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Monday Morning Update 12/10/12

December 8, 2012 News 8 Comments

12-8-2012 10-47-35 AM

From HITEsq: “Re: Epic. It appears they aren’t happy with some consultant, suing two individuals and three similar sounding entities (KS Information Technologies). They were granted a motion to seal the complaint to protect sensitive information. Maybe someone knows more.”

12-8-2012 7-55-53 AM

The government should get more proof that providers have met Meaningful Use requirements before sending them a check, according to 72 percent of poll respondents. New poll to your right: should FDA create an Office of Wireless Health as proposed by Rep. Michael Honda (D-CA)? I’ve generously included a “don’t know/don’t care” option for those anxious to participate despite indifference to the topic.

My latest Spotify playlist includes the usual mix of music I like, including Villagers, This Providence, Gov’t Mule, Faith No More, and going back decades, Mountain, Throwing Muses, and even the virtually unknown 60s Detroit band Frijid Pink. I spend a fair amount of time choosing what I think is worth listening to and then play the list several times to make sure it makes sense, not that I’m in need of extra work. Give it a listen if you’re stuck in a musical rut.

12-8-2012 8-23-29 AM

I never look at (and in fact am annoyed by) infographics, those trendy, huge, multi-font pictures that fool short attention span Internet skimmers into thinking they understand a complex topic, often created by someone who hopes their agenda will be accepted as truth instead of opinion because it’s easier to stare at dumbed-down pictures instead of using your brain to read something more challenging and informative. If you don’t feel that way, cruise over to ONC’s EHR infographic for consumers. At least theirs is footnoted.

The secretaries of Veterans Affairs and Defense say they will present a plan in January to speed up the VA-DoD EHR integration. The planned go-live date of 2017 may be moved up. 

Manitoba’s eChart HIE  will allow users to hide their information even though they can’t opt out of the service. It will contain prescription information, immunization histories, demographics, and lab results.

The Jewish Healthcare Foundation, the Pittsburgh Regional Health Initiative, and Health Careers Futures form the Pittsburgh-based QIT training center, funded by the foundation and the County tourism office. It will offer training to healthcare executives and workers on emerging technology. ONC Deputy Director Jason Kunzman is former CFO of the foundation. Also announced was the QIT Health Innovators Fellowship program for graduate students in the health professions, who will submit IT solutions for judging in a 10-week program.

Healthcare provider CIOs on the 2013 Computerworld Premier 100 IT Leaders list:

  • Horace Blackman, Department of Veterans Affairs
  • George Brenckle, UMass Memorial Health Care
  • Thomas Bres, Sparrow Health System
  • Sonya Christian, West Georgia Health
  • Chad Eckes, Cancer Treatment Centers of America
  • Randall Gaboriault, Christiana Care Health System
  • Theresa Meadows, Cook Children’s Health Care System
  • Mark Moroses, Continuum Health Partners Inc.
  • Stephanie Reel, Johns Hopkins Health System
  • Kathleen Scheirman, Kaiser Permanente
  • Thomas Smith, NorthShore University HealthSystem

12-8-2012 9-11-37 AM

A new KLAS report on revenue cycle performance finds that Meaningful Use, reduced payments, and ICD-10 fears are forcing providers to examine their revenue cycles more closely for efficiency and effectiveness, with many of them engaging outside assistance.

RSNA attendance was down 9 percent this year, with possible reasons being lack of technology breakthroughs and a new policy that required guest attendees to pay.

12-8-2012 9-47-54 AM

A technical school in the Philippines creates a telenurse training program, preparing nurses to offer their patient consultation services via smart phones. ClickMedix, an online health company is participating, offering the nurses access to its smart phone application, doctors, and medical library in return for a percentage of their billings. Experts say it’s time to create business models for nurses to become online health consultants. I tracked down ClickMedix, which turns out to be a US-based company (Rockville, MD) formed by faculty and students of MIT and Carnegie Mellon to address global healthcare challenges. The company’s mHealth platform offers modules for delivery of medical services, patient management, administration, and healthcare services purchasing.

Ergonomics researchers warn that the increased use of EMRs and other keyboard-based technologies for long periods of time raises the risk that providers will sustain repetitive stress injuries as happened when offices computerized in the 1980s. A small study found that more than a third of doctors reported RSI-related pain in their neck, shoulders, back, or wrists. In what could be an indirect measure of the uptake of EMRs, another small provider study found that more than 90 percent use a computer, averaging more than five hours a day.

12-8-2012 10-07-12 AM

An article in the Rochester paper describes the use of contracted scribes in the ED of Rochester General Hospital, which says its 60 ED scribes cost $1 million annually but save the health system $1.6 million per year. According to the associate ED chief, “When you come to see the doctor, you want to see the doctor. You want eye contact. You don’t want us standing at a computer screen. I care for people. I’ve never been trained to be a good typist or a data entry specialist.”

An Atlanta nephrologist serving as the medical director of a clinic owned by dialysis provider DaVita files a whistleblower lawsuit against the company under the False Claims Act after noticing that its computer systems showed large amounts of wasted drugs. His suit claims DaVita overcharged Medicare for up to $800 million over eight years by intentionally using oversized vials of medication and discarding the remainder, billing Medicare for unavoidable waste. The doctor was noticed by his fellow whistleblower, a nurse who says the company was pushing employees to increase their drug revenue. The company says CMS approved all of its practices.

12-8-2012 10-22-02 AM

Scheurer Hospital (MI) renovates its patient rooms to include technology improvements, placing a computer in each room to allow nurses to document at the bedside. They also added a new patient call system that alerts nurses on cell phones.

The former executive director of Syringa General Hospital Foundation (ID) is sentenced to six months in prison and is ordered to pay $115,000 in restitution after pleading guilty to using the hospital’s computer system to transfer money to her personal accounts.

Aetna will pay $120 million to settle lawsuits claiming that it used databases from UnitedHealth Group’s former Ingenix unit to intentionally underpay insurance claims for members using out-of-network medical services. UnitedHealth paid $350 million in 2009 to settle a similar lawsuit in New York, at which time Aetna also settled by agreeing to stop using the Ingenix database and paying $20 million to help create an independently developed replacement for it.

