October. Despite my “success” about 10 days ago signing up for insurance, my application now appears to be in limbo. After two support chat sessions, two support phone calls, and an email exchange with my selected insurance carrier, I’ve been advised that the normal 48 hour “acceptance” process has been delayed. I’m trying to remain optimistic that the new plan will be in place in time for me to cancel my current plan so I won’t be stuck paying for two plans come January.

CMS tells industry stakeholders it might reconsider performing external, end-to-end ICD-10 testing with physician offices following recent problems with its Healthcare.gov site. CMS said previously it would not offer external testing and that it was confident with its current internal testing.

11-12-2013 6-23-55 PM

Former National Coordinator David Blumenthal, MD, now president of The Commonwealth Fund, says President Obama’s call for federal government IT procurement reform after the contractor-assisted bungling of Healthcare.gov is necessary because “the federal process is clearly broken.” He says of his experience at ONC:

Our staff would decide what services we needed, write a request for proposals (RFP), and send it off to a totally independent contracting office. That office could be within the Department of Health and Human Services (DHHS), but if the DHHS office was too busy, the RFP could go almost anywhere: the Department of the Interior, the Department of Housing and Urban Development, the Department of Education — whatever contracting office had time to process the work. Officials extensively trained in the details of federal procurement, but lacking familiarity with our programs or field of work, would put the RFP out to bid. An expert panel–over which we had minimal control — would evaluate the responses. Months later, the contracting office would present us with the signed contract. The winner was usually picked from a group of companies with considerable experience working the federal procurement process. If we weren’t happy with the firm, or with their later performance, there was virtually nothing we could do about it. Getting out of this shotgun marriage meant months of litigation, during which the funds would be frozen and the work itself would grind to a halt.

11-12-2013 8-07-25 PM

News I missed from several weeks ago, if it was announced:  CMS awards several companies an $800 million contract to support the Measure and Instrument Development and Support program for healthcare quality measures as part of HITECH.

11-12-2013 8-08-44 PM

It’s not just the federal insurance exchange website that’s having problems. Users report that the Massachusetts Health Connector site won’t accept hyphenated names and requires proof of incarceration for non-prisoners. The spokesperson gave the same response as those for Healthcare.gov – sorry for the problems, we’re fixing them, but in the mean time, pick up the phone or mail a paper form.

Innovation and Research

11-12-2013 8-09-30 PM

The New York Digital Health Accelerator celebrates its first year and the recent success of two graduates of its nine-month mentorship program: Avado (patient relationship management tools, acquired by WebMD) and Cureatr (secure physician messaging, obtained $5.7 million in funding).


11-12-2013 4-34-12 PM

inga_small If you are like me, you may be a little flash-mobbed out. However, this video of a woman dancing with the OR staff minutes before undergoing a double mastectomy brought tears to my eyes. Got to love the doctors, nurses, and techs who busted some moves with Deborah Cohan, an OB/GYN and mom of two who I wouldn’t mind having as a BFF.

Patient Privacy Rights launches a “Save Health Privacy” campaign on crowdfunding site Indiegogo, hoping to raise $10,000 to purchase privacy-friendly technology and to create a privacy education app. Donate $500 and you’ll get a dinner with PPR Founder Deborah Peel, MD.

11-12-2013 6-31-54 PM

The National Patient Safety Foundation releases an online, self-paced course titled “Health Information Technology through the Lens of Patient Safety,” targeting physicians, pharmacists, nurses, and quality professionals who are involved with both IT strategy and patient safety. Topics include organizational culture, transparency, patient engagement, integration of care, and human factors engineering. The course costs $30 and CE credits are provided. McKesson provided an educational grant to make the course possible. I’ll most likely take the course myself and report back.

A Pittsburgh internist sues a local medical billing company after its systems fail with no usable backup. The doctor concludes, “It is all in the cloud, and if the cloud disappears someday, we are all in trouble.”

11-12-2013 8-02-34 PM

Weird News Andy notes the story of an ABC reporter who got her first-ever mammogram on live national TV to call attention raise awareness for Breast Cancer Awareness Month, only to have the test reveal that she has cancer. Amy Robach, 40, will have a double mastectomy performed this week. WNA observes that under new guidelines, she would not have been a mammogram candidate until she turned 50, assuming she had lived that long without treatment.

Sponsor Updates

  • Salar sponsors the Student Design Challenge: Reinventing Clinical Documentation at next week’s AMIA 2013 Annual Symposium in Washington, DC.
  • Amcom Software hosts its annual user conference, Connect 13, this week in San Diego.
  • NextGen Healthcare is hosting 5,000 attendees this week at its user group meeting in Las Vegas. Dr. Jayne’s personal physician offers her impressions of the conference on HIStalk Practice.
  • Hyland Software and Bottomline Technologies will integrate their mobile data capture and ECM technologies.
  • Elsevier adds new content types and an enhanced mobile app to Mosby’s Nursing Consult .
  • Kootenai Health (ID) estimates that its implementation of the Summit Interoperability Platform saved the organization $50,000 to $75,000 in 2012 through the elimination of duplicate interface purchases and maintenance costs and the reallocation of hospital IT staff.
  • ChartMaxx hosts webinars November 13 and 21 discussing ways to provide high quality care while cutting costs and improving revenue cycle.
  • LDM Group sponsors the iPatientCare National User Conference November 15-17.
  • Strata Decision Technology hosts a November 18 webinar on high performance decision support operations.
  • Market research firm Harvey Spencer Associates ranks Nuance Communications the world’s leading scanning and capture software vendor based on market share.


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

More news: HIStalk Practice, HIStalk Connect.


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November 12, 2013 News 21 Comments

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