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Monday Morning Update 10/29/12

October 28, 2012 News 11 Comments

10-28-2012 9-57-56 AM

From The PACS Designer: “Re: iPod’s 11th anniversary on November 10. The four versions of iPod are Shuffle, Nano, Classic, and Touch. While primarily a storage device for music, they can be used as a storage device for other data elements. Can there be a use in healthcare for the iPod? Let’s have some discussion on the subject.” My Touch is like an iPhone without the calling capability provided you’re in WiFi range, so I would say yes. You would think that a hospital might look at the Touch as a pager replacement for nurses for in-hospital use – it’s cheap and portable, it doesn’t require a cell contract since it works on WiFi, it comes with a camera and Facetime, and it runs most iPhone apps.

10-28-2012 2-32-03 PM

From Fertile Imagination: “Re: clinical raffles. I’m speechless that providers would turn this into a contest.” A New York in vitro fertilization clinic runs a contest offering IVF free services to contestants who submit the winning emotional or entertaining essay or video explaining why they deserve the prize. One winner was notified on the day after Labor Day in a scene worthy of a Publisher’s Clearing House commercial: a doctor carrying balloons knocked on her door. Another winner earned her prize by running in a 5K race, where each registration came with one raffle entry. CDC says 1 percent of American-born babies are conceived by IVF. A Harvard Medical School ethics professor concludes, “I think it’s a good parody of the unfair system in which important medical services are only available to those who can afford them. Nevertheless, sometimes these raffles exploit the despair of couples or their misunderstanding of statistics to extract money from them.”

10-28-2012 11-36-59 AM

From HITEsq: “Re: Craneware. Being sued by the American Hospital Association for copyright infringement regarding its unlicensed use of the UB-04 codes. My personal take: none of these codes, as codes, should be the subject of copyright, especially when they are used only for functional purposes for which they were created which the AHA helpfully explains in paragraph 7. What’s more, they go on about all the work in maintaining them. Of course, in copyright law, ‘sweat of brow’ does not make something copyrightable.”

Listening: Real Estate, gentle and summery pop music featuring jangly, liquid guitars with a lot of nice vocals and instrumental work hiding behind the obvious hooks so that you can play it repeatedly without getting tired of it.

10-28-2012 8-36-58 AM

Only one survey respondent reported that his or her PCP uses Twitter for medical purposes. New poll to your right, for providers: which sources do you find valuable when evaluating vendors? Feel free to choose more than one or check “none” of you don’t find any of them useful. Your comments are welcome as well – after you vote, you’ll see a Comments link.

I’m healthy and fortunately get few chances to evaluate healthcare IT as a patient, but my annual physical last week provided an opportunity. Thinking about it afterward, I was surprised at how many positive technology elements have crept in. I had changed my appointment online a couple of times using the practice’s online portal instead of wasting time on the telephone. I pre-paid my co-pay online and printed a barcoded itinerary. I scanned that paper at the kiosk when I arrived and didn’t need to wait in line since that checked me in. My doc pulled up the EMR screen after the usual chit-chat (the practice just switched to Epic a few months ago) and noticed my weight was the lowest in the seven years I’ve been going to him, so the EMR information allowed him to reinforce that behavior effectively. He did medication reconciliation and reviewed my history over the past year while we looked at the EMR’s screen together. My one and only maintenance med (hydrochlorothiazide, since I used to have high blood pressure) went out to the pharmacy by e-prescribing. I received an e-mail this weekend saying my lab results were available on the practice’s portal, where I could review them in printable PDF format along with a reassuring note from my doc (“Wow, these all look great!”) Also on the portal was a printable visit summary for future reference. We IT types may argue incessantly about the clinical value value of technology in care delivery, but as a patient, I’m sold on the convenience factor. Not to mention that my doctor knows exactly how to use technology to support the way he practices medicine instead of allowing it to dominate either the encounter or our relationship.

10-28-2012 9-28-29 AM

I don’t know of many hospitals that developed their own clinical systems, and the cost and torrid development pace required to keep up with Meaningful Use and changing care models have led most of those to cry uncle and replace their old stuff with commercial products. Vanderbilt is apparently hanging in there according to an article in the VUMC newsletter that says they’ve made some nursing documentation enhancements to StarChart/StarPanel, VUMC’s clinical data repository that holds electronic and scanned paper patient documentation. Vandy offsets some of the expense by licensing its creations to vendors: McKesson bought WizOrders (relabeled as the marginally successful but dying Horizon Expert Orders) and Informatics Corporation of America commercialized StarChart/StarPanel.

I’ve read several articles lately about the rapidly increasing cost of the bipartisan-supported, pseudo-socialist American government in which fewer and fewer workers subsidize those who aren’t contributing (either because they can’t or because they choose not to). I don’t always agree with George Will, but his editorial on disability payments mirrors what I’ve read elsewhere. Disability payments are now going to 8.6 million people, more than half of them claiming unprovable mood disorders or back pain. The ratio of workers to those receiving government disability checks has gone from 134:1 in 1960 to 16:1 today even as the number of physically strenuous jobs dropped significantly. The healthcare connection, according to George: “The radiating corruption of this entitlement involves the collaboration of doctors and health care professionals who certify dubious disability claims. The judicial system, too, is compromised in the process of setting disability standards that enable all this.” I’ll take a broader societal view: there’s no longer any shame or embarrassment involved in cashing the many forms of automated government checks that career politicians and indifferent bureaucrats dole out like vote-seeking lollipops, so the only thing standing between unmotivated or unprepared Americans and the government food trough is ever-dwindling personal responsibility. Check the federal deficit and entitlement spending if you want to see how that’s working for us.

10-28-2012 2-33-18 PM

Cerner shares jumped 13 percent on Friday following a good earnings report. The company said in the earnings call that its clients acquired 75 hospitals in the past 18 months, potentially expanding Cerner’s customer base with minimal effort required. They also predict an “acceleration in the displacement market” (i.e. replacements of Epic) over 5-7 years as organizations look at “the horse they bet on and make a decision to go in a different direction.” Neal Patterson dropped by at the end to say that Cerner has “reinstated a boldness around here” and declared the company to be “the most significant innovator in healthcare.”

The Detroit business paper says that Henry Ford Health System may be acquiring Beaumont Health System.

10-28-2012 11-42-07 AM

Mark Clark (Poudre Valley Health Care) is named CIO of Great Plains Regional Medical Center (NE).

10-28-2012 2-34-08 PM

Quality Systems (NextGen) announces Q2 results: revenue up 8 percent, EPS $0.26 vs. $0.35, missing consensus estimates on both. Shares closed Friday at $17.19, down 3 percent and now 60 percent off from their price in April. System sales revenue was down by 15 percent, but was partially offset by implementation revenue (warning sign: reduced sales now means less implementation revenue down the road). The usual obvious reactionary steps were announced: restructure the sales organization and consolidate development efforts (always begging the equally obvious question: if it’s such a good idea, why wasn’t it done before?)  The hospital division sold to six new hospitals, but still lost money. The company will continue paying dividends to shareholders but won’t institute a share buy-back program, saying they would rather use the money to fund possible acquisitions of several companies they’re talking to (they hinted at revenue cycle, hospital products, and ACO-type service offerings). They also say that they expect many of the 462 Stage 1 EHR vendors to fail at achieving Stage 2, leading to a big replacement market. NextGen won’t issue guidance this fiscal year, citing rapidly changing market conditions and the proxy fight it recently endured.

10-28-2012 12-05-45 PM

Here’s the five-year Quality Systems share price vs. the Nasdaq in red. QSII was on a nice run, but all that’s been wiped out to the point that performance would have been just as good buying a Nasdaq index fund (“just as good” being relative – you would have done little better than break even either way).

CPSI’s Q3 numbers: revenue up 8 percent, EPS $0.63 vs. $0.54.

10-28-2012 2-34-52 PM

A Senate investigation finds that medical device manufacturer Medtronic paid millions to surgeons who put their name as authors on journal articles that were actually written by the company’s marketing team. Medtronic paid $210 million to doctors over 15 years related to its Infuse spine surgery product, including $34 million to University of Wisconsin orthopedic surgeon Thomas Zdeblick (who is himself the editor of a medical journal, Journal of Spinal Disorders & Techniques). Medtronic hired Yale University to review Infuse and his comments don’t sound nearly as pro-Medtronic as the allegedly shilled articles: “This sounds eerily familiar to many of the transgressions we’ve read about from the pharmaceutical industry. It paints a picture of a company very heavily involved in the science; marketing contaminating the science; and the medical profession and researchers being complicit. It’s no wonder the public has lost confidence in the drug and device industries.” My question, as always: Medtronic’s annual sales are $16 billion and its market cap is $42 billion, so how big of a fine would be needed to send a clear message if indeed they’re guilty? I’m thinking $5 billion and some jail time for the scumbag executives who were involved, but that’s just me. And for that matter, why not hit some of those greedy docs with some mega-fines and maybe suspend their medical licenses for producing phony medical research? This business of Uncle Sam settling out of court with mega-corporations for a financial slap on the wrist needs to stop. Medtronic paid a measly $24 million a few months ago to get DOJ off its back over paying kickbacks to doctors and $85 million to settle shareholder suits claiming it made misleading statements about Infuse.

Another argument that paying providers for quality doesn’t really work: the rate of catheter-related infections didn’t go down when Medicare stopped paying for them. That’s great news if you’re a fan of well-intentioned incompetence.

10-28-2012 1-22-34 PM

eClinicalWorks held its user group meeting this past weekend at the Gaylord National Hotel and Convention Center in the DC area, with 4,500 attendees and keynote speakers Surgeon General Regina Benjamin, MD and former eCW customer National Coordinator Farzad Mostashari, MD (who used eClinicalWorks, Epic, and NextGen when he worked for NYC’s Department of Health).

Weird News Andy must be brewing over missing this sad story, sent over by a worthy competitor. A new student nurse in Brazil accidentally kills an 80-year-old woman by somehow hooking up her IV to a cup of coffee. She explained on national TV: “As they were next to each other, anyone can get confused. I injected the coffee and I put it in the wrong place."

The Florida office of HHS’s Office of Inspector General says that thieves are stealing claims data from companies that administer Medicare claims. Scammers prefer Medicare records because CMS has balked at the effort required to change its identifier from Social Security number like everybody else has done, which allows the thieves to file fraudulent tax returns and collect refunds since IRS, like CMS, pays first and ask questions later (or never). In other words, one federal agency’s electronic data is used to create another agency’s electronic data for larcenous purposes, like interoperability for crooks. Did you ever get the feeling that government is the only organization where the more technology it uses, the more vulnerable it becomes to fraud because of poor oversight?

10-28-2012 2-20-44 PM

Athenahealth is negotiating with Harvard University for the purchase of Arsenal on the Charles, an 11-building office campus and former US Army arsenal in Watertown, MA that includes athena’s headquarters. The company seeks 1 million square feet, while the Arsenal property, estimated to cost about $200 million, has 765,000 square feet.

Vince checks in from Europe with good news about John Sacco (founder of JS Data) and sad news about Ed Meehan (Keane/NTT Data). As always, if you have memories, photos, or ephemera from healthcare IT companies of old (from before 1990 or so, let’s say) then Vince would enjoy hearing from you, especially if you have e-mail addresses or phone numbers for some of the long-lost folks who ran them.


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

More news: HIStalk Practice, HIStalk Mobile.

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October 28, 2012 News 11 Comments

News 10/26/12

October 25, 2012 News 2 Comments

Top News


Cerner reports an 18 percent increase in Q3 revenues from a year ago, with EPS of $0.56 versus 2011’s $0.45. Net earnings grew 25 percent and the company’s $769.9 million in third quarter bookings represent an 18 percent jump over last year.

Reader Comments

10-24-2012 3-43-36 PM

 inga_small From Weird News Andy: “Re: MGMA write-ups. This is too good a post not to have a comment.” WNA is referring to one of the four updates posted to HIStalk Practice this week covering the MGMA meeting in San Antonio. If you are interested getting the scoop on the conference, check out the writeups from  Monday, Tuesday morning, Tuesday evening, and Wednesday. I covered an assortment of topics including educational sessions, exhibit hall happenings, and parties. Other publications may offer a more in-depth look at some of the specific sessions, but I bet none published a photo of mariachis with Ronald McDonald.

10-25-2012 3-53-17 PM

From Junior Birdman: “Re: MGMA. The athena rep told me that two-thirds of the demos they were doing were for current Allscripts and GE customers.” Unverified.

From Empire Statesman: “Re: Allscripts. A totally unverified rumor is that they filed the HHC protest just in case a New York-based private equity company turns out to be their buyer and can then exert local influence on HHC to change its mind. The slim hope they will prevail may also delay the market’s reaction long enough to get them sold before the decision is announced.” Unverified. Another reader’s unverified rumor is that Allscripts had a big meeting with a PE firm on Thursday.

From CIO Reader: “Re: CIOs reading HIStalk. You’ve taken a good first step in running the excellent work of Ed Marx and Bill Rieger. Perhaps include other writing from insightful and innovate CIOs and/or CMIOs?” I’m happy to do that. If you’re both interested and interesting, there’s a place for you here.


From King Biscuit: “Re: RazorInsights. I’m telling you, these guys are going to leapfrog everyone … so cool!  Best engineered software, by far.  Blows Epic and Cerner away.” Unverified, but KB is a non-anonymous expert whose name you’d instantly recognize and who has no horse in this particular race, so I respect that opinion. Some company communication I intercepted says they are #2 in KLAS (behind Epic) and #1 in the community hospitals category, with 64 hospitals in the pipeline.


From HITesq: “Re: Allscripts. You can confirm the unhappy Allscripts issue. Allscripts sued Aprima in the Northern District of Illinois.  Complaint attached. Alleges trademark infringement and unfair competition.” Allscripts demands that Aprima stop using the MyWay name in its advertising and stop insinuating that Allscripts is sunsetting the product. I’ll side with Allscripts. I’m not a lawyer like HITesq, but I assume Aprima can continue to target its advertising to MyWay customers as long as it doesn’t imply that Allscripts is forcing those customers to change and perhaps adds the common disclaimer that MyWay is an Allscripts trademark and product. Kudos, by the way, to HITesq for always finding these interesting legal nuggets from sources the rest us don’t have access to.

From AnotherOneBitesTheDust: “Re: GE. Will be sunsetting it Oracle-based Centricity product – the old Logician – after upgrading it for MU 2 next year.” Unverified. 

HIStalk Announcements and Requests

I get several e-mails each week imploring me to take advantage of the many ways I could make more money from HIStalk (recent ones: drastically raise the admittedly low sponsorship costs, rent the mailing list, make it a pay site, sell consulting services to vendors). I’ll be honest in saying that I have no plans for any of those since I do it for fun, not money, and the more it would become a real business, the less I’d like it. All I need is the satisfaction, and that’s where you come in: (a) sign up for the e-mail updates since Inga loves seeing that number increase; (b) connect with us on Facebook, Twitter, LinkedIn, and Dann’s 2,821-member HIStalk Fan Club; (c) cruise the ads of our loyal sponsors, check out their listings in the Resource Center, and shoot out your consulting RFIs to several companies at once via the RFI Blaster; (d) send us news, rumors, guest posts, or ideas of how we can help the industry and patients; and (e) tell your colleagues you read here since the only way we get new readers is via word of mouth and Google. Thank you for spending time with us.

Acquisitions, Funding, Business, and Stock

McKesson will acquire PSS World Medicine Inc. for about $2.1 billion. PSS is primarily a medical products distributor, but is also an athenahealth reseller. Analysts estimate that PSS’s athenahealth sales represent less than five percent of athena’s new customers per year.

AdvantEdge Healthcare Solutions, a provider of billing, practice management, and coding services for specialty physicians and hospitals, acquires Medrium, a Delaware-based billing and PM company.

10-25-2012 2-05-22 PM

HIT raised $194 million in VC funds from 37 deals during the third quarter, according to Mercom Capital Group.

Compuware reports fiscal year 2013 Q2 financials: revenues down 15.4 percent, net income down 53.3 percent, and EPS of $0.05 versus $0.10. Analysts were expecting $0.06/share. Compuware’s Covisint division reported a 17 percent increase in revenues from a year ago.


In Australia, Queensland Health expands its use of iMDsoft’s MetaVision ICU system by purchasing a statewide enterprise license.

10-25-2012 3-57-31 PM

University Physicians Group (NY) will implement the PatientPoint Care Coordination platform and its electronic Check-In/Check out process.

Johns Hopkins Medicine expands its relationship with MModal by rolling out its Natural Language Understanding to all facilities.

10-25-2012 4-01-27 PM

Hi-Desert Medical Center (CA) selects iDoc from CareTech Solutions for document imaging and management with Meditech’s EHR and health information management systems.

Partners Healthcare (MA) renews its contract with Omnicell for pharmacy automation.

10-25-2012 4-02-52 PM

MedVirginia signs a multi-year contract extension with Alere Wellogic, the creator of the HIE’s technology infrastructure.

The Defense Health Services Systems awards an $11 million prime contract to SAIC for support of the TRICARE Online system and expansion of Blue Button capability.

Holston Medical Group (TN/VA) selects Performance Clinical Systems and the Symphony platform for care coordination.

10-25-2012 4-04-57 PM

Queens Long Island Medical Group (NY) chooses MU Assistant from SA Ignite to automate MU reporting and enable one-click electronic attestation to CMS.

Rochester General Health System (NY) purchases Carestream Vue for Cardiology PACS.

Prime Healthcare Services (CA) selects FairWarning Patient Privacy Monitoring for privacy auditing with its Meditech system.


10-25-2012 4-11-43 PM

Phreesia appoints Ralph Gonzales, MD (UC San Francisco) as chief medical advisor.

10-25-2012 4-13-06 PM

Convergent Revenue Cycle Management names Mark Schanck (HBCS) SVP of sales and marketing.

10-25-2012 4-14-06 PM

David Bates, MD, the SVP for quality and safety at Brigham and Women’s Hospital, joins the EarlySense medical advisory board.

Announcements and Implementations

Family Healthcare (ND/MN) goes live with RTLS from Intelligent InSites to track patients, staff, and equipment.

10-25-2012 2-55-53 PM

Van Buren County Hospital, an affiliate of Iowa Hospital and Clinics,  goes live on Epic.

Government and Politics

OIG says in the video above that among its planned 2013 work is to “identify fraud and abuse vulnerabilities in electronic health records (EHR) systems.” I assume the HHS/OIG survey I ran earlier this week was the first step in that effort.

The VA announces plans to get its VistA system Meaningful Use certified, but says that probably won’t be completed until 2014.

CMS publishes a document containing minor corrections to the Stage 2 MU Final Rule.

Innovation and Research

10-25-2012 4-32-53 PM

KLAS finds that 70 percent of providers are using mobile devices to access clinical applications. Physicians using McKesson and Epic applications are more likely to view data on a mobile device than providers running other EMRs. Providers and healthcare organizations say their biggest concerns with mobile devices are preserving the security of patient data and managing and tracking devices.


Most healthcare data breaches occur in facilities with less than 100 employees, according to a Verizon study. The majority of attacks on healthcare systems are financially motivated and target personal and payment data.

The Australian federal government terminates a $23 million contract with IBM to build the National Authentication Service for Health, citing missed deadlines and delays.

Sponsor Updates

  • Informatica introduces PowerCenter Big Data Edition, which allows organizations to leverage data for advanced analytics.
  • Eugene Gastroenterology Consultants (OR) selects ProVation MD for GI from Wolters Kluwer Health.
  • Surgical Information Systems renews its HFMA Peer Reviewed designation for its rules-based charging product.
  • Tigermed Consulting Co selects Merge eClinical’s CTMS solution to streamline clinical trial management.
  • ROI is not the primary measurement used by organizations to gauge the success of their EMR systems, according to a Beacon Partners survey. The report also finds that quality management and IT departments are the ones most often responsible for EMR performance measures. Beacon also hosts a Webinar featuring a discussion of navigating unknown risk in a practice.

EPtalk by Dr. Jayne


Inga and I are back from MGMA. She is drowning in e-mails I am drowning in the sea of humanity that is a double shift in the ER. I recently started watching Doc Martin on Netflix and sometimes wish I could channel his bedside manner to those folks that think that every ER visit comes with a meal tray and a complimentary can of Sierra Mist.

Like Inga, I was underwhelmed by the lack of buzz both in the meetings and in the exhibit hall. I’m chalking it up to the fact that practices are simply beaten down. Those that have already gone to EHR have spent their available cash and are focused on optimizing what they have. It might have been a good sales opportunity for consulting groups to peddle their skills.

I only saw a handful with booths, but I did run into several consultant colleagues who were there as attendees. There were a lot of complaints about sessions being too full and one Central Business Office Director told me she was skimping on the exhibit hall to make sure she had a seat in sessions.


As you can see, Inga and I were not the only celebrities in town.


San Antonio Banderas responded to my comment about the bottles and trash I saw on the Riverwalk during my morning jog. “I have attended many conventions in San Antonio in my last career, and always referred to the Riverwalk as the Sewerwalk. And Inga said she was walking barefoot back to the hotel? Ick! Have you experienced having a snack or drink at one of the nasty riverside restaurants or bars and have the pigeons land on your table, only to shed feathers and dander all over you when you shooed them away? Ick, ick!” Luckily I haven’t had the pigeon experience, and I’m happy to relay that most of Inga’s shoeless wandering was in hotel lobbies and the occasional restaurant. As her personal physician, I do try to look after her health and welfare, offering the above cowboy-style galoshes as a potential solution.


I wanted to get a better photo of these guys and their sassy purple paisley pants, but I could never find their booth. I assume they were exhibitors rather than two friends who share a stylist. The “Cushiest Carpet” award goes to Pulse. Although they wouldn’t give Inga a pair of green sneakers, they did try to buy our love with coffee at a time when we sorely needed a pick-me-up.

We spent some time cruising the hall together. I admit that I still have to stifle a giggle every time I see my signature on the HIStalk placards. I had the chance to get to know some of our sponsors better and to hear more about the plans for the upcoming HIStalkapalooza. Let me just say it’s going to be something to remember, and based on the theme, I have the perfect wardrobe for the event.


I’m looking forward to next year’s MGMA in San Diego and hope to be joined by Bianca Biller for even better perspective. I seriously doubt, however, that I will find any pastry in the shape of California in 2013. God Bless Texas!


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

More news: HIStalk Practice, HIStalk Mobile.

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October 25, 2012 News 2 Comments

News 10/24/12

October 23, 2012 News 9 Comments

Top News

10-23-2012 7-08-18 PM

Pam McNutt, SVP/CIO of Methodist Health System of Dallas, tells me that she has received a detailed fraud survey from OIG that covers a lot of territory. She will send it over if the hospital’s legal department gives the OK, but in the mean time, she provided a summary of what’s on OIG’s mind:

  • Computer-assisted coding
  • HIPAA security practices related to access to the EHR, both remote and internal
  • Numerous questions on practices and protections involving allowing patients and non-employees to access EHR data
  • Seventeen questions about audit log capabilities and how audit logs are monitored
  • Thirteen questions on clinician progress notes, whether cut/paste/copy is allowed, and how record changes are performed
  • General HIPAA privacy compliance questions

OIG Survey

UPDATE: Thanks to another reader who provided a copy of the survey, which is specific to hospitals. I found Question #44 involving patient access to their EHR data to be the most interesting given that this is a fraud questionnaire. Not only is allowing patients to see information about them a good thing in general, they can be on the lookout for questionable billing for services on their behalf. Click here for larger, printable version of the survey from my original upload.

Reader Comments

10-23-2012 8-56-40 PM

From THB: “Re: Sherman Health in Chicago. I’ll bet a dollar to your favorite charity that they join Cadence since it’s an Epic shop.” Drop a buck into a Salvation Army kettle: Sherman chooses the other suitor, Advocate.

From Back from CHIME: “Re: HIStalk. As a long-time HIStalk follower, I think everyone should know about it for keeping current. Few of my peer group seem to. How can that gap be bridged?” Let’s crowdsource some reader ideas: what should I do to make HIStalk imperative CIO reading or make them more aware of its existence?

10-23-2012 7-32-36 PM

From Michael: “Re: EHRs in the NFL. I thought HIStalk would appreciate this.” Indeed I did. A New York Times article talks about NFL teams that use technology to maintain the health of their expensive biological assets (players). Among them: electronic medical records, concussion evaluation apps, sideline video replays so trainers and doctors can quickly figure out the source of a player’s injury, and iPads for viewing player X-rays. The league hopes to move all teams to a cloud-based EHR system soon so that prospects won’t need to be X-rayed by every team that’s considering their services. According to the SVP of medical services for the New York Giants, “Electronic medical records league wide would save a player from a lot of unnecessary radiation. All of this helps on so many levels from before the game to during the game to after the game. It all just makes it easier to help the players stay healthy.” ”

HIStalk Announcements and Requests

Inga and Dr. Jayne are having quite a time for themselves at MGMA, apparently. Inga’s posts (with lots of pictures since she’s determined to wave her iPhone 5 around at every opportunity) are up from MondayTuesday, and Tuesday Part 2. Inga is #4 on the list of Twitter influencers using the #mgma12 hashtag, she told me proudly.

On the Jobs Board: Systems Implementation Engineer, Billing Services Manager, Database Administrator (Oracle).

10-23-2012 9-00-26 PM

Welcome to new HIStalk Platinum Sponsor Craneware. The company is all about revenue integrity: charge master management solutions, business intelligence, and revenue cycle management. I was startled to see its growth from the days long ago when my hospital signed up as an early adopter, and now I see that 25 percent of US hospitals are its customers for a variety of products: Chargemaster ToolkitBill Analyzer, Physician Revenue Toolkit, InSight Medical Necessity, Patient Charge Estimator, Pricing Analyzer, and even more solutions for supply management, denials, audits, payment variance analysis, and a broad line of professional services. Thanks to Craneware for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

10-23-2012 9-26-24 PM

Health education systems vendor HealthStream acquires provider enrollment and credentialing system vendor Sy.Med Development. Both companies are located in the Nashville area. HealthStream also announces Q3 results: revenue up 28 percent, EPS $0.08 vs. $0.08. 

Perceptive Software saw a 78 percent revenue increase in Q3, according to filings by parent company Lexmark.

Vocera shares were the biggest percentage decliner on the New York Stock Exchange Friday, down 6.7 percent. They regained 2.32 percent Tuesday amidst a big market selloff, however.


Memorial Hospital (CO) will deploy SIS Analytics across its three facilities.

10-23-2012 9-13-13 PM

Beaufort Memorial Hospital (SC) selects Wolters Kluwer Health’s ProVation Order Sets.

Vanguard Health Systems (TN) will deploy AirStrip’s complete mHealth platform throughout its 28 hospitals.

10-23-2012 9-29-47 PM

Samaritan Health Services (OR) will use Passport Health’s Patient Access and Payment Certainty solutions throughout its enterprise.

Huntington Medical Foundation (CA) selects Allscripts RCM for its 50 providers to integrate with its Allscripts EMR.

HealthEast Care System (MN) chooses the Wellcentive Advance Outcomes Manager population health management solution.

Carroll County Memorial Hospital (KY) chooses OfficeEMR from iSALUS.

Announcements and Implementations

10-23-2012 9-31-01 PM

eClinicalWorks launches an all-inclusive RCM service at MGMA that includes its PM/EHR and services for 2.9 percent of monthly revenue collections.

10-23-2012 9-14-40 PM

Vitera announces Intergy Stat, a pre-configured subscription- and cloud-based PM/EHR system for independent physicians. Also announced: Vitera Intergy Mobile, an iPad app that provides mobile providers with read-only access to Vitera Intergy v8.00.

Oncology solutions vendor Prowess will incorporate tools for e-prescribing, medication adherence, and communications from DrFirst.

Government and Politics

Northern Ireland’s health minister is attending a Boston conference to urge healthcare vendors to test their products in his country, touting its single integrated health and social care system. Among the American speakers at the EU-US eHealth Markeplace are Anand Basu (ONC), David Seltz (Massachusetts governor’s office), Dave Whitlinger (New York eHealth Collaborative), Doug Fridsma (ONC), Farzad Mostashari (ONC), Joy Pritts (ONC), Judy Murphy (ONC), Katherine Luzuriaga (UMass), Laura Raimondo (UPMC Italy), and Bill Hersh (OHSU).

10-23-2012 9-39-45 PM

The VA hasn’t made much progress on encrypting its computers since a high-profile 2006 data breach, a report investigating an anonymous tip finds. The agency bought 400,000 encryption licenses for almost $6 million, but has installed the software on only 65,000 devices. The VA’s technology office says they had compatibility problems with older computers and stopped the encryption program until the computers were upgraded. The OIG report says they don’t even know if the software meets the VA’s needs and blames poor planning and project management for the outcome.


10-23-2012 7-58-07 PM

Apple announces the slightly smaller iPad mini, pricing it surprisingly high at $329 for a Wi-Fi only model. Concerns are that it still can’t compete with the $199 Kindle Fire (subsidized by the Amazon product sales it generates) or the $199 Google Nexus (sold at cost.) It could, however, take away from sales of its $499 big brother. Also announced: yet another generation of the iPad to make the one(s) you already have obsolete, thinner MacBook Pro laptops featuring the Retina display, and upgrades to the iMac and Mac Mini. Apple shares closed down 3.26 percent.

10-23-2012 9-46-17 PM

Diagnotes wins an Indiana innovation contest for its On Call program that connects hospital staff to offsite physicians who can view medical records on their smart phones and send orders back via secure messaging. The company’s CEO is Dave Wortman, who I interviewed many years ago when he was running Mezzia,  the healthcare budgeting company he formed in 1999. It was sold to VFA in 2006.


A University of Wisconsin-Madison biochemistry professor whose research involves the flowering of plants is arrested after police find that the specimens in his lab are actually marijuana. My first reaction: sounds like “Breaking Bad” since I’m watching that on Netflix.

In England, a hospital blames an unspecified technical issue in apologizing to 120 breast cancer patients whose incorrect estrogen receptor biopsy results caused them to miss potentially needed hormonal therapy. The hospital is also on shaky financial ground, saying it could run out of cash in January.

An internist’s Wall Street Journal opinion piece on electronic medical records concludes:

At first I thought EMR sounded like a good idea. Then our practice started using one … checking patients into the office is an odyssey involving scanners and the collection of demographic data—their race, their preferred language, and so much more—required by Medicare to prove that we are achieving "meaningful use" of our EMR … it seems as if this is all about taking care of the chart, as opposed to taking care of the patient … With all the data entry the electronic system requires, my laptop presents a barrier between my patient and me, both physically and metaphorically. It’s hard to be both stenographer and empathetic listener at the same time.

Life Sciences Angel Network will present a November 20 conference, “Healthcare Information Technology: Change, Outlook, and Opportunity,” at Beth Israel Medical Center in New York. Investor Esther Dyson will deliver the keynote; program panelists include representatives from Aetna, Nike, Continuum Health Partners, Castlight Health, and the FDA. Registration is $120.

10-23-2012 8-31-17 PM

Medical students from Johns Hopkins University and the University of Maryland who volunteer at Baltimore Rescue Mission develop an EMR system for the free clinic using open source software. They plan to expand it to similar organizations and connect it to Maryland’s CRISP HIE. They’ve formed an organization called Networking Health.

Here’s a music video from the recent CHIME conference. I recognize quite a few of the stars.

Sponsor Updates

  • Imprivata announces the agenda of its first annual user conference in Boston.
  • Gartner positions Informatica in the leaders quadrant in its 2012 Magic Quadrant for Master Data Management of Customer Data Integration report.
  • GetWellNetwork experiences a 125 percent growth surge year over year as patient engagement becomes an imperative component for MU reimbursements.
  • First Databank releases its enhanced drug knowledge to support interoperable medication management.
  • Iatric Systems receives ONC-ATCB 2011/2012 Certification for its PtAccess V1.0.11.
  • QlikView expands its mobile access with QlikView for iOS, available for the iPad.
  • NextGate signs 15 new clients during its third quarter for its EMPI and Provider Registry solutions.
  • Park Place International introduces its Sustaining Healthcare IT blog to assist Meditech hospitals in achieving sustainability.
  • Anesthesia Healthcare Partners chooses to McKesson Revenue Management Services for 30 locations across eight states.
  • AdvancedMD releases its survey results at MGMA indicating that only 26 percent of physicians feel they are in control of their finances, while more than half expect their patient load to increase because of the Affordable Care Act.


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

More news: HIStalk Practice, HIStalk Mobile.

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October 23, 2012 News 9 Comments

Monday Morning Update 10/22/12

October 21, 2012 News 13 Comments

10-20-2012 9-30-04 PM 10-20-2012 9-30-49 PM

From MyWay or the HyWay: “Re: Aprima. I hear that Allscripts is upset that Aprima is offering MyWay customers a free conversion to Aprima. I don’t understand the situation there.” Unverified, but that’s surely the case. Here’s some history for the industry newcomers. Misys was a train wreck in 2007, a clueless British company stuck with a bunch of badly aging practice EMRs that could not compete with newer, better, and cheaper competitors that were flooding the small practice market. Instead of developing a new product, Misys took the questionable step of paying iMedica for the source code to its EMR product in a non-exclusive agreement that allowed each company to do its own development going forward, with Misys relabeling its copy as MyWay and selling it through resellers instead of the traditional sales channel. The relationship got ugly, with all kinds of legal actions and maneuvering.

Misys then merged with Allscripts in 2008, its old HealthMatics EMR product was renamed Allscripts Professional, and iMedica changed its name to Aprima in 2009 (for a first-person historical snapshot, see my 2008 interview with Aprima CEO Michael Nissenbaum and my 2010 interview with Glen Tullman and the since-departed Phil Pead from Allscripts.)

Fast-forward to 2012: Allscripts tells customers it won’t enhance MyWay to meet ICD-10 or Meaningful Use Stage 2 requirements, but will support their continued use of their product as-is or convert them to Allscripts Professional for free. Aprima, sensing opportunity, offers those customers a similar deal to move to its product, which is a lot more like MyWay than Allscripts Professional (Aprima’s product isn’t ICD-10 or MU Stage 2 ready either, but the company has said those enhancements are on its roadmap.)

MyWay customers have four options:

  1. Keep using MyWay, realizing that while Allscripts support will continue to be available, the product is moving into maintenance mode with no planned ICD-10 or Meaningful Use Stage 2 capabilities. Practices that don’t need those enhancements don’t need to make any change at all right away. Historically, however, vendors usually don’t continue to indefinitely support maintenance mode products, so this option is realistically more of a decision deferral than a long-term strategy.
  2. Accept the rather generous Allscripts offer of a free conversion and no-change maintenance cost in moving to the arguably more comprehensive but also more complex Allscripts Professional. That’s a great deal on the surface, but with a caveat: even free EMR conversions to an entirely different product are painful and productivity-sapping, not to mention that the Allscripts conversion schedule is ambitious and they’ve previously struggled with even same-product upgrades (TouchWorks).
  3. Convert from MyWay to Aprima at no charge. The Aprima product should look and feel more like MyWay than Allscripts Pro. The switch involves signing up with a different company, which could be good or bad depending on how you feel about Allscripts as a vendor. I don’t know if Aprima has ever done a conversion of that type, but I would suspect they haven’t.
  4. Buy a competitor’s product instead of accepting a unwelcome migration to either Allscripts Pro or Aprima. That option makes sense only for a limited subset of customers given the effort and expense required for an on-your-own switch. However, kicking tires doesn’t cost anything, so some customers will probably at least explore competitive products, driving their sales reps crazy since “free” is a tough selling point to beat.

In comparing products, KLAS customer respondents score them about the same:

Aprima EHR 72.39
Aprima PM 71.58
Allscripts MyWay EHR 70.54
Allscripts Professional EHR 69.81

Aprima beats Allscripts significantly in the all-important “would you buy it again” number from real-life customers, which I consider to be the most important KLAS measure since it summarizes both the product and the company:

Aprima EHR 80 percent
Aprima PM 71 percent
Allscripts MyWay EHR 60 percent
Allscripts Professional EHR 60 percent

I’d want assurances from either vendor:

  1. How much productivity will you lose during the switch?
  2. Can you talk to reference sites that converted before yours? You don’t want to be the first one.
  3. What information will be converted automatically? “Conversion” is not necessarily a generic term.
  4. What’s the cost of any required third-party product licenses, hardware upgrades, optional maintenance costs, after-hours support availability, on site training if you think you’ll need it, etc.? Both companies suggest minimal changes, but I’d want that in writing.
  5. Will they guaranteed maintenance costs with limited escalation?
  6. Will they send you a sample project plan for the conversion?
  7. What if something goes wrong? Every factor that’s important to your practice should be covered by a contractual promise from the vendor and a contractual penalty if they fail to meet it.

I’m a cheap-seater on this issue, so comments from Allscripts and Aprima users are welcome.

10-20-2012 9-28-13 PM

From Now Seriously: “Re: Paul Levy’s Stockholm syndrome comments about Epic. For some reason in his mind, it’s a bad thing that Epic skated to where the puck was going and got there first with string of solid installs that are successful models for the industry. His poor judgment and lack of clear thinking must have helped him achieve the title of ‘former CEO’ and his blog’s title change to ‘Not Running a Hospital.’” Paul is certainly entitled to his opinion even when it’s uncharacteristically negative, but he (and the pedantic EHR-haters that posts like this one always attract) would carry more credibility with actual experience using Epic or any other commercially available product. It’s the height of arrogance to dismiss the first-hand opinions and experiences of hundreds of hospitals and thousands of actual users of Epic or any other clinical system by writing them off as collectively deluded, like a know-it-all nosebleed-section sports fan shouting out naïve advice to a professional athlete. Paul finishes on a wild tangent in predicting that any Epic error (of which the documented incidence is apparently zero) will cause “a bunch of Congressional committees to come down on the firm like a ton of bricks.” That didn’t happen with Cerner at UPMC Children’s Hospital, the homegrown CPOE system at Cedars-Sinai, or Eclipsys at El Camino Hospital, where IT problems definitely threatened patients. Or for that matter, at Paul’s former employer BIDMC, where a multi-day network outage in 2001 that included its homegrown EMR surely exposed its patients to harm. The crux of his message seems to be that someone should stop Epic’s domination of the hospital systems market (like their competitors, maybe?) and the FDA should regulate clinical software, which always elicits passionate, conflicting opinions about whether government intervention generally improves a given situation.  

10-20-2012 2-10-12 PM

From HIPAA Girl: “Re: Blount Memorial Hospital. The Tennessee hospital’s stolen laptop contained information on 27,000 patients.” The laptop stolen from an employee’s home contained only basic demographic information. The hospital says the laptop was password protected, which usually means not encrypted.

From Virtual Virtuosity: “Re: copying and pasting of patient information in EHRs. Is Dr. Mostashari aware that this is how most EHRs work? Does HHS and ONC really expect providers to individually enter every piece of data from a clinic visit? We had a doctor join our practice from the same Kaiser office I used to work at. She had been using Epic for eight years and I asked her how she did it. She said it was initially hard, but she and most of her colleagues finally just made 20 templates and copied them for the vast majority of patients. EHRs from Epic and everybody else were designed to improve efficiency by copying and pasting. If HHS and ONC really expect providers to manually enter every piece of data from every patient visit, we’ll need double or triple the number of primary care providers to keep up with demand. That also brings up another point: as we read the rah-rah press reports about how Kaiser is a shining beacon on a hill for gathering and collecting data to improve healthcare, aren’t they just analyzing the same data constantly if their doctors are just using those 20 templates over and over? How does that reduce costs or improve efficiency?” My opinion is that providers have met every expectation as long as each patient’s EHR information is accurate. If HHS wants providers to craft innovative and individualized prose just for the sake of making every patient record pointlessly different, then they need to set a payment rate for creative writing. First they wanted discrete data, then they decided that what they really want is lots of plain text to assure them that they aren’t being defrauded since they are apparently powerless to determine otherwise. I’ve said it before: the reason that EHRs haven’t improved patient outcomes is because HHS and other payors have forced vendors to focus their development efforts on administrivia enhancements to meet needlessly complex payment requirements that have nothing to do with patients. You could develop a kick-butt EHR if you weren’t required to get bogged down in the Vietnam-like quagmire of billing documentation requirements that allows payors (Uncle Sam included) to avoid writing checks. Unfortunately, that situation is getting worse instead of better as the government insinuates itself even deeper into the practice of medicine. I bet you could design a really cool EMR for cash-only practices, except you’d have few prospects to sell it to.

From Minor Key: “Re: Michigan HIEs. Talk to providers and practices in the state and you’ll hear a different story. They’re realizing benefits now, with little jeopardy or delay in the HIE’s work toward the longer-term goal of interconnection.”

From Jock Ewing: “Re: FDA and biomedical system OS, antivirus, and software patches. This 2005 article says it’s a common ploy for vendors to tell customers that applying software patches would require re-approval by FDA. FDA has clearly said that this is not the case. The bottom line is that manufacturers are supposed to be validating patches and the only issue with getting that done is their willingness to dedicate resources to the task. It’s up to their customers to demand that they validate patches in a timely manner.”

10-21-2012 10-23-15 AM

From The PACS Designer: “Re: busy week ahead. Both Apple and Microsoft plan to introduce new hardware and software next week. First, we hear from Apple on the 23rd with the expected offering of new smaller versions of their product line, and on the 26th we will hear from Microsoft on the introduction of Windows 8. Windows 8 is the big deal of the week because it is projected to be the key operating system that will replace Windows XP, and will be used in many upgrade efforts across all of industry, academics, healthcare, and home computing. One of the first apps in healthcare space will be Pariscribe’s Windows EMR Surface (above), which should draw some interest from practitioners.”

From LaRusso: “Re: Fast Company. Several pages on healthcare IT are in the current issue.” It’s mostly the usual oversimplified geek piece on how tiny software startups you’ve never heard of are going to not only disrupt healthcare IT, but healthcare itself because they have brash founders, a few thousand dollars of VC or incubator money, and cool Web pages. I don’t recall many industries that have been disrupted by apps or websites, other than retailers outflanked by competitors who started selling first via the Web, so I’m skeptical that most of these companies will even survive, much less single-handedly transform the highly profitable, political, and parochial healthcare system into a consumer-driven and transparent industry where good defeats evil. Companies get my attention once they hit $5 million in revenue since that’s the point where the concept has been validated, initial development and scaling has been completed, the organizational culture has been defined, and skilled management has been brought in to protect the VC’s investment from the managerial whim of the inexperienced founders. That’s when companies become worth writing about, if for no other reason than the strong possibility that some old-school company will just buy them outright, making the founders as rich as they’d hoped while usually ruining what they created.

Now that I’ve been predictably curmudgeonly in dismissing wide-eyed startups and their naïve faithful who really believe that every David will inevitably rise to defeat his personal Goliath, I’ll take my own counterpoint in reminding myself that I ran a successful series of profiles awhile back called Innovator’s Showcase that introduced several companies to the more traditional side of the industry that most of us work in. I want those small companies to innovate and succeed and that was my way of trying to give them a boost, choosing those that seemed to have predictors of success. Some of them have done quite well since then from all appearances. If your healthcare IT-related company is less than five years old, has sold your offering to real customers, and brings in revenue of less than $2.5 million from selling a truly innovative product or service, e-mail me and tell me why my readers should be interested — I might include it in future posts. Those companies I’ve showcased previously include Aventura, Caristix, Health Care DataWorks, Health Nuts Media, Logical Progression, OptimizeHIT, and Trans World Health Services. There’s work for both of us to do if you’re chosen, so don’t take it lightly.

10-20-2012 7-51-23 AM

Widespread interoperability is limited because (a) technology or standards are limited, and (b) because providers have no incentive to share the data they keep. New poll to your right: does your PCP use Twitter for medically related tweets? I don’t really care so I wasn’t sure if mine did, but I’m guessing no since he doesn’t turn up in a Twitter search.

10-20-2012 10-10-42 PM

Welcome to new HIStalk Gold Sponsor HealthTronics, which offers a wide portfolio of urology-specific services (mobile lithotripsy, laser prostate treatments, cryotherapy, equipment services) that includes IT solutions such as its market-leading, urology-specific EHR used by over 2,100 providers seeing 18,000 patients daily and who have received more than $12 million in HITECH incentive payments. Its UroChartEHR and MeridianEMR were among the first EHR products to earn certification. Features include hundreds of templates and treatment plans specific to urology, pre-programmed urology terms, an easily understood user interface that requires minimal training and offers a one-screen patient encounter, PQRI, eRX, a sketch pad, device integration, built-in practice analytics and economics analysis, and remote access via iOS and the Web. HealthTronics joined Endo Health Solutions in 2010. Thanks to HealthTronics for supporting HIStalk.

10-20-2012 3-39-17 PM

Mrs. HIStalk dragged me to my once-a-year trip to the mall this weekend since I needed some new cooler weather clothes. I noticed that a Microsoft Surface kiosk is scheduled to open there shortly (in the mean time, it was serving as a place to deposit partially consumed cups of coffee and food court trash). The tablet is scheduled to ship on October 26, but pre-orders have sold out. Microsoft is getting killed as iPads have eroded sales of Windows-using PCs (Apple is the #1 PC maker in the world if you consider an iPad a PC as many consumers apparently do) and they need Surface to stop the bleeding. It comes in two versions: one that’s priced similar to the iPad running Windows RT (which has a micro-percentage of the number of apps as the iPad and a questionable apps ecosystem to compete with iTunes) and an expensive Surface Pro running Windows 8. I don’t see it making a dent in consumer iPad sales or even those of Android devices, but Microsoft’s one advantage over Apple is enterprise credibility. I would say their best chance for Surface success is that companies push off employees demanding to use iPads by offering Surface as an less-desirable but acceptable enterprise alternative. Otherwise, I expect few consumers to pony up $499 for a Surface RT tablet (not including the $100 keyboard) with they can get an iPad for the same money. If you can’t beat Apple on price, you’re screwed, because they own the customer experience.

10-20-2012 2-02-12 PM

T-System is on a roll with its funny HIT-related e-cards.

10-20-2012 2-05-38 PM

John Glaser of Siemens Healthcare wins CHIME’s lifetime achievement award. Above is a photo of the occasion taken by Ed Marx.

10-20-2012 2-08-03 PM

Also at CHIME, Ed Martinez, SVP/CIO of Miami Children’s Hospital, is awarded CHIME’s Innovator of the Year award.

A newspaper covering the highly publicized opening of the Massachusetts HIE provides a good reminder of where healthcare stands compared to other industries: “To those in fully automated industries, like banking, the state’s rollout of a new health information network last week must seem sadly behind the times … the experience can leave anyone who has ever used an Internet driven technology like Facebook or even simple email wondering just how exciting it can be to send one file electronically from one organization to another? Very exciting, say those in the health care profession.”

Athenahealth shares took a dive Friday as investors reacted to earnings that were improved, but increased less than expected following its Proxsys acquisition. ATHN closed at $73.31, down more than 8 percent to levels last seen in June. In the earnings call, Jonathan Bush blames Epic for extending the company’s sales cycles and a lowering its close rate:

They go out and sort of do some Bush Doctrine, saying, “In three years, we’re going to be live with this thing, and it’s going to slice and dice and bring world peace. You’re either going to be on it or not allowed in our hospital … you’ll be cut out of our ACO. You’re going to not be clinically integrated with us if you’re not on this thing.” … I believe that all of the banks in America may not be on one instance of one software, and yet all of us can stumble up to any cash machine we want and exchange information. It’s a ludicrous, pre-Internet idea.

El Camino Hospital (CA) provides most of the funding for a group that’s trying to defeat a November 6 ballot measure called Measure M, which would cap ECH’s executive compensation as a tax district-supported hospital. ECH’s CEO makes $700K and can earn a 30 percent bonus. The measure was proposed by the SEIU labor union, which says it’s less interested in that topic now since another bill has earned its undivided attention – one that would limit the ability of unions to raise money for political candidates.

Quite a few readers are fans of snarkmeisters The Onion and feel-good TED talks that tend to be long on inspiration but short on applicability, so here’s what happen when they meet. “I’ll be your visionary, and you do the things I come up with.”

The parents of an 8-year-old boy sue a Chicago hospital for pronouncing their son dead and taking him off life support for five hours until the patients insisted on a cardiac ultrasound that showed he was actually alive. Family members said doctors told them that the boy wasn’t actually opening and closing his eyes – it was just the medications he’d been given that made it look that way. The hospital says he really was dead, but they’re happy that his heart function returned spontaneously.

Sponsor Updates

10-20-2012 3-05-39 PM

  • Medicomp hosted the two-day MEDCIN U for 32 EHR developers and vendors last week in Reston, VA, teaching attendees about integrating the company’s MEDCIN engine and Quippe into their applications. That’s Medicomp CEO Dave Lareau and Clinical Architecture CEO Charlie Harp above.
  • EHR vendor Prowess will use the OrdersAnywhere CPOE product from Ignis Systems for lab orders, results, and lab integration. OrdersAnywhere has been integrated with 120 lab and radiology systems and is being used to satisfy Meaningful Use Stage 2 orders requirements.
  • Quest Diagnostics announces that it has certified the first 20 EHRs under its Health IT Quality Solutions program that recognizes EHRs that share data with Quest’s clinical laboratory system. The full list is here.


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

More news: HIStalk Practice, HIStalk Mobile.

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October 21, 2012 News 13 Comments

News 10/19/12

October 18, 2012 News 3 Comments

Top News

10-18-2012 6-22-53 PM

AirStrip Technologies wastes no time in filing a lawsuit claiming that clinical mobility vendor mVisum is violating its remote monitoring patent, awarded September 11, 2012. Travis wrote about the patent on HIStalk Mobile at that time, musing about its potential effect on innovation against the backdrop of Apple’s $1 billion patent victory over Samsung. Travis said:

There isn’t an answer yet as to exactly how this patent will protect AirStrip or how it will affect other mobile health vendors developing solutions to enable remote, mobile viewing of physiologic data by providers. As a methodology patent, can AirStrip use it to protect the experience of viewing a EKG, zooming into specific leads, accessing relevant additional data at the at point in time? … It’s interesting to consider the potential of a company’s defining and protecting the experience of mobile patient data viewing. As we start to see more intuitive user experience design for providers, will a standard emerge and can it be protected, enabling a patent holder to require licensing of the its patents to mirror the user experience?

Reader Comments

10-18-2012 3-14-00 PM

From Iguana: “Re: MED3OOO leadership conference. I was pleased to hear McKesson exec Pat Leonard suggest that InteGreat may be the go-forward ambulatory EHR product for hospitals implementing Paragon. Another highlight was former Highmark CEO Kenneth Melani, who provided a terrific synopsis of healthcare reform and where it’s heading.” The MED3OOO folks say several hundred clients participated in last week’s National Healthcare Leadership Conference and Users Meeting in St Thomas, USVI.

10-17-2012 4-09-12 PM

From Ms. Kravitz “Re: HIStalk’s Must See Vendors for MGMA 12. How do vendors get on this list?” The“Must See Vendors” lists for MGMA and HIMSS includes those HIStalk, HIStalk Practice, and HIStalk Mobile sponsors who chose to be included (there’s no charge) and provided exhibit information. The MGMA list includes over 50 vendors. Most of them will have a booth on the exhibit floor, while a few others aren’t exhibiting but will have people available for one-on-one meetings.

From F. Jackie: “Re: LogiXML fake 1960s TV commercial. Totally cheesy, but I needed a good laugh and it delivered.” I like it.

From Awkward Debates: “Re: degrees. I’m considering a post-grad education and wonder how the industry, particularly the vendor side, views degrees. MBA? Health informatics? Finance?” Vendor side, I’d go with an MBA unless you’re interested in sales or the executive ranks, in which case degrees (advanced or otherwise) matter little and many folks in the job don’t have them. Health informatics is a good advanced degree or certificate program, but less useful if you don’t already have a clinical degree to pair it up with. My experience is that if you have good qualities (ambition, smarts, relevant experience) and make early connections then a degree doesn’t matter all that much, especially the higher you go up the ladder, and there aren’t many cases where the degree itself is going to get you a job that you couldn’t get otherwise except in technical areas. Personally, I’d say an MBA was my best investment, but the one I admire the most in healthcare specifically is an MPH plus a professional degree (physician, nurse, pharmacist, PT, etc.) We’re going to need public health expertise since you can’t fix healthcare while ignoring health.

From Academic CIO: “Re: Allscripts protest of NYHHC’s Epic selection. We had a similar experience with Cerner. After losing on all counts, including price (Cerner’s five-year cost of ownership was twice Epic’s), Cerner had the audacity to aggressively pursue a Freedom of Information Act request for all of our e-mails, notes, meeting minutes, and Epic-supplied documents in an obvious attempt to get competitive information on Epic. At the end of day, we didn’t have to give it them, but it cost us a great of taxpayer-supplied resources to comply with their request. This was one of many attempts they made to circumvent the selection process. I would never do business again with them under any circumstances.” As I wrote previously, it’s a high-reward, high-risk strategy for a vendor to try to force itself on a customer who prefers a competitor’s product. Maybe you get a desperately needed new client and keep Wall Street off your back for one quarter, but who’s going to invite you to bid in the future knowing your history of being a sore loser?

10-18-2012 7-08-59 PM

From In the Know: “Re: Arcadia Solutions and the Azara Healthcare spinoff. The Pohlad family will sell them to a private equity firm, with the deal expected to close November 1.” Unverified. Arcadia is a consulting firm, while Azara offers analytics. The Minneapolis-based Pohlad Family Companies, which made its founder one of the richest people in America, bought Arcadia in 2007, adding it to holdings that include the Minnesota Twins, real estate, car dealerships, and banks.

10-18-2012 8-25-14 PM

From Oh MyWay – Dust in the Wind: “Re: MyWay. Here’s the Allscripts letter sent to each MyWay client with the grim confirmation. Interesting that the letter wasn’t from Glen, but rather Laurie McGraw. I guess he has bigger issues trying to find a buyer for his company.” It’s a good deal (free) for those MyWay customers who want Pro, but it’s anybody’s guess as to the percentage of MyWay customers in that camp, not to mention that changing systems is always tough. Allscripts says everybody will be upgraded from January to September 2013, which seems ambitious given the tendency of practices to delay until the last minute. I’m curious: if you attended ACE in August, what was said about MyWay then? I assume MyWay clients weren’t forewarned even though Allscripts surely had already planned its strategy. Given that Allscripts says MyWay isn’t ready for Meaningful Use Stage 2 or ICD-10, what were customers led to expect? Still, it’s probably a good decision – Inga asked Glen Tullman an insightful question when she interviewed him on HIStalk Practice in April 2010:

It seems almost as if Allscripts really has two businesses, one that’s focused on the selling the inexpensive MyWay option to small practices through resellers and the other focused on selling to the large, integrated delivery networks and hospitals that subsidize the small practices and offering them the Allscripts EHR products. Explain the strategy and tell me how you avoid channel conflicts.

From Lady Pharmacist: “Re: National Health-System Pharmacy Week next week. It’s time for the annual shout-out to pharmacists and pharmacy technicians, who from an IT perspective are helping their organizations attest for Meaningful Use, closing practicing gaps, and helping with medication-related safety initiatives related to CPOE, medication reconciliation, barcode medication administration, and e-prescribing.” Consider it shouted out.

From Patty Melt: “Re: HIEs. This article from Crain’s Detroit reminds me of the Rodney King line – can’t we all just get along? Do you ever wonder what the cost to society is for lack of consensus and cooperation?” The article says that the state’s two biggest HIEs (Great Lakes HIE and Michigan Health Connect) are competing to become the statewide exchange and aren’t sharing patient information with each other. The CEO of Oakwood Healthcare says they’re happy with Epic and not interested in joining an HIE until there’s just one because they could connect with one that won’t survive. Beaumont, also on Epic, said the state needs to get more involved but healthcare reform will force information exchange in any case.



HIStalk Announcements and Requests

inga_small Highlights from HIStalk Practice this week include: Mount Sinai Queens (NY) implements Epic at its ambulatory care locations. MED3OOO and SRS provide updates on their user conferences. Patients who are comfortable accessing and understanding their health information online will use PHRs more willingly. A REC advocacy organization defends the Meaningful Use program. CBS Morning News profiles a pediatrician’s use of social media. Dr. Gregg ponders whether HIT is becoming passé. And as mentioned above, our HIStalk Must See Vendor Guide for MGMA12 is a must-read for anyone heading to MGMA in San Antonio this weekend. Nothing says I love you like a gift of Lucchese cowboy boots (since I am Texas-bound) or your e-mail address for our HIStalk Practice updates. Thanks for reading.

inga_small Speaking of MGMA, I will be posting conference updates starting Sunday night or Monday morning (depending, of course, on the quality of the Sunday evening parties.) Our exhibiting HIStalk sponsors will have signs indicating their support of HIStalk, so please take a moment to tell them thanks on our behalf. If you have any suggestions for sessions or exhibits I should peruse, let me know. Please also take a moment to share any conference comments you might have, as well as your photos. See you in San Antonio! E-mail me.

10-18-2012 7-23-57 PM

I was initially startled and then pleased to receive this HIStalk sponsorship announcement at my hospital e-mail address. I finally realized that it went out a broad audience, not just me. Inga got one too, and we agreed that it’s nice when a sponsor is publicly proud of supporting our work (as most seem to be). It made our day.

10-18-2012 7-55-12 PM

Welcome to Aprima, sponsoring both HIStalk and HIStalk Practice at the Platinum level. The company offers a certified, fully integrated, single application, single database EHR/PM solution along with RCM services. The template-free design is chief complaint-driven with adaptive learning capability. The company, which has a 14-year track record, is offering a timely deal (free license and data migration with a signed support agreement) to users of Allscripts MyWay, for which it provided the original code in 2008. A partial list of the nearly 1,000 enhancements Aprima has made to the product since then is here. MyWay customers and resellers can connect with the Aprima folks at MGMA next week or AAFP this week. Thanks to Aprima for supporting HIStalk and HIStalk Practice.

10-18-2012 9-15-50 PM

Welcome to new HIStalk Platinum Sponsor SuccessEHS. The Birmingham, AL-based company offers a Certified Complete EHR and PM that it says can prepare practices for Meaningful Use within 60 days, not to mention that its clients experience an average 11 percent in visit increases and a 19 percent increase in collections in the first six months. The company has been in business for 15 years and is profitable and debt free, with 425 clients and 4,200 providers. Calling support gets you an in-house employee sitting in Birmingham. They’ll be at MGMA next week, also presenting the results of their new practice survey on maximizing revenue. They’re also offering a white paper on healthcare reform (e-Prescribing incentive, Meaningful Use, ICD-10, PQRS). Thanks to SuccessEHS for supporting HIStalk.

I always hit YouTube to see what a new sponsor has out there, so here’s an introductory video from SuccessEHS.

Listening: new from Brooklyn-based Woods, sometimes labeled as folk, but to my ear is more 1970s-influenced trippy, jangly guitar rock with lots of hooks and thoughtful lyrics. I liked it even from the first listen. Best song to me: “Find Them Empty,” featuring wailing psychedelic guitars and keyboard work that could pass for paisley ‘70s bands like Strawberry Alarm Clock or Vanilla Fudge.

On the Jobs Page: Product Manager, Regional Sales Executive.

Acquisitions, Funding, Business, and Stock

10-18-2012 9-47-41 PM

Athenahealth reports Q3 numbers: revenue up 26 percent, EPS $0.30 vs. $0.24, falling short on revenue expectations. Shares are down 3 percent in after hours trading.

Microsoft’s Q1 numbers: revenue down 7.9 percent, EPS $0.53 vs. $0.68, missing earnings estimates on continued weakening in PC demand and a corresponding drop in Windows sales.

Shares in Google dropped precipitously Thursday when the company’s financial printer filed its 8K report in the middle of the trading day instead of after hours as intended. Trading in GOOG was temporarily halted, but shares still ended up down 8 percent at the market’s close because of slowing revenue growth.

Trinity Health and Catholic Health East announce plans to merge, forming a new system with annual operating revenues of about $13.3 billion and 87,000 employees. Trinity’s president and CEO Joseph R. Swedish would head the new organization and Catholic Health East’s president CEO Judith M. Persichilli would be EVP. The organizations anticipate reaching a definitive consolidation agreement in the spring of 2013.


Australia’s UnitingCare Health will implement Cerner at the recently-opened St. Stephen’s Hospital, which claims it will be the country’s first digital hospital.

The 60-provider Mid Dakota Clinic (ND) selects athenahealth’s EHR, practice management, and care coordination solutions.

10-18-2012 10-10-02 PM

Wenatchee Valley Medical Center (WA) chooses Merge’s iConnect Enterprise Archive.

The University of California, Irvine Medical Center, will deploy MModal Fluency Direct and MModal Catalyst integrated with Allscripts Sunrise Clinical Manager.


10-18-2012 5-42-37 PM

RCM and consulting services provider Cymetrix names Jeffrey Nieman (Accelion) SVP of remote operations.

10-18-2012 5-44-12 PM

Alan Fowles, managing director of Cerner Europe and overseer of the first Cerner NHS installations, resigns after 11 years with the company.

10-18-2012 5-45-26 PM

RCM provider Office Ally names Daniel Wojta (United Healthcare) director of eSolutions and business development.

10-18-2012 5-46-34 PM

Health First (FL) appoints Lori DeLone (PatientKeeper) SVP/CIO.

10-18-2012 11-08-33 AM

Mobile PHR provider Cognovant hires Andrew Lambert (Press Ganey) as EVP of business development.

10-18-2012 11-13-41 AM

Lynn Danko (Lawson Software) joins Amcom Software as CFO.

Ambulatory surgical center and rehabilitation clinic software vendor SourceMedical announces the resignation of CEO Larry McTavish and the promotion of Ralph Riccardi from EVP/COO to president and CEO. The company announced last month that PE firm ABRY Partners had made a significant investment.

Standard Register promotes John King from VP of sales to president of Standard Register Healthcare. He replaces Brad Cates, who is leaving the company to serve as CEO at another company.

Announcements and Implementations

Omnicell and Cerner will develop interoperability between their products using CareAware iBus,  Cerner’s medical device connectivity solution .

HIMSS names the 91-provider Coastal Medical (RI) the winner of its 2012 Ambulatory HIMSS Davies Award of Excellence.

10-18-2012 5-53-25 PM

Kennewick General Hospital (WA) launches McKesson Paragon CPOE.

10-18-2012 5-54-42 PM

Baptist Memorial Health Care (TN) deploys EMC VNX and Citrix virtualization technologies in advance of its Epic implementation.

University of Kentucky Healthcare implements Harris Corporation’s Business Intelligence Documentation and Coding dashboard.

MedAptus announces the availability of its ICD-10 software suite.

Government and Politics

National Coordinator Farzad Mostashari, MD says the HIT Policy committee will review whether EHRs are leading doctors to overbill Medicare. He says repeated copying and pasting of patient information is “not good medicine” and wants to determine if EHR functions that prompt doctors to inflate their bills should be made “off limits.”

An Institute of Medicine report finds that the DoD and VA’s failure to create a sequential prescription number system has hindered joint EHR development at the co-managed Captain James A. Lovell Federal Health Center (IL). Because the DoD and VA have both agreed not to charge their respective EHRs, the departments are spending $700,000 a year for pharmacists to manually input prescription data. The IOM recommends that the DoD and VA avoid establishing other combined facilities until an integrated EHR is available.

The VA launches a contest to encourage the development of an appointment scheduling system to work with VistA EHR open source applications.

10-18-2012 12-20-22 PM

ONC announces availability of Cypress, an open source certification tool for testing the availability of complete or modular EHR systems to meet Stage 2 MU requirements for clinical quality measures.

As of September, almost 50 percent of all EPs and nearly 81 percent of hospitals have registered for the MU program. CMS also reports total program-to-date payments of $7.7 billion, including $4.8 billion to hospitals and $2.6 billion to eligible providers and healthcare professionals.

10-18-2012 5-59-29 PM

Two weeks after House Republicans call for a freeze on all MU payments, four Republican senators request a meeting with HHS Secretary Sebelius to discuss the incentive program. The senators would like CMS and ONC to address four questions, including whether EHRs are increasing the volume of diagnostic tests and Medicare billings. One of those questions (above) indicates a lack of familiarity with the HITECH program, which did not require providers to buy anything at all to qualify for taxpayer-funded incentives.


10-18-2012 6-02-21 PM

eMDs launches its nMotion EHR iPad application.

Medsphere Systems contributes its MSC FileMan database management system to the OSEHRA open source community, which chose it for collaborative development work on VistA.

An article in MIT’s Technology Review says that medical devices in hospitals are regularly infected with viruses because vendors are so scared of the FDA’s requirements that they won’t allow hospitals to keep their operating system patches and antivirus software current. I’ve seen this personally: my former hospital had a nasty worm that was flinging itself with impunity from one networked system to another because our vendors wouldn’t allow us to apply any changes to their FDA-approved configuration (even including applying the latest antivirus update that was known to fix the problem). We had to take the entire imaging network and several systems offline to the extreme displeasure of our physicians, while the vendor said they might get us an answer in a few weeks. I told the network team to ignore everything they had heard and simply do what they knew needed to be done. We were worm-free within a few hours and I have no doubt patients would have suffered had we not ignored our vendor’s advice, albeit at our own risk.


Former Beth Israel Deaconess Medical Center CEO Paul Levy, writing in his Not Running a Hospital blog, equates buying Epic to the Stockholm syndrome, where hostages develop affection for their captors. He concludes that Epic’s market share, driven by HITECH money, makes the company a target for Congressional retribution if a system malfunction harms patients. He also complains, “How did this firm get such a big share of such a critical market with no government review?”

The local paper covers Michigan-based HipaaCat, an image sharing and messaging app developed by a plastic surgeon.

10-18-2012 7-45-55 PM

Dan and Colin from Divurgent said Olympic bling-bearers Kerri Walsh Jennings and Misty May-Treanor were “great fun and great sports” in posing with attendees like themselves at CHIME 2012 this week. They (Kerri and Misty, that is) look a lot different with sunglasses off and clothes on.

In England, a healthcare trust that’s in such serious financial straits that it may be dissolved takes heat from the local paper for sending five managers to the Cerner Health Conference. The paper couldn’t find a source to back up its predetermined editorial outrage, so it quoted some guy who whose partner “does not wish to be named who worked as a nurse at Princess Royal Hospital.” It also seems to find a sinister connotation to KC’s power and light district, which it repeatedly places inside quotation marks as though it’s a code word for a hooker-staffed crack house. Must have been a slow news day.

Weird News Andy thinks maybe someone misspelled “birth” as “berth” in this story: a woman delivers her one-month premature baby in a Philadelphia subway car in which she is the only occupant. She calmly walks off the car and finds a police officer, who says the newborn girl “took on her personality” in exhibiting the same calm demeanor as her mother as they were taken to the hospital.

Tweets from CHIME

Sponsor Updates

10-18-2012 9-57-20 PM

  • PatientKeeper employees donate services, goods, and cash to help a Boston-area homeless family move into a furnished apartment.
  • GetWellNetwork launches its Transformative Health blog with an introductory post by CEO Michael O’Neill, Jr.
  • Intelligent InSites shares best practices for deploying an enterprise-wide RTLS during an October 25 Webinar.
  • Infor opens its new headquarters in NYC and unveils updated branding. Also, the Institute for Transfusion Medicine (PA) upgrades its Infor Healthcare Revenue Management solution to integrate with its outpatient records and receivables solution.
  • Oregon Medical Association will offer Dr. First’s RcopiaMU e-prescribing services to its members.
  • Emdeon releases a white paper on payment collection best practices for small physician offices.
  • Teradata will integrate QlikView in-memory data with Teradata’s Integrated Data Warehouse via the QlikView Direct Discovery  utility.
  • Physicians in Costa Rica’s public health system use DynaMed’s clinical reference tools to create national breast cancer guidelines.
  • Quality IT Partners sponsored last month’s 2012 Hillman Cancer Center Gala in Pittsburgh.
  • Imprivata announces 10 additional sponsors of its Imprivata HealthCon 2012 User Conference next month in Boston.
  • Cancer Treatment Centers of America and CareTech Solutions present a case study on the need for clinical help desks at this week’s CHIME CIO Forum.
  • American Well CEO Roy Schoenberg and Allscripts CMO Douglas A. Gentile discuss the benefits of integrating American Well’s telehealth offer with EHRs offered by Allscripts.
    McKesson integrates RelayHealth’s procedure and test results functionality into its Practice Choice EMR and financial management software.
  • T-System announces six winners of its T-System Client Excellence Awards.

EPtalk by Dr. Jayne

Researchers at Duke University create a 3D training application for transesophageal echocardiography for anesthesiology residents. It runs only on the iPad, leading one researcher to state that it would have greater effect if it worked on multiple platforms.

Speaking at the American Academy of Family Physicians annual meeting in Philadelphia, Farzad Mostashari encourages physicians to “turn the tables” on vendors that aren’t addressing interoperability issues. He reportedly advised users to report vendors to certification bodies. Considering the rank-and-file primary care physicians I work with every day, I’m not sure many of them are savvy enough to understand the certification requirements, let alone to become whistle-blowers. I’d rather see physicians spending their time learning to use their EHRs efficiently to deliver quality care. I invite my family physician readers who may have heard the speech in its entirety to weigh in – don’t worry, I’ll keep you anonymous.

The Breast Tissue Screening Bra from First Warning Systems has been designed to detect minute temperature changes in breast tissue that may indicate cancer via sensing the growth of new blood vessels. Temperature data is uploaded to the Internet and algorithms provide a reading to the patient. FDA approval is pending, but release in Europe is anticipated next year.

An impending change in the ranks of Medicare administrative contractors prompts concerns from providers that payments could be delayed. CMS is in the process of re-bidding contracts for claims processing, program enrollment, and other administrative functions in several regions. During a 2008 change, some payments were delayed for six to 12 months. Given the rigor with which CMS audits providers and the narrow tolerances in which we must perform to get paid, it would sure be nice if they held their contractors to the same standards. If we don’t file promptly, we don’t get paid – maybe if they don’t pay promptly, they should be fined.


I have to admit that I’ve been jealous reading about Inga’s plans to attend the MGMA meeting in San Antonio next week. I’m trying to find a way to sneak away for a day so the two of us can make a pilgrimage to the source of some of the hottest boots known to (wo)man. I had a chance to buy these beauties last year and flinched. Cross your fingers!


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

More news: HIStalk Practice, HIStalk Mobile.

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October 18, 2012 News 3 Comments

News 10/17/12

October 16, 2012 News 8 Comments

Top News

10-16-2012 10-22-48 PM

10-16-2012 10-24-35 PM

Massachusetts Governor Deval Patrick and other state officials celebrate the launching of the Massachusetts state HIE as the first medical record is transmitted from Massachusetts General Hospital to Baystate Medical Center. The Massachusetts HIway was funded by a $17 million federal grant. John Halamka writes about the significance, professional and personal, on his blog (his photo of the “Golden Spike” is above).

Reader Comments

10-16-2012 9-00-02 PM

From FirstHand: “Re: MModal changes. SVP of strategic business development Taras Silecky has left the company. Not sure if it is a one-off personnel change or a sign of restructuring following several acquisitions.” Unverified. MModal declined to comment, citing policies prohibiting disclosure of personnel information. His LinkedIn page says he’s still there, but those are notoriously unreliable.

10-16-2012 9-01-00 PM

From Allagash: “Re: Aprima. Aprima gave indication that they would have a direct migration from MyWay to Aprima. Not the case. Aprima says that the client needs to contact Allscripts and beg for the database, which won’t come easy since they’re trying to sell us Pro. I get the impression there’s a large fee as well.” Aprima President and CEO Michael Nissenbaum responded as follows: “Aprima offers a free software license and upgrade for MyWay customers with the purchase of an annual support and maintenance agreement. MyWay customers have a multitude of environments in which they reside, including hosted with Allscripts, hosted with independent hosting entities, as well as practices having their own servers. Aprima’s statements regarding our offer are based on the practice having access to their database and an ability to move it to a server / hosting location of their choosing. In most scenarios hosting is a service offering, and as long as the practice is in compliance with the hosting contract, they should have access to their database. Most companies do not hold the practice’s data hostage.” Specific details of Aprima’s migration offer are here.

From Scrooge: “Re: CIO cost pressures. Reports say that CIOs in all industries are having a hard time justifying the long-term operating costs for advanced systems. Hospitals are under pressure to cut staff and other costs due to Medicare cuts. Maybe a topic for a survey?” I would be interested in hearing from hospital IT executives on this issue in a bit more detail than a poll allows. Send me your thoughts and I’ll run them, anonymously if you so indicate.

10-16-2012 10-07-52 PM

From Cool School: “Re: Pulse. I received an e-mail indicating that Basil Hourani (director, president, and CEO) and Alif Hourani (executive chairman and CTO) are ‘retiring,’ leaving former CFO Jeff Burton as CEO. Lots of blah about amazing journey, innovation, vision, etc. Recall that they were bought out by Cegedim two years ago. Significance?” Unverified, but reported by several readers. The PM/EMR vendor’s web page has no news. I’ll defer to readers to comment.

From Shock & Awe: “Re: Will Showalter, VP/CIO @ Sisters of Mercy Health System in St. Louis. Left last week. Can you find out why? Everyone loved and adored him!” As mentioned below, Mercy (as the former Sisters of Mercy now calls itself) has replaced him with no explanation. I’ll update if he checks in.

10-16-2012 8-54-31 PM

From Magenta: “Re: Cerner Health Conference. The tagline was ‘because it’s personal,’ which I thought was a little ridiculous on all the signs and displays. I didn’t realize how much until I saw this sign.”

10-16-2012 9-18-13 PM

From Buffalo Tom: “Re: Health 2.0 and Stanford MedX conferences. Free recorded streams are available from a company called Learn it Live that’s trying to disrupt the learning market. The interview with Lumeris CEO Mike Long was especially inspiring – he said mercenary companies look for where to make the most money, while missionary companies want to solve big problems and hope to make money. Sign up for free, choose the ‘three CEOs’ session, and go to the 31.25 mark.” He’s fun to watch. He gives his e-mail address and invites people creating cool things to contact him because he doesn’t think the big companies are moving fast enough.  

10-16-2012 10-10-40 PM

From PC Doc: “Re: pharmacy chains encroaching on the practice of medicine. Walgreens has walk-in clinics whose mission is to sell what’s on their shelves, give vaccine injections, and now deliver meds to hospital bedsides to ‘curb readmissions!!’ I smell a coordination nightmare as patients get mammograms at the local retail pharmacies and pharmacists manage diabetes, not to mention that Walgreens is smelling profit while physicians are again asleep at the wheel.” It is interesting that just as we see EMRs taking a firm hold and interoperability taking a shaky one, now you’ve got disconnected non-EPs out there whose corporate parents may lack the interest or ability to share the medical information they’re creating. I don’t know how they’ll play in the ACO world, though – maybe they’ll just pick up the cash-paying business. Those with long memories may recall that the difference between EMRs and EHRs was that the latter were supposed to collect information from every potential point of healthcare service, but here we are years later still thrilled when docs working for the same health system can exchange information with the hospital and each other. That’s a problem with the proprietary EHR-centric model in which neither providers nor vendors have much reason to push their data out in a way that everybody can use it, and the further away you get from the traditional office practice, the less likely those providers are going to be on the grid. In other countries, patients are expected to keep their own medical records and bring them in – sounds primitive, but with all the technology investments we’re not too far beyond that here with our printout and faxes. Not to mention that at least in those countries, the patients are in control of their own information.

HIStalk Announcements and Requests

10-16-2012 6-28-29 PM

Going to MGMA next week in San Antonio? Here is our annual list of Must See Vendors. Inga will be there to pick up trinkets, make stealth observations, and post daily updates.

10-16-2012 7-02-44 PM 10-16-2012 7-03-53 PM

Welcome to new HIStalk Gold Sponsor Direct Consulting Associates and its sister organization Direct Recruiters Inc., both of Solon, OH. DCA offers IT consulting and staffing solutions (staff augmentation, temp to perm, and permanent placement), providing individuals or entire teams to help with Epic, Allscripts, Cerner, Meditech, McKesson, and other healthcare IT systems for short- or long-term contracts. DRI is an executive search firm with a healthcare IT practice that places top professionals (CXO, VP sales, sales rep, product manager, applications engineer, IT director, CMIO, etc.) The company’s site has a nice testimonial from Medicity that calls Director of Healthcare IT Mike Silverstein a “trusted resource” who doesn’t push candidates, but rather listens to understand the talent needs first and makes sure to present only the most qualified candidates. Thanks to DCA and DRI for supporting HIStalk.

10-16-2012 7-20-35 PM

Also supporting HIStalk is new Platinum Sponsor PatientPay of Durham, NC. PatientPay is an innovative, patented, Web-based service that addresses the physician practice challenge of managing patient balances. Practices can be up and running within 30 minutes of signing up online, with no IT help required to instantly integrate PatientPay into the practice management system. Patients review their balances and pay online by credit card, while the cost of managing paper is reduced by half. No upfront or monthly costs are involved, just a small, flat per-transaction fee that means they get paid only when the practice gets paid. The company’s goal is to be the most attractive patient payment solution for their ambulatory PM/RCM vendor partners. They’ve been around since 2008, and you may recall hearing a couple of months ago that David Bond (A4, Medic, Allscripts) has joined the company as EVP of sales and marketing. They’ll be at MGMA, so drop by and tell them you saw them mentioned on HIStalk. Thanks to PatientPay for supporting my work.

Speaking of my (endless) work, I’ve reluctantly reached the conclusion that I need more help to make HIStalk, HIStalk Practice, and HIStalk Mobile the best they can be while not getting fired from my hospital job. I’m interested in hiring someone, but I’m picky about capabilities: a stellar and fast writer, lots of energy, an enviable sense of humor, skill with social media, and knowledge about healthcare IT. Sometime with a full-time job probably won’t work since I need more hours. I’m looking for a self-starter who probably doesn’t need to be prompted about what to do next, but here’s a hint since it worked for Inga and Dr. Jayne: tell me why I should hire you while demonstrating the qualities I mentioned.

Acquisitions, Funding, Business, and Stock

The UK-based Wellcome Trust secures an equity stake in AirStrip Technologies.

10-16-2012 10-12-12 PM

Healthrageous, a developer of Web and mobile health apps for consumers,  raises $6.5 million in Series B financing.

10-16-2012 3-08-49 PM

Nuance discloses that it paid $230 million in cash for QuadraMed’s Quantim HIM division and another $265 million for JA Thomas and Associates, raising its 10-year acquisition total to 34 companies at a cost of $3.6 billion (Nuance’s market cap today is $7.2 billion). Maybe its best deal was paying $400 million for eScription in 2008 to get a strong healthcare foothold. Historians (hello, Vince?) may recall Nuance’s origins as a vendor of scanners under the ScanSoft and Visioneer names  — the PaperPort was all the rage in the mid-1990s.

UnitedHealth Group’s Q3 numbers: revenue up  8%, EPS $1.50 vs. $1.17, beating expectations of $1.34. Growth of its Optum division contributed to the $1.56 billion of quarterly profit, although the company warned of uncertainty about competition and the November election. Analysts say the company always sets conservative expectations, with one saying, “There’s nothing there that reform is going to hurt.”


10-16-2012 10-13-12 PM

Regional Medical Center at Memphis (TN) replaces its Cisco wireless network with Aruba.

Sigmund Software will embed OrdersAnywhere from Ignis Systems into its behavioral health EHR to manage lab orders and results.

Emergency Medicine Specialists of Orange County (CA) selects McKesson Revenue Management Solutions to provide billing and RCM for its 40-physician practice.

The Military Health System’s TRICARE Management Activity segment awards Four Points Technology a multi-year contract to facilitate an expanded rollout of RelayHealth’s Medical Home Support Package.


10-16-2012 6-17-53 PM

Richard Poulton (AAR Corp) joins Allscripts as CFO. An SEC filing discloses that Poulton will earn an annual salary of $450,000, a $450,000 annual bonus target, a one-time cash payment of $750,000, and stock grants worth up to $2 million. He’s also guaranteed double his salary and target bonus plus full equity vesting if terminated due to a change of control, which could be relevant if the company goes private as has been rumored.

10-16-2012 6-21-43 PM

Clinithink names Phil Davies (NHS Connecting for Health) CIO.

10-16-2012 2-38-36 PM

Mercy (MO) names Gilbert Hoffman (Maritz) VP and CIO, replacing Will Showalter.

10-16-2012 6-26-10 PM

Kathy Ebbert (Achieve CCA) joins Clearwater Compliance as EVP and COO.

Delta Health Technologies names Ben Clay (Prognosis Health Information Systems) VP of product development.

Announcements and Implementations

InterSystems Corporation and eHealth Technologies will offer offer single-click access to diagnostic quality images via the InterSystems HealthShare platform.

EXTENSION added 22 customers of its critical alerting and HIPAA-compliant texting solutions during the third quarter.

VersaSuite announces that its certified ambulatory EHR is the first to earn CCHIT’s certification for Clinical Research, with the capability to automatically determine if a patient is eligible for an open clinical trial.

UMass Memorial Health Care is working with with Informatica and MedCPU on a readmissions reduction project.

AHRQ awards the Oregon Health & Science University a $1 million grant to create smarter and better organized EHR systems.

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10-16-2012 8-27-14 PM

NYeC and Partnership for New York City Fund select eight early- and growth-stage companies for its inaugural class of the NY Digital Health Accelerator. The winning companies, which were selected from 250 applicants, were each awarded up to $300,000, plus mentoring opportunities from senior-level hospital executives. The Accelerator program is expected to create 1,500 jobs over five years and attract $150 to $200 million in VC investment post-program.

North American Partners in Anesthesia partners with SIS to offer a combined AIMS and managed anesthesia services solution.

Electronic patient payment processor BillingTree announces a new partner program for solution providers interested in integrating a payment portal into their products.

10-16-2012 10-15-09 PM

Nuance Communications announces that its voice recognition technology is now integrated into Epic’s Haiku for iPhone and Canto for iPad applications.

10-16-2012 8-57-14 PM

Industry long-timers Bill Spooner, Bert Reese, and Colin Konschak are the editors of a newly published book called Accountable Care: Bridging the Health Information Technology Divide. It’s on Amazon for $89.99.

DrFirst launches Patient Advisor, a medication adherence solution designed to work with DrFirst’s Rcopia e-prescribing platform or any EMR or HIT solution.

DSS releases its Patient Search Tool Extension and Launcher to the Open Source EHR Agent via the Apache 2.0 Open Source license, enabling VistA EHR users to search for free text data within a chart.

Government and Politics

ONC names iBlueButton from Humetrix the winner of its Blue Button Mash Up Challenge to make personal health information for usable and meaningful for consumers. ONC also awards Apollo’s Pinaxis top honors in the EHR Accessibility Module Challenge for creating an Internet portal to allow patients to interact with any provider’s existing EHR system over the Web.


Akron General Medical Center (OH) fires several employees for unauthorized access of computerized patient records following the fatal shooting of an ICU patient.

Epic will install six 262-foot wind turbines on its Verona campus that, along with its geothermal and solar systems, will allow it to generate 85 percent of its energy needs by 2014.

I haven’t watched Saturday Night Live for years, but this week’s skewering of the iPhone 5 and self-obsessed Americans in general was savagely funny. It’s slightly mHealth related, at least if you watch through to around the 5:00 mark for the punch line.

The Methodist Hospitals (IN) settles its 2011 lawsuit against FTI Cambio, HealthNET, and Meditech. The hospital hired Cambio to review its entire operation, part of which involved bringing in HealthNET to review its Epic implementation that had already cost $26 million. The lawsuit says HealthNet recommending dumping Epic and buying Meditech for $16 million because of lower maintenance costs. The hospital says the consultants lied in saying it would cost $25 million to finish the Epic project when in fact it would have been only $11 million. It also claims that Meditech never worked and caused a host of problems to the point that the implementation was abandoned in 2009.

10-16-2012 10-05-02 PM

The Italian hacker who turned to the Web for help with his brain cancer diagnosis has received 200,000 responses in a month from his Open Source Cure plea. The Italian government is interested in his project as an example of opening up medical records since he struggled to obtain his records and images in an easily read electronic format. He has decided to have surgery, but is talking to 40 doctors about which procedure to have, and will also follow a crowd-sourced diet in the hospital.

Sponsor Updates

  • A study by Truven Health Analytics finds that hospital employees are less healthy and more likely to be hospitalized compared to the general workface, with their healthcare costs also running nine percent above average.
  • Versus customer Northwest Michigan Surgery Center discusses its use of RTLS to maximize patient flow during an AHA Solutions Webinar.
  • Liaison Healthcare launches its Healthcare Information as a Service solution suite.
  • GetWellNetwork and Treatment Diaries partner to provide additional resources for patients during and after their hospital stay.
  • ZirMed showcases its RCM solution at this month’s MedTrade, MGMA, NAHC and APTA conferences.
  • Ninety percent of anesthesia providers believe that perioperative solutions increase success rates, according to a Surgical Information Systems-commissioned study.
  • HIStalk sponsors earning a spot on Modern Healthcare’s Healthcare’s Hottest 2012 based on revenue growth include: ESD (1,455%), Allscripts (533%), Cumberland Consulting Group (328%), Merge Healthcare (213%), Beacon Partners (172%), and The Advisory Board Company (92%).
  • MEDSEEK moves to new office space in Fitchburg, WI after almost doubling its Wisconsin operations over the last year.
  • Two teams of Craneware employees spend a week Peru volunteering with medical staff at the Villa la Paz Center for Destitute and Sick Children.
  • Aspen Advisors principal Guy Scalzi discusses HIT governance at this week’s CHIME Fall CIO Forum.
  • Digital Prospectors Corp wins a subcontractor role as part of a $15 billion Alliant Small Business Governmentwide Acquisition Contract.
  • MModal partners with the BigHand Group for next month’s BigHand Healthcare user conference on digital dictation, speech recognition, and clinical correspondence system .
  • A SuccessEHS survey of MGMA registrants finds that the majority are losing revenue due to four problems: clean claims, same-day collections, preventable denials, and underpayments.
  • Klinikum Weis-Grieskirchen Hospital (AU) reports saving 10-20 seconds per login session with Imprivata’s OneSign single sign-on solution.
  • NextGen adds Logi Info from LogiXML as its embedded actionable analytics tools within the NextGen Dashboard product.


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

More news: HIStalk Practice, HIStalk Mobile.

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October 16, 2012 News 8 Comments


October 12, 2012 News 16 Comments

Top News

Allscripts files a protest against New York City’s hospital system after losing a $303 million contract to Epic. Allscripts claims that its solution would be $700 million cheaper over 15 years than the $1.4 billion total cost to implement Epic. The president of the Health and Hospitals Corporation, which runs the city’s 11 public hospitals, said Allscripts’ coast analysis was false and unrealistic and the selection of Epic came after four years of consideration and analysis of nine different vendors.

Reader Comments

From Straight Arrow: “Re: Allscripts NYC protest. Allscripts comes across as a sore loser, and trying to invoke ‘teachers and doctors’ smacks of desperation. Instead of asking the health system why they chose Epic (they mention Allscripts’ history of management and financial problems) they should have left well enough alone. Nobody ever wins these challenges and cooler PR heads should have prevailed; now the market smells Allscripts’ fear.”

From HitTheRoad: “Re: Allscripts missteps. In the New York Times article, Glen Tullman is quoted as saying Epic’s ‘language is more expensive to maintain.’ That is perhaps the least-informed comment ever uttered by a vendor CEO. That comment, their bizarre bid, the MyWay announcement, and the baiting of a former prospect in a public debate that they are bound to lose in an embarrassing fashion could easily mark the beginning of the end of Allscripts.”

From MDRX Knows: “Rumor: Re: MyWay Rescue Program and Allscripts Buyout. Good for Aprima to step in and try to capitalize on a poor move by Allscripts to shut down MyWay. Converting MyWay clients to Professional is laughable. Professional is embroiled in enough trouble of its own without taking on more clients, including a lack of product functionality and overall application inefficiency. Perhaps if the buyout is successful, Glen and company can take the opportunity to clean the Professional house and actually make it the product they claim it to be, not the one they are currently selling.”

10-12-2012 4-25-41 AM

From Nasty Parts: “Costco. Word on street is that Costco is going to file a lawsuit against Allscripts over the whole MyWay fiasco. Costco is sitting on a good number of licenses that are not moving, especially with the recent news.” eTransmedia, the Allscripts reseller that owns the Costco relationship, declined to comment.

From Tracker: “Re: VA RTLS The previously announced VA RTLS award of ‘up to’ $540M to HP Enterprise Services has been vacated based IBM’s successful appeal. The entire project on hold until they decide to either re-issue after rewriting the RFP; re-examine the previously submitted responses with a possible different outcome award based on that reexamination (read – work it out so more of the pie is split and the parties agree not to fight the new decision); or, put the entire project on hold. Given the political and budget variables now present I predict there will be a modest delay for now.” Last week the GAO issued the decision stating that “the VA had made several prejudicial errors in its evaluation of the offerors’ proposals. Those errors led to a source selection decision that GAO found was unreasonable since it relied on the erroneous evaluation conclusions to support the award decision.”

10-11-2012 5-08-37 AM

From CDiff: “Re: Advice. Asking you and the readers for help in avoiding a slippery slope. Could buying a shoe ornament be considered contributing to a shoe fetish and therefore to be avoided or one of those things that we just wink at and go ahead in the spirit of gift giving with best wishes?” How could gifting a loved one with something as amazing as these shoe ornaments be wrong? Not to mention the cost is a fraction of the cost of a new pair of Christian Louboutins (size 8, in case anyone is doing some early Christmas shopping.)

HIStalk Announcements and Requests

inga thumbMany thanks to all the readers who sent notes or Facebook posts wishing me a happy birthday. All the greetings were lovely, but I particularly liked the sentiment expressed here:

May you have the ability to happily wear your shoes high, proud and with padded insoles where necessary!

The best gift will be Mr. H’s return, since this job is not nearly as fun without him. Though not necessarily birthday related, I will note that several readers asked for that perfect margarita recipe. Alas, I am still waiting for the cabana boy applications.

This week on HIStalk Practice: athenahealth integrates Entrada voice services into its EHR. Women’s preventative healthcare improves when providers use EHRs. Doximity grows to 100,000 verified members. Miami Children’s Hospital selects CareCloud for RCM. BetterDoctor launches its doctor-connect app nationwide. If you are still looking to give me the perfect birthday, let me make it easy on you: take a moment to sign up for the HIStalk Practice email updates and click on a few of the sponsors’ ads to learn more about their offerings. Thanks for reading.

Acquisitions, Funding, Business, and Stock

TELUS Health acquires KinLogix, a cloud-based EMR provider headquartered in Quebec.

HealthTech Holdings acquires perioperative solutions provider Acuitec. HealthTech will integrate Acuitec’s VPIMS solution into the HMS EMR.

10-11-2012 5-10-25 PM

Investment bank Berkery Noyes reports a year-to-date 19 percent increase in healthcare and pharma IT M&A activity compared to 2011.


The Norwegian Directorate of Health awards Accenture a five-year contract to build and implement Norway’s EHR system.

10-12-2012 4-07-25 AM_thumb

OhioHealth contracts with Health Care DataWorks, Inc. for its KnowledgeEdge Enterprise Data Warehouse.

10-12-2012 4-09-57 AM_thumb

Partners HealthCare (MA) extends its contract for MedeAnalytics’ Revenue Cycle Intelligence solution for an additional three years.

10-12-2012 4-11-09 AM_thumb

Day Kimball Healthcare (CT) will implement SCI Solutions’ Schedule Maximizer and Order Facilitator for it employed and affiliated physicians.

10-12-2012 4-13-11 AM_thumb

University Physician Associates of New Jersey signs a five-year contract renewal with MedAptus for its Professional Charge Capture software.


10-12-2012 4-05-39 AM_thumb

Tenet Healthcare names Paul T. Browne (Trinity Health) CIO, succeeding the retiring Stephen F. Brown.

Announcements and Implementations

Country Villa Health Services (CA) will be the first organization to implement the AHRQ On-Time Avoidable Nursing Home Transfer Module from HealthMEDX.

Mt. Ascutney Hospital and Health Center (VT) implements Cerner Millennium EMR under the management of The Huntzinger Management Group.

Continuum Health Partners deploys Caradigm eHealth solutions, including the eHealth Community Desktop clinical portal and the eHealth Information Exchange.

The EHR/HIE Interoperability Workgroup, the NYeC, and Healtheway establish a testing program to certify EHRs and other HIT for the reliable transfer of data within and across organizations and state boundaries.  CCHIT will perform the testing.

Government and Politics

10-12-2012 4-31-13 AM

Kinergy Health’s MyKinergy wins the Patient Engagement Blue Button Challenge, sponsored by the ONC and The Advisory Board Company, and is awarded the $25,000 grand prize. Other finalists winning $5,000 each include Humetrix, TrialX, Jardogs, and mHealthCoach.

About 284,000 Medicare patients who are potential victims of identity theft are facing difficulties getting healthcare benefits because the government won’t issue new IDs. Medicare officials claim it’s too expensive and too many agencies are involved to reissue the cards.

Innovation and Research

Medicare’s policy to block hospital reimbursements for certain preventable, hospital-acquired infections has not significantly changed the rates of two types of infection.


Cerner will embed Nuance’s cloud-based medical voice recognition technology into its mobile EHR products including PowerChart Touch. Cerner is also integrating Nuance’s PowerScribe 360 radiology reporting product with Cerner’s RadNet RIS.


10-11-2012 5-05-13 PM

The development company overseeing the conversion of the Nashville Convention Center to a medical mart suspends the project, saying that the “leases signed to date do not yet enable the project to be financially feasible.”

10-12-2012 4-22-50 AM_thumb

Meditech purchases a 26-acre office and conference center in Foxboro, MA for $19.8 million. The site, which will undergo renovations over the next year, will eventually employ 500 workers.

Sponsor Updates

  • Impact Advisors releases its 2014 ONC EHR Standards and Certification Criteria primer.
  • EBSCO Publishing announces the availability of the Health Economic Evaluation Database, which provides comparative analysis of of medicines for health economists.
  • HIStalk sponsors earning a spot on the 2012 Best Places to Work in Healthcare list include: Aspen Advisors, Divurgent, Encore Health Resources, ESD, Hayes Management Consulting, Iatric Systems, Impact Advisors, Imprivata, Intellect Resources, Intelligent InSites, maxIT Healthcare, Santa Rosa Consulting, and The Advisory Board.
  • Surgical Information Systems releases its SIS Surgery Dashboard, which displays real-time current case statuses on mobile devices.
  • Elsevier recognizes four “Superheroes of Nursing” at this week’s ANCC Magnet Conference.
  • University Physician Associates of New Jersey renews its charge capture contract with MedAptus.
  • EBSCO Publishing releases its Applied Science & Technology Source resource to facilitate the research needs applied sciences and computing users.
  • CommVault announces the integration of its Simpana 9 data and information management platform with Microsoft’s Cloud OS, including Windows Server 2012, Hyper-V, and Windows Azure.
  • MedHOK is named a finalist for the Tampa Bay Technology Forum Emerging Technology Company of the Year Award.
  • TeleTracking Technologies offers a three-part Webinar on reducing hospital costs through automated asset management.

EPtalk by Dr. Jayne

Another acronym bites the dust: ONC announces that the Nationwide Health Information Network (NwHIN) Exchange is now eHealth Exchange. Nonprofit Healtheway assumes operational support.

Now that 2012 is almost over, CMS has announced distribution of ePrescribing program incentives and PQRS payments from 2011. Accompanying feedback reports, manuals for interpreting the data, and guides for understanding incentive payments are available on CMS’s Quality Net portal. Don’t spend all that money in one place, folks.

10-11-2012 4-19-02 AM

An apple a day: Inga shared this article that suggests doctors practice healthy behaviors more often than other workers in the US. I’m glad they didn’t report on doctors who have become administrators or IT staffers. I was definitely healthier when I was running around a practice as opposed to sitting in endless meetings. I think I’m going to have to start adding “stand and stretch” to my time-boxed agendas if I want to avoid getting a blood clot from immobility.

Speaking of health, I went for my physical today so I can scuba dive again. As I sat in the waiting room, my phone buzzed and it was an email from the receptionist inviting me to enroll in the practice’s patient portal and fill out my introductory health questionnaire. It’s always fun to see these things actually work in a practice. Now we’ll just have to see how long it takes before my clinical summary is available.

10-11-2012 4-21-03 AM

Jeers to Anthem BlueCross BlueShield who continues to recycle tired old jokes about physician handwriting. If they want something fresh and modern to pick on, let’s try poor typing skills.

I wasn’t able to attend Health 2.0 although I enjoyed reading the reflections by Dr. Travis on HIStalk Mobile. I was glad to hear that Extormity made a with their strategic plan to acquire every application developer in attendance.

Today is my BFF’s birthday, so if you haven’t done so already please take a moment to send Inga your congratulations. I hope her day is full of sassy shoes and adoring fans.



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

More news: HIStalk Practice, HIStalk Mobile.

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October 12, 2012 News 16 Comments

News 10/10/12

October 10, 2012 News 7 Comments

Top News

10-9-2012 3-18-02 PM

Bloomberg reports that Allscripts has received first-round bids for a leveraged buyout from PE firms Blackstone Group LP and Carlyle Group LP and expects additional offers within three to four weeks. Allscripts closed Tuesday at $13.57 per share.

Reader Comments

10-9-2012 8-35-23 AM

From Master Yoda: “Re: Cerner Health Conference. I doubt you will be able to make it to the conference, but if any of your readers are going, I’ll be the one in the guayabera with the hair that says ‘he really isn’t trying to impress anyone.’ I hope to see Farzad speak and I wonder how long it will take before I hear someone say ‘Epic’?” Cerner provides its own Day One Recap here.

From Innovator: “Re: Cerner conference. The vibe here is cautiously optimistic. Cerner has put a significant emphasis on mobility. PowerChart Touch (Cerner iPad app) and Cerner Careaware Connect (nurse iPhone app). Both are very impressive and the immediate reaction from the customer base seems very positive. However, you can sense a bit of hesitation, as if customers are cautious about getting too excited about new technology because they have been burned in the past.”

From Motown Nurse: “Re: HCA and Beaumont. A couple of my CRNA colleagues who work for Beaumont state that they were informed that HCA has purchased their health system. I had not read this as confirmed anywhere yet though I may have missed it.” The local Detroit business news mentioned a rumored sale last month but I could not find confirmation. Meanwhile Beaumont’s Physician Organization and United Physicians announce plans to combine operations by the end of the year.

From Future Perfect: “Re: Cerner. Have you heard about Cerner trying to sell a single patient accounting system for both hospitals and physician offices? Usually Cerner sells ProFit for hospital billing and Powerchart for physician billing but now they are trying to sell ProFit for both and compete head-to-head with Epic’s combined billing solution. Does it really work and is it tested?” Do any readers have an answer?

From Retired Barkeep:Inspiration by drink. I have a great single-serving margarita recipe for you.” Thanks for the recipe, which I am happy to share with interested readers. I am pretty sure I will need at least a double by the time Mr. H return at week’s end. Retired Barkeep was unable to offer cabana boy services to accompany the beverage(s) so I will continue to accept applications.

From Amarba: “Stan Opstad. Stan was the product SVP at Healthland but is no longer there.” Healthland confirmed that the company’s product management and development operations were consolidated under SVP Michael Karaman in 2011 and that Opstad left the company in August.

HIStalk Announcements and Requests

inga thumbMr. H has yet to check in with me, other than to report a typo, so I suspect he is in total relaxation mode. Feel free to send me your burning HIT news until he returns this weekend.

Acquisitions, Funding, Business, and Stock

Orion Health’s managing director and majority owner says the company is “strongly considering” going public.

10-9-2012 7-03-35 AM

Health Tech Hatch, a crowd-funding site, launches to provide early funding and mentoring to HIT innovators that are developing new companies and products.

Volate secures $6 million in new funding from an unnamed HIT leader and a major healthcare system. The company plans to triple its staff to almost 150 over the next 18 months.


Massachusetts Eye and Ear Infirmary selects MedeAnalytics’ Clinical Performance Intelligence and Revenue Cycle Intelligence solutions to analyze physician utilization and quality metrics. MedeAnalytics also secures a five-year contract extension with West Tennessee Healthcare for its Compliance and Revenue Integrity and Revenue Cycle Intelligence solutions.


10-9-2012 8-16-36 AM

MediRevv appoints Patrick Tierney (above – University of Iowa Hospital and Clinics) managing director of consulting services and Matthew Reat and Diana Moore (CSC) senior consultants.

10-9-2012 6-31-18 AM

Medecision names Jerry Baker (Halfpenny Technologies) SVP and GM of its value-based healthcare solutions business for care delivery systems.

10-9-2012 8-12-10 AM

Consulting services firm SISU Medical Solutions names Scott Lee (Lee Advisory Services, KPMG) CEO.

10-9-2012 9-56-03 AM

RegisterPatient, which just raised $4.1 million in series A funding, hires Jana Skewes (Shared Health) as CEO.

10-9-2012 11-45-56 AM  10-9-2012 11-23-54 AM  10-9-2012 11-26-44 AM

CHIME elects Pamela Arora (Children’s Medical Center Dallas), Charles Christian (Good Samaritan Hospital), and George McCullock (Vanderbilt University Medical Center) to its board of trustees.

Announcements and Implementations

10-9-2012 4-24-47 PM

Awarepoint announces 226% deployment growth, including new activations at Kaiser Permanente, Yale New Haven Health System (CT), Monongahela Valley Hospital (PA) and Vidant Medical Center (NC).

The town of New Canaan, CT pilots a teleheath program that provides 10 seniors iwith Pad or Acer tablets to communicate with nurses two to three times per week. The participants, who range in age from 70 to 85, will also be provided medical equipment to monitor and report vital signs.

10-9-2012 4-26-32 PM

Hillcrest Medical Center (OK) goes live on Forerun’s FlexChart physician documentation in its ED.

AT&T and IBM will begin selling private cloud computing services next year over a mutually owned network.

10-9-2012 4-28-28 PM

Southern Tier HealthLink (NY) joins the New York eHealth Collaborative’s Health Information Network.

Allscripts announces its Open App Challenge, which offers $750,000 in rewards for developers that create and integrate applications that build upon Allscripts Open EHR platform.

10-8-2012 12-46-07 PM

Aprima reminds MyWay customers that the software is based on Aprima’s PRM 2008 version and offers a no-charge license migration, as long as practices sign up for maintenance and support. Aprima also says that MyWay resellers can join Aprima’s reseller network and offer their customers an upgrade option.

Innovation and Research

Physicians using EHR scored significantly higher on quality of care for four screening measures for diabetes, breast cancer, chlamydia, and colorectal cancer, according to a study published in the Journal of General Internal Medicine.


10-9-2012 12-11-33 PM

Imprivata releases Cortext, a free HIPAA-compliant text messaging solution for iPhones and Android devices and Web-based chat solution for nurses without smartphone access.

Anesthesia Business Consultants and iMDsoft launch cloud-based myAnesthesia for the iPad.


10-9-2012 1-15-25 PM

Providers need to work together to accelerate interoperability and electronic information sharing across care settings, according to a report from the Bipartisan Policy Center. The Center also recommends a national strategy to improve accuracy of patient matching; an extension of Stark Law exceptions and Anti-Kickback Statute for safe harbors for HIT donations; and improved clarity of federal privacy and security laws.

Doctors are generally healthier than other US workers according Gallup-Healthways report. A physical health index that considers such factors as obesity, colds, the flu, headaches, and sick days gives doctors a score of 86, nurses 80, and other employed adults 81.

The New York Times takes a look at the use of telemedicine on Nantucket Island, MA as a means to increase access to specialists and decrease costs. Nantucket Cottage Hospital’s CEO estimates that the island’s use of tele-dermatology is saving $29,000 per year and provides patients’ access to dermatologists six times a month instead of just four times a year.

Sponsor Updates

10-9-2012 7-46-23 AM

  • Three hundred Encore Health Resources’ employees build and deliver fifty wheelchairs to Houston-area veterans and the disabled during the company’s annual retreat.
  • Aspen Advisors’ Fran Turisco and Dan Coate deliver a presentation on patient monitoring technologies and accountable care at next week’s NY eHealth Collaborative Digital Health Conference.
  • NTT DATA will integrate Dart Chart Systems’ proactive analytics tools into its NetSolutions POC software.
  • A local Eden Prairie (MN) publication profiles Virtelligence, which was recently named as one of the country’s fastest-growing companies.
  • Wellcentive’s VP of product strategy Mason Beard discusses six pillars of population health management.
  • Mike Reppart, (Hendrick Medical Center TX), and Kelley Blair (Craneware) will speak at the 2012 AAHAM ANI Conference on RCM strategies and performance improvements.
  • IDC Health Insights recognizes Harris Corporation as a leader in the packaged HIE segment.
  • Beacon Partners offers two Webinars in October on risk management.
  • Infor releases its Workforce Management 6.0 solution and announces a private beta availability of its iPaaS stack on the IBM SmartCloud platform.
  • EBSCO Publishing and Elsevier will provide access to Elsevier’s Scopus database from within EBSCO’s Discovery Service.
  • Imprivata customer Dr Harald Eder joins a panel discussion on improving patient care with cloud-based desktops during VMworld 2012. Imprivata also announces the finalists for its inaugural Healthcare Innovation Awards.
  • Visage Imaging will participate at the second annual Imaging Informatics Summit this week in Washington, DC.
  • McKesson announces general availability of its Reimbursement Manager to assist with bundled payments and fee-for-service reimbursement models.
  • Surgical Information Systems offers integration with abeo’s MedSuite billing software.

Clarification from Allscripts

We asked Allscripts to answer a few additional questions about their MyWay to Professional Suite upgrade option. We appreciate their providing us with these responses.

Could you clarify “free upgrade?” Is that a free license, a free conversion, or both?

This upgrade includes software, implementation and training. It will start in January 2013 and end in September 2013. The implementation will be facilitated by enhanced tools that make data conversion and interface activation seamless. This, coupled with tailored simulation learning and a hands-on weekend learning event, will prepare clients to take advantage of their newly upgraded software.

Does the maintenance fee change for MyWay clients once they’re on Pro?

The maintenance fees will remain the same as what is defined in a MyWay client’s current agreement.

And when you say “converged platform,” how is it different than the current Pro product?

We are launching a converged platform and the first step is to move our MyWay clients to this platform. They will experience many enhancements including mobility with Wand, our native iPad mobility solution, additional content including more specialties, and real time point of care/clinical decision support. In addition, the converged platform will be able to process ICD-10 codes and is planned to be certified for Meaningful Use Stage 2.

More news: HIStalk Practice, HIStalk Mobile.

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October 10, 2012 News 7 Comments

Monday Morning Update 10/8/12

October 7, 2012 News 12 Comments

From Factory Girl: “Re: Allscripts. My company is an Allscripts partner and last week they told us they were not planning to make any official announcement about the decision to move customers off the MyWay platform. Yet I see that the day after HIStalk mentioned it, they posted details on their WebSite.” Allscripts also filed an 8-K so they probably figured everyone would know even if they didn’t read HIStalk. Allscripts is taking a $10-$13 million write-down on MyWay so that business apparently won’t be sold as once rumored.

10-7-2012 9-20-35 AM

athenahealth CEO Jonathan Bush says his company is considering a move to a larger location or an expansion of its Watertown, MA headquarters from 330,000 to one million square feet.

The local paper profiles Nashville-based Shareable Ink, which has grown from two customers at the beginning of 2011 to almost 100 hospitals and clinics today. CEO Stephen Hau says he expects the company to grow from 40 employees to 80 within the next six months.

The 100+ physician Colorado Springs Health Partners chooses Humedica’s MinedShare clinical intelligence platform.

10-5-2012 9-10-33 AM

The use of EHRs isn’t increasing Medicare fraud, say 78 percent of poll respondents. New poll to your right: what is the primary motivation of the House members who are urging cessation of HITECH payments?

Listening: new from reader-recommended The Vaccines, an English indie band that sometimes sounds like the Ramones, but is a good (better) listen even when they don’t. I’m also wistfully listening to YouTube recordings of The Howard Stern Show from the early 1990s when it was actually good (Howard, Robin, Fred, Jackie, and Billy, and especially the Jackie Puppet).

10-7-2012 8-16-52 AM

Streamline Health Solutions promotes Matthew S. Seefeld from chief strategist of revenue cycle to SVP of solutions strategy.

Providers rank CareFusion, Omnicell, and McKesson the top providers of anesthesia cabinets based on functionality, implementation, and training, according to KLAS. Half of users that have implemented anesthesia cabinet systems say the main benefit of OR-specific cabinets is having an organized and controlled medication inventory.

10-7-2012 8-59-50 AM

Surgical Information Systems integrates its perioperative IT solution with OpenTempo’s surgical and anesthesia workforce scheduling tool.

10-7-2012 9-55-28 AM

The T-System folks forwarded this card, which they developed in advance of this week’s ACEP Scientific Assembly in Denver.

The former HIM manager of a small Nevada hospital files a wrongful termination lawsuit against her former employer, claiming she was fired for questioning what she says was ED upcoding.

inga Just a reminder that Mr. H is taking some R&R this week. If you send him an e-mail and he fails to respond, hopefully that means he is busy reclining on an exotic beach sipping umbrella drinks. Actually I don’t think he is an umbrella drink/exotic beach kind of guy, but since that’s my idea of the perfect vacation, that’s what I am envisioning for him. While he is out of pocket this week, feel free to drop me a note, should you have any burning HIT news to share, want to offer encouragement, or have any umbrella drink recipes worth consideration.

10-7-2012 7-56-43 AM

Thankfully Weird News Andy never takes a break and sends over this story about one Florida county’s attempt to have patients waive their privacy rights. The Sarasota County sheriff’s office is encouraging pain physicians to have their patients sign a form authorizing the release of PHI to law enforcement, should a physician believes a criminal violation has occurred. The local paper reports that the medical community is is concerned the move violates “HIPPA law.”

Vince provided a HIS-tory this week after all, continuing his QuadraMed history with a fascinating look at Health Data Sciences, which was the hottest vendor going a couple of decades ago. My favorite trivia: founder Ralph Korpman MD was a computer genius who started medical school at 15.


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

More news: HIStalk Practice, HIStalk Mobile.

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October 7, 2012 News 12 Comments

News 10/5/12

October 4, 2012 News 4 Comments

Top News

10-4-2012 6-05-54 PM

10-4-2012 6-11-18 PM

10-4-2012 5-56-15 PM

From DrLyle: “Re: House committee call to suspend HITECH payments. I’m at this meeting. Farzad is keeping his cool. He says it’s just pre-election rumblings and nothing can change without major legislative work.” Several House Republicans call on HHS Secretary Kathleen Sebelius (copying CMS Administrator Marilyn Tavenner and National Coordinator Farzad Mostashari) in an October 4 letter to immediately suspend HITECH payments because the Meaningful Use bar is set too low, resulting in a program that “squanders taxpayer dollars and does little, if anything, to improve outcomes for Medicare.” It claims that $10 billion has been wasted. It also references increasing payments due to higher levels of provider coding, as well as Stage 2 rules that don’t emphasize interoperability enough, leading to “our health care system trapped in information silos, much like it was before the incentive payments.” The letter also directly challenges the HHS/ONC count of HITECH provider participants, saying that HHS is “trying to pad participation rates.”

Signers of the House letter were Rep. Dave Camp (R-MI, Chairman, Committee on Ways and Means), Rep. Fred Upton (R-MI, Chairman, Committee on Energy and Commerce), Rep. Wally Herger (R-CA, Chairman, Committee on Ways and Means, Subcommittee on Health), and Rep. Joe Pitts (R-PA, Chairman, Committee on Energy and Commerce, Subcommittee on Health). One might presume given the timing and the fact that all four signatories are Republican that there’s a political motive, although that doesn’t change the fact that you either do or don’t agree with their assessment of HITECH. If their arguments are sincere, perhaps they should have made them earlier. Also, note that their objections aren’t to the value of EHRs but rather to the value of taxpayers in subsidizing them, so reciting a list of why EMRs are inherently good is not an appropriate rebuttal, nor would a list of accomplished users like Kaiser who got free money for using something they’d already bought without taxpayer bribes.

10-4-2012 6-54-59 PM

From BadgerMom: “Re: Valley Medical Center, Renton, WA. Goes live with Epic inpatient.” Congratulations to them. Thanks for the picture.

From Horshack’s Laugh: “Re: Caradigm. The company was simply a consolidation of two non-performing assets so that GE and MSFT could get them off their respective books and write off their significant losses ($1 billion over seven years for Qualibria alone) and allow Immelt and Ballmer to save face.” Unverified. I asked that question in my interview with CEO Michael Simpson.

From THB: “Re: Epic’s succession plan. What about HIStalk’s succession plan? You have built a great open source forum, but at some point you will be the old curmudgeon (and I mean that in the nicest sense!) Believe me, Judy reads this site, as does Glen T. and the rest of them. You share what you can and keep close to the vest what you cannot (that is a fine display of TRUST).” HIStalk is to me a hobby rather than a business, and given that I do it part time (as do my far-flung co-conspirators Inga, Dr. Jayne, Dr. Travis, etc.) I don’t have a specific plan for it to continue without me, nor am I vain enough to think that the healthcare IT world will stop spinning on its axis when I stop typing. Sometimes I feel guilty that Mrs. HIStalk would get no financial benefit from my years of labor if I flamed out tomorrow, but I don’t have a solution. It’s an inherently and intentionally amateurish operation.

10-4-2012 7-34-11 PM

10-4-2012 7-45-34 PM

From Jeeves: “Re: Patrick Soon-Shiong. His announcement was a big deal. I want to point out that at the end of last year when all the pundits were doing their predictions, Travis of HIStalk Mobile was the only one that I’m aware of that said this would be the year that Patrick’s stuff becomes real.” Travis is looking good with his predictions for the year so far: (a) smart phones everywhere; (b) more research and pilots on mHealth; (c) AirStrip as the biggest mover in mHealth; (d) price transparency gets a foothold; and several others. Travis has a lot of experience (MD, startup, NGO, etc.) and you’re missing out on his insight if you haven’t signed up for e-mail alerts when he posts something new. Soon-Shiong’s announcement this week that his NantWorks group of companies has developed a package of supercomputing, high-speed networking, and mobile access that will let doctors instantly individualize cancer treatment based on the patient’s genome. I listened to the live webcast for a few minutes while I was at work and heard him taking the usual shots against outdated, MUMPS-based systems that don’t talk to each other, although I’m not sure what that has to do with his project, which in itself sounds fascinating depending on who’s paying for it and who’s making money from it. BPC has posted the full video of the all-day event, although I haven’t had time to watch it. There’s bonus footage of an extremely cool Farzad bow tie in his segment at around the 180-minute mark.

Reader Comments

10-4-2012 6-20-21 PM

From Pick Six: “Re: Allscripts. Replacing MyWay with Pro.” An internal Allscripts e-mail says that it will standardize its small physician market offering on Allscripts Professional Product Suite, with free migration of MyWay users starting in January. The company also announced that its VAR network will be reduced from 40 to four resellers and that Pro Suite pricing will be standardized (it’s not clear from the wording whether MyWay users will get a free license or just a free migration once they’ve paid for Pro). Also not mentioned is what happens to MyWay, although the most common rumor we’ve heard is that it will be sold rather than mothballed (which makes more sense than Allscripts taking a write-off of some of its Misys acquisition costs). Allscripts is trying to consolidate platforms because of the development effort required for ICD-10, Meaningful Use Stage 2, and accountable care. The risks are that users of MyWay, rumored to be the most popular product Allscripts sells, could look elsewhere given the decision the company has forced on them. One potential winner is Aprima, which under its former name iMedica built the original version of MyWay that Misys licensed in 2007, followed by ugly disputes between the companies (see my July 2008 interview with Michael Nissenbaum). Since then, Aprima has rewritten the PM app and upgraded their version of both EHR and PM, so the gloves will come off if Aprima decides to offer an easy conversion from MyWay to their similar product, potentially also signing on some of the former Allscripts VARs who will be left scrambling. Also affected will be Etransmedia, an Allscripts partner that sells MyWay for $499 per month through Costco.

HIStalk Announcements and Requests

10-4-2012 3-38-32 PM

inga_small I noticed that one of my new Twitter followers is a “healthcare visionary,” leading me to ponder how one earns that designation. Self-assigned? Or is it an advanced accreditation available through HIMSS for those over-achieving members who feel the need for additional titles? I’m going with self-assigned, so from here on out I will refer to myself as Inga HIStalk, HV. Maybe I will get Mr. H to make some ribbons for HIMSS so fellow healthcare visionaries can promote themselves. By the way, feel free to follow me and my HIStalk buddies on Twitter, connect with us on LinkedIn, and be our virtual BFFs on Facebook.

inga_small This week’s highlights from HIStalk Practice: a rumor and a response from e-MDs. CareCloud gives Florida International University informatics students access to its EHR. Practice owners struggle over how to allocate incentive payments for employed providers.The Ohio AFP pilots a project to transform practices to the PCMH model, train medical students, and recruit physicians to practice in the state. Julie McGovern of Practice Wise offers tips for physicians to train for their EHR training – and don’t miss the comment from MarathonMan. You know what makes me happy: that two-second signup for HIStalk Practice e-mail updates. Thanks for reading. 

10-4-2012 8-05-40 PM

inga_small  Am I the luckiest gal in HIT or what? That’s Dr. Mostashari and Dr. Lyle Berkowitz holding up an IimageInga sign at today’s CMIO Leadership Forum. (Eat your heart out, BFF Dr. Jayne.)

10-4-2012 5-24-43 PM

Welcome to new HIStalk Platinum Sponsor VMware, which offers dependable, always-on frontline clinical systems access. Connect to your mobile clinical desktop from anywhere, view medical images, use any digital device securely with no clumsy security steps, and save time with a clinical desktop that follows you everywhere with fast logins to patient care systems. VMware offers cost-saving, secure, and IT-friendly solutions for virtualization, non-stop point-of-care desktops, trusted cloud security and compliance, and zero-downtime continuity and recovery. Thanks to VMware for supporting HIStalk.

From my obligatory YouTube cruise, I found the above VMware video wrap-up of HIMSS12. I like that they pictured and thanked their employees who staffed the booth.

10-4-2012 5-38-52 PM

Thanks to Philips Healthcare, supporting HIStalk as a Platinum Sponsor. The company’s solutions address interoperability (IntelliBridge Enterprise and Bedside to connect Philips products with others); clinical decision support (sepsis monitoring, vital signs and alert trending, EKG analysis, cardiac decision support); mobility (OB TraceVue for iPad-powered fetal information, HeartStartMRx ECG to smartphone, and IntelliSpace Event Management); and telehealth (eICU, IntelliSpace PACS, and Home Telehealth Solutions). I interviewed CMIO Joe Frassica, MD in August, who not only explained the company’s offerings well, but also got promoted to CMIO/CTO/VP right after the interview ran, according to his LinkedIn profile. Thanks to Philips Healthcare for supporting my work.

Here’s a brand new Philips Healthcare video that seems appropriate for Breast Cancer Awareness Month.

As a change of pace, I’ll refrain this week from urging you to sign up for e-mail updates and Like us and all that. Instead, I will suggest just one course of action: tell your colleagues you get news and opinions from HIStalk. I’ve received many e-mails from new readers and new sponsors who admitted that they hadn’t heard of HIStalk until people whose opinion they valued kept telling them they should read it. I appreciate that a lot.

I’ll be taking a little break next week, although I’m sure I won’t be able to resist the laptop’s siren song. My hiatus is minuscule compared to that of Vince Ciotti, who’s enviably taking his bride of 40 years to Europe for the whole month of October to re-live their honeymoon (and unlike me, he’s vowing to stay off the laptop). That means HIS-tory will return in November, and I can honestly say I will miss it since I enjoy every one of them.

Acquisitions, Funding, Business, and Stock

Homecare Homebase closes $75 million in senior securing financing from CIT Group.

Peak Health Solutions acquires the assets of consulting firm Health Data Essentials.


Managed care health plan Kern Health Systems selects McKesson’s VITAL Care Management programs to provide members with care management and educational materials.

10-4-2012 8-52-41 PM

Scottsdale Healthcare and Scottsdale Physician Organization will implement Harris Corporation’s Clinical Integration Solution to connect its hospitals, physicians, labs, and other providers.

Booz Allen Hamilton Holding announces 35 new federal and private healthcare contracts totaling more than $112 million in August and September.


10-4-2012 10-42-14 AM

Patient flow software provider Central Logic names Steve Erickson (SageCreek Partners) CFO.

10-4-2012 3-07-24 PM

Stephen Lawrence (Southern Illinois Healthcare Foundation) joins the Lincoln Land HIE as executive director.

10-4-2012 3-18-49 PM

Kaiser Permanente Chairman and CEO George Halvorson announces his retirement effective December 2013.

Announcements and Implementations

Inova (VA) becomes the first organization to participate in the ConnectVirginia HIE.

The New England Healthcare Exchange Network (NEHEN) selects the Massachusetts eHealth Collaborative to take over its executive management, business development, and operations management.

Mediware Information Systems earns updated 510(k) clearance from the FDA for its core blood management software products.

10-4-2012 8-54-09 PM

Penn State Milton S. Hershey Medical Center implements an interconnected CareFusion and Cerner solution that centralizes clinical information between the Pyxis MedStation 4000 system and Cerner Millennium EHR using Cerner’s CareAware iBus integrated device connectivity architecture.

Horm Memorial Hospital (IA) and Faulkton County Memorial Hospital (SC) beta-test Healthland’s Centriq Clinic, an ambulatory care solution for rural physicians.

Iowa Specialty Hospitals, The Gabrielson Clinic, and Orthopedic Specialists go live on EMR Oct. 8. The hospitals and clinics are all part of University of Iowa Healthcare, so that’s probably Epic.

CliniComp commits to meeting ONC Stage 2 MU certification with its Essentris EMR.

AHIMA calls for improved EHR patient documentation standards and principles at its conference this week.

Government and Politics

10-4-2012 6-50-43 PM

The Medicare Fraud Strike Force charges 91 individuals — including doctors, nurses, and other medical professionals — for falsely billing the government $492 million, including more than $230 million in home health fraud, $100 million in mental health fraud, and $49 million in ambulance transport fraud. Half the people, not surprisingly, operated out of Miami.


Qualcomm Foundation awards Scripps Health a three-year, $3.75 million grant to develop wireless medical devices, including biosensors that are inserted into the blood stream for disease detection; a mobile app that captures medical data from biosensors and transmits it to patients’ smart phones; and a handheld device to detect genetic variations that may prevent particular medications from working correctly.


St. Francis Health Center’s (KS) will lay off eight patient accounting employees as a result of the hospital’s November 1 transition to Epic.

10-4-2012 7-15-33 PM

A Wall Street Journal article called “Hospital Horrors” covers a newly published book on hospital transparency written by a Hopkins surgeon. He says state medical boards do a poor job of policing doctors, hospitals are pushed by lower reimbursement to increase volumes to unsafe levels, and bad treatments pay better than good ones in many cases. He quotes a recent Hopkins survey of employees of 60 high-quality hospitals, where more than half of the respondents said they would not feel comfortable receiving care in the unit in which they work. I’ve said that many times: those of us working in the healthcare system are a lot more scared of it than laypeople when we become patients.

Friday is the premiere of “Escape Fire: The Fight to Rescue American Healthcare.” Variety gave it a pretty good review from its Sundance screening in January, but said it should have included more about how lobbying keeps the healthcare industry safe from political action.

Weird News Andy says he might believe the woman who blames lupus-triggered delusions for causing her to strip naked and chant religious phrases outside a high school, but that doesn’t explain why she was joined by her two adult daughters and teenage son. The adults got probation after pleading guilty to indecent exposure.

inga_small A Utah man is convicted of disorderly conduct and charged a $140 fine after paying a disputed $25 doctor bill in pennies. Apparently the practice did not appreciate having 2,500 pennies dumped onto the receptionist’s desk. Personally, I think his approach was creative, and I bet quite liberating.

inga_small Just in time for Breast Cancer Awareness month: a “smart” bra that uses sensors and predictive analytics for early breast cancer detection. Don’t look for it at Victoria’s Secret or anywhere else any time soon: the company does not expect to launch the product in the US until 2014.


inga_small Men with shaved heads are perceived to be more masculine, dominant, and in some case have greater leadership potential than those with longer or thinning hair. Thank you, University of Pennsylvania’s Wharton School for confirming what I have known for quite some time.

Bizarre: a man sues a stripper who was performing at his bachelor party, claiming she slid down the stripper pole and landed so hard on his abdomen that she ruptured his bladder.

Sponsor Updates

  • CMS names SuccessEHS a 2013 EHR Direct Qualified Vendor.
  • CareTech Solutions offers discounted pricing for its BoardNet portal to members of the AHA Center for Healthcare Governance.
  • The CliniSync REC (OH) profiles Premier Physician Center and its use of e-MDs.
  • API Healthcare celebrates customer service week by honoring its client-facing support staff.
  • The Journal of the Medical Library Association ranks DynaMed in the top ten among online clinical resources.
  • NextGate joins the partner network of HIT consulting firm Exsede.
  • Shareable Ink introduces its Meaningful Use program for anesthesiologists.
  • QlikView hosts an October 11 webinar featuring Nationwide Children’s Hospital (OH) and its use of QlikView for data discovery.
  • MedHOK announces that its technology platform positions participants in the Comprehensive Primary Care initiative to share in savings and improve patient care.
  • T-System showcases its RevCycle+ physician coding and billing solution at next week’s ACEP Scientific Assembly in Denver.
  • iSirona sponsors a Code-A-Thon programming challenge at Florida State University’s department of computer science.
  • Datapharm Australia Pty selects Merge Healthcare’s eClinical OS solution for enterprise-wide electronic data capture.

EPtalk by Dr. Jayne

I’m mourning the loss of a colleague today – one of my favorite partners is leaving our group. Patients adore him and I’d trust him to care for my loved ones. The reason: he’s fed up with insurance, bureaucracy, and paperwork and is launching a cash-only practice.

He will be sorely missed, but he’s not the only one. Increasing numbers of physicians are dropping participation in insurance plans. It doesn’t do much good to have patients insured when few will accept low-paying insurance plans (see: Medicaid). A New York Times piece this week shares some additional stories. More interesting than the feature itself are the reader comments.


Sponsored by ONC, the Blue Button Video Challenge runs through November 13. This is your chance to create an “engaging and entertaining” two-minute video to advocate use of the Blue Button to access health information online. Judging criteria include submissions being “fun, edgy, and memorable.” First prize is $3,000 to help motivate you creative types.

In the medical staff lounge this week, there has been a fair amount of discussion around the Annals of Internal Medicine article covering patient access to physician notes. The authors concluded that patients felt the practice was beneficial and that providers experienced “no more than a modest effect on their work lives.”

So many of my colleagues think the sky will fall if their patients have access to visit documentation. Not a week goes by that one of my peers doesn’t corner me about making parts of the patient plan documentation “hidden” or “non-patient-facing.” Although they profess concern that patients can’t handle the truth or that phone calls to explain the notes will be a burden, I really think they’re afraid that patients will discover their poor written communication skills.

Reading the notes of some of my peers is exhausting even when they’re dictated, so one can’t always blame the EHR. I wonder if some of them know how pompous they sound or that they simply ramble with no concept of sentence structure? In order to make sure our patients (and sometimes our colleagues) understand us, we need to be communicating clearly and often at an elementary-school reading level.

Even if your organization doesn’t have an open notes policy, I strongly encourage providers to start documenting as if patients will read the notes. Chances are they’ll be reading them in a few years whether you like it or not. Better to prepare now.

For those that are worried that patients can’t handle the truth (aka, “She’s not going to like it if I say she’s obese”) it’s time to be direct with patients. Tiptoeing around the edge of major national health problems like obesity, diabetes, hypertension, and coronary artery disease because we’re worried about hurting a patient’s feelings isn’t good for the patient or for society. I’m not saying we need to be unfeeling or unkind, but sometimes we need to just call it what it is and work to help patients address their health needs.

Being able to communicate well is a learned skill and needs to be taught in medical school and reinforced in residency and continuing professional activities. Last time I checked, online translator software doesn’t offer “Doctor” as a language choice (although I did find a pirate translator), so it’s time for healthcare providers to get with the program.

What do you think about patient-facing documentation? Do you use it in your practice? E-mail me.



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

More news: HIStalk Practice, HIStalk Mobile.

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October 4, 2012 News 4 Comments

News 10/3/12

October 2, 2012 News 8 Comments

Top News

10-2-2012 6-33-03 PM

Patients say they are better equipped to help manage their own medical conditions when physicians give them access to their visit notes, according to the year-long OpenNotes study published in Annals of Internal Medicine. Ninety-nine percent of patients at the three participating hospitals who responded to the survey said they wanted the project to continue. None of the participating physicians elected to end their participation at the study’s conclusion — they were less enthusiastic about the patient benefits, but found that allowing patients to review their notes didn’t require any additional time or effort on their part. Responses to the potential benefits in the graphic above are indicated by circles (patients) and squares (physicians).

Reader Comments

From Jedi Knight: “Re: EHR adoption numbers. Has anyone pointed out that ONC and CDC are tracking very different numbers? They are showing 58 and 39 percent, respectively.”

From Start and Stop Again: “Re: Nuance. How do you think 3M feels with Nuance acquiring QuadraMed’s Quantim and JATA, who clearly compete with 3M? This has to signal the end of Nuance’s Computer-Assisted Physician Documentation announced last February in a partnership with 3M. Does Nuance think it can stitch the pieces of two dusty companies into Frankenstein?” Unverified.

10-2-2012 7-28-23 PM

From Familiar with the Transaction: “Re: McKesson acquiring MED3OOO. It’s a good fit. MCK gets the InteGreat EHR, which has a lot of functionality including a data warehouse and integration with Medicomp’s Quippe. They get instant market share in specialty revenue cycle management such as lab, emergency, and ambulance billing. They get a new market in full management of multispecialty groups, and ACO market opportunity from someone further down the path than they were. Not to mention that they take out a competitor and pick up a decent client base.”

10-2-2012 9-49-49 PM

From What, Me Worry?: “Re: West Penn Allegheny downtime. Patient care was not affected – we rely on meaningfully used paper.” West Penn’s servers went down Tuesday morning after a power surge, forcing the hospital to use paper backups. Some systems were up eight hours later and others were expected to come online overnight. It’s not much of an EHR pitch when a hospital claims that being without the computer didn’t really make any difference in patient care. That’s probably more of a PR observation rather than a medical one, though.

From THB: “Re: Allscripts. Are the reports that the company is putting itself up for sale accurate? After your hard day at work, here I am asking you to validate more information, i.e. do more work.” Bloomberg News claimed Friday that Allscripts talked to several private equity firms before engaging Citigroup to explore its options, but neither company would confirm. Shares have risen 11 percent since then, which might be meaningless since (a) the original rumor may have been planted by someone anxious to sell their shares, which is always possible; (b) the rumor may be incorrect; or (c) the rumor may be correct, but may not result in any decisive action. Reasons that going private makes sense: (a) the company’s shares tanked and haven’t recovered after an ugly day in April in which the company fired its board chair, saw three other board members quit in protest, announced the departure of its CFO, and reported lower earnings and guidance; (b) the company conceded to demands by a large shareholder to add its three candidates to the Allscripts board, and those new directors may be influencing the discussion of strategic alternatives; (c) the critical Q3 earnings numbers will be announced in November, and if they aren’t looking so good, this would be the time to plan an escape route from the bloodbath that’s likely to follow; and (d) the stock has fared so poorly in a generally good market that any major strategic changes might be better conducted outside of Wall Street’s baleful glare. My answer, then, is that I have no idea if the rumor is true, but I suspect that it is, and even that wouldn’t mean much until Allscripts decides what it wants to do.

HIStalk Announcements and Requests

10-2-2012 4-49-59 PM

inga_small My new iPhone 5 arrived last Friday and I am happy to report I have successfully made the migration. It’s definitely faster, the camera is better, it’s lighter, and I like the bigger screen. The battery life, however, does not seem any better than the iPhone 4 and actually seems worse, if that is possible. Maybe the battery life is longer in standby mode, but not when you are using all the cool new features. I also checked out the new maps utility and was amused that my “hospitals” search presented me with an option for “The Shoe Hospital” and for an animal hospital, but no traditional hospitals. It did find more choices when I searched “hospital” (singular), however. An “emergency room”  search found a few urgent care centers, but missed the three closest me and didn’t find any ERs attached to a hospital. Good luck with that issue, Mr. Cook.

Acquisitions, Funding, Business, and Stock

10-2-2012 9-50-58 PM

Tenet Healthcare subsidiary Conifer Health Solutions will acquire InforMed Health Care Solutions, an information management and services company.

Ontario-based Kallo, Inc. enters into a $2 million stock purchase agreement with Kodiak Capital Group. The company offers EMR, PACS, and medical device connectivity solutions.

10-2-2012 9-51-50 PM

Nuance acquires JA Thomas and Associates, which offers clinical documentation improvement programs. Obviously Nuance is interested in clinical documentation and the ICD-10 transition given the September 27 announcement that it had acquired QuadraMed’s HIM solutions (coding, compliance, computer-assisted coding, abstracting, record and document management, workflow, and clinical documentation integrity) and its acquisition earlier this year of Transcend, which offered transcription and clinical documentation (including the documentation and charge capture solutions of Salar, which Transcend acquired last summer).

HIMSS acquires CapSite, which offers a vendor database that includes actual pricing and contract information as well as research services that HIMSS will fold into HIMSS Analytics. It will be interesting to see how HIMSS balances the confidentiality desires of its vendor members against CapSite’s detailed and vendor-specific pricing and contracting information. My speculation is that it will go away, replaced by aggregated non-identifiable vendor information. And as I tweeted when the news was announced, that means that HIMSS is now an inadvertent HIStalk sponsor, which Inga pounced on with great glee.

In one of the oddest healthcare transactions in recent memory, The Washington Post Co. buys a majority stake in a hospice and home health service, obviously desperate for further non-media diversification as its Kaplan education cash cow dries up after the government reins in for-profit colleges.

10-2-2012 9-14-38 PM

10-2-2012 9-13-00 PM

Healthcare billionaire Patrick Soon-Shiong announces a deal between his NantHealth company and Blue Shield of California, which will work with St. John’s Health Center in Santa Monica, CA to roll out healthcare breakthroughs and personalized medicine. He will present the news to a Bipartisan Policy Center conference in Washington, DC on Wednesday, starting with an invitation-only 8:00 a.m. small-group breakfast session and then a larger session later in the morning. He’ll be joined in the session covering the use of supercomputer-powered genomic medicine by Senator Bill Frist; J. Michael McGinnis of the IOM; the president of Blue Shield of California; the top medical executives from AT&T, Verizon, and Caremark; and several academics.


10-2-2012 8-38-44 PM

The board of New York City Health and Hospitals Corporation approves execution of a ten-year, $303 million contract to implement Epic throughout the entire corporation. I believe the incumbent was QuadraMed Affinity, although it’s been a long time since I’ve thought about HHC. Cerner and Allscripts were the losing bidders and Allscripts has formally protested the award to Epic, which I would assume means HHC passed on the lower bid by Allscripts, which isn’t at all unusual when prospects get Epic fever. I assume the only difference from the usual hospital decision is that HHC is a government entity, so there’s someone to complain to. UPDATE: readers tell me the product HHC is running is QuadraMed CPR, the former HDS Ulticare / Per Se Patient1 / Misys CPR that they bought from HDS in the early 1990s and used in all inpatient, outpatient, and ancillary areas. It won them a Davies Award in 2006.

Baton Rouge General Medical Center (LA) chooses RelayHealth for its enterprise HIE.

The 77-physician Optimal Radiology selects McKesson Revenue Management Solutions for billing, reporting, and collections.

10-2-2012 9-52-58 PM

Faxton St. Luke’s Healthcare (NY) adds the Surgical Information System anesthesia information management system to its Allscripts Sunrise Surgery perioperative system.

The US Coast Guard awards Lockheed Martin a $2.3 million contract to develop a mobile interface to its Epic-powered EHR.


10-2-2012 6-16-38 PM 10-2-2012 6-17-19 PM 10-2-2012 6-18-00 PM

Device integration provider Nuvon appoints Christopher Gatti (Living Strategies) CEO and Stephen Spencer (Advantis Medical) VP of sales and marketing. Cathleen Asch will transition from CEO to EVP of strategic initiatives and remain on Nuvon’s board.

10-2-2012 6-19-41 PM

Jo Ann Rooney (DoD – above) and Robert Mills (ACS/Xerox) join Huron Consulting Group’s healthcare practice as managing directors.

10-2-2012 6-23-30 PM

The Military Health System names David Bowen (FAA) CIO.

10-2-2012 6-38-06 PM

University of Buffalo School of Medicine names Peter Winkelstein, MD as executive director of the school’s Institute for Healthcare Informatics. He is also CMIO of UB/MD.

10-2-2012 7-10-15 PM

Impact Advisors hires C. Lydon Neumann (Accenture) as VP.

10-2-2012 7-13-19 PM

Health Care DataWorks names founder Jyoti Kamal, PhD as president. She was previously deputy CIO and director for the information warehouse at The Ohio State University Wexner Medical Center.

10-2-2012 7-40-03 PM

Aspirus names Todd Richardson (Deaconess Health System) as CIO.

10-2-2012 8-14-32 PM

Jonathan Grau (AMIA) joins National Quality Forum as senior director of stakeholder collaboration.

10-2-2012 8-54-28 PM

Florence Chang is promoted to EVP of MultiCare Health System (WA). She was previously SVP of clinical support services and CIO.

Announcements and Implementations

WakeMed Health & Hospitals (NC) implements the Philips eICU remote critical care monitoring technology.

10-2-2012 9-53-55 PM

AHIMA awards the University of Wisconsin Hospital and Clinics the Grace Award for demonstrating effective and innovative approaches in using health information to deliver high quality healthcare.

Healthland will integrate Health Language’s terminology platform to support ICD-10 readiness and terminology standardization.

UnitedHealthcare commits $20 million to help 11 critical access hospitals in California improve their technology, including the addition of EHRs.

Partners HealthCare pledges to award Massachusetts community health centers $90 million over the next 15 years to upgrade technology and make other infrastructure improvements.

CORHIO announces that all six northern Colorado hospitals are connected to the HIE.

UPMC, Oracle, IBM, Informatica, and dbMotion will create a $100 million data warehouse that combines clinical, financial, administrative, and genomic information for analytics and predictive modeling applications.

Orion Health awards Cognosante a contract to provide integration and identity management for the first stage of the Massachusetts Statewide HIE program.

MModal makes available its Catalyst for Quality solution for clinical documentation.

North Carolina Healthcare Information & Communications Alliance offers a Vendor Management Policy Template that addresses HITECH requirements for business associate agreements. It’s free to NCHICA members, $50 otherwise.

A study published in the Journal of Clinical Epidemiology finds that DynaMed is ranked highest of 10 online clinical resources based on timeliness, breadth of coverage, and quality of supporting evidence.

CTG signs an Epic implementation contract with an unnamed five-hospital IDN.

The city of Billings, MT goes live with an ONC-funded and Dossia-powered pilot project to give its employees the ability to view and manage their electronic health information.

10-2-2012 7-50-16 PM

Dolbey announces the VoiceBox recording system that tags physician dictation so that the completed transcription can be inserted into the correct location of the EMR.

Verizon announces a cloud and data center infrastructure for storing and sharing PHI. Unlike non-healthcare cloud providers, Verizon will sign a business associate agreement that meets HIPAA requirements.

VersaSuite announces that its 8.0 product has earned pre-market CCHIT ED certification. VersaSuite is certified for both inpatient and ambulatory use, a distinction it says only two companies have achieved.

Government and Politics

Medicare initiates two ACA-legislated programs that target quality of care and readmission rates in hospitals. The Hospital Value-Based Purchasing Program allows the government to pay hospitals bonuses if they meet high performance standards on certain quality measures, while the Hospital Readmissions Reduction Program enables Medicare to reduce reimbursements up to one percent for hospitals with high readmission rates.

ONC announces a goal of helping 1,000 critical access hospitals achieve Meaningful Use by the end of 2014.

ONC releases a consumer-focused video on the benefits of electronic medical records, with cameos by Todd Park, Don Berwick, Farzad Mostashari, David Blumenthal, and others.

Innovation and Research

Kaiser Permanente researchers find that the use of an EHR improved drug therapy and follow-up monitoring of Type 2 diabetics, as well as improved the patients’ glycemic and lipid control.

10-2-2012 8-13-07 PM

Health Nuts Media launches a crowdfunding campaign, hoping to raise $90,000 to develop an asthma education app for children. Rewards are offered for various donation levels, with a $50 contribution earning a copy of the app, a “Wall of Fame” credit, coloring pages, a poster, recognition in the app, and a tote bag.


10-2-2012 4-43-10 PM

CalHealth prepares to launch MD Mouse, a device that measures pressure information when a finger is slid inside a cuff that folds out from the middle section of the mouse.


The Census Bureau says adults under age 65 made an average of 3.9 visits to physicians in 2010, down from 4.8 visits in 2001. Possible explanations: more uninsured, fewer physicians, higher patient costs, innovation that allows providers to accomplish more in a single visits, and more meds available without a prescription.

Cerner expects over 10,000 attendees from 21 countries at its 27th annual Cerner Health Conference next week in Kansas City.

An Irish pediatric surgeon is found guilty of poor professional performance after a 2010 error in which the wrong mouth surgery was performed on a baby. The doctor correctly ordered an upper lingual frenulectomy in his patient notes, but an administrator entering the procedure into the hospital’s computer system said the only option it gave him was “tongue-tie.” He chose that option, it printed on the OR list, and the surgeons performed that operation. They chairman of the inquiry committee said he was satisfied with the decision even though the committee had concerns about the OR scheduling and coding systems.

10-2-2012 7-01-33 PM

Weird News Andy is amused that a study finds that tickling rats after inducing a stroke appears to prevent paralysis and sensory deficits, possibly by forcing a rerouting of blood through unblocked veins. Playing music seems to work equally well, leading to the “it may not help, but it can’t hurt” recommendation that when someone is suspected of having a stroke, squeeze their hand and talk to them. WNA is also amused at the prospect of giving the rats warfarin as a stroke treatment, which usually is dosed in much larger quantities in the form of rat poison.

WNA cheers this story with a hearty “Hear, hear.” Doctors at Johns Hopkins successfully create a new ear for a woman who lost the original to cancer. They grew the new ear under the skin of her arm until it was ready to be attached.

Strange: a veteran sues the VA for $10 million, claiming that a nurse packed his groin with ice for 19 hours following his genital surgery, causing frostbite that required reconstructive surgery.

Sponsor Updates

10-2-2012 9-57-30 PM

  • Elsevier launches its nationwide ClinicalKey Experience Tour, an all-day outdoor event at hospitals and academic centers to promote its ClinicalKey clinical reference tool.
  • Iatric Systems offers an October 11 webcast on Meaningful Use Stage 2 featuring Beth Israel Deaconess Medical Center CIO John Halamka, MD.
  • Michigan Orthopaedic Institute (MI) selects the SRS EHR for its 17 providers.
  • Intelligent InSites announces members of its Healthcare Advisory Board.
  • Collom and Carney Clinic Association (TX) selects MModal Fluency Direct to voice-enable its EHR.
  • Cynergis Tek CEO Mac McMillan achieves the Fellow of HIMSS designation in recognition of his advancement of privacy and security within healthcare.
  • Balsam Healthcare Corporation (Saudi Arabia) licenses First Databank’s Middle East Drug Knowledge solution for integration with the OASIS HMIS system. FDB also releases new customizable alert categories within its FCB AlertSpace alert management system.
  • Delta Health Technologies selects ZirMed as a preferred business partner to provide RCM solutions to homecare providers.
  • McKesson hosts its 25th Health Solutions Conference next week in Orlando.
  • Gregg Mohrmann and Mark Van Kooy, MD of Aspen Advisors will lead sessions at this week’s New Jersey HIMSS/Delaware Valley HIMSS joint annual conference.

A Report from athenahealth’s “More Disruption Please: The CEO Retreat”
By Jonathan Baran, Co-Founder and CEO, Healthfinch

10-2-2012 7-37-48 PM

Athenahealth’s recent "More Disruption Please" event brought together 50 CEOs of health IT companies and their investors to the Point Lookout Resort in Maine (a resort that athenahealth bought for $7.7M… a steal!). Each CEO was given their own private log cabin to stay in (or to sleep off late nights with Jonathan Bush). The purpose of the meeting was for athenahealth and these newer, innovative HIT companies to get to know and learn from each other.

Any time you get to spend time with Jonathan Bush, you never know what to expect. He did not disappoint, as he began at eight in the morning by impersonating Ali G, telling everyone how athenahealth gets "ka-ching and da bling for doing the right thing!" A couple of more presentations followed, including one by Marty Anderson, who asked how innovation can come from the top-down when "the healthcare industry is a giant cartel."

Then the fun began as 30 CEOs gave two-minute pitches, with five finalists promised a ten-minute presentation to 2,500 of athenahealth’s users. We (Healthfinch) were selected as one of the five finalists, along with iTriage, Entrada, Epion, and Wellframe. In a smart market research move, athenahealth then asked their customers to vote on which company’s product they would most like to see integrated with athenahealth. Ultimately, our scrappy startup from Madison, Wisconsin took second place to Aetna’s iTriage.

Jonathan Bush’s final display of how to "keep it real even when you’re CEO of a publicly traded company" began when he gave us a lesson on how to build a successful business model. Jonathan, like every other EMR CEO, drew inspiration from the “Saturday Night Live” skit, "D— in a Box." He gave us all the following instructions:

  1. Get a box (find a pile of work that users hate and suck at).
  2. Cut a hole in the box (figure out how to break into the market).
  3. Put your junk in the box (bring your secret sauce to the market).

I couldn’t say it any better myself.

Athenahealth also discussed more of their plans for their entire "More Disruption Please" program, the smartest move being their recognition that the biggest challenge in bringing innovation to market (and thus allowing small companies to flourish) is in the distribution channel. That’s why athenahealth is promising to bring the top innovations to their customers by rapidly scaling interesting products and innovations to their entire user base.

Time will tell if athenahealth can live up to its grand plans to become the information backbone of the health system, but their program (and their conference) seem to indicate they are on the right track.


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

More news: HIStalk Practice, HIStalk Mobile.

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October 2, 2012 News 8 Comments

News 9/28/12

September 27, 2012 News 2 Comments

Top News

9-27-2012 7-39-56 AM

The American Hospital association agrees in a letter to HHS Secretary Kathleen Sebelius and the Attorney General Eric Holder that EMR-assisted cloning and upcoding should not be tolerated, but retorts that CMS has ignored its repeated recommendations to expand E/M (evaluation and management) codes to create a national standard for hospital ED and clinic services. My opinion: the election-sensitive, administration-friendly HHS’ers got blindsided by a Center for Public Integrity article that insinuated but didn’t prove that a shift to higher complexity codes means that EDs and physician practices are gaming the system to the tune of $11 billion, so given too little time between now and the November 6 election to actually do something useful (like identify and prosecute someone who’s actually guilty), HHS just went public with meaningless finger-wagging to make it appear that they’re on top of the situation. HHS keeps bragging on how great their fraud detection systems are (which they should be, given the hundreds of millions paid to fat cat contractors to develop them), yet they apparently trust journalists more than their own armies of bureaucrats to tell them they have a problem. The reimbursement system is even worse than the tax laws in being a confusing hodgepodge of rules that nobody, even CMS, really understands or can interpret consistently. Some providers are undoubtedly committing fraud and the 99% honest ones would love to see them shut down and punished. However, as with tax loopholes, there’s nothing illegal or immoral about taking the maximum benefit that the law allows. There’s a reason that crime syndicates are moving from drug dealing to Medicare fraud: payment is quick and rarely questioned, the money is great, and the risk of actually going to jail is almost zero.

Reader Comments

From High Roller: “Re: QuadraMed. Quantum is just the first QuadraMed domino to fall. Franciscan Partners isn’t interested in holding on to the rest of the company forever, so it won’t be long before the other pieces are sold off. QuadraMed has a large enough client base, so they could milk their revenue stream for awhile. More likely, Franciscan will look to sell what’s left to someone like Allscripts who’d be interested in having a larger client base to sell into.”

HIStalk Announcements and Requests

inga Highlights from the last week on HIStalk Practice: patients want more online access to their health records but most doctors don’t offer the option. Lack of staff impacts EHR adoption, especially in smaller practices. Tips for using an EHR as a marketing tool and to increase patient satisfaction. Parents are more likely to fill children’s e-prescribed prescriptions than paper ones. Physicians are working fewer hours and seeing fewer patients than they were four years ago. I am looking for some MGMA picks. Thanks for reading.

9-27-2012 5-59-09 AM

Welcome to new HIStalk Platinum Sponsor Emdat, which offers hybrid clinical documentation and transcription solutions that improve the productivity and satisfaction of EHR-using physicians. Instead of pointing and clicking, physicians continue to use the most efficient method of documenting patient encounters – dictation. Emdat’s DaRT system automatically tags sections of transcription content (chief complaint, medical history, etc.) and then seamlessly auto-populates discrete information directly into the EHR just as though the physician entered it directly using structured documentation. Its Emdat Mobile solution not only allows physicians to document encounters on the go, but provides a more patient-friendly way to document during an encounter. Loyola University Health System uses it with Epic and says the setup was simple, reducing transcription turnaround time by 50% and allowed doctors to continue dictation, which they say is faster and better for patient care. Thanks to Emdat for supporting HIStalk.

inga Mr. H took off a little early to treat Mrs. H to some fun, so today’s post is a bit shorter than usual.  He’ll be back to serve up a full course of the Monday Morning Update over the weekend.

Acquisitions, Funding, Business, and Stock

 9-27-2012 7-40-04 AM

9-27-2012 7-35-34 AM

As reported earlier today, Nuance will acquire QuadraMed’s Quantim product line. You have to wonder if Nuance didn’t rush the announcement a bit following our Wednesday mention of the deal on Twitter and HIStalk: early Thursday morning Nuance posted these (now corrected) announcements referring to “QuadaMed” and “Quantrim.”

The Kentucky Economic Development Finance Authority approves a $150,000 grant for Health Catalyst, a business accelerator for companies creating health-related software, including life-sciences and HIT companies. Health Catalyst will nurture five startups a year by providing work space, mentoring, and seed funding.


9-27-2012 3-48-26 PM

Evergreen Health (WA) selects MEDSEEK’s ecoSmart Patient Precisioning solution for predictive analytics.

Adventist Health selects MedeAnalytics’ Patient Access Intelligence solution for point-of-service cash collection across its 16 hospitals.


9-27-2012 6-42-20 AM

Mark Burgess (Cerner) joins Allscripts as director of solutions management.

Fletcher Allen Health Care (VT) hires Adam P. Buckley, MD (Beth Israel Medical Center) to be the organization’s first CMIO.

Announcements and Implementations

9-27-2012 3-31-19 PM

Wake Forest Baptist Health (NC) goes live on Epic.

Wellcentive announces Advance Risk Manager, a predictive risk modeling system for population health management that allows providers to focus on patients with specific risk profiles.

The three largest health systems in St. Louis join the Missouri Health Connection HIE.

Government and Politics

9-27-2012 4-41-20 PM

Rep. Mike Honda (D-CA) will introduce a bill to set up an Office of Mobile Health at the FDA to provide recommendations on mobile health issues. The legislation also calls for the creation of a support program at the HHS to advise app developers on privacy regulations and for a low-interest loan program for physician offices to purchase new technology.


9-27-2012 3-14-20 PM

The West Health Institute is developing Sense4Baby, a wireless and portable fetal monitor for high-risk pregnancies in remote clinics. The system, which is being piloted in Mexico, sends the captured data over a cellular network to the patient’s physician.


The Seattle Times covers Caradigm, the Microsoft-GE joint venture whose headquarters opened this week in Bellevue,WA. Positive comments from Providence about Amalga are included, along with less enthusiastic ones from Swedish CMIO Tom Wood, who says he’s not sure how they can add a layer on top of EMRs without a lot of cooperation.

UMass Memorial Health Care (MA) will eliminate 140 positions, some of them in IT, in seeking $80 million in cost reductions.

John Reynolds, the former CEO of Hospital for Special Surgery (NY), is arrested for racketeering, charged with soliciting kickbacks from prospective vendors and extorting $300,000 from a hospital employee in return for arranging an annual bonus.

9-27-2012 6-59-04 AM

Weird News Andy wonders how this is possible. A women who is “internally decapitated” when her skull is torn from her spine in a car accident not only survives, but is basically back to normal.

Here’s a new video from St. Jude Children’s Research Hospital, featuring patients, employees, and celebrities singing “Hey, Jude” to highlight National Childhood Cancer Awareness Month. Some of those featured are Jennifer Aniston, Betty White, Robin Williams, and Michael Jordan.

Two-thirds of CHIME members report staff shortages and are in most need of more specialists to implement and support clinical applications.

A study published in the Journal of the American Medical Informatics Association concludes that CPOE was the main challenge among hospitals failing to achieve MU in the program’s first year.

Sponsor Updates

9-27-2012 6-50-09 AM

  • TELUS Health brings its TELUSHealth.com portal live to showcase its solutions that link Canadian patients to their providers.
  • Elsevier unveils its EduCode Clinical Documentation Improvement eLearning curriculum for ICD-10 at next week’s AHIMA meeting.
  • New York eHealth Collaborative spotlights five health IT champions at the NYeC gala October 15.
  • Muhannad Samaan, MD of Aultman Inpatient Medicine discusses how Ingenious Med’s charge capture software improved patient hand-off and communications.
  • Software Magazine ranks Macadamian #435 on its Software 500 list, which is based on revenues of the world’s largest software and services suppliers.
  • Sandlot Solutions releases a report on using data and analytics to improve healthcare delivery.
  • Skylight Healthcare Systems integrates its Service Recovery process with Vocera’s communication devices.
  • Optum launches its Optum ICD-10 Core Education program.
  • TI combines its DM8148 system on-a-chip with Imprivata OneSign to provide out-of-the-box strong user authentication into any software application.
  • McKesson expands its Intelligent Coding portfolio to include observation services.
  • First Databank executives Keith Fisher, MS and Patrick Lupinetti, JD  will present educational sessions at next month’s AMCP 2012 Educational Conference.
  • Vitera Healthcare Solutions reports record attendance at this month’s VIBE conference in Orlando.
  • 3M Health Information Systems adds 18 physician education modules to its Web-based curriculum to address ICD-10 readiness.

EPtalk by Dr. Jayne

Don’t forget — October 3 is the last day for Eligible Professionals to begin their 90-day reporting period for the Medicare EHR Incentive Program, aka Meaningful Use. One of my buddies in the consulting business has been sharing e-mails he is receiving from providers. Today’s special: “I would like to be Meaningful Use but do not know to begin. I need the money. Please send tips for me to start?” I guess that’s someone’s idea of a consulting RFP.

An American Medical News article lists common EHR blunders. I’ve seen all of these in various forms across practices from small to large. Topping the list: lack of infrastructure, lack of workflow assessment, lack of training, lack of buy-in, failure to communicate with patients about delays during the transition, and failure to appropriately integrate the computer into the patient-physician relationship.

News flash: Nearly one-third of US medical school students who initially planned to enter primary care ended up switching to a more lucrative specialty. Surveys of students in New York show that “medical students who anticipated high levels of debt upon graduation and placed a premium on high income were more likely to enter a high-paying medical specialty.” Really.

In similar news, the US medical schools that still don’t have Family Medicine departments are starting to get with the program. Some of these schools are big name and I know all too well what it’s like to attend one. Now we just need to get all medical schools to incorporate informatics into their programs. Let’s teach budding doctors (and nurses, and everyone else) how to leverage technology to better care for patients rather than fighting it or trying to undermine it. Although the new generation seems tech savvy, I see too many students trying to short-cut their documentation.


Mashable lists “10 Office Technologies on Their Way Out.” The list of items they predict will vanish in the next five years includes obvious items like fax machines, tape recorders, and the Rolodex. I’m not sure about desktop computers, cubicles, and standard working hours. There are a lot of entrenched management types out there who will resist. Although I won’t miss formal business attire, which includes pantyhose (#7), I’d like to lobby to keep fashionable shoes part of the equation. If I see one more pair of flip-flops in the office, I just might scream.

The Greater Atlanta area is a hotbed of health IT vendors, so I hope that none of you were recipients of the free kittens given away in the parking lot of the McDonough Walmart. Apparently they were rabid.

As Mr. H mentioned earlier this week, HIMSS registration is open and the room supplies are dwindling. I’m glad he gave me a reminder. I booked tonight, yet wasn’t able to get my preferred hotel or even my preferred dates. I’m leaving a day early, but that’s probably OK since I have to take vacation to attend this year. My hospital no longer has a conference budget or paid professional development days, so I’m not complaining about spending one less night in an overpriced hotel. Plus, I was able to snag a super-cheap plane ticket so I can afford some hot new shoes for Histalkapalooza.



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

More news: HIStalk Practice, HIStalk Mobile.

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September 27, 2012 News 2 Comments

News 9/26/12

September 25, 2012 News 4 Comments

Top News

9-25-2012 5-32-10 PM

HHS Secretary Kathleen Sebelius and US Attorney General Eric Holder warn AHA and other hospital organizations that the government will take appropriate steps to pursue healthcare providers who misuse EHRs to defraud Medicare, specifically calling out upcoding and cloning of medical records.

Reader Comments

9-25-2012 8-30-24 PM

inga_small From Wicked Fun: “Re: HIStalkapalooza planning. I just moved from the vendor side to a provider organization. As much as I am loving my brand new job, I miss the ‘fray’ of the world of HIT. The first comment from one of my MD friends  was, ‘What if you don’t go to HIMSS? We always go to the HIStalk party together!’’” The lesson here for the HIStalkapalooza faithful is to add our annual event as a mandatory condition of employment in your contract negotiations. If you like planning ahead, the 2013 version of HIStalkapalooza is scheduled for Monday, March 4, with registration opening sometime in January.

9-25-2012 7-25-33 PM

From Plinker: “Re: Northwestern in Chicago. Going Epic.” I don’t recall if I’ve mentioned that previously.

9-25-2012 6-50-30 PM

From Squint Eastwood: “Re: Vermont. Not a rumor, but interesting.” Fletcher Allen Health Care and Dartmouth-Hitchcock Medical Center submit an ACO plan that would create the for-profit OneCare Vermont LLC, which would include 13 of the state’s 14 hospitals (Porter Medical Center passed), 58 medical practices, two FQHCs, and other organizations. If approved in October, OneCare would be up and running by January 1, serving most of the state’s 105,000 Medicare beneficiaries. Fletcher Allen SVP Todd Moore, who will be CEO of OneCare if it’s approved, says access to data was a driver. “This is really an access to information revolution as much as it is anything else for us. This gives us access to the full claims set for the first time to Medicare beneficiaries that we treat … to understand how they seek care, how often they go to (the doctor) — whether it be at Fletcher Allen or at Northwestern Medical Center or in Florida.”

9-25-2012 7-24-04 PM

From Adam: “Re: Tampa General Hospital. Saw they’re going with RelayHealth for HIE. Aren’t they an Epic shop?” They are indeed.

From HereWeGo: “Re: MCK acquisition of MedVentive. The fat, spoiled kitty found a new toy to bat around and destroy until the next shiny object captures its attention.” Usually the fat cat in a given deal is the seller, so at least some of MCK’s cash trickled down to the MedVentive owners. I should clarify that the rumored MCK acquisition that I mentioned last week isn’t MedVentive, so another announcement could be coming if the rumor turns out to be accurate.

From Bobby D: “Re: MCK acquisition of MedVentive. This is the second company that Nancy Brown has been involved with that McKesson bought, the first being Abaton.com. She has two to go to catch Mike Myers of CliniCom history, who has sold them four companies.” Mike’s at QuadraMed now, I’m told, so he could bag “one for the thumb” if MCK happens to buy QuadraMed’s Quantim line, if indeed the rumor is true that it’s about to be sold (and even if it is, MCK hasn’t been mentioned as a player.) UPDATE: per Federal Trade Commission filings, Nuance will be the acquirer of Quantim.

From Moak: “Re: upcoding. How did you miss this one?” I get at least one e-mail per day (including this one) with a link to a big news story that I’ve already covered, so skimmers are missing out. Still, I appreciate the notice just in case I really did miss something, and Moak brings up an interesting point: the feds gave Faxton St. Luke’s Healthcare (NY) as an example of an ED whose higher levels of treatment jumped 43 percent in 2009, the same year it implemented EHRs. He says the hospital only has 22 days’ cash on hand and therefore is not stealing from anyone. I wouldn’t necessary make that assumption since poverty usually encourages rather than discourages criminality, but I think his point is that the hospital was struggling financially and may have simply cracked down on sloppy billing practices. One might assume that the feds would do some audits before slamming the entire healthcare provider universe with unproven fraud innuendo, but given its poor track record in uncovering even widespread fraud (see: South Florida), maybe the only arrow in its quiver is to bluff. If they have found even one case of EHR-abetted fraud and wanted to deliver an effective message, they should have had a photo op with someone in handcuffs.

HIStalk Announcements and Requests

9-25-2012 8-33-06 PM

inga_small A big thanks to all the readers who sent me notes bragging that they had already gotten their iPhone 5s after little or no wait at their local Apple store. My phone will arrive from China on Thursday. I loved the lightweight feel of a friend’s iPhone and had fun taking a few panoramic photos. My friend claims it is much faster than the iPhone 4, but she is not yet convinced the battery life is dramatically improved.

9-25-2012 6-07-15 PM

Welcome to new HIStalk Platinum Sponsor VersaSuite. The Austin, TX company offers an integrated system for medical enterprises (hospitals, clinics, surgery centers) that includes a hospital information system (including CPOE and eMAR), inventory management, RIS/PACS, laboratory information system, pharmacy management system, accounting, and HR. It’s all built on a single Windows-based stack running on a single database, standardizing the user experience across inpatient, outpatient, and ED. The company says it holds the largest number of CCHIT certifications of any single product, including CCHIT’s enterprise certification, giving healthcare systems one product that is MU certified for both EPs and hospitals. VersaSuite’s EHR includes specialty-specific templates for 24 disciplines, keyboard-free data entry, dashboards, tablet support, and a four-click assessment/plan for outpatients that takes only 5-10 seconds vs. up to two minutes in competing EHRs. The company is a member of IHE and its products support interoperability standards such as HL7 and DICOM and are compliant with HIPAA 5010 and ICD-10. Thanks to VersaSuite for supporting HIStalk.  

I booked my HIMSS room this week and suggest you don’t wait too long. I got my first choice, but the supply for close-in rooms is dwindling. HIMSS usually opens up more hotels later, but they’re usually a long shuttle bus ride to BFE.

Acquisitions, Funding, Business, and Stock

9-25-2012 7-28-59 PM

Cancer support site Navigating Cancer raises $2.3 million to hire developers and integrate its patient portal into EMR applications.

McKesson announces that it will acquire MedVentive, which offers population and risk management tools.


9-25-2012 8-34-56 PM

Wentworth-Douglass Hospital (NH) selects the Siemens perioperative management system by SIS.

The Upper Peninsula HIE (MI) will implement ICA’s CareAlign CareExchange platform.

Tampa General Hospital (FL) selects RelayHealth Enterprise HIE for CCD data exchange.

9-25-2012 8-36-06 PM

Johns Hopkins Hospital and Health System (MD) selects 3M’s 360 Encompass System for automated coding and clinical documentation.

Health plan service provider Magnacare (NY) will offer online appointment scheduling services from DocASAP, a startup competitor to ZocDoc.

Methodist Dallas Medical Center (TX) selects ProVation Order Sets from Wolters Kluwer Health.

9-25-2012 6-04-21 PM

Amcon’s Australian division announces the launch of its Messenger clinical alerting middleware at the 848-bed St. Vincent’s Hospital Melbourne.


9-25-2012 9-17-18 AM

M*Modal hires Mike Etue (OptumInsight, Allscripts) as EVP of sales, replacing Michael Clark.

9-25-2012 10-54-01 AM

Former PatientKeeper VP Michael Bertrand joins home health software provider HealthWyse as VP of development.

9-25-2012 5-28-50 PM

RemitDATA appoints John Stanton (Beacon Partners, above) as VP of consulting and Phillip McClure (MedeAnalytics) as VP of sales.

9-25-2012 1-40-21 PM

Beacon Partners promotes Christopher Kondrat from principal to VP of professional services.

9-25-2012 7-17-08 PM

Phillip Madden (Cerner) is named director of client sales at Orion Health.

Yuma Regional Medical Center names Robert Budman, MD (Catholic Healthcare East) as CMIO.

Besler Consulting appoints Edward J. Niewiadomski, MD (Southern Ocean Medical Center) as senior medical advisor.

Quality Systems, Inc. appoints Daniel J. Morefield (LEADS360) as EVP/COO.

Announcements and Implementations

Munson Healthcare (MI) implements VPLEX Metro virtual storage from EMC and private cloud technology from EMC and VMware.

9-25-2012 3-10-10 PM

SCIOinspire Corp. changes its name to SCIO Health Analytics.

Prognosis adds a configurable template engine and a physician rounding tool to its ChartNotes EHR.

In the UK, CSC admits that it will sunset the former iSOFT physician systems, including Synergy, Premiere, and Ganymede, that are used by about six percent of England’s practices. It denied the rumor of the impending retirement until Monday’s announcement.

9-25-2012 6-00-41 PM

PerfectServe adds a patient-centered rounding feature to its communications system, allowing clinicians to contact the appropriate physician for each patient.

Cleveland Clinic is implementing software from its new spinoff iVHR, which will present information from its Epic system to doctors in a visual form. The software will create maps patient locations with indicators of patient condition that link to all the background data from Epic, displaying it visually to help doctors see the big picture.

Government and Politics

The FCC’s mHealth Task Force recommends that wireless health and e-Care technologies be incorporated as best practices for medical care by 2017. Example technologies are remote monitoring devices, apps, body sensors, implanted microstimulation devices, medical device data systems, provider apps for remote image viewing, patient portals, clinical decision support tools, and a broadband-enabled HIT infrastructure. Some of its specific recommendations to the FCC include: (a) fill the open position for an FCC healthcare director; (b) provide education and outreach; (c) work more closely with ONC and CMS, specifically helping ONC with secure health messaging and communications standards; and (d) open up more of the communications spectrum for mobile broadband.

9-25-2012 8-37-47 PM

UC Davis Health System signs a 16-month, $17.5 million agreement to take over the state’s struggling HIE, formerly run by Cal eConnect. The project has been renamed the California Health eQuality Program (CHeQ) and will be led by Ken Kizer, MD MPH of UC Davis, who was previously CEO of the VA healthcare system, Medsphere, and the National Quality Forum. The project is halfway through its four-year, $39 million grant. They claim they are confident they’ll seamlessly move to a post-grant revenue model when the federal breast runs dry in 2014, which will make them one of almost none if they actually pull it off.

9-25-2012 8-38-30 PM

NPR posts the audio and transcript from Tuesday’s “The Diane Rehm Show,” featuring Farzad Mostashari and others on “The Pluses and Minuses of Electronic Medical Records” (but not Diane Rehm, who was on vacation, and not Farzad for the second half because he had to leave). The substitute host led an inordinate amount of the discussion toward upcoding, which made it a lot less interesting. What Farzad said: (a) maybe the EHR just captured the charges correctly; (b) the current system pays doctors more for recording what they actually do, so why wouldn’t they?; (c) EHR or not, fraud is illegal, and in fact the audit trails of EHRs can make it easier to detect. A former healthcare CIO and practice manager named Jim called in to say that his docs always intentionally downcoded with paper records because they were afraid insurance companies would challenge their recordkeeping, but were more confident that electronic records made it safe to bill accurately.


OIG finds that Essentia Health (MN) overbilled Medicare by $865,000, or $3.18 for every $1.00 it was owed. Essentia blames its billing system, which it says it has replaced.

Avado CEO Dave Chase opines in a Forbes article that New York is “the epicenter of healthcare’s reinvention.” He cites as examples health accelerators, Medicaid HMOs, WebMD, the New York eHealth Collaborative, the state HIE, IBM, and Farzad Mostashari.

9-25-2012 8-40-14 PM

Weird News Andy finds an article from the physician author of Bad Pharma stating what everybody knows: drug companies selectively publish studies that make their drugs look good, using tricks such as small-numbers studies and statistical tricks that exaggerate questionable benefits. Less-flattering studies get shelved. Industry-funded drug trials were positive 85 percent of the time, while only 50 percent of government-funded studies were. Industry-sponsored studies of statin drugs were 20 times more likely to favor the test drugs. From the book’s description, “We like to imagine that doctors are familiar with the research literature surrounding a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients.”

Another WNA find, which he labels “workaholic”: the New York Post digs through public records to find city-employed psychiatrists who make multiples of their base salaries by claiming extensive overtime for ED coverage. One psychiatrist boosted his $173K base pay to $481K by claiming he worked 80 hours per week. The same doctor made $689K in 2009 by turning in 3,820 hours of overtime, including one non-stop stretch of 96 hours. The physicians are also allowed to operate private practices.

9-25-2012 6-40-48 PM

Here’s the latest cartoon from Imprivata.

Sponsor Updates

  • eClinicalWorks releases the agenda for its October 25-28 National Users Conference.
  • DrFirst creates an infographic called “Key Dates You Need to Know to Maximize Meaningful Use Incentive Payments.”
  • Lifepoint Informatics announces its Gold Level sponsorship of the G2 Lab Institute Conference in Alexandria, VA October 10-12.
  • MED3OOO VP Steven Stout discusses the risk and rewards of contracting for global risk in an October 3 Webinar.
  • McKesson hosts a September 27 Webinar on strategies for driving reimbursement.
  • A survey by commissioned by simplifyMD finds that EMR vendors often convince practices to replace their practice management system when implementing their EMR, but practices often experienced problems with cash flow and employee productivity as a result.
  • MedVentive offers demos of its Population Manager and Risk Manager products during next week’s AMGA Institute for Quality Leadership Annual Meeting.
  • Benefis Health System (MT) realizes a $4.9 million increase in appropriate hospital charges, a $3.5 million increase in reimbursement, and a $2.3 million reduction in uncompensated care within four months of implementing the first phase of its RCM initiative with MedAssets.
  • MedAptus releases its Mobile Schedule application for Apple iOS.
  • An Imprivata-sponsored survey finds that 72 percent of hospital IT decision makers believe pagers will be replaced by secure text messaging within three years.
  • iSirona releases a white paper on device integration.
  • Wellsoft will participate in the 2012 ACEP Scientific Assembly next month in Denver.


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

More news: HIStalk Practice, HIStalk Mobile.

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September 25, 2012 News 4 Comments

News 9/21/12

September 20, 2012 News 8 Comments

Top News

9-20-2012 9-03-43 PM 9-20-2012 9-04-29 PM

The Forbes 400 list of richest Americans includes Epic’s Judy Faulkner (#285 with a net worth of $1.7 billion) and Cerner’s Neal Patterson (#391 at $1.12 billion).

Reader Comments

9-20-2012 5-28-10 PM

From HIStalk Fan: “Re: EHR experience reporting. The IOM recommendations could improve outcomes and safety. It remains puzzling that ONC is against robust vetting for safety and efficacy.” ONC asked the IOM to suggest ways to collect and report EHR user experiences, particularly those involving problems with patient safety. IOM’s just-published paper lays out ways that could be done. Possibilities include (a) testing vendor products against use cases; (b) placing a “report a problem here” button on EHR screens to allow users to quickly report problems; (c) have EHRs collect information such as number of clicks or the number of screen views and mine that data to look for problems; (d) conduct user surveys; and (e) develop a formal reporting program. The article recommends posting the collected information on a website that would rate individual functions vendor by vendor using a star-type rating system.

From Misys_Ex: “Re: QuadraMed. Not all to be sold, only the HIM/Quantim line. Sale to close in a week. Spending and hiring freeze in effect. MModal is the rumored buyer.” Unverified. An all-company call has been scheduled for October 1, rumor has it, which would logically place the announcement on the first day of the AHIMA conference.

9-20-2012 7-01-07 PM

From Dale Sanders: "Re: odd iPad requirement. The Colorado Department of Health Care Policy and Financing is re-competing its Medicare and Medicaid Information System contract. The draft RFP requires each vendor to submit their response on seven iPads, one for each member of the selection committee.” The rationale is that the iPad saves printing and shipping cost, although you could do a lot of printing for the $3,500 or so. The state says vendors like the idea and the iPads are more secure than paper, ensuring that documents don’t fall into the hands of competitors and thereby force an expensive re-bid and/or legal challenge for the $100 million project. None of that would seem to preclude returning the iPads given that the state plans to erase and reuse them anyway.

9-20-2012 7-13-32 PM

From Laura: “Re: Practice Fusion. Another cloud downtime.” Only for a few minutes, apparently, but judging from the comments, I bet that Like button didn’t get much action while the users killed time waiting to get back on.

9-20-2012 9-15-18 PM

From Writing My Resume: “Re: McKesson’s Better Health 2020. Will go down as the largest mistake in the history of HIT. Customers like Providence, Southwest Washington, Ohiohealth, John Muir, Valley Health, WellStar, HealthEast, and Resurrection are moving from Horizon to Epic. The new Paragon customers are small community hospitals and it will take 10-15 of them to replace one Horizon customer. Rumors of another layoff coming.” Unverified. I interviewed MPT President Dave Souerwine when the program was announced in December 2011. Better Health 2020 was a series of commitments to (a) invest $1 billion in R&D over the following two years, a good bit of that in enhancing Paragon over a 30-month development cycle; (b) sunset no products, but shift resources away from Horizon clinical applications to Paragon; (c) stop the development of Horizon Enterprise Revenue Management and lay off 174 employees immediately; and (d) continue to support Horizon customers through Meaningful Use and ICD-10.

HIStalk Announcements and Requests

inga_small Are you current on all the latest ambulatory HIT news? Here are some highlights from HIStalk Practice over the last week: RAC auditing of physicians begins in 15 states, focusing on higher-level E/M codes. The state of Colorado reports that Medicaid medical homes are reducing hospital inpatient stays and ER visits. EHR adoption at community health center grows to 74 percent, thanks to HITECH funding. eClinicalWorks predicts a 23 percent increase in revenues for 2012. Implementation costs and low patient adoption are big barriers for practices wanting to add patient portals. A physician weighs in on the impact of the ACA, incentives, and EHR. Nuesoft Technologies’ Blake LeGate offers tips for preparing for ICD-10. Dr. Gregg thinks (a lot) about going back to paper. Some days, especially those when Mr. H is especially busy at his day job, the only way I know I am appreciated is to see that someone new has subscribed to HIStalk Practice. When you check out these stories, show me the love and sign up for the e-mail updates. Thanks for reading.

Working anonymously is good in some ways, bad in others. On the “bad” side, Inga, Dr. Jayne, and I labor in our otherwise empty rooms with no human contact, meaning our little HIStalk world will evaporate the moment we quit or get hit by that proverbial bus. It’s up to you to write our electronic epitaph in advance, as follows: (a) connect with us and Like us (note to Mark Z — a Love button would be better) on the usual ego-feeding social not-working sites; (b) sign up for our spam-free electronic updates; (c) show your appreciation for the companies that keep our caustic keyboards clacking by reviewing the gallery-quality ads to your left and impulsively clicking those that pique your interest; (d) inspect the more detailed sponsor information housed in the Resource Center and consider using the Consulting RFI Blaster to effortlessly contact several consulting firms at once about your needs; (e) send us news, rumors, photos, ideas, or anything else that interests you and therefore would probably interest the rest of the HIStalk universe; and (f) look into the nearest reflective surface and give yourself a jaunty thumbs-up on our behalf for being discerning enough to recognize that despite its amateurish presentation, occasionally inappropriate content, and intentionally ironic pipe-smoking logo character, HIStalk does a mostly OK job in keeping you informed as well as a guy with a full-time hospital job can do.

My inbox is bulging and I have a lot of catching up to do this weekend. That’s the best I can do, unfortunately. Re-sending your e-mail doesn’t really help solve my problem of needing to sleep five hours or so, which is about all the time I have left at the end of the day. I promise I have not forgotten you.

9-20-2012 7-30-12 PM

Welcome to new HIStalk Platinum Sponsor TeraRecon of Foster City, CA. The company is a global leader in enterprise image management solutions, especially with regard to advanced imaging procedures. Its zero-footprint iNtuition EMV (Enterprise Medical Viewer) can deliver interactive images to any Web browser for even the largest and most complex CT exam, even interactive 3D. Instead of a peering at static JPGs in the EMR or a generic 2D viewer short on useful tools, physicians get a rich viewer with contextual tools and viewing configurations that are automatically set based on image type. Specialists in particular get real value from 3D images. The flagship iNtuition solution integrates with any vendor-neutral archive, so it works with a wide variety of systems including PACS from any vendor. TeraRecon created the concept of advanced visualization and iNtuition is the leader in enterprise-wide, thin-client server-based visualization with over 4,500 installations all over the world. Thanks to TeraRecon for supporting HIStalk.

I admit that imaging solutions aren’t my strong suit, so hopefully this TeraRecon overview video that I found on YouTube will make up for any deficiencies that I shamelessly exposed in my introduction above.

Acquisitions, Funding, Business, and Stock

Skylight Healthcare Systems, a provider of interactive patient systems, raises $5 million in Series D financing.


The New York eHealth Collaborative selects MedAllies to operate its Direct Solution on the Statewide HIN of NY.

CMS awards HP a $43 million task order to continue providing IT services for the EHR incentive program and for maintaining the CMS Integrated Data Repository database.

9-20-2012 9-17-21 PM

Loma Linda University Medical Center (CA) selects Nuvon to provide medical device connectivity and interoperability as it migrates its OR, ICU, and dialysis center to Epic.

The VA awards Systems Made Simple (SMS) a $27 million renewal contract to support the Veterans Service Network program and Benefits Gateway System development project.


9-20-2012 4-54-04 PM

Bill Conroy joins Kareo’s board, a position he also holds for Prognosis Health Information Systems and Phreesia.

9-20-2012 9-32-24 PM

Ben-Tzion Karsh, a University of Wisconsin-Madison professor of engineering and one of the authors of the IOM article on EHR experience reporting that I mentioned above, died last month at 40.

Announcements and Implementations

INTEGRIS Health (OK) implements PatientSecure by HT Systems for biometric palm scanning.

Intelligent Medical Objects announces a search engine appliance to deliver just-in-time secure terminology services at the point of care.

Elsevier releases a version of its ClinicalKey reference system aimed at individual clinicians, which features information from 900 textbooks and 500 medical journals covering 41 specialties.

In Canada, three-employee Clinisys launches its first product, a cloud-based EMR.

9-20-2012 9-35-55 PM

New in the AMA’s CPT 2013 data file: consumer-friendly descriptors of each CPT code for patients and caregivers.

9-20-2012 8-29-52 PM

Santa Fe-based Seamless Medical Systems launches an iPad app for physician waiting rooms that allows patients to complete their forms online, review educational material, take notes during the visit and e-mail them to themselves, and play games.

Government and Politics

Sen. John Kerry (D-MA) introduces MITECH, a bill that expands the MU program to include safety net clinics that don’t necessarily qualify under the Medicaid incentive program. Kerry’s legislation would allow providers to qualify for incentives if at least 30 percent of their patient volume comes from lower-income patients.

ONC posts the vendors who signed up for the Blue Button Pledge (Alere Wellogic, Allscripts, athenahealth, AZZLY, Cerner, eClinicalWorks, Greenway, Intellicure, NextGen, and SOAPware) and invites other vendors to tweet their #VDTnow pledge to be added. Above is Farzad Mostashari’s welcome to the Consumer Health IT Summit where the companies were announced.

9-20-2012 8-34-49 PM

The US Army tests real-time medical communication software that uses mobile devices and 4G networks to support battlefield medics treating severely wounded solders. Portable physiologic monitors are used to to send streaming video, voice, and photos, along with treatment records, to surgeons that in real-life situations would be located in remote hospitals.

Innovation and Research

Mobile health apps that help manage medications and blood glucose are linked to improved diabetes management in socially disadvantaged populations.


The board of directors of the Kansas HIE votes to transfer its duties to the Kansas Department of Health and Environment by October, 2013, which will save $350,000 a year.

The Joint Commission designates 620 hospitals as top performers on 45 evidence-based care processes closely linked to positive outcomes.

Joe Goedert of Health Data Management wrote a rebuttal to the Soumerai and Koppel editorial that ran in The Wall Street Journal this week called A Major Glitch for Digitized Health-Care Records. Joe mentioned some of the same points I did in my criticism of the editorial and the studies it selectively cited, but added quite a few more in Bad Research Shouldn’t Affect Good Policy. I respect the opinions of the authors and I’m as cynical as the next guy, but the editorial had just enough citations to possibly fool someone into thinking that it was new research (or that the old research mentioned was actually well done, which it wasn’t.) My criteria for assessing the objectivity of articles on almost any contentious topic (religion, politics, sports, or healthcare IT) is this: if the authors never give credibility to anything that doesn’t match their own beliefs, then I simply don’t bother reading because I already know what they’re going to say. I should note, though, that Ross Koppel was one of the authors of the IOM report on EHR problem reporting that I mentioned above and that’s a nice credit.

Job postings for healthcare professionals with EHR skills have jumped 31 percent over the last year.

Georgia Tech is offering a free, online Health Informatics in the Cloud class taught by Mark Braunstein MD, who has more relevant experience than anyone I can think of. Students don’t need a technical background – just five to seven hours per week for 10 weeks. The class is offered via Coursera, an online education startup that has already enrolled 1.5 million students in its “massive open online courses.” Its partners include Brown, Columbia, Stanford, Penn, and other topnotch schools that aren’t ordinarily interested in giving away their courses for free. This looks really good, especially for folks who don’t have a lot of formal healthcare IT education on their resume.

The family of a man who died in the ED of Beebe Medical Center (DE) files suit against the hospital and the ED staffing company it uses. The patient was discharged from the ED after being seen for chest pain, but he made it no further than a chair in the lobby before dying of a heart attack while waiting for a ride. Nobody noticed until hours later.

People who have eaten in Epic’s cafeteria will enjoy this profile of Executive Chef Eric Rupert (not celebrity French chef Eric Ripert, although I’m sure Epic could afford him if they wanted). The chef says Judy is a serious foodie — the only non-chef he’ll talk to about food — and she insists that Epic’s employees and visitors be fed well. He leads a staff of 78 Epic employees and describes the company environment: “There really is very little hierarchy here. You’re either a team member or a team leader, and the team leaders do everything that team members do, and then they also manage people. It’s not considered a promotion to go from a team member to a team leader; it’s just additional responsibilities.” He says Epic is different from its Silicon Valley counterparts in that employees pay the cost of ingredients for their meals instead of getting them for free, and everything is made in-house, even the baked goods. But like Google and other high-tech companies, Epic uses their food as a recruiting tool and has a diverse group of employees to feed, representing 55 countries.

Inga masquerades as Weird News Andy in finding this story. A Colorado man sues several food companies for “popcorn lung,” claiming that he ate microwave popcorn for years and the artificial butter fumes damaged his lungs. The jury, who apparently didn’t find his years of exposure to carpet-cleaning chemicals to be contributory, awards him $7 million. Inga adds that she hopes he gets his money in a Jiffy.

Epic UGM Report
By David Miller

Dave Miller, vice chancellor and CIO of University of Arkansas for Medical Sciences, e-mailed me privately about Epic’s UGM. I asked him if I could run his comments on HIStalk since non-Epic customers are always mystified by the company’s cult-like following. If you were one of the 8,000 UGM customer attendees and would care to share your thoughts about why it’s different than other user group meetings you’ve attended, I’d like to hear from you.

I have been to a number of UGMs at Epic, though it has been about three years since my last one. I am always amazed at the creativity of the Epic staff and the almost flawless way in which they execute the logistics to handle almost 8,000 users.

It continues to be primarily a user-driven event, from the advisory councils to the UGM sessions and even to the entertainment. The sessions themselves demonstrate the excitement that their users feel with what they have been able to do with one of the top healthcare IT products.

At the end of the day, it really comes down to Epic’s ability to instill their culture in each and every employee. Their simple focus on customer service was demonstrated by every employee I encountered. They had people stationed everywhere on campus to give directions, to drive golf carts to your destination, or just about anything else you needed.

I actually did not see a lot of Judy, but when she was present, she cheerfully took pictures with about anyone who would ask. Pretty amazing for a CEO of that stature. In my experience, most individuals in her position are self-absorbed and would never mingle like she does. I’ve also known Carl Dvorak for about 15 years, and he is about the most down-to-earth individual you would ever want to meet.

Judy creates an atmosphere for her employees that encourages and enables them to be at their creative best. The end result is a really good set of tools to manage the complexity of issues that healthcare organizations deal with every single day. Yes, there are imperfections, but they are so outweighed by the positives that they become irrelevant.

They used to say that no CFO ever got fired for hiring a Big 8 firm. Short of having someone completely inept in that role, I think I would say the same thing about a CIO.

Sponsor Updates

9-20-2012 9-24-10 PM

  • ChartWise Medical Systems profiles Jennie Stuart Medical Center (KY) and its use of ChartWise:CDI to improve documentation an reporting.
  • SuccessEHS reports that more than 10 percent of its EHR and PM client are now using its RCM services.
  • Health Care DataWorks offers a September 25 webinar on CMS’s Value-Based Purchasing program.
  • DrFirst offers Meaningful Use webinars over the next three weeks covering avoiding penalties, data exchange, the EHR as a clinical tool, and clinical quality measures.
  • Orion Health’s portal solution for Alberta Netcare reaches 100 million views since its 2006 implementation.
  • Versus features Northwest Michigan Surgery Center in its October 17 Webinar on maximizing patient flow with RTLS.
  • TELUS Health Solutions and Sun Life Financial launch an eClaims solution for extended care providers across Canada.
  • The Web Marketing Association recognizes CareTech Solutions as Outstanding Website Developer for winning nine WebAwards in 2012.
  • CommVault joins The Association of Certified E-Discovery Specialists as an affiliate member.
  • Awarepoint integrates its awareED module with Rauland Responder’s nurse call system.
  • CDN Channel Elite recognizes NexJ Systems with gold awards for best cloud computing and best mobile solutions.
  • MEDSEEK hosts roundtable discussions on marketing’s role in MU at this week’s Society for Healthcare Strategy and Market Development conference.
  • Greenway hosts a Webinar series addressing the trends of electronification, consumerism, and improving population health.  
  • Lifepoint Informatics will sponsor the Pathology Informatics 2012 conference in Chicago October 9-12.

EPtalk by Dr. Jayne

I read a variety of newsletters in an attempt to keep up. I got a chuckle out of a pair of articles in a single e-mail. The first article suggests evening and weekend appointments as a way to reduce annual medical expenses. It calls for physicians to “rearrange schedules to offer greater availability when patients are off work.” Just a few blurbs down, another piece by the same author discusses recent survey findings that new physicians find a four-day work week highly desirable.

I’m guessing that many of those that want a four-day week don’t intend for it to be made up of weekends or evenings. Most of my colleagues who run 10-hour days see patients 7:00 a.m. to 5:00 p.m. Even though running extended hours with more providers increases utilize of office space and changes the overhead profile, I don’t see it luring providers without a change in the compensation model.

I used to have evening hours in my practice. I didn’t mind it, but it was extremely hard on my staff, who struggled to find child care after 6:00 p.m. Just another illustration of why fixing the access issue isn’t as simple as it initially seems.


It’s not health IT, but it’s a great story. A British teenager floats his own science platform 20 miles into the atmosphere, capturing amazing photos with a camera he bought on eBay. The camera and other instruments survived a 150 mph descent and were recovered about 30 miles from the launch site.

Midmark @MidmarkNews tweeted yesterday about vitals workflows based on research findings. I’m all about evidence-based medicine, so it got my attention. Their brochure documents some interesting findings from a study they did on efficiency and accuracy of vital signs capture. Covering both manual and EHR-integrated automated devices, their data parallels what I’ve seen in practice. Even though it’s a sales piece, I liked their use of workflow diagrams. They point out some of the problems with the design of the average physician office: lack of space to place belongings when standing on the scale, facilities that aren’t conducive to accompanying family members, and workflow bottlenecks. I unfortunately work with a healthcare architect that is still designing exam rooms from the 1950s. I think I’ll leave a copy on his desk anonymously.

I seem to be getting farther and farther behind on e-mail. I’m not sure how Mr. H does it, but I must get him to teach me his secrets. Reader Dr. Nurse responded to my piece on why IT alone will not fix health care:

I have mild Crohn’s disease, so I get the wonderful privilege of having every-other-year colonoscopies. Being the dutiful patient I am, when my PCP reminds me it is “time,” I schedule my appointment. I called our local hospital to schedule the appointment. Despite their Epic implementation, which allows them to view my history, insurance coverage, PCP info, etc. the scheduler informed me that I could not self-refer for a colonoscopy and would need to have a doctor’s order faxed from my PCP’s office. I told her my insurance (BCBS) did indeed allow me to schedule such tests, but she refused.

She goes on to share a tale of woe spanning two weeks, ending with a procedure at an independent outpatient clinic and a letter of complaint to the hospital that resulted in a “horrified” apology from the hospital’s VP of client services. She asks, “If I have excellent insurance and they insist on placing such silly barriers to care in front of me, what do less-privileged people do?”

That is exactly the kind of problem solving we need to be working on in tandem with IT. Let’s leverage real-time eligibility, medical necessity determination, and clinical histories to knock down the barriers.

Do you have a story about integrated care that works well? E-mail me.



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

More news: HIStalk Practice, HIStalk Mobile.

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Top News

9-18-2012 10-03-17 PM

Massachusetts Eye and Ear Infirmary and its physician group will pay HHS $1.5 million to settle potential HIPAA violations following the theft of an unencrypted laptop containing electronic PHI of patients and research subjects.

Reader Comments

9-18-2012 3-47-27 PM

inga_small From Honky Cat: “Re: Waiting in line at Apple. Don’t wait in line for your iPhone upgrade. Go to this link and pre-order your phone. They will ship it to you in two to three weeks. Surely you can wait that long for it.” I considered setting my alarm to be one of the first people to go online last Friday and place an order. Instead, I slept in and waited until 6:00 am to get online. By that time Apple had stopped taking orders to reserve the iPhone 5s for pick up at the local Apple store, so I’ll wait for mine to be delivered in a couple of weeks. Apple, by the way, sold two million iPhone 5s in the first 24 hours of pre-orders, more than double the previous record set in 2011.

9-18-2012 6-11-25 PM

From The PACS Designer: “Re: mobile image viewing. TPD congratulates Aycan Medical Systems for being one of the first to gain FDA approval for its Aycan Mobile for the iPad. Now that the FDA is involved with mobile solutions, we’ll see more teleradiology mobile solution approvals for other vendors.“

From Steve: “Re: QuadraMed. To be sold in the next 7-10 days.” Unverified.

From Pointer: “Re: EHRs. A vendor-agnostic viewpoint on how they don’t change the cost curve.” It may be vendor-agnostic, but this particular article is a clearly labeled opinion piece written by authors who have been historically negative toward EMRs, EMR vendors, and government. They are entitled to their opinions, but recognize them as such despite the bait-and-switch newspaper headline trumpeting “A Major Glitch.” Their editorial conclusion is accurate, though – most studies have failed to prove that EMRs save money (I haven’t seen any studies that convinced me that paper records save money or improve outcomes either, of course.) That’s not to say they don’t, only that it’s tough to prove since nothing in healthcare stays unchanged long enough to get a baseline. It’s also true that expecting technology alone to create savings without changing incentives is unreasonable. I agree with the authors that blowing taxpayer billions to get providers to buy software they weren’t willing to spend their own money on was illogical, but no amount of Monday morning quarterbacking will bring that cash back or cause providers to toss their EMRs out the nearest window. It’s time to move on, realize that healthcare IT is here to stay, and constructively make it better instead of hand-wringing. Like everything else, the industry has 10% cheerleaders, 10% naysayers, and 80% rational people who don’t need the self-proclaimed experts on either end of the spectrum to tell them what to think or do. If you’re a provider, choose EMR or paper as you desire, do something innovative with it that improves outcomes and reduces costs, and then write your own article. That’s the one I’d rather read.

From Looking Deeper: “Re: patient portals and self-scheduling. I install patient portals for a living, including scheduling. There really aren’t technical challenges any more. Providing convenient, immediate online scheduling is a solved problem even in healthcare, especially in primary care. The problem is in people’s heads. Whenever online scheduling comes up, physicians and clinic staff will tell you that their patients can’t possibly handle it – they’ll schedule the wrong kind of visit (office visit vs. physical) or create some other vague problem. I dutifully inform them that online scheduling is working fine in clinics and practices across the nation. ‘Other clinics find that their patients can handle this,’ I always say. They usually say, ‘Not our patients.’ Interestingly, clinics serving less-affluent areas and the indigent tend to be more in favor of such patient-centric services. ‘Our patients are an especially incompetent group’ is a pretty negative view to hold of the people you’re trying to care for. If we could just get past this attitude, pretty much all primary care visits could be scheduled online. In the rare case where something needs to change, the clinic can call or e-mail the patient and reschedule, but that’s less than 5 percent of appointments scheduled online. Specialty and procedure visits are a different beast and need some careful analysis before they are opened up to online scheduling, but online scheduling for primary care is a solved problem.”

HIStalk Announcements and Requests

inga_small I have newfound respect for anyone working with insurance companies to secure payments. I had mentioned a few months ago that I had a minor medical procedure that resulted in some complications, lots of doctor office visits, and about 20 different medical claims. I was lucky enough to have both primary and secondary coverage in place since the claims were in the thousands. I also thought I was lucky because both policies were from the same very big insurance company. Unfortunately, the insurance company has spent the last four months trying to decide internally which policy should be primary, and so far no claims coordination has occurred. After several weeks of hour-long phone calls, yesterday I finally turned “not nice” and demanded to speak to a supervisor. I explained that I didn’t give a (expletive) which policy was primary or secondary, it was all one insurance company, and the (expletive) claims needed to be paid. I actually believe the claims will finally be processed correctly. The moral of this story is that if you work in a hospital or practice, take a moment to say thanks to your billing and collection staff. And bring them chocolate on a regular basis.

I don’t know about you, but I’ve been busy turning off all my Facebook and Twitter connections to folks who keep preaching politics. Has anybody ever convinced someone to change their political beliefs by proudly posting a Facebook link to the latest nut-job partisan article? Actually, they sometimes almost convince me to vote the other way out of annoyance.

9-18-2012 8-38-27 PM

Thanks to Healthcare Quality Catalyst supporting HIStalk as a Platinum Sponsor. The Salt Lake City company offers a practical clinical data warehouse solution that combine technology and clinical improvement methodologies to improve care. The information needed to answer a clinical improvement question is scattered in most hospitals (satisfaction surveys, Epic Clarity transactions, and lab and prescription information, for example) and HQC puts it together in its Adaptive Data Warehouse and subject-specific data marts (such as women and newborns) to support continuous, evidence-based care improvements. HQC offers more than just the tools, supplying clinical improvement methodologies such as role definitions and process templates to create effective improvement teams. If you’ve been around the industry for some time, you surely know some of their folks: Todd Cozzens, Larry Grandia, Dale Sanders, Bruce Turkstra, and David Burton, MD were some of those I immediately recognized. I interviewed co-founder and CIO Steve Barlow a year ago and got a good background on the company. Thanks to Healthcare Quality Catalyst for supporting HIStalk.

I naturally cruised over to YouTube and found this video that introduces Healthcare Quality Catalyst better than I did.

Acquisitions, Funding, Business, and Stock

9-18-2012 6-02-11 PM

PE firm ABRY Partners makes a “significant” investment in SourceMedical Solutions, a provider of software and services for ASCs and rehab centers.

In England, a company that commercializes university research invests in an Oxford spinoff whose software that can monitor pulse, respiration, and oxygen saturation using only a webcam.

Also in England, eHealth Insider reports that CSC will stop selling iSoft GP systems to NHS markets, in which it has 582 practice customers. CSC denies the report.

Vipaar, which sells surgery proctoring software based on technology developed at the University of Alabama at Birmingham medical school, raises half of its $1.2 million funding goal.


9-18-2012 6-03-58 PM

Community Medical Center (NE) selects BridgeHead Software’s Healthcare Data Management Solution for backup and archiving.

CommUnity Care (TX) will deploy NextGen RCM Services throughout its 22 clinics.

9-18-2012 7-47-39 PM

Pemiscot Memorial Health Systems will expand its deployment of Prognosis Health Information System by implementing its financial system and its laboratory information system powered by Orchard.

Community Hospital Grand Junction (CO) chooses the perioperative system of Surgical Information Systems.


 9-18-2012 10-51-46 AM

Zotec Partners hires Kristy Floyd (American Society of Anesthesiologists) as director of anesthesia business development.

9-18-2012 11-13-49 AM

The Medical College of Wisconsin appoints David C. Hotchkiss (University of Texas Health Science Center) VP/CIO.

9-18-2012 3-28-44 PM

Healthland names Patrick Spangler (Epocrates) CFO.

9-18-2012 8-19-54 PM

Douglas Billian, founder of Billian Publishing, died September 15 at 84.

Announcements and Implementations

9-18-2012 6-05-42 PM

HIMSS Analytics recognizes Fort HealthCare (WI) with its Stage 7 Award for EMR adoption.

Providence Medford Medical Center and Asante Rogue Regional Medical Center (OR) will complete their hospital and clinic implementations of Epic in April.

9-18-2012 6-06-34 PM

Nuance will purchase Ditech Networks, a provider of voice technologies and voice-to-text services, for $22.5 million.

AMA releases the 2013 CPT code set, which goes into effect for claims filed as of January 1, 2013.

Certify Data Systems announces the general availability of its HealthLogix HIE platform, which it says is the first to deliver an aggregated patient view from all community health encounters regardless of EHR.

9-18-2012 6-08-43 PM

Cincinnati Children’s Hospital Medical Center (OH) implements Passport Health’s PatientSimple and Smart Statement online billing solutions.

9-18-2012 6-01-14 PM

eClinicalWorks launches its $10 million open, secure collaboration platform that works with any EHR or even paper-based practices. The NHIN Direct-compatible network allows members to transmit electronic referrals and patient records with attachments.

Government and Politics

ONC posts the second wave of draft test procedures for the 2014 Edition EHR certification criteria.

I don’t think Farzad ever followed through on his promise to name the EMR vendors who took his #VDTnow pledge to allow patients to view, download, and transmit their medical information. Claudia Williams of ONC tweeted her list, which I assume is complete: Allscripts, NextGen, AlereWellogic, Intellicure, eClinicalWorks, Greenway, SOAPware, athenahealth, Azzly, and Cerner. Conspicuously but not surprisingly missing is Epic, which doesn’t even have a Twitter account as far as I know. Maybe they already offer the capability as some have suggested, but if so, all they had to do was tweet out their already-met pledge. Judy’s on ONC’s Health IT Policy Committee, after all.

Innovation and Research

The National Library of Medicine awards The Ohio State University College of Medicine’s Department of Biomedical Informatics $1.3 million to develop a system that uses EHRs to identify potential patients for clinical trials.


inga_small Wider use of EHRs over the last decade may be contributing to a growing up-coding trend that has added $11 billion to healthcare costs. Physicians argue the higher codes are justified because care of seniors has become more complex and technology allows them to code more accurately. Critics say the findings suggest billing abuse and fraud. I I were still selling EMRs, I’d be handing this study to doctors and touting it as proof that technology is helping physicians bill and be paid for the actual care provided. Meanwhile, naysayers like Mr. H will probably dig deeper and suggest objections to such hasty conclusions.

inga_small Hell hath no fury: a Washington dermatologist wins a $600,000 settlement and a rare apology from state health officials who had investigated him for drug abuse and medical fraud. An anonymous tipster had reported that the doctor was falsifying drug records, using cocaine, and running in-office orgies among his staff, patients, and prostitutes. In a separate lawsuit, the doctor was award more than $100,000 from his former wife, who turned out to be the anonymous tipster who had filed the complaint late in the couple’s bitter divorce proceedings.

The folks from Arizona Associated Surgeons sent over their video for the Western Users Group meeting at ACE (the Allscripts user meeting) last month.

9-18-2012 9-03-09 PM

Want to rub elbows with sexy celebrities on your hospital employer’s dime? CHIME’s Fall CIO Forum will feature Olympic beach volleyball gold medalists Misty May-Treanor and Kerri Walsh Jennings, mostly known for leaping around nearly naked in prime time reminiscent of the much-beloved “Girls on Trampolines” segment of The Man Show except with smaller bikinis. Misty and Kerri (or was that Misti and Kerry?) will discuss Meaningful Use Stage 2 and … no, wait, they’ll pose with star-struck CIOs, sign autographs, and collect a big non-amateur payday courtesy of patients who pay $5 for an aspirin.

A group of 30+ physicians labeling themselves as “Doccupy” complain to Contra Costa, CA county supervisors about the $45 million implementation of Epic at its hospitals. They said 10 percent of ED patients are leaving without seeing a doctor, a number that increased after the hospital’s July 1 go-live as the average time in the ED increased from three hours to four. Patient loads were cut in half to prepare for the implementation, but the doctors claim that several of their peers still quit because of stress, saying, “We were not ready for Epic and Epic was not ready for us.” An ED physician going off shift said she still had documentation to complete for 16 patients, adding, “It’s going to implode.” Some doctors spoke up about the advantages of Epic, and all agreed that it’s important to have an integrated electronic record. Detention facility nurses had complained about Epic to the supervisors last month.

9-18-2012 8-15-51 PM

The Cure JM Foundation (juvenile myositis) is in the running for a $250K research grant that will go to the charity with the highest number of Facebook votes. Information and voting links are here. Several HIT folks I’ve heard from have children with JM and I’m sure they would appreciate your vote.

Patients storm Charlton Memorial Hospital (GA) after a contracted collection company incorrectly manipulates the hospital-provided data file, sending patients collection notices for bills they don’t owe.

9-18-2012 9-52-28 PM

Of the seven highest-earning non-profit CEOs in the country, four run hospitals, according to the Chronicle of Philanthropy. I think they’ve missed a few since I’ve seen several hospital tax forms with CEO salaries above these figures.

9-18-2012 9-22-57 PM

Bloomberg Businessweek profiles Terry Ragon, founder of the Boston-based InterSystems, which sells the Cache’ database that runs Epic, Meditech, and quite a few other MUMPS-based healthcare systems. The article calls Ragon a “Hidden Software Billionaire,” estimating the value of the company he directly owns at $2 billion.

9-18-2012 8-32-54 PM

Here’s a fun coincidence. Dave Miller, vice chancellor and CIO of the University of Arkansas for Medical Sciences, sent over the above video of him doing a nice cover of “Mustang Sally” at Epic’s UGM (his wife had the camera 90 degrees off kilter for a few seconds, but his singing was fine). The day they got back home, he impulsively bought some raffle tickets from a charity fundraiser. He won the prize, which was made in 1967, the same year Wilson Pickett released “Mustang Sally” on an album – a classic Ford Mustang.

Sponsor Updates

  • SuccessEHR grows its RCM services business 92 percent over the last year.
  • First Databank hosts its 2012 FDB Customer Seminar this week in San Diego.
  • T-System offers Webinars this week on  improving ED throughput.
  • Melanie Pita JD, EVP of product management at Prognosis Health Information Systems, presented a session on EHRs and Meaningful Use at the Georgia Rural Health Association conference this week at Callaway Gardens.
  • TeraRecon is exhibiting its advanced visualization solutions for medical imaging this week at CIRSE 2012 in Lisbon, Portugal.
  • Michigan Health Connect HIE and Greenway Medical will provide data exchange between Greenway’s PrimeSUITE customers and hospitals on the Michigan Health Connect platform.   
  • MedPlus offers a three-part Webinar series hosted by Steven Waldren, MD, director of the AAFP’s Center for Health IT.
  • White Plume releases a white paper discussing practical considerations to minimize losses while migrating to ICD-10.
  • ChartWise Medical Systems unveils its ChartWise:CDI software at this month’s AHIMA convention in Chicago.
  • Orion Health opens an office in Singapore for development and technical support employees.


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

More news: HIStalk Practice, HIStalk Mobile.

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September 18, 2012 News 6 Comments

News 9/14/12

September 13, 2012 News 6 Comments

Top News

9-13-2012 8-59-31 PM

Mediware will be acquired by PE firm Thoma Bravo LLC for $195 million, the company announced Wednesday. The $22 per share cash offer represents a 40% premium over Tuesday’s closing price.

Reader Comments

From Shades of Green: “Re: RECs and EPs. You point out that only 17,144 EPs have demonstrated Meaningful Use through the REC program. I did a little digging and found that total grants for RECs to date (which does include some funding for rural hospitals) is $706 million. That comes to $41,181 for each of the 17,144 EPs demonstrating Meaningful Use.”

9-13-2012 6-35-59 PM

From N2InformaticsRN: “Re: MappyHealth. You mentioned a few weeks back our entry into the HHS NowTrending 2012 Challenge. I have an update – we won! Not bad for two nurse informaticists and a computer science student.” Social Health Insights LLC’s free application mines real-time tweets via Twitter’s open APIs to serve as an surveillance system for emerging health issues. The challenge, which drew 33 entries, was created by HHS after it observed that social media trends can be correlated to disease outbreak. The team is Brian Norris, Charles Boicey, and Mark Silverberg. I’m sure they are keeping their fingers crossed that their app doesn’t get hosed as Twitter continues to reduce the functionality and terms of service of its APIs in hopes of monetizing tweets instead of allowing others to build applications around them. Several small companies whose only products were Twitter add-ons have already gone belly up when their data hose went dry.

From The PACS Designer: “Re: iPhone 5. Faster, thinner, 4” display, and iOS 6. Apple is prepared to meet Q4 demand by preparing suppliers to ship as many as 50 million of them in the quarter.” The only Apple products I own are an iPad and a Nano, but I still watch blow-by-blow live-blogging of every Apple announcement, which is an indication of how dramatic Apple makes their unveilings (not to mention how well they keep those huge, world-impacting announcements a secret, which is truly amazing to me). I can’t think of any reason I should care given that I’m not in the market for new Apple products, but I still do. I’m not convinced that the iPhone 5 is better than some of the Samsung or other Android phones (many of the new iPhone features have been on Android for a long time, leading some analysts to openly ridicule Apple for under-delivering), but I can safely predict that the fanboys will be camping out at the Apple store next Thursday night (what recession?) I read the other day that Apple’s iPhone sales volume alone is bigger than all of Microsoft.

9-13-2012 9-25-16 PM

From Arnold: “Re: KLAS report on Epic consulting firms. They just posted an update saying one firm has been removed because KLAS mistakenly gave them credit for another company’s survey. How shoddy, and it isn’t the first time we’ve seen this kind of mistake.” I blurred the company’s name on the KLAS announcement since it’s a good news/bad news thing – in removing some other company’s negative survey, this company’s score went up, but then it didn’t have enough surveys, so KLAS removed it completely from the updated report.

From Blue Dog: “Re: Allscripts Enterprise EHR. Heard CHS in Oklahoma City had a great implementation and they are re-looking at using it in other markets. They had a huge contractor downsizing and had postponed or shifted to athenaclinicals in many markets.” Unverified.  

HIStalk Announcements and Requests

inga_small This week’s HIStalk Practice highlights include an example of “EMR garbage.” Opinions on why specialists may seek MU incentives less often than primary care providers. Healthcare expenditures fall when patients have more access to office-based care after hours. An internal medicine physician grades his EHR. More feedback from the HIStalk Practice Advisory Panel on the ACA’s potential impact on patient volumes. Culbert Healthcare Solutions VP Jeff Wasserman offers strategies to help independent practices enjoy the financial benefits of quality-based care. Thanks for reading.

inga_small Despite the inconvenience of the new adapter, I am ready to take advantage of the $199 option to upgrade my iPhone 4 to the 5. The fast-draining battery has always been my biggest gripe with the iPhone, so longer battery life is the most appealing new feature. A bigger display will also be nice and I am envisioning all the cool panoramic photos I’ll be able to take at the upcoming MGMA meeting. I’ll be one of the geeks standing in line at the Apple store on September 21.

I was waiting for the elevator at work today with the “going up” button lit. As I stood patiently, some guy charged around me and gave the already-lit button several quick jabs. Do you suppose he thinks there’s an algorithm built in that gives preference to the number of times the button is pushed, does he harbor suspicions that elevator lights are rigged, or is he just an impatient jerk who assumes I’m not capable of pushing the button correctly?

Acquisitions, Funding, Business, and Stock

9-13-2012 9-03-00 PM

Streamline Health reports Q2 results: revenue up 22%, EPS –$0.04 vs. $0.00.

MRO Corp. acquires the assets of Florida Medical Records Services, a provider of release of information services.

9-13-2012 9-04-19 PM

Athenahealth signs a definitive agreement to acquire Healthcare Data Services, a provider of healthcare data analysis and population health management solutions for payers and providers.

Nightingale Informatix secures $2.75 million in Series B funding.

In England, mental health EHR vendor Strand Technology is acquired by Advanced Computer Software Group for $3 million.


9-13-2012 9-18-00 PM

Community Hospital Anderson will use Summit Healthcare’s Express Connect and Provider Exchange technology  for internal and bi-directional integration with its Meditech system.

Cherry County Hospital (NE) chooses Access Intelligent Forms Suite for electronic forms management as it migrates to Meditech 6.0.

The Federal Economic Development Agency will use the Connected Wellness Platform of NexJ Systems for its Connected Health and Wellness Project.

Fort Drum Regional Health Planning Organization (NY) selects Wellcentive to provide disease registry, case management, and predictive analytics.

9-13-2012 9-19-40 PM

Anne Arundel Medical Center (MD) chooses Medseek’s ecoSmart Patient Precisioning CRM solution for patient engagement and education.

9-13-2012 9-21-00 PM

Key-Whitman Eye Center (TX) selects Versus Advantages RTLS to track patient progression and staff workflows.

HealthEast Care System (MN) chooses Humedica for its ACO and PCMH initiatives.


9-13-2012 7-04-15 PM

Lance Fusacchia (Webmedx) joins Shareable Ink as CFO.

9-13-2012 7-04-53 PM

CHIME awards its State Advocacy Award to Texas Health Resources SVP/CIO Ed Marx.

9-13-2012 8-36-50 PM

Tom Penno (Indiana HIE) joins NoMoreClipboard as VP of channel management.

SuccessEHS promotes Lori Junkins and Elizabeth Featheringill Pharo to VP and Elizabeth Pitman to general counsel.

9-13-2012 7-44-00 PM

Jim Speros, who led the VA’s innovation prize contests and promoted its use of Blue Button, died September 3 at 59.

John Cox, former CIO at the Hospital for Special Surgery (NY), died September 12.

Announcements and Implementations

HIMSS names Hawai’i Pacific Health the winner of the 2012 Enterprise HIMSS Davies Award of Excellence.

9-13-2012 7-13-46 PM

In the UK, Moorfields Eye Hospital NHS Foundation Trust adds three modules to OpenEyes, its self-developed, open source patient management system. The new modules include surgical notes, discharge letters, and prescriptions.

Government and Politics

HHS announces $983,100 in grants to support improved healthcare access and coordination for veterans living in rural areas using telehealth and health information exchanges.

HHS Secretary Kathleen Sebelius admits to violating the Hatch Act, a federal law that restricts the political activity by government employees. Sebelius called for the re-election of President Obama at a February speech to a gay rights group. Sebelius has apologized and the Democratic National Committee has reimbursed the government for the cost of her trip.

9-13-2012 9-29-20 PM

ONC’s blog urges nurses to request a copy of their own electronic health record, verify the accuracy of its contents, and sign an online pledge. I suspect few of us in healthcare IT have requested electronic copies of our information, so I will post this as a challenge of my own to all readers. Request a copy of your EHR information and let me know how the process went – how convoluted the request process was, how long it took, and how accurate and complete your information was. I’ll run anything you send me. Somehow I think that, like almost everything related to healthcare, it doesn’t work nearly as well as patients have a right to expect. It’s not exactly Golden Rule territory.

9-13-2012 8-21-35 PM

ONC releases its educational security training game for medical practices. I played it and it’s pretty cool.

Medicare says it won’t pay providers based on copied-and-pasted patient notes.


9-13-2012 8-14-33 PM

Beth Israel Deaconess Medical Center is named the #1 company in the InformationWeek 500 list of the most innovative users of business technology. Other healthcare organizations in the top 50 include Quintiles (#6), Sparrow Health System (#16), Premier Inc. (#30), Miami Children’s Hospital (#31), RadNet (#32), McKesson (#34), Intermountain Healthcare (#48), Kindred Healthcare (#48), and Sharp HealthCare (#50).

CareCloud will establish a Massachusetts office to take advantage of the region’s technical talent.

I said in January when US CTO Aneesh Chopra resigned that I expected him to run for lieutenant governor of Virginia, but instead he went back his previous employer, The Advisory Board Company. I should have paid more attention to the election calendar: the election is in 2013 and he has announced as a Democratic candidate for that office.

A Financial Times article called “Healthcare: Cyber wards” covers Silicon Valley companies trying to break into healthcare. It doesn’t contain anything all that interesting, but it does quote an entrepreneur who says VCs are still wary of investing in companies because of long healthcare sales cycles and their previous experience with products that were never perfected.

University of Minnesota Medical Center, Fairview violated patient protection and EMTALA laws by its aggressive collections tactics overseen by Accretive Health, a federal investigation finds. Fairview says they “continue to learn from this experience.” Shares in Accretive were down 11% Thursday on the news, by far the biggest percentage loser on the NYSE. The company had already paid a $2.5 million fine and agreed to cease operations in Minnesota. Shares owned by founder and CEO Mary Tolan  are still worth $108 million.

9-13-2012 6-49-43 PM

Weird News Andy is convinced that being real smart doesn’t preclude being real stupid. Richard Keller MD, a pediatric endocrinologist and Harvard Medical School instructor (WNA summarizes as “a vile human being,” at least assuming he’s found guilty), is arrested when a package containing 50 DVDs of child pornography is delivered to his attention at Phillips Academy, where he was medical director until last year. He might be one of few people whose life goes directly into the toilet because he forgot to update his shipping address or perhaps had the misfortune of back-ordered porn.

Markle Foundation puts out a video promoting the consumer use of Blue Button.

9-13-2012 7-20-42 PM

The computer hacker / brain tumor patient in Italy who cracked the proprietary formats of his electronic medical records so he could post them publicly to seek help has updated his site with the ideas he has received so far. It’s getting interesting – he’s about to publish a tutorial explaining the quirks he found with DICOM images and he’s putting out some rather eloquent ideas about health and technology:

The definition of "diseases" is "reserved" to doctors. Often using words which we don’t understand and, most important of all, touching only a part of the human condition, which is made from body, but also of spirit and sociality. The DICOM format is open, yes, but in a very "peculiar" condition of openness: it is like the openness of the words which they use to tell you about your health condition, and with which they describe and actuate their version of the "cure": you can’t understand it, you can’t reuse it, you can’t combine it with other possibilities. It is thought for "experts" and "professionals" (of one single type), leaving little space for other possibilities for expression and socialization … Maybe we could start to think about an "open" world in this sense, too, not dedicated to "professionals" and "procedures", but also to human beings.

Sponsor Updates

9-13-2012 8-09-14 PM

  • Vonlay created a Web page featuring live tweets and photos from the Epic UGM this week.
  • PDR Network announces that its flagship service meets Meaningful Use Stage 2 requirements in delivering real-time FDA drug safety alerts and product program information at the point of prescribing.
  • More than 50 employees from the Burlington, VT office of Allscripts will take part in a Habitat for Humanity build this week.
  • Amerinet makes McKesson’s pharmacy automation solutions available to its 3,000 hospital members.
  • Intelligent InSites integrates its RTLS with Haldor’s ORLocate surgical instrument tagging to offer a surgical instrument management and tracking solution.
  • Lifepoint Informatics announces its Silver Level sponsorship of next month’s Pathology Informatics 2012 conference in Chicago.
  • LDM will provide consumer medication information from Polyglot Systems in its point-of-care messaging solutions.
  • HIStalk sponsors Allscripts, NTT Data (formerly Keane Inc.), and World Wide Technology earn spots on the annual InformationWeek 500 list of innovative business technology users .
  • Forbes cites Greenway as being “ahead of the pack” in delivering information exchange and interoperability between its PrimeSUITE and the EHRs of other vendors.
  • Orion Health will incorporate images from Agfa’s clinical imaging platform into its clinical portal.
  • DrFirst and Meditech will demonstrate their combined solutions during a series of Webinars in September and October.

EPtalk by Dr. Jayne


Although I was initially skeptical, Twitter has proved to be a great source of interesting health IT information. It can also be a huge time suck, so I’ve had to unfortunately cut back on some of the humorous tweeps I’ve been following because I just cannot keep up. I did enjoy a piece that Evan Steele shared the other day, entitled What My Doctor Thinks of Obamacare. Written by former Senate Majority Leader (and surgeon) Bill Frist, the interview is great and the comments are even better.

For readers who are gamers, ONC’s Office of the Chief Privacy offer announced the release of what it calls its “first web-based security training game.” Users have to respond to privacy and security challenges faced in a typical small medical practice. Choosing the right answers lets your practice grow and earn items such as exam room furniture and a new TV for the break room. The wrong choices hurts the practice and can cost you your exam room. I give ONC full credit for using the word “gamification” in its release e-mail.


Everyone seems to be buzzing about the Epic user group meeting taking place this week. It’s not the only show going, though. My good friend Bianca Biller is attending the Healthcare Billing & Management Association Fall Conference taking place this week. She reports in from Capitol Hill:

On Tuesday, it was an honor and privilege to participate in the HBMA Capitol Hill Visit and Lobby Day – 75 of us! Not only was I able to meet with members and health staff of the US House of Representatives and Senate, encouraging our Congress to pass a permanent fix to the SGR and to understand the importance of our billing organization, but I was able to see all the members of Congress come together to commemorate the anniversary of 9/11 on the steps of the Capitol building by singing the national anthem.

We delivered the message on behalf of our physicians that the SGR formula is flawed and our physicians cannot continue to have this looming over their heads year after year with threats of a 30% cut in reimbursement. We also discussed the concept of a centralized credentialing process for our providers. We truly believe if someone could figure this out that this would qualify as ‘administrative simplification’ without doubt! I believe our message was heard however we know that nothing will be addressed until after the election. That message was conveyed loud and clear.

The opening keynote Wednesday was the Honorable Newt Gingrich. His messages of “cheerful persistence” and encouraging us as citizens to bring forward answers to Washington DC rang out to more than 250 HBMA members attending. He also encouraged us to bring a generation of innovation (and of course to check out his new venture, newtuniversity.com). He believes the doctor crisis is real and we need to get care organized, and soon!

Next up is two full days of sessions on client modeling, EHR liability, ICD-10 updates, and Privacy and Security policy and enforcement. As usual, a great conference!

I think many providers (and an awful lot if IT people) don’t fully understand how crazily complex medical billing requirements are. I appreciate everything Bianca does to collect 99% of the money I’m due. Here’s a salute to all the billing professionals out there. When ICD-10 hits, I will be happy to commiserate with you over a martini.



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

More news: HIStalk Practice, HIStalk Mobile.

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September 13, 2012 News 6 Comments

News 9/12/12

September 11, 2012 News 12 Comments

Top News

9-11-2012 6-15-21 PM

ONC publishes a Health IT Dashboard that includes six views and 250 custom dashboards for states, ONC programs, and grantees. It includes charts, maps, and downloadable tables pertaining to EHR adoption, REC programs, and HIT workforce training. An interesting statistic: of the 143,890 EPs enrolled in RECs, only 17,144 (12%) have demonstrated MU. Also surprising: only 39% of acute care hospitals were using even a basic EHR by the end of 2011.

Reader Comments

9-11-2012 7-11-30 PM

From David: “Re: Dr. Jayne’s comment on ‘educational session’ put on for members of Congress. As someone who used to put these on, these are simply a forum for making a lobbying pitch to lawmakers and Congressional staff under the guise of education. The ‘education’ is to get lawmakers to vote in the interests of the event’s corporate sponsors.” Sponsors listed include HIMSS, Ingenix, Allscripts, BCBSA, and a bunch of other companies, government contractors, and member organizations. It was the Washington schmoozing and complete surrender to its Diamond members that largely turned me against HIMSS as an organization that represents me as a non-profit hospital employee and dues-paying member instead of a piece of meat offered up for ogling by its conference exhibitors. I would rather see HIMSS split into two groups, one for providers only (like it almost was before the current regime got dollar signs in their eyes) and the other being the vendor trade association that HIMSS denies being despite ample similarities.

From Dell-lightful: “Re: Dell Services layoff. It’s true. I’ve spoken to two senior salespeople in the healthcare vertical who were laid off in recent weeks. One of them said the action was called Operation Savings Storm. He e-mailed me a picture of him shaking hands and smiling with Michael Dell. I suppose that only Michael is smiling now since his labor cost just went down, good for his quarterly report.”

9-11-2012 9-37-58 PM

From Eileen Dover: “Re: Lahey Clinic. Scrapping their Allscripts implementation and going big with Epic. You probably already knew that.” I ran reader rumors to that effect in June, but got no response from the CIO when I asked about the “unified architecture” the rumor said they were pursuing (which means they’re planning to buy Epic nine times out of ten). Their original strategy involved using Orion Health to serve up scanned PDFs of inpatient records and using Allscripts on the outpatient side, which doesn’t sound like much of a strategy at all given Meaningful Use requirements and changing care models. I’ll leave this as Unverified since I’m missing the standard confirmation: the posting of a ton of Epic jobs on their site.

9-11-2012 9-34-00 PM

From SubDude: “Re: athenahealth. Saw this poster on the green line of the Boston T.”

From Empty Handed: “Re: Encore Health Resources. In talks to be acquired by Dell.” I asked the Encore folks a few weeks back and they said this rumor isn’t true. I believe them, but I also noted from experience with other companies being acquired that you always get that same answer even when it really is true, with an apology later for being less than truthful out of necessity. All I can say is that I’ve heard the rumor from anonymous readers twice now, the company denies it, and I have nothing to back it up.

From Debunker: “Re: the EMR cost study you mentioned. There are also significant issues with how the HIMSS Analytics data collection is performed when you look under the covers at the raw data.” That’s a good point. Everybody trying to do these lazy database-matching “studies” assumes that those databases have perfect information, which I’m sure they do not.

From Neal: “Re: Glen Tullman compensation by Allscripts. Thanks for keeping an eye on the mega-earnings of the vendor CEOs. However, it’s fair to note their value is not reflected solely by share price. Tullman grew Allscripts from a niche ambulatory vendor to a near-competitor with Cerner if not yet Epic across virtually every segment of the market. It’s too early to tell if he’ll be successful, but they will be a serious competitor if they can integrate their myriad solutions. He has one year, two tops, to deliver or face the boot from his new board.” Glen did a masterful job of wresting control of the company from Misys and then buying Eclipsys. The mistakes he’s made from my cheap seats view: (a) paying too much for Eclipsys, which nobody else seemed to want; (b) declaring mission accomplished with Sunrise integration almost immediately after the acquisition, backing up that statement with questionable comments that having two unrelated systems both running on Microsoft-powered servers meant they could just start happily interoperating once the ink dried on the sales collateral; (c) trying to pass off Allscripts as a serious competitor to Epic; and (d) escaping an ugly board power struggle and then caving in to a proxy fight that gave a dissident shareholder board seats. You are right that Wall Street encourages actions that boost share price for all the wrong reasons, often at the cost of long-term possibilities, like when Cerner stock took a beating in the late 1990s as they dared spend research dollars to build Millennium instead of booking big earnings per share. Allscripts needs to deliver technically before the competition (both inpatient and ambulatory) pushes it permanently into the mid-majors. If you’re a customer, you’re better off with Glen in charge than selling off to private equity investors, who would have a field day retiring products, selling off divisions piecemeal, and milking services revenue to juice the bottom line to enable a quick flip. We’re already down to basically three vendors for big hospitals (Epic, Cerner, and Allscripts plus a bit of Meditech in the mix). I don’t see Allscripts gaining much inpatient ground given its few announced sales to mostly small hospitals, which is the same problem Eclipsys had despite an arguably superior product, but I hope they keep it competitive. I should have also mentioned that despite seemingly generous compensation, this particular bonus plan announcement actually represented a pay cut for Glen.

HIStalk Announcements and Requests

9-11-2012 7-52-25 PM

Say hello to LDM Group, supporting HIStalk as a Platinum Sponsor. The St. Louis-based company offers behavior-changing prescription management programs. Specifically, its patented process improves patient compliance and outcomes by connecting patients with their prescribers and pharmacists. The company’s electronically targeted ScriptGuide messaging (print, e-mail, SMS) helps build tighter provider-patient relationships and helps meet Meaningful Use and ACO requirements for customized patient education and engagement. LDM Group’s network of providers, EMR/EHR vendors, and sponsors of educational material (pharma, payers, health plans, and PBMs) help patients become better educated about their healthcare via personalized messaging from their trusted providers right at the point of service. The company’s case studies show that medication adherence increases up to 16% for specific disease categories, potentially avoiding expensive interventions due to non-compliance. Thanks to LDM Group for supporting HIStalk.

Epic’s UGM is underway. Your report, photos, etc. are welcome since we are not in attendance. So many conferences, so little time.

Acquisitions, Funding, Business, and Stock

9-11-2012 8-25-48 PM

Mediware completes its acquisition of the assets of Strategic Healthcare Group, a provider of blood management consulting, education, and informatics solutions. Mediware also reports Q4 results: revenue up 4%, EPS $0.29 vs. $0.25.

9-11-2012 8-26-26 PM

Elsevier acquires ExitCare, LLC, an enterprise-wide solution for patient education and discharge instructions.


Rush University Medical Center (IL) selects MethodCare’s Charge Recovery Solution to optimize charge capture.

9-11-2012 8-27-41 PM

The University of Colorado Hospital will implement Infor Lawson Healthcare’s financial, supply chain management, and human capital applications.

Coordinated Health (PA/NJ) selects Allscripts Sunrise Clinical Manager. Their hospitals are Coordinated Health Allentown Hospital (22 beds) and Coordinated Health Bethlehem Hospital (20 beds).

Cancer Treatment Centers of America chooses QlikView to replace its existing business intelligence software, using its analytic capabilities to find opportunities for improvement and planning its future use to predict which therapy options will work best for a given patient.


9-11-2012 6-07-54 PM

Clarity Health names Bill Bunker (Vertafore Agency Markets) as CEO, taking over for founding CEO and newly appointed executive chairman Peter Gelpi.

The GAO appoints Christopher Boone, director of outpatient quality and HIT for the American Heart Association, to fill a vacant patient advocate seat on the HIT Policy Committee

Announcements and Implementations

9-11-2012 8-29-32 PM

West Virginia University Healthcare installs the Patient Safety Net incident reporting system from Datix and UHC.

9-11-2012 8-30-33 PM 9-11-2012 8-31-21 PM

HIMSS Analytics recognizes Hennepin County Medical Center (MN) and Truman Medical Center (MO) with its Stage 7 award for EMR adoption.

Franciscan Alliance goes live with iSirona’s device connectivity solution at multiple facilities.

9-11-2012 8-37-49 PM

In Southeast Texas, CHRISTUS Health, Texas Children’s Hospital, UTMB Galveston, and Legacy Community Health Services sign up with Greater Houston Healthconnect to exchange patient information.

Medecision’s care management solution is added to the Availity network to support post-discharge planning and coordination.

Government and Politics

ONC posts draft test procedures and test data files for the 2014 Edition EHR certification criteria.

HHS Secretary Kathleen Sebelius announces that the public can vote for their favorite innovation among finalists in the HHSinnovates Program, which is designed to recognize innovative projects developed by HHS employees to solve healthcare challenges. Public voting is open until September 14.

9-11-2012 9-27-08 PM

Allscripts CEO Glen Tullman pens a Forbes opinion piece extolling the accomplishments of his friend President Barack Obama, also saying great things about his stimulus bill, particularly the HITECH part that benefited Allscripts immeasurably. He concludes, “Now what he needs is one more term to finish the job.


AirStrip Technologies is awarded a patent for its technology and process for delivering physiologic monitoring data to smartphones, tablets, and other devices.

A 17-year-old invents an inexpensive and portable EKG that collects heart rhythm data via Bluetooth and sends it to a remote physician.

An orthopedic surgeon uses an iPod Touch in knee replacement surgeries, saying it allows more precise placement of the artificial knee and thus reduces complications and provides a greater range of motion.

9-11-2012 9-01-52 PM

Weight loss company Diet Doc offers its customers weight loss consultations with physicians at its 30 locations via Skype. The (female) CEO cites the “growing possibilities that telehealth has” in decided to replace its telephone-based consultations with video in managing its human chorionic gonadotropin diet plans. They’re probably the only telehealth-using provider featuring a Star magazine cover of Kim Kardashian with the CEO’s unsolicited opinion that “comfort foods added a few pounds to her frame” but that she has thankfully “slimmed down to snag a man.” The FDA doesn’t have anything good to say about HCG diets and has banned non-prescription sales. It requires prescription HCG products to be labeled with a warning that there’s no proof that they work.


Two University of Miami Hospital employees are accused of selling the information of thousands of patients they obtained from registration face sheets over 22 months. The university’s medical school reported the theft of a pathologist’s briefcase earlier this year that contained an unencrypted flash drive with six years’ worth of patient medical record data.

9-11-2012 6-30-47 PM 9-11-2012 6-33-17 PM

A computer hacker in Italy with brain cancer, desperate for second opinions, cracks the proprietary format of his electronic medical records, converts them to an open format, and shares them on his Web site. Two doctors responded in the first 24 hours to what the patient is calling “My Open Source Cure.” He invites doctors, hackers, musicians, or anyone who can help to review his information and e-mail him their “cure,” which he will post on his site. If you’d like to help out, you will need someone who can read Italian to translate the scanned records.

9-11-2012 9-09-29 PM

The former hospital equipment designer who in 1982 designed the first laptop computer, the GRiD Compass, has died. Bill Moggridge was 69.

In the UK, Fujitsu is reportedly blacklisted from being awarded any government services contracts after previous failures, notably its work on the failed NPfIT project.

A Chicago-area health department says EMR implementation temporarily reduced the walk-in patient capacity of its clinics by half right after go-live last week. At a two-physician clinic whose appointments are booked out for months, one patient said the line that snaked around the corner looked like “a Depression-era soup line.”

Weird News Andy says an interdiction might be placed on the future work of this surgeon, who is being sued by a patient whose lawsuit claims his cancerous penis was amputated without his consent.

Sponsor Updates

  • HTMS, an Emdeon company, and Managed Care Executive Group launch the fourth annual Industry Pulse Survey to identify issues and concerns important to healthcare payers.
  • Pivot Point and NextGate collaborate to offer identity management, credentialing, and RCM enhancement solutions to HIEs, ACOs, and health systems.
  • Orion Health posts the agenda for its October Healthcare Collaborative in Colorado.
  • Imprivata demonstrates its secure no-click access at Epic’s annual UG meeting and offers a white paper on optimizing Epic clinical workflow.
  • Awarepoint adds VT Group as a VAR for its aware360 RTLS suite.
  • MED3OOO announces the keynote speakers and agenda for its October National Healthcare Leadership Conference in St. Thomas, USVI.
  • Greenway recognizes Pediatric Associates (WA), Premier Family Physicians (TX), and Medical Park Orthopaedic and Sports Medicine Clinic (AR) for their innovative use of Greenway solutions to improve care delivery.


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

More news: HIStalk Practice, HIStalk Mobile.

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September 11, 2012 News 12 Comments

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  • Bignurse: Fantastic, next-generation thinking that merges patient-centered concepts with EMR. Data is the key and we need to thin...
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  • : The definition of cloud means nothing because we have watered it down so that everyone can say that they have one. I ad...
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