Weird News Andy says he now knows how your mom always knew what you were thinking. Researchers find that a mother’s brain often hosts living cells from her children born decades earlier. WNA also digests new medical research as being an explanation for crazy cat ladies: a common cat parasite is found to have the ability to enter the human brain and to possibly cause behavioral changes.

More on CPSI in this week’s HIS-tory from Vince, putting it into current perspective by reviewing the MU success of its customers and how its practices parallel those of Meditech and Epic. Next up is NextGen’s inpatient division, so connect with Vince if you can help him out with background information.


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

More news: HIStalk Practice, HIStalk Mobile.

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December 8, 2012 News 8 Comments

News 12/7/12

December 6, 2012 News 8 Comments

Top News

12-6-2012 4-57-11 PM

Reuters reports that PE firms Thoma Bravo LLC, Thomas H. Lee Partners LP, and Francisco Partners have submitted revised takeover offers for Merge Healthcare and are awaiting a decision from the company.

Reader Comments

From Nasty Parts: “Re: MedeAnalytics. Oracle backed out of a deal to buy the company, so they’re re-orging and putting a number of folks on the street.” Unverified.

12-6-2012 6-20-02 PM

From Spamalot: “Re: funny vendor spam. The ridiculous image and hilariously misspelled text caught my eye before I could hit the delete key.” Could it be that the company has decided to offend as many of the senses as possible, with your delayed “delete” validating their cunning premise of turning your head like a gruesome car wreck? Surely it was not a native English speaker who composed the pitch for business “coninuity” and referred to network security as a “new sexy term.” The company’s two addresses appear to be mail drops, and the Facebook link in the spam goes to a marketing person’s personal page that features family photos and cutesy kitty porn. I’ll hazard a guess that their incoming lines won’t be overwhelmed by clamoring prospects.

HIStalk Announcements and Requests

inga_small In case you have missed any HIStalk Practice posts in the last week, here are some highlights. Most physicians who e-prescribe believe it reduces prescription fraud and facilitates decision-making. Vermont’s eight FQHCs go live on five different EMRs. OIG finds that physicians who protest the denial of Medicare claims win their cases 61 percent of the time. Spring Medical Systems will offer its EHR clients an analytics solution from Clinigence. The AMA argues that pre-payment MU audits would be too burdensome for physicians. None of this news can be found on HIStalk, so if you are interested in the ambulatory HIT world, make sure to sign up for the HIStalk Practice e-mail updates. Thanks for reading.

On the Jobs Board: Director of Reimbursement, Cerner Activation Consultant, Director of Marketing, Marketing Programs Manager.

I’m not really interested in two front teeth for Christmas since I don’t have a spot for them, but I could use some holly jolly reader gifts that cost nothing: (a) take 10 seconds max to sign up for spam-free e-mail updates from HIStalk, HIStalk Practice, and HIStalk Connect; (b) sleuth us out on Facebook, LinkedIn, Twitter and make the electronic connection; (c) support the companies that pay the bills by checking out their ads to your left, reviewing their offerings in the Resource Center, and sending out an effortless request for consulting information via the RFI Blaster; and (d) graduate from spectator to player by sending me news, rumors, and guest posts. I note that Dann’s HIStalk Fan Club on LinkedIn now has 2,881 members, all of whom get extra attention when requesting something because I’m reassured that they aren’t ashamed of reading HIStalk. A reminder: we’ve got the top headlines each weekday morning on HIStalk, courtesy of the newest crew member, Lt. Dan. You won’t get an e-mail blast to remind you since I figured that would be really annoying, so just head over to the main page and you’ll see what’s new before you head out for work (like I do).

Acquisitions, Funding, Business, and Stock

12-6-2012 4-53-27 PM

Toronto-based Constellation Software purchases 100 percent of the fully diluted shares of Salar from Transcend Services, a division of Nuance. Transcend purchased physician documentation and charge capture systems vendor Salar in July of 2011 for $11 million, followed by Nuance’s acquisition of Transcend for $300 million in March 2012. We ran an accurate reader rumor report of the then-unannounced sale on November 30.

12-6-2012 4-55-35 PM

EMR vendor Modernizing Medicine raises $12 million in Series B financing to expand into the orthopedic and ENT markets.

12-6-2012 8-32-42 PM

SAIC announces Q3 results: revenue up 3 percent, EPS $0.33 vs. –$0.28, missing on expectations of $0.35. The company said it signed over $100 million in contracts from its recent acquisitions, maxIT Healthcare and Vitalize Consulting Solutions. SAIC also announced that it will cut 700 jobs in advance of possible fiscal cliff federal spending cuts that would decrease defense spending. Shares that were at $20 in early 2010 closed Thursday at $11.26, valuing the company at just under $4 billion.


Presbyterian Healthcare Services (NM) signs a multi-year agreement with IT service provider T-Systems to manage the health system’s data center operations.

Martin’s Point Health Care (ME/NH) selects athenahealth to provide EHR, billing, PM, and care coordination services for its 90 providers.

Catholic Health Initiatives will partner with Encore Health Resources to create a suite of electronic healthcare intelligence solutions focused on quality, performance, and risk analytics.

12-6-2012 5-01-20 PM

Indiana University Health selects Healthcare Quality Catalyst’s data warehouse platform for reporting and analytics.

Mercy Medical Center (IA) will implement iSirona’s device connectivity software to automate the flow of patient data from more than 150 devices into Epic.

12-6-2012 5-04-33 PM

Abington Health System (PA) selects the Surgical Information Systems perioperative IT solution for its two hospitals.

WellSpan Health (PA) subscribes to the CapSite Database to improve its purchasing processes.

Maury Regional Health System (TN) selects Medseek’s patient portal solution.

Ophthalmic Consultants (MA) adopts the Professional Charge Capture solution from MedAptus.


12-6-2012 5-05-37 PM

Interoperability software provider Compressus names Joe Lavelle (Results First Consulting) as COO.

12-6-2012 5-07-09 PM 12-6-2012 5-07-53 PM

Clinithink hires Fiona Lodge, PhD (Microsoft) as director of technical operations and Nathan Skorick (Altos Solutions) as business development executive.

12-6-2012 5-09-04 PM

Huntzinger Management Group VP William Reed (above) joins the company’s board of directors, along with Richard Sorensen (US Health Holdings.)

12-6-2012 5-14-31 PM 12-6-2012 5-15-26 PM

Emdeon adds former Allscripts Chairman Philip Pead and former Harris Corp. CEO Howard Lance to its board.

12-6-2012 7-56-26 PM

Hospitalist Fred Chan, MD is named to the newly created position of CMIO for GBMC HealthCare System (MD).

12-6-2012 8-01-31 PM

Jardogs names Ken Mikesh (MyHealthDIRECT, above) as SVP of strategy and business development and Brenda Stewart (Merge Healthcare) as SVP of marketing.

12-6-2012 7-00-24 PM

Homer Warner, a cardiologist and medical informatics pioneer, died November 30. He started developing clinical software at University of Utah and Intermountain Healthcare in the mid-1950s and wrote Intermountain’s ground-breaking and still-used HELP system in the 1970s, one of the first electronic medical records and clinical decision support systems. He was chair of University of Utah’s Department of Medical Informatics, the first such program offered by a medical school. Intermountain opened the Homer Warner Center for Informatics Research at Intermountain Medical Center in 2011. He remained active, vital, and humorous until his death at age 90, as evidenced by this video interview conducted a few weeks ago.

Announcements and Implementations

Vitera closes its hardware support business unit through a partnership with DecisionOne, which will hire Vitera’s field technicians. Vitera notes that it has added more than 270 employees this year and anticipates filling another 200 positions.

12-6-2012 1-59-53 PM

The University of Texas at Austin launches the country’s first HIE laboratory, which is funded by ICA, Orion Health, eClinicalWorks, and e-MDs.

DrFirst announces Akario, a free secure clinical messaging system.

GE Healthcare launches its Centricity Business 5.1 RCM solution.

Allscripts releases Sunrise Financial Manager, a revenue cycle solution designed for accountable and value-based care payment models.

The HIEs of West Virginia and Alabama, both customers of Truven Health Analytics, earn federal recognition for reaching milestones for full query-based and directed information exchange.

MModal opens a medical transcription center in Mysore (India), where the company plans to create 100 jobs over the next two years.

12-6-2012 8-15-10 PM

Cisco Systems is providing video calls with Santa to patients at 31 children’s hospitals (including Children’s of Alabama in a photo from Tuesday, above) via its Santa Connection Program, which runs through December 21 .

Government and Politics

The IRS releases a final rule subjecting the sale of medical devices to a 2.3 percent tax beginning in 2013, which is expected raise $29 billion in tax revenue through 2022.

Innovation and Research

Independence Blue Cross, Penn Medicine, and DreamIt Ventures create Philadelphia-based DreamIt Health, yet another digital healthcare accelerator. It offers $50,000, a four-month boot camp, office space, mentoring, and a demo day. It gets 8 percent of the equity in return.


12-6-2012 5-22-44 PM

Athenahealth will buy the 29-acre, 11-building, 760,000 square foot Arsenal on the Charles complex in Watertown, MA from Harvard University for $169 million. The company was already leasing 330,000 of space in the complex for its headquarters.

 12-6-2012 3-34-57 PM

A CapSite survey finds that one-third of US hospitals have adopted a vendor-neutral archive, while another 19 percent plan to do so.

Kaiser Permanente will open a new IT center in the Denver, Colorado area and will hire 500 IT employees by 2015.

A survey finds that 94 percent of healthcare organizations suffered at least one data breach in the last year. Other findings: (a) 69 percent don’t secure PHI-containing medical devices such as insulin pumps, and (b) almost all of them use cloud-based solutions and allow employees to use their own medical devices even though half of the organizations question the security of those technologies.

12-6-2012 3-22-22 PM

The CDC reports that 40 percent of office-based physicians now use an EHR with a basic level of functions, up from 34 percent a year ago.

At a dermatologist appointment this week, I noticed signs on the window urging patience, as the one-doc practice had just changed EMR systems. I asked the doctor and got an earful in return. He had already attested for Meaningful Use Stage 1, but was convinced by a salesperson to trash his EMR and move to GE Centricity. He said it’s the worst business decision he has ever made, not because Centricity is bad, but because he spent a lot of money, he’s being hit constantly with additional upgrade and maintenance fees, and to top it all off, he now realizes that he has no chance of collecting Stage 2 money because the bar is set too high for his practice. Not to mention that as a specialist, the EMR is not providing much patient value. He says he’s hoping to hold on for the 2-3 years it will take to get his practice back on its feet again, as the EMR is now his single largest expense. I can only describe his behavior as ashamed, followed by relieved as he realized from our discussion that he’s not the only one struggling to pay for something that he probably should never have bought in the first place. Needless to say, he’s not exactly thrilled with the HITECH program. It’s an eye-opener to realize that these little practices are cash-strapped businesses run by folks who may be excellent clinicians, but who are also marginal, accidental businesspeople just trying to keep the doors open and their employees paid. Derms are usually well paid and minimally stressed thanks to acne and Botox, so I can only imagine what it’s like for a primary care practice.

In Canada, Vancouver Coastal Health fires a long-time clerical employee for looking up the electronic records of five local media personalities out of curiosity.

Hello, Doc, Internet porn is free: a female employee of a doctor’s practice notices a red light glowing behind supplies in the restroom. She finds a video camera pointed at the toilet. The doctor finds his career potentially in that same toilet, as police executing a search warrant find the camera-controlling software on his computer. Maybe he should claim that the restroom doubles as a telemedicine station.

A privacy “weakest link” example. MC and Mel, a couple of morning zoo-type deejays from Australia sporting the worst fake British accents in history, call up the London hospital treating the Duchess of Cambridge for morning sickness, doing hilariously unskilled and giggling impersonations of Queen Elizabeth II, Prince Charles, and barking Corgi dogs. They get through to a nurse who provides a full update on the former Kate Middleton’s condition, learning that Kate “hasn’t had any retching with me.” The hospital is evaluating its privacy practices. UPDATE: in a not-so-funny ending to the story, the nurse who took the prank call has apparently committed suicide.

Sponsor Updates

12-6-2012 6-54-18 PM

  • Billian sponsored the December 4 Health IT Leadership Summit at the Fox Theater in Atlanta, which attracted 600 attendees. Above are Ellen McDermott (University of West Georgia), Jennifer Dennard (Billian Inc.), David Hartnett (Metro Atlanta Chamber of Commerce), and Cynthia Porter (Porter Research).
  • AT&T adds a remote interactive patient monitoring solution from Ericsson to its ForHealth remote patient monitoring platform.
  • Mercy Regional Hospital (KS) implements a paperless employee time off request process using Access Evolution.
  • Healthcare Clinical Informatics offers ten tips for realizing the value of EHR.
  • Shareable Ink will exhibit at next month’s ASA Conference on Practice Management in Las Vegas.
  • Beacon Partners and its employees donate over $9,500 in support of the Red Cross’s Hurricane Sandy relief efforts.
  • ChartWise Medical Systems will integrate TruCode’s grouper, pricer, and editing Web Services into its ChartWise:CDI software.
  • Imprivata publishes a white paper highlighting best practices for realizing care team collaboration and productivity benefits using HIPAA-compliant texting.
  • CPU Medical Management Systems, a MED3OOO company, partners with RISARC Consulting to provide CPU customers an option for secure electronic document exchange.

EPtalk by Dr. Jayne


ONC holds its annual meeting on Wednesday, December 12 in Washington, DC and also accessible by webcast. It will include sessions on HIE and interoperability, patient engagement, and of course Meaningful Use.

A study in the December issue of Pediatrics lists five key features needed for pediatric EHRs: well visit tracking, support of growth chart analysis, immunization tracking, immunization forecasting, and weight-based drug dosing. Although the article notes that “it’s nearly impossible to find an EHR that meets those standards,” I guess I’m lucky because my system supports all of these. One of my friends is looking to replace her system and I’m attending a demo with her over the holidays. We’ll have to see how that vendor stacks up.

Over on HIStalk practice, Inga mentioned a survey on e-prescribing. Although I’m optimistic about its potential, I’m skeptical about the ability of pharmacies to keep up. Case in point: e-prescribing of controlled substances. Although the DEA finally approved this and several vendors piloted it in a handful of states, there is still a lack of awareness. I happened to stop by the pharmacy at a local supermarket chain and ask if they’re ready to receive such scripts (because I’m more than ready to start transmitting them) and received a stern lecture from the pharmacist about how he’s been told it’s illegal to do so.

Weird news story of the week: A New Orleans ambulance crew finds their vehicle immobilized with a parking boot, applied while they were on the scene with a patient.

I previously mentioned Scanadu, the startup that hopes to make a Star Trek-style medical scanner a reality. The company unveiled its SCOUT product, which is headed to the FDA for approval as a home diagnostic device. If it really delivers what it says – five vital sign results in 10 seconds with 99 percent accuracy – I think they’re missing a major market. For physician practices where rooming patients quickly is essential, this would be a killer app.

One of my favorite Tweeps is @MeetingBoy. Since I shared my holiday party recipes, I’ll share his piece on Eight Reasons Why I’m Skipping the Office Christmas Party.  I’ve never been to a real-life office Christmas party – we don’t have those in non-profit land. The closest we have is the holiday potluck. I’d love to live vicariously through HIStalk readers and of course promise to keep you anonymous. Bonus points for anyone who has received a corporate logo holiday gift worse than what I received one year: jumper cables.

Flu season has arrived early. If you haven’t received the vaccine, there’s still time. Whether you’re vaccinated or not, please keep covering those coughs, stay home when you’re sick, and keep washing those hands. And in case you wondered, paper towels spread fewer germs than drying your hands with a blower.



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

More news: HIStalk Practice, HIStalk Mobile.

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December 6, 2012 News 8 Comments

News 12/5/12

December 4, 2012 News 19 Comments

Top News

12-4-2012 9-55-58 PM

The Atlanta newspaper covers the case of an internist whose stolen identity was used to apply for a National Provider Identification number, then used to incorporate a fictitious Buckhead medical clinic using a UPS Store mail box as an address with “Olga Teplukhina” named as the clinic’s CEO. The paper then did its own investigation, finding 131 CMS-registered medical providers that used an Atlanta UPS Store as their practice location, resulting in OIG looking into at least two dozen of them. One UPS Store-based company was found to have billed Medicare for $1.2 million in fraudulent injections, but is still in business because companies that are barred from billing Medicare can still bill private insurance. Despite the fact that the newspaper created the list of 131 practices using minimal effort and desktop software, CMS says it doesn’t have the technology to recognize private mailboxes since they carry a regular street address. The article says CMS pays claims that it really should deny under existing regulations because it worries that legitimate provider mistakes would unduly delay payments. One doctor complained to CMS that his name was being used to bill Medicare fraudulently, but two years later, the phony provider still has an active NPI that uses the doctor’s name.

Reader Comments

From Diminutive Avian: “Re: Epic. Most people don’t know that Epic has one final implementation check. Judy has to personally give the go-ahead. If she doesn’t like what she sees, she tells the customer she’s pulling out and gives them their money back. That’s another reason why the company has only successful implementations. Unlike publicly traded vendors, Epic is more than willing to walk away if the client is botching the install and ignoring Epic’s recommendations.” I’ve been told that at least two big academic medical centers are in precisely this predicament as we speak. From what I’ve heard, Judy gives the client two choices: (a) agree to let Epic send in a SWAT team to take over the project, or (b) find themselves another vendor.

From BubbaLove: “Re: Duke University. Heard they’re being sued by Deloitte for breach of contract due to mismanagement of the Epic implementation.” Unverified. Perhaps HITEsq or another attorney reader can scour the legal databases and report back. UPDATE: two well-placed sources and one even better second-hand source contacted me to say there’s no truth to this rumor. I’ve also had no volunteers tell me they’ve turned up any legal documents. I’m concluding that the reader’s report report, which they admitted was second hand, is inaccurate –the Duke and Deloitte working relationship hasn’t changed as the project continues.

12-4-2012 7-18-57 PM

From Current Epic Employee: “Re: Epic’s employee ages. In the November staff meeting it was announced that Epic’s #2 Carl Dvorak has worked for Epic for 25 years. He showed a slide saying that 42 percent of the current employees weren’t born then — i.e. are under 25 — and 78 percent are under 31.” People get nervous at the idea of fresh graduates telling major medical centers how to run their business, but it seems to work and it’s brilliant on Epic’s part. You take new graduates whose career prospects are negligible, plant them in Wisconsin where there aren’t many other jobs, and pay them more than they would make otherwise but less than everybody else pays their more senior HIT people. You train them in skills with minimal value elsewhere, like MUMPS programming, and give them job perks that make them feel like they’re working for Google. The young folks don’t complain much, they don’t bring in all the bad habits they learned working for less successful vendors, and by following the formula they almost always get the job done. That makes Epic almost infinitely scalable unless Midwestern universities stop graduating liberal arts majors with high GPAs. Nobody seems to mind except the experienced people who Epic won’t hire.

From UKnowMe: “Re: IBM. Seems like several high-ranking healthcare people are getting very connected on LinkedIn lately. A sign of change to come?” I don’t know, but I think your observation has business merit for LinkedIn. They could sell the names of companies that have a large percentage of current employees updating their profiles (preparing to bail) or companies newly added to a lot of profiles (on a hiring binge).

From HC IT Advisor: “Re: AeroScout, recently acquired by Stanley Black and Decker. Has issued a cease and desist order to Centrak and will be filing a patent infringement suit. Apparently Centrak is using the patented CCA capability in their new WiFi tags.” Unverified. Calling HITEsq again, either that or I need to sign up for one of the lawsuit databases like PACER so I can look these up myself.

Acquisitions, Funding, Business, and Stock

Health analytics and research company Decision Resources Group acquires the UK-based Abacus, a health economics consulting firm.

12-4-2012 10-02-32 PM

Talent management software provider HealthcareSource acquires NetLearning, which makes learning management software for the healthcare industry.

12-4-2012 9-37-29 PM

Nuance acquires Accentus, an Ontario-based transcription, documenting imaging, and remote coding technology vendor.

An article in the San Antonio newspaper questions whether Gene Powell, chairman of the University of Texas Board of Regents and co-founder of AirStrip Technologies, should have disclosed that Vanguard Health Systems, which the board chose to launch a new $350 million children’s hospital in San Antonio, had a pending business deal with AirStrip at the time. Powell did not vote on the issue, did not recommend Vanguard, and was not legally required to make any disclosure since he owns no Vanguard stock and is not a Vanguard employee, so perhaps it was a slow news day.

The former Big Five accounting firm Arthur Andersen, driven out of business in 2002 for its role as Enron’s auditor, is ordered to pay an additional and final $9.5 million for its similar auditing involvement in the 1999 merger of McKesson and HBOC. Andersen agreed to pay $73 million to settle McKesson HBOC-related class action claims in 2006, with the possibility of contingent payment claims.


12-4-2012 12-33-35 PM

Children’s Hospital of Central California will implement athenaClinicals, athenaCollector, and athenaCommunicator across its 127-provider system.

Marietta Memorial Hospital (OH) extends its IT services contract with CareTech Solutions for an additional three years.

Twenty-one VA medical centers will implement GetWellNetwork’s interactive patient care solution, including the new Interactive Patient Whiteboard.

12-4-2012 12-26-37 PM

Memorial Health System (IL) purchases the Omni-Patient enterprise master data application and the WebFOCUS BI platform from Information Builders.

MemorialCare Health System (CA) renews and expands its relationship with MedAssets to include GPO services for supplies and purchased services and MedAssets Capital and Construction solutions.

12-4-2012 10-08-07 PM

Huntsman Cancer Institute at the University of Utah selects Wolters Kluwer Health’s ProVation MultiCaregiver EHR.

Contract resource organization NCGS selects Merge’s eClinical OS and clinical trial management solution.

Consulting firm AmpliPHY will provide Wellcentive’s data analytics platform to primary care practices.

Managed care company Amerigroup Corporation chooses McKesson Clear Coverage for point-of-care utilization management, coverage determination, and network compliance.

Michigan Health Information Network Shared Services signs with HIPAAT International for technology that allows patients to control the sharing of their PHI and allow them to view an audit log of who has viewed it.


12-4-2012 7-09-38 AM

Qualis Health hires David Chamberlain (Cardiac Science and Criticare Systems) as CIO.

12-4-2012 11-56-27 AM

Saint Francis Hospital and Medical Center (CT) names Sudeep Bansal, MD as the organization’s first CMIO. 

12-4-2012 7-49-18 PM

Todd Johnson, former president and CEO of Salar and SVP of Transcend Services/Nuance after Salar’s acquisition, is named CEO of HealthLoop.

12-4-2012 8-41-37 PM

Michael Waldrum, whose roles at the UAB Health System included a five-year stint as CIO through 2004, is named CEO of University of Arizona Health Network.

12-4-2012 9-43-44 PM

Charlie Baxter, AVP of Iatric Systems and former Army captain, died Friday at 48. The guest book is here.

Announcements and Implementations

Allscripts EHR customer Primary Physician Partners (CO) becomes the first practice to connects to the CORHIO.

The Indiana HIE says that more than 750 physicians and 174 practice sites have agreed to publicly post their clinical quality measure scores on the Quality Health First Program’s public reporting website.

12-4-2012 10-09-35 PM

Imprivata announces that more than 250 healthcare organizations enrolled in its Cortext HIPAA-compliant, pager-replacing text messaging solution its first 60 days of release. Pricing ranges from free (unlimited users, unlimited messaging, unlimited photo messages, standard support, 30 days’ archiving) to $5 per user per month (upgraded support and archiving).

Elsevier integrates its ExitCare library of discharge instructions and patient education with Meditech’s EHR.

ICSA Labs and IHE USA unveil a certification program to test and certify the security and interoperability of HIT, with three tiers of certification: conformance to IHE profiles, demonstrated interoperability among disparate systems, and validated implementations of deployed certified technologies. Participants in January’s 2013 NA Connectathon in Chicago can register for testing at the event.

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Montrue Technologies releases a free version of its Sparrow EDIS iPad-based emergency department information system. I interviewed Co-Founder and CEO Brian Phelps, MD earlier this year.

Government and Politics

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Recovery auditors collected $2.2 billion in overpayments in fiscal year 2012 and gave providers $109 million in underpayments. Net 2012 corrections were $2.4 billion, compared to 2011’s $939 million.

Congressman Mike Honda (D-CA) introduces the Healthcare Innovation and Marketplace Technologies Act to foster more healthcare innovation through the development of marketplace incentives, challenge grants, and increased workforce retraining. The bill would also establish an Office of Wireless Health at the FDA.

Innovation and Research

A Microsoft Research documentary shows the organization’s work in using technology to fight tuberculosis in India, including development of a biometric monitoring system to make sure patients keep their healthcare appointments and systems that trigger an SMS message to a manager when a patient misses scheduled medication doses. Treatment is effective and straightforward, but requires more than 40 clinic visits in six months. Non-compliance causes TB spread, drug resistance, and nearly 1,000 deaths per day in India.

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UCLA engineering school researchers create BigFoot, a software package that allows people with chronic foot problems to track their conditions using a PC and flatbed scanner.


Streamline Health, which acquired Atlanta-based Interpoint Partners a year ago, will move its corporate headquarters from Cincinnati to Atlanta. The company will continue to operate the Cincinnati and New York City offices.

12-4-2012 8-28-41 PM

Cerner analyst Staci Klinginsmith is crowned Miss Kansas USA.

University of Virginia Medical Center warns patients that a mobile device used by on-call IV pharmacists in its home health agency is missing and contains patient information, including diagnoses, medications, and Social Security numbers used as health insurance ID numbers.

HIMSS, responding to OIG’s recommendation that the bar for Meaningful Use payments should be raised via pre-payment reviews, improved EHR MU reporting, and improved EHR reporting certification, supports CMS developing guidelines that will help providers prepare and retain audit-related documentation. In other words, like CMS, HIMSS isn’t a fan of pre-payment reviews.

I’ve spent a considerable amount of money and energy on programming workarounds required to make HIStalk work on the incredibly buggy and standards-breaking Internet Explorer, but I’ve noticed its gradual improvement. I’m encouraged that Microsoft gets the lack of browser love it receives and can even poke fun at itself with a fun “it sucks less” video (above) and a new site, www.browseryoulovetohate.com. I’m checking it out in Firefox, of course, since I’m not that forgiving of IE’s past transgressions, but I may download the IE10 beta just to see what all the fuss is about.

A new JAMA article finds that the average dentist now out-earns the average physician, with pharmacists not too far behind.

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Lyle Berkowitz, MD (Northwestern University) and Chris McCarthy, MPH, MBA (Kaiser Permanente Innovation Consultancy) are editors of the newly published Innovation with Information Technologies in Healthcare. DrLyle says it tells the stories of 20 organizations who are HIT innovators in improving care quality and value, with details that he describes as “a big cookbook of recipes on how to innovate with HIT” divided into sections covering electronic medical records, telehealth, and advanced technology. I took a quick skim over a couple of the sample chapters he sent over and it’s meaty, without the usual fluff that makes some HIT books seem like a handful of good ideas and thoughts that were shamelessly padded to justify an author credit and a higher selling price. The book is $74.14 on Amazon and you can use the Look Inside! option to try before you buy.

A Colorado Public Radio article covers EMR adoption, showcasing a five-physician practice that expected its new EMR to increase patient capacity by 25% and get its bills out more quickly. That turned out to be wishful thinking on the salesperson’s part. They never got back up to more than 80 percent of their pre-EMR workload, they found that their Medicare patient volume was too low to qualify for incentive payments, one doctor quit over frustration with the EMR, and the remaining four partners were on the hook for the $200,000 they had borrowed to buy it. The end result: they had to sell their practice.

Use of mobile technology to view patient information and to access non-protected health information is on the rise, according to a HIMSS mobile technology survey. Key uses include collection of data at the bedside, bar code reading, monitoring data from medical devices, and capturing visual representation of patient data. Funding and security concerns are the top barriers to mobile technology adoption.

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Athenahealth’s Jonathan Bush channels Dr. Mostashari on Fox Business wearing a holiday-red bowtie and pitching healthcare technology.

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A local paper shares the story of a clerical supervisor in a British Columbia hospital who was conducting training on the Vocera communication system when the device issued a Code Orange, warning of an impending flood. Clinical staff moved patients to safety just before a wall collapsed in a flood of water, while the supervisor scrambled to save paper charts and the hospital’s stockpile of 75 Vocera badges.

Weird News Andy is really fired up about use of the Liverpool Care Pathway for palliative care in the UK. An audit of records from 178 NHS hospitals finds that nearly half of the dying patients who had life-saving treatment (drugs, fluids, food) withdrawn via the protocol weren’t told that fact, 22 percent had no documented evidence that their care and comfort was maintained, and a third of the families didn’t receive literature explaining the process. A proposal is on the table to require consulting with the patient or family before initiating the pathway, which leads to patient death in an average of 29 hours.

WNA could contribute only a “sheesh” to this article, which finds that Dallas mothers and daughters are bonding over cosmetic surgery procedures, often motivated by reality TV shows that make that practice seem normal.

A former Microsoft manager takes advantage of newly legalized marijuana in Washington by opening a “premium marijuana” retail business, expressing his desire to position his brand of weed like fine brandy or cigars to high-income baby boomers. He says, “Think of us as the Neiman Marcus of marijuana … the buzz is in the air.” He says he came up with the plan while high and will name the business after his marijuana-farming great-grandfather.

12-4-2012 9-23-41 PM

In Brazil, an apparently computer-savvy thief robs an ATM by replacing its USB security camera with a Plug and Play keyboard and a USB stick, then restarts the machine and keys commands to withdraw all its cash. He was caught. The article mentions the recent discovery of several ATMs at Inova Fairfax Hospital (VA) that were rigged with “ATM skimmers” that fit over the card slot, capturing the card’s number and in some cases using video recording to capture the user’s PIN.

Sponsor Updates

12-4-2012 12-10-39 PM

  • Aspen Advisors hosted 62 associates at its annual retreat in Fort Lauderdale, which included a run fun that raised $1,000 for the University of Miami Health System.
  • Besler Consulting representatives will present at upcoming New Jersey and Metropolitan Philadelphia HFMA seminars.
  • Santa Rosa Consulting announces E2E Activation Support, a service line that will provide elbow-to-elbow EMR go-live support.
  • The Black Book Rankings names DrFirst the top vendor for e-prescribing and recognizes Emdeon for outstanding developments in clinical exchange solutions. Other HIStalk sponsors earning honors include Allscripts, e-MDs, Vitera, Aprima, SRS, Quest MedPlus Care 360, and McKesson.
  • A local paper profiles eClinicalWorks CEO Girish Kumar Navani and the success of his company.
  • AT&T names its top five healthcare trends for 2013, which emphasize growth in mobile apps and telehealth.
  • Sacred Heart Health Systems (FL/AL) shares how Iatric Systems’ Security Audit Manager has aided privacy compliance by capturing audit log data from its Siemens, McKesson, and Picis systems. 
  • Three Informatica customers win Ventana Research Leadership Awards, including HMS Holdings (IT Leadership Award for Analytics and Overall IT Leader); Moffitt Cancer Center (Business Technology Award for Big Data); and  Ochsner Health System (IT Leadership Award for Information Management.) Informatica’s PowerCenter Big Data Edition also won the Ventana Research Technology Innovation Award.
  • Mark Van Kooy, Myra Aubuchon, and Dawn Mitchell of Aspen Advisors present a December 5 Webinar on addressing EMR value with a hospital board.
  • 3M Health Information Systems offers a Webcast featuring 3M CMIO Sandeep Wadhwa’s presentation on improving ACO efficiency and outcomes.
  • Cumberland Consulting promotes Charles Taylor to principal and Jose Gonzalez to executive consultant.
  • The Advisory Board Company’s Southwind program recognizes Dignity Health (CA), Adirondack Region Medical Home Pilot (NY), and Lancaster General Health (PA) for successful physician partnerships.
  • Covisint releases a white paper that outlines the evolution, growth, and future of HIEs.
  • Beacon Partners employees assemble 108 care packages for troops during the company’s annual meeting.
  • Wellcentive’s VP of Product Strategy Mason Beard discusses interface strategies for population health management in a blog post. 


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

More news: HIStalk Practice, HIStalk Connect.

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December 4, 2012 News 19 Comments

Monday Morning Update 12/3/12

December 1, 2012 News 12 Comments

11-30-2012 6-26-29 PM 

From NoNamesPls: “Re: MD Anderson. They will replace not only their in-house developed EMR, but also commercial systems for pharmacy, lab, RIS/PACS, and ADT/Scheduling. Epic and Cerner are the frontrunners.” Another reader forwarded me the internal e-mail from the deputy CIO and the CMIO, which says MDACC spends $20-$30 million per year on its homegrown ClinicStation but still can’t keep up with federal regulations. The RFP goes out in January. It’s interesting that the e-mail suggests that they’re happy with the patient benefits of their existing system, but will spend hundreds of millions of dollars to replace it for non-patient reasons. Somehow you have to wonder if that’s really a good thing.

12-1-2012 7-59-39 AM

From Upon Further Review: “Re: three hospitals of Dignity Health (formerly CHW). Scrapping their Meditech 6.0 and Medhost implementation that was supposed to start going live last week and moving to Cerner. Go-live required by January 1, 2014.” Above is part of Friday’s letter sent to employees by Chuck Cova, president and CEO of Marian Regional Medical Center, which says, “We are not confident in the Medhost and Meditech system’s meaningful use and ability to perform at a high level for optimal use.” It went down to the wire: Medhost was to supposed to be brought live starting November 26, but the project was delayed on November 13 and then killed on November 30.

DZA MD replied to my Time Capsule editorial from 2008 in which I suggested that patient encounters be recorded on video now that multimedia storage is cheap (security cameras are running everywhere, after all, and your encounters with Las Vegas card dealers are recorded in multi-angle splendor). Here’s what DZA MD had to say:

Imagine how well behaved everyone would suddenly be! Patients and caregivers. Both are in need of civility IMHO.

Though certainly not the first, I proposed this solution to patient care documentation to interested academics at my institution  round the millennium. It was not taken seriously and was viscerally scary in a dot.gov sort of way, but the time has arrived. Some consequences (positive):

  • Documentation. Real-time video and audio. Obvious. Supplement with dictated or keyed notes into the EMR, capturing decision-making and care coordination / consults. Even online research pertinent to the visit (can sarcoidosis cause GI symptoms?) could be incorporated into the record (browser history), supporting decision making and due diligence. These AVI files are completely portable without need for interface language.
  • Billing. How about simply paying an hourly rate for time spent, like lawyers? Time stamps on audio and video, post-visit data entry and online patient care research would serve as indisputable evidence of billable time.
  • Legal. ‘Nuff said. Patients who opt in to AV documentation assent to legal arbitration. And benefit from reduced insurance costs associated with this documentation product. Patients who opt out must use the traditional tort pathway, but are exposed to the added expense of that course of action.
  • Patient education and self care. An electronic copy (edited or not) of the visit can be provided to the patient. Presumably the interaction involves patient education elements from the clinician.
  • QA. NLP can sort through audio files for key words related to quality metrics. AV files can be used for clinician feedback for both physical exam skills as well as interpersonal behavioral skills.
  • Cost.  Memory is cheap. AVI files are portable, searchable, and easily indexed and archived. Insurers could develop pilot programs using this technology to study cost impacts in preparation for wide release if promising.

I hand-picked this week’s Spotify playlist with music sharing only one attribute: I like everything I included. On it: Pond, RPWL, The Killers, Band of Horses, Marina and the Diamonds, Turtle Giant, and a searing live version of “Little Wing” from Clapton/Winwood. Here’s a trivia throw-down: what movie (one of my favorites) opens with Tune #13 as buses drive by in the night? If you want to play along at home, I also created this empty playlist to which you can add your song du jour — I’ll listen to them and choose some for next week’s playlist (it’s like a clinical inbox for music referrals).

 11-30-2012 6-45-18 PM

Welcome to new HIStalk Platinum Sponsor Fujifilm, which offers the Synapse product line (RIS, PACS, 3D suite, virtualization, managed services, and teleradiology RIS). The Web-based Synapse radiology management solution provides hospitals and outpatient imaging facilities such capabilities as integrated dictation, a referring physician portal, electronic dashboards, mammography reporting, peer review that meets ACR guidelines, and critical result notification, all included at no extra cost. Users can craft their own workflows via built-in tools for instant messaging, automated e-mail notification, and digital forms creation. They can also use drawable consent forms, inventory tracking, and real-time eligibility checking. The RIS integrates with every PACS on the market, including of course Synapse PACS. It even includes teleradiology capabilities. You can choose Synapse RIS as a turnkey system that includes software, hardware, hosting, system management, upgrades, and optional disaster recovery services and off-site archiving. Customers pay by exam volume rather than per user or per site, which makes it affordable for facilities ranging from small imaging centers to multi-facility enterprises. Thanks to Fujifilm for supporting HIStalk.

Here’s an overview of Fujifilm’s Synapse RIS that I found on YouTube.

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

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 11-30-2012 6-00-37 PM

The vast majority of survey respondents believe that transcription is a commodity service differentiated primarily on price. New poll to your right: should the government require more upfront proof of attaining Meaningful Use before before sending payments?

Few people buy traditional software (i.e. PC programs in a box instead of apps in a Web store) these days, and those who do are rarely delighted. I’m happy to report an exception. I bought the just-released Dragon Naturally Speaking 12 and it’s amazing. The accuracy approaches 100 percent and it’s quite fast. I bought the premium version from Amazon for $126, which also includes the ability to transcribe pre-recorded dictation, sort of like Nuance’s eScription server-based speech recognition (the Home Version is only $50). You can speak at least three times faster than you can type, not to mention saving your wrists. I’ve used previous versions as well as the Windows 7 speech recognition and Siri and there’s no comparison. (Disclosure: Nuance is a sponsor and has offered me free copies several times, but I paid out of my own pocket so I wouldn’t feel bad about saying I hated DNS if that was the case). DNS 12 is one of the most amazing things I’ve ever seen run on a PC, although as critics always point out, you can’t use it with an EMR since that requires the more expensive medical version. But if you want to feel like Bill Shatner sprawling back in a chair on the Enterprise bridge and barking out orders for the computer to obey, you need it. It must be a miracle for people with handicaps who can’t use computers in traditional ways.

Scanadu, the 20-employee company whose tagline is “Sending your Smartphone to Med School,” announces that it will release three consumer tools by the end of 2013. The $150 Scanadu Scout is held to the temple and in less than 10 seconds, checks pulse, heart activity, temperature, and pulse oximetry and sends the results via Bluetooth to its smartphone app. Project ScanaFlo is a disposable cartridge that turns a smartphone into a urine analysis reader (pregnancy complications, gestational diabetes, kidney failure, or UTI). Project ScanaFlu is a saliva tester that detects cold symptoms by checking for strep, influenza, adenovirus,and RSV. Scanadu is best known for working on a tricorder-like health assessment device and these modules are the first components of it. Above is a Friday interview with the co-founder and CEO, who seems to be at a loss of how to explain medical principles to the sing-songy twenty-something interviewer who nods intently while saying “sort of “ and “you know” a lot while clearly not understanding most of what he’s saying.

It appears that Blackstone Group has become the frontrunner to acquire Allscripts, although the company is rumored to be holding out for more money than Blackstone thinks it’s worth. Shares dropped 11 percent Friday, having lost most of the gains that occurred after rumors of the company’s sale slipped out in late September. The other bidders were claimed to be Carlyle Group LP and TPG Capital Management LP. I don’t understand SEC rules, but this business of running newspaper stories quoting insiders about who’s making offers and at what price sure seems to open the door for cheating, like intentionally leaking out news that will move the share price up or down in a way that will benefit the leaker.

CareFusion announces that Children’s Hospitals and Clinics of Minnesota has gone live on wireless connectivity between its Alaris smart IV pumps and Cerner Millennium.

Health Management Associates warns investors that a “60 Minutes” report is expected to claim that the for-profit hospital operator’s contracted ED doctors were pressured to admit patients who didn’t need to be hospitalized. Both HMA and Community Health Systems have disclosed in SEC filings that several government agencies are following up on whistle-blower allegations by requesting admissions information. HMA says it thinks authorities want to know how more about its vendor-provided ED software and whether it was programmed to admit patients unnecessarily. Tenet Healthcare had accused competitor CHS in early 2011 of using ProMed Clinical Systems software to boost its admissions in a lawsuit, but a judge dismissed the claim. HMA is also a user of ProMed’s Web-based vEDIS software, which is ONC-ATCB certified. I seriously doubt that ProMed makes admission decisions that the ED docs can’t override, so if there’s a smoking gun, I’d expect to find it in internal e-mails, meeting minutes, or in interviews conducted with the actual ED docs.

12-1-2012 7-52-49 AM

Kansas Health Information Network becomes the first HIE to connect directly to the CDC’s BioSense outbreak tracker, allowing hospitals to quickly share information about threats and report them to CDC to investigate possible outbreaks.

Advanced Data Processing announces that it has fired an employee who admitted stealing data from an ambulance billing system it runs and selling it to a criminal group suspected of using the information to file fraudulent tax returns to collect refunds. The information came from Cape Fear Valley Hospital Health System (NC). The same scam has led to the arrest of three people in Florida, at least one of them an employee of Florida Hospital Tampa, who used hospital patient billing information to collect $1.5 million in IRS tax refunds.

Why can’t American healthcare strikers be this much fun? Public health workers in Spain protest government spending cuts and healthcare privatization by performing a flash mob dance outside La Paz Hospital in Madrid.

GE CEO Jeff Immelt says, “The next holy grail is about decision support and analytics.”

A rare Weird News Andy weekend update: in France, a man is awarded $250,000 in his lawsuit against GSK, maker of the Parkinson’s drug that he claims caused him to become addicted to gay sex and gambling. The suggestion that gay sex is a shameful addiction that requires compensation is kind of insulting, but apparently the jury bought it.

Bizarre: a pharmacist pleads guilty to planting mercury in areas of Albany Medical Center Hospital (NY) in the hopes that the ensuing panic would drive patients away. Police searching the home of the man, who was upset that the had hospital billed him for treatment, found child pornography, Nazi memorabilia, and a stockpile of guns and ammunition.

Also bizarre: a Washington veterinarian and aspiring EMT is charged with animal abuse after former employees claim he punched and choked animals under his care. He had already admitted to stealing and using drugs from his practice. The owner of one animal that was allegedly mistreated summarized, “Well, I wouldn’t want him to be my first responder. Golly.” The doctor’s Facebook blames disgruntled former employees and lawyers trying to change the state’s veterinary malpractice laws, which limit plaintiffs to recovering the “market value” of their animal with no pain and suffering award available for the lawyers to skim their 33 percent of.

Vince covers the fascinating HIS-tory of CPSI this time around, getting some help from Troy Rosser, