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Monday Morning Update 10/21/13

October 20, 2013 News 15 Comments

10-20-2013 6-28-06 AM

From Across the Pond: “Re: Epic. Two large academic hospitals in Amsterdam, AMC and VUmc in The Netherlands, signed a contract with Epic last week.” Academic Medical Center has 7,000 employees, 2,300 medical students, 120 medical informatics students, and an annual volume of 26,000 admissions and 350,000 outpatient visits . VUmc, which cooperates closely with AMC, is affiliated with the other big university in Amsterdam. Wikipedia says The Netherlands has eight university medical centers and 10 large non-university hospitals.

10-19-2013 2-36-03 PM

From Jane Jetson: “Re: Weight Watchers. I received an email this morning owning to the fact that they had technical problems. Perhaps I should forward to Kathleen Sebelius so that Healthcare.gov could borrow the wording.” The problem with the government is that nobody is ever individually responsible for anything; the incompetence is collective. It would be unheard of to acknowledge that something isn’t working except for political gain, or to accept responsibility for anything but success. All of the professional bureaucrats are busy trying to hang onto jobs that must be pretty sweet given their ducking and covering to keep them.

From Kittanning: “Re: startups. Why don’t you cover more startups? That’s where the innovation will come from.” I cover startups that have interesting consumer-facing technology, but rarely those who are targeting hospitals. Reason: most of them think their great technology idea will offset the founders’ lack of knowledge (and lack of interest) about how hospitals and doctors work and who just want to cash in quickly rather than helping patients or providers. Newbies can’t come in guns blazing telling everyone in healthcare that they’ve figured it all out as a 30-year-old programmer turned self-proclaimed CEO, insulting those who have more years in healthcare than they’ve had breathing, and nobody in a position of enterprise IT responsibility is going to be impressed by swaggering overconfidence from unpolished newcomers who think they’re the next Steve Jobs just because they are as abrasive as he was. I’ve seen very few great startup ideas that have the potential to turn into anything more than a spare bedroom business, and of those, only a tiny percentage are being run by people on whom you’d make even a small bet as a customer or investor. Creating enterprise technology innovation, unlike writing cute iPhone apps, requires a lot more than a Foosball table and cases of Red Bull. I’ve seen company pitches, most of them naive and unskillfully prepared, and the commonalities are: (a) lack of money and of a realistic plan for profitability that will allow ever bringing their product to scale; (b) a low barrier to entry that virtually guarantees that any degree of success can quickly be replicated by competitors; (c) lack of realization that it takes a lot of skill, money, and time to connect your great idea to hospitals even willing to undertake a pilot, much less buy the product, and the lack of appreciation of just how long the hospital sales cycle is and how imitative their purchases are; (d) having no one on the team who has ever sold technology to hospitals or partnered with similar firms; and (e) lack of understanding that people bet on the jockey, not on the horse, and impressive developers usually don’t make impressive CEOs regardless of their level of hubris. Great ideas are  a dime a dozen; the hard work is the long, expensive slog trying to get traction with them, and if you are new to healthcare selling a product whose target customer is hospitals, it’s a near-certainty that you’re going to justifiably fail, with your only hope that a better company will buy yours before it splats to the ground. That’s not anti-innovation at work – it’s the reality that healthcare attracts a lot of flaky, poorly thought out startups that don’t deserve to succeed. Come back when you hit $1 million in annual revenue.

10-19-2013 3-46-16 PM

From The PACS Designer: “Re: Omate watch. Another watch, funded through Kickstarter, is now available for purchase starting at $249. The Omate TrueSmart Watch can be used as a phone with its Bluetooth capability while still being fully functional without the phone. This no-hands phone style of watch will surely be used in healthcare settings.”

From Expense Reports Gone Wild: “Re: consultants. I continue to get bothered by the number of submissions on the bills of consultants for coffee, snacks, lunch, dinner, beverages, protein bars, etc. Why is it that we as a customer are expected pay for all this sustenance? Is the $200+ hour not enough? I am fine with paying for folks to get from home to the location, but why has there been this tradition of paying for other than travel? I think it is time to begin to object to these costs. If we are going to be part of saving health care we can’t continue to exacerbate the issue with rampant unnecessary spending. I have heard all the arguments around inconvenience of travel and this to make up for that but then let the employer of that person eat the cost. The per diem fee doesn’t fly either — when I go to work, I have to pay for my food, just because work means getting on a plane doesn’t excuse one from that obligation. Convince me I am misguided.” I agree, but taking the counterpoint as a consultant might, I could make the same argument for buying $500K hospital CIOs cars, club memberships, travel of a questionably patient-valuable nature, and bonuses for doing the job they were already paid to do. I think the conclusion is that everybody gets to pass the literal buck down to the patient bill, and only recently did big hospitals worry about their inability to create enough charges to pass through the excessive costs.

10-19-2013 2-27-00 PM

The problems with Healthcare.gov are either due to (a) screwed-up government software bidding and contractor oversight , or (b) not unexpected for a rollout of that scope, say most poll respondents. New poll to your right: is the influence of private equity firms on healthcare IT positive or negative? Your answer doesn’t provide any context, so after you’ve voted, click the Comments link to explain.

10-19-2013 2-40-16 PM

Welcome to new HIStalk Platinum Sponsor Sentry Data Systems, which offers hospital pharmacy procurement, revenue cycle, and compliance solutions. Sentinel RCM manages financials, inventory, charge master, auditing, and order flow, allowing them to track drugs from the point of purchase all the way to billing. Sentrex helps hospitals manage their 340B contract pharmacy relationships to maintain compliance by using a proprietary rules-based engine to apply hospital policies and procedures, supporting both 340B and Own Use programs. These products run on the Datanex infrastructure platform that processes millions of transactions each day. Hospitals running a 340B drug program need specialized technology to avoid running afoul of a maze of regulatory and auditing challenges and Sentry is the company to call. Thanks to Sentry Data Systems for supporting HIStalk.

I cruised YouTube for more on Sentry Data Systems and found this pharmacy director testimonial.

10-19-2013 3-48-35 PM 

AtHoc is a brand new HIStalk Gold Sponsor. Over 200 hospitals rely on AtHoc for critical communication and personnel safety, turning their IP network into a closed-loop, multi-modal notification and communication system. Examples: protecting home health nurses with a smartphone duress/panic button, communicating with clinicians during IT downtime, and automating shift availability and filling processes. Above is a video on Kaiser Permanente’s use of AtHoc for staffing. Thanks to AtHoc for supporting HIStalk.

10-19-2013 3-04-35 PM

Athenahealth turned in unimpressive numbers that fell short of expectations Thursday, some but not all of them related to its Epocrates acquisition, but that didn’t stop shares from going on a tear after the announcement. ATHN hit an all-time high Friday and closed up 24 percent on the day at $130.83, valuing the company at almost $5 billion. Investors apparently ignored the financial results and instead were encouraged by a growing client base and an extended contract with PSS World that will put more salespeople on the ground pushing athenahealth offerings. Above is the one-year chart of ATHN (blue) vs. the Nasdaq (red). Jonathan Bush holds $40 million worth. From the earnings call, which is always informative whether you care about ATHN or not because Bush is willing to say what others won’t:

  • One large client, an ambulance company that was never named at that company’s request (but had to be Rural/Metro), went bankrupt even before going to pilot with athenahealth and “new leadership fired us.”
  • Like everybody else, athenahealth talks about population health a lot.
  • The company will roll out athenaKnowledge in 2014, which will provide financial and clinical decision support to physicians.
  • AthenaClinicals  can automatically make a note in the chart when patient prescriptions are filled, although so far that works in only about 23 percent of orders.
  • AthenaClinicals users who also use athenaCoordinator can exchange patient information via athenaNet with no additional interfaces or exchanges.
  • When asked whether athenahealth would gain or lose hospital business through consolidation, Bush replied, “I don’t know, dude. I assume we’ll win. I mean — the for-profit sector is where most of these mergers are going on that you’re talking about, and it’s a very rational sector. Most of the headwind we face in the enterprise world is with institutions who don’t view their bottom line as all that important. And their reputation as the bringer of great new physicians into the world and their reputation as the provider of procedures that no one else can provide, trump their abilities, their interest in asset efficiency. Now as we’ve said in past calls, we believe that asset efficiency is going to rise in appeal to even the most theoretical of academic medical centers as the pressure builds.”
  • According to Bush, “At some point, the idea of information being liquid across people who don’t own each other is a major trump card when you think of this tragic lemming march of acquisitions, doctors and hospitals marrying up in marriages of convenience, nothing wrong with doctors and hospitals marrying up in marriages of love, but this wave of kind of moony, large-scale marriages of convenience just to get information integrated when there is another way, to me, it’s sort of a profound megatrend to watch.”
  • When asked about hospitals using athenahealth products to control physician behavior, Bush said, “Well, I’ll tell you every proposal to a new enterprise today include a Google Map of all of the doctors that have admitting privileges at their institutions that are already on athenaNet. And those Google Maps are getting more and more dotty, lots and lots of little dots around their blue H. And the fact that now we don’t say we can direct, but we say, ‘Listen, hospital, do you want to — speaking of manifestos, do you want to get compliance via force or do you want to get compliance via love?’ … be the most high-quality, easy-to-do business with receiver of patient referrals. Be big and successful and survive this drought that’s coming by being the best, and that means being the most integrated, the most available … we don’t even need the tipping point for that, right? We could just show up and say, hey, you’re going to do a go-to-market strategy with your subsidized EMR the way poor Long Island Jewish did with Allscripts banging away, giving it away at red lights, trying to get the windshield wiper guys to give it away. Here, you got thousands of doctors paying for it, wanting it, and all you’ve got to do is light up your logo inside of the order screen.
  • On selling athenaClinicals to customers who already have an EMR, “I know the last time I looked, it was 40 percent of our clinical sales today were people throwing one out … you have a huge wave of folks who looked, went out and jammed the EMR thing because Obama told them to, and then they got to Meaningful Use day and they got nothing … Used properly, they’ll get you Meaningful Use. But doctors are not supposed to be using them properly. All they’re supposed to be doing is seeing patients … Nobody wants to go back to their Board of Directors or their Board of Doctor Owners and say, ‘Yes, so sorry but I convinced you spend thousands and at times, millions of dollars on something that I really want to throw out now.’ But it is what it is. It’s a cash-on-cash no brainer. You just have to go through the embarrassment.”

John Lynn did an ICD-10 Hangout on EMR & EHR Videos.

GE reports Q3 numbers: revenue down 1.5 percent, adjusted EPS $0.31 vs. $0.33, but train and plane sales along with aggressive cost-cutting helped the company exceed Wall Street’s expectations, sending shares to a five-year high. GE Healthcare’s sales were flat, but earnings rose 7 percent.

A series of Wisconsin Democratic Party focus group meetings identifies the two favored candidates for governor, one of whom is Judy Faulkner of Epic. The strengths the groups favored were a wealthy, politically outsider woman not from Dane or Milwaukee Counties with name recognition who hates everything about Republican Governor Scott Walker.  I don’t think I’d take the results too seriously since they seemed to favor celebrity status over political qualifications – the group’s other choice was just-retired Green Bay Packer and “Dancing with the Stars” winner Donald Driver.

10-19-2013 4-49-35 PM

Eric Topol, MD isn’t impressed with MD Anderson’s use if IBM’s Watson to undertake a “moon shot” aimed at eliminating cancer. He tweeted, “This ‘Ending Cancer stuff, while a laudable goal, is sending a wrong message to public.” He didn’t explain, but I assume he meant that cancer isn’t one disease and the likelihood of eliminating it, with or without Watson, is nearly nil. Prevention is more important than treatment, I conclude, but if MD Anderson thinks Watson can help eliminate cancer (or help it market itself to cancer patients, which bring it nearly $4 billion per year in revenue for treating cancer rather than preventing it), then it’s worth a shot, moon-worthy or otherwise, even if it does encourage minimally intellectual Americans to think that anything less than a cure is a failure.

10-20-2013 6-55-09 AM

Val Jones, MD (aka blogger Dr. Val) says that despite her previous support of digital data in medicine, EMRs are doing more harm than good. Her reason: data entry is “an enormous time-suck for physicians” that harms thoughtful interaction with patients that would allow a correct diagnosis and sensible treatment plan. She doesn’t like correcting offshore transcription, hospitals with large IT departments (“40 young tech support engineers were furiously working to keep the EMR from crashing on a daily basis”), and EMR-required data fields (she called out Allscripts, whose system requires the doctor to indicate for every discharge prescription whether the medication comes in a tablet or capsule, which the system knows full well but which has to be entered again to allow the inpatient EMR to accept the information). I think she might have aimed her wrath more precisely at the one hospital at which she apparently had a bad experience since what she describes is certainly not universal, but certainly some hospitals are exactly as she describes.

Peace River Center, a Florida non-profit psychiatric agency, is awarded a $30,000 United Way of Central Florida grant to implement technology that will allow its home case workers and clinicians to remotely connect to its EMR.

In Canada, Victoria County Memorial Hospital loses its telephone service and Internet connectivity when a construction vehicle severs cables, causing the hospital to cancel walk-in diagnostic and lab services.

Twitter’s just-announced November IPO may be tarnished by “Twitter quitters,” those who try the service but abandon it because they can’t figure it out or don’t find value in it. A new poll shows that 36 percent of those who sign up for Twitter don’t use it and 7 percent close their accounts, much worse numbers than for Facebook. According to an active Facebook user who stopped using Twitter, "I didn’t really get the point of it at all. Most of them were people I wasn’t interested in hearing what they had to say anyway.” Twitter is big, but then again so were Second Life and Myspace.

Madison, WI-based 11-employee Wellbe raises $1.4 million in funding. The company’s Patient Guidance System, which it describes as a GPS for health, sends patients emails and information before and after their surgeries.

10-20-2013 8-02-13 AM

HHS gave UK-based government contractor Serco, under investigation there for contract fraud, an $87 million contract extension to its existing $114 million CMS contract to handle paper insurance applications just five days before the launch of Healthcare.gov, leading to speculation that the government knew Healthcare.gov was going to fail and paid Serco to handle the inevitable flood of paper-based insurance applications. However, CMS suggests that the Congressional Budget Office had estimated that 20 million people would apply, with 6 million of those doing so on paper, and the 2,000 people Serco hired were necessary to process the paper applications. HHS gave Serco a $1.2 billion contract in July to manage paper insurance applications for 34 state insurance exchanges in its first-ever US healthcare project. The parent company has annual revenue of around $8 billion. Serco took over NHS’s largest hospital pathology laboratories in 2009 in a privatization joint venture worth $1.3 billion over 10 years and was involved in a series of admitted serious patient errors, including losing samples, incorrect computer flagging resulting in administration of inappropriate blood, a software problem that calculated kidney function incorrectly, and a section of blood chemistry equipment that had to be shut down for four days after a computer virus infection. The 1,000-employee JV, called GSTS Pathology, couldn’t control its costs, had to borrow money from the hospitals to continue its operations, and announced that it would need to pull out of certain markets. GSTS Pathology continues to bid on new UK business, hoping to capture 30 percent of the pathology market.

10-20-2013 7-21-58 AM

California Attorney General Kamala D. Harris issues “Medical Identity Theft – Recommendations for the Age of Electronic Medical Records.” It cites a recent report stating that nearly half of medical identify theft isn’t really that at all – it occurs when someone with insurance loans their card to someone who doesn’t have insurance. EHR-specific recommendations include:

  • Implement role-based access controls.
  • Embed a copy of a patient’s photo (but not a government-issued ID) into the EMR.
  • Give patients clear instructions on how to get a copy of their information.
  • Give patients a copy of Clinical Care Summary documents asking them to verify the information but warning them keep it confidential.
  • Set up the EMR to flag suspicious issues (known a “red flags”), such as a patient refusing to show an ID (other than in the ED); presenting an ID whose photo doesn’t match their appearance; presenting an ID with a name or address that doesn’t match the EMR information; giving a Social Security number, address, or telephone number that is already assigned to another patient;  receiving returned, undeliverable mail from the patient’s address; receiving previous denial of payment for situations such as a second appendix removal; bills returned as undeliverable while new charges continue under that same address; patient interview information is inconsistent with the EMR information; observing that a patient is not aware of the information in their record; and finding information in the EMR that conflicts with other information or with the patient’s presentation.
  • Develop a process for instantly reporting any of the red flags above to a team that will review all available records and place affected accounts on hold, looking for problems such as erroneous data entry or inappropriate medical records merge.
  • Document findings and policies in the EHR where it can be seen.
  • Create a database of identities that have been used fraudulently.
  • Add a message to the patient portal encouraging patients to review their records regularly, also giving them instructions on how to report discrepancies.
  • Audit EHRs for unauthorized access.
  • Build demand for provider detection software, which the report says is offered by only a handful of unnamed vendors whose applications are too expensive for all but the largest health systems.
  • Correct records as needed, either annotating them or moving them to a specific “medical identify theft” location and then starting a new record.
  • Use the Continuity of Care Document to electronically notify business associates and other providers that the record has been corrected.
  • Follow HIE rules for correcting information.
  • Encourage development of technical standards that would allow Health Information Organizations to exchange red flag information, such as modifying the MPI to indicate the addition of a red flag by a member.
  • ONC should include red flag recommendations in Meaningful Use Stage 3.

Weird News Andy titles this story GIGO, wondering, “Who, if anybody, tested this thing?” (answer: government contractors). Not only is Healthcare.gov failing to allow most would-be users to get into the system, it’s also sending erroneous data to insurance companies from those who do. Duplicate enrollments, spouses listed as children, and missing data have been reported.

WNA also files these reports from his Weird Newsroom. Doctors are unable to determine why a Tennessee man has been crying blood for seven years, an unnerving trait that has cost him every job he has held. A Denver woman whose arm was unnecessarily removed after an incorrect cancer diagnosis tries out a robotic arm, but her rare underlying condition remains – any bruise she gets turns to bone, which is gradually transforming her into a human statue who knows she will be fully immobile soon.

A hospital sues one of its patients who refuses to leave because she likes her bed there. The patient was discharged after a four-day stay for pneumonia, but intentionally had her state-provided hospital bed removed from her home so that she could argue that her discharge was unsafe. The hospital says the patient is abusive to staff and fellow patients, complains if her room is at any temperature other than 83 degrees, and repeatedly calls the police department, public health department, and the attorney general to complain about her stay. The hospital wants a temporary injunction to send her packing.

Vince continues his fascinating HIS-tory of McKesson, specifically HBO, with information he received directly from Walter Huff himself. It’s fascinating to read how many early HIT pioneers were hospital CFOs who did programming or other computer work for their hospitals, and how many vendor systems came out of those hospitals.


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

More news: HIStalk Practice, HIStalk Connect.


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October 20, 2013 News 15 Comments

News 10/18/13

October 17, 2013 News 2 Comments

Top News

10-17-2013 8-40-26 PM

HHS Secretary Kathleen Sebelius is reported to have no intention of quitting after Republican criticism of the Healthcare.gov online insurance exchange debacle. Sebelius has acknowledged the problems, but says fixes are being put in place and those who were unable to sign up should try again. Success rates for those attempting to enroll were less than 20 percent the week of its rollout on October 1 and under 13 percent the second week, although one researcher says fewer than 1 percent of those who tried to register were successful. Another report finds that the cost for the system ballooned from the original estimate of $94 million to $292 million, with those payments going to the US federal government division of Canada-based CGI. Other estimates peg the total cost of Healthcare.gov to be more than $500 million.

Reader Comments

10-17-2013 1-09-42 PM

inga_small From Dr. Travis: “Re: Color me pink. Breast cancer awareness month has jumped the shark this year.” Travis tells me he likes the innuendo of this poster’s message, which I believe was from the Twisted Taco restaurant in the Atlanta area. Thanks for the reminder to support breast cancer research, get screened regularly, and/or encourage your loved ones to be screened.

From Reader One: “Re: from a vendor-specific forum today. ‘We inadvertently assigned 5,000 accounts to a bad debt agency. Is there a way to mass cancel?’ Now that’s what I call exciting.”

HIStalk Announcements and Requests

10-17-2013 5-46-56 PM

Welcome to new HIStalk Platinum Sponsor Boston Software Systems. The company offers an error-free workflow automation platform that allows its healthcare customers and business partners to streamline their business processes and improve productivity. Boston WorkStation lets IT departments efficiently solve problems and eliminate performance gaps in existing IT systems – integrating third-party registrations, performing eligibility checks, integrating lab results, posting payments and collections notes, performing mass updates, creating backup databases, running and distributing reports, and managing dictionaries and tables. Existing systems can be enhanced by creating new business rules and workflows and providing real-time access to external applications. IT departments love Swiss Army knife-type solutions that be used to enhance systems without vendor involvement or ongoing labor requirements, such as the hospital that’s saving 125 hours per month using Boston WorkStation to automatically create a pre-registration account at the time of scheduling or another that saves $500K by automating their materials management system to load inventory purchases and manage price updates. The company also offers Cognauto, the next-generation automation platform. The company’s products are used by over 2,500 hospital customers running many IT systems. Thanks to Boston Software Systems for supporting HIStalk and for issuing a very cool press release announcing that fact.

10-17-2013 6-59-48 PM

10-17-2013 6-55-21 PM 
Thanks to Bonny and Catherine from Aventura, self-proclaimed “HIStalk minions” who volunteered to report from the American College of Emergency Physicians Scientific Assembly (ACEP13) in Seattle this week. They conducted some ED doc interviews about IT that I’ll have up later, but here are some of Bonny’s observations:

  • The topic of scribes performing EMR data entry split the group, with some ED physicians expressing satisfaction in offloading tasks to what is often a pre-med student, but others feel guilty about making scribes do what some would say is their work.
  • The best-of breed EDIS vendors were there (Picis, T-System, MEDHOST) as were the big enterprise vendors with EDIS, with Epic notably being MIA.
  • Education and discharge instructions vendors (Discharge 1-2-3, Elsevier ExitCare, Krames) were exhibiting.
  • Bonny says MEDHOST stole the show with a patient throughput solution that pushes preemptive communication about patients from the ED or OR, such as when a patient is likely to be admitted but whose emergency care is still underway. It also offers real-time and forecasted financial operational metrics for executives.
  • ACEP rented out the Space Needle, the Chihuly Museum, and the Experience Music Project for attendee events.
  • In the all-important vendor swag category, Bonny lauds Interactive Health Massage Chairs, whose booth was across from Aventura’s such that Bonny and Catherine could perform their own first-hand research as well as watch attendees shed their stress and exit happy. Check out the photo above – who wouldn’t want to have a chair massage while covered lightly with a blanket right on the show floor?

inga_small Highlights from HIStalk Practice this week include: a local paper profiles two physicians with opposing views on EMRs. CMS pushes a PQRS reporting deadline back three days. A vendor speaks out against shortened exhibit hours at MGMA. Most medical practices are concerned that ACA insurance exchanges will lead to increased collection burdens and lower reimbursements. Epocrates adds a provider directory to help members identify clinicians for consults and referrals. Emdeon will pay its departing CEO $2.4 million over the next two years. Thanks for reading.

Acquisitions, Funding, Business, and Stock

10-17-2013 6-14-23 PM

Athenahealth announces Q3 results: revenue up 43 percent, adjusted EPS $0.29 vs. $0.30, missing analyst estimates on both.

IVantage Health Analytics acquires Professional Data Services, a provider of managed care analytics and benchmarking solutions for hospitals.

10-17-2013 9-02-48 AM

StartUp Health admits 14 new companies to its three-year development program for health technology startups. Lt. Dan profiles the companies on HIStalk Connect.

10-17-2013 7-14-52 PM

Medical practice technology vendor Waiting Room Solutions changes its name to WRS Health.


Medical Services of America (SC) chooses Allscripts Homecare for its 70 home care service locations.

Elmcroft Senior Living (MO) will install Cerner CareTracker at its 85 assisted living facilities.

The 30-bed Aspire Hospital (TX) will implement clinical and financial applications from Healthcare Management Systems and physician documentation from Patient Logic.

The VA and DoD award Systems Made Simple a re-compete of the iEHR system contract for systems integration and engineering support.

10-17-2013 8-44-20 PM

Saint Luke’s Health System selects PeriGen’s PeriCALM fetal surveillance system for seven birthing hospitals in northwest Missouri and northeast Kansas.

The VA awards Harris Corporation a $60 million, four-year contract to design, install, and support the wireless infrastructure at 112 VA medical centers.

Riverside Medical Group (VA) selects athenaCollector for billing and practice management for its 300+ physicians.

The Texas Health Services Authority chooses EHNAC to develop a state accreditation program for private and public HIEs operating in Texas.

Texas Health Physicians Group selects StrataJazz from Strata Decision Technology as its integrated financial platform.

10-17-2013 8-45-28 PM

St. Luke’s Health System (ID) will implement Epic at a cost of $200 million and will offer Epic ambulatory to independent practices through an affiliate program.  St. Luke’s, defending itself against antitrust claims for its purchase of Salzer Medical Group, says Epic is a superior system that will allow providers to share information with patients and with each other more easily.


10-17-2013 4-29-12 PM

Northwest Community Healthcare (IL) names Glen Malan (Cadence Health) VP/CIO.

OpenTempo names Jim Crook (IDX) chairman of the board, Walt Marti (GE Healthcare) chief administrative officer, and John Jordan (dbMotion) VP of sales and marketing.

Announcements and Implementations

Quantros releases IRIS 2.4, a configurable dashboard to view overall hospital performance and display trends, distribution, and variations in performance.

Government and Politics

inga_small A California state appellate court rules that providers do not necessarily have liability to patients when medical records are stolen or misappropriated unless they are accessed by a third party. The ruling stems from a 2011 incident in which a UCLA Health physician’s laptop containing medical records on 16,000 patients was stolen from his home. The provider could have been liable for up to $16 million as part of the  class action lawsuit, even though there was never any indication the data had been accessed. The suit was dismissed. Rebecca Fayed, associate general counsel and privacy officer at The Advisory Board Company, tells me the ruling only applies to California, which has its own statute governing the disclosure of medical information and allows affected individuals to sue for damages for certain violations. She adds:

Although the ruling would not apply nationwide at the federal level, other states with similar state laws may look to this case for reasoning and may analogize to it even if it has no precedential value in any state other than California.

10-17-2013 1-51-48 PM

inga_small The ONC Tweeters seem happy to be back at the keyboard after a 16-day furlough.

Innovation and Research

10-17-2013 7-10-10 PM 

Children’s Hospital of Philadelphia (CHOP) offers Harvest, an NIH grant-funded open source software toolkit that allows biomedical researchers to explore large data sets, such as those from EHRs and genomic databases. Researchers from CHOP’s Center for Biomedical Informatics are testing Harvest against several data collections, including the Longitudinal Pediatric Data Resource that tracks data from children with conditions detected in newborn screenings.


Deloitte introduces PopulationMiner, a data analytics solution that draws clinical, financial, and operational data from Intermountain Healthcare’s warehouse to support patient-outcome analysis.

ArborMetrix integrates surgical video analysis capabilities into its reporting and analytics platform, enabling healthcare organizations to improve performance benchmarking of surgeons.

Ninety percent of surveyed nursing home physicians say their use of drug references on mobile devices prevented at least one adverse drug event the month before the survey.


Virtualization software and dictation with speech recognition applications are emerging as top areas for growth potential in hospitals, according to a HIMSS Analytics report on the US hospital IT market. The demand for ambulatory EMRs and ambulatory PACS also appears to be growing.

10-17-2013 7-47-45 PM

Joint Commission issues a sentinel alert warning for objects left inside surgery patients, which it says has caused 16 deaths in the past eight years. Most of the recommended actions involve processes and communication, but consideration of “assistive technology” such as RFID-tagged counting systems are also recommended.

10-17-2013 8-47-11 PM

In Canada, information on 2,000 patients of Parkwood Hospital is exposed when an unencrypted laptop is stolen from the car of a McKesson Automation employee.

10-17-2013 7-28-08 PM

Weird News Andy notes that California’s insurance exchange, Covered California, pulled down its online provider directory just eight days after go-live when the California Medical Association noted that obstetricians were labeled as ophthalmologists and doctors were incorrectly identified as speaking foreign languages. CMA also observed that some doctors were listed as exchange providers who didn’t actually sign up since insurance companies were permitted to add their in-network doctors to the list without their permission unless the doctor specifically opted out.

Staff and patients of Unit 5, the children’s cancer floor of the University of Minnesota Amplatz Children’s Hospital, create a video titled “Brave.”

Sponsor Updates

10-17-2013 12-27-57 PM

  • SRSsoft hosts about 300 customers at its User Summit this week in Greenwich, CT.
  • Sunquest and the Association for Pathology Informatics will offer an October 24 webinar on the topic of IT-driven virtual autopsies.
  • Clinovations celebrates its five-year anniversary and highlights a few of its awards and honors.
  • E-MDs integrates PatientPay’s online bill pay solutions within its PM software. The company will also integrate Phreesia’s point-of-care check-in solution into its EHR .
  • St. Elizabeth Hospital’s (WA) use of e-form solutions from Access and hosted services from Inland Northwest Health Services helped the hospital meet HIMSS Stage 7 paperless requirements while eliminating the need for dedicated on-site hardware.
  • Greythorn conducts a market survey for HIT professionals to analyze compensation, benefits, job satisfaction, hiring trends, and industry participation. Greythorn will donate $1 to the Boys and Girls Clubs of Bellevue and Chicago for every submission by November 20.
  • Ed Bayliss, executive director for ChartMaxx, participates in a panel discussion on data exchange across the continuum of care at the eHealth Initiative 2013 Data Exchange Summit October 30-31 in Washington, DC.
  • Humedica publishes a case study detailing how Mayo Clinic Health System prepared for value contracting using Humedica MinedShare.
  • ZeOmega will embed Health Language technology from Wolters Kluwer Health into its Jiva care management platform.
  • The Drummond Group certifies SRS EHR as a 2014 Complete EHR.

EPtalk by Dr. Jayne


You can tell that fall has arrived when every coffee vendor (including the one in the hospital lobby) is pushing pumpkin spice latte. Unfortunately, it is also the time I start sweating the fact that I need to come up with an extremely creative Halloween costume and come up with it stat. One of my favorite former bosses throws a massive party and the price of admission is a great costume. I enjoy Halloween immensely and have a closet full of costume options, but this party is peopled with brilliant individuals from academia, healthcare, and health IT so throwing on the Princess Leia braids simply will not do.

Maybe I’ll print a bunch of completely random attributes (some of which relate to me and some that do not) and go as my LinkedIn profile. I always laugh when people endorse me for knowledge of vendors I have never even heard of. I know several of the attendees are faithful HIStalk readers. Maybe I can convince my date to adopt a couples costume and we can go as Inga and Mr. H. Of course I could always go as Dr. Jayne, but that might be a little obvious. I guarantee at least one attendee will be wearing a bowtie and a Farzad-worthy grin.

The lobby of our medical school has a wall with pictures of our staff who have won various Nobel prizes. I could always dress as one of them and see if anyone picks up on it. Getting someone to identify that choice might be a little dependent on how far after the start of the cocktail hour I arrive, though, so not entirely a safe bet. I’m leaning towards possibly a World War I nurse just to have an excuse to purchase an awesome vintage cape. In medicine (and nursing) we used to dress more formally and I miss that. I understand that the current culture of scrubs is all about comfort and practicality, but I can’t help but think that if we dressed more seriously our patients (and administrators) might take us more seriously.

I took a course recently that covered communication and corporate culture. We did several exercises looking at how appearance plays a role in group dynamics. Watching several videos, we scored the characters based on believability, authority, seniority, and a host of other factors. Regardless of the scenario, those characters who dressed in traditional business attire scored higher than those who dressed casually. Besides dress, there are a lot of other factors at play with power dynamics, including the position of the participants (same height vs. seated/standing), tone, demeanor, etc.

I had the opportunity to rotate through a hospital in the UK during the late 1990s and was struck by the formality of the nursing staff. They still wore traditional dress whites (with caps) and nursing trainees wore blue. Physicians wore the long white coat and neckties. There were very few female physicians who I interacted with during my rotation, so I can’t particularly remember what they wore.

I trained at an academic medical center with an extremely traditional surgery department. Surgeons were never to wear scrubs outside the operating room. Trainees were not allowed to consume food or drink in the hallways – not even a sip of coffee – and white coats were to be fully buttoned at all times. Conversely, the OB/GYN house staff wore scrubs and sneakers 24×7, which created more than a few resentments. I wonder though if the patients or other hospital staff really perceived the departments differently? Was it a factor of dress code or of other factors that the dress code exemplified, such as discipline, order, and precision?

Scrubs and casual dress have become a way of life for most hospitals and medical offices. My hospital requires care teams to wear certain colors of scrubs depending on employee roles. Nurses wear navy, respiratory therapy wears light blue, patient care technicians wear khaki, etc. This seems to better help patients understand who is caring for them and what to expect. Unfortunately, physicians run the gamut between coat and tie and whatever scrubs they put on at the last hospital they rounded at. Some are so casual it’s hard to take them seriously. In response to a number of male physicians going sockless in loafers, one local facility created a rule requiring that “hosiery be worn at all times.” I’d like to have been a fly on the wall at the medical staff meeting where that was discussed: readmission rates, surgical site infections, ventilator-associated pneumonia, and bare ankles.

In the ambulatory care setting, the proliferation of scrub styles is mind boggling. We see a lot of “hip” medical assistants and patient care techs in low rider scrubs with flare bottoms that drag the ground to the point where they fray. I hope they never have to run to a code or crouch down to provide CPR, and if they do, that they have their waistband firmly in hand. One pediatrician I know has hand painted lab coats for every holiday and season. She’s the only physician on staff who wears a blue coat, so it really stands out. I smile every time I see her in the elevator, but I’m not sure what some of the patients and visitors think.

Generally I think the offices where staff dresses in a more uniform manner appear more organized and professional, but again maybe the dress code is a side product of management rather than a causative factor. Many of our offices provide staff with practice-logo polo shirts to be worn with khaki pants. This can be useful to reinforce an office brand as well as to help patients identify staff members, especially in busy offices with many ancillary services. That might be a great costume idea – maybe I’ll borrow a polo and masquerade as a staffer for a competitor practice.

I didn’t set out to write a fashion review, but perhaps Inga has been a greater influence on my writing than I previously thought. I could write an entire column on sassy patent leather hospital clogs, but we’ll save that for another night. I’m off to the internet for costume ideas. Got a great one? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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October 17, 2013 News 2 Comments

News 10/16/13

October 15, 2013 News 3 Comments

Top News

10-15-2013 10-09-26 PM

Cerner shares hit a 52-week high Tuesday following announcement of a partnership with Wolters Kluwer Health to develop a physician documentation system using Provation Clinic Note content with Cerner Millennium. CERN shares are up 52 percent in the past year, with the company’s market cap now at $19 billion. 

Reader Comments

10-15-2013 9-13-05 AM

inga_small From Veteran: “Re: insurance marketplace. I take it all back. This really is a disaster. A New York Times article this weekend chronicled a whole series of issues going back months, not the least of which was HHS’s decision to project manage this themselves when they (and everyone else) knew they had neither the expertise nor the experience. Hope this doesn’t set health reform back years.” Veteran (and a few others) were critical of my comment that the opening day of the insurance marketplace was a “failure” because I was unable to access the system. According to the Times, insiders were aware of the system flaws long before the launch, but because of political concerns, continued with the original timeline. By one estimate the project is now about 70 percent of the way toward operating properly, but the time frame for completion could be anywhere from two weeks to a couple of months. Apparently I am just one of a few thousand people who have opted to wait a few weeks before making additional attempts to enroll.

From CA/DC Fellow: “Re: failed health insurance exchange site. Will US CTO Todd Park take the fall?” Healthcare.gov is a high-profile political embarrassment. In politics and government, someone has to be lynched publicly to appease the press. Todd was sent out to try unsuccessfully to talk around the situation, which I think puts him at risk. Sebelius would toss him overboard in a second to save her image. Nobody ever blames the contractors since it was someone’s job to manage them.

HIStalk Announcements and Requests

Listening: Nada Surf, a nearly perfectly listenable alternative rock band that’s been around for 20 years. I’m playing them constantly.

Acquisitions, Funding, Business, and Stock

10-15-2013 10-57-32 AM

A report predicts that HIT funding will double over last year thanks to the implementation of the ACA and HITECH. Venture capitalists invested $737 million in 51 deals during the third quarter, compared to $623 million in 168 deals a year ago.

CareCloud CEO Albert Santalo tells the Boston Business Journal that his company may launch an IPO next year.

10-15-2013 10-12-17 PM

A business publication says transcription vendor MModal, saddled with heavy debt and slow sales, may need to seek restructuring if its current turnaround efforts fail.


Australia’s NSW Heath will implement iMDsoft’s MetaVision throughout the state’s adult, pediatric, and neonatal ICU beds.

Adventist Health System selects the Explorys suite of analytic and population health management solutions.

TeamHealth (TN) chooses Shareable Ink’s Anesthesia Cloud and ShareMU solutions for selected sites nationally.

Virginia Hospital Center Physician Group selects eClinicalWorks EHR for its 100 employed physicians.


10-15-2013 3-12-46 PM

Henry Schein appoints Steve Klis (CareFusion) president of global practice solutions.

10-15-2013 9-27-43 AM

CareCloud names R. Scott Lentz (Aprima Medical, Picis) CFO.

10-15-2013 8-36-53 PM

AtHoc names John Tempesco (Informatics Corporation of America) as senior director of healthcare operations and marketing.

Vocera Communications hires Paul Johnson (Intuit) as EVP of sales and services.

Announcements and Implementations

10-15-2013 10-14-04 PM

Heritage Valley Health System (PA) activates Allscripts Sunrise for its Beaver and Sewickley campuses.

10-15-2013 1-40-27 PM

Medfusion rebrands its recently reacquired Inuit Health patient portal technology back to its original name and adds Vern Davenport (formerly of MModal) and Buck Goldstein (UNC Chapel Hill) to its board.

10-15-2013 10-15-26 PM

For-profit surgical hospital operator Victory Healthcare (TX) implements Omnicell’s G4 Unity medication management system.

Optum and Dignity Health introduce Optum360, a new company that will address the back office functions of healthcare systems.

Unified emergency notification systems Vendor AtHoc announces the launch of its healthcare vertical with the launch of AtHoc Home Care Alerts, which offer home care service organizations with mobile duress and emergency alerting, field reporting, and personnel tracking.

Jordan Shlain, MD and Todd Johnson of automated patient follow-up solution vendor HealthLoop will present at the UHC Conference Innovation State on Friday.

10-15-2013 10-17-02 PM

Lewistown Hospital (PA) implements Summit Downtime Reporting System for business continuity.

Lucca Consulting Group and ICD-10 Coach announce a partnership to help small hospitals and practices implement ICD-10.  

Government and Politics

The VA names Health eTime the winner of its medical appointment scheduling competition and a $1.8 million prize. The open source app allows veterans to schedule visits across VA locations and gives VA providers the ability to share appointments with the personal digital calendars of veterans.

A Pittsburgh Tribune-Review investigation finds that the VA is one of the largest violators of health privacy laws. From 2010 to May 31, 2013, VA workers or contractors committed 14,215 privacy violations at 167 facilities that victimized at least 101,018 veterans and 551 VA employees. Violations included postings of anatomy on social media sites and identities stolen to create fraudulent credit cards.

Innovation and Research

CEOs of hospitals with high levels of advanced technologic capabilities earn an average of $135,862 more than hospitals with low levels of technology, according to a study published in JAMA Internal Medicine. Hospitals with high performance on patient satisfaction also compensated their CEOs more, but no association was found between CEO pay and processes of care, patient outcomes, or community benefit. Based on the findings, researchers suggest that hospital boards place more emphasis on quality when setting compensation.

Two graduate students in Israel develop a computerized system for diagnosing Parkinson’s disease consistently. The patient performs specific movements in front of a 3-D depth camera, whose data is the analyzed by computer to determine a diagnosis with 94 percent accuracy.


10-15-2013 11-22-36 AM

Encore earns top scores in a KLAS report on go-live support vendors. Santa Rosa Consulting was recognized for having the most engagements overall, followed by Encore and ESD.

The Carolina eHealth Alliance (SC) reports that the four hospital systems participating in its electronic exchange network saved more than $1 million over a 12-month period by reducing unnecessary admissions and redundant procedures.

Clinithink posts an animated video depicting the role of clinical NLP in transforming healthcare.

An article in Medical Marketing & Media says that mobile devices are yesterday’s news for marketing drugs to physicians, concluding that “EHRs will become the dominant context for physicians” in promoting drugs at the time of e-prescribing. However, it warns that overly aggressive drug promotion could lead to regulation. A drug company spokesperson predicts  consolidation of the EHR industry, saying “a relative few will own the space and will own the access” for drug companies to promote their products as part of physician workflow. Drug companies are doing away with traditional field reps for product promotion.

10-15-2013 10-19-55 PM

The local newspaper writes up Novant Health (NC), which earned HIMSS Stage 7 EMRAM last week for its $600 million Epic implementation, which Novant says it finished three years ahead of schedule and under budget.

Sponsor Updates
  • Caradigm will add predictive clinical analytics capabilities from MEDai to its Care Management platform.
  • Sunquest announces a new partnership with the Boys & Girls Clubs of Tucson.
  • Cynthia Davis, RN, FACHE of CIC Advisory will speak Thursday at the 2013 Annual Healthcare IT Symposium in Las Vegas sponsored by the Shriners Hospital for Children. Her topic will be “Paddling Upstream: From Data Collection to Better Patient Care.”
  • Epic will allow direct use of the QlikView Business Directory platform within Hyperspace and will support content sharing between joint Epic and QlikView customers.
  • NTT DATA’s Optimum Suite achieves 2014 Edition Complete EHR Inpatient certification.
  • The SSI Group announces that both its clearinghouse services and RCM solutions are ICD-10 ready and that it is currently testing with provider and payer communities.
  • An Imprivata survey finds that the adoption of server-hosted virtual desktops in the EMEA healthcare industry could increase 74 percent within 24 months.
  • Trinity Health (MI) shares how it generated $3.1 million in profits and an eight to one ROI in five years using Medseek Predict for marketing campaigns.
  • VitalWare partners with DCBA to create CDiDocuMint, a clinical documentation improvement tool that uses a query and tracking methodology.
  • The Washington Business Journal recognizes Clinovations as the 10th fastest-growing company in the district.
  • Utah Business Magazine honors Health Catalyst Chairman David Burton, MD for his lifetime achievement as a healthcare hero.
  • Weill Cornell Medical College CIO Curtis L. Cole shares how he helped Intelligent Medical Objects develop its flagship product.
  • UltraLinq Healthcare Solutions partners with Mobisante to integrate UltraLinq’s image management platform with MobiUS point-of-care imaging devices, enabling providers to deliver remote diagnosis and second opinions.
  • LDM Group’s pharma messaging technology is featured in an article on engaging physicians through EHR messaging.


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

More news: HIStalk Practice, HIStalk Connect.


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October 15, 2013 News 3 Comments

Monday Morning Update 10/14/13

October 12, 2013 News 7 Comments

10-12-2013 3-18-30 PM

From Alarm Fatigue: “Re: patient death. Alarms on hospital doors are ignored.” San Francisco General Hospital (CA) offers no explanation of how a 57-year-old patient reported missing from her hospital bed was found dead 17 days later in an alarm-equipped hospital stairwell. The hospital’s chief medical officer suggests that alert fatigue from “a cacaphony of chirps and beeps” may have contributed to the problem.

From Patient Advocate: “Re: retina surgeon follow-up appointment. My two drugs had a dosage change, given to me verbally. I started second guessing myself as I was sent upstairs to see my specialist, who reviewed the surgeon’s notes send by fax with different dosage instructions. The meds seemed to be pre-printed on the form, so I asked the tech to check with the surgeon. The specialist then added another drug, giving me a sample with no dosage label and verbal instructions. Most of this specialist’s patients are 50 an over, going home with verbal instructions only. How about a simple printout of dosage instructions? As I was leaving the exam room, the person charting on the laptop asked me about my other eye drugs so she could enter data.  Guess she was seeing the trees and I was walking through the forest … with less than perfect vision.” Technology should get neither the blame nor the credit for how providers interact with their patients. They are responsible for choosing and using whatever tools they need to get the job done. I can’t think of any other professionals who blame the computer for their inability to perform at a reasonable level, although I also can’t think of any professionals whose minute-by-minute behavior is managed by government, insurance companies, and unseen owners using the computer as a blunt instrument of control.

10-12-2013 1-57-15 PM

From The PACS Designer: “Re: 5th Gen iPad. Now that we have the news that October 22 is the launch for the 5th Gen slimmer iPad-mini, here’s an advanced look courtesy of the Sonny Dickson website. The smaller form factor is destined to be a hot item, and eagerly sought by those who are constantly attached to their device.”

10-12-2013 1-12-24 PM

The reader-requested poll about ICD-10 and liability and workers comp insurers yielded a scattershot of inconclusive responses. New poll to your right: what’s the cause of Healthcare.gov insurance marketplace technical problems?

Here’s John Lynn’s latest  Hangout, recorded live at CHIME 13.  

10-12-2013 3-19-29 PM

In Northern Ireland, medical imaging technology firm Cirdan Ultra acquires the assets of GE Healthcare’s Centricity Laboratory Division and will take over support for the former Triple-G product, which was at one time the highest-rated LIS (before GE acquired it, obviously).

ESD wins the Best Video Award at the CHIME CIO Fall Forum with a CIO-customized Diamond Dave-style version of “Just a Gigolo.”

10-12-2013 3-20-51 PM

Weird News Andy concludes that “this just doesn’t cut it.” A man in China suffering from arterial embolism saws off his own leg after being turned down by a doctor because he didn’t have enough money to pay for the procedure. He jammed a block of wood in his mouth and cut the leg off with a saw, also losing three teeth from biting down hard in pain. The man appealed for help to have the other leg amputated, resulting in a doctor offering his services for free.

The non-profit New Cities Foundation publishes a video describing its urban e-health project in Rio de Janeiro, in which GE Healthcare provided “e-health backpacks” to allow home visits for health maintenance in an urban environment.

For the geeks among us looking for a new technical toy, check out WearScript for Google Glass, which allows programmers to control and develop for Google Glass using Javascript. The developers hope to create an open ecosystem around Glass and to encourage accessibility.

Berlin will host the first HIMSS European mHealth Summit in May 2014.

10-12-2013 2-48-20 PM 10-12-2013 2-46-57 PM

The sold-out eClinicalWorks user conference started this weekend at JW Marriott Hill Country in San Antonio, TX.

10-12-2013 2-51-27 PM

On tap this week: Cleveland Clinic’s 2013 Medical Innovation Summit a the just-opened Global Center for Health Innovation in Cleveland. I’m surprised any healthcare work gets done at all in October given the number of people that seem to do nothing all month except attend conferences.

Crain’s Chicago Business names the board of Merge Healthcare as having the least-competent Chicago-area board of directors given their pay, noting that the company lost $28.8 million last year while the six-member board took home $8.2 million in compensation.

Vince launches his HIS-tory of McKesson, having tapped into the personal memories of several industry pioneers including Walt Huff himself (the “H” in HBO & Company). Vince also got some reader help in identifying some of the HIT faces of yesteryear. Vince spends a lot of time gathering information that you won’t find anywhere else, and I for one enjoy the heck out of every episode.


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

More news: HIStalk Practice, HIStalk Connect.


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October 12, 2013 News 7 Comments

News 10/11/13

October 10, 2013 News 5 Comments

Top News

10-10-2013 7-03-28 PM

The DoD issues a solicitation to EHR vendors to demonstrate their products the week of October 21 for market research and planning purposes. The DoD says it is interested in “off the shelf” enterprise EHRs, including VistA solutions, to replace its legacy systems and notes that participation in the demonstration “is not mandatory, required, or a prerequisite for any future procurement activities.”

Reader Comments

From Curious: Re: PatientKeeper. Does anyone know if PatientKeeper is MU certified? Couldn’t find them by name on the CHPL website, but that’s not the world’s most reliable or usable site.” The folks at PatientKeeper shared this response:

PatientKeeper is certified for 2011 Edition as a Modular EHR, including CPOE and Medication Reconciliation, and we will be seeking 2014 Edition certification by the end of this year.

From HIS Junkie: “Re: HIPAA. Does HIPAA apply to the ACA Health Insurance sites? If there is a breach, will OCR slap HHS with a $1.5 million fine for each breach. No doubt we’ll soon find out. In a recent report, testers identified five major breach weaknesses in the Health Insurance web sites. They were: fake sites, all access requests for other sites, click jacking threats, cookie threats, and scam psychology threats. Firms like HPs web security group and Trend Micro did the testing. Clearly the slapped together sites would fail a HIPAA compliance audit. With people registering having to put in all their family member’s SSNs, the report concludes, ‘Expect Mischief.’”

From Wannabe Recovering Consultant: “Re: anonymous CIO interview. Incredibly fascinating. I would love it if you could do more of them. His or her insights into the thinking of a CFO made me think that an anonymous CFO interview would be equally insightful as relates to IT expenditures and activities.” That would be fun, too, if anyone wants to volunteer.

From MoreCowBells: “Re: California Medicaid. Any truth to the rumor that they won’t be ready to accept ICD-10 by next October. Are other states in the same situation?”

HIStalk Announcements and Requests

inga_small I spent most of the week in San Diego at the annual MGMA conference and posted several updates on HIStalk Practice. Take a read to get my impressions on some of the sessions, what was cool and not so cool in the exhibit hall, the scoop on after-hours parties, and what folks were talking about. If you prefer a more visual experience, you’ll find lots of pictures, including one or two of hot shoes. I also encourage you to check out Dr. Gregg’s latest post, which offers a few comebacks to the EHR nay-sayers. Thanks for reading.

10-10-2013 5-40-57 PM

Welcome to new HIStalk Platinum Sponsor Medi-Span, part of Wolters Kluwer Health. Medi-Span offers customized drug databases and medication decision support modules that enhance patient safety, support interoperability, and decrease alert fatigue. Medi-Span makes EHRs and other clinical systems smarter, supporting functions that include prescribing, dispensing, and claims processing for 1,600 hospitals, 49,000 retail pharmacies, and all 10 of the top pharmacy benefits managers. In addition to drug information, decision support, and pricing tools, MediSpan’s new offerings include Controlled Substances File that covers both federal and state requirements; Alert Control customization capability, Patient Safety Programs File that identifies drugs that have Black Box Warnings, Medication Guides, tallman names, or REMS; and ICD-10 Mapping Files. Thanks to Medi-Span and Wolters Kluwer Health for supporting HIStalk.


Health Catalyst will offer “Surviving Value-Based Purchasing: A Road Map to Success Under the New Reimbursement Model” on Tuesday, October 15 from 1:00 – 2:00 p.m. Eastern. Presenters will be Bobbi Brown, VP of financial engagement for Health Catalyst, and Jane Felmlee, healthcare consultant.

Acquisitions, Funding, Business, and Stock

10-10-2013 7-07-01 PM

Francisco Partners makes a strategic investment in EMR/PM vendor NexTech.

10-10-2013 7-07-53 PM

Three top executives of Bottomline Technologies take a pay cut from the previous fiscal year following the company’s 2012 net loss of $14.4 million. The combined compensation packages fell from $5 million to $4 million.

10-10-2013 7-08-29 PM

API Healthcare announces Q3 accomplishments that include a 23 percent increase in bookings and 35 new healthcare customers.


10-10-2013 7-10-50 PM

Augusta Health (VA) will implement community HIE technology from Sandlot Solutions.

Sentara Healthcare selects HealthMEDX to automate its clinical and financial operations for its skilling nursing, transitional care, and assisted living facilities.

San Luis Valley Health (CO) adds the iDoc document management software from CareTech Solutions.

Northern Colorado Anesthesia Professionals, LLC (CO) chooses Shareable Ink’s Anesthesia Cloud for data capture, billing, and scheduling and will use the company’s ShareMU program to help its providers earn EHR incentive payments.  

UNC Health Care (NC) extends its relationship with Practical Data Solutions, Inc. to deploy data models for Epic Resolute and Cadence, adding to its previous work with UNC on GE Centricity and Allscripts Enterprise.


10-10-2013 10-55-45 AM

Alere ACS hires Helen Figge (HIMSS) as VP of clinical integration.

10-10-2013 5-37-36 PM

St. Joseph’s Healthcare System (NJ) names Jane Tsui-Wu (Stony Brook University Hospital) as VP/CIO.

10-10-2013 6-37-20 PM

Streamline Health Solutions names Jack W. Kennedy, Jr. (PRGX Global, Inc.) as SVP/chief legal counsel.

Ian Gordon (Topaz Shared Services) joins McKesson Health Solutions as SVP/GM for decision management.

Liaison Technologies announces three new board members: William E. Kitgaard (Covance Global IT), David Parker (WebLogics), and Joseph B. Volpe III (Merck Global Health Innovation Group).

Announcements and Implementations

10-10-2013 7-12-12 PM

Knoxville Hospital and Clinics (IA) goes live on its $2.8 million Cerner implementation.

Bon Secours Health System (MD) integrates Wolters Kluwer Health’s UpToDate clinical decision resource within Epic.

10-10-2013 11-39-15 AM

Athenahealth will monitor and share population health information on flu outbreaks and other communicable diseases from its national database to fill the current gap in CDC reporting. Because of the government shutdown, the CDC has furloughed 8,754 employees (70 percent). Makes you wonder how much money the government could save if the private sector took over a few more tasks.

iMDsoft makes the MetaVision AIMS, MV-OR available via cloud-based hosting, with licenses offered on a subscription basis.

10-10-2013 5-38-56 PM

MEDHOST introduces AXON, a native iPad app that enables clinicians to interact with the MEDHOST EDIS.

Infor launches Health 3.0, the company’s vision for the future of HIT, which includes a suite of products that address the shift to value-based reimbursements.

Government and Politics

The VA Office of Information and Technology furloughs 2,754 employees, halting all software development on the VA’s benefits management system.

Union members of the Iowa City, IA VA medical center protest the effect of the government shutdown on the hospital’s IT workers. “Right now, the Information Technology section of our hospital that does all of our computer systems doesn’t have a budget, and those employees are currently working without pay. [Hospital employees] pretty much are at a loss for everything — charting, documentation, everything is at a loss.”

Innovation and Research

NIH awards Sutter Health, IBM Research, and Geisinger Health System a $2 million research grant to develop analytics methods to detect heart failure using EHR data.

Virtual assistant developer Next IT announces GA of Alme for Healthcare, which will respond to customer service questions and increase patient engagement.


Epocrates introduces Provider Directory to help members easily identify other clinicians for consultations and patient referrals.

A RAND study finds that the primary driver of job satisfaction for physicians is being able to provide high-quality healthcare. EHR use impacts doctor job satisfaction because of worries that EHR use interferes with face-to-face patient interaction increases clerical work by doctors. Physicians also have concerns that medical record accuracy may be negatively impact when templates are used.

American Well expands its $49 a visit telehealth consult services to 44 states and DC.

The Orlando business newspaper lists the salaries of executives of Adventist Health System. CIO Brent Snyder made the list with $1.14 million in salary in 2011.

Kansas City’s City Council Planning, Zoning & Economic Development Committee unanimously approves a plan to give Cerner $1.63 billion in tax incentives for its $4.3 billion expansion project. The full council is expected to extend approval Thursday for the 11-building, 4 million square foot development that would be built in 14 phases over the next 10 years.

A quality incentive program for salaried physicians at Massachusetts General Hospital improved EHR adoption and hand hygiene compliance, reduced ED use, and increased efficiency in radiology and cancer centers, according to a study published in Health Affairs. Physicians could earn incentives of up to two percent of their annual income, leading researchers to conclude that even small incentives can impact behaviors that improve the quality of care.

Sponsor Updates

10-10-2013 12-13-51 PM

  • eClinicalWorks hosts its national users conference October 11-14 in San Antonio.
  • Gartner positions Informatica as a leader in its 2013 Magic Quadrant for Data Quality Tools report.
  • Visage Imaging is exhibiting at this week’s ACR Annual Informatics Summit in Washington, DC, with GM Brad Levin participating in an October 11 vendor panel on mobile imaging solutions.
  • Aprima Medical offers customers an option to use TSPi’s MicroCloud Platform as a Service solution to host their Aprima EHR.
  • Billian’s HealthDATA and the Alliance for Home Health Quality & Innovation co-host an October 22 Twitter chat on mobile health and in-home technologies.
  • CCHIT extends ONC 2014 Edition Modular EHR Certification to PatientTouch System 3.2.2 and PatientTouch System 3.3 from PatientSafe Solutions.
  • Cerner will add Wolters Kluwer Health’s Provation Clinic Note content and decision support into Cerner Millennium.
  • TriZetto releases details of its 2013 Executive Vision Summit November 12-14 in Scottsdale.
  • The American Hospital Association extends its exclusive endorsement of data center hosting services from CareTech Solutions.
  • Michael Mutterer, VP of senior services at Riverside Medical Center (IL), shares his thoughts about “I couldn’t live without … HealthMEDX clinical EMR.”
  • pMD explains how its mobile charge capture solution can improve the PQRS reporting process.
  • Technology from Awarepoint and Versus are featured in a 24X7 article on the growing use of RTLS in healthcare.
  • EClinicalWorks adds Elsevier’s ExitCare technology for evidence-based patient education and discharge instructions into its EHR.
  • Quality Systems’ subsidiary Mirth releases Mirth Connect 3.0, an open source healthcare integration engine for HL7 message integration.
  • 3M Health Information Systems introduces the 3M Outpatient CDI Program, which offers consulting services for outpatient facilities and physician practices needing to improve the documentation and coding process.

EPtalk by Dr. Jayne


I’m completely disheartened by the behavior of our elected officials during this government shutdown and the months leading up to it. Regardless of your side of the aisle, it seems everyone is behaving badly at this point.

One of the things that surprised me is the shutting down of government websites. I was looking for information on a potential vacation site and discovered the National Park Service websites are down. I understand not paying people to create new content or update pages, but am not following the logic on how taking down the websites is saving a significant amount of money.

If they’re using commercial hosting at all, I doubt their vendors decided to quit charging them due to lack of appropriations. If they’re self-hosted, did they just turn out the lights at the data center and leave a few random servers up to share the message of gloom and doom? Are they hoping to cut their cooling bill as a way to balance the budget? I understand it’s all a political maneuver to make it as uncomfortable for everyone as possible, but it seems a little over the top. I decided to do some informal surfing to determine which websites were “essential” or not.

The National Park Service sites are down. Everything redirects to the Department of the Interior home page, which is up. Also live is the Deepwater Horizon oil spill page for those urgent updates from the 2010 spill. Not sure why that’s essential. The web pages of the USDA Forest Service are live with a disclaimer that they will remain available for public safety announcements and updates for wildfires, floods, and other natural disasters, which seems reasonable.

The Centers for Medical & Medicaid Services sites are up, with a disclaimer that information may not be up to date. That approach at least makes more sense than what the National Park Service has done. Is depriving fifth graders the ability to read about Old Faithful really the best way to serve the next generation of leaders? I think not.

One page that I found live with absolutely no disclaimer or mention of the shutdown is the HealthIT.gov page on How to Implement EHRs. Even the HHS HealthITBuzz blog is up without a disclaimer, although the last update was September 26. I wish the majority of physicians I worked with shared the same urgency for EHR adoption as the website does. Also, I was happy to see most of the Veteran’s Affairs websites still up (although there may not be people processing anything on the other side of the wires, which is shameful).

Those of us that work in healthcare IT are constantly preparing and refining our business continuity plans. We make sure we know how to deal with a business disruption and how to actually resume our processes when the systems come up. I wonder how many federal IT departments have the same level of thought or planning? I doubt they perform regular “government shutdown” drills and they probably don’t even have a downtime box because there would be no one there to use its contents. We can only assume that when the systems come back on line things will be messy.

Hopefully the parties involved will figure out a way to come together and start serving the American people again but, I think that’s probably asking a lot at this point. In the meantime the rest of us will continue doing our jobs, caring for patients, keeping the systems running, and paying our bills. And at least one of us will be dreaming of the Dry Tortugas. Got a seaplane? Want to sneak into a National Park? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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October 10, 2013 News 5 Comments

News 10/9/13

October 8, 2013 News 5 Comments

Top News

10-8-2013 7-28-00 PM

US CTO Todd Park tells USA Today that the Healthcare.gov insurance marketplace wouldn’t be failing if the site hadn’t drawn five times the expected number of simultaneous users. “Take away the volume and it works,” he said. Former National Coordinator and Republican appointee David Brailer wasn’t impressed with the Democratic appointee’s explanation: “Whoever thought it would draw 60,000 people wasn’t reading the administration’s press releases. The Medicare Part D site was supposed to have 20,000 simultaneous users and was (built for) 150,000, and that was back when computing was done on an abacus. It isn’t that hard.” A Wall Street Journal investigation finds that an Experian identity module is crashing frequently, the site contains orphan programming code that appears to do nothing, and caching was not employed for efficiency. It estimates that up to 99 percent of those people who try to register can’t complete the process. The previously chatty government contractors involved are now declining to return calls.

Reader Comments

From Patient Presents Without Comment: “Re: ICD 10. I wish I could see when, You’d be part of my past, and be gone; Your codeset is fine, but look: I prefer Nine. It’s opinion- how can it be wrong? There’s just under a year- it’s a while, but I fear, That there’s yet quite some Gantt chart to go; Could you install yourself? It’d be good for my health. So please MYOB, IMO.”

From Beer Reviewer: “Re: Monday morning news. The posts have been short. Is the news in short supply?” It is, actually. I go through the same steps every weekend to put together the Monday Morning Update, just like I’ve been doing since 2003. Lately news has been nearly non-existent. I could do like everybody else and pad it out with worthless, self-serving press releases masquerading as useful information, but I assume you would rather me not waste your time. Nobody has pointed out anything important that I’ve missed, a test I apply every single day to what I write.

From More Please: “Re: anonymous CIO interview. Fascinating! I would like to see more.” So would I. All I need are CIOs who are willing to be interviewed anonymously. If that’s you, let me know.

HIStalk Announcements and Requests

Everybody knows that most everything Yahoo is hopelessly antiquated crap, but I’ve stuck loyally with the paid version of Yahoo Mail for nearly 10 years because I like it better than the alternatives. No more. Yahoo is having a spam-related spat with Spamcop blacklisting that was causing my emails to fail and despite all the hoopla about improving the user experience, Yahoo has apparently removed every possible way of contacting support (even via an online form – thanks, Marissa Mayer). The best way to get me now is mr_histalk@histalk.com.

Acquisitions, Funding, Business, and Stock

10-8-2013 7-17-51 PM

Luminate Health, which offers a patient-friendly lab results portal, raises $1 million.

Nuance gives in to activist investor Carl Icahn by adding two of his nominees to its board in return for his support of the company’s slate.


Sacramento Family Medical Clinic (CA) is implementing Forward Health Group’s PopulationManager as it joins forces with The Guideline Advantage to improve quality outcomes and patient care.

Partners HealthCare (MA) selects InterSystems HealthShare to replace several integration engines as it consolidates to a single EHR.

The Valley Hospital (NJ) will implement Merge Healthcare’s CTMS for Investigators solution to organize and centralize its clinical research operations.

Aegis Sciences will implement Passport Health’s OrderSmart and PaymentSafe to automate transactions between its CBO and U.S. locations.

10-8-2013 7-33-50 PM

Washington Health System (PA) selects eClinicalWorks EHR for its 87 physicians and 21 residents in its family practice residency program.

In Brazil, Hospital Israelita Albert Einstein chooses Cerner Millennium.


10-8-2013 3-40-00 PM

St. Francis Medical Center (CA) names Judi Binderman, MD, MBA, MHSA (Encore Health Resources) as CMIO. 

10-8-2013 3-51-08 PM

Former ONC Principal Deputy Director David Muntz will join GetWellNetwork as CIO. We ran this as a reader rumor last week.

10-8-2013 3-57-23 PM

Encore Health Resources promotes Steve Eckert to partner of client services.

10-8-2013 5-40-50 PM

Alameda Health System (CA) names Dave Gravender (Kaweah Healthcare District) as CIO.

Clinovations hires Brian Morton (Halley Consulting) as VP of physician networks, Kim Tombragel (maxIT-Vitalize) as SVP of business development, and Robin Walters (Halley Consulting) as business development manager.

Announcements and Implementations 

10-11-2013 7-14-30 PM

A KLAS report finds that PatientKeeper is the most user-friendly standalone CPOE system on the market, with its 8.3 score on a nine-point scale beating Epic inpatient by almost a full point. All PatientKeeper customers interviewed by KLAS said they would buy it again, with an overall company performance score of 86.4 and reported physician user training time of as little as 10 minutes.

Nuance announces its Clinic 360 suite, an outsourced transcription service and application for physician practices and ambulatory clinics that manages dictation, review, editing, and sign-off for specialties such as oncology.

ADP AdvancedMD introduces its business intelligence solution AdvancedInsight during MGMA. The company also ADP releases its iPhone app.

Harris Healthcare achieves critical milestones while deploying its Service Oriented Architecture Suite across the US Department of Veterans Affairs and the DoD.

Vitera is previewing Intergy V9.00 at MGMA this week.

Capario introduces CaparioOne, its redesigned web portal application for revenue cycle management.

10-8-2013 4-49-11 PM

Next Wave Health launches Next Wave Connect, a problem-solving social network for healthcare organizations. Drex DeFord will serve as CEO and Mike Davis as EVP of research and analytics.

VHA Mid-Atlantic will offer its hospitals mobile patient satisfaction and experience tools from Marbella Technologies.

10-8-2013 5-32-04 PM

Peer60 offers HospitalTCO.com, which allows hospitals to determine total cost of ownership for IT systems over 10 years. It’s free.

Athenahealth announces its readiness for Meaningful Use Stage 2.

Mediware says it will expand the CPR+ platform it acquired in July 2013 to create a management tool covering home medical equipment, home infusion, specialty pharmacy, and home health.


10-8-2013 7-38-52 PM

Officials of Dane County (WI) Regional Airport are planning a $30 million parking deck expansion to handle the increasing number of Epic Systems travelers.

10-8-2013 6-11-43 PM

HIMSS releases a photo of its Innovation Center inside the just-opened Global Center for Health Innovation in Cleveland.

The local newspaper covers the $125 million Epic project of WellStar (GA).

10-8-2013 7-39-44 PM

UNC Health Care (NC) says it expects to post an operating loss for the fiscal year due to reduced volumes caused by its Epic go-live. 

Sponsor Updates

  • T-System launches two solutions to assist EDs overcome negative aspects of EHRs, including a paper-based note-taking tool (Doc Notes) and an ED physician documentation application (EV for physicians).
  • InstaMed says use of its Member Payments solution, launched earlier this year, will exceed $100 million in patient payments.
  • CareTech Solutions signs its first long-term care facility to its Clinical Service Desk support service.
  • PeriGen will offer an October 9 Webinar, “Uterine Tachysystole: How much is really too much?
  • The HCI Group is honored as the fastest growing private company in Florida by the Florida Business Journal.
  • Billian’s HealthDATA will host an October 16 webinar offering three perspectives on patient and provider engagement.
  • Predixion Software CEO Simon Arkell briefs the Boulder Business Intelligence Brain Trust on V3.1 of Predixion Enterprise Insight and its Machine Learning Semantic Model.
  • Genesis Health System (IA) discusses the performance efficiencies they’ve experienced since the integration of Vocera’s wireless communication system with their Cerner EHR.
  • Intermountain Healthcare and Craneware will present “Structuring Multidisciplinary Teams for Revenue Cycle Improvement” during the 2013 HFMA MAP Event October 28 in Ft. Lauderdale, FL.
  • Elsevier and Jefferson Medical College (PA) are co-sponsoring the “Art + Medicine: How Art Can Make Better Doctors” conference November 2-3 in Philadelphia.
  • Health Care Software participates in the AHCA/NCAL 64th Annual Conference and Expo in Phoenix this week.
  • Intelligent InSites will present “The Why’s and How’s of Reforming Healthcare Operations” on October 9.
  • NextGen Inpatient Clinicals V2.6 receives 2014 ONC HIT certification as a complete EHR.
  • Aspen Advisors Jody Cervenak is moderating a panel on the optimization of physician documentation during the CHIME13 Fall CIO Forum in Scottsdale this week.
  • ZirMed signs over 900 clients processing over 2.2 billion transactions while launching three additional products in the first nine months of 2013.
  • Greenway supports the national eHealth Exchange by joining Healtheway.
  • Dan Charney, managing partner of Direct Recruiters, Inc. / Direct Consulting Associates, is named a “Forty under 40” honoree by Crain’s Cleveland Business.
  • Orchestrate Healthcare is hosting an October 17 business intelligence Webinar.


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

More news: HIStalk Practice, HIStalk Connect.


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October 8, 2013 News 5 Comments

Monday Morning Update 10/7/13

October 5, 2013 News 2 Comments

From Insider: “Re: David Muntz from ONC. Will join GetWellNetwork’s leadership team.” Unverified.

From The PACS Designer: “Re: iOS7. Now that the hoopla has subsided over the 5C/5S, thought it would be good to reveal what are the improvements that Apple brings us with iOS7. They say, ‘It has a new structure, applied across the whole system, that brings clarity to the entire experience. The interface is purposely unobtrusive. Conspicuous ornamentation has been stripped away. Unnecessary bars and buttons have been removed. And in taking away design elements that don’t add value, suddenly there’s greater focus on what matters most: your content.’ Other features are improved graphics, audio, and many other areas to numerous to mention here. With Apple’s acquisition of Cue, a personal assistance app, the solution will surely find is way into iOS7 healthcare communications software.”

10-5-2013 4-21-58 PM

From THB: “Re: Northwestern Memorial in Chicago. Leaving the Cerner fold and going to Epic, but I don’t see it mentioned in searching your site. Am I missing something? It’s been going on for the last several months, so is this a big secret, or is it hiding in plain sight?” I ran a reader’s rumor about the switch a year ago, and another reader’s rumor before that.

10-5-2013 9-01-10 AM

Most poll respondents don’t see customers of either Vitera or Greenway benefitting from their single ownership. New poll to your right (which is actually an earlier poll that few saw since it wasn’t the featured poll): how will hospitals handle liability and workers comp insurers that won’t accept ICD-10 data until 2015?

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

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Kyle scored an interview with Aaron Levie, co-founder and CEO of Box, at Health 2.0.

10-5-2013 10-12-04 AM 10-5-2013 10-11-21 AM

Sunquest announces two new executives: Jonathan Pierson (MedAssets) as VP Solution Adoption Center of Excellence and Keith Laughman (MedFusion) as EVP of Community Care Solutions.

10-5-2013 4-18-37 PM

CaroMont Health (NC) announces a breach involving the records of 1,310 patients that were sent by an employee via unsecured email.

10-5-2013 4-26-57 PM

Weird News Andy says it’s usually a brother-in-law: a two-year-old boy in China with a swollen stomach and difficulty in breathing is found to have a parasitic twin with fully formed spine and limbs growing inside his stomach. Doctors removed the eight-inch-wide twin.

Vince identifies several vendor C-suite executives of long ago this HIS-tory edition, but he seeks help filling in some of the blanks.


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

More news: HIStalk Practice, HIStalk Connect.


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October 5, 2013 News 2 Comments

News 10/4/13

October 3, 2013 News 6 Comments

Top News

10-3-2013 5-38-48 PM

Lexmark International acquires PACSGEAR, which provides connectivity solutions for sharing medical images with PACS and EMRs. The price was $54 million in cash. The acquisition will be operated from Lexmark’s Perceptive Software.

Reader Comments

From Frank: “Re: certification scoreboard. A check of the certified inpatient systems still shows some big names missing. For full EHR certified systems missing are two biggies, Cerner and Siemens. Also no shows are Healthland, QuadraMed and NTT-Keane. A week ago Dr. Mostashari was quoted as saying that two-thirds of the systems in use were already 2014 (Stage 2) certified. That’s hard to believe with Siemens and Cerner still out, and McKesson only certified for Paragon. That’s got to cover at least half the hospitals in the country. Also somewhat ironic is Siemens is not certified. Remember John Glaser was a key member on the HIT Committees that set up the criteria for Certification/MU program. I remember him being quoted two years ago in an HIStalk interview saying that the program was not going to be easy and some organizations just won’t make it. Well he’s proving himself a prophet now!”

HIStalk Announcements and Requests

inga_small Some news you might have missed this week from HIStalk Practice: CareCloud and Box integrate Box’s content-sharing capabilities into the CareCloud platform. My top educational session pick for MGMA, plus my tentative party agenda. Most physicians are satisfied with the e-prescribing workflow for controlled substances. Medicare awards Arch Systems a contract to validate the accuracy of data submitted to the eRX and PQRS programs. Physicians claim EMR use is stressful. If you are headed to MGMA, you’ll want to peruse our annual list of Must See Vendors. The guide includes essential details such as vendor booth numbers, product offerings, and fun giveaways. Thanks for reading.

inga_small I’ll be reporting from MGMA beginning on Sunday so keep reading HIStalk Practice (or sign up for email alerts) for all the conference updates. Feel free to email me if you have any recommendations for conference sessions, exhibit booths, or after-hours festivities.

On the Jobs Board: Chief Medical Officer, Clinical Analyst, Epic Revenue Cycle Project Director.

Acquisitions, Funding, Business, and Stock

Mobile healthcare communications provider Duet Health secures an undisclosed investment from Baird Capital.


PIH Health (CA) selects Allscripts Sunrise EHR for its newly acquired PIH Health Hospital-Downey and extends its hosting and managed services agreement.

10-3-2013 6-03-42 PM

Southern Regional Medical Center (GA) engages MedAssets for A/R services and revenue cycle consulting.


10-3-2013 3-41-21 PM

AirStrip promotes Matt Patterson, MD from chief transformation officer to COO.

10-3-2013 5-14-25 PM

MaineHealth names interim CIO Andy Crowder as CIO.

10-3-2013 5-30-19 PM

Farzad Mostashari, MD will join the Engelberg Center for Health Care Reform of The Brookings Institution as a visiting fellow.

10-3-2013 5-33-17 PM

NorthCrest Medical Center (TN) promotes Randy Davis as president and CEO. He had previously served as VP/CIO.

Shelia Mitsuma, MD, who holds positions with Brigham and Women’s Hospital and Massachusetts General Hospital, joins EBSCO Information Services as deputy editor of its DynaMed clinical reference tool.

Announcements and Implementations

Newton Medical Center  connects its Meditech EHR to the Kansas HIN using ICA’s CareAlign interoperability platform.

inga_small Cerner announces a strategic relationship with Shawnee Mission Medical Center and TMC Lakewood and designates the organizations “Certified Maternity Partners” for its KC-area employees. Cerner says the arrangement is designed to “improve infant and maternal health outcomes,” while “managing rising healthcare costs for its associates.” I suppose that means that many Cerner employees or their covered spouses may need to change providers in order to receive full maternity benefits. I’ll be curious to see how receptive Cerner employees are to this change since my experience is that women in particular prefer to exercise maximum control over their own health issues, including their choice of providers.

The Georgia Department of Community Health launches its statewide HIE network with the Truven Health Analytics platform, powered by CareEvolution.

Government and Politics

ONC reports that as of July 31, 1,115 critical access hospitals and small, rural hospitals had attested for MU, which exceeded ONC’s goal of 1,000 by 2014.

The VA warns that the federal government shutdown will reverse its progress on decreasing the backlog of disability claims because claims processors cannot be paid overtime.

Innovation and Research

10-3-2013 10-13-22 AM

Inpatient providers report a high level of adoption for eligibility and scheduling solutions from RCM vendors, according to a HIMSS Analytics study. Many respondents say they intend to replace or purchase new RCM solutions to handle pre-certification, address validation, and bill estimation. The most-considered RCM vendors include Passport, RelayHealth, Emdeon, and MedAssets.


Athenahealth and Epocrates introduce Bugs + Drugs, a free app to identify the most common bacterial infections recorded in a geographic region using data collected  from athena customers.

Royal Philips and Accenture demonstrate a proof of concept for the use of Google Glass to aid in surgery. Researchers successfully transferred patient vital signs from Philips Intellivue software to Google Glass, giving surgeons continual access to patient data hands free.


10-3-2013 1-02-38 PM

Xerox, provider of the Midas+ product,  is named the “vendor to beat” in a KLAS report on quality management solutions. Nuance and Premier earned the next-highest performance scores. Providers say they want more from their vendors than just regulatory reporting functionality and are looking for solutions that will facilitate operational and financial improvements to drive better outcomes.

A multi-day systems outage at a Scottish hospital trust that forced cancellation of hundreds of appointments is blamed on a corrupted Microsoft Active Directory.

A man who gave a phony name in his hospital admission rips out his IV, steals another patient’s iPhone and iPod, and slips out of the hospital. The man is a suspect in several similar incidents at other hospitals.

Sponsor Updates

  • CTG Health Solutions publishes a white paper with recommendations and steps for setting up executive dashboards to manage EHR implementation project issues or risks.
  • Elsevier names five winners of its third annual Mosby’s Suite Superheroes of Nursing contest.
  • Vocera Communications previews its Vocera Collaboration Suite at the ANCC National Magnet Conference this week in Orlando. Also at ANCC: GetWellNetwork will demonstrate its new patient user interface.
  • Levi, Ray & Shoup opens a Paris, France office to provide support for its LRS Output Management software.
  • Truven Health Analytics establishes a Singapore-based regional office as its Asia Pacific headquarters.
  • Infor CMIO Barry Chaiken, MD and Infor customer Joel Vengco, CIO at Baystate Health, will discuss learning to leverage social networking and user experience optimization tools to drive patient-centered clinical workflow at next week’s CHIME 13 Fall CIO Forum in Scottsdale.
  • Aventura earns Gold status in the Golden Bridge Awards for its innovative, secure, and effective IT awareness computing platform.
  • Forward Health Group reports it is poised to nearly double the number of deployments of its PopulationManager platform within a matter of weeks.
  • HCS will exhibit at next week’s AHCA/NCAL 64th Annual Conference and Expo.

EPtalk by Dr. Jayne

The past week has been uncharacteristically low key for me.  Our IT teams have been working hard to knock out strategic projects because we know our EHR vendor is on the cusp of releasing their ICD-10 ready package to the general public. Once that happens, it’s going to be all hands on deck and full speed ahead.  Luckily we’ve been more efficient than usual so we have a bit of a lull while we wait.  It feels a bit like they describe the eye of a hurricane as we wait for the beating that’s surely coming.

I’ve been catching up on email, reassuring providers that we’re going to meet all our deadlines, and trying to stay away from any new projects the operations people try to sneak in. We’ve had a terrible time prioritizing new initiatives and finally have a good process in place, but there is one administrator who is always pushing a pet project. It usually doesn’t have funding or a well-defined scope, so I’m avoiding him at all costs.

I guess I shouldn’t be shocked anymore at how far some of his initiatives make it before someone finally says no. It seems like our hospital administration is increasingly reactive, responding to the squeakiest wheel or the sparkliest thing dangled in front of them regardless of its lack of purpose in context of our long term goals. There were a lot of strategic planning apple carts upset over the last few years as hospitals struggled to plan for upgrades and other initiatives around Meaningful Use and ICD-10. The only unknown on the horizon now is Meaningful Use Stage Three and I think we can at least make some reasonable plans based on what we think will make it in the final requirements.

I have appreciated the opportunity we’ve had to roll up our sleeves and take care of all the things we put on hold over the last few years. On the technical front we’ve expanded interface capabilities for our ambulatory sites, implemented some great new reports, and increased our patient outreach efforts. On the workflow front, we have had fewer new implementations so we can actually spend time going back to retrain staff and reinforce best practices. Our operations teams have actually had time to do some process redesign work and build on the clinical transformation we started with EHR.

Of course, we’re still doing all the day to day “care and feeding” activities such as maintenance and patches but it’s been nice to feel like we’re making up some of the ground we lost with all the focus on MU. Our compliance teams are starting to train ICD-10 in earnest and I’ve enjoyed fielding questions from colleagues who seem to have been under a rock or locked in a biodome for the last few months. Somehow they missed all the demos we did showing that yes indeed the system will be capable and ready come October next year.

I wonder if vendors are experiencing any of the lull that we are. It would be great to know that they’re able to focus on greater usability, expanded content, and designing the next best way to document patient visits rather than checking the box on regulatory requirements. Many of our vendors have been through the wringer during the last couple of years. It will never be the way it was before Meaningful Use, but I’m looking forward to a new normal where we can again collaborate rather than scrambling madly in the same general direction.

I figure I’ve got about two weeks of the good life left and then I’m going to be back in an upgrade cycle with all the standing meetings that entails. I’ll be back in the trenches testing workflows and trying to find defects as quickly as possible so that our vendor can roll them into patches before we go live. Every time we upgrade it reminds me more and more of some kind of military assault. I’m not sure if it’s just the way we run them or a little bit of post-traumatic stress. Maybe it’s a little of both.

Are you in the calm before the storm? Planning an upgrade or just trying to stay afloat? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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October 3, 2013 News 6 Comments

News 10/2/13

October 1, 2013 News 16 Comments

Top News

10-1-2013 11-09-42 AM
10-1-2013 3-30-46 PM

10-1-2013 4-21-38 PM

All but four of 184 ONC staffers are furloughed as a result of the October 1 government shutdown, along with about 40,000 (52 percent) HHS employees. ONC has also put on hold its Standards and Interoperability work, privacy and security policy activities, clinical quality measure development, and maintenance of the Certified Health IT Product List. Tweeting is apparently considered a non-essential service.

Reader Comments

10-1-2013 4-48-54 PM

From Ole: “Re: David Muntz. He won’t be returning to Baylor Scott & White. Matt Chambers is the new CIO, reporting to COO Bob Pryor. Both are from Scott  White. Vic Richey is the newly appointed CIO for the Baylor (Northern) division.” Verified from the LinkedIn profile of Matt Chambers (above).

10-1-2013 4-50-16 PM

From HIT Pundit: “Re: Leidos, the former maxIT-Vitalize. Major changes in leadership. The website confirms that people are gone.”

From Clafouti: “Re: Dr. Jane’s comments about Greenway. It was not only biased toward sponsors (which I understand to a point) it was verbatim of what Tee says in his speeches. Next time you claim to be independent, don’t quote the CEO and call it your own words.” Dr. Jayne has never met Tee or heard him speak. She wrote that post a year or so ago and decided it wasn’t appropriate to run at the time, but the Greenway acquisition made it more timely.

HIStalk Announcements and Requests

10-1-2013 3-48-00 PM

Welcome to new HIStalk Platinum Sponsor pMD. You may note and appreciate, as did I given the dearth of it in healthcare IT, pMD’s appreciation for whimsy. The San Francisco company lets doctors record charges in seven seconds on a mobile device, or as one hospitalist says, “If you can hold a beer, then you can use pMD”  (many testimonials are here). Users report an increase in Medicare payments for post-discharge follow-up appointments and improved care coordination driven by its handoff tools. Native apps are provided for Android, iPhone, BlackBerry, and iPad and support is provided 24×7 by actual employees. Thanks to pMD for supporting HIStalk.

A YouTube cruise turned up this video describing pMD’s mobile charge capture solution.

Acquisitions, Funding, Business, and Stock

10-1-2013 4-51-58 PM

Evolent Health, which offers a population health and risk management platform, secures $100 million in Series B funding led by The Advisory Board Company and UPMC Healthcare, bringing the company’s total funding to $124.5 million.

10-1-2013 4-53-21 PM


Baylor Health Care System (TX) and Scott & White Healthcare (TX) complete their merger and form Baylor Scott & White Health, the state’s largest not-for-profit health system with $8.3 billion in assets.

Tenet Healthcare closes on its $4.3 billion acquisition of Vanguard Health Systems.

10-1-2013 4-54-54 PM

Healthrageous, a Center for Connected Health spinoff that offered patient engagement tools, sells off its assets to an unnamed “leading healthcare companies.” Even the website is gone.


Knoxville Comprehensive Breast Center (TN) will implement Sectra breast imaging PACS and RIS.

10-1-2013 4-56-00 PM

Adirondack Health (NY), Baylor Health Care System (TX), Mission Health (NC), North Shore Long Island Jewish Medical Center (NY), and University of Chicago Medical Center (IL) select Vocera’s Care Experience Suite.



10-2-2013 5-42-31 AM   10-1-2013 1-49-14 PM

Emdeon appoints Neil E. de Crescenzo (Oracle – on left) president and CEO, replacing George I. Lazenby, IV (right), who will become a senior advisor for Emdeon’s majority investor, Blackstone Capital Partners.

10-1-2013 3-00-40 PM

McKesson names James A. Beer (Symantec) EVP/CFO.

10-1-2013 1-51-22 PM

Johanna Epstein (Mount Sinai Doctors Faculty Practice) joins Culbert Healthcare as VP of strategy and executive leadership services.

10-1-2013 10-28-26 AM

PeriGen hires Rebecca Cypher (Madigan Army Medical Center) as chief nursing officer.

eHealth Ontario appoints its chairman Ray Hession to serve as interim CEO following the departure of Greg Reed, who quit six months into the job and left with a $406,250 severance package.

10-1-2013 1-53-10 PM

SRS names Peter Bennfors (Asset Control) CFO.

10-1-2013 4-04-17 PM

Infina Connect names Mark Hefner (Allscripts) as CEO.

MedData appoints appoints Stephen Ghiglieri (NeurogesX) CFO and Dustin Whisenhunt (Prognosis) VP of client services and sales.

Amy Amick (MModal) joins MedAssets as president of the company’s RCM segment.


Announcements and Implementations

The 25-bed Cobre Valley Regional Medical Center (AZ) goes live on Meditech 6.0.

The New York Giants converts the medical records of its players to eClinicalWorks.

10-1-2013 11-16-19 AM

Saint Luke’s Health System (MO) goes live on Covisint’s cloud engagement platform.

Family Service of Madison (WI) implements Forward Health Group’s PopulationManager to identify and monitor progress in patients with substance use disorders and depression.

Summit Healthcare adds Summit Care Exchange to its interoperability suite, allowing hospitals to exchange PDQ and XDS messages in sending continuity of care documents to external entities.

AirStrip announces the launch of AirStrip ONE Cardiology for Windows 8.1.

Health Catalyst receives the highest grade in the clinical analytics market in a Chilmark Research report.


A Xerox survey (conducted online, and therefore with shaky statistical certainty)finds that more than two-thirds of American adults don’t believe their physicians gave them a good explanation about the switch to EMRs. Most are also concerned with the security of their records and less than a third want their records to be digital. However, 62 percent believe that EHRs will reduce healthcare costs and 73 percent think they’ll get better service from practices that use EHRs. In case it wasn’t already obvious, Americans are confused.

10-1-2013 5-00-02 PM

Cerner expects more than 10,000 attendees at its 25th annual conference in Kansas City that runs October 6-9.

John at EMR & EHR Videos will conduct a Google+ Hangout with Kareo CMIO Tom Giannulli, MD, MS on Thursday, October 3 at 1:00 Eastern.

An MGMA survey finds that medical practice IT spending has risen from $15,211 in 2008 to $19,439 in 2012.

10-1-2013 9-23-52 AM

10-1-2013 9-25-13 AM

10-1-2013 9-26-59 AM

inga_small I don’t know why this bothers me so much, but I continue to be annoyed by articles in the main stream press that suggest EMRs are a requirement of the Affordable Care Act. I’ve even noticed recently a few vendors have made this statement in their marketing materials. As a reminder: ARRA (specifically the HITECH ACT) was the legislation that included the requirement for EMR adoption and provided the groundwork for incentives and penalties. Maybe some of the confusion stems from the fact that the ACA includes provisions for the secure exchange of electronic health information. Regardless, I have read so many articles that tie ACA to EMR and Meaningful Use that I had to do some fact checking just to be sure I hadn’t incorrectly rewritten history.

10-1-2013 9-38-46 AM

inga_small While I am ranting, I am self-insured, so I decided it might be worth my while to investigate available options on the Health Insurance Marketplace. I first attempted to get on the site at 8:00 a.m. EST and despite multiple attempts, I’ve yet to be able to create an account (the security questions never appear). Several hours later, I’ve still not gotten a response from anyone using the online chat feature. I realize it is only Day 1, but so far I have to call the online process a failure.

10-1-2013 1-39-59 PM

inga_small On a much happier note, my veterinarian sent me an email to inform me that I can now set up a PHR for my pets. It took about three minutes to register and now I can see health histories online. I’m not really sure why I need online health records for pets, but it’s still cool to say it’s there.

10-1-2013 10-00-15 AM

inga_small Someone please assure me that none of my tax dollars were used to fund this study that developed BAPS (Belief About Penis Size Scale).

The family of newborn delivered at 24 weeks gestation creates a video thanking Fletcher Allen Health Care. I’m trying to preserve the feel-good moment by not thinking about the healthcare resources consumed by a 98-day NICU stay and the fact that similar babies are intentionally aborted at that same 24-week mark.

Here’s an Intermountain video describing its Cerner selection.

Sponsor Updates

10-1-2013 4-06-10 PM

  • ESD sponsored Sunday’s Northwest Ohio Susan G. Komen Race for the Cure, with participating employees raising $1,500 in donations.
  • Medseek partners with Vitals to help healthcare organizations connect consumers with providers and facilities.
  • The Web Marketing Association recognizes CareTech Solutions with an Information Services Standards of Excellence Award and presents 2013 WebAwards to 10 CareTech customers.
  • NCQA awards GE Healthcare’s Centricity Practice 11 Solution PCMH pre-certification status.
  • Gartner places Perceptive Software in the Leaders Quadrant for enterprise content management solutions.
  • INHS reports that its use of IBM server and storage technology has improved its delivery of cloud-based EHR services to physicians and medical facilities.
  • Predixion Software launches an OEM program aimed at embedding its predictive analytics solutions into BI and analytics programs.
  • Beacon Partners hosts an October 17 webinar on using data to optimize clinical and financial systems.
  • Summit Healthcare adds Summit Care Exchange to its interoperability suite and introduces enhancements to its current Express Connect and Provider Exchange products.
  • Divurgent will participate in the CHIME13 Fall Forum October 8-11 in Scottsdale, AZ.
  • Hospitals that have implemented ProVation Order Sets by Wolters Kluwer Health report clinical benefits and ROI in as little as 13 months.
  • Seamless Medical Systems posts a case study highlighting how a geriatrics practice streamlined patient workflow, reduced operational costs, and improved the patient experience though its use of SNAP Practice.
  • Wellsoft will exhibit at the 2013 ACEP Scientific Assembly October 14-16 in Seattle.
  • Dave Himes, IS group director for Billian’s HealthDATA, delivers a Letterman-style list of top ten CRM integration tips.


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

More news: HIStalk Practice, HIStalk Connect.


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October 1, 2013 News 16 Comments

Monday Morning Update 9/30/13

September 28, 2013 News 12 Comments

9-28-2013 3-13-26 PM

9-28-2013 3-15-26 PM

From Cerner Rules: “Re: Intermountain. Finally the Epic backlash has begun.” I wouldn’t make that assessment without a review of the Cerner-Intermountain agreement since I don’t know the price or the concessions Cerner gave to earn the business. We heard similar partnership hype in 2005 when Intermountain struck a 10-year, $100 million collaboration deal with GE Healthcare to develop new technologies around Centricity that would “set the standard for the industry to follow.” The net result is that nothing ever happened, Centricity slid even deeper into irrelevance, and Intermountain bailed out early over dissatisfaction with the result and courted its next bedmate. Intermountain is a development shop with a long IT history and an unhealthy allegiance to its antiquated HELP system, which I would bet makes them a pain as the development partner of a bureaucratic and publicly traded vendor like either GE or Cerner. I don’t recall many examples like this where the vendor ended up with commercial software with wide appeal, not to mention that it’s the federal government that’s driving the development agenda anyway with prescriptive rules for Medicare payments, Meaningful Use, and ICD-10, most of which provides no benefit to patients at all. It’s a good deal for Cerner from a PR perspective and they may fare better than GE Healthcare, but I wouldn’t hold my breath in anticipation of a flood of amazing new Millennium functionality since Intermountain is hardly Cerner’s only smart customer (that’s another risk – alienating the lesser-anointed longstanding customers). Probably the best bet is analytics since Intermountain is strong there and Epic got a late start. I’m talking to Neal Patterson this week, so I’ll let you know what he says. Intermountain Health Care changed its name to make the “Healthcare” part one word and eliminated the previously acceptable “IHC” designation later in 2005, so the GE Healthcare announcement spelled it right even though it looks wrong. Now if we could just convince the “HealthCare” holdouts to spell it right …

From BigMoneyInPatient Portals: “Re: patient portals. A report says the market will jump from $280 million to $900 million in the next five years. I guess HCIT corporate development people have found their next acquisition target.” I don’t pay the slightest attention to those come-on press releases from market research firms that claim to know how big a particular market will be, information they will gladly share with you for several thousand dollars. I don’t see many follow-up press releases extolling the accuracy of their previous predictions, the reason for which you can probably infer. I think the patient portal hype is overblown given that every vendor offers one, meaning patients are supposed to log on to several depending on what system their providers use. Kaiser can do great things with MyChart because most of the encounters are within their system and the patient can get everything in one place, but I don’t think the concept will work in most areas. Imagine if your bank had separate portals for deposits, checks, loans, and investments, all with their own look and feel and log-in credentials. Not only would nobody use them, the banks would irritate their customers for even suggesting that they should. Portals are a proprietary distraction to interoperability, not a solution for it.

9-28-2013 5-27-33 PM

From Raj: “Re: UMass Hospital System. Missed the deadline to go live with CPOE and missed out on millions of dollars from the taxpayers. They have unionized nurses who stood up and demanded HIT accountability like in Ohio and California.” Unverified. I will say that I’ve worked rather uncomfortably with unionized nurses and that’s an experience I’d rather not repeat (or experience as a patient). The visual memories of watching nurses trashing hospital equipment and blocking ambulance access during an ugly labor dispute soured me for good on their concern for patients.

9-28-2013 5-28-13 PM

From IsItTrue: “Re: David Muntz. Rumor is he will return to Baylor to lead the newly merged Baylor Scott & White IT organization.” I wouldn’t be surprised. Quite a few of the departed ONC folks have gone back to their previous jobs after finishing their abbreviated government service. Baylor Health Care and Scott & White Healthcare agreed to merge in late June to create Baylor Scott & White (I’m really annoyed at the omitted commas), which will have 40 hospitals, $6 billion in annual revenue, and 34,000 employees.

From Patient Advocate: “Re: EHRs. My ophthalmologist appoint ran 90 minutes late. The doctor said it was because they were converting to a computer system, but nobody told that to the waiting patients. She started whining that it had been a month, they were still delayed, and she was working until 6 every night. I told her the practice should adjust the patient load to reflect the number they can actually see. She said, ‘We have to see patients’ and didn’t seem to agree as she stashed her iPad mini into her lab coat. I finally left two hours later, and as I fought rush hour traffic, I thought, you chose this profession. I did not choose to need an eye specialist. Don’t tell me how rough your life is with a computer system implementation for which someone set the wrong expectations. I left without making a follow-up appointment since I couldn’t find the energy.”

9-28-2013 1-19-31 PM

Most poll respondents expect population health and analytics opportunities to kick in within four years. New poll to your right: which customers benefit from combining Vitera and Greenway under a single private equity owner?

Upcoming HIStalk Webinar: “Strengthen Financial Performance: Start with Lab Outreach” on Wednesday, October 16 at 2:00 p.m. Eastern. Presented by Liaison.

9-28-2013 4-04-13 PM

Friday’s quarterly report from BlackBerry will probably form its epitaph as it announces a $1 billion quarterly loss, almost all of it due to unsold Z10 touch phones on which the company had bet the farm. It’s hard to believe people still actually work there, but the former RIM (renamed in January to distance the stench of failure) will hack another 4,500 jobs and move its focus to corporate customers. The one-hit-wonder company has evaporated $75 billion in market value in the past five years.

A Toronto surgeon develops an “OR Black Box” that records every aspect of surgical procedures by video and audio, although he points out that it probably couldn’t have happened in the lawsuit-happy USA.

9-28-2013 5-21-11 PM

Bridgeport Hospital goes live on Epic, completing Yale School of Medicine and Yale New Haven Health System’s $300 million project on time and under budget as CEO Bill Jennings throws the ceremonial switch.

9-28-2013 5-29-36 PM

Administrators at  at one of England’s highest-mortality hospitals open up staff access to Twitter and Facebook, with the intention of promoting “openness and transparency” but causing critics to warn that “the last thing this hospital and its patient needs is staff getting distracted by Facebook and Twitter whilst at work.”

Government subcontractor programmers are being pushed to fix the health insurance exchange software that is scheduled to go live October 1 whether it’s ready or not. Known problems include delays in the Spanish version, specific exchanges that can’t calculate federal subsidies, and erroneous displays. Oregon is so worried that it won’t let anyone try to enroll in insurance plans without the help of a trained agent. The system integrator is India-based Infosys. The saving grace is polls that show two-thirds of Americans have never heard of the insurance exchanges anyway.

9-28-2013 4-31-58 PM

Truven Health Analytics names Mason Russell (inVentiv Health) as VP of strategic consulting.

Private equity firm KKR will acquire Panasonic’s healthcare unit for $1.67 billion

9-28-2013 2-38-08 PM

Weird News Andy provides a “Man Bites Dog” story. A 33-year-old medical student falls onto a Boston subway track in a drunken stupor after celebrating passing his board exams. Onlookers jumped down to pull him to safety.

Sponsor Updates

  • PeriGen will demonstrate the PeriCALM fetal surveillance system at the MedAassets Technology & Innovations Forum in Orlando this week.

Vince’s HIS-tory this week is about the people who founded and ran the early healthcare IT vendor firms. If you’ve been around for awhile and are good at matching names to faces, Vince is looking for help in identifying some of the industry pioneers pictured.


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

More news: HIStalk Practice, HIStalk Connect.


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September 28, 2013 News 12 Comments

News 9/27/13

September 26, 2013 News 11 Comments

Top News

9-26-2013 11-24-53 AM

9-26-2013 8-02-35 PM

ONC Principal Deputy National Coordinator David Muntz will leave his post next month, according to an ONC email to staffers. Muntz, who joined ONC in January 2012 after six years as SVP/CIO of Baylor Health Care System, was considered by some as a potential successor to Farzad Mostashari, MD. Chief Medical Officer Jacob Reider, MD will serve as acting ONC director, while current Deputy National Coordinator for Operations Lisa Lewis will take over as acting principal deputy.

Reader Comments

9-26-2013 8-49-59 PM

From Frank: “Re: Consumer Reports list of patient medical gripes. Health IT can resolve many of these issues.” Actually, it’s the use of health IT that might solve some of these problems. I say that intentionally because doctors could fix most of these problems themselves without adding technology at all, and if they haven’t fixed them, turning themselves into technology users may not help.

From Jim: “Re: Jonathan Bush on CNBC. A classic quote on healthcare industry consolidation.” Per Bush, “The dinosaurs are mating as the ice cap is melting.”

From Horschack’s Laugh: “Re: RFI/RFP template for provided EDW/BI solution (build, buy, license options)?” I’ll allow readers to respond.

9-26-2013 9-26-52 PM

From Bo Knows: “Re: McKesson InSight in Orlando. So big it’s almost a mini-HIMSS.”

HIStalk Announcements and Requests

A few highlights from HIStalk Practice over the last week include: a chat with the CEOs of Vitera and Greenway about the impending shared ownership of their companies. A look at Practice Fusion and its plans to grow revenues and its customer base. CMS offers an online calculator to determine payment adjustments based on participation in Medicare’s e-prescribing, MU, and PQRS initiatives. A British Columbia newspaper provides insights into the province’s EMR adoption program. The American College of Physicians offers an online clinical decision support tool for internal medicine physicians. Jason Drusak, manger of consulting services at Culbert Healthcare Solutions, offers tips for preparing for Stage 2 MU. And, coming to HIStalk Practice this weekend: our annual list of must-see vendors at MGMA, all of which happen to be faithful HIStalk sponsors. Sign up for email updates so you don’t miss details on how to find these vendors and what they will be discussing at next month’s conference. Thanks for reading.

Acquisitions, Funding, Business, and Stock

9-26-2013 7-48-13 PM

Group purchasing organization Premier Inc. raises $760 million in its IPO. Shares rose 13.5 percent Thursday.

9-26-2013 7-51-27 PM

Shares of Compuware spinoff Covisint jumped 23 percent on their first day of trading Thursday.

9-26-2013 7-52-33 PM

Aventura completes a $4.3 million investment led by current investors.


9-26-2013 7-55-06 PM

F.W. Huston Medical Center (KS) will implement RazorInsights ONE-Health System Edition EHR and financials platform.

The VA extends a three-year, $8 million contract to Harris Corporation for a Correspondence Tracking Software system to improve communications between the VA and veterans.

Intermountain Healthcare (UT) selects Security Audit Manager from Iatric Systems to provide patient privacy auditing and incident risk management across its 22 hospitals and 195 clinics.

Orthopaedics & Sports Medicine Owensboro (KY/IN) selects SRS EHR for its 11 providers.

WellSpan Health chooses Perceptive Software’s vendor-neutral archive for enterprise clinical content management.


9-26-2013 8-18-07 PM

Shareable Ink appoints Dave Runck (Baxa Corporation) as CFO and announces the opening of an expanded office in Boston’s Innovation District.

9-26-2013 8-19-47 PM

Aventura appoints acting CEO John Gobron to president and CEO.

Announcements and Implementations

Cerner and Children’s National Medical Center (DC) invest several million dollars each to build an HIT center for pediatric technology innovation.

Henry County Health Center (IA) becomes the first healthcare facility to go live on the Iowa HIN.

Boston Children’s Hospital (MA)and IBM pioneer OPENPediatrics, a cloud-based learning platform for sharing best practices for the care of critically ill children.

9-26-2013 11-58-25 AM

Hillary Rodham Clinton will become the second Clinton in as many years to provide a keynote address at the HIMSS annual conference. President Bill Clinton drew such a large crowd last year that the overflow masses could only view the speech from a monitor outside the ballroom. Hillary may not attract the same numbers her husband did, but just in case, I hope HIMSS is securing a sufficiently large room to accommodate me and a few thousand of my fellow political junkies.

9-26-2013 8-30-55 PM

Fox Army Health Center (AL) goes live on Tricare Online and RelayHealth online portals.

9-26-2013 8-31-56 PM

The University of Mississippi Medical Center uses MediQuant’s DataArk active archive technology to migrate financial and patient records to a new information system.

9-26-2013 11-33-51 AM

Dossia rolls out Dossia Dashboard, a population health management system that works with the company’s personal health management platform with real-time data analytics and evidence-based health rules.

9-26-2013 9-15-47 PM

Specialty EMR vendor Modernizing Medicine will work with Miraca Life Sciences to develop an enhanced system for communicating diagnostic information between dermatologists and pathologists.

National eHealth Collaborative opens board member nominations.


9-26-2013 8-47-07 PM

Regions Hospital (MN) reduces the average amount of blood transfused by 14 percent after implementing a decision support tool with its EHR. The tool, which Regions developed with the American Red Cross, uses evidence-based clinical guidelines to determine the appropriate use of red blood cells.

Doctors in Colombia amputate a 66-year-old man’s fractured and gangrenous penis after he intentionally overdosed on Viagra to impress his new girlfriend. No word on whether she remains impressed.

Weird News Andy adds a Rodney Dangerfield quote to this story: “I was such as ugly baby that when the afterbirth came out, the doctor said, ‘Twins!’” New mothers are practicing umbilical non-severance, or lotus birth, in which the baby’s placenta is left attached until it falls off on its own days later.

Sponsor Updates

  • SCI Solutions announces details of its Client Innovation Summit next month in Braselton, GA.
  • EDCO releases a recorded Webinar, “Point of Care Medical Record Scanning.”
  • Intelligent Medical Objects releases new videos on ProblemIT and its mobile app.
  • Shaun Shakib, medical informaticist for Clinical Architecture, offers some considerations for organizations implementing and utilizing controlled clinical terminology.
  • HIStalk sponsors earning a spot on Healthcare’s Hottest recognition program for the industry’s fastest-growing companies measured by revenue growth include Allscripts, Beacon Partners, CTG Health Solutions, Cumberland Consulting Group, ESD, Impact Advisors, Imprivata, Intellect Resources, and The Advisory Board Company.
  • AirWatch announces comprehensive enterprise management support for iOS7.
  • Iatric Systems announces that its Meaningful Use Manager and all three Public Health Interfaces have been certified as modular EHRs.
  • Martin’s Point Health Care (ME) details how Forward Health Group’s PopulationManager is helping improve patient care.
  • Valence Health releases details of its November 12-13 thought leadership conference.
  • Chilmark Research selects Wellcentive as a best-of-breed vendor in its 2013 Clinical Analytics for Pop Health Market Trends Report.
  • Ping Identity CTO Patrick Harding joins the board of the Open Identity Exchange.
  • Seven disease management programs supported by TriZetto’s CareAdvantage Enterprise solution earn NCQA Disease Management Systems certification.
  • SuccessEHS hosts more than 475 attendees at its annual user conference this week in Birmingham, AL.
  • Care Team Connects offers an October 8 webinar highlighting the upcoming Medicaid expansion and what it means from a care management perspective.
  • EXTENSION will showcase its alarm safety and event response platform for nurses and other caregivers at the American Nurses Credentialing Center National Magnet Conference October 2-4.

EPtalk by Dr. Jayne

9-26-2013 7-44-23 PM

The recent announcement of the pending union of Greenway and Vitera has been hot news in the physicians’ lounge this week. One of my colleagues was even reading Inga’s interview with Tee Green and Matthew Hawkins while we were talking. Several of the providers at the table were Greenway customers and they are understandably concerned about where things are headed.

Once upon a time I was a user of Medical Manager and then of Intergy, both of which have been absorbed into the Vitera product line. Back in the day, the best part of Intergy was its use of the MEDCIN terminology as the framework for documentation. The process of building point-of-care templates was straightforward (although tedious) and it was fairly easy to document visits. Looking at Intergy now, it barely resembles its original self, which in the software life cycle is a good thing.

Since I’ve been around the EHR world a fairly long time compared to many of my primary care peers, I am sometimes asked to help a practice create an RFP document or to offer an opinion on their system selection process. Recently, I was asked to attend a demo of Greenway and to give my opinion, although my colleague wouldn’t divulge the identities of the other two competitors involved. I thought that was an interesting way to get an opinion without the pros and cons of the other products overshadowing what Greenway had to offer.

I had intended to write it up for HIStalk (after enough of a newsroom embargo to shield my identity) but didn’t want to appear as if I was just talking about a sponsor to talk about a sponsor. Now that Greenway is front page news, though, it seemed like the right time. As background, this was a web demo given by a seasoned Greenway rep and was targeted towards a solo physician in primary care.

He delivered the standard sales background, including number of specialties and clients live. Walgreens and their TakeCare business line was included, with it live in over 4,000 locations. I thought this was interesting given the prevalence of pharmacy-owned clinics in our area and thought that the potential interoperability on that might be kind of nice for the solo primary care doc I was with. He really sold the fact that PrimeSuite focused on the EHR and practice management infrastructure, positioning Greenway as a company that didn’t want to allow other business lines to distract from their core offering.

One surprise was that Greenway wasn’t keen on interfacing with an existing practice management system – it’s an all-or-nothing deal, which is generally a good idea. I’ve seen practices tank implementing a perfectly good EHR because they’ve slaved it to a dud of a practice management system using interfaces that led to dual data entry and a whole lot of headaches. In a lot of ways, refusing to interface would help a vendor choose its customers to some degree. I know several vendors who would benefit from being willing to walk away from practices who don’t understand the benefits of a unified system.

We continued on with the background including their high KLAS rankings over the last decade, which they attributed to word of mouth and happy customers. One of the reasons their customers are happy is their training approach. Their goal is to spell it out to customers as far as what it takes to be successful and how many training hours are needed – it sounded like they take a hard line with customers who don’t want to agree to the recommended amount of training. At the time, ongoing training was available with classes offered nearly every day. I’d have to check with actual clients to see if this is still the case, but it sounds better than what I’ve seen with other vendors, who let clients cheap out on training which leads to crises later.

The inclusion of upgrades in the monthly support fee is a benefit for the Meaningful Use crowd. Having been hit by one particular vendor for upgrade charges in the past, I know this can be a big deal. Greenway has been CCHIT certified a number of times and is offering a guarantee to ensure they maintain certification, otherwise they will compensate providers equal to the amount of lost stimulus funds. A pretty extensive list of happy clients was offered up without asking, including multiple sites within a 30-minute drive. That’s always a good thing to hear during a demo.

In addition to the flagship PrimeSUITE product, they have an interface engine, patient portal, mobile app, and clinical device integration, which I would expect from any vendor who plans to be a contender. Interoperability with Cerner and Epic was mentioned more than once. One offering stands out and that’s their clinical research module, PrimeRESEARCH. Not only does it have a system for managing clinical trials, it allows participating practices to network in hopes of increasing the number of eligible patients. I don’t think there are a lot of vendors offering that functionality, let alone the ability to track trial budgets, patient stipends, and sponsor funding, which it also apparently does. Monthly emails let the practice know if it has patients who would qualify for a trial. Having done outcomes research for a local medical school, this is a potential game changer for community physicians who want to participate in trials but hate the hassle.

With all that out of the way, we finally got into the product itself. Navigation was quick with the ability for users to configure it on the fly. It had everything I would expect in an ambulatory EHR as far as lab display, flowsheets, and tasking. Clinical alerts are generated based on criteria which can be customized from the base set they provide. There was an audible “ooh” from my colleague when he showed their clinical summary face sheet, which is user-customizable with drag-and-drop panes as well as the ability to hover over data elements for more information. Those of us who use products with these features every day tend to forget that a lot of systems out there don’t offer these niceties.

Visit note documentation was pretty standard, as was the ability to pull forward information from previous documents. I liked that abnormal physical exam findings displayed in red and italics. There seemed to be a lot of user-customizable features, but of course the proof is in the pudding when you actually get your hands on it rather than watching a demo. One feature that differs from some other vendors is the ability to keep multiple patients open at a time, which can be both a blessing and a curse. I have to admit I was taken by their document management (scanning) system. It has some nice features including fax integration and the ability to match incoming documents with outstanding orders, which is the holy grail for closed-loop order management.

A couple of months have passed and my colleague still hasn’t decided what she’s going to do. Thinking back on the demo as well as the company that Greenway will be keeping, it will be interesting to see what the future holds. I have several friends who work at Greenway, and for their sake, I hope it’s smooth sailing.

I’d love to hear from current customers on either the Greenway or Vitera products. What do you think the union will bring? Are there any product features you hope to jettison for something better? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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September 26, 2013 News 11 Comments

News 9/25/13

September 24, 2013 News 3 Comments

Top News

The FDA issues final guidance for mobile medical apps, saying it will exercise “enforcement discretion” (meaning it will not enforce requirements under the Federal Drug & Cosmetic Act) for the majority of health and wellness apps since they pose little risk for consumers. Examples of  low risk apps include those for self-managing a disease or condition and apps for the self-tracking of health information, exercise, or diet. Oversight focus will be on apps that present a greater risk to patients if they do not work as intended, such as those used as a medical device accessory (such as viewing a medical image on a smartphone) or as a mobile platform as a medical device (like an app that allows a smartphone to be used as an ECG to detect abnormal heart rhythms.)

Reader Comments

9-24-2013 10-50-48 PM

9-24-2013 10-51-55 PM

From The Fixer: “Combining Greenway and Vitera. I think the deal makes sense given that Greenway has more of a healthcare IT platform than Vitera does and Greenway is much more well run than Vitera. Over time, they will migrate all Vitera clients to Greenway’s platform and realize tremendous cost savings and synergies by leveraging Greenway’s infrastructure.” Perhaps they will head in that direction, but Matt Hawkins and Tee Green kept their plans pretty close to the vest when I talked with them Monday evening. Green noted that “maintaining multiple platforms probably isn’t going to be the long term strategy because that doesn’t create value for your customers and your team,” while Hawkins stressed that Vitera would continue to support, maintain, and update its various product platforms. Both declined to say who would lead the company going forward, but my money is on Hawkins taking the top spot.

From InsideOutsider: “Culture clash. Greenway has long had a reputation for its strong, family-oriented corporate culture. Kudos to Vitera for recognizing that and for trying to leverage Greenway’s better reputation and brand. Meanwhile, Greenway employees better hang on for the pending culture shock.”

From Upon Further Review: “Re: HIS Junkie’s statements about ONC systems. PopHealth is still an active project and has nothing to do with certification. Cypress had bugs, but it’s still being refined.”


HIStalk Announcements and Requests

9-24-2013 8-25-41 PM

Welcome to new HIStalk Gold Sponsor Summit Healthcare. The company offers application integration tools that include Summit Express Connect (the industry’s most powerful integration engine) and the Summit Scripting Toolkit that can automate any process (budget updates, point-of-care device integration, patient self registration.) The company has been a Meditech integration leader since 1999. Summit Provider Exchange allows patient information to be exchanged between hospitals and physician EMRs, while the Summit Downtime Reporting System gives users access to a patient data snapshot for managing  scheduled or unscheduled downtime. Thanks to Summit Healthcare for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

9-24-2013 10-11-21 PM

Practice Fusion raises $70 million in a series D round, bringing total funding to $134 million and valuing the company at an estimated $700 million.

9-24-2013 10-12-33 PM

PatientSafe Solutions closes an investment from EDBI, the investment arm of the Singapore Economic Development Board, bringing its total Series C funding to $27 million.

Mobile medication management solution provider MediSafe raises $1 million in funding, co-led by TriVentures and lool Ventures.

Online patient billing company Simplee raises $10 million in Series B funding, led by Heritage Group.

Inga interviewed the CEOs of Greenway and Vitera about their impending shared ownership on HIStalk Practice.


9-24-2013 10-15-55 PM

St. Joseph’s Hospital Health Center (NY) selects PeriGen’s PeriCALM Tracings fetal surveillance system.

University Health System (TX) licenses iSirona’s device connectivity solution for its 24 clinics, hospitals, and outpatient facilities.

South Jersey Family Medicine will replace its Alteer platform with e-MDs Solution Series EHR, PM, and patient portal solutions.

Michigan Spine Surgery Improvement Collaborative selects ArborMetrix’s registry solution to create a statewide database and reporting system for spinal surgeries.

Imaging Specialists of Charleston and Charleston Radiologists (SC) select Merge Healthcare’s Outpatient Radiology Suite and Honeycomb Archive platform.

The Houston City Council approves a $1.6 million contract with Oregon Community Health Information Network to implement an EHR for the city’s Department of Public Health and Human Services.



9-24-2013 9-02-35 AM

SyTrue hires Ketan Patel, MD (US Pain Management Corp.) as CMO.

9-24-2013 11-28-48 AM

Healthcare Data Solutions names David M. Thomas (IMS Health) to its board.

9-24-2013 11-35-20 AM

Transcription and coding solutions and services provider Amphion Medical Solutions appoints Subbu Ravi (Symphony Data Corporation) COO.

9-24-2013 10-30-10 PM

CORE Security names Eric Cowperthwaite (Providence Health & Services) as VP of advanced security and strategy.

Announcements and Implementations

9-24-2013 10-19-20 PM

The board of Greenville Hospital System (SC) approves a $97 million expense to implement Epic, replacing GE Healthcare and Siemens Soarian.

EClinicalWorks and Epic develop bidirectional interoperability between their EHRs.

Government and Politics

9-24-2013 2-46-58 PM

Seventeen GOP senators ask HHS Secretary Kathleen Sebelius for a one-year extension for Stage 2 MU to give providers extra time to meet the new requirements. The lawmakers agree that providers who are ready to attest to Stage 2 should be able to do so consistent with the current policy.


MyMedicalRecords files a complaint for patent infringement against Allscripts, alleging that its Jardogs FollowMyHealth technology violates MMR’s PHR patents.

9-24-2013 9-31-53 AM

A KLAS report finds that EHR replacement rates are up in the small practice (1-10 physician) market. Athenahealth, SRSsoft, and Practice Fusion are having the most success delivering quick and easy implementations of value-based products. Pediatrics-specific EHR PCC earned the top performance score among 27 vendors, while customers of McKesson, GE Healthcare, Allscripts, and Vitera expressed the highest levels of dissatisfaction based on unmet product expectations, poor upgrade releases, and inadequate relationships.

Senior hospital IT executives say that exchanging patient information in robust, meaningful ways and budget and staffing limitations are the biggest barriers for health information exchange between other hospitals, according to a HIMSS Analytics report.

John Lynn of EMR and HIPAA will interview Mandi Bishop of Adaptive Project Solutions Thursday from 1:00 to 1:30 on “Healthcare Big Data and Meaningful Use Challenges.” The Google+ Video Hangout will stream live, with the recording available afterward.

Zirmed earns  the highest customer satisfaction rating from large hospitals and academic medical centers in a Black Book research report on the RCM industry. Among small / rural and community hospitals, SSI Group scored highest, while Relay Health earned the highest marks from hospital systems, IDNs, CINs, chains, and ACOs.

Weird News Andy finds more weirdness: a man who had just used a university’s computer lab to Google symptoms of pain, tightness of chest, and sweating is found dead in his car in the parking lot.


Sponsor Updates

  • Elsevier launches SimChart for the Medical Office, a competency-based, simulated EHR that gives medical assisting students hands-on practice performing business and clinical skills.
  • Visage Imaging announces upgrades to Visage 7 Enterprise Imaging and Visage Ease.
  • VMware announces the GA of VMware vCloud Suite 5.5 and VMware vSphere with Operations Management 5.5. VMware also makes VMware Virtual SAN available for download and trial via a public beta program.
  • Oracle awards NTT DATA the 2013 Oracle Excellence Award for Specialized Partner of the Year – North America in Health and Life Sciences for demonstrating outstanding and innovative solutions based on Oracle products.
  • Intellect Resources President Tiffany Crenshaw talks about what’s behind the growth of her company after taking top honors in The Business Journal’s 2013 Fast 50 awards.
  • Craneware EVP of Revenue Integrity Operations Karen Bowden will lead a session on preparing for audits at next month’s 2013 CH100 Leadership and Strategy Conference in Greensboro, GA.
  • Orion Health offers scholarships and graduate recruitment programs through the University of Canterbury in New Zealand in an effort to attract talent and encourage more IT graduates.
  • Hayes Management Consulting offers two white papers to help organizations improve clinical optimization.
  • Nuance launches Clintegrity 360 | ICD-10 Education Services, an ICD-10 readiness program for physicians, coders, and clinical documentation specialists.
  • Capsule’s business development manager Elizabeth Skinner will discuss medical device integration at this week’s McKesson’s Insight365: 2013 Annual Conference in Orlando.
  • Caradigm introduces new versions of Caradigm Single Sign-On and Caradigm Context Management products, which feature tightened integration with virtual desktop technologies, simplified security compliance, and accelerated clinical workstation deployment.


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

More news: HIStalk Practice, HIStalk Connect.

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September 24, 2013 News 3 Comments

Monday Morning Update 9/23/13

September 21, 2013 News 9 Comments

9-21-2013 6-03-19 PM

From HIS Junkie: “Re: ONC. I find it absolutely depressing that the government has created a monster bureaucracy to test and certify healthcare software and spends over $70 million a year to do that,  yet these same people cannot release one piece of software that works right from the get-go. There is an article in the Wall Street Journal entitled ‘Pricing Glitch Afflicts Rollout of Online Health Exchanges.’ Another buggy system brought to you by Uncle Sam. If that was the only  glitch, I could look past it. But consider that over the last two years ONC has issued three software systems to support the vendor certification process and all have bombed more than once. They were – POP Health, Cypress, and the Transmission Transport Test tool. They eventually killed POP Health. All were needed to pass ONC certification. Each one created major delays and resubmits for vendors, not to mention the related wasted time and costs. Amazing that a federal agency that can’t get relatively simple software right the first time is telling vendors of mission critical complex software how to build theirs. I think we need to create another federal agency to certify ONC software before we let them move to Stage 3.”

9-21-2013 6-21-51 PM

From Vandy Watch: “Re: Vandy VPIMS lawsuit. I wonder if other facilities could be at risk? According to Acuitec’s website, ‘Acuitec’s flagship products are VPIMS, an integrated clinical solution for the perioperative continuum of care, and Vigilance, a customizable remote presence monitoring solution. Our strategic relationship with Vanderbilt Medical Center (VMC) enables us to ensure our products are thoroughly tested and clinically verified.’" I wouldn’t be too worried. The government hasn’t proven their rather broad claims against VUMC and even if they really did use VPIMS to intentionally overbill Medicare, that doesn’t mean anyone else would be forced to use VPIMS in the same way. It’s unlikely that fraud was baked into the product.

From The PACS Designer: “Re: Google Glass. The Yale football team got a chance to test Google Glass in a practice game and found the experience exciting from a quarterback perspective. The Internet link could present some interesting uses in healthcare for physicians seeking to inform others of their daily wants and needs.”

9-22-2013 5-49-14 AM

Poll respondents say the most valuable part of an electronic medical records system is clinical decision support. New poll to your right: when will vendor opportunities for population health and analytics really kick in?

Listening: new from The Sadies, Canadians who offer a compelling blend of American music styles like country, surf, and psychedelia. One of the members is Travis Good, no relation as far as I know to Travis Good, MD from HIStalk Connect.

9-21-2013 4-33-20 PM

Welcome to new HIStalk Gold Sponsor AirWatch, the leader in enterprise-grade mobility and security solutions. More than 8,000 customers across the world trust AirWatch to manage their most valuable assets: their mobile devices. The company’s highly scalable solution provides an integrated, real-time view of an entire fleet of corporate, employee-owned, and shared iPads, iPhones, Androids, Toughbooks, and more. With AirWatch, healthcare IT can automate the management and tracking of all mobile assets; reduce the cost and effort of device deployments; improve the technical support experience for device users; and enable and enforce IT security and compliance policies that secure the device and its data. Thanks to AirWatch for supporting HIStalk.

Here’s a YouTube video I found on AirWatch’s mobile device management.

9-21-2013 3-52-02 PM

The local paper covers the move from Healthland to Epic of Heart of 20-bed Heart of America Medical Center (ND).

9-21-2013 5-18-49 PM

I interviewed a patient about her use of the Good to Go recorded discharge instructions system from ExperiaHealth.

The HCI Group creates an integration and testing services division, naming Scott Hassler and Mark Jackson as VPs of integration services.  Both were previously with Information Technology Architects.

ABC for Health, a Madison, WI-based nonprofit healthcare advocacy law firm, receives a $1.2 million NIH grant to develop software that determines if a patient is eligible for government health programs.

Upcoming Webinars

9-21-2013 6-01-04 PM

Speaking of Webinars, I said when I started doing them that I wanted to showcase fresh ideas, giving a voice to folks who don’t usually do conference presentations. I’m really happy that several of those Webinars will be coming your way soon. I’m certain you will enjoy the topics and the presenters. Vendor-sponsored webinars make it possible to offer these non-commercial ones where everybody can use the Webinar platform I’m already paying for. If you have a great message that needs an audience, let me know.

9-21-2013 6-02-31 PM

FDA issues a rule requiring medical devices to bear manufacturer tracking codes. FDA will used the IDs to create a publicly searchable database. The likely next steps: (a) FDA, Joint Commission, Medicare, and insurance companies require logging the ID of each device implanted, and (b) vendors of systems used in the OR or elsewhere will be pressured to make recording and recalling this information easier.

Vince finishes up his HIS-tory of Cerner this week. Next up will be McKesson, which should be interesting.

Craig Richardville on the Future

Carolinas HealthCare SVP/CIO Craig Richardville followed up his September 13 interview on HIStalk with thoughts on the future.

As you look ahead over the next several years, one thing we can count on — it will be here and gone before you know it. The boost of HITECH has made technology more than an enabler as it has become a foundational element for all future endeavors. It is the common thread that not only provides the glue within service lines and organizations, but also connects the care, the care team ,and our patients across the continuum. 

The financing challenges of healthcare requires us to be more selective in our ideas, as only the best of the best will survive, and more innovative in how we deliver care and maintain the health of our consumer. As part of the Triple Aim, a main focus is on quality and high quality will become the norm to play in the game, and the other two elements — service and pricing — will become equally dominant as the industry continues its movement towards consumerism and choice. 

Healthcare will start to take on other characteristics of other consumer industries such as retail and banking. Online services will become the routine. Consumers will access a variety of comparative sources to make decisions, the same that we do today for other personal products and services, such as Consumer Reports, Angie’s List, Google Reviews, etc. Technology will be used to transform operations to be more efficient and provide access and engagement for the consumer, wherever and whenever it is required or requested. 

The care offered will continue to travel rapidly to the patient. Self-service tools will be a necessity. We will connect to patients via mobility, instant access, and migrate monitoring for fixed devices to smartphone apps and wearable devices. We will go to the patient, wherever they are and whenever they need us — the workplace, the home, across state boundaries, and while in motion. We will see competitive communities becoming connected and unifying for the benefit and health of the patient and of our populations.

Historically competitive organizations will start to share data and collaborate to ensure that we are reducing duplication and providing all information necessary to treat the patient. We will not compete on data, but rather on how we use the data. Predictors and analytics will be a core competency and those who get their first, will have a small advantage as others will get there as well, and then we will need to quickly move to the next prospect. 

Expectations will continue to rise and new innovations discovered and the ability to be agile and collaborative will create a competitive advantage. Look to the use of data, ensuring privacy and security, development of new evidence, analytics, genomics and be prepared for the next unknown and seize the opportunity not to compete on transactional data, but predicting and engaging. 

There is not a day that goes by that new opportunities to optimize and advance arise, times will be challenging, and also very opportunistic. The best of times are ahead for all of us, especially our patients.


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

More news: HIStalk Practice, HIStalk Connect.


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September 21, 2013 News 9 Comments

News 9/20/13

September 19, 2013 News 12 Comments

Top News


The Greater Madison Convention & Visitors Bureau estimates the economic impact this week’s Epic user group meeting is $6.5 million, second only to the World Dairy Expo. Despite being behind the cow show, Judy Faulkner was apparently pleased to tell her 15,000 customers and employees that Epic now serves 51 percent of US patients and 2.4 percent of the world’s. She also reports that 86 percent of Epic implementation projects over the past two years have come in under budget.

Reader Comments

From Wild Duke: “Re: Caradigm. Did a major executive purge. Chief Medical Officer Brandon Savage and SVP of Product Management Mark Johnson both gone. COO Nigel Mason is heading back to GE. CTO Neal Singh is now running the show.” A Caradigm spokesperson responded to our inquiries by saying, “I can confirm that earlier this week Caradigm made some organizational changes within our product teams to drive greater alignment and focus on our healthcare analytics and population health solutions.” We’ll call it unverified since companies can’t comment on the status of individual employees.

9-19-2013 6-42-43 PM

FromPit Viper: “Re: VA. Under Secretary Petzel is resigning.” Unverified, but Pit Viper has been a good VA source previously. Robert Petzel, MD is Under Secretary for Health in the Department of Veterans Affairs.

9-19-2013 6-51-57 PM

From Would Like to Know:“Re: ICD-10. CMS is not requiring it for coding Liability Insurance, No-Fault, and Workers Comp until April 1, 2015. For vendors that rely on UB-04 billing data, this exception is causing some angst. We’ve heard hospitals will code in ICD-10 and then either crosswalk back to ICD-9 or code to ICD-9 for these insurers. Would you be able to survey hospitals about this? I love HIStalk and have promoted it inside my company, plus we are now a sponsor.” Thanks. I created a poll that will take hospital folks maybe 10 seconds to complete. I’ll share the results here in a few days.

9-19-2013 7-02-35 PM

From Movie Sign: “Re: open.epic. Epic’s big announcement to the world of modern startups looks like it was designed by an amateur. It doesn’t help accusations that legacy vendors are out of touch.” Nobody seems to know anything about open.epic other than what’s on the site, which indicates that it’s a connection from EpicCare to personal health devices. Folks attending UGM probably got more details.


HIStalk Announcements and Requests

9-19-2013 12-02-32 PM

inga_small Thanks to Jennifer Dennard (@SmyrnaGirl) of Billian’s HealthDATA for hosting Thursday’s #HITchicks tweetup, which happened to be the first TweetChat I’ve ever attended. The discussion covered women in the healthcare C-suite, mentoring, HIT week, and, my favorite: should women have to “harden” or “soften” themselves when in positions of leadership. I agreed with the consensus view that women (and men) must remain genuine and true to themselves. Nice job moderating, Jennifer!

9-19-2013 5-49-04 PM

inga_small I updated my iPhone 5 to iOS 7.0 last night (it took about an hour) and, so far, so good. I did have to delete about 2GB of videos to make room for the update, so beware if you are low on storage. I am excited about the new camera features, which include Instagram-like tools for enhancing photos and a faster shutter speed (which will be perfect for taking stealth photos of shoes at MGMA.) The iTunes Radio is also fun and should give Pandora a run for its money, especially since it’s ad free. I listened to a few tunes using the Bluetooth in my car, but then realized that too many tunes may be a quick way to eat up all the data included in my cell phone plan. Finally, the overall navigation is enhanced in several areas, resulting in fewer swipes to get where you are going.

9-19-2013 5-58-56 PM

Welcome to new HIStalk Platinum Sponsor Prominence Advisors. The company, founded by former Epic managers who hire Epic superstars, provides the country’s foremost healthcare organizations with Epic expertise, with over 90 percent of the company’s employees being Verona alumni. Prominence is a QlikView healthcare implementation partner, levering its knowledge of Epic’s data model to help organizations aggregate data from multiple systems to spot trends, predictively improve patient care, optimize revenue cycles, and monitor operational performance. High-profile projects require extraordinary, high-performing talent and Prominence has earned the reputation of deep domain expertise and exemplary character as it provides services in analytics, strategy, and execution. Thanks to Prominence Advisors for supporting HIStalk.

Bored? (a) sign up for email updates so you’ll be the first to know; (b) repeat for HIStalk Connect, where your signup gets you really cool HIT innovation news from Travis, Lt. Dan, and Kyle; (c) connect with us on Facebook, Twitter, and LinkedIn, including the HIStalk Fan Club that Reader Dann created a long time ago that now has 3,242 members, making my mom very proud even though she’s not sure why; (d) peruse and occasionally click the ads of the folks who keep me in keyboards and check them out in the Resource Center and Consulting RFI Blaster; (e) send me rumors, pictures, or whatever interesting stuff you have using the secure Rumor Report form that goes straight to my inbox along with any attachments you’ve included; (f) check out the Webinar Calendar and vow to learn something; and (g) accept my appreciation for your  support of HIStalk in whatever form that support takes (just reading it counts a lot.)

Upcoming conferences: Inga will be at MGMA in October, I’ll be at the mHealth Summit in December. That’s all we have on our dance cards for now.

HIStalk Webinars

9-19-2013 6-26-20 PM

Encore Health Resources will present “Full Speed Ahead: Creating Go-Live Success” on Tuesday, September 24, 2013, 1:00 – 1:45 p.m. Eastern, featuring William Sangster, MD. Dr. Bill will impart wisdom, I’ll say a few words that will be far less wise, and a lucky attendee will win a $50 Amazon gift card door prize. Register now.

Speaking of webinars, we’re doing quite a few of them and I could use a few more CIO-type reviewers. Here’s how it works: I’ll send you a link to the recorded rehearsal, you’ll spend 30 minutes or watching it and jotting down suggestions for improvement, and you’ll earn the same gift certificate as the Encore door prize winner. Let me know if you’re interested. Thanks to the folks who have been reviewing all along – your feedback is making the Webinars better and more enjoyable for everyone.

Acquisitions, Funding, Business, and Stock

9-19-2013 4-05-53 PM

Health tech business accelerator Healthbox selects its first Nashville class of seven companies, each of which will receive a $50,000 seed investment and four months of mentorship. Chosen were:

9-19-2013 8-45-00 PM

DreamIt Ventures launches DreamIT Health Baltimore, a partnership with The Johns Hopkins University and BioHealth Innovative, to accelerate the growth of early-stage HIT companies.

9-19-2013 6-21-15 PM

HIMSS acquires Health Story Project, which focuses on standards related to non-EHR clinical documentation such as transcription and electronic documents.


Skilled nursing and rehab operator Greystone Healthcare Management selects HealthMEDX as its HIT solution.

The New York Office of Mental Health awards health system integrator CGI a $48.7 contract to implement an EMR platform, including NTT DATA’s Optimum. Document Storage Systems will provide additional implementation services for the vxVistA EHR.

Vanderbilt University Medical Center (TN) will deploy MedAptus Technical Charge Capture solution to code and bill hospital-based procedures.

UC San Diego Health System (CA) selects Merge iConnect Access to image-enable its Epic EHR.

9-19-2013 9-00-19 PM

Self Regional Healthcare (SC) selects McKesson Paragon .

The New York City Health and Hospitals Corp. awards IBM an one-year, $10 million contract to build an analytics platform to improve patient care and operational efficiency.

9-19-2013 9-01-28 PM

The Torrance Memorial Medical Center (CA) selects Daylight IQ for disease-based clinical protocols.


9-19-2013 4-20-31 PM

Bronson Healthcare (MI) hires Paul Peabody (Palomar Health) as VP/CIO.

9-19-2013 4-31-22 PM

Emmi Solutions names Steve Martin (Merge Healthcare) as SVP of sales.

9-19-2013 7-31-25 PM

Ron Strachan (Community Health Network) is named CIO of McLaren Health Care.

9-19-2013 7-12-05 PM 9-19-2013 7-12-36 PM 9-19-2013 7-14-43 PM

Health Care DataWorks Co-founder Jason Buskirk is named CEO, Ivo Nelson becomes board chair, and John Gomez is engaged as a development consultant.


Announcements and Implementations

Fairfield Memorial Hospital (SC) goes live on Cerner.

9-19-2013 9-03-45 PM

Duke University Health System reports that it has installed Epic ahead of time and under budget throughout the entire system, including 223 outpatient facilities and Duke University Hospital. Epic says it was one of the company’s biggest single-day go-lives with 16,000 Duke employees trained. Competing Research Triangle health systems WakeMed and UNC are also implementing Epic.

Pacific Alliance Medical Center (CA) deploys electronic patient signature and e-forms solutions from Access.

Government and Politics

9-19-2013 7-32-34 AM

CMS publishes an online ICD-10 implementation guide to help practices, small hospitals, and payers navigate the ICD-10 transition.

9-19-2013 10-14-53 AM

ONC names GenieMD the winner of its Blue Button Co-Design Challenge for its app that helps users diagnose their symptoms, find providers, and learn more about medical conditions.

9-19-2013 10-45-36 AM

inga_small From an ONC post I missed last week: 54 percent of EPs have 2014 Edition EHR technology available to them from their primary 2011 EHR vendor; 45 percent of EHs/CAHs have 2014 Edition EHR technology available from their primary 2011 Edition vendor. An additional 13 percent of EPs and 19 percent of EHs/CAHs have a primary 2011 Edition EHR vendor that is on track toward providing a 2014 Edition solution. Translation: one out of three providers attested with EHRs that are potentially not on track with 2014 Edition technology. Another interesting nugget: 31 percent of the 861 ambulatory EHR vendors on the Certified HIT Product List and 49 percent of the 277 inpatient EHR vendors don’t have a single MU attestation. In other words, look for a sizable reduction in the number of vendors listed for 2014 Edition certification.

Here’s a new ONC video on interoperability.


The CMS Office of the Actuary projects that healthcare spending will increase at an annual rate of 5.8 percent from 2012 to 2022, or one percent faster than the GDP.

A former advisor to Australia’s billion-dollar eHealth system calls it “shambolic,” with incorrectly loaded data and doctors who don’t have the software to read it. The medical association pegs the odds of finding useful information for a given patient at 0.5 percent.

John over at EMR and EHR Videos has a Google Plus Hangout video featuring the always-fascinating Dr. Nick, aka Nick van Terheyden, MBBS, CMIO of Nuance Healthcare. You can also get on the update list and check the schedule of future events that are streamed live.

9-19-2013 6-55-36 PM

The Milwaukee newspaper runs an article about the growth in lucrative Epic consulting jobs, featuring a cool photo of Mark and Drew from Nordic, which has 350 employees and is adding 20 per month after bringing in $38 million in investor money in the past year. Frank Myeroff of Direct Consulting Associates is quoted in the article as saying the number of Epic consulting firms may approach 2,000. Also mentioned are Vonlay and BlueTree Network.

In Canada, Jewish General Hospital goes on diversion and elective imaging tests are postponed when its data center overheats, taking all of its servers down Thursday morning.

9-19-2013 7-25-27 PM

A report by Wells Fargo Securities says that CMS’s July attestation data suggests that the replacement EHR market will heat up in 2014 as practices drop productivity-sapping EHRs in favor of those products with a higher MU attestation rate. The report also says, “Replacement activity could
intensify further if CMS ever decided to audit providers who pocketed the Medicaid incentives instead of using them to fund actual EHR adoption. “

Weird News Andy, who as he says is “putting the ‘News’ in Weird News Andy for the past five minutes,” notes that Cleveland Clinic is shrinking. Employees were told this week that $330 million needs to be trimmed from the clinic’s 2014 budget and layoffs may be required.

9-19-2013 8-27-04 PM

At least it wasn’t healthcare: a BBC TV news anchor grabs a pack of copy paper instead of the intended iPad and bizarrely carries it around while reading the news. Anchors there hold the iPad to pretend they are technology-savvy journalists instead of talking heads reading off a screen, an illusion suffering mightily from this incident.

Sponsor Updates

  • The Colorado Technology Association names Ping Identity winner of its Technology Company of the Year award.
  • HCI Group posts an article titled “Credentialed Trainers – Secret Superstars of the Install.”
  • Lifepoint Informatics serves as a gold sponsor for next month’s G2 Lab Institute Conference in Arlington, VA.
  • Sunquest is attending ASCP in Chicago this week, exhibiting in Booth #219.
  • Direct Recruiters is named a Weatherhead 100 winner as one of the 100 fastest growing companies in Northeast Ohio.
  • Jeff Bell, director of IT security and risk services for CareTech Solutions, joins the HIMSS Privacy and Security Committee for a two-year term.
  • CCHIT certifies that Medseek Empower enterprise patient portal is compliant with the ONC 2014 Edition criteria and awards it certification as an EHR Module.
  • Merge Healthcare reports that radiologists use its certified EHR technology more than any other, according to HHS MU attestation data.
  • Drummond Group certifies that two SuccessEHS products, SuccessEHS 7.0 and MediaDent 9.0, are compliant with ONC 2014 Edition criteria.
  • CIC Advisory launches a Facebook page to provide an interactive forum on the operational and regulatory challenges facing HIT execs.
  • API Healthcare President and CEO JP Fingado participated in this week’s Healthcare Workforce Information Exchange demonstration.
  • Hospital Physician Partners (FL) reports on its experience using Ingenious Med’s business analytics platform.
  • Xerox researchers address the challenge of big data and what to do with social media analytics.
  • HCI Group details three areas a good credentialed trainer can impact during an EMR implementation.
  • Beacon Partners outlines six steps to minimize ICD-10’s negative impact on revenue cycle.
  • Nordic Consulting reports that its $38.3 million influx of capital from investment partners has allowed it to increase service offerings, bolster staff to over 300, and grow clients and partnerships to over 75.
  • Quantros hosts an Advisory Panel this week to discuss the commercial viability of data in an intermediary role and the value of bundled safety products.
  • Clients attending this week’s Verisk Health user conference prepared 2,000 food packs for Second Harvest Food Bank of Central Florida’s Hi-Five Kids Pack Program.
  • Vitera Intergy EHR is tested and certified as a complete EHR under the Drummond Group’s EHR ONC-ACB program and is an ONC 2014 Edition-approved solution.
  • Anita Archer, Hayes Management Consulting’s director of regulatory compliance, co-authors a HIMSS-published article entitled, “ICD-10 Documentation for State Medicaid Agencies (SMA) Health Conditions Categories.”

EPtalk by Dr. Jayne


Lt. Dan tweeted this morning about Google’s launch of Calico, a company that will focus on “the challenge of aging and associated diseases.” The venture will be led by Arthur Levinson, chairman and former CEO of Genentech. He’s also a director of drug giant Hoffman-La Roche and chairman of Apple.

My initial response to the announcement was that there are some significant conflicts of interest here. Others have had that thought as well, with Time posting a piece about it in the context of previous Google vs. Apple conflicts that received scrutiny from the Federal Trade Commission. My mind, however, was going more towards the conflict stemming from having a company like Google — which controls vast amounts of information about seemingly everything and everyone — cozying up with the pharmaceutical and genetic sphere.

For quite some time, I’ve had concerns about so-called personalized medicine. Farzad Mostashari tweeted about this earlier this week, sharing why personalized medicine might be bad for all of us. The focus of the opinion piece is that when people increase focus on themselves and their personal choices, they tend to decrease focus on population-based health, such as global vaccination efforts and other public health initiatives. It also mentions pharmacogenetics, where drugs can be targeted for patients who have certain mutations present. It mentions the example of vemurafenib as a drug for metastatic melanoma, which can help 25 percent of patients live seven months longer.

This kind of data leads me to my chief concern with personalized medicine – is it cost effective, and who is going to pay for it? Vemurafenib costs $56,400 for a six-month supply. (Surprise, when I did my Google search to find out the cost, I discovered it is made by Genentech.) If it only works 25 percent of the time for patients with a specific mutation, and their lives are only extended seven months, should we be routinely recommending it? As a primary care physician who has cared for numerous terminal patients, I understand the appeal. If it helps a father live long enough to see his daughter married, or a mother long enough to see her son graduate from college, these are the Hallmark moments we all want to think of. But in our situation where the healthcare system is collapsing under its own weight and excess, I could really make the argument that spending $56,000 to help fight diabetes, obesity, or heart disease for many patients is a better investment of our increasingly scarce healthcare dollars.

One could argue that personalized medicine is for those who can afford it, but then we will have the counter argument about healthcare being a right and about treating everyone equally. Eventually we have to come to the realization that we can’t afford to provide these expensive treatments for everyone no matter how hard our heartstrings are tugged. As a family physician, I’m all for health promotion and disease prevention. I am not, however, in favor of extending life just because we can, and I think this venture has the potential to drive efforts in the wrong direction.

I recently saw an elderly patient in her mid-90s who has been blessed with extremely good health. She has taken care of herself all her life, watched her weight, didn’t drink alcohol, and didn’t smoke. Her only “vice” was wearing high heels every day, which has caused some orthopedic problems. As for medications, all she takes are pain relievers that she takes as needed for aches and pains. She is a remarkable lady. She has been widowed for more than 30 years, outliving most of her close friends and some of her family members. She doesn’t want to live forever.

When people think of halting the aging process, I think they expect it to be something like the movie “Cocoon,” where you have a bunch of sassy septugenarians frolicking around. How are we going to fund retirement for these folks? Will they understand that if they’re going to live to be 100 they need to work until they are at least 75 or 80 because the average person cannot save enough money to fund a 35- to 40-year retirement during a 45-year working life? We already have people who can’t save enough money for retirement period, let alone an extended one. The focus on instant gratification and the “me” generation can only skew that further as people spend their current income rather than saving it.

Anyone who has worked on a medical/surgical unit at a hospital has seen the people who are not as fortunate as my ultra-healthy patient. What about the people whose lives have been prolonged through multiple invasive treatments but who are debilitated and have a very low quality of life? Wouldn’t it make more sense to talk about palliative care for the obese smoker who has had four heart attacks, multiple cardiac catheterizations and a bypass, and can’t walk to the bathroom without being exhausted than to bankrupt his family by pursuing more invasive treatments?

I’m sure the argument here is that they want to come up with technologies to help that patient have a better quality of life, but I’m not sure I buy it. Looking at the players involved (Genentech, Roche, Google, and probably multiple intermingled board members from other companies) this feels more like a profit-driven venture than a humanitarian one. Like commercial space travel, it will be only for the ultra-wealthy and will potentially divert resources and attention from important work that could benefit all patients.

What do you think about Calico? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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September 19, 2013 News 12 Comments

News 9/18/13

September 17, 2013 News 8 Comments

Top News

9-17-2013 1-52-50 PM

Here’s a news item that Judy Faulkner probably won’t mention when addressing the Epic masses in Verona this week. She earns the #243 spot on the annual “Forbes 400 Ranking of the Richest Americans” with an estimated net worth of $2.3 billion. Terry Ragon of InterSystems, which sells the Caché database that runs Epic and other healthcare IT systems, also makes the list, tying Cerner’s Neal Patterson in the #352 position with a net worth of $1.5 billion.

Reader Comments

 9-17-2013 4-25-40 PM 9-17-2013 4-26-25 PM

9-17-2013 4-18-00 PM

inga_small From Spacey: “Re: Epic UGM. Over 15,000 people in attendance including 8,500 customers and 6,600 Epic employees. They now cover over 50 percent of US patients!” We reported in 2010 that attendance was 5,500 versus 3,800 in 2009. At the rate the Epic UGM is growing, it could surpass the HIMSS conference in a few years.

From GomiesGone: “Re: Nuance. Dropped the ball by failing to release Dragon Medical Network DM360 v2.0 as promised on September 16. Word is upper management is arguing over logistics.” Unverified.

9-17-2013 6-40-20 PM

From Curious: “Re: Epic. Looks like they’re no longer hiring project managers / installers for their US locations. Does anyone know why?”

From Reluctant Epic User: “Re: HIStalk. If you’re ever in my town and willing to blow your anonymity, I’d be thrilled to buy you a beer or two for the great work you do. People in my health system routinely think I’m a genius simply because of knowledge I have gained by reading your site faithfully for the last six years.” I appreciate both the nice comment and the six years of reading. I do like beer, so that just might sway me.

Acquisitions, Funding, Business, and Stock

9-17-2013 6-47-12 PM

In England, Emis, which provides physician practice systems, will buy hospital systems vendor Ascribe for $95 million.

9-17-2013 8-03-54 PM

A UK report says that CSC will pay $98 million to settle a class action suit in which shareholders claim the company knew its Lorenzo EMR, developed by iSoft, could never be implemented in the NHS’s NPfIT program long before a Department of Health breach of contract charge sent shares down sharply. Meanwhile, a watchdog’s report says costs continue to pile up for the failed NPfIT project because of ongoing liabilities and vendor termination fees, leading it to conclude that the project is “one of the worst and most expensive contracting fiascos in the history of the public sector” as updated cost estimates are revised upward to $15.5 billion vs. an estimated benefit of $6 billion.


Hunt Regional Healthcare (TX) will implement T-System PerformNext Care Continuity.

9-17-2013 8-04-45 PM

Tift Regional Medical Center (GA) will deploy RelayHealth’s RelayClinical platform for its HIE.

NYC Health and Hospitals Corporation selects Elsevier’s ClinicalKey to provide electronic medical reference and knowledge-based information to its clinicians.

9-17-2013 8-06-46 PM

CentraCare Health (MN) selects Strata Decision Technology’s StrataJazz for costing accounting, operating budgeting, capital planning, and rolling forecasting.


9-17-2013 3-34-05 PM 9-17-2013 3-34-52 PM

The Massachusetts Technology Leadership Council names athenahealth CEO Jonathan Bush CEO of the Year and Nuance Communications CTO Vlad Sejnoha CTO of the Year.

9-17-2013 3-36-23 PM

Voalte hires Kenda West (Johns Hopkins Medicine) as COO.

9-17-2013 3-37-34 PM

Amazing Charts names John Squire (Microsoft) president and COO.

9-17-2013 4-12-29 PM

Coastal Healthcare Consulting hires Gay Fright (Pivot Point Consulting) as EVP of business development.

9-17-2013 5-57-05 PM

Virtual Radiologic names Shannon Werb (Acuo Technologies) as CIO.

9-17-2013 6-43-18 PM

Bill Keyes (Allscripts ) is named SVP of sales of CoCENTRIX.

HIMSS recognizes Farzad Mostashari, MD, Congressman Tim Murphy, CMS Administrator Marilyn Tavenner, and Rhode Island State Representative Brian Patrick Kennedy with HIT Leadership Awards in recognition of their work to improve health with IT initiatives.  

9-17-2013 6-37-34 PM

WHITEC, the Wisconsin REC, provides a bow tie tribute to outgoing National Coordinator Farzad Mostashari, MD.

Announcements and Implementations

9-17-2013 8-09-56 PM

Mid Coast Hospital (ME) implements Gemalto’s Sealys MultiApp ID smart cards and LifeMed ID’s SecureReg solution to enable secure patient authentication.

Children’s Medical Center Dallas (TX) launches its TeleNICU, which will provide regional hospitals with access its neonatologists.

9-17-2013 8-08-33 PM

HIMSS awards the University of California-Davis Medical Center its 2013 Enterprise HIMSS Davies Award of Excellence.

HealtheLink connects three other New York state RHIOs to provide sharing for 5.4 million patient health records and links to 44 hospitals.

9-17-2013 4-02-57 PM

VitalWare introduces VitalCoder, a coding and compliance resource that includes real-time, automatic updates for organization-specific coding, regulatory, and financial data.

Nuance Communications announces an Epic-optimized version of its Dragon Medical 360 | Network Edition that contains 1,000 customized commands to enhance physician productivity in a Citrix environment.

PDR Network launches PDR+ for Patients, which incorporates drug  information into EHRs so that prescribers can discuss proper use with patients during the encounter.

Government and Politics

9-17-2013 10-34-08 AM

ONC releases online tools for providers and HIEs to educate patients about the electronic sharing of health information. 

9-17-2013 3-42-16 PM

ONC also publishes models for Notices of Privacy Practices for healthcare providers, which reflect the Omnibus Rule regulatory changes that go into effect September 23.

CMS commissions the National Academy of Sciences to study how best to add social and behavioral factors to EHRs without compromising privacy.

GAO identifies 12 potentially duplicate investments at three federal agencies that over the last five years have accounted for $321 million in IT spending, including $256 million for four HHS information security systems.

9-17-2013 3-44-37 PM

The House of Representatives is considering the TELEmedicine for MEDicare (TELE-MED) Act of 2013, which would allow Medicare providers to treat patients across state lines using telehealth technology without requiring them obtain medical licenses in multiple states.

Innovation and Research

9-17-2013 3-59-22 PM

A study published in The Journal of Maternal-Fetal & Neonatal Medicine finds that neonatal depression can best be predicted not only by common excessive uterine contractions, but also the concurrent presence of fetal heart rate deceleration. The study used tracing data from PeriGen’s PeriCALM system, which allows real-time detection of the condition.


PatientPoint releases PatientPoint Tracker, a patient engagement tool for tracking patients across the care continuum.

Caradigm releases Care Management, a population health management tool developed in partnership with Geisinger Health Plan.


9-17-2013 12-49-21 PM 

inga_small Canada becomes the thirteenth country to issue a patent to MMRGlobal’s MyMedicalRecords  subsidiary for its online medical records technology. In an MMR press release, the company notes it is negotiating an agreement with an investment fund specializing in financing the enforcement and licensing of global intellectual property rights which would “maximize MMR’s ability to exploit its global health IT patent portfolio.” “Exploit” sounds like an appropriate term to describe MMR’s apparent  modus operandi.

An Accenture survey finds that 40 percent of Americans would switch doctors to gain online access to their electronic medical records. That sounds like a suspiciously high number and no doubt it is – Accenture conducted the survey online.

9-17-2013 7-10-16 PM

CHIME President and CEO Russ Branzell pens a National Health IT Week piece called “HIT Capabilities – They Are Personally Important to Me.”

9-17-2013 4-29-24 PM

MU Stage 2 is accelerating EMR-specific patient portal adoption, though the trend is negatively impacting best-of-breed vendors that are not as well equipped as EMR offerings, according to a KLAS report on patient portals. Athenahealth, Epic, and Allscripts were the top-performing vendors.

9-17-2013 6-33-49 PM

A population health management report created for institutional investors by equity research firm JAAG Research concludes that the big PHM market opportunities are at least 10 years away; that lack of data standardization, timeliness, and completeness makes a “Big Data Mess;” and on the CommonWell Alliance “Maybe it’s just us, but all of this soft, ‘.org’ alliance, love-in, ‘we’re in this together for the good of the patients’ blather sounds more like a plan for each vendor to appear collegially engaged from a public policy perspective while keeping the government from forcing a solution on the market. Meanwhile, each ‘member’ works on its own, potentially more profitable solution, outside of the auspices of the happy ‘.org’ shell.” It concludes that “PHM will require a reengineering – almost a complete rebuild – of the healthcare payment and delivery process as we know it.” It’s an excellent report and a tremendously fun read.

I found the Epic UGM tweets and photos above using the cool page that Vonlay built to curate the event. Look carefully and you’ll see Judy in her Avatar outfit.

Weird News Andy titles this story as “Doctor Gives Patient the Finger.” A Florida doctor grows back a man’s amputated finger by using a pig’s bladder as a mold.

Sponsor Updates

  • CCHIT certifies that Wellsoft’s EDIS v.11 is compliant with the ONC 2014 Edition criteria and certifies it as an EHR Module.
  • NCQA awards Case Management Accreditation to Alere and OptumHealth.
  • Quantros hosts its first annual Pharmacy Quality and Safety Summit September 25-26 in Sarasota, FL.
  • Valence Health launches its Pathfinder Accelerator Grant program, which makes $1 million available to hospitals and health systems to apply towards Valence Health’s Pathfinder services for transitioning from volume-based to value-based care.
  • Vocera Communications CMO Bridget Duffy, MD will discuss improving the patient experience at two upcoming industry events.
  • 3M Health Information Systems will offer its suite of ICD-10 and CDI consulting services and software integrated with MedPartners HIM’s credentialed and clinical documentation improvement staffing resources.
  • Consulting magazine recognizes Aspen Advisors, Cumberland Consulting, and Impact Advisors on its list of “Best Small Firms to Work For 2013” and Deloitte Consulting on its list of  “Best Firms to Work for 2013.”
  • Frost & Sullivan presents Vitera Healthcare Solutions its 2013 North American Customer Value Enhancement Award for outstanding performance and success, which recognizes the company’s focus on implementing strategies to create customer value.
  • ReadyDock partners with IT provider Red River.
  • Managed Health Care Associates will launch MHAuthorizeRx, a solution powered by CoverMyMeds and designed to streamline the drug prior authorization process for pharmacies.


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

More news: HIStalk Practice, HIStalk Connect.


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September 17, 2013 News 8 Comments

Monday Morning Update 9/16/13

September 15, 2013 News 7 Comments

9-15-2013 7-37-58 AM

From Thinking UGMs: “Re: user group meetings. Our company is getting large enough to be considering holding our first user group meeting. Do you have ideas?” It’s a great question – quite a few companies are getting big enough to consider throwing a UGM. Let’s crowdsource the idea – take the survey I created and I’ll collect and publish all the ideas right here on HIStalk. What factors would help make a company’s first user group meeting successful?

9-15-2013 7-57-16 AM

From Neutron Jack: “Re: HealtheWay. It’s supposed to be the national backbone for clinical data traffic, but maybe it’s not ready for prime time production.” A reader forwarded an email detailing abysmal technical support from the public-private collaborative that supports the eHealth Exchange, formerly the ONC-run program known as Nationwide Health Information Network Exchange (NwHIN, although technically it should have been NwHINE).  A simple support ticket didn’t get a response for a week despite three requests and an email to the CEO.

9-15-2013 8-03-23 AM

From Keeping the News: “Re: MEA/NEA. Did you see the company that Lindy Benton runs has been acquired by Accel-KKR? MEA has grown with their esMD participation. This could take the company to the next level.” Lower middle market private equity firm Accel-KKR takes a majority position in EA Holdings, which owns National Electronic Attachment (NEA) and Medical Electronic Attachment (MEA). The companies offer a platform for the electronic exchange of medical and dental claims attachments.

From The PACS Designer: “Re: Big data. Recent comments on HIStalk about big data deserve a response. TPD never uses big data in early conversations with customers since it is so vague and can falsely represent giving data viewers valuable information about their practices. For big data to add the value proposition, you need to transform your data through vendor partnerships so the greatest gain in value can be achieved. Only when you impress intended users can the real value be realized for storage of big data.”

From Informatics Professor: “Re: HIPAA Omnibus webinar. Best information I have gotten on the topic. As always, HIStalk is the best source of info on anything related to HIT.” Thanks for those nice words, and thanks to Rebecca Fayed and Eric Banks of The Advisory Board Company for doing their presentation pro bono for HIStalk’s readers.

9-14-2013 3-25-24 PM 


9-14-2013 4-51-35 PM 9-14-2013 4-52-19 PM

Health Catalyst will present “Predictive Analytics: It’s the Intervention That Matters” on Tuesday, September 24 from 1:00 to 2:30 p.m. EDT. It’s a great topic: predictive analytics aren’t worth much if an organization doesn’t have the culture and process to intervene effectively to help the patient. Presenters will be Dale Sanders (SVP) and David Crockett, PhD (senior director of research and predictive analytics). Both are amply credentialed to speak on the topic — Dale’s been a CIO and data architect, while David is a PhD in biomedical informatics and pathology expert. I’ve signed up.

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

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9-15-2013 3-05-14 PM

I’ve had two recent needs met by one free (for personal use) software tool: TeamViewer. It’s really cool for remoting into someone’s PC to fix problems and also for transferring files from their PC to yours. I leave my desktop PC on all the time and Dropbox is good if you know in advance what files you might on other devices (like a laptop or phone), but TeamViewer allows navigating the entire hard drive in a password-protected session. It can also be used like GoToMeeting to run desktop sharing, as in online meetings and training.

9-15-2013 3-35-21 PM

Welcome to new HIStalk Platinum Sponsor MedData and its company MedDirect. The Brecksville, OH-based MedDirect provides reimbursement for outstanding patient balances while improving the patient experience. Utilizing proven patient segmentation and outreach strategies that educate, engage and communicate with patients in a way that drives results, MedDirect ensures that patients are treated with dignity and respect, exceeding patient expectations throughout every interaction. MedDirect services include innovative solutions for outstanding patient balances, patient satisfaction services, appointment scheduling and reminders, registration Point of Service payment portal, and patient billing. Thanks to MedDirect for supporting HIStalk.

Former Merge Healthcare CEO Jeff Surges will be named Monday as board chair of population health management systems vendor Strategic Health Services. Co-founder Tasso Coin will continue as a director.

9-15-2013 3-11-00 PM

GetWellNetwork will on Monday announce that Karen Drenkard, PhD, RN (American Nurses Credentialing Center) will join the company as chief clinical/nursing officer.

9-15-2013 3-18-39 PM

Medical provider database vendor Enclarity is acquired by LexisNexis Risk Solutions, joining previous acquisitions MEDai (analytics) and EDIWatch (fraud detection technology).

Texas Health Presbyterian Hospital Rockwall is implementing patient engagement technology from Emmi Solutions.

Thousands of Epic users are in Verona, WI this week for UGM. Madison-based Vonlay provides a user guide for attendees that includes useful tips, such as how to get to a local brewery using the hotel shuttles and where to rent bikes.

It’s only slightly HIT-related, but fun. Jeff Travis, a biomedical engineer who developed the database architecture of the Premise Patient Flow solution years ago, is now a filmmaker. Dragon Day, his first feature-length film, will premiere in theaters on November 1. It’s an ingenious plotline and looks like a fun watch if you like doomsday thrillers (and I do).

9-15-2013 4-24-50 PM

A Covisint-Porter Research study to be released Monday finds that provider executives are comfortable with the concept of cloud computing. Also: a third of respondents say their EHRs lack population health management capabilities and accountable care is on the radar or providers but isn’t a reality for them yet. The fact that jumped out at me is that most providers are still getting most of their inbound information by fax. Healthcare: the retirement home for 1980s technology.

The Congressional Budget Office says that replacing Medicare’s sustainable growth rate (SGR) reimbursement formula will cost $175 billion of your taxpayer dollars. CBO also found that very few Medicare demonstration projects actually reduced Medicare spending.

9-15-2013 5-33-46 PM

The local paper profiles Mary Carroll Ford, SVP/CIO of Lakeland Regional Medical Center (FL), although it manages to misspell her name in its headline.  

9-15-2013 5-29-23 PM

Allscripts CFO Rick Poulton, responding to a Chicago business paper’s dismissal of the company as a poor example for the city’s healthcare IT sector, says Allscripts is recovering from “a lot of self-inflicted wounds in 2011 and 2012” but concludes that, “We may not be as pretty as we could be, but we’re not a rehabilitation case.” Poulton blames the company’s problems on its 2010 merger with Eclipsys. He says Allscripts is still trying to integrate its hospital and ambulatory systems to compete with Epic’s “one patient, one record” architecture. Poulton has been with the company for less than a year.

9-15-2013 6-46-59 PM

The respective investment firms of former Allscripts CEO Glen Tullman and Chicago entrepreneur Brad Keywell form Zest Health, which will offer mobile apps that include Talk to Me (mobile phone access to clinicians), Schedule Me (booking medical appointments) Inform Me (patient education), and Track Me (a personal health record). Tullman’s company includes former Allscripts President Lee Shapiro. Zest Health’s CEO is Karen Ferrell, former CEO of Apollo Health Street.

9-15-2013 7-49-24 AM

Weird News Andy calls this Migration Malfunction. Patients of a Tacoma, WA non-profit breast center find that their electronic medical records contain information from other patients after a system conversion going back to September 2012.  A medical record number glitch caused problems, especially with scanned documents, in converting to the center’s radiology information system. The patient who complained to the state found that her 900-page chart contained 141 pages of information that wasn’t hers.

WNA also likes this item, which he clarifies isn’t about chastity belts, but rather security “breaches.” An employee of Minnesota’s new health insurance exchange releases the confidential information – including Social Security numbers – of 2,400 insurance agents by accidentally sending the file to an insurance broker’s office.

Vince’s HIS-tory of Cerner Part 5 covers HNA and acquisitions.


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

More news: HIStalk Practice, HIStalk Connect.


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September 15, 2013 News 7 Comments

News 9/13/13

September 12, 2013 News 7 Comments

Top News

9-12-2013 8-32-39 PM

A newly unsealed Medicare fraud lawsuit against Vanderbilt University Medical Center claims that its internally developed Vanderbilt Perioperative Information Management System (VPIMS) was used to bill services for physicians who were not physically present. Documents filed with the lawsuit, which claims the fraud spanned more than 10 years, include a Vanderbilt email telling surgeons to avoid documenting which rooms they were actually covering because “it only confuses and complicates the billing and documentation process.” The lawsuit concludes, “VIPIMS’ purported improvements in billing efficiency are, in fact, largely a function of Vanderbilt’s development of mandatory default software settings that require its physicians, in all instances, to document that they meet Medicare’s conditions for payment.” VUMC says its own investigation has uncovered no billing irregularities and vows to defend itself vigorously.

Reader Comments

9-12-2013 8-36-55 PM

inga_small From Bronwyn: “Re: Cerner Dynamic Documentation. Do you know of any hospitals currently using it who would be willing talk to a CIO about their experience?” Readers, send Inga a note if you can help.

9-12-2013 6-07-12 AM

9-12-2013 9-44-59 AM

inga_small From Reviewer: “HIPAA violation. If this isn’t the most egregious HIPAA violation ever, I don’t know what is!” A parent of a three-year-old patient posts a negative review on Yelp following a visit to a Phoenix plastic surgery clinic. The practice’s operations coordinator posts a reply that includes significant details about the patient and the office visit, as well as some harsh criticism of the mother and her parenting skills. Rebecca Fayed, associate general counsel and privacy officer at The Advisory Board Company, provided us her assessment:

I think that providers (or any covered entity or business associate for that matter) need to be particularly careful when posting anything online, whether it be on Yelp or other social media sites, that could be interpreted as a disclosure of protected health information. In this post,  HHS-OCR could view the response by the provider as a  disclosure of protected health information not permitted by the HIPAA Privacy Rule.

From Former Employee: “Re: Experian Healthcare, formerly Medical Present Value. Underwent its third round of layoffs this week, including its entire SME group and other client support staff. Sales are significantly down under Experian.” Unverified.

9-12-2013 6-13-00 PM

From small_data: “Re: misuse of the ‘Big Data’ buzzword. Simply storing data for archival purposes without intent of using that data for any kind of quantitative analysis is surely not ‘Big Data.’” The solution in question stores medical images. Everybody with a database now has “Big Data.” If they can export that information to Excel, they have enterprise analytics and business intelligence. If that worksheet can be emailed, they offer interoperability. If the worksheet can be stored on a Web server, it’s scalable and cloud-based. These are no longer technical terms with precise meanings; they have been hijacked by the sales and marketing people.

9-12-2013 8-07-06 PM

From Over It: “Re: Jody Albright, CIO, Overlake Hospital. Internal email says her position was eliminated and chief compliance officer will take on CIO duties. She had limited involvement with the Epic project and the go-live was a firestorm on several levels.” Unverified, but above is a purported internal email forwarded my way.

HIStalk Announcements and Requests

inga_small The latest news from HIStalk Practice includes: use of an EMR that includes automated growth monitoring helps doctors pick up on cases of possible growth disorders among kids.The AMA offers a toolkit (perhaps a little late) to help physicians prepare for upcoming HIPAA changes. HIT expenditures in physician offices jumped 28 percent from 2008 to 2012. Will cloud-based EHR/PMs really save practices from acquisition? Patients from Advocate Medical Group file a class-action lawsuit following the theft of unencrypted computers. Rhode Island primary care practices can earn up to $10,000 to connect to the state’s HIE. Culbert Healthcare Solutions VP Brad Boyd offers some advice for defining and measuring an EHR’s ROI. Thanks for reading!

9-12-2013 6-34-11 PM

Welcome to new HIStalk Platinum Sponsor EXTENSION. The Fort Wayne, IN company offers contextual alerting, secure messaging, and care team collaboration technologies, including specific solutions that address Joint Commission’s 2014 National Patient Safety Goal, “Improve the safety of clinical alarm systems.” First-generation systems just throw out a lot of alerts, but EXTENSION’s next-generation platform combines alarm safety software with a secure text messaging solution to optimize the workflow involved with clinical event response. The company’s HealthAlert solution solves the challenge of getting important clinical event notifications in the hands of clinicians, routing critical lab results, stat orders, staff assignment, patient monitoring, and patient nurse call requests. The system prioritizes the alerts, escalates based on defined rules, announces the event verbally to the recipient, and maintains an audit trail. It works with Android, Apple, Ascom, Cisco, Spectralink, and Vocera devices, including a mobile app that can run on a clinician’s own smartphone.  Thanks to EXTENSION for supporting HIStalk.

I found this short introductory YouTube video from EXTENSION called “The Power of the EHR-Extender.”

On the Jobs Board: Manager North America Professional Services West, Implementation Engineer (East Coast), Services Operations Manager.

HIStalk Webinar


Informatica will present “Best Practices for Delivering Better Quality Care and Reducing Preventable Patient Readmissions” on Thursday, September 26 from 1:00 – 1:45 p.m. Eastern.  Speakers are George Brenckle, PhD, SVP/CIO of UMass Memorial Health Care and Richard Cramer, chief healthcare strategist of Informatica (I interviewed him awhile back). Register here.

9-12-2013 8-28-25 PM

I recorded the HIPAA Omnibus webinar given by Rebecca Fayed and Eric Banks of The Advisory Board Company earlier this week and posted it to YouTube. The slides are here. Thanks to Rebecca and Eric, who stepped up when I asked for volunteers to run through the changes with HIStalk readers. We had a nice turnout, and in typical Advisory Board fashion, not a second was wasted due to inadequate preparation or lack of focus.

Acquisitions, Funding, Business, and Stock

Covisint will raise at least $64 million in its IPO by offering 6.4 million shares at an expected price of $9 to $11. The company generated $94 million in revenue for the 12 months that ended June 30.

Three partners of Morgenthaler Ventures create a new management company and the $175 million Canvas Venture Fund that will focus on early stage investments of $5 to $15 million in mobile, health IT, financial technology, and enterprise technology. The parent VC company invested in physician social network Doximity and free EMR vendor Practice Fusion.

9-12-2013 8-39-49 PM

The CSI Companies acquires Atlanta-based IT staffing firm Anteo Group.

9-12-2013 8-00-21 PM

Lincor Solutions moves its headquarters from Ireland to Nashville.


9-12-2013 8-41-38 PM

Estes Park Medical Center (CO) will implement HealthCare Anytime’s patient portal technology at its hospital and outpatient clinic.

The Valley Hospital (NJ) selects Merge Healthcare’s CTMS for Investigators to manage its clinical research operations.

UHS-Pruitt Corporation, a provider of post-acute care services, will implement healthcare analytics and population health solutions from Caradigm.

The 110-provider Prima CARE (MA/RI) selects Ingenious Med’s mobile revenue capture technology.

Washington Orthopaedics & Sports Medicine (DC/MD) selects SRS EHR for its 11 providers and three locations.


9-12-2013 3-34-37 PM

Wellcentive names Tom Zajac (Elsevier) CEO.

9-12-2013 10-14-16 AM

Health Catalyst appoints David K. Crockett, PhD (ARUP Laboratories) senior director of research and predictive analytics.

9-12-2013 5-17-06 PM

Robert Porr (Accenture)  joins Sandlot Solutions as EVP of sales and marketing.

9-12-2013 6-16-26 PM

Nancy Killefer (Department of the Treasury, IRS Oversight Board, McKinsey & Company) joins the board of The Advisory Board Company.

9-12-2013 6-31-43 PM

University of Missouri-Kansas City hires Mark Hoffman, PhD (Cerner) as director of bioinformatics core and associate professor to establish its Center for Health Insights informatics program.

9-12-2013 7-27-12 PM 9-12-2013 7-27-53 PM

Stanford Hospitals & Clinics (CA) promotes Pravene Nath, MD to CIO and Christopher Sharp, MD to CMIO.

MGMA-ACMPE names Garth Jordan (EDUCAUSE) COO.

Prime Healthcare Services (CA) will implement  Infor financials, supply chain and human capital management, clinical bridge, and analytics.

Announcements and Implementations

Quest Diagnostics joins LabCorp and almost all of Colorado’s large hospital laboratories in connecting to the Colorado RHIO.

The HIEs Michigan Health Connect and Michiana HIN will share health records between Michigan and Indiana providers.

The Patient-Centered Outcomes Research Institute board of governors issues 71 awards totaling more than $114 million to fund comparative clinical effectiveness research, including studies to improve the applicability of data collected through EHRs and social media sites and methods for engaging minority patients and caregivers in patient-centered health research.

9-12-2013 11-45-45 AM

Ivo Nelson’s Next Wave Health forms Smart Social Media, Inc., a software company that will develop a healthcare social media platform. Next Wave Health acquired the OneXPage social media platform from Digiapolis, Inc., founded by Minneapolis entrepreneur Eric Lopez, who will be CEO of Smart Social Media.

Gastroenterology EHR vendor gMed will use behavior-based prescription management messaging from LDM Group to improve medication adherence and highlight therapy options.

Government and Politics

ONC launches a patient matching initiative to seek common denominators and best practices being used by private healthcare systems and federal agencies.

Innovation and Research

The use of an electronic decision support tool linked to patients’ EMRs helped reduce deaths from pneumonia in EDs by up to 25 percent according to researchers from Intermountain Healthcare and the University of Utah.

9-12-2013 10-21-51 AM

inga_small An athenahealth analysis of EHR data from its user network reveals no signs of a national decline in childhood obesity over the last three years. Athenahealth obviously has a wealth of clinical data at its disposal and this type of analysis is interesting and arguably beneficial. However, are practices and patients aware of how athenahealth and other EMR companies may be using personal health information? More importantly, should they? To the latter question I say yes, and mechanisms should be in place to allow practices and patients to opt in or out.


AirStrip will develop and optimize its AirStrip ONE solution for Samsung tablets running Android and Windows 8.1 operating systems, as well as Samsung convertible and all-in-one desktop and laptop PCs with touch screens.

9-12-2013 8-43-40 PM

Lt. Dan covers the iPhone 5S announcement in his excellent HIStalk Connect analysis, “Apple Comes Up Big On The iPhone 5S Unveil: What it Means for Healthcare.”


The Tax Increment Financing Commission of Kansas City approves a $1.635 billion incentive for Cerner’s proposed plan to develop a 4.5 million square foot mixed-used campus.

VA psychiatrists and researchers are using natural language processing and query searches of doctors’ free-text notes to flag patients who present a clear risk of suicide.

9-12-2013 1-29-05 PM

Crittenton Hospital (MI) will provide free electronic copies of medical records to the families of patients treated by Farid Fata, MD. Fata is the Michigan Hematology Oncology physician accused of deliberately misdiagnosing patients and improperly administering chemotherapy as part of a $35 million Medicare billing fraud scheme. The hospital provides records free only to medical doctors, but reversed its policy after the doctor’s patients staged a protest.

The New England Journal of Medicine gets banned from posting pictures on Facebook after running a medical image of a patient with scrotal calcinosis, which Facebook found pornographic. Facebook changed its mind shortly after.

Sponsor Updates

  • Aventura publishes an informative and entertaining HIT Survival Handbook.
  • Allscripts will add Inovalon’s quality improvement and risk score accuracy analytics  to its EHR platform.
  • Health leaders in Leeds, UK will evaluate whether outcomes can be improved by using Alere’s healthcare platform.
  • Medseek Empower 5.0 earns CCHIT certification as an EHR Module and is compliant with the ONC 2014 Edition criteria.
  • Campbell Clinic (TN) reports that its use of Emdat’s medical documentation solutions has improved documentation completion, workflow, and transcriptionist productivity.
  • Billian’s HealthDATA interviews Collin Searle, social media manager for Intermountain Healthcare (UT), about the health system’s social media strategy. 
  • Clinovations CEO Trenor Williams discusses the need for pharma companies to  use technology and think more strategically about communications with health providers and patients. 
  • Innovative Healthcare Solutions offers a white paper series that includes tips for a successful project outcome.
  • Hot jobs on the site of Henry Elliott & Company, which specializes in Caché and M/MUMPS technology positions, include Senior M/Caché P/A, Caché M/Mumps Web Developer, VistA Analyst, and .NET/Caché Developer.
  • Cleveland Clinic’s use of BI dashboards from Harris Healthcare has driven significant ROI and performance improvement, including a $10 million increase in net income.
  • Intelligent InSites announces details of InSites Build 2013, an RTLS learning event October 28-30 in Fargo, ND.
  • Sunquest Information Systems and the Association for Pathology Informatics will host a September 26 educational webinar on pathology informatics featuring Walter Henricks, MD of Cleveland Clinic.
  • Florida Hospital Celebration Health realizes increases in key HCAHPS categories since implementing GetWellNetwork’s Interactive Patient Care and Clinical Practice Design solutions.
  • UnitedHealth reports its use of InstaMed online payment option has resulted in over $3 million in payments since its late July rollout.
  • Trinitas Regional Medical Center (NJ) enhances staff safety with Versus Visibility Staff Assist RTLS technology.
  • Hayes Management Technology adds its go-live support and legacy support services to its website.
  • Divurgent and Medix will host a Retro Arcade Event during Epic UGM. Readers may RSVP here.

EPtalk by Dr. Jayne

Mr. H mentioned that PatientSafe Solutions has joined us as a Platinum Sponsor, but I wanted to offer my own shout out for its PatientTouch system. I first saw it at HIMSS13, and as Inga can attest, was really geeked out about it. I’d love to see it installed at my institution, so maybe I’ll “accidentally” leave their information on my boss’s printer.

I spent the earlier part of this week at the AMIA Clinical Informatics Board Review Course in Chicago. There were enough sassy young female physicians in attendance, so I feel fairly safe in admitting it while being able to still remain anonymous. I even saw some sassy shoes, so I felt like I was in good company.

Why a board review, and why now? This fall marks the first opportunity for physicians to actually seek board certification in the subspecialty of Clinical Informatics through the American Board of Preventive Medicine. There’s also a pathway through the American Board of Pathology – based on the number of pathologists in the class I don’t want to neglect to mention that because I know if they’re reading they’ll correct me – but the majority of informatics physicians I know are not pathologists.

As a new specialty, they’re offering a “practice pathway” for those of us who are not fellowship-trained to seek certification, through 2017. Candidates in this pathway have to demonstrate at least 25 percent practice in clinical informatics during three of the five years preceding application. In 2018 and later, candidates will have to have completed a minimum of 24 months in an ACGME-accredited Clinical Informatics fellowship program.

Many of us are not fellowship trained. Instead we’re homegrown informaticists who have been at this quite a while. We may have done some coursework in informatics or had intensive mentoring in order to reach our level of performance. In my case, the thought of trying to go back and do a formal training program on top of working the number of hours I do currently made my skin crawl, as did the idea of spending $40,000 or more on a degree that wouldn’t raise my income or the level of respect from my peers.

After a little cajoling from a colleague, I decided to aim for certification in the first round through the practice pathway. It’s a bit daunting because it’s a brand new exam. None of us really knows what to expect, and although the Board has published an “examination content outline,”  it’s pretty daunting since the level of detail they could be expecting could be all over the map. The application process was also daunting, as I had to track down former bosses who could best attest to the time I’ve spent in the field. I’ve had five bosses at three jobs in the last five years and only one is still working at the hospital where we were colleagues.

I’ve never taken a board review course before, so this seemed like a good time to try it given the breadth of the material. The class was a nice mix including average working CMIOs and high-powered names from major academic institutions. The VA and military were well represented, as were ambulatory organizations, payers, and vendors. I’m happy to report a Bowtie Index of 3.67 bpd (bowties per day) with one attendee having particularly fetching choices.

The group was pretty social and there were some key themes heard during the cocktail hour and various breaks. One is that there are quite a few institutions out there that still don’t value the contribution that a CMIO brings to the table. Many CMIOs are forced to try to do the job without the title or the appropriate level of authority. If you’re at one of those facilities who still question whether you need a CMIO, check that exam content outline to learn more about what we do and what we can bring to the table.

Another key theme is that there is never enough money to do the work that needs to be done. That goes right along with the theme that there are always more projects to be done than can be humanly accomplished. I also learned that many physician informaticists are very driven and devoted to the field – so much so that one physician sitting near me said his colleague’s inhuman level of work product clearly means that she’s a cyborg.

I’m unfortunately having to play catch up for the days out of the office, so you’ll have to wait until Monday’s Curbside Consult to hear about the rest of the course and some fun things I learned including some informatics jokes. I’ll leave you with this one in the interim:

A programmer is asked by his spouse to get some groceries. She asks, “Can you pick up a loaf of bread, and if they have eggs, get a dozen.” He returns home with 13 loaves of bread. She asks, “What happened?” His response: “They had eggs.”


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

More news: HIStalk Practice, HIStalk Connect.


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September 12, 2013 News 7 Comments

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