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News 8/23/13

August 22, 2013 News 12 Comments

Top News

8-22-2013 7-46-29 PM

Steve Malik, the Cary, NC entrepreneur who sold his Medfusion patient portal startup to Intuit in 2010 for $91 million, acknowledges that he has bought the business back from Intuit, which had announced its intention to divest Intuit Health Group to focus on its core tax and financial software business. Intuit wrote down $46 million earlier this year when partner Allscripts decided to look elsewhere for a portal solution. Revenue was down to $16 million in 2013. Malik says he looked at healthcare IT startups before realizing that his former company held the highest potential. Malik, the sole owner of the company, says he hasn’t decided whether he will revive the Medfusion name (my vote and expectation would be yes even thought the name isn’t descriptive.)

Reader Comments

From Boy Wonder: “Cerner and Epic. Are you aware of any health systems that have switched or are in the process of switching from Cerner to Epic? Just wondering.” I was thinking that Aurora had done so. I assume the specific interest would be those that switched voluntarily rather than being forced by acquisition. Readers?

From Vendor Venting: “Re: McKesson Horizon. As a customer, we have noticed that support and services have steadily declined since the ‘Better Health 2020’ announcement in December 2012. The average tenure of support employees supporting us has dropped severely with resignations. We have to run a gauntlet of triage and bottom-tier support before most of our issues are escalated to a rare senior resource. They are exerting pressure for us to migrate to Paragon while failing in their commitment to support us on Horizon. In the BH 2020 announcement, we were assured that there would continue to be a commitment to Horizon customers, but the executives who made those commitments have moved on. Actions speak louder than words and customers have been left to deal with the fallout.” Unverified. I would be interested in speaking to a customer that has moved from Horizon to Paragon since those mentioned by the company seem to be happy.

8-22-2013 7-05-11 PM

From CDiff: “Re: ICD-10 codes for High Life in the ER. Wondering if Weird News Andy has reported the need for five ICD-10 codes for beer?” A Johns Hopkins Hospital study of the one-third of ED visits that are alcohol-related finds that the beer brands most often involved are those most appropriately consumed from a paper bag koozie rather than a tulip glass: Budweiser, Steel Reserve, Colt 45, Bud Ice, and Bud Light. They’re planning to extend the study to see if it’s just a Bal’more thing.

From Pacific Girl: “Re: CIO Unplugged 8/12/13. Mr. HIStalk, that is by far the most moving post I’ve read from your site, and it couldn’t have come at a better time. Thank you, thank you, thank you.” I think people sometimes underestimate how hard it must be for Ed Marx to write soul-baring articles like “Falling from Grace” and post them publicly for his peers with his name on them, opening himself up to criticism from folks who enjoy the benefit of anonymity. Ed doesn’t seem to mind as long as he makes them think.

From Boston Beans: “Re: John Halamka. Why do people feel the need to run him down? He’s doing his job at BIDMC or they wouldn’t keep him.” Long-time readers may recall that I was unflaggingly cynical about him years ago given his ubiquity, but that changed when I met people who know him and then met him myself (as me, not Mr. H) He’s the real deal and I detected no self-serving agenda at all. He won’t take money for doing work external to BIDMC because he considers his time paid for by them, he is patient in explaining what he knows when I’m sure I wouldn’t be, and I think he really cares about patients more than anything else. I interviewed him in 2010 and was impressed at his lack of pretension or ego. I may or may not agree with every IT decision he’s made and he’s got some biases unique to Harvard and Boston, but he’s a good guy. Folks who say he isn’t usually haven’t actually met him. If you’re looking for egotistical douchebag CIOs or executives, you have many more deserving choices.

HIStalk Announcements and Requests

inga_small Some HIStalk Practice highlights from the last week include: MGMA urges HHS to not penalize physicians who have met Stage 1 MU requirements but may miss the Stage 2 deadline. The Air Force’s 62nd Air Division highlights its use of RelayHealth’s secure messaging platform. An AHRQ report concludes that the use of HIT in ambulatory care settings has a positive impact on care delivery and provider satisfaction. Physicians can expect an average salary increase of 2.4 percent in 2014. Thanks for reading.

8-22-2013 7-21-49 PM

Inga needed a new laptop and asked me if this one from Office Depot was OK (Toshiba Satellite C55-A5286). I was shocked that an Intel-powered 8GB memory Windows 8 laptop with a memory card reader, USB 3.0, a decent screen, and a DVD drive could be bought for $380 after rebate, to the point that I joined Inga in buying one and so did our newest HIStalk colleague. I’m extremely happy with it after doing the usual setup tasks: opening Internet Explorer long enough to download Firefox and Chrome, de-installing all of the bloatware that the manufacturer gets paid to include, and installing a utility that bypasses the new (and confusing) Metro interface in favor of the old Win 7 start menu.

Listening: the entire catalog of Portland-based indie band The Thermals. Also, new Superchunk.

Ed has updated his CIO Unplugged “Falling from Grace” post with a response to the comments left by readers.

Acquisitions, Funding, Business, and Stock

8-22-2013 6-22-10 AM

Bottomline Technologies reports Q4 earnings: revenue up 5.86 percent, adjusted EPS $0.32 vs. $0.26, beating analyst estimates of $0.29.

8-22-2013 8-50-54 PM

Nuance adopts a poison pill defense, hoping to prevent investor Carl Icahn from taking control of the company and selling it off in pieces.

Orange Health acquires the software assets of ExtendMD, which offers patient-physician communications technology.

8-22-2013 4-07-55 PM

Connecticut Innovations, which provides funding for Connecticut technology startups, extends a $200,000 follow-on funding commitment to tablet computer sterilizer manufacturer ReadyDock.


8-22-2013 9-04-42 PM

The Lott AQ Group, a healthcare IT quality assurance and consulting firm, will use VitalWare’s VitalSigns auditing and financial risk assessment tool for ICD-10 testing.


8-22-2013 4-09-51 PM

Jim Jirjis, MD (Vanderbilt University Medical Center ) is named chief health information officer for HCA.

8-22-2013 10-51-54 AM

St. John’s Riverside Hospital (NY) appoints Daniel Morreale (Kingsbrook Health System) VP/CIO.

8-22-2013 8-20-20 PM

Denis Connaghan (etrials) joins clinical trials network provider Clinverse as CEO.

The San Francisco Department of Public Health names Bill Kim (Dignity Health) to the newly created position of CIO.

Announcements and Implementations

EHNAC releases updated and final 2013 criteria for the electronic exchange of clinical data.

8-22-2013 1-11-44 PM

The Southeast Michigan Beacon Community names Quest Diagnostics its first provider of diagnostic information services for its HIE, BeaconLink2Health.

8-22-2013 4-12-57 PM

Allscripts names healthfinch the grand prize winner of its Open Apps Challenge for its automated prescription renewal request app. We interviewed healthfinch CEO and Co-Founder Jonathan Baran on HIStalk Connect last year.

8-22-2013 8-34-10 PM

AirStrip and Vivify Health will develop a remote care platform for the AT&T mHealth Platform.

Innovation and Research

8-22-2013 8-54-28 PM

Robert Wood Johnson Foundation offers $100,000 in prizes for entrants who combine healthcare with public health data to improve community health.


8-22-2013 4-25-49 PM

The CVS drugstore chain notifies 36 prescribers that it will no longer fill their controlled substances prescriptions after an analysis of its million-prescriber database indicates a high likelihood of improper prescribing.

8-22-2013 8-46-32 PM

In England, the final tab for the failed NPfIT project is tallied at nearly $16 billion, having delivered an estimated $4 billion in benefits.

8-22-2013 5-54-23 PM

Meditech announced to employees this week that it has acquired a six-story, 108,500-square-foot office building from Adobe Systems in Waltham, MA on Route 128. The company will fully occupy the 400-seat, three-year-old LEED Certified Platinum building when existing tenant leases expire in late 2015.

8-22-2013 5-18-53 PM|8-22-2013 5-20-11 PM

Peer60, which offers customer intelligence tools, has put together a pretty funny downloadable e-book called “Executives Are Idiots,” which pokes fun at getting executive feedback.

8-22-2013 6-27-11 PM

A major national health system work group studying copy-and-paste issues in EMRs recommends monitoring the practice within existing documentation audits, according to an internal PowerPoint presentation forwarded by a reader.

8-22-2013 7-36-14 PM

Dubai Health Authority orders 3,000 Android tablets, vowing to provide one for every patient bed toward its plan to use “the latest IT technology to enhance customer service experience.” The hospitals will roll out their EMR in the next 2-3 years.

UMass Memorial Medical Center (MA) pays $66,000 to settle fraud charges in which it was accused by a whistleblower of intentionally mailing bills to a homeless shelter so it could then bill the state for the unpaid amounts.

8-22-2013 6-33-29 PM

Weird News Andy says of the story headlined German Doctors Remove Tumours From Liver Using an iPad that he would have used a scalpel instead since it’s sharper.

WNA also likes this story, which he titles “Herniating Money.” A man is told by a hospital that his hernia surgery will cost $20,000 upfront with his insurance company covering the rest. Instead, he heads over to another hospital and has the surgery done the next day for a total price of $3,000 without using his insurance at all. The surgeon who penned the article concludes, “It was clear to both of us that the only way to make health care more affordable is to diminish the role of third-party payers. Let consumers and providers interact through market forces to drive down prices and drive up quality, like we do when we buy groceries, clothing, cars, computers, etc. Drop the focus on prepaid health plans and return to the days of real health insurance—that covers major, unforeseen events, leaving the everyday expenses to the consumer—just like auto and homeowners’ insurance.”

8-22-2013 8-56-15 PM

In England, a patient dies after employees omit the an apostrophe in her last name while looking up her electronic records, causing them to miss her history of depression. She was discharged and killed herself with a sleeping pill overdose shortly after.

Sponsor Updates

8-22-2013 5-50-15 PM

  • Sunquest held its annual Executive Summit last week in Scottsdale, AZ at the beginning of its SUG annual user group conference.
  • Emdat releases a video highlighting the advantages of using its medical documentation system within an EHR.
  • LG Electronics will integrate Imprivata’s OneSign authentication solution into its V-Series zero client systems.
  • Zirmed partners with Catch Data Systems to provide GE Centricity customers integration with ZirMed’s RCM, clinical communications, and analytics solutions.
  • The Washington State Hospital Association endorses Besler’s Transfer DRG and IME revenue recovery services.
  • Vitera Healthcare Solutions announces details of its VIBE 2013 user conference, to be held September 10-13 in Orlando.
  • Forbes features Xerox in an article about 3-D printing in healthcare.
  • Two KishHealth System hospitals advance their EHR initiatives with the implementation of Access’s e-form on demand solution.
  • Care Team Connect hosts an October 8 Webinar highlighting the implications of Medicaid expansion on care management.
  • Greenway Medical adds Krames Staywell’s Integrated Patient Education solution to its online Marketplace as a certified API.
  • T-System CMIO Robert Hitchcock, MD discusses an all-in enterprise model for data needs.
  • Sunrise Women’s Medical Group (CA) shares how its use of ADP AdvancedMD PM/EHR improved workflow and coding and billing.
  • Cornerstone Advisors is named to Inc. 500’s 2103 Fastest Growing Companies in America. Also on the list is Intellect Resources.
  • Direct Recruiters made the Inc. 5000 list announced this week.

EPtalk by Dr. Jayne


I’ve heard a lot of complaining recently about the Medicare Physician Compare website. The AMA and other physician advocacy organizations have complained about the redesigned site and its errors, which include problems identifying physician location, hospital affiliations, board certification, and other practice information. I searched for myself and even broadened the criteria to a 100-mile radius around my hospital but still can’t get myself to display, so yes, I would agree it’s inaccurate.

I seem to be running into more and more physicians who are integrating scribes into their practices. Some cite EHR as the reason, feeling like it has turned them into data entry clerks. Others see the scribe as a key partner in team care, freeing up the physician to perform cognitive work rather than data gathering and results tracking. I found this nice document from the American Academy of Family Physicians that outlines the potential duties of a scribe (which they expand on using the concept of a clinical assistant) during a routine office visit.

Having implemented EHR with several hundred physicians, I know the importance of helping physicians realize that the support staff is a great asset in prepping both the chart and the patient for the office visit. The document points out the staff role in collecting any recent lab/diagnostic test results and updating preventive care information before the physician ever sees the patient. Whether you use scribes or not, seeing patients in the age of Accountable Care, Pay for Performance, and Meaningful Use definitely takes a village.

AAFP also offers its Family Practice Management Toolbox, which was one of my favorite sites when I was in traditional primary care. Check out their section on practice improvement tools for some interesting practice assessment and improvement worksheets.


The American College of Emergency Physicians will be hosting its annual Scientific Assembly this October in Seattle. I had hoped to attend, but I have an unavoidable conflict that week. I don’t see a huge number of ED physicians in the informatics realm, but I am interested in what products ED docs think are hot and which are not. Ever thought of seeking fame and fortune as a roving reporter? If you’re a HIStalk reader and planning to attend, I’d love to hear from you.


Speaking of the emergency department, quite a few of you reached out to offer your condolences after I wrote about the closing of the quick care unit at one of the facilities where I was seeing patients. I’m happy to report that another facility has offered me a part-time position, although I’m not sure how much inspiration it will provide for writing since its physicians document on paper. Going electronic isn’t an impossible dream, however, as our paper system is provided by HIStalk sponsor T-System. I was happy to see the smoking doc logo on their website.

My email inbox is always deluged with invitations to various webinars, symposia, and conference calls. Some are from vendors and others are from professional organizations, but nearly all suffer from lack of lead time. Some arrive less than two days before the event being promoted. Word to the wise, marketing people — if you’re really trying to reach CMIOs or other C-levels, you should allow at least two weeks notice. Happily Mr. H advertises our HIStalk webinars well in advance – I’ll be listening in on the ICD-10 webinar on September 12. Hope to see you there!


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

More news: HIStalk Practice, HIStalk Connect.


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August 22, 2013 News 12 Comments

News 8/21/13

August 20, 2013 News No Comments

Top News

8-20-2013 9-42-53 PM

8-20-2013 9-18-45 PM

From Left Tackle: “Re: Intuit Health Group. Was bought back Monday by Stephen Malik, who founded Medfusion and sold it to Intuit in the first place.” Verified. He was saying just a few weeks ago that he had no interest in buying back the Cary, NC-based company he sold to Intuit for $91 million in 2010. That probably means the asking price and/or the number of interested suitors dropped since then.

Reader Comments

8-20-2013 3-52-16 PM

From MoJo: “Re: Allscripts reorg. Allscripts made an internal announcement of (yet another) reorganize to ‘further improve accountability, performance.’” Some of the changes noted in a company memo: the addition of new business units (international, Sunrise, and enterprise); the hiring of Greg White (Cerner) and Ricker Berner (Caradigm) to head the enterprise and international segments, respectively; the addition of new client sales regions and changes to leadership; and the realignment of the client advocate and solutions management teams.

8-20-2013 1-32-02 PM

From Partner: “ACE. Dozens of companies are spending big marketing dollars to exhibit at ACE.” The Allscripts annual conference kicked off Tuesday in Chicago. Attendance hasn’t been announced, but the exhibitor directory includes at least 50 vendors.

From Broadway Joe: “Re: North Shore LIJ. Buying a stake in Allscripts.” Unverified.

8-20-2013 5-50-50 PM

From Turk: “Re: Rose Harr. Interesting news about the CEO of BlueWare, a small imaging system that claims to be an EHR.” The former Brevard County, Florida Clerk of Court is arrested on a variety of corruption charges that include approving $8.52 million in county scanning contracts with BlueWare for personal financial gain. State law enforcement agents say that BlueWare didn’t own any scanning equipment at the time and 75 percent of the records they were paid to scan could have been discarded without scanning. BlueWare CEO Harr turned herself in was arrested for bribery and bid tampering, but is out on bond. She has an interesting LinkedIn profile that includes running companies that are flipping properties, making a cartoon about Boston Terriers, and selling big imaging deals to NHS hospitals in England.

From I’m Not Creative: “Re: Siemens Soarian customers. Only getting six weeks to upgrade from version 3.3 to 3.4 due to the number of clients who need to get upgraded to meet MU2 requirements. Talk about feeling the burn.” Unverified.

8-20-2013 6-02-15 PM

From TexasHeart: “Re: ONC Blue Button announcements. Is this smoke and mirrors because state HIEs are failing and most docs, include a fourth of them in Epic, don’t want to trade? Why would people use Blue Button as a portal? Will docs even accept records sent by a patient?”

From Escapade: “Re: CIOs. You should do some CIO interviews and leave them anonymous so they can be brutally honest and vent. “ That’s a brilliant idea. I would happily do that, as well as running anonymous blog posts (either one-time or ongoing) by CIOs who want provide uncensored opinion without fear of reprisal.  Contact me if you’re a CIO who likes the idea as much as I do.  The anonymous interview would be a super easy and great fun.

HIStalk Webinars

8-20-2013 5-29-31 PM 8-20-2013 5-37-34 PM

Beacon Partners will present “The Transition to ICD-10: Building the Bridge as You Walk on It” on Thursday, September 12 at 2:00 Eastern. With the transition to ICD-10 only 15 months away, healthcare organizations will have to find inventive ways to create their roadmap and execute on their plans. Rather than taking valuable time to complete a gap analysis and then create the plan, leaders and project managers should consider how to do these tasks concurrently. Examples from healthcare organizations will provide ideas for choosing the right partners, defining program strategies, and incorporating ICD-10 work into already existing teams. Even if you assemble the plane as you fly it – or build the bridge as you walk on it – it’s time to move forward and make the ICD-10 transition a reality. The target audience for this presentation is mid-senior level financial, clinical and IT, CFO, COO, CIO, ICD-10 program manager, and ICD-10 team leads. The speaker will be Chris Kalish, national practice director in the Strategic Advisory Group. One of my reviewers summarized, “With approximately only one year to go and a lot of work still to be done, this Webinar provides hospitals with strategies to prepare for ICD-10 if the hospitals are late starters.”

8-20-2013 5-40-37 PM

Speaking of Webinars, there’s a list of those upcoming in the column to your right. Clicking on one brings up the full calendar.

Acquisitions, Funding, Business, and Stock

8-20-2013 3-56-55 PM

Summit Partners invests $14 million in specialty EMR provider Modernizing Medicine.

8-20-2013 9-31-30 PM

Champion Medical Technologies, which sells tracking software for implanted medical devices, receives an unspecified investment from Jump Capital.

8-20-2013 3-55-57 PM

The SSI Group acquires Medtelligence, dba Medibis, a provider of analytic, dashboard, and mobile applications.

8-20-2013 9-52-04 PM

Greenway reports Q4 earnings: revenue down 2.34 percent, adjusted EPS -$0.08 vs. $0.10, missing analysts’ estimates of -$0.02. Shares rose 3 percent Tuesday after Monday’s announcement. CEO Tee Green notes that the results reflect the company’s continued transition from a one-time system sales and training model to a recurring revenue model. From the earnings call:

  • Greenway is live with CCD exchange at Epic and Cerner sites
  • Up to 80 percent of new customers are choosing cloud solutions paid for via the subscription model, which is driving training revenue down
  • Only 10 percent of users are using the company’s mobile EHR access app
  • The company’s growth is expected to be driven by EDI and services
  • Greenway says it expects to lose $5-6 million in FY14, with system sales down 50-60 percent

8-20-2013 4-02-05 PM

Above is the one-year GWAY stock chart, with Greenway in blue, Allscripts in red, athenahealth in green, and the Nasdaq composite index in brown.

8-20-2013 4-39-46 PM

Teleheath software provider SnapMD raises $600,000 in a seed round led by Shea Venture and Whittier Trust.

8-20-2013 9-46-36 PM

First Databank acquires medication reconciliation software vendor Design Clinicals. More information and thoughts from Design Clinicals CEO Dewey Howell, MD, PhD are available in the Tuesday morning announcement on HIStalk.


8-20-2013 1-46-47 PM

Wahiawa General Hospital (HI) will implement MEDHOST’s EDIS.

The Healthcare Access San Antonio HIE will offer consumers access to a portal developed by Intellica Corp.

The Defense Logistics Agency awards McKesson a $29.9 million medical imaging technology contract.

Community Health Information Collaborative (MN) selects Orion Health to power its statewide HIE.

Arcadia Solutions selects the Compuware Application Performance Management platform for EHR infrastructure performance optimization.


8-20-2013 4-45-49 PM

AHRQ names Richard Kronick (HHS) director, replacing the retiring Carolyn Clancy, MD.

Lisa Stump is promoted to VP/associate CIO of Yale-New Haven Health System.

EBSCO Information Services hires Elizabeth Jones (American Medical News) as VP of medical product management and chief content officer.

Announcements and Implementations

UnitedHealthcare adds online electronic bill payment services to its plan participant portal via the InstaMed payment network.

The Liverpool Heart and Chest Hospital (UK) and Robinson Memorial Hospital (OH) go live with integrated OnBase ECM and Allscripts EMR solutions.

8-20-2013 5-09-19 PM

Qstream announces new clients for its mobile healthcare education platform that include Boston Children’s Hospital, Partners HealthCare, Mayo Clinic, and Baylor College of Medicine.

Vivature EHR chooses Liaison Healthcare for connecting its Oracle-based EHR to more than 120 labs and imaging departments via Liaison’s EMR-Link hub.

HCA says in an entrepreneur workshop that it likes doing business with Boston-area companies that have an MIT or other academic connection, including Meditech, PatientKeeper, eClinicalWorks, and EMC.

Government and Politics

8-20-2013 6-27-45 PM

Florida Senator Arthenia Joyner introduces a bill that would force insurers to pay for telehealth visits. Critics say the bill is flawed because the state’s Board of Medicine allows telemedicine consultations only when a patient relationship has already been established and it also would require insurers to pay the same amount for a telemedicine visit as an in-office visit. Similar bills have failed previously.

Innovation and Research

Via @cascadia:  Intermountain Healthcare looks at the “Personalized Patient Room,” including an in-room camera; a server to support teleconsultations by pharmacists and interpreters; and video chat for bringing in remote family members to participate in the patient’s care. They’re also considering using touchscreens instead of pillow speakers for pushing educational content, entertainment, and information in languages other than English.

Three entrepreneurs form Oscar, a technology-powered insurance company that hopes to reform healthcare via the PPACA-mandated health insurance exchanges. Users of its application can enter their symptoms and click a button that will let them find nearby providers or speak live to a doctor through a partnership with TeleDoc. Patients can request prescription refills through a Twitter-like timeline. The company is analyzing large data sets to guide patients through rational medical decisions. They’ve raised $40 million in funding and will launch in 2014.


Greenway Medical launches PrimePATIENT, a patient portal integrated with PrimeSUITE.

Allscripts introduces Population Health Analytics, a real-time chronic disease management solution that provides comparative analytics at the point of care. Allscripts also announces the GA of its native iPad app Wand 2.0 for Enterprise EHR.


8-20-2013 9-48-52 PM

Virtual Radiologic and its NightHawk Radiology subsidiary file a lawsuit claiming patent infringement by Tandem Radiology related to its teleradiology and order creation technologies.

Mayo Clinic’s Center for Innovation offers $89 Web stream access to its Rochester, MN-based Transform 2013 conference September 8-10.

An Oracle survey finds that 84 percent of CFOs are working more closely with their CIO peers as technology becomes their second-highest focus area, placing behind only industry knowledge.

inga_small A Nebraska woman lands in the ER after a post-baby shower brawl in which another woman stabs her in the face with her own six-inch stiletto heel. Police said the altercation resulted from the stabber’s “relationship with the father of the victim’s child.” Once again I am reminded how mundane my life is.

8-20-2013 6-05-49 PM

Weird News Andy urges, “EMT, heal thyself.” A Detroit EMT performing in-transit CPR on a patient has a heart attack himself, ending up recovering three hospital beds over from his patient after both receive identical stents.

Sponsor Updates

  • iHT2 releases details of its August 21-22 Health IT Summit in Seattle.
  • A Triple Tree report, ACOs: The Accountable Care Opportunity, says the organization was impressed by population management and clinical analytics solutions from Forward Health Group.
  • Jennifer Dennard of Billian is appointed to the board of the Technology Association of Georgia.
  • The Massachusetts eHealth Institute awards eClinicalWorks a $150,000 grant to advance the use of EHRs with the state’s HIE.
  • Helix Health Solutions will distribute Wolters Kluwer Health’s Provation Medical software to healthcare organizations outside of North America.
  • Greenway Medical adds Seamless Medical Systems to its online Marketplace as a value-added partner.
  • The Truven Health Advantage Suite healthcare data and analytics platform version 5 achieves Oracle Exadata Ready status through Oracle PartnerNetwork.
  • Laura Kreofsky, principal advisor with Impact Advisors, discusses Stage 2 MU challenges.
  • HIStalk sponsors named to the 2013 Inc. 5000 list of fastest growing companies in America include Beacon Partners, Clinovations, Cornerstone Advisors, CoverMyMeds, CSI, Culbert Healthcare Solutions, Cumberland Consulting Group, DIVURGENT, eClinicalWorks, Enovate, ESD, eTransmedia Technology, Forward Health, Iatric Systems, Impact Advisors, iSirona, Intellect Resources, Kareo, Kony, Santa Rosa Consulting, SRSsoft, Strata Decision Technology, and Virtelligence.
  • Clinical Architecture introduces Symedical Content Portal, which acquires and maintains clinical and administrative vocabulary files.
  • PatientKeeper hosts a September 24 webinar explaining how to make the ICD-10 transition a non-event for physicians. (sent to us)
  • T-System CMO Tom Ward, MD discusses ICD-10 compliance in the ED.


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

More news: HIStalk Practice, HIStalk Connect.


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August 20, 2013 News No Comments

Monday Morning Update 8/19/13

August 17, 2013 News 6 Comments

8-17-2013 2-18-16 PM

From DanburyWhaler: “Re: Norwalk Hospital. No longer hooking up with Western Connecticut Health Network, now part of Yale-New Haven. Stay tuned for lots more consolidation in Connecticut” That would be interesting since Norwalk just signed up as a WCHN affiliate in January.

8-17-2013 2-22-18 PM

From Jon: “Re: HIMSS. They emailed members about the ICD-10 Playbook, and when I click the links, I get the infamous registration form before I can view it. It is sponsored by vendors, which is appropriate, but it should be available to all members with no strings attached for all the money we spend on dues. Now we will be bombarded with sales calls. No, thanks. I think my HIMSS membership days are over. Hopefully others will join me in sending a message.” HIMSS has gotten so commercial and so intertwined with its vendor members that I treat them like any other vendor, i.e. I always assume anything they send is spam. I’m rarely wrong on that. All the resources that require registration are on the site of MedTech Media (Healthcare IT News, Government Health IT, etc.), a private company of which HIMSS bought the majority position of shares in 2011.

The more important debate to me is this: are vendors doing themselves a favor by hiding their promotional material behind a registration form? Vendors think this way: we need leads, and any names we can get, even of people with marginal interest, make us feel more successful. I think this way: why in the world would you make it harder to see your advertisement? Nobody wants to be cold-called just because they took a quick look at a white paper. I would bet people often do as I do in just inserting phony contact information to avoid the dreaded phone call (note to vendors: if you are trying to reach a CIO named Scatman Crothers who used a phony email address, that’s me.) Don’t listen to your marketing and sales people – put your stuff out there where everybody can see it. Do the right thing and the HIMSS problem goes away with it.

8-17-2013 9-40-59 AM

Two-thirds of respondents say it’s OK if Farzad Mostashari’s replacement isn’t a physician, although most of the respondents probably aren’t members of Congress who may expect to see an MD in charge. New poll to your right: will the FDASIA report help improve patient safety with healthcare IT? Vote first, then click the Comments link at the bottom of the poll to explain your thoughts because “yes” or “no” votes don’t create rich debate.

Speaking of FDASIA, I made that the lead item in “This Week in HIT,” a partly serious, partly snarky weekly news update that I’ll do on Fridays. It will focus on the most important stories of the week, which admittedly aren’t all that fascinating at the moment given the summer doldrums before the inevitable September pickup (hint to vendors: it’s a great time to make announcements.) Long-time readers will remember the format from the Brev+IT weekly newsletter I used to send out until the volume of work overwhelmed me, much of which went toward coming up with Onion-like headlines. People have asked for a weekly summary of just the major news items, so this is it.

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

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8-17-2013 9-55-26 AM

Wake Forest Baptist Urgent Care – Clemmons goes live with UrgentQ, a “fastpass for healthcare” that lets patients choose an open visit time and receive text message updates of when to come in. It’s from Lightshed Healthcare Technologies, a new company founded by Dialog Medical Founder Mike Burke.

8-17-2013 10-31-59 AM

Cerner will develop the biggest office project in Kansas City history if its plans for the former Bannister Mall are approved. The campus will cover 4.5 million square feet on 251 acres and will be valued at $4.1 billion upon completion. It will house up to 15,000 employees. Cerner wants $1.2 billion in tax incentives to build it, offering to chip in $2.9 billion of its own money.


Readers have asked for an update on the HIPAA Omnibus Rule, for which enforcement begins in just a few weeks. I publicly solicited pro bono volunteers to to review the changes via Webinar. Doing so will be a couple of excellent presenters from The Advisory Board Company: Associate General Counsel / Privacy Officer Rebecca C. Fayed and Information Security Officer Eric Banks. Sign up for The HIPAA Omnibus Rule: What You Should Know and Do as Enforcement Begins, which will be held on September 10, 2013, from 2:00 to 2:45 p.m. Eastern. I reviewed their slides and they are excellent in the usual Advisory Board fashion – very meaty and to the point as they cover changes related to business associates, breach thresholds, and everything else covered entities need to know and do. This is a non-commercial presentation offered strictly to benefit readers by Rebecca and Eric. I appreciate their involvement.

The West Virginia Health Information Network has added several hospitals recently, bringing its total to nine.

8-17-2013 1-47-45 PM 8-17-2013 1-50-34 PM

Louis Kraml, CEO of Bingham Memorial Hospital (ID) pleads guilty to stalking charges for illegally wiretapping a former hospital physician, aided by three of the hospital’s IT department employees. Charges were dropped against two of the employees because they were following the instructions of IT Director Jack York, who had been accused last year of running a bogus consulting company that was charging the hospital for IT services. The court has issued a warrant for the arrest of York, who didn’t show up in court. The charges aren’t mention on LouisKraml.com, the CEO’s official website.

8-17-2013 1-06-08 PM

HIMSS urges HHS to start Meaningful Use Stage 2 as scheduled, but suggests extending the attestation window to 18 months.

The Fort Lauderdale, FL newspaper covers the use by several hospitals, most of them VA facilities, of the GetWellNetwork patient engagement solution.

8-17-2013 2-00-08 PM

The National Science Foundation issues a five-year, $10 million cybersecurity grant to Trustworthy Health and Wellness program that will develop tools for authentication and privacy, malware detection, and medical IT auditing. Experts from Dartmouth, Johns Hopkins, University of Illinois at Urbana-Champaign, and University of Michigan are on the team.

Sidney Health Center (MT), a 25-bed critical access hospital, will implement Epic as part of an agreement with Sanford Health (ND).

Vince commences his HIS-tory coverage of Cerner, aided by Neal Patterson (who responded quickly and warmly to Vince’s inquiry) and the archives of Cerner’s April Martin. The details they provided are fascinating.


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

More news: HIStalk Practice, HIStalk Connect.


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August 17, 2013 News 6 Comments

This Week in HIT 8/16/13

August 16, 2013 This Week in HIT 1 Comment



Facts and Background
The 2012 Food and Drug Safety and Innovation Act (FDASIA) requires HHS to evaluate the patient safety risk of healthcare IT in the context of encouraging innovation and avoiding regulatory duplication. The FDASIA committee released its draft report this week, which concludes that FDA regulation of healthcare IT is not necessary, but better surveillance of live systems and post-implementation testing is needed.

The committee likes the status quo a lot. Vendors can breathe a sigh of relief that the draft suggests only better communication about product safety issues and potentially a move away from product certification. 


  • The committee found it frustrating that definitions of healthcare IT and specific functionality that would trigger FDA oversight are not clear.
  • The report calls for creating a surveillance mechanism to track patient harm and near misses for unregulated software. Surveillance is an easy first step, but somehow it never seems to get done successfully. Who would a practicing physician contact when faced with a patient-endangering software defect?
  • The report wasn’t a big fan of product certification, saying it pushes vendors to meet the same checklist, gives prospects no way to compare products since they all pass, and focuses on features rather than outcomes. It recommended marketplace transparency instead.
  • The committee agreed with an earlier IOM report in saying that the federal government should discourage vendors from interfering with the free flow of product safety information.

Epic Has a Cow (Campus)

Photo: Amber Arnold, State Journal

Facts and Background
Epic Systems is finishing up construction of the third office complex on its 950-acre Verona, WI campus. The Farm Campus will house 1,000 employees.

Whimsy is a strong attraction for candidates not overjoyed at the prospect of moving from a major metro area to Wisconsin farm country. The company needs the space and can afford it, employees and customers like it, construction costs are way less in Verona than many places, and building a cool building probably doesn’t cost much more than putting up a drab one. Non-profit hospitals and thus patients (and taxpayers via the federal government) are paying for it, but healthcare waste and extravagance is a target-rich environment.


  • Epic has 6,500 employees, hired 1,000 people in the past year, and took in $1.5 billion in revenue.
  • Construction of a fourth campus will begin almost immediately, expected to have a Harry Potter-type theme.
  • The 11,000-seat Deep Space auditorium will be ready for Epic’s user group meeting in three weeks.
  • Cost of the Farm Campus and Deep Space was estimated at $400 million by the city, with the total value of the property estimated at $800 million.
  • The company has 4,500 offices on the Verona property.

Merge Purges Surges


Facts and Background
Merge Healthcare fired CEO Jeff Surges after another bad quarter in which revenue fell and losses increased, replacing him with former CEO Justin Dearborn.

Merge has a lot of problems as a company. Jeff Surges may or may not have been one of them. He gave a pretty rosy outlook during last quarter’s earnings call, so poor results forced the company’s hand.


  • Surges joined Merge in November 2010, but was a director of the company since May 2010.
  • He came from Allscripts, where he had been president for three years. Both Chicago-based companies have struggled with proxy fights, management turnover, and poor financial performance.
  • Surges was named as one of Modern Healthcare’s “Healthcare’s Hottest” fluff award at #21 in September 2012, although perhaps they were referring to his seat.
  • MRGE shares have dropped almost 50 percent in the past week.
  • MRGE share price tripled during Justin Dearborn’s previous stint as CEO from 2008-2010.

Health Plan’s Leased Copy Machines End Up Costing $1.2 Million


Facts and Background
Affinity Health Plan pays $1.2 million for failing to erase the hard drives of leased photocopiers it returned to Canon Financial Services, which were later found to contain the protected health information of 345,000 patients.

It’s likely that most hospitals have made the same mistake, either because they didn’t think of copiers as containing PHI or wrote unenforced policies for their disposal. It’s interesting that Canon Financial Services didn’t erase the drives themselves just like a seller of refurbished computers would – while not all customers copy PHI, all of them copy confidential information.


  • Talk about bad luck – one of the returned copiers was then sold to CBS, giving its news people an easy story to hype.
  • The Federal Trade Commission offers a reminder that “digital copiers are computers” and provides advice on how to secure their information.
  • Affinity should sue Canon Financial Services for failing to exercise reasonable care to prevent exposure of its data.

EHRs Aren’t Disruptive


Facts and Background
A blog entry by the Clayton Christensen Institute for Disruptive Innovation says that EHRs aren’t disruptive.

Who said they were or should be? EHRs were primarily designed make data retrieval more convenient for regulators and insurance companies, not to provide innovative benefits to clinicians or patients. EHRs, rightly or wrongly, reflect what the market requires, excepting of course the skewing of that market by HITECH.


  • The article says that 80 percent of hospitals now have EHRs, yet none of the $81 billion per year in healthcare savings predicted by the vendor-funded 2005 RAND study have materialized. Nobody believed that study other than Presidents Bush and Obama, so that’s hardly a surprise.
  • It points out that “disruption” means small companies with cheaper, simpler technologies that target small customers or non-customers, but then move upstream to threaten entrenched competitors. That’s not the case in healthcare, where EHRs are a “sustaining innovation” that offer more features at a higher cost, but within the same customer business model.
  • “Implementing new technology to sustain the way you already make money almost always keeps costs high and prevents true disruption.”
  • The article recommends building systems that are based around doctor workflows instead of replicating paper, but that’s a lazy conclusion that assumes doctors are in charge rather than the government, insurance companies, and employers. The real problem is the lack of motivation for disruption and the absence of possible disruptors. There’s nobody to arm with technology to topple the status quo.


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

More news: HIStalk Practice, HIStalk Connect.

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August 16, 2013 This Week in HIT 1 Comment

News 8/16/13

August 15, 2013 News 3 Comments

Top News

8-15-2013 9-19-55 PM

CareCloud secures an additional $9 million from Adams Street Partners as part of its Series B financing round, bringing the company’s total funding to $55 million.

Reader Comments

From Frank Poggio: “Re: certification scoreboard. Here we are just six weeks away from the termination of Stage 1 vendor Certifications on 9/30/13 and there are only six Inpatient EHR vendors with 2014 Edition Certified systems (aka Stage 2). They are: Epic, McKesson (Paragon only), Allscripts, Meditech, HMS, and CPSI. No-shows for full EHRs are Cerner, GE, Siemens, Healthland, QuadraMed, and NTT-Data (Keane). If you are running a Stage 1 Certified system on 10/1/13, it will be considered a non-certified product even though you’ve not changed a line of code. As I have said on this blog before, the process and details under 2014 are far more difficult than ONC would admit, and even today the test scripts are still changing. In fact, while working through some test data with several of my clients this week, we came across three situations where the test data is in error. When we brought this to the attention of the test labs they simply said, ‘We’ll notify ONC, but for now just ignore it.’”   

From Dodging a Bullet: “With all the praise and glory for the soon-to-be former ONC head, you have to wonder about the timing of his departure. Does this really mean that MU2 will be pushed back and he doesn’t want to be at the helm when that takes place?” I can’t imagine the timing of Stage 2 would be enough to make Farzad leave. He’s been through Congressional grillings, has taken every kind of criticism there could be, and works for an agency that rarely sticks to dates it sets.

8-15-2013 6-49-59 PM

From Potha Cary: “Re: Allscripts tip of the week. Tells you how to look up a zip code on the United States Postal Service website. Asinine.” It would be nice if the app could do the lookup itself, but at least if not, they gave users good instructions that they may or may not need. I don’t see a problem with that.

HIStalk Announcements and Requests

8-14-2013 1-14-06 PM

inga_small Hot news from HIStalk Practice this week includes: the AAFP urges CMS to add a 12-month extension to the timeframe for Stage 2 MU compliance. MGMA-ACMPE adds almost 600 new members as HCA Physician Services joins the association. The majority of physicians believe EMRs have at least some positive impact on patient care according to an athenahealth / Epocrates survey, though 17 percent believe they worsen care. Thanks for reading.

inga_small Facebook reports that 128 million Americans and 24 million UK users access Facebook every day. A mere 278 of those are my friends, which happens to be a few more than Mr. H and Dr. Jayne but far less than the 2,271 who like our HIStalk page. We are collectively of the belief that you can never have too many friends, so send us a request and we’ll be happy to join your inner circle. If you prefer to keep it professional, you can connect with Mr. H and me through LinkedIn.

8-15-2013 5-52-17 PM

Welcome to new HIStalk Platinum Sponsor Symantec, which secures the IT systems and health information of medical practices, hospitals, and payers. Symantec Backup Exec simplifies backup and disaster recovery for practices. The company’s healthcare software solutions provide security, data loss prevention, HIPAA compliance automation, business continuity, and storage and infrastructure management (the list of specific products is surprisingly long, and Mobile Management is probably worth a look, as is Endpoint Virtualization for managing applications and standardizing single sign-on). Many of these tools are available as free trial downloads. Thanks to Symantec for supporting HIStalk.

Surescripts Mini-Interview

8-15-2013 4-42-52 PM

Surescripts announced Tuesday that it has added 19 state HIEs and health information providers to its clinical interoperability network, allowing them to exchange referrals, discharges lab results, CCD, prior authorization, and notes via the Surescripts network. I spoke to Jeff Miller, SVP/GM of clinical interoperability for Surescripts, who says the company “decided to move out of just electronic prescribing and support a wider set of clinical information on the Surescripts network.”

Surescripts network members have always been able to communicate with each other through the network directory, but Miller says that “communities of networks have significant populations we need to reach.” Now that Greater Rochester RHIO is on the network as one of the 19 new participants, for example, any of its members can communicate with any member of the Surescripts network and vice versa. Surescripts is paid by hospitals and EHR vendors, who may or may not pass along charges to their own users, but there’s no extra charge to use the gateway. 

Miller says the connectivity marketplace consists of HIE applications that poll EHRs to get information and send messages and EHRs that can exchange information within their own vendor-specific network or through partners such as Surescripts. The EHR-based solutions allow that communication to be integrated into user workflow, so that an Epic user discharging a patient can look up a provider in the directory and send a message out without launching another mailbox-type application. Miller says over 600 EHR vendors are connected to its network.

I asked how this type of messaging could support population health management. He says networks need to support three models: (a) a push or message-based model; (b) a pull or query-based model; and (c) a publish model, such as moving data to a repository to support managing populations. The benefit to patients, he says, “is to get rid of that clipboard you get at the practice. Let the doctors become more proactive. Take cost out and improve quality.”

Acquisitions, Funding, Business, and Stock

8-15-2013 9-22-27 PM

Imprivata announces that Q2 bookings grew 30 percent and headcount was increased to 250 with the addition of 48 new employees.

8-15-2013 9-23-26 PM

A stock analysis firm starting its coverage Quality Systems with lukewarm enthusiasm claims that the company’s customers, and presumably those of other EHR vendors, are being lost to enterprise vendors such as Cerner and Epic as hospitals acquire practices.


8-15-2013 9-24-18 PM

The NY eHealth Collaborative awards Mana Health a contract to build the “Patient Portal for New Yorkers.” 

8-15-2013 1-43-15 PM

Orthopaedic Associates of Augusta (GA) selects SRS EHR for its 14 providers.

8-15-2013 12-25-34 PM

Charleston Area Medical Center (WV) contracts with Besler Consulting to assist with the identification of Transfer DRG underpayments.

8-15-2013 12-23-24 PM

The NFL’s Buffalo Bills will implement medical imaging technology from Carestream at the Bills’ Ralph Wilson Stadium to provide early detection and monitoring of brain injuries.


8-15-2013 12-49-24 PM

James McDevitt (GE Healthcare) joins API Healthcare as VP of human resources.

8-15-2013 12-51-26 PM

The Integrating the Healthcare Enterprise Patient Care Device Domain Technical Committee names Iatric VP Jeff McGeath co-chair.

8-15-2013 7-58-25 PM

Jeff Finkelstein, MD, former chief of emergency medicine and CMIO of The Hospital of Central Connecticut (CT), joins Hartford Hospital (CT) as chief of emergency medicine.

8-15-2013 9-02-28 PM

Standard Register Healthcare names Kevin Lilly (McKesson) as VP of marketing and product management.

8-15-2013 9-10-21 PM

John Halamka,MD is named to the board of Imprivata.

Announcements and Implementations

8-15-2013 12-54-23 PM

Hawaii Health System concurrently implements Perioperative Management by SIS and Siemens Soarian.

8-15-2013 12-55-52 PM

The Central Illinois HIE launches Direct communication between its members and other HIEs using ICA CareAlign Connect technology.

8-15-2013 12-56-53 PM

Prime HealthCare Services will connect its 23 hospitals to the Inland Empire HIE, which is based on the Orion Health HIE platform.

Appalachian Regional Healthcare System (NC) goes live on Allscripts Sunrise Clinical Manager.

Diagnotes launches a mobile clinical communications system for patient information, caregiver communication, and documentation.

Innovation and Research

ShiftyBits, LLC releases ID My Pill, a $4.99 iPhone app that identifies prescription tablets using the phone’s camera.


Weird News Andy concludes about a story he titles “En Fuego” that, “Well, they are part of the fire department.” Two Washington, DC ambulances catch fire in separate incidents on the same day, fortunately with no injuries. WNA also likes this story, in which a surgeon intentionally lied to a patient for reasons unknown in claiming that he had removed her brain tumor, when in fact he had not.

8-15-2013 7-06-21 PM

An OIG audit finds that Medicare paid $449 million too much in 2011 to hospitals that shouldn’t be considered critical access hospitals because they aren’t in rural areas and aren’t far from other hospitals. States were allowed to override the location criteria until 2006; OIG says it’s time to take their exemptions away and CMS seems to agree.

Sponsor Updates

  • Greenway Medical approves Master Mobility iPad and iPad mini applications as certified API solutions for its PrimeSUITE platform.
  • An article by Brad Levin of Visage Imaging covers radiology’s “imaging IT disorders.”
  • Intelligent InSites celebrates its 10th anniversary.
  • Aprima reports having over 600 participants at annual user group conference earlier this month in Dallas.
  • A Santa Rosa Consulting article offers a test to determine whether an organization needs to conduct an IT cost optimization review.
  • GetWellNetwork publishes an e-book on transformative health trailblazers.
  • Ohio State University’s Wexner Medical Center and GE Healthcare collaborate to find ways to make healthcare more enjoyable for patients.
  • HIStalk sponsors earning a spot on “Best Places to Work 2013” are Aspen Advisors, CTG Health Solutions, Cumberland Consulting Group, Divurgent, Encore Health Resources, ESD, Hayes Management Consulting, Health Catalyst, Iatric Systems, Impact Advisors, Imprivata, iSirona, Sagacious Consultants, Santa Rosa Consulting, and The Advisory Board Company.
  • ORA Orthopedics (IA/IL) reports that its implementation of Emdat’s clinical documentation technology has yielded operational and administrative advantages.
  • Direct Consulting Associates and Direct Recruiters expand their offices, staff, and services. 
  • HIMSS Analytics’ James Gaston, senior director of clinical and business intelligence, will participate in a panel discussion on leveraging analytics in clinical operations at next month’s Midwest Hospital Cloud Forum. 
  • Wolters Kluwer Health introduces iPad and iPhone apps of Lippincott’s Nursing Drug Handbook.

EPtalk by Dr. Jayne

Now here’s an app I’d use. A group of New York University researchers has developed a mathematical model to help identify which preventive measures would most improve a patient’s life expectancy. Responding to the challenges physicians face when trying to address the mass of preventive recommendations that exist, they hope to integrate the model into EHRs to prioritize guidelines on an individual basis. It’s not ready for prime time, but I’m seriously intrigued.

An app that is actually on the market, “Health through Breath – Pranayama” includes controlled breathing exercises intended to relieve tension and promote relaxation. I wish I could have beamed it to the attendees of a meeting I was in the other day because everyone was keyed up and irritable. Its topic: the cost of ICD-10 readiness.

Speaking of apps, Medical Economics releases its list of the top 10 apps physicians recommend to their patients. Four of the 10 are diabetes related, which parallels the percentage of patients I seem to be seeing.

The National Uniform Claim Committee publishes its transition timeline for the new CMS 1500 claim form. The timeline meshes with Medicare’s and proposes that payers begin accepting the new form in January 2014 with a dual-use period through April 1, 2014 when the new form is required. I may have mentioned this before but it’s worth mentioning again – I don’t know how a lot of providers keep up with this and I’ve gotten quite a few questions on it in the last few weeks.


The American Academy of Family Physicians proposes a revised Stage 2 compliance timeline for Meaningful Use. The proposal actually includes three different revisions depending on whether 2014 is your first, second, or third/fourth payment year.

It’s not just a photocopier any more. Affinity Health Plan settles with the US Department of Health and Human Services over HIPAA violations. A returned leased copies rwas later sold to the CBS television network and investigators checking the hard drive found protected health information belong to over 300,000 patients. According to the documents, Affinity didn’t include photocopier hard drives in its HIPAA risk analysis as required. Show of hands: who is pulling out their risk analysis right now to double check? The FTC’s guidance on copier hard drives is here for your reading pleasure.


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

More news: HIStalk Practice, HIStalk Connect.


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August 15, 2013 News 3 Comments

News 8/14/13

August 13, 2013 News 11 Comments

Top News

8-13-2013 5-48-53 PM

Surescripts adds 19 state HIEs and health information service providers to its national health information network, including Cerner, ICA, and Quest Diagnostics.

HIStalk Announcements and Requests

inga Mr. H has taken a day or two off so I am flying solo tonight. He can never rest for long so be assured he’ll be back at the keyboard later this week.

Reader Comments

  8-13-2013 5-42-00 PM  8-13-2013 5-43-38 PM

From Elsie: “Re: Epic’s new campus. If I were a cow I think I’d want to live in Verona.”  Epic opens its Farm Campus, which includes a white farmhouse with a wraparound porch, a red barn with a silo, a creamery, and a John Deere tractor. The buildings, which have standard offices on the inside, will house up to 1,000 employees and include extra decorative touches that follow the farm motif. Verona city officials have estimated the value of the farm campus and Epic’s new 11,000-seat auditorium at about $400 million.

Acquisitions, Funding, Business, and Stock

8-13-2013 8-01-21 PM

Marlin Equity Partners acquires long-term care software vendor 6N Systems, which will be merged with Marlin’s portfolio company SigmaCare.

8-13-2013 8-03-30 PM

Emdeon reports Q2 adjusted earnings of $77.2 million, down 3.7 percent from a year ago. Revenues were up almost six percent to $311 million.

8-13-2013 8-04-40 PM

Endo Health Solutions subsidiary HealthTronics agrees to sell HealthTronics Laboratory Solutions, its anatomical pathology business, to Metamark Genetics as part of Endo’s announced plan to pursue strategic alternatives for HealthTronics.

Medical device maker Medtronic buys Cardiocom, a provider of telehealth and patient monitoring services, for $200 million.

CareFusion reports Q4 earnings: revenues down six percent, adjusted EPS $0.49 vs. $0.55 and in line with expectations. The company also announced a $750 million share repurchase program.


8-13-2013 8-07-46 PM

East Tennessee HIN selects DataMotion Direct as its secure messaging service.

Apria, a provider of home healthcare products and services, extends its contract with predictive analytics provider Connance.

8-13-2013 8-42-40 PM

Brazosport Regional Health System (TX) will implement MEDHOST’s EDIS.

8-13-2013 8-46-29 PM

Mercy Health System (ME) selects Allscripts RCM Services for back office processing and patient collections.

The Chain Drug Consortium renews its agreement with Emdeon to provide services through the Emdeon Clinical Exchange eRx Network.

The AHRQ awards ECRI Institute a contract to continue operating, maintaining, and enhancing the AHRQ National Guideline Clearinghouse and the National Quality Measure Clearinghouse.

PinnacleHealth System (PA) and Meridian Health System (NJ) select the SIS perioperative IT platform.


8-13-2013 8-48-24 PM   8-13-2013 8-49-12 PM

Impact Advisors promotes Matt Duncan and Kent Gray from principal advisors to VPs.

8-13-2013 8-50-21 PM

Conifer Health Solutions hires James C. Bohnsack (TransUnion Healthcare) as VP of acquisition strategy.

Healthcare analytics provider PTS Physicians names Penn Krause (Treatspace) CEO, replacing the retiring William Bennett.

8-13-2013 8-56-37 PM

WebMD names David Schlanger its permanent CEO following three months serving as interim CEO. The company also promoted Steven Zatz from VP of professional services to president.

8-13-2013 8-54-02 PM

US HealthCenter hires Paul A. Markham (V3 Healthcare Strategies) as chief strategy officer.

Announcements and Implementations

8-13-2013 8-58-44 PM

Cullman Regional Medical Center (AL) deploys the MedSnap ID Enterprise application, which can identify a patient’s pills from a single image and identify the name and strength of each drug. Mr. H mentioned the app several months ago and characterized it as “brilliant.”

Humana agrees to subsidize up to 85 percent of the purchase of Greenway’s PrimeSuite EHR for physicians practicing in the Humana network.

8-13-2013 9-00-03 PM

Appalachian Regional Healthcare System (NC) implements Allscripts Sunrise Clinical Manager.

8-13-2013 9-01-17 PM

Connections Counseling (WI) installs Forward Health Group’s PopulationManager for analytics.

The Kansas HIN will launch a statewide patient portal next month, which will be free to patients and based on the NoMoreClipboard PHR platform.

8-13-2013 9-02-25 PM

The Dallas Business Journal reports that Baylor Health Care System (TX) providers are electronically placing about 94,000 orders each weekday. Orders originate from multiple EHRs but integrate into Baylor’s existing EHR (Allscripts Sunrise, I believe.)

8-13-2013 2-06-52 PM

Novant Health (NC) begins implementation of its $1.1 million patient identification iris scanning system from M2SYS Technology.

Nuance Communications announces that in the last three month 100 hospitals and radiology practices, including 50 new customers, have converted to the latest PowerScribe 360 platform,


Government and Politics

The Obama administration reports that the VA backlog of disability claims is now 496,000, a 20 percent reduction since March.

8-13-2013 3-48-01 PM

The ONC selects 28 practicing providers and staff from 18 states to serve as the inaugural class of the Health IT Fellows program, which aims to “help other providers overcome challenges faster and more efficiently by sharing key lessons learned.’”

Innovation and Research

The Scripps Translational Science Institute launches Wired for Health, a clinical study to evaluate whether the integration of wireless technologies, online social networks, and medicine have a direct effect on healthcare spending. Half of the study’s 200 participants will use a mobile health device for six months to monitor blood pressure, heart rhythm, or blood glucose and will have the ability to track their conditions through a web portal or mobile device. Researchers will evaluate whether the device-wearing patients have more online interaction with their providers and more success managing their health conditions.



The FDA extends 510(k) clearance for Verizon’s Converged Health Management remote patient monitoring medical device.

LRS and Siemens Healthcare jointly develop a solution that reduces the number of Windows print servers and printer drivers that need to be defined and maintained within the Siemens Soarian platform.


8-13-2013 9-06-37 PM

The Jackson Clinic (TN) reports positive results from the first year of its collaborative accountable care initiative, including better than market measures for annual eye exams and kidney disease screenings for diabetics, breast cancer screenings, and adolescent well-child visits, as well as lower total medical costs compared to the local market.

Sign of the times: The AMA announces it will shut down its print and online news magazine because of its inability to generate a profit over the last 10 years. AM News has a print circulation of about 230,000 but saw an $8.7 million decline in print display advertising last year. Pharma advertising has historically accounted for the bulk of the publication’s advertising revenue.

8-13-2013 9-07-24 PM

Only 38 percent of providers participating in an athenahealth/Epocrates survey claim they are at least somewhat confident in their practice’s ability to transition to the ICD-10 code set, while 79 percent express confidence in satisfying the requirements for Stage 2 MU.

Sponsor Updates

  • Frost & Sullivan awards Kareo its 2013 North American Physician Practice Management Customer Value Enhancement Award for demonstrating excellence in implementing strategies that create value for its customers.
  • Vitera Healthcare offers an August 28 Webinar to help physicians and their staff prepare for MU Stage 2.
  • NextGen Healthcare will utilize Clinical Architecture’s Symedical Server for its terminology integration architecture within the NextGen Hospital Solutions suite.
  • Allscripts Enterprise 11.4.1 and Professional 13.0 EHRs receive 2014 ONC HIT Certification from the Drummond Group.
  • API Healthcare looks at the healthcare system trend of eliminating differential pay in order to reduce costs.
  • Impact Advisors identifies three challenges in achieving MU Stage 2.
  • Billian’s HealthDATA ranks MedAssets the top healthcare group purchasing organization based on the number of affiliate beds.
  • Pro golfer Jason Dufner, who is sponsored by Greenway, wins the 2013 PGA Championship, his first major title since partnering with Greenway two years ago.
  • Alere Analytics releases its Electronic Laboratory Reporting solution for hospital reporting of results to state health departments and to improve care coordination between lab personnel and clinicians.
  • Ophthalmology EMR provider Medflow will give users access to LDM Group’s healthcare messaging programs for improved patient medication compliance.
  • iSirona posts a video featuring its client services team and how it supports hospitals’ medical device integration efforts.


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

More news: HIStalk Practice, HIStalk Connect.


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August 13, 2013 News 11 Comments

Monday Morning Update 8/12/13

August 12, 2013 News 7 Comments

8-11-2013 9-53-53 PM

From Ramblin’ Gambler: “Re: HIT Policy Committee’s FDASIA workgroup. They released their draft EHR patient safety guidelines. I don’t think they went far enough.” The draft guidelines call for leaving healthcare IT unregulated by FDA, but encourage reporting,  post-implementation safety testing, and allowing customers to publicly rate their applications. They also call for national standards for quality process and interoperability and encouraging vendors to publicly share patient safety information.

From Leopold: “Re: breach. I had to chuckle at this one. The mixup was caused by a vendor named Infocrossing.” A programing error causes the medical information of 1,300 patients of MO HealthNet to be sent to incorrect addresses. Infocrossing is owned by India-based Wipro.

From Tennessee Dreamer: “Re: Re: Halamka’s view from the bunker. One really has to wonder whom he thinks he is fooling. When a topnotch trainee, who can do his residency at BIDMC, with its cloud-hosted, thin client, mobile friendly, highly interoperable software that is used nowhere beyond a city block from campus, or go to Mass General and use a commercial product that they will very likely use in their academic careers no matter where they wind up, will they decide to contribute to or chip away at BIDMC’s ‘strategic advantage?’ To express the obvious, that the academic, informatics-based HIT development enterprise has been a failure, clearly exemplified by BIDMC being surrounded by Epic in an over-before-it-began war for keyboards and eyeballs in the Boston healthcare market, would be too much to ask of Halamka, half of whose political capital is gained by his ever optimistic view of HIT. Yes, you can build a great suite of software when the only people you have to please are your friends and colleagues in your own neighborhood, when it really gets tough is please hundreds of other institutions at the same time. If Halamka was going to have made a real impact on healthcare, he and others in  the informatics community would have stopped living off government grants and taken the plunge to commercialize their products, putting their necks on the line in the marketplace and, if they were good enough, actually winning the war, to the benefit of everyone. But why do that, when even today you can retreat to the ever fewer centers, give each other tenure and Collen awards and cite each others’ JAMIA papers for research on products that hardly anyone uses? There are many useful lessons to be learned, and productive plans to be made in the current situation. Sitting in the last Boston holdout convincing yourself that you’ve fought the competition to a tie, and might yet win, isn’t one of them.”

8-11-2013 8-16-31 PM

Nearly 80 percent of poll respondents say they don’t pay any attention to Most Wired-type magazine awards. New poll to your right: is it necessary that the next National Coordinator be a physician?

8-11-2013 9-05-29 PM

Welcome to new HIStalk Platinum Sponsor lifeIMAGE. The company provides a network for sharing medical imaging information. Physicians, hospitals, and patients can securely exchange images from any location and integrate the images with EHRs and other systems. Workflows are defined for managing CD-based exams, receiving exams electronically from any source, importing images from outside into local systems, and sharing exams with physicians and patients. The network also includes a secure social component that allows individual users to connect with each other to exchange images. The company was the first to undergo a comprehensive KLAS review, with results that include 94 percent “would buy again” responses, along with 97 percent of clients interviewed saying the company keeps its promises. Notable customers include Boston Children’s Hospital, Mass Genera, and CHOP. Thanks to lifeIMAGE for supporting HIStalk.

I found this YouTube video describing how lifeIMAGE works.  

8-11-2013 9-26-05 PM

Private equity firm LLR Partners makes an investment in Philadelphia-area consulting firm HighPoint Solutions, which says it will become the largest life sciences and healthcare IT consulting company in the world by 2017.

HIStalk Webinar

8-11-2013 8-20-58 PM

Elsevier will present “Invigorate Order Set Management: Four Essential Steps” on Tuesday, August 27 from 12:00 – 12:45 p.m. Eastern. Presenters will be Jim Nolin, MD, editor in chief for order sets at Elsevier, and Kevin W. Hatton, MD, medical director of clinical decision support at University of Kentucky HealthCare.

University of Michigan researchers develop WattsUpDoc, which detects malware in biomedical devices by looking for changes in the power they consume.

Amendola Communications employees create a fundraising page for a co-worker, hoping to raise $10,000 towards the cost of brain tumor treatments for her newly diagnosed three-year-old son.

Merge Healthcare announces that CEO Jeff Surges has resigned due to poor company sales and will be replaced by Justin Dearborn, president of the company. Shares dropped 46 percent Friday on the news, dropping its market cap to $227 million.

It’s Siemens Part 4 this week in Vince’s HIS-tory.


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

More news: HIStalk Practice, HIStalk Connect.

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August 12, 2013 News 7 Comments

News 8/9/13

August 8, 2013 News 15 Comments

Top News

8-8-2013 7-53-34 PM
8-8-2013 6-09-57 PM

Allscripts reports Q2 results: revenue down 7 percent, adjusted EPS $0.05 vs. $0.16, missing earnings expectations of $0.10. Revenue of $345 million missed expectations of $357 million. Shares are down 6 percent in after-hours trading. It’s the third straight quarter that MDRX has fallen short of expected profit. The announcement’s headline is a clear signal of a bad quarter given that neither revenue nor earnings are mentioned, indicating that the company was forced to dive deeper into the financials to find something to brag about. Allscripts is moving its focus (or at least the attention of analysts) to population health management given the minimal mention of its ambulatory solutions. I tried to listen to the conference call, but felt cognitive dissonance as the optimism I heard didn’t match the pessimism the numbers suggest.

Reader Comments

8-8-2013 3-51-18 PM

From Fraudbuster: “Re: Farid Fata, MD. Charged with Medicare fraud. He is affiliated with Crittenton Hospital in Rochester, MI and its cancer center. It’s big news in the Detroit metro.” Federal agents arrested the doctor at his practice Tuesday, charging him with a $35 million Medicare fraud scheme that included administering chemotherapy and PET scans to cancer patients who had no chance of survival. He is accused of employing hundreds of unlicensed doctors trained outside the US to see patients first so he could visit with 50-70 patients per day and bill Medicare for his time, which totaled $25 million plus another $24 million in drug infusions, making him #1 in Michigan. He’s also accused of taking home bags of patient records to do billing from his home. The complaint says that in one case, the doctor insisted that a male patient who had fallen and struck his head on the way to the clinic be given his chemo before being taken to the ED, where he later died of the head injury. You might think CMS suspicion might have been raised earlier(and payments frozen) by doctor billing $25 million.

From Bob: “Re: McKesson Horizon. My hospital is looking to migrate to Paragon. Can anyone share insight?” If your hospital has done the conversion or is underway, please leave a comment.

From DCInternRoomate: “Re: ONC-funded HIEs. They are failing, so expect a huge Blue Button push next week.” I’m assuming you are saying that HIEs have had minimal impact, so patients will be reenlisted as the hand-carrying human interfaces between non-interoperable systems. I wouldn’t necessarily disagree. Technology bears some of the blame for mandatory sneakernet, but mostly it’s the screwy US health system that created the problems involved with expecting competitors to freely share information, not to mention to disenfranchise the patient to the point where they are merely the widget that must be processed in order to trigger sending out a bill. Medicare in the 1960s made healthcare a business and not a charitable endeavor or a public health project as it simultaneous drove (short term) and drained (long term) the US economy, so it’s hard to work corporate empathy and compassion in there. Hospitals have generally good intentions but poor execution.

8-8-2013 6-57-11 PM

From Velvet Hammer: “Re: HCA. This e-mail should give you an idea about HCA’s EMR plans.” The e-mail describes plans for HCA and Reston Hospital Center to roll out Meditech Advanced Clinicals, which would suggest that perhaps HCA won’t abandon Meditech for Epic or Cerner after all.

8-8-2013 6-58-02 PM

From MyFirstTime: “Re: [vendor’s name omitted]. I called them to learn more, but they say they are getting so many calls that they have started a wait list for new customers. Is healthcare IT so popular that it is now mainstream?” I can’t imagine that a lab ordering and results solution is creating such demand no matter how good it is, but readers have reported that it’s the real deal. I’m not mentioning the name again because this comment smells a bit like a company planted item, having originated in the same location as the company’s headquarters.  

8-8-2013 6-59-19 PM

From Gordian Knot: “Re: Halamka’s recent self-indulgent blog post about benefits of keeping his organization homegrown. First, I really, really wonder what the cost analysis is when sites need to meet current regs. Second, I do find it humorous how other bloggers and semi-news sources immediately linked his comments with Maine Med having issues with an install of Epic. It all sounded like voices that have been waiting to jump on anything negative about Epic. How many people in leadership got ejected because of an install gone bad with Allscripts or Cerner or Siemens any other system? Look at Lahey and UCSF as extremes of installs gone bad. Since Epic is just about the only one installing anything,  a few missteps gonna happen.” I used to advocate homegrown software, but those days were gone once the federal government started setting the development agenda. It’s ironic that hospitals that outsource activities such as food service, ED coverage, and even clinical departments assume that they are better enterprise software developers than companies whose own core mission is exactly that. Sometimes organizations really do have expertise and processes that preclude using commercial software effectively, but usually they just overestimate their wonderfulness. Those big hospital systems that like developing their own systems (not BIDMC specifically – I ‘m generalizing now) often have the money to run huge IT departments because they’ve created a lofty-brand pricing monopoly rather than because they have the highest efficiency or best outcomes, and with reimbursement changes, they will just keep buying up practices and hospitals and spreading mediocrity.

HIStalk Announcements and Requests

inga_small From HIStalk Practice this week: 80 percent of clinicians use smartphones and almost half of physicians use a combination of smartphones, tablets, and laptops / desktops for professional work. Patients using EMRs through online portals express significantly higher satisfaction with their physicians and believe they are receiving better care. The AMA says CMS still has more work to do on the Medicare Physician Compare website. A reader reports on Aprima’s national user conference. A Colorado orthopedic clinic fires an employee who emailed PHI to her personal email in order to do some work from home. August is “Admit You’re Happy Month” which seems like the perfect reason to admit you’d love to make me happy by signing up for HIStalk Practice email updates. Thanks for reading.

Some recent HIStalk Connect posts worth your time:

Epocrates Mobile Trends 2013
HIStalk Connect Interviews Joe Reinardy, Founder and CEO, CenterX
Battle of the App Stores: athena vs. Greenway

Listening: Built to Spill, Idaho-based catchy guitar indie rockers that hit their popularity peak in the late 1990s that I’ve somehow missed until now. They’re on tour and I’m likely to check them out.

8-8-2013 4-08-56 PM

Welcome to new HIStalk Platinum Sponsor Valence Health, which offers providers turnkey solutions for delivering value-based care. The Chicago-based company has been doing that for 20 years and serves 35,000 physicians, 115 hospitals, and 15 million patients. Customers include Cleveland Clinic, Scott & White, OhioHealth, and half of the country’s freestanding children’s hospitals. Hospital solutions include clinical integration, population health, care management, analytics, managed services, physician network development, and financial analysis of value-based arrangements. Its Vision platform combines data from practice-based PM/EMRs, standardizes it with other data (hospital bills, labs, PBMs, LTC, payer), runs it through a proprietary EMPI, and then generates reports and analytics that measure quality, cost, and utilization and provides risk scores, identification of high-risk patients, and information to establish programs for specific populations and conditions. Its vMine technology obtains daily data from all certified PM/EMR systems and takes only 30 minutes to install remotely. Thanks to Valence Health for supporting HIStalk.

HIStalk Webinar

Elsevier will present “Invigorate Order Set Management: Four Essential Steps” on Tuesday, August 27 from 12:00 – 12:45 p.m. Eastern. Presenters will be Jim Nolin, MD, editor in chief for order sets at Elsevier, and Kevin W. Hatton, MD, medical director of clinical decision support at University of Kentucky HealthCare.

Acquisitions, Funding, Business, and Stock

8-8-2013 8-05-16 PM

LifeNexus, which offers a personalized health information smart card, raises $3.7 million from unnamed investors. Smart cards have been a solution looking for a healthcare problem for at least 20 years and almost always fail miserably, even when packaged as a hospital loyalty card.

8-8-2013 8-07-21 PM

Could computing vendor ClearDATA secures $7 million in second-round funding from Excel Venture Management and Norwest Venture Partners.

SEC filings indicate that activist investor Carl Icahn has increased his stake in Nuance from the 9.3 percent of the company’s shares he reported in April to 16 percent now.


Geisinger Health System selects VisiQuate to develop predictive revenue cycle analytics to increase efficiencies and lower collection costs.

Boulder Community Hospital Physician Clinics select Wellcentive’s Advance platform to facilitate care coordination in support of its PCMH implementation and as part of its comprehensive primary care initiative.

8-8-2013 8-08-45 PM

Twenty-four bed Cozby-Germany Hospital (TX) will implement RazorInsights ONE-Enterprise Edition.


Chris Belmont (Ochsner Health System) will be named as VP/CIO of The University of Texas MD Anderson Cancer Center (TX). I interviewed him in February.

Announcements and Implementations

St. Louis Children’s Hospital (MO) goes live on iMDsoft’s MetaVision for perioperative.

8-8-2013 8-10-50 PM

The Medical Center of Central Georgia (GA) implements Cerner CPOE with assistance from HCI Group.

The Baylor Quality Alliance ACO (TX) will expand its private HIE into a community HIE using technology from Sandlot Solutions.

Quantros will announce Friday that more than 1,500 Target stores and 50 Target clinics will implement its Safety Rx medication incident reporting system.

8-8-2013 8-12-23 PM

Texas Health Harris Methodist Hospital Hurst-Euless-Bedford, which surely must possess the longest and least-pronounceable hospital name in America, goes live on PCCI’s Pieces EMR-driven clinical surveillance and risk scoring system. PCCI is Parkland Center for Clinical Innovation, launched by Dallas-based Parkland Health & Hospital System in October 2012. Meanwhile, Parkland Memorial Hospital was finally deemed safe by CMS on Wednesday, which threatened in 2011 to cut off the hospital’s Medicare and Medicaid funding because of patient safety issues. The federal government said then that Parkland’s problems posed “an immediate and serious threat to patient health and safety,” forcing the hospital to spend $75 million on changes in the past two years.

Lubbock, TX hospitals launch the Llano Estacado Access Partners HIE, with the $80K startup costs underwritten by University Medical Center and Covenant Health System. 

Government and Politics

HHS releases a strategy for accelerating HIE in support of delivery and payment reform. Specific strategies and policies include:

  • Developing regulations and guidance on existing programs to enable the secure portability of health information
  • Advancing HIE among long-term, post-acute, behavioral health, and laboratory providers
  • Developing standards, including an interoperability and certification road map and HIT standards for quality measurement and improvement
  • Implementing incentive and reward-based policies to encourage providers to incrementally incremental adopt electronic HIE.

Innovation and Research

The Inova Translational Medicine Institute at Inova Fairfax Hospital (VA) and GNS Healthcare will develop and commercialize computer models for predicting risk of preterm live birth using next generation sequencing and EMR data.


8-8-2013 3-06-54 PM

Seventy-nine percent of providers using clinical decision support surveillance software report that utilizing the technology has a moderate to significant impact on clinical outcomes, according to a KLAS report. Nearly all Epic, Hospira, and Wolters Kluwer users reported a moderate to significant impact on clinical outcomes, including reductions in length of stay, antibiotic usage, medication costs, and adverse reactions as well as better IV-to-PO conversions.

Highly rated with preliminary data in the KLAS report is PeraHealth, formerly Rothman Healthcare Corporation. I interviewed co-founder Michael Rothman in 2010 about what was then known as the Rothman Index, a real-time patient assessment and clinical decision support tool that readers found promising.

8-8-2013 7-20-18 PM

Genesis Health (IA) alerts several hundred patients that the transcription company used by Cogent Healthcare, its contract hospitalist provider, had exposed their information. It turns out it wasn’t just Genesis: Cogent now says India-based M2ComSys exposed information on 32,000 patients due to an incorrectly secured Web server. Cogent has since fired M2ComSys, which might have triggered confidence concerns initially given that all the photos on its home page still bear the stock photography watermark indicating that they apparently just stole the pictures instead of licensing them.

GlaxoSmithKline announces that packages of its vaccines will include two-dimension bar codes, which are smaller and can contain more information that linear bar codes. GSK will include lot number and expiration date so that hospitals and practices can log the information automatically in their EMRs.

Weird News Andy says he isn’t Captain Renault, but he is shocked – shocked – to read that CMS is months behind in testing data security for the health insurance exchanges that are supposed to be operational on October 1. CMS, having missed two June test dates, says it will instead test security on September 30, the day before the PPACA-mandated insurance exchanges are scheduled to be open for business.

Sponsor Updates

  • Encore Health Resources announces that its Activation Support Services has supported 28 go-lives in 22 hospitals involving more than 10,000 physicians in the past 18 months. Chief Medical Officer Judi Binderman, MD will present EHR go-live challenges in an August 15 HIStalk Webinar, “Full Speed Ahead: Creating Go-Live Success.”
  • Sharp HealthCare (CA) reports that its use of Caradigm’s Identity and Access Management suite has allowed it to grant system access requests in an average of one day compared to 21 days previously.
    NextGen Healthcare reseller ITelagen introduces UroWorx, a series of urology-focused templates for use with NextGen Ambulatory EHR.
  • Imprivata announces that its OneSign solution is the most widely deployed SSO product at hospitals using Siemens Soarian Clinicals.
  • CTG Health Solutions posts a white paper outlining the potential impact of big data on healthcare organizations.
  • TrustHCS joins Greenway Medical’s online marketplace to offer PrimeSUITE customers access to its coding and ICD-10-readiness solutions.
  • StrataRx releases details of its annual conference September 25-27 in Boston.
  • iHT2 interviews Rick MacCornack, chief systems integration office for Northwest Physicians Networks (WA), who will be a featured speaker at iHT2’s August 21-22 HIT Summit in Seattle.
  • Emdeon simplifies the new ACA operating rules and guidelines in its August newsletter.

EPtalk by Dr. Jayne


I can’t count the number of emails and text messages I received this week asking what I thought about Dr. Farzad Mostashari’s impending departure from ONC. Of all the names that are being thrown around as possible successors, none of them happen to share his impeccable taste in neckwear. I’m going to continue to appreciate each day that he remains on the job, although I suspect I will likely have to go into mourning when he leaves. I have a feeling we haven’t seen the end of his influence on health IT regardless of where he lands.

CMS issues a clarification on how multiple eligible professionals contributing to a patient portal may count a patient who views information. I’m glad they clarified that the patient does not have to specifically view information contributed by a particular provider for him/her to receive credit. Trying to track that level of data would truly be a chore.

Registration for ONC’s Third Annual Consumer Health IT Summit will begin on August 12. The event is September 16 and will include an announcement about a new eHealth campaign. How’s that for a teaser? The email from ONC was quite mysterious, and although it included a sentence missing the object of a preposition, it didn’t include a link to register or a specific website.

It may be old news, but I didn’t want to fail to mention the planned partnership to link LOINC and SNOMED. It should help with interoperability and hopefully will make things a little less difficult for those of us who have to hook everything up behind the scenes for hospitals and health systems.

Earlier this week one of my good friends mentioned he was frustrated with my health system’s lack of a patient portal. He can access the competitor’s portal but not ours and wanted to let me know. I was surprised since I helped install it almost four years ago. Turns out his physician is merely on staff at one of our hospitals rather than being employed by us, therefore uses a different EHR that may or may not have a portal live. We had a nice chat about the different kinds of community physicians and that their choice of EHR is largely determined by their employment status. It reminded me how obtuse the architecture of our healthcare delivery system is and how ridiculous it must seem to people working in more reasonably structured industries.

Pressure ulcers are a major problem in debilitated patients and ONC announced the winners of their mobile app challenge aimed at assisting nurses in documenting assessments and interventions for ulcer risk and prevention. The winning solution was WoundMAP PUMP from MobileHealthWare. It includes automatic graphing of wound size and time-lapse review of photos. The app is currently in beta testing.


I always like to hear about low-tech solutions and this story got my goat. Eco-Goats provides “environmentally friendly vegetation control,” which will be used at Washington’s Congressional Cemetery. Maybe I can get them to assist with my kudzu problem.


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

More news: HIStalk Practice, HIStalk Connect.

 smoking doc

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August 8, 2013 News 15 Comments

News 8/7/13

August 6, 2013 News 2 Comments

Top News

Farzad Mostashari, MD, MSc announces via Twitter that he has resigned his position as National Coordinator for Health Information Technology, a post he has held for two years and will vacate in the fall. The internal announcements are here.  Who would you choose to replace him, either the individual or the ideal background? Leave a comment with your thoughts – you never know who might be listening.

Reader Comments

8-6-2013 8-18-41 PM

From BowTie No More: “Re: ONC. Big announcement coming out tomorrow …” I received this anonymous rumor report Monday. I asked the official ONC press contact as well as an insider if Farzad was resigning and received no response from either, which I told Inga seemed suspicious. The tiebreaker was that Inga’s contact didn’t know anything about it, so I decided to wait and see. I should have direct messaged Farzad, although he probably would not have confirmed.

From Piker: “Re: Farzad. Where’s he going?” He claims he doesn’t know. I would do what he’s doing: announce my availability well before my last day at ONC and see what offers roll in during the interim. He’s not making a mint working for Uncle Sam and therefore probably can’t undertake a lengthy job hunt after his federal checks stop, but he certainly can cash in big time afterward if that’s his ambition. A reader sent a rumor that he described as “weak” that perhaps Farzad is going to Siemens, playing off an earlier rumor that the company was about to hire an unnamed notable. Other than Farzad’s relationship with Siemens Medical Solutions CEO John Glaser, I don’t know why he would go there, so I would put those odds as low.

From Lazlo Hollyfeld: “Re: Farzad. Vendor – no way.  He’ll join a policy / consulting shop (maybe a K Street firm or not), get a few director positions on various boards (10-20k/year for each director position that is almost free), and reevaluate what he wants to do. It’s time for him to go make some easy cash, stop getting grilled on the Hill, and kick back.” That’s more along the lines of what I would expect him to do. His conscience would be clear that he didn’t sell out completely since he would still involved with healthcare IT at a high level, he wouldn’t have to deal with ugly vendor issues like profitability and product lines, and his value would be highest in offering his cache to the highest bidders. 

inga_small From InfoDoc: “Re: HIMSS board. I am considering running for a position. Will it be worth my time? Will HIMSS be gaining or losing power in the next four years?” The general consensus is that HIMSS has become increasing vendor-focused in recent years, as opposed to provider-focused. With that shift, I am sure there are plenty of providers and provider organizations who believe HIMSS is not the unbiased advocate it may have been 10 or 15 years ago. On the other hand, you don’t have to look further than the increasingly crowded exhibition floor at the annual conference to recognize the importance that vendors place on HIMSS. As to whether a board position is worth your time, I’d say it in part depends on whether you are hoping to be a voice of providers or of vendors. Readers?

8-6-2013 6-07-02 PM

From Boy Lee: “Re: recruiter. This recruiter needs 20 analysts per Cerner module. Is a large nation-state converting to Cerner?” That’s a lot of analysts, suggesting a fast rollout by a big organization. I thought first of HCA, which at one time was looking at Cerner and Epic as an alternative to Meditech 6.0. If you know who it is, tell me. I started to call the recruiter, but dreaded getting locked into a lengthy conversation that probably wouldn’t have resulted in my getting the employer’s name anyway.

8-6-2013 6-43-03 PM

From Larry: “Re: Practice Fusion HL7 ORU laboratory specs. The tech writer forgot to take the spec doc out of Word’s Track Changes mode before saving it as a PDF. Perhaps you can drop a hint to accept all changes, turn off the balloon display option, and convert it to a clean PDF with working hyperlinks? Just trying to help on the long slog to interoperability.” Hopefully this will provide the hint.

HIStalk Announcements and Requests


inga_small Forget MU and all of Farzad’s accomplishments at the ONC. The real bummer is that Dr. Jayne and I will have to seek a new HIT crush. This is my favorite picture of Dr. Jayne, by the way, who photo-bombed an intense conversation between Farzad and Jonathan Bush at this year’s HIStalkapalooza.

Lt. Dan not only writes  the daily HIStalk news headlines and articles on HIStalk Connect, he’s also a veteran and healthcare IT guy. I ran his comments about how he would approach the never-ending (and always expensive) VA-DoD EHR issues. He got a response from an Army Medicine physician who’s working on project similar to what Lt. Dan proposed. We may have updates, depending on what can be said publicly at this point since it’s more of a concept than a finished project.

8-6-2013 6-17-58 PM

Welcome to new HIStalk Gold Sponsor Talksoft, which offers HIPAA-compliant patient reminder systems (phone, email, mobile, and SMS) for appointments, recall reminders, broadcast messages such as last-minute practice closings, payment reminders, notification of new lab results, and outreach calls to help meet Meaningful Use requirements. Practices can estimate their ROI with the on-screen calculator. Orthopedic Associates of Rochester felt pretty good about its 9.4 percent no-show rate vs. the national average of 16 percent, but using Talksoft dropped it to 5.6 percent. Setup took a week (some customers are up and running within a day), one hour of office time, and no phone line or computer hardware, plus Talksoft charges only for usage with no subscription commitment required. I enjoyed playing around with the sample messages and looking at the audit report, and thought it was cool that the practice’s brand is protected because caller ID shows the practice’s number, all aspects are customizable, and the practice records its own messages so the patient hears a familiar voice. Thanks to Talksoft for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

8-6-2013 8-21-42 PM

The SSI Group acquires the Dallas-based Claimsnet.com, a provider of claims processing solutions and payer connections.

8-6-2013 8-23-01 PM

Hospital billing provider HealthTech Solutions acquires RCM provider Gaffey.

8-6-2013 8-23-35 PM

Vocera reports Q2 results: revenue up 12.9 percent, adjusted EPS $0.01 vs. $0.09, beating earnings expectations of –$0.03. Shares are up 18 percent in after-hours trading.

8-6-2013 8-24-33 PM

Nuance announces Q3 results: revenue up 9.5 percent, adjusted EPS $0.34 vs. $0.45. CEO Paul Ricci warned that a shift to a subscription-based revenue model will hurt revenue and margins of its mobile offerings in the short term. The company’s healthcare unit was the star, with sales up 29 percent.


Providence Health & Services contracts with Quantros to provide safety performance improvement advising services across 16 of its facilities.

8-6-2013 8-34-33 PM

BCBS of Tennessee will implement Care Team Connect’s population health management platform.

The VA awards CACI International a $14 million contract in to build a data exchange platform that consolidates EHR data and benefits information across the VA, DoD, and other agencies as part of its VLER program.

Rideout Health (CA) chooses the Pavisse incident management solution from RGP Healthcare.

American Medical Software selects Health Language applications from Wolters Kluwer Health to enhance clinical documentation and regulatory compliance in its ambulatory EHR solutions.

The Indian Health Service awards SAIC a $17 million task order to help replace the agency’s electronic dental record system.

8-6-2013 7-54-41 PM

HealthSouth signs a five-year deal worth up to $20 million to implement a nurse communications system from Australia-based Austco Marketing and Services.


8-6-2013 4-01-37 PM

David Furnas, CIO of Gila Regional Medical Center (NM), resigns in the wake of the hospital’s financial crisis that has resulted in the departure of most of the senior leadership team.

8-6-2013 11-57-45 AM

TeraRecon names Jeff Sorenson (Hyland Software) SVP of global sales, marketing, and business development.

8-6-2013 4-03-12 PM

UltraLinq Healthcare Solutions hires Bao Ho (Canon Healthcare Solutions) as VP of sales.

Announcements and Implementations

The Indiana HIE and Predixion Software will jointly develop predictive health analytics solutions to be offered by IHIE to ACOs and hospitals across Indiana.

8-6-2013 8-36-25 PM

Taylor Regional Hospital (GA) integrates its CPSI EHR with PeriGen’s PeriCALM perinatal system.

The Mount Sinai Medical Center launches RateMyHospital, a real-time patient feedback survey tool for patients seen in its cancer treatment center.

Modern Healthcare announces what it calls “Healthcare’s Hottest,” its list of the 40 fastest-growing companies (companies nominate themselves and their own financial information is used to choose the winners). I don’t recognize all the names, but sponsors that were included are Allscripts, Beacon Partners, CTG Health Solutions, Cumberland Consulting Group, ESD, Impact Advisors, Imprivata, Intellect Resources, and The Advisory Board Company.

Government and Politics

ONC’s Consumer Health IT Summit will be held in Washington, DC on September 16, 2013. Admission is free and the morning’s general session will be streamed live. Registration opens next week.


According to a Health Affairs-published study co-authored by the ONC’s Farzad Mostashari, MD, almost six in 10 hospitals actively exchanged electronic health data in 2012., an increase of 41 percent since 2008.

8-6-2013 5-08-00 PM

An organization-wide e-mail sent by Kaiser Foundation Hospitals and Health Plan CEO Bernard J. Tyson says the organization needs to focus on affordability and intends to hold per-member, per-month costs flat, reducing the current 3 percent trend to zero, because of “competitors who are enjoying unprecedented success in managing costs.” He wants to see membership growth, care transformation, and standardization of care and service at all locations. HealthConnect wasn’t mentioned, which never would have happened under George Halvorson.

8-6-2013 8-30-56 PM

The CEO of Fletcher Allen Health Care (VT) says that despite an expected $200 million in losses over the next 10 years due to Medicare cuts, the health system will add 280 jobs. Many of them will apparently result from its implementation of Epic. According to the CEO, “You do create new jobs. If you’re going to interface new technology, you need people who are savvy about health care and that are savvy at getting into relatively complex software and systems.”

An investigative report finds that six of UCLA’s 17 academic deans claim that their medical conditions require them to fly first class despite a University of California ban prohibiting it. One of them is triathlon competitor and self-professed “cardio junkie.”

Weird News Andy is moved by this story. A man who has been hospitalized and ventilated for 45 years after a bout of polio-caused infantile paralysis teaches himself computer animation and is creating a TV series about his life.  

Trustwave warns that a luxury toilet’s Android app could allow hackers to “cause the unit to unexpectedly open/close the lid, activate bidet or air-dry functions, causing discomfort or distress to user.”

Report from the AHDI Conference
By Jay Vance, CMT, CHP

8-6-2013 6-57-50 PM

The Association for Healthcare Documentation Integrity (AHDI) has wrapped up its Annual Conference & Expo held this year at the Buena Vista Palace Resort in Orlando. This is the annual meeting of the professional association for Healthcare Documentation Specialists (formerly referred to as medical transcriptionists).

Unabashed rebranding is underway to portray HDS as true HIM professionals who are important contributors to accurate clinical documentation, quality patient care, and by extension, to improved reimbursement. As part of this rebranding, future annual meetings, beginning next year in Las Vegas, will be known as Healthcare Documentation Integrity Conferences. Additionally, AHDI is working closely with AHIMA, the American Health Information Management Association, to bring greater understanding of the important role of HDS to a wider audience.

Admittedly late out of the starting gate, our association is nevertheless pushing back hard against the perception of HDS as glorified typists who cost money and are easily replaced by technology such as speech recognition technology and, of course, electronic medical records systems. The reality is that SRT still requires thorough review by human editors, while many EMRs are so user-unfriendly that an entire medical scribing industry is springing up to relieve caregivers from the burden of having to use those expensive EMRs which were supposed to reduce costs by eliminating the need for transcription.

Furthermore, it seems more than coincidental to many HDS that costly clinical documentation improvement programs have grown in inverse proportion to our devaluation and outright elimination. Declining physician productivity and satisfaction? Those have also gotten worse as dictation has been eliminated and transcription budgets have been slashed.

Of course we understand that correlation doesn’t necessarily equate to causation, and certainly there are other forces in play. But just because we’re paranoid doesn’t mean they aren’t out to get us. All facetiousness aside, there are a number of research initiatives underway within our industry to quantify in real terms to what degree, if any, removing skilled HDS from the clinical documentation process has adversely affected the quality of documentation, and concomitantly, negatively impacted patient care and provider revenues.

Sponsor Updates

  • Stern Cardiovascular Foundation (TN) reports that its use of Emdat for dictation and transcription services has resulted in significant process improvements, reduced costs, and improved provider productivity.
  • Orion Health introduces a converged cloud service based on HP’s CloudSystem Matrix, which will support cloud services tailored to individual customers.
  • Siemens Healthcare will offer mobile alert, notification, and secure messaging services from EXTENSION to users of Siemens Soarian and legacy Siemens EHR products.
  • CCHIT designates eClinicalWorks V10 compliant with the ONC 2014 Edition criteria and certifies it as a complete EHR.
  • CIC Advisory releases a report on the challenges and opportunities facing the country’s top healthcare organizations.
  • Aprima PRM 2014 EHR/PM v. 14.0 earns Meaningful Use Stage 2 certification as a Complete EHR.
  • The FDA grants 510(k) market clearance for Alere MobileLink, a self-testing at home device that connects to Alere’s Connected Health platform.
  • Allscripts, McKesson, Medicity, and Sandlot Solutions sponsor a webinar discussing how leading healthcare organizations are using data and analytics.
  • Outside Magazine names iSirona to its list of best places to work.
  • The Association of Affiliated Plans names CTG Health Solutions a preferred vendor.
  • Clinical Architecture CEO Charlie Harp reviews data normalization in a blog post.


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

More news: HIStalk Practice, HIStalk Connect.


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August 6, 2013 News 2 Comments

Monday Morning Update 8/5/13

August 3, 2013 News 2 Comments

8-3-2013 2-20-57 PM

From DCIntern: “Re: Stage 3 Meaningful Use. Expect ONC to recommend a delay during National Health IT Week.” Unverified.

From Fly on the Wall: “Re: [vendor name omitted]. Having glitches nationally and worldwide in its medication reconciliation programming, causing patient discharge medication lists to be in error. A safety letter was issued on August 1.” I’ve asked the company to confirm, but in fairness I’m leaving their name off until I hear back. A copy of the safety letter would be nice to have.

8-3-2013 3-24-47 PM

I needed updated copies of Microsoft Office and wasn’t too thrilled at the price or the limit of installing it on only one PC (it was three PCs in previous versions), so I was happy to have stumbled onto Office 365. The Premium version (Word, Excel, PowerPoint, Outlook, OneNote, Access, and Publisher, all in 2013 version) runs $99.99 year for up to five PCs or Macs and also five mobile devices. I don’t like renting software instead of owning but was about to bite the bullet when I strayed onto Office 365 University. Students, faculty, and staff of approved education institutions (like my hospital) can get a four-year, two-PC subscription that includes 20GB of SkyDrive storage for $79.99, which I did –$20 per year is just fine with me. Installation was slick, fast, and in the background. The new software versions work great, but I haven’t been able to figure out how to use the cloud features, especially with Outlook. It would be a really slick package if Microsoft offered an easy guide on how to use all the file-sharing features it touts. I admit that I didn’t spend much time trying to figure it out, but so far I’m using it just like the old CD version.

8-3-2013 1-08-53 PM

Three-fourths of poll respondents don’t see HIMSS as a major player in the debate about healthcare quality and cost. New poll to your right: do you follow the “Most Wired Hospital” type awards? The poll accepts comments once you’ve voted if you would care to elaborate.

Stock picking TV celebrity Jim Cramer, whose lips were perpetually planted on Glen Tullman’s posterior until Cramer finally advised dumping Allscripts shares way too late, is now enamored with Jonathan Bush and athenahealth. Cramer is entertaining, but watching him can be expensive if you take his stock advice. Bush says hospitals are in a decline and struggling ones are being bought up by sharp for-profit operators whose efficiency allows them to make a profit. Cramer says athenahealth “is solving a lot of the healthcare problems in this country.”

8-3-2013 8-38-47 PM

Financially struggling MaineHealth will shut down its nine-hospital tele-ICU program that loses $500K annually. One hospital says it pays $150K each year to participate, but, “While the service is fantastic for our patients, it’s not reimbursable … The consequence of this will be that some patients that may have stayed in the local community may have to travel further for care that we won’t be able to offer. MaineHealth signed a splashy deal with VISICU (now Philips) in 2005, with the health system’s president saying then, “The savings in lives and ultimately in dollars make it an important investment. It’s the kind of service that is possible only because we have forward-thinking clinical and administrative leadership.”

The previously insignificant number of physician practices that don’t accept Medicare is growing, according to a Wall Street Journal report that says 9,500 doctors opted out in 2012.

In England, a study of Internet searches for takeout food that originated from a hospital IP address finds that those searches quadrupled in one year.

An Iowa nursing home fires two employees for taking inappropriate photos of a resident and posting them on an unnamed social media site.

A former Health Management Associates hospital CFO files a whistleblower lawsuit claiming that the for-profit HMA and Tenet hospital chains paid kickbacks to two Georgia clinics in return for sending pregnant illegal aliens to their hospitals so they could bill Medicaid for emergency services. The clinics, which advertised, “We care about your health, not your immigration status,” were paid kickbacks disguised as translation service fees, according to the lawsuit. Illegals aren’t eligible for Medicaid, but emergency services, including childbirth, are covered.

Vince covers the HIS-tory of Siemens, Part 3 this week.


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

More news: HIStalk Practice, HIStalk Connect.


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August 3, 2013 News 2 Comments

News 8/2/13

August 1, 2013 News 12 Comments

Top News

8-1-2013 11-03-44 PM

Cerner announces plans to acquire a 237-acre abandoned mall near its Innovation campus in Kansas City. A new campus on the property will eventually house up to 15,000 new Cerner employees as the company grows over the years.

Reader Comments

From Jobu: “Re: access control. Have there been recent discussions about deploying fingerprint or iris scanner recognition systems vs. multiple passwords?” I’m sure there’s a case study out there somewhere from Caragidm or Imprivata or another user access systems vendor. Feel free to point the way if you’ve seen something.

8-1-2013 9-09-24 PM

From Bluebonnet: “Re: Oregon Health & Science University patient information stored on Google Drive or Gmail. Does this not point to an organization not meeting the needs of its users to promote patient care? Given that this organization has been pretty progressive, is it not troublesome?” That question rarely gets asked: what system deficiencies created the need to store information on consumer-grade services in the first place? OHSU plastic surgery residents were keeping a spreadsheet of their service’s patients on Google Docs, which contained minimal patient information. A similar practice was discovered in the urology and kidney transplant areas. Questions: (a) was the only problem that the hospital didn’t have a business associate agreement with Google? (b) does the hospital’s system not provide a snapshot of which patients each service is covering? (c) if not, then does the hospital not provide network storage for saving copies of files, or was the problem related to mobile devices? Give the residents credit for trying to do the right thing in making sure handoffs were done and using technology to do it. It’s a tough sell to argue that ubiquitous cloud storage is fine for almost everything except PHI.

From HIS Junkie: “Re: Siemens. Looks like the CFO will take over. Is the SMS ride about to end? Less R&D for Malvern? John Glaser in trouble? We all know they been losing their client base to Epic and others for the last three years. Will they come to the same conclusion as GE – healthcare IT can’t be a winner?” Siemens issues a surprise profit warning and uncharacteristically quickly fires its CEO, replacing him with the CFO (you just can’t beat the excitement of an engineering company run by a bean counter.) The new guy says the company tried to grown too fast and needs to get back to execution (not referring to that of his predecessor). The deposed CEO, who steered the company around its global bribery scandals, will get $20 million in severance and a $20 million pension for his six years in the job.

A reader asked whether outside healthcare IT experts could help veterans and what the 90-day agenda would look like. Proud veteran, healthcare IT guy, and HIStalk/HIStalk Connect contributor Lt. Dan provided this response:

I’d scrap iEHR and spend what’s left of the money creating a patient portal that would make the soldier the acting custodian of their own electronic medical record. After every clinic visit, ED visit, or hospitalization, the entire chart from that visit is pushed to the patient portal. It has lab results, physician notes, PT/ OT, all of it, an exact carbon copy of everything entered in the chart for every visit. The portal IS the medical record, and it houses all details of any injuries or illnesses treated.

The portal follows them through their military career and grows as they need services. If they’re transferring from Ft. Bragg, NC to Ft. Stewart, GA they process out of medical at Bragg where the Bragg doctor signs off on the chart and the portal is updated to show that the soldier is transferring to a new duty station, and that Ft. Stewart is now the primary care location.

When the soldier is ready to be discharged, they have their entire military record on the portal from all bases, including medical and dental. When they get back to the civilian world and meet their new civilian PCP, they can at worst print out the medical record for them, and at best leverage some type of HL7 interface to push a medical summary (CCD) to the provider with extractable allergies, prescriptions, problems, and medical history.

If the vet needs to submit a disability claim with the VA, they grant access to their portal so VA reps can review the records immediately, rather than waiting up to 90 days for DoD to find, print, and mail them a copy.

Vets already have a portal. It’s called My HealtheVet. It looks exactly like your typical portal. A dumbed-down, patient-centric version of a medical record. It’s fine, it’s just missing much of the information clinicians will want to see if they’re taking you on as a new patient after military service, or information that a VA rep would want to see if they’re processing a disability claim.

To help vets within 90 days, I’d get the entire medical record from the first day the soldier enters the military, feeding into that patient portal so that soldiers would have custodianship of their own medical record. Then I’d enhance that portal so that vets can easily authorize access to any or all of the content within it and could transmit a CCD from it.

I’d get a team of sergeants, corporals, and privates to execute the plan. It would be done in 89 days and there would be enough money left over in the budget to spend the last day drinking beer and barbecuing.

HIStalk Announcements and Requests

inga_small What you may have missed this week on HIStalk Practice: the number of physicians opting out of Medicare has tripled since 2009, according to CMS. CareCloud adds more than 150 new medical groups in the second quarter, with more than half also selecting CareCloud’s integrated EHR/PM. Dr. Gregg shares a story of a blogosphere encounter with another physician who took his office fully live on EMR in one day. Dr. Gregg offers additional insight on the doctor’s EMR platform in a subsequent post. Click over to HIStalk Practice and catch up on the latest ambulatory HIT news, sign up for e-mail updates, and check out the offerings of our sponsors. Thanks for reading.

Acquisitions, Funding, Business, and Stock

8-1-2013 11-07-25 PM

Ascension Health Ventures invests in Quantros, a portfolio company of Francisco Partners.

8-1-2013 11-10-49 PM

The Advisory Board Company reports Q1 results: revenue up 18 percent, adjusted EPS $0.31 vs. $0.31. The company also announces its purchase of referral technology vendor Medical Referral Source for $11.5 million.

8-1-2013 11-11-33 PM

MedAssets reports Q2 results: revenue up 4.7 percent, adjusted EPS $0.30 vs. $0.28.

McKesson re-elects all its board members at the company’s annual meeting despite dissent from activist shareholders who wanted the company to cut CEO John Hammergren’s pay and split his chairman and CEO roles.

A Bloomberg article says, without any facts to back it up, that Quality Systems has become a Siemens and McKesson takeover target because its share price has dropped and proxy fights have pushed the company to reevaluate its strategy.


8-1-2013 11-12-29 PM

Hallmark Health System (MA) selects athenahealth’s athenaClarity to proactively manage its patient population and engage in new reimbursement contracts.

The Hospital for Sick Children in Toronto selects MetaVision’s MVperfusion solution.


HIT Application Solutions names Betty Jo Bomentre, MD (Vitalize Consulting Solutions) CMIO.

8-1-2013 5-57-57 PM

Healthwise SVP Karen Baker joins the board of Center for Plain Language, a nonprofit that advocates for clear communication in government and business documents.

8-1-2013 9-56-07 PM

Health Care DataWorks names Kathleen Kimmel (MedeAnalytics) chief clinical officer.

Announcements and Implementations

Cerner opens an on-site health center for 2,800 employees and covered dependents of the California-based ViaSat, a communication products company. Providers will use Cerner’s EHR and patients will have access to the Cerner Patient Portal.

Brightree changes the name of its CareAnyware EMR software to Brightree Home Health and Hospice.

8-1-2013 11-14-37 PM

NorthCrest Medical Center (TN) implements Allscripts Sunrise Clinical Manager.

PinnacleHealth (PA) goes live on Soarian Financials.

University of Arkansas for Medical Sciences had the first of three Epic go-lives Thursday, bringing up ambulatory scheduling and registration, kiosks, referring physician portal, retail pharmacy, MyChart, and professional billing in all of its clinics. A third of the clinics also went live on EMR.

The Discovery Channel aired an episode of “Today in America” highlighting PeriGen’s PeriCALM and PeriBirth on Thursday. It’s pretty good, although host and former NFL quarterback Terry Bradshaw struggles painfully to pronounce the big words as he adopts the “Serious Terry” persona instead of his usual goofy on-screen presence.

The US Patient & Trademark Office awards EDCO Group a patent for its Solarity medical record scanning and indexing process that identifies a scanned document type by its recognizable content rather than by a printed bar code.

PatientOrderSets.com announces the integration of its order set tools with Cerner Millennium.


Government and Politics

VA Undersecretary of Health Robert Petzel, MD says that while one million veterans currently use some type of VA telehealth offering, he hopes to boost the number to more than four million.

Above is Farzad Mostashari, MD responding to questions at the Senate Finance Committee hearing on healthcare IT this week, courtesy of Brian Ahier.

8-1-2013 8-33-36 PM

ONC releases its user guide to EHR contract terms.

Innovation and Research

Researchers find that providers who use EHR clinical decision support predictive tools at the point of care are less likely to order antibiotics for respiratory tract infections.


8-1-2013 8-53-44 PM

The American Hospital Association says even EHR-experienced hospitals are struggling to implement electronic clinical quality measures, recommending: (a) slow the transition by reducing and then improving the measures; (b) make EHRs and eCQM tools more flexible; (c) improve EHR and eCQM standards to meet Meaningful Use expectations; (d) test eCQMs to make sure they are reliable and valid before rolling them out nationally; and (e) provide more tools and guidance for the transition.


8-1-2013 6-03-40 PM

inga_small A Capterra infographic lists the 20 most popular ambulatory EHRs based on number of customers, number of users, and social media presence. The accuracy of the information is suspect given that Epic is listed as having one to 50 employees rather than its actual 6,500. Potential buyers should note that “most popular” is not the same thing as “most likely to succeed” in a given practice, where the vendor’s prolific Tweeting and Facebook likes may provide little consolation.

Consumer advocates in Florida oppose a proposal that would boost allowed charges for providing copies of medical records to $1.00 per page rather than $1.00 per page for the first 25 pages and then $0.25 per page afterward. Lobbyists for release of information provider HealthPort technologies filed the request, surely seeing dollar signs at the prospect of nearly quadrupling revenue given the size of the average chart.

Dialysis patients of Boston Medical Center (MA) were exposed to hepatitis B earlier this year because nurses weren’t allowed to use the hospital’s EMR, the state health department has concluded. Contracted dialysis nurses from DaVita weren’t given access to the EMR that would have flagged an infected dialysis patient, leading them to improperly sterilize equipment and expose 13 patients to the disease. The state said the hospital should give EMR access to non-employed nurses who are delivering patient care.

Healthcare employers cut 6,843  jobs in July, the highest monthly total since November 2009. Hospital finances have been hurt by sequestration, Medicare payment cuts, and lower utilization as patients move to high-deductible insurance policies.

8-1-2013 11-22-12 PM

The CEO of WakeMed Health & Hospitals (NC) warns employees of possible cost-cutting and layoffs as the health system’s accumulated losses hit $15 million before the September fiscal year end. The hospital is spending $100 million implementing Epic and expects a $23 million reduction in payments next year.

The bond ratings agency for Johns Hopkins Health System gives it kudos for its system integration, including installing Epic system-wide.

In England, the BBC finds that Royal Berkshire Hospital has paid $25 million to 200 consultants over five years to help it bring up Cerner Millennium. The article says the total cost is $42 million so far, it’s still not working right, the annual cost is $10 million, and IT is now one of the biggest departments in the hospital.

Sponsor Updates

  • Joseph Eberle of CTG Health Solutions presents a case study on using data analytics to improve outcomes for chronic kidney disease patients at this week’s National Forum on Data & Analytics.
  • Impact Advisors’ Senior Advisor Janice Wurz co-authors an article with Henry Ford Health CTO John Hendricks on planning and designing strategic technologies for clinical BI.
  • Allscripts adds integration with Spaulding webECG, allowing the app to be launched from within Allscripts Enterprise EHR to support physician orders and provide access to ECG reports.
  • 3M Health Information Systems introduces Patient-focused Episodes software, which considers the costs and outcomes of longitudinal care.
  • Quest Diagnostics works with Greater Houston Healthconnect to make lab results available to providers.
  • Ingenious Med offers a white paper, “Transition from ICD-9 to ICD-10: Managing the Process.”
  • Andre L’Heureux and and Kevin Entricken of Wolters Kluwer participate in a roundtable on the genome approach to investing.
  • INHS recognizes 18 of its customers that were named Most Wired.
  • API Healthcare reports that it expanded its market reach to include behavioral health and rehabilitation centers in the second quarter.
  • Truven Health Analytics will add animated videos from Health Nuts Media to its Micromedex Patient Connect Suite.
  • Holon’s Scott McCall discusses the importance of good communication skills for HIE implementation team.
  • INHS client St. Elizabeth Hospital (WA) earns HIMSS Analytics’ Stage 7 recognition for EHR adoption.
  • Health Catalyst SVP Dale Sanders lists five indispensable information systems needed for ACO success.
  • RazorInsights will showcase its ONE Enterprise HIS solution during the Illinois Rural Health Association Educational Conference Aug. 22-23.
  • Five Medicity clients are serving as HIO ambassadors to a Chinese delegation gathering best practices for organizing, administering, and sustaining an HIO.

EPtalk by Dr. Jayne


The American Academy of Family Physicians has a new Web page covering the Medicaid-Medicare parity payments specified in the Affordable Care Act. Included is a checklist with the steps providers must follow to obtain the payments.

Clinical Decision Support update time: The US Preventive Services Taskforce publishes a draft recommendation for annual screening of high risk smokers by CT scan. Although it’s still a draft and insurers are not paying yet, it’s a good excuse to review the steps needed to configure new screening guidelines in your EHR.

I was intrigued by a blurb about Cisco’s “Video-enabled virtual patient observation” offering. Essentially it’s remote monitoring of patients who would normally require a “sitter” to ensure they don’t fall out of bed, remove IVs and other tubes, or otherwise cause self-harm. I wanted to find out more about it, but couldn’t without filling out a 17-field questionnaire including budget and timeline information. Based on my recent experiences from the patient perspective, I’d lobby that no technology can replace the presence of a family member at the bedside. For those who can’t have someone there 24×7 or for hospitals that have a shortage, it might be an interesting option.

Researchers at Temple University in Philadelphia are conducting a two-year study looking at virtual speech therapy. Patients will be pushed to spontaneously generate speech rather than practicing scripted conversations.

There have been several additions to the HealthIT.gov site recently, including a document on key terms used in EHR contracts. Based on some of the questions I receive from our affiliated providers, it should be required reading for anyone thinking about purchasing an EHR or going live on a hospital’s platform as part of an alignment strategy or Accountable Care Organization. It’s not a bad read on legal terms in general, especially for providers in the habit of signing documents without reading them.

Bianca Biller alerted me to the proposed cuts to the 2014 Medicare physician fee schedule. Highlights include the (now usual) 24.4 percent cut due to the SGR formula, implementation of value-based modifiers, changes to the Physician Quality Reporting System, and limitations on nearly 200 services where the physician fee schedule non-facility payment is more than the total payment for the same service in a facility setting.


It’s been a rough couple of weeks in the trenches, so I’m going to recharge my magic wand with a long weekend somewhere sunny. If I were a fairy godmother, this is what I would feel like about now. Here’s to sunscreen and fruity drinks.


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

More news: HIStalk Practice, HIStalk Connect.

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August 1, 2013 News 12 Comments

News 7/31/13

July 30, 2013 News 5 Comments

Top News

7-30-2013 8-31-15 PM

Community Health Systems will buy for-profit hospital competitor Health Management Associates for about $3.6 billion in cash and stock. With the assumption of debt, the merger is valued at $7.6 billion and includes 206 hospitals in 29 states. It will be interesting to see if HMA shareholders approve the deal since it only pays $10.50 per share compared to Monday’s closing stock price of $13.92.

Acquisitions, Funding, Business, and Stock

7-30-2013 7-22-55 PM

Specialty medical billing vendor Zotec Partners will acquire Atlanta-based ED billing firm Medical Management Professionals for $200 million from CBIZ. The combined companies will have 1,750 employees and $215 million in annual revenue.

7-30-2013 8-32-52 PM

Mediware CEO Kelly Mann says the company, which has acquired five home health software companies, will acquire one or two software vendors each year, focusing on home health and long-term care.


7-30-2013 5-50-19 PM

Excela Health (PA) contracts with SCI Solutions for its Schedule Maximizer, Order Facilitator, and Results Facilitator solutions.

The Arkansas Office of HIT selects Get Real Health as the patient portal development vendor for providers participating in the statewide HIE.


7-30-2013 3-58-42 PM

CareTech Solutions CEO Jim Giordano is named chairman of the St. John Providence Health System (MI) board of trustees.

7-30-2013 3-59-54 PM



John Lutz (Navigant Consulting) joins Huron Consulting Group as managing director of the company’s healthcare practice.

7-30-2013 6-11-48 PM

Justin Graham, MD (NorthBay Healthcare) is named chief innovation officer, healthcare of Hearst Business Media.

7-30-2013 6-16-15 PM

Dann Lemerand (The HCI Group) joins eVariant as vice president, solution engineering.

Clinical Architecture appoints Andrew Frangleton (UBM Medica) managing director of the company’s UK office.


Announcements and Implementations

Qsource and the Tennessee Office of eHealth Initiatives introduce Direct Technology for secure exchange of patient data.

7-30-2013 8-37-49 PM

Catholic Health Initiatives reports savings of nearly $1.5 million from reduced overtime and $3 million for reduced length of stay since its 2010 implementation of the Cerner Clairvia workforce and operations suite in 14 of its hospitals.

TECSYS announces the OR Inventory Manager perioperative supply change management system.

7-30-2013 8-35-56 PM

Napa State Hospital (CA) and two other psychiatric facilities give employees Ekahau RFID-powered name badges to signal for help and transmit their location in an emergency.

7-30-2013 7-10-17 PM

Baltimore-based Parallax Enterprises will begin beta testing its CHaRM OR safety checklist system starting in the fall.

Government and Politics

7-30-2013 5-56-58 PM

Through the end of June, 305,778 EPs and 4,024 hospitals collected more than $15.5 billion in EHR MU incentives.

inga_small In a Politico opinion piece, Senators Chuck Grassley (R-IA) and Ron Wyden (D-OR) argue for the passage of legislation that would make Medicare claims data available through a free, searchable online database. The senators contend, “The publication of Medicare data will become healthcare’s new financial baseline; the measure of what America’s largest and most powerful buyer of healthcare gets for nearly $600 billion a year.” I understand that privacy issues remain a chief concern, but I have yet to hear a argument compelling enough to convince me that keeping this data largely sealed is preferable to open access and transparency for researchers and consumers.

7-30-2013 8-42-31 PM

A Time article recaps a Washington Post investigative article from earlier this month that describes the AMA group that tells the government how much Medicare should pay doctors. According to former CMS Administrator Tom Scully, “The idea that $100 billion in federal spending is based on fixed prices that go through an industry trade association in a process that is not open to the public is pretty wild.” The AMA criticized the article saying its recommendations are just optional guidelines, but left out the fact that the government accepts 90 percent of those recommendations without question.

Innovation and Research

7-30-2013 8-43-29 PM

A team from the Houston VA Medical Center creates EHR-based triggers to make sure that clinicians follow up on abnormal lab results that can indicate cancer (PSA, occult blood, iron-deficiency anemia, and bloody stools.) Positive predictive value ranged from 58 to 70 percent.

A heart surgeon in India who founded a chain of 21 medical centers offers coronary bypass surgery for $1,583 and hopes to drop the price to $800 within 10 years. The same procedure at Cleveland Clinic costs $106,000.


7-30-2013 8-44-22 PM

MMRGlobal announces Australian singer Guy Sebastian as the spokesperson for its “Don’t Worry Be Happy” advertising campaign for its personal health record.

The ratings agency for Catholic Health Services of Long Island downgrades its bonds, with a key ratings driver being, “Additional expense pressures in fiscal 2013 related to the implementation of an electronic medical record (EMR) has resulted in an operating loss of $18 million for the interim period.” The system filed a $144 million certificate of need in 2010 to implement Epic, which it estimated would add $40 million to its bottom line beyond HITECH payments, including a projection that its length of stay would drop 0.5 days for an annual savings of $28 million.

A jury awards a woman $1.44 million after a female Walgreens pharmacist shared her prescription records with the pharmacist’s husband, who was also the patient’s former boyfriend. Walgreens says the jury was wrong in finding it responsible for the actions of an employee who intentionally violated company policy and says it will appeal.

Weird News Andy calls this article “Potty Mouth.” A China-based research team grows teeth from stem cells extracted from urine. WNA says of this article about a venipuncture robot, “He vants to drink your blaad.”

Sponsor Updates

  • CommVault announces enhancements to its Edge software that give users the ability to securely share, search, and restore files across their mobile, desktop, and laptop devices.
  • NextGen reseller TSI Healthcare will integrate PatientPay with NextGen PM.
  • HealthTronics will integrate SampleMD’s eCoupon and eVoucher solutions from OPTIMIZERx Corp. within its UroChartEHR and meridianEMR platforms.
  • McKesson adds real-time analytics and mobile access to its Strategic Supply Sourcing supply chain solution.
  • ONC head Farzad Mostashari, MD and MGMA Healthcare Consulting Group’s Rosemarie Nelson will deliver keynote addresses at this week’s Aprima 2013 Annual User Conference in Dallas.
  • Greenway Medical will provide its PrimeSUITE customers access to PatientCo’s patient financial engagement  platform.
  • Greythorn Senior Account Executive Paul Tran writes about the importance of “soft skills” within a technology environment.
  • LiquidEHR partners with DrFirst to offer users integrated e-prescribing functionality.
  • Allscripts profiles Manitoba e-Health and its implementation of dbMotion’s eChart solution.
  • Infor Healthcare highlights the success of its supply chain management solutions at several organizations, including MLK Community Hospitals (CA), Huntington Hospital (CA), Prime Healthcare (CA), WellStar Health System (GA), University Health System (TX), and Greenville Health System (SC).
  • Talksoft Corporation integrates its portfolio of messaging services within the Healthpac Computer Systems billing platform.
  • Craneware introduces an update to its Supplies ChargeLink solution that includes an automated search function to identify HCPCS codes.
  • Ingenious Med releases a white paper that offers tips for transitioning to ICD-10.
  • A local publication features the use by Colquitt Regional Medical Center (GA) of Versus RTLS to improve patient care.



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

More news: HIStalk Practice, HIStalk Connect.

smoking doc

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July 30, 2013 News 5 Comments

News 7/26/13

July 25, 2013 News 2 Comments

Top News

7-25-2013 11-14-10 AM

CIOs and CMIOs tell the HIT Standards Committee that Stage 2 MU needs to be delayed a year. They argue that EHR vendors will not deliver 2014 certified software updates in time for hospitals to implement, validate, and train on the changes and meet the July 1, 2014 deadline for starting the 90-day Stage 2 reporting period. The AHA and AMA also submitted recommendations to extend the MU timelines and make them more flexible.

HIStalk Announcements and Requests

inga_small Hot stuff this week from HIStalk Practice includes: comments on why EMR selection should not be based on features. MGMA urges HHS to conduct ICD-10 testing with external trading partners, including physician offices. Social media experts offer tips for physicians. Commentary on EHR vendor consolidation and provider dissatisfaction. EPs share their reasons for dropping out of the MU program. Legislation moves forward to to repeal the Medicare SGR payment formula and develop a payment program based on quality and efficiency. Nothing is more refreshing on a hot summer day than an ice cold beverage and a quick perusal of HIStalk Practice. Thanks for reading.

On the Jobs Board: Developer, Full Stack Android (Google Glass), Sales Director.

HIStalk Webinars

7-25-2013 5-48-30 PM

Encore Health Resources will present Full Speed Ahead: Creating Go-Live Success on Thursday, August 15 at 2:00 Eastern, presented by Judi Binderman, MD, chief medical officer.

In implementing a new EHR, organizations typically focus on getting the software ready … building workflows, creating interfaces, and performing data conversions. Just as critical as having the software reflect the organization’s needs is having the go-live activities mirror the organization’s culture, goals, and end user support needs. This webinar will give an in-depth discussion of those items frequently overlooked and under resourced in bringing an EHR live. Encore Health Resources will share our experiences and lessons learned in supporting 28 go-lives for 22 facilities and over 10,000 physicians.

C-level HIStalk readers have provided presenter feedback and the session will be moderated by HIStalk. Register here.

Acquisitions, Funding, Business, and Stock

Kareo acquires ECCO Health, a Las Vegas-based medical billing provider.

7-25-2013 6-06-21 PM

Compuware’s Q1 results: revenue up 0.6 percent, adjusted EPS $0.10 vs. $0.09. Revenue of its Covisint division was up 17 percent.

7-25-2013 6-07-38 PM

VMware’s Q2 numbers: revenue up 11 percent, EPS $0.57 vs. $0.44.

7-25-2013 6-08-26 PM

Cerner’s Q2 report: revenue up 11 percent, adjusted EPS $0.34 vs. $0.29, meeting earnings estimates but falling short on revenue.

7-25-2013 6-29-33 PM

McKesson’s Q1 results: revenue up 5 percent, EPS $1.83 vs. $1.58,  beating earnings expectations but falling short on revenue. Technology Solutions revenue was up 9 percent, with the company reporting growth in RelayHealth, McKesson Health Solutions, enterprise, medical imaging, and Paragon, which is tracking ahead of projections on getting Horizon customers to switch. Hospital Automation and International Technology have been moved to discontinued operations.

7-25-2013 10-30-07 PM

Vitera Healthcare completes its acquisition of SuccessEHS, which was announced June 17.

7-25-2013 10-30-48 PM

From the Quality Systems earnings call: the Hospital Systems business unit saw a 52 percent drop in revenue as it sustained a $2.6 million loss. The company said it caved in to the threatened proxy fight by dissident shareholder Clinton Group to avoid being “faced with what would be a two-month period of yet another proxy fight like we had last year.” The company says the proxy issue and rumors of a potential sale of the company hasn’t affected the sales pipeline.


7-25-2013 10-31-34 PM

Sunnybrook Health Sciences Centre in Toronto will implement iMDsoft’s MetaVision clinical information system in its ICUs.

Boston Medical Center selects MModal’s transcription services for its healthcare provider network.

The Denver Endoscopy Center selects ProVation Medical from Wolters Kluwer Health.

7-25-2013 10-33-56 PM

Santa Clara Valley Health & Hospital System (CA) will deploy Capsule Tech’s DataCaptor medical device integration software.

Congress Medical Associates (CA) selects SRS EHR for its 21 orthopedic providers and two locations.

The Physician Alliance (MI) expands its use of Wellcentive to include Wellcentive Advance for creating a quality improvement registry.


7-25-2013 6-12-07 PM

Caremerge hires Greg Silvey (PSS World Medical) as VP of business development.

7-25-2013 7-41-24 PM

Direct Consulting Associates names Andrew Tipton (Direct Recruiters, Inc.) project manager.

Announcements and Implementations

7-25-2013 10-34-38 PM

CPSI and Sunquest Information Systems join CommonWell Health Alliance.

7-25-2013 12-32-34 PM

The Regenstrief Institute and the International Health Terminology Standards Development Organisation will link their global healthcare terminologies LOINC and SNOMED.

Siemens Healthcare releases a series of nine videos recorded at the HIMSS conference in which experts address critical health IT issues using only three slides and three minutes. Above is our own CIO Unplugged and Texas Health Resources CIO Ed Marx talking about social media and the hospital CIO.

SCI Solutions announces the the integration of its Order Facilitator product with the Surescripts Clinical Interoperability network.

7-25-2013 7-17-17 PM

Healthcare Growth Partners releases its mid-year 2013 HIT Market and M&A review. It says that healthcare IT buyers will outnumber sellers this year, with competition keen for companies with strong recurring revenue, products that are beyond proof of concept, revenue of at least $5 million, software with strong ROI delivered as a service, and ideally with offerings that fit in risk-based models.

Users of pMD’s mobile charge capture solution increased their Medicare reimbursement by automatically scheduling follow-up visits for discharged patients that are reimbursed under two new CPT codes (99495 and 99496) that pay for transitional or follow-up care if the patient is contacted within two days, the company says. The company says its almost impossible to meet the requirements using a paper-based system because of the tight timelines. If your goal is amusement rather than reimbursement, check out the company’s FAQ page, which in answering a question about the types of reports provided, the answer is “completely, totally amazing ones.”

Innovation and Research

7-25-2013 7-36-00 PM

Qualcomm and Palomar Health (CA) launch Glassomics, the first medically-focused Google Glass incubator.

Above is the just-released TEDMED presentation by Harvard’s Isaac Kohane of the SMART Platform, which advocates the use of extensible, open source apps that sit on top of vendor EHR systems.

7-25-2013 9-19-23 PM

The commercialization arm of Wake Forest Baptist Medical Center (NC) signs a deal with Charlotte-based app vendor Novarus Healthcare to develop disease management apps.

Philips Healthcare announces plans to start an incubator in Israel, where it has a large development center and has made previous acquisitions.


7-25-2013 10-21-28 AM

inga_small St. Luke’s Medical Center in the Philippines introduces an online service that allows patients to book their preferred rooms in advance based on price and room amenities. I kind of like the $1,155 per night Presidential Suite, which includes a receiving room, guest room, PC and printer, eight-seat dining area, and three plasma TVs.

inga_small The mail processing company for  Clark Memorial Hospital (IN) blames a “processing error” for sending 1,093 billing statements to the wrong address.

7-25-2013 3-02-41 PM

inga_small Ezekiel Emanuel, MD, occasional White House advisor and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, calls the U.S. News & World Report “Best Hospitals” rankings and similar rankings “flawed to the point of being nearly useless.” In an opinion piece published in the Wall Street Journal, Emmanuel says the criteria used for rankings are “unrelated to quality, easily manipulated, and incentivize the wrong choices and behaviors.” Emanuel contends that if hospitals showed more transparency about quality, patients wouldn’t need rankings to select the best healthcare.

A Harvard Business Review article suggests that organizations are asking too much of their CIOs, saying the next generation of CIOs will need to balance four personas: infrastructure management, integrating systems, business intelligence, and innovation, possessing an integrative mind, focus and vision, and a trusting and trustworthy nature.

7-25-2013 6-40-31 PM

A Forbes analysis from last month of John Hammergren’s compensation titled “The World’s Most Outrageous Pension Deal?” says the McKesson CEO’s numbers are “utterly absurd”: a $159 million pension if he were to quit today, $131 million in one-year compensation,  a rumored $469 million if he’s fired by any new owners of the company, and $260 million due to his heirs if he dies or becomes disabled. The article says most companies other than McKesson cut back on very high CEO pension plans after SEC rules changed in 2007 requiring them to disclose those deals publicly. It also says the company gave Hammergren credit for years he didn’t work and pay he didn’t receive to come up with the big number, also waiving its early retirement penalty that applies to its other employees.

7-25-2013 7-54-29 PM

New analysis of CMS EHR attestation data for May by from Jamie Stockton of Wells Fargo Securities finds that Meditech, Cerner, and Epic hospitals lead the way in total numbers with over 400 attesting hospitals each, while Cerner, Epic, and HMS are the frontrunners in client percentages with 65 percent of their hospital customers successfully attesting. Trailing in customer percentages with 50 percent or less are McKesson (50 percent), Siemens (45 percent), and QuadraMed (25 percent.)

China’s public hospitals would collapse without the rampant bribery involving underpaid doctors and administrators, according to a Reuters review. New doctors earn $490 per month, the same as cab drivers, and without bribes would simply walk away from medicine. Patients are often expected to pay doctors extra in cash to ensure successful outcomes and to skip the line of waiting patients.

Sponsor Updates

  • e-MDs recognizes six of its clients selected by ONC as either as an Healthcare IT Champion or Meaningful Use Vanguard.
  • Black Book Rankings ranks Vitera the top ambulatory EHR in its user satisfaction survey. Other HIStalk sponsors earning high marks include Care360 Quest, Greenway, GE Healthcare, Kareo, Allscripts, McKesson, and eClinicalWorks.
  • First Databank releases the FDB High Risk Medication Module to help users identify medications designated as high risk by the FDA and with a Risk Evaluation and Mitigation Strategy (REMS) requirement.
  • Aspen Advisors Principal Dawn Mitchell discusses how to build a technology roadmap for emerging value-based care modules in a CHIME College live Webinar.
  • Jessica Clifton, product marketing manager for Billian’s HealthDATA, offers predictions of which healthcare skills will be in demand over the next decade.

EPtalk by Dr. Jayne


My “meeting of the week” award goes to our internal discussion on upcoming changes to the NCQA Patient-Centered Medical Home program, due to launch next spring. New proposed standards call for better integration between behavioral health and primary care. It seems like most of our time in primary care is spent in some flavor of behavioral health anyway – even when dealing with chronic conditions such as hypertension, diabetes, and hyperlipidemia, many of the best solutions are behaviorally driven rather than pharmaceutically derived.

This fifth version of the PCMH recognition program also aims to reduce duplicative testing, focus resources based on patient need, and emphasize outcomes. It sounds a lot like old-time family doctoring, when we aimed to treat what could be fixed as efficiently as possible and not waste resources when they wouldn’t change things.

Somehow I don’t think it’s going to be that easy, though. NCQA accepted comments (limited to 1,800 characters each) until a few days ago. The funniest comment was by my colleague who didn’t find out about the comment period until today, saying he was sorry he missed the opportunity to demonstrate the heightened abbreviation skills he’s mastered after a decade of using EHRs with character limits.

CMS will host a July 30 Webinar on one my favorite topics: Administrative Simplification. All medical students and residents should have to sit through a session like this so that they can see what they are really getting themselves into. If I had any idea how much I would have to learn about medical billing and other non-clinical arenas just to get by, I might have taken my sibling’s offer to pay for the LSAT exam a little more seriously.

Speaking of things that make physicians go “hmm…” the Washington Post runs a piece on doctors’ pet peeves. Items at the top of the list include patients talking on cell phones, late arrivals, no-shows, failure to share all information, lying, asking physicians to commit fraud, and “by-the-way” questions at the end of visits. I recently started moonlighting at a new emergency facility that is very busy and I’m trying to put a positive spin on the exhaustion. Maybe patients talking on the phone when you’re trying to interview them is a good thing – it’s a quick and easy indicator that you have time to run to the bathroom before you see them.

CMS releases the 2015 PQRS Payment Adjustment Fact Sheet, which my billing colleague dubbed “the penalty page.” Read and enjoy!


The MGMA Annual Conference is coming up in San Diego. Inga texted me the other day to see if I was ready to try to beat last year’s record for most parties attended by two bloggers in a single evening. Unfortunately, I’ll be sitting for the new Clinical Informatics board exam that week so I had to let her down gently. Hopefully I made up for it, though, by sharing the happiest bow tie I’ve seen this summer.



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

More news: HIStalk Practice, HIStalk Connect.


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July 25, 2013 News 2 Comments

News 7/24/13

July 23, 2013 News 1 Comment

Top News

A report finds that 81 percent of medical practice respondents who previously said they planned to eventually replace their EHR will actually do it within the next 12 months.

Reader Comments

7-23-2013 10-01-01 PM

inga_small From Boots: “Re: Quality Systems/NextGen. As a long-time client I don’t know what to make of the situation there. Sometimes the company’s actions make no sense. They seem to be managing to distractions and not to vision or mission. As to the rumors that NextGen is looking for a buyer, I’m not sure they will find one who will meet the shareholders’ often unrealistic expectations.” A couple of industry insiders tell me they believe NextGen is ripe for acquisition, given recent declines in net new software sales and uncertain positioning in the replacement market. A big vendor, such as Siemens, may be interested in them to gain market share. Alternatively a PE firm may pursue them with the intent to clean house, increase revenues, and eventually spin off.

From ShowMe: “Data breach lawsuit. It should be interesting to see what happens in the lawsuit against the federal government following the loss of a VA laptop. Am I the only one who thinks the government is showing a little chutzpah with its argument that the suit should be dismissed since there’s no proof of identity theft … yet?  The government should spend its energy encrypting devices and quit asking our veterans to find a smoking gun.” Details on the lawsuit and the motion for dismissal are here.

Acquisitions, Funding, Business, and Stock

7-23-2013 9-48-19 PM

CTG announces Q2 numbers: revenues up 0.4 percent from a year ago, EPS of $0.24 versus $0.25. The company notes that earnings growth in 2013 will be less than originally expected due to hospital clients dealing with “reimbursement reductions caused by the US federal budget sequestration.”

7-23-2013 9-49-14 PM

GE reports that its healthcare division logged a five percent increase in Q2 profit, though revenue was flat.

7-23-2013 9-51-05 PM

HealthStream reports Q2 results: revenue up 24 percent, EPS flat, but beating estimates by a penny. Shares hit an all-time high Tuesday with an 11.4 percent jump, up 60 percent since mid-April.

7-23-2013 9-52-04 PM

Lexmark reports good Q2 results, with revenue of its Perceptive Software business unit up 34 percent as the company transitions out of the inkjet printer business and into services.


7-23-2013 10-03-00 PM

Catholic Health Initiatives selects Conifer Health Solutions to provide population health management and data analytics tools.

Hospital Sisters Health System will deploy iSirona’s device connectivity solution in nine of its hospitals.

Whittier IPA (MA) contracts with Alere Accountable Care Solutions to build a community-wide HIE.


7-23-2013 5-59-21 PM

Culbert Healthcare Solutions hires Jaffer Traish (Zynx Health) as director of Epic consulting.

7-23-2013 3-29-31 PM

AHIMA appoints Meryl Bloomrosen VP of thought leadership, practice excellence, and public policy.

7-23-2013 6-56-08 PM

Encore Health Resources names Anne Dillon (Oracle) as client services executive for Southern California, New Mexico, and Arizona.

Announcements and Implementations

Surescripts expands its clinical messaging capabilities to users of Greenway, Inofile, SCI Solutions, and SOAPware.

The Colorado RHIO reports that with the addition of Exempla Healthcare, all of the state’s 100+ bed hospitals are connected to the HIE or are in the process of connecting.

7-23-2013 3-31-24 PM

Fairfield Memorial Hospital (SC) goes live on Cerner in September.

7-23-2013 3-36-05 PM

Atlantic General Hospital (MD) joins the Delaware HIN, becoming the first acute care hospital in the country to join an HIE located in another state.

Health Catalyst introduces Health Catalyst 2.0, which offers improved automation of metadata gathering from multiple IT systems and includes new content-driven applications for the enterprise data warehouse platform.

Government and Politics

7-23-2013 2-47-36 PM

inga_small ONC posts a progress report highlighting the steps taken since 2011 to implement the federal government’s strategic plan for using HIT to improve health and healthcare. We aren’t there yet, but in toto, the achievements to date are impressive.

In Australia, The Alfred Hospital reports that a university-created trauma decision support system reduced ED errors by 21 percent. It displays vital signs, captures the encounter on video, and incorporates 40 algorithms pertinent to the first 30 minute of a trauma case.


The NYC Economic Development Corp. names Kinsa the winner of its Innovate Health Tech NYC competition for its smartphone-connected thermometer that allows patients to track illness history, share details with physicians, and manage their illness.

Children’s Health Fund launches a telemedicine-enabled mobile clinic for underserved children in Miami on Thursday, July 25.


7-23-2013 6-33-31 PM 7-23-2013 7-44-47 PM

Travis from HIStalk Connect spotted a Nordic Consulting billboard at the Verona, WI exit for Epic. He sees this as the next advertising beachhead outside of the Madison airport security checkpoint and wonders if blimps and skywriting planes are being engaged for Epic’s UGM. The Epic campus photo on the right is from Steve Knurr of Vonlay, just in case you wondered how nice summer days are in Wisconsin.

Sisters of Charity of Leavenworth Health System sues hospital operator Prime Healthcare Services, to which it sold two Kansas hospitals earlier this year. SCLHS says Prime is using its billing software illegally and hasn’t handled patient billing as required by the sales agreement.

Healthcare costs not only bankrupt large numbers of US citizens, they appear to be on track to bringing entire cities to their financial knees. Detroit’s bankruptcy filing raises the possibility that Chicago could be next, with both cities struggling under the weight of underfunded retiree benefits. Chicago probably won’t get much help from the the state since Illinois has a $97 billion pension shortfall of its own. A large chunk of the underfunding is due to medical costs, with a recent study concluding that 61 major US cities have enough money to cover only six percent of their healthcare liabilities. Baltimore’s overly generous retiree healthcare obligations have caused the city to run up a debt of more than $10,000 per household.

Children’s Hospital Los Angeles (CA) will host the third annual Meaningful Use of Complex Medical Data Symposium on August 16-17. It connects clinical researchers and practicing physicians to big data computer experts with the goal of gaining medical insights from electronic information.

Weird News Andy says this doctor failed the “first do no harm” credo and wonders what the second one is. A Nebraska medical resident pleads not guilty to killing four people after being dismissed from the program.

I had some technical problems with Vince’s HIS-tory this past weekend that I didn’t have time to fix for the Monday Morning Update, so here is the belated Part 2 of Siemens.

Sponsor Updates

  • Consulting firm The HCI Group is named Northeast Florida’s fastest-growing company of 2013, with 1,301 percent average annual revenue growth since 2010.
  • NextGen will offer LDM Group’s healthcare messaging platform to its NextGen EHR clients.
  • The Orange County Register profiles Kareo and deems it a “most promising” company.
  • ADP AdvancedMD offers an on-demand Webinar outlining ways private physicians can save their practices.
  • Nuesoft Technologies changes the name of its Nuetopia product to NueMD Medical Billing Services and its Nuesoft Xpress offering to NueMD for Student Health.
  • Ping Identity joins the Cloud Security Alliance Security, Trust & Assurance Registry.
  • NextGen will integrate is Ambulatory EHR with Florida Blue and Availity to make patient-specific clinical information available at the point of care to both providers and payers concurrently.
  • Gartner places Informatica Corp. in the leaders quadrant in its 2013 Data Integration Magic Quadrant report.
  • Intelligent Medical Objects reports that 2,500 hospitals have licensed its interface terminology services, including new customers Catholic Health East (PA), Hospital Corporation of America (TN), Avera Health (SD) and Christus Health (TX).
  • Baystate Medical Center (MA) uses data derived from PeriGen’s PeriBirth EHR to calculate reductions in unnecessary inductions, C-sections, and NICU admissions.
  • First Databank will provide Geneix with its drug knowledge and clinical decision support solution.
  • SGS Life Science Services selects Merge eClinical OS for Phase I-IV studies.
  • Coeur d’Alene Pediatrics (ID) shares how its implementation of Vitera’s EHR, PM, and patient portal solutions led to $300,000 in MU incentive payments and resolved business challenges.
  • Medicity client Vermont Information Technology Leaders shares details of its successful HIE.
  • CoverMyMeds reports that its five millionth prior authorization request was received this week and that the site is now processing 25 percent of all prior authorizations submitted annually in the US.


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

More news: HIStalk Practice, HIStalk Connect.


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July 23, 2013 News 1 Comment

News 7/17/13

July 16, 2013 News 9 Comments

Top News

7-16-2013 8-47-36 PM

A Massachusetts eHealth Collaborative-sponsored study finds that EHR adoption by doctors in three communities generated no statistically significant per-member, per-month cost savings, although EHR usage appeared to be associated with less-rapid cost increases. Participating communities were chosen as having the highest likelihood of EHR success by MAeHC, which also paid most of their system and implementation costs. The most commonly used systems were from Allscripts, GE Healthcare, eClinicalWorks, and NextGen. Insurance cost information from 2005-2009 was used.

Reader Comments

From Jessica: “Re: speakers. I love HIStalk and am an avid reader. Can you recommend speakers that you’ve seen and liked?” I haven’t heard many lately, so I will defer to readers. Who stood out?

HIStalk Announcements and Requests

7-16-2013 6-45-28 PM

HIStalk’s seven millionth visit was logged Tuesday morning. Thanks for contributing to that number.

7-16-2013 7-29-37 PM

7-16-2013 7-43-36 PM

Welcome to new HIStalk Platinum Sponsor CareWire. The Excelsior, MN-based company’s mobile solution improves outcomes and loyalty by engaging patients in timely communication that is tailored, thoughtful, and relevant. It sends mobile messages that are encounter-specific, personalized, and perfectly timed: patient instructions, arrival information, and links to services or provider-specific content. The result for providers is a reduction in the cost of no-shows, fewer manual interventions, and improved outcomes and reduced risk. According to the executive director of an outpatient surgery center, “CareWire is like air traffic control for my patients.” The SaaS-based solution requires minimal interfacing – just send it a daily flat file and it’s happy. CareWire’s proprietary rules engine identifies the patients and their mobile numbers, determines the appropriate messages to send, and allows authorized users to send their own messages directly to patients. Templates are provided for appointments, procedures, and case-based episodes that span visits and procedures. Thanks to CareWire for supporting HIStalk.

7-16-2013 7-54-16 PM 7-16-2013 7-58-45 PM

I’m really enjoying Pepperland, a fun novel about music, anarchy, computers and sexual freedom in the 1970s. The Amazon reviews include a quick one I wrote that compares its detail, in-jokes, and pop culture to something Stephen King would have written without his bloated excess and often ridiculous supernatural themes. The author is the amazing Barry Wightman, writer, musician, voiceover guy, and VP of marketing for Forward Health Group. I hardly ever read fiction because it usually annoys me and I have a microscopic attention span, but Pepperland is a blast.

7-16-2013 8-06-31 PM

I usually notice when a company is proud enough of sponsoring HIStalk that they say so on their Web page. The iHT2 folks do and I appreciate it. I keep thinking I’ll attend one of their Summits since readers have told me good things about them.

Acquisitions, Funding, Business, and Stock

7-16-2013 8-50-26 PM

Healthcare analytics provider ArborMetrix closes $7 million in Series B financing.

Ping Identity closes a $44 million investment round.

Caremerge, a developer of communication and care coordination apps for seniors, raises $2.1 million in Series A funding.

7-16-2013 6-34-49 PM

Reed Elsevier Group will move  Elsevier/MEDai to its LexisNexis Risk Solutions business unit, where it will join the acquired EDIWatch as a fraud and abuse solution.

NPR profiles Cerner in an EHR series it’s running, pointing out its HITECH-fueled employment boom in which 3,000 employees were hired in the past two years.


7-16-2013 8-54-14 PM

Winthrop-University Hospital (NY) chooses PeriGen’s PeriCALM Plus charting and fetal monitoring system.

Celebration Orthopaedic & Sports Medicine Institute (FL) selects simplifyMD’s EHR/PM system for its 10 providers.

7-16-2013 8-52-52 PM

Pacific Alliance Medical Center (CA) will implement Summit Healthcare’s Express Connect interface engine.

Wishard-Eskenazi Health (IN) selects eClinicalWorks PM for 385 providers across eight locations.

Harris Corporation will use Symedical Server from Clinical Architecture to enhance terminology management, interoperability, and data normalization in its HIE and clinical integration solutions.

The Scarborough Hospital (Ontario) selects SIS.

Canada’s Fortius Sport & Health will implement EMR and PHR technologies from Telus.

7-16-2013 8-57-23 PM

Georgia Regents Health System (GA) signs a 15-year, $300 million contract with Philips Healthcare for consulting services, medical technologies, and operational performance, planning, and maintenance services.


7-16-2013 5-26-59 PM

Anthelio appoints Asif Ahmad (McKesson Specialty Health, Duke University Health System) CEO, replacing co-founder Rick Kneipper, who will remain as chief strategy and innovation officer and chair of the company’s healthcare innovation council.

7-16-2013 6-05-08 PM

Bruce Brandes (AirStrip) joins Valence Health as EVP for growth and innovation. David Kirshner (Boston Children’s Hospital) also joins the company as VP of corporate and business development.

7-16-2013 7-20-05 PM

PathCentral, which offers a online information exchange and digital consultation forum for pathologists, names David Frishberg, MD chief medical advisor. He will continue in his pathology roles with Cedars-Sinai Medical Center.

Announcements and Implementations

Michigan Health Connect becomes the state’s first HIE to transfer infectious disease lab reports from hospitals to the state health department.

7-16-2013 12-54-25 PM

HIMSS introduces the HIMSS Health IT Value Suite, a knowledge repository that classifies, quantifies, and articulates the clinical, financial, and business impact of HIT investments. In reading the press release and details on the HIMSS Website, it appears that HIMSS is positioning it as an industry resource as opposed to a product or service available for purchase.

MModal rebrands its Philippines-based medical transcription provider MxSecure to MModal Global Services.

Southern Health NHS Foundation Trust deploys SEIM and content security technology from Trustwave.

Open Door Center for Change (WI) installs Forward Health Group’s PopulationManager.

NCH Healthcare System (FL) completes its implementation of Cerner this week.

7-16-2013 7-27-42 PM

Deep Domain releases Version 3.0 of its EHR reporting software. It charges $78 per provider per month for a reports subscription.

AHIMA and CHIME announce plans to join forces in conducting HIM/HIT research, presenting sponsored Webinars, co-presenting sessions at CHIME’s Fall CIO Forum, and working together on advocacy issues.

Government and Politics

Only 18 of the 32 first-year Pioneer ACOs reduced Medicare costs in their first year, though all improved their quality measures. Seven of those that did not produce savings say they will switch to the Medicare Shared Savings Program, while two others will leave the program entirely. While the Pioneer program rewards providers for shared savings, the majority of a provider’s patients are likely still covered by traditional fee-for-service contracts.

National Coordinator Farzad Mostashari, MD, interviewed by NPR: “Paper works just fine if you want to deliver healthcare the way you sell shoes. If you want to wait in your office for the door to open and say, jingle, jingle, and you say, can I help you, and pull a chart and deliver care, and then when you close that chart, that information is dead, paper works just fine. If you want to coordinate care with other providers, if you want to share information with the patient and engage them as partners in their own care, paper doesn’t work just fine.”

Innovation and Research

7-16-2013 6-54-47 PM

A video by Vonlay’s Steve Knurr, Google Glass Explorer, records cycle racing using the device. He plans to help develop a heads-up cycling display that will include bike telemetry, biometrics, and race information.

It’s not all Google Glass in the computing eyewear field. Italy-based GlassUp, running its launch campaign on Indiegogo, will offer a camera-free and more stylish alternative that will cost only $399 ($299 as a Indiegogo donation, or $1,500 for 10 pairs right off the first production run.) They will also offer a prescription version for those who already wear glasses.


7-16-2013 2-46-56 PM

A Wolters Kluwer Health survey finds that changing reimbursement, financial challenges, and finding time to spend with patients are the top challenges facing doctors.

The healthcare business intelligence market lacks a clearly perceived leader, according to a KLAS report. Large BI vendors such as IBM, SAP, Microsoft, and Oracle command the largest mindshare, but the lack of sufficient healthcare focus leaves most providers with unmet needs.

7-16-2013 8-59-00 PM

US News & World Report releases its annual hospital rankings. Johns Hopkins (above) reclaimed the top spot, followed by Mass General, Mayo Clinic, Cleveland Clinic, UCLA Medical Center, Northwestern, New York-Presbyterian, UCSF, Brigham and Women’s, UPMC, HUP, Duke, Cedars-Sinai, NYU, Barnes-Jewish, IU Health, Thomas Jefferson, and University Hospitals Case Medical Center.

7-16-2013 6-24-34 PM

The top administrator of a Georgia cancer treatment center files a whistleblower lawsuit claiming its health system owner overcharged the government by upcoding claims. It also charges that Columbus Regional Healthcare System essentially pre-paid a referral kickback by intentionally overpaying for a local cancer center it bought for $10.5 million; that its medical director modified the medical record to justify higher charges because he was upset at a potential income loss caused by regulatory changes; and an insurance company executive who sat on the hospital’s board threatened to withdraw his financial donations to the hospital if the medical director were to leave in a contract dispute.

A Wall Street Journal article covers hospitals that use big data, specifically The Advisory Board Company’s Crimson platform, to encourage higher-quality, lower-cost physician behavior by showing doctors how they compare to their peers. 

7-16-2013 7-09-31 PM

A labor publication editorial written by a union-represented RN complains that EMRs “are getting in the way of the fundamental work nurses do.” She says that the union understands benefits of EMRs, but doesn’t want nurses “to become lost in the land of acronyms, drop-down menus, non-existing options, and endless grey pages in which endless boxes must be clicked.” She concludes that her employer needs to replace McKesson Paragon with a system that “fulfills both the legal compliance needs and the needs of the patients who are hospitalized for competent, attentive, and effective nursing care” The author has previously argued that nurses should work for independent agencies rather than directly for hospitals.

7-16-2013 6-29-32 PM

The Judy Maple Foundation will hold a charity golf tournament on July 27 in East Springfield, OH hoping to raise money for the Charity Hospice of Wintersville to replace outdated computers for use with its EMR.

Sponsor Updates

  • Aventura is named as one of 10 Denver startups with cool offices, complete with pinball machines, a gym, and healthy food. 
  • Beacon Partners hosts a July 26 Webinar on optimizing clinical systems.
  • IHE USA and ICSA Labs certify eight HIT products under its pilot certification program to test security and interoperability in the IHE Patient Care Device or IHE IT infrastructure domains.
  • InstaMed announces the availability of its InstaMed Network, which allows providers to accept electronic payer and patient payments.
  • Levi, Ray & Shoup finalizes its purchase of Capella Technologies.
  • Kareo outlines five ways it can help users prevent denials.
  • Emdeon will integrate the Simplicity Settlement Services by ECHO into the Emdeon Payment Network. The company also introduces Virtual Card Services, an electronic payment option to reduce payment distribution costs and payment processes.
  • KLAS Research adds MModal Fluency Direct to its customer rankings.
  • BayCare Health System CIO Tim Thompson shares his organization’s experience implementing Medicity’s HIE platform.
  • The Nashville Business Journal profiles Shareable Ink CEO Laurie McGraw.


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

More news: HIStalk Practice, HIStalk Connect.


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July 16, 2013 News 9 Comments

Monday Morning Update 7/15/13

July 14, 2013 News 7 Comments

7-14-2013 7-04-39 AM

From Flyswatter: “Re: Practice Fusion. Running out of money, expanding, or both?” Free, ad-supported EMR vendor (are you a vendor if your product doesn’t cost anything?) Practice Fusion is rumored to be raising another $60 million after a $34 million round held less than a year ago.

7-13-2013 6-38-03 AM

Three-quarters of respondents say healthcare organizations should continue with their plans to buy software in preparation for Affordable Care Act-related changes even though the future of the ACA is uncertain. New poll to your right: how has the DoD/VA discussion about a shared EHR changed your perception of those organizations?

7-14-2013 7-06-53 AM

I mentioned last week that it would be fun to hear from folks who have been reading HIStalk since the beginning 10 years ago. Some replies:

  • ”I know I’ve been reading your stuff since the beginning for sure. I think a friend of mine referred the site to me, but I can’t remember who and/or exactly when… all I know is that now you can’t get rid of me.”
  • “I count you as one of my celebrity acquaintances.” [this tongue-in-cheek comment came from someone who knows me]
  • “I found HIStalk while searching for a primary source of unbiased information about the healthcare IT world. I found HIStalk to be one of the few outlets at the time willing to publish all things healthcare IT (good, bad and the ugly) and provide value to sponsors and readers alike. It’s been wonderful watching HIStalk grow with the healthcare IT industry. Congratulations!”
  • “In 2003 I worked for Eclipsys, and one of our sales reps asked if I read HIStalk. He said it was the best blog about the industry he had ever read, and that if I wanted to be in the know and feel hip at the same time, I should check it out.  And so I did. And stayed. Congratulations!”

HIStalk Webinar Monday, July 29

7-14-2013 9-05-04 PM

Jonathan Teich MD, PhD of Elsevier will present “Clinical Decision Support: The Promise, Pitfalls, and Practicalities” on Monday, July 29 from 2:00 to 2:45 p.m. Eastern. He will provide practical insights into the key success factors for selection, design, management and rollout of CDS interventions and will describe 10 types of CDS and how to apply them. My CIO reviewers who provided feedback on the rehearsal gave this Webinar rave reviews, with one of them saying he was so engrossed by the CDS examples that he wished it had lasted 30-45 minutes longer (when’s the last time you heard that about a Webinar?) I thought it was really well done myself. You can register here.

Also upcoming: “Five Steps to an Enterprise Imaging Strategy,” presented by Merge Healthcare, on Wednesday, July 24 from 3:00 to 3:45 p.m. Eastern.

These Webinars meet HIStalk’s standards for quality, clarity, and attendee value. They have been critiqued by experts and are moderated by folks who work with me.

7-14-2013 8-17-14 AM

Six people lose their jobs for inappropriately viewing electronic patient records at Cedars-Sinai Medical Center, possibly those of Kim Kardashian. Four employees of community physician practices were found to have been using the login credentials of their physician employer and were dismissed, along with a medical assistant and an unpaid student research assistant. The journalistically rigorous TMZ decided that a phony quote and Photoshopped picture were the perfect way to illustrate its uncredited rumor, which was repeated by traditionally privacy-indifferent press anxious to jump on the celebrity gossip bandwagon without appearing to be pandering to intellectual lightweights.

7-13-2013 8-55-36 PM

Another nurse union uses an EMR implementation to publicly criticize a health system. The California Nurses Association cites 100 reports from RNs claiming Sutter Health’s $1 billion implementation endangers patients of Alta Bates Summit Medical Center. The nurses say the system requires too much nursing time, delays care, and isn’t clinician friendly. The union wasn’t nearly as concerned about patient safety eight weeks ago when it ordered its nurses to walk off the job for seven days in those same Sutter East Bay facilities to protest a reduction in their health benefits.

Intermountain Healthcare says it has developed an EHR module that allows state death certificates to be completed automatically.

7-14-2013 8-49-45 AM

A Silicon Valley business newspaper profiles former professional quarterback Steve Young, now a private equity deal-maker for HGGC (formerly Huntsman Gay Global Capitalist). The article says he was involved in that private equity firm’s investment in Sunquest, which it later sold to Roper Industries.  

A dozen employees from the Raleigh, NC offices of Allscripts volunteered to help clean up tornado damage in Moore, OK and presented the local hospital with a check for $50,000. Allscripts covered all of their expenses and paid their full salaries.

7-14-2013 8-55-20 PM

Ivo Nelson’s Next Wave Health advisory and investment firm will announce Monday that former Steward Health Care CIO Drexel DeFord has joined the company as a principal advisor.

7-14-2013 8-50-48 AM

Shares of athenahealth jumped 20 percent on Friday after the company filed SEC documents disclosing a June 30 deal with Ascension Health Network’s physician segment, which will deploy the company’s system to its 4,000 providers and affiliates. Athenahealth’s market cap is now $4 billion, with Jonathan Bush holding shares worth $33 million. A $10,000 investment in ATHN shares on this day three years ago would be worth $48,000 today.

Also earning a spot on the Nasdaq’s top percentage gainers for Friday were WebMD (up 25 percent on its sales outlook) and Quality Systems (up 12 percent on an analyst’s upgrade).

7-14-2013 7-08-48 AM

Showing his HIStalk colors at the top of Mt. Bachelor in Oregon is Dean Sitting, PhD, professor of biomedical informatics at UT Health Science Center in Houston.

Maybe it’s just me: every time I get an e-mail survey from HIMSS, I dutifully start completing it, but then bail out in annoyance just a few questions in. Every HIMSS survey is way too long, has endless answer choices but often not the one I need, and uses a stiff and authoritarian tone that makes me feel like I’m dealing with IRS instead of an organization to which I voluntarily pay dues out of my own pocket.

Blue Cross Blue Shield of North Carolina is called out for sending out live patient data to software developer DST Systems for testing its systems. Cigna went on record saying it would never do that, while Aetna said it shares data in similar situations.

Brown University researchers create software that can analyze the cries of an infant, hoping that the 80 auditory parameters can detect developmental problems.

An interesting New York Times opinion piece questions whether clinical drug trials work, wondering if disease and response is so individualized that mass testing creates more frustration than usable knowledge. It says drug companies are just playing the lottery in testing drugs they don’t expect to be effective, hoping for a statistical miracle. It also says that nearly every study is biased from the outset because drug companies pay for them, turning them into a “straw-man comparator” of drug vs. placebo instead of a real quest for finding the best treatments. The healthcare IT connection: genomics, which could effectively match patients with drugs likely to benefit them.

Vince starts his history of Siemens in this week’s HIS-tory. He is trying to find the lost history of the IBM SHAS (Shared Hospital Accounting System), so if you know more than what’s on Vince’s slides, he would enjoy hearing from you. Vince loves this stuff and his enthusiasm and fun memories come through loud and clear in his HIS-tories.

Sponsor Updates
  • Intelligent InSites will host a July 25 Webinar, “The Hospitality Environment” – Improving the Patient Experience with Innovative Technology.”
  • O’Reilly’s Strata Rx Conference, “Data Makes a Difference,” offers HIStalk readers a 20 percent discount on registration through August 15. It will be in Boston September 25-27 and feature speakers from athenahealth, Valence Health, HHS, and Humedica.


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

More news: HIStalk Practice, HIStalk Connect.


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July 14, 2013 News 7 Comments

News 7/12/13

July 11, 2013 News 7 Comments

Top News

7-11-2013 8-30-30 PM

DoD and VA officials tell the House Armed Services and Veteran Affairs Committees that they will focus on creating a system that will display standardized information from both organizations instead of pursuing an integrated health record now estimated to cost $28 billion. DoD also announces that it will tender bids for replacement of its AHLTA, CliniComp Essentris, SAIC CHCS, and TMDS systems. Video of the hearing is here, although a lot of it involves the famous claims backlog. The DoD people are grilled at around 45:00 as to why they are ignoring the President’s mandate for an integrated record and are instead off shopping commercial software for themselves. The answer is not nearly as direct as the question, although in an interesting moment, DoD Undersecretary Frank Kendall disputes a quote about his department’s intentions and criticizes the source as “entirely incorrect,” only to be told that the quote came from the Secretary of Defense.

Reader Comments

7-11-2013 8-21-30 PM

From Lance Boyles: “Re: HCA. Just consolidated its IT staffing vendor list to just Zycron, Robert Half Technology, and Insight Global. TEKsystems, shockingly, did not make the cut even with its long-term, high-value corporate relationship.” Unverified.

7-11-2013 6-23-28 PM

From Punditry: “Re: Senate Finance Committee. Has called Farzad Mostashari, MD from ONC and Patrick Conway, MD from Center for Clinical Standards and Quality to testify at a July 17 hearing called Health Information Technology: A Building Block to Quality Care.”

From Fresh: “Re: CIOs fired during or after an Epic install. I was curious on your take.” CIOs do indeed get fired during or after their installs of Epic … and Cerner, Allscripts, Meditech, and every other system out there. My take:

  • You hear about the Epic ones because, by definition, they are the highest-profile hospitals and CIOs, and the high cost of their implementation projects increases the risk of being made a sacrificial lamb when things don’t go smoothly.
  • Epic takes quite a bit of time to install because it’s usually replacing most major systems, and with CIO turnover being what it is, there’s a good chance that some CIOs will leave in those years purely by chance.
  • Some hospitals want an Epic-experienced CIO knowing the many millions of dollars that are at risk and — either at their own initiative or because Epic identifies potential problems — decide to make a change.
  • I would hope that hospitals don’t put the CIO in charge of the project since that’s a big mistake, but I would also hope that the CIO and IT department don’t let the Epic train roll over them by being anything but ecstatic over a project that has already been embraced with possibly irrational exuberance by operational leadership.
  • When you read about high-profile Epic failures, I would bet you any amount of money that the risks were spelled out well in advance in the extremely detailed (and blunt) executive status reports that Epic provides regularly, which means the facility probably either ignored its recommendations or wasn’t functional enough to fix the noted problems. If those chips fall on the CIO, hilarity will not ensue.

From Deep Thoughts: “Re: EHR usability. It’s one piece of a complex puzzle. I’ve worked with EHRs that are loved by physicians, but lack basic capabilities, like allergy checking if a medication name is spelled wrong. Per this quote about the stethoscope from 1834, there is resistance to change, and the key is channeling it into systemic improvements.” The 1834 stethoscope quote: “It will never come into general use, not withstanding its value; it is extremely doubtful because its beneficial application requires too much time and gives a good bit of trouble both to the patient and the physician because its character is foreign and opposed to all of our habits and associations.”

HIStalk Announcements and Requests

inga_small Recent highlights from HIStalk Practice include: a reader wonders how EMR requirements differ between small and large practices. The American Academy of Ophthalmology will implement an eye disease patient database. A third of physician executives think healthcare costs rise when hospitals buy physician practices. CMS proposes paying providers for non-face-to-face care of patients with multiple chronic conditions if the provider uses a certified EHR. ONC’s Farzad Mostashari, MD predicts an uptick in full EHR adoption in 2014 just before providers risk penalties for not meeting MU standards. Federal financial incentive programs have spurred e-prescribing adoption. Brad Boyd of Culbert Healthcare Solutions offers recommendations to avoid impacting cash flows when prepping for ICD-10. Reading HIStalk Practice may not be a cure for the summertime blues, but it is a cool way to catch up on the latest ambulatory HIT news. Thanks for reading. 

7-11-2013 6-27-29 PM

Earn HIStalk Karma Points by: (a) signing up for spam-free e-mail updates; (b) searching or navigating your way to finding the offerings of HIStalk sponsors in the Resource Center; (c) finding a consulting firm painlessly by blasting your quickly-entered RFI to the companies of your choosing – including all of them as an option – via the Consulting RFI Blaster;  (d) connecting with us on Facebook, Twitter, and LinkedIn, including the HIStalk Fan Club that reader Dann set up in 2008 (happy five years, Dann!) that now has 3,200 members; and (e) sharing my amazement at the impressive roster of industry-leading companies that support HIStalk by perusing and occasionally clicking their ad to your right and telling them in person that you saw them on HIStalk. Thank you for reading, with extra gratitude to that handful of readers who were there with me when I started writing HIStalk in June 2003.

Actually, there may be more than a handful of 10-year readers out there, so if you’re one and would like to tell me how you found HIStalk in 2003 and why you’ve kept reading, that would be fun.

On the Jobs Board: Health Analytics Data Analyst, Senior Healthcare Policy Analyst, Marketing Specialist, Systems Administrator.

7-11-2013 6-41-58 PM

HIStalk Connect’s Dr. Travis and Kyle were at the Converge conference in Philadelphia this week, with Kyle on the right sporting Google Glass and Travis jealously wishing his plain old optical glasses were half as cool. A report from Travis is here.

Acquisitions, Funding, Business, and Stock

7-11-2013 8-18-42 PM

Allscripts announces that it expects Q2 bookings and contract backlog to increase 3 percent and 13 percent, respectively. That includes the just-announced $400 million services extension by North-Shore-LIJ Health System, which provided important validation that the company can meet the needs of a large health system.

7-11-2013 8-17-32 PM

In the same SEC filing, Allscripts announces that EVP of Sales Steve Shute, who joined the company in July 2011, will resign effective August 8, 2013 and will receive as severance his expected one-year compensation of $880,000.


Kindred Healthcare (KY) selects dbMotion create a single patient record.

Medical Center Hospital (TX) chooses Convergent Revenue Cycle Management.

7-11-2013 8-11-55 PM

Gundersen Health System (WI) will implement iSirona’s device connectivity solution.

The Specialty IPA of Kansas retains Wellcentive to facilitate clinical integration, manage P4P programs, and support its integrated network of primary care physicians.


7-11-2013 5-25-40 PM

Health Catalyst names Scott Holbrook (Medicity/KLAS) as a strategic advisor.

7-11-2013 12-13-59 PM

Bill Korn (Antenna Software) joins MTBC as CFO.

7-11-2013 2-54-14 PM

Scripps Health names Steven Steinhubl, MD director of its Digital Medicine program, tasked with leading the scientific evaluation of mobile health devices through the Scripps Translational Science Institute.

7-11-2013 5-29-27 PM

Systems Made Simple elects CFO Christopher Roberts to its board.

Acusis appoints Robert Parsons (Cerner) VP of strategic business solutions.

Announcements and Implementations

Nuance announces that 750 developers have joined its healthcare developer community.

The health IT program at the University of Texas at Austin and Jericho Systems will participate in an ONC-approved national pilot to explore advanced patient control over shared medical records and how patients can better control the release of their PHI when requested electronically from their providers.

Government and Politics

7-11-2013 1-43-11 PM

ONC issues an ONC Certified HIT mark for EHR technology that has 2014 edition certification requirements.

The HIT Policy Committee’s Information Exchange Workgroup issues preliminary recommendations on patient record queries and provider directions for Stage 3 MU.

Innovation and Research

Healthbox partners with BlueCross BlueShield of Tennessee to launch a new health IT accelerator in Nashville, joining its locations in Chicago, Boston, and London. The first class will start in September at the Nashville Entrepreneur Center.


Pixie Scientific develops a diaper that works with a smartphone app to detect possible UTIs, kidney dysfunction, and dehydration, transmitting its findings to a physician. The developers say the diaper also has potential as a consumer product and would likely cost about 30 percent more than regular diapers.

inga_small In contrast to the simple genius of this diaper, I was reminded yesterday just how far behind healthcare is. My new insurance carrier offers online access to an electronic image of the insurance card. I thought it was semi-brilliant of me to take a photo of the online image with my iPhone instead of printing it. It was easy to hand the pharmacy tech my phone so she could enter the numbers into their system. The doctor’s office, however, requires the actual card so they can scan it into their system. I would have been pleased two years ago to have my card scanned for a computer system instead of photocopied for a paper chart. Today I am annoyed because the doctor’s office was unable to think outside the box  and accept my electronic copy.


7-11-2013 2-13-04 PM

A HIMSS Analytics survey finds that network/architecture support and security are the jobs that most often require industry certification.

7-11-2013 6-33-59 PM

Indiana University School of Medicine and Regenstrief Institute endow a chair to honor informatics pioneer and LOINC inventor Clem McDonald, MD (left in the photo above). The first Clem McDonald Professor of Biomedical Informatics is Titus Schleyer, DMD, PhD, MBA, director of the Regenstrief Institute (right in the photo above).

HHS fines insurer WellPoint $1.7 million for exposing the medical information of 600,000 people in 2009-2010 due to Internet server security issues.

7-11-2013 7-47-52 PM

Texas Health Harris Methodist Hospital Fort Worth notifies several hundred thousand former patients that their medical information from the 1980s has been exposed when several microfiche pages are found in a park. The hospital says its disposal contractor, Shred-it, didn’t.

Friends of industry long-timer Milton Antonakos, who died along with his family in a plane crash in Alaska earlier this week, are welcome at a remembrance get-together at the Columbia, SC offices of Allscripts on Friday, July 12 (today) at 3 p.m. Inga will provide the RSVP information and location details if you e-mail her.

Citizens of a small town in Canada whose only doctor will be away on his honeymoon for six weeks are offered telemedicine services in the interim by the province to mixed reaction. According to one resident, “I did the doctor camera thing. Basically I diagnosed myself and he gave me a prescription. It was pretty impersonal.”

7-11-2013 7-36-15 PM

PCWorld, the only remaining print edition consumer computer magazine, publishes its last paper issue to focus on its online and digital editions.

7-11-2013 7-06-06 PM

Healthcare isn’t behind in technology, we’re just on the leading edge of security. The Kremlin, panicked by the release of electronic secrets by WikiLeaks and Edward Snowden, issues an RFP for electric typewriters of the specific German model above. Retro-secure fax machines and pagers can’t be far behind.

Sponsor Updates

  • Covisint expands its partnership program to enable organizations to resell, refer, or white-label Covisint Identity Services.
  • Beacon Partners will provide consulting expertise to help organizations using Information Builders’ BI and analytics solution.
  • Marshfield Clinic Information Services subscribes to the Capsite Database to assist with health technology procurement and purchasing.
  • CIC Advisory launches a blog entitled, “Think.Learn.Care.” or TLC, which profiles hospital leaders who are effectively using technology to improve the efficiency and effectiveness of patient care.
  • Emmi Solutions selects Truven Health Analytics as its preferred partner provider of patient discharge instructions.
  • Quest Diagnostics provides access to de-identified hepatitis C test results from its Health Trends national clinical laboratory database to the CDC for public health analysis.
  • T-System publishes an infographic depicting the MU history of its EV product.
  • University of Florida Health and Florida Hospital securely exchange PHI with the Florida HIE Patient Look-Up Service developed by Harris Corporation.
  • O’Reilly Strata RX Conference posts the schedule for its September 25-27 conference.
  • Surgical Information Systems discusses the role of IT in quality reporting. 
  • Billian’s HealthDATA Jennifer Dennard takes on Google and inaccurate hospital data. 
  • TeleTracking Technologies looks at patient care satisfaction and its impact on an organization. 
  • SpeechCheck’s Ken Schafer discusses the importance of accurately recording narrative data within the EHR.
  • Advanced Medical Imaging (CO) discusses how it increased point-of-care patient collections by 315 percent within a year of implementing ZirMed’s Patient Estimation solution.
  • Verisk Health announces details of its annual conference September 18-20 in Orlando.
  • Optum’s CMO Miles Snowden, MD discusses how to navigate the journey from providing care to managing health.
  • HMC HealthWorks will integrate the Healthwise Care Management solution into ProGuide, the HMC care management platform.

EPtalk by Dr. Jayne

7-11-2013 6-16-23 PM

Alberta Children’s Hospital has deployed a robot named MEDi to aid children receiving flu shots. Those who engaged with the robot reported less pain and distress than those who didn’t. The study involved 57 children with moderate to severe fear of needles. In addition to distracting patients, the robot also provides instructions for relaxation and deep breathing.

Nearly a third of “Pioneer” ACOs may opt out, with some joining the Medicare Shared Shavings Program instead. Some have been threatening to do so since a dispute over measures in March. Although CMS did make some changes, it may not have been enough. Pioneer ACOs have until next Monday to notify CMS of their plans to leave that model and until July 31 to apply for the Shared Savings Program.

Health Affairs looks at the reasons poor patients prefer hospitals over office-based care. Researchers from the University of Pennsylvania documented patterns where patients using less preventive care were more likely to become acutely ill and/or require hospital care, costing over $30 billion each year. Reasons cited by patients included hospitals being less costly and more convenient with better quality care. That’s a sad commentary on our clinic and safety net ambulatory systems.

7-11-2013 6-20-04 PM

Congratulations to HIStalk contributor Ed Marx, who reached the summit of Mt. Elbrus in Russia earlier this week.

Thanks to everyone who sent good wishes for my laboratory orders go-live this week. It went fairly well and the phone lines were pretty quiet. We rarely receive compliments, but sometimes not hearing complaints is enough to know we did the job right. It’s been a tiring week, nevertheless, so I’m keeping tonight’s piece short and going to bed early.


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

More news: HIStalk Practice, HIStalk Connect.



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July 11, 2013 News 7 Comments

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Reader Comments

  • Sara Coulter: Great work you are doing Chris! We need more medical informatics leaders like you to solve the quality and cost of care ...
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  • Leonard Smith, MD, MS: Chris, Great work by you and your team. With ePrescribing via EHRs and Surescripts Rx History, patient lab and diagnost...
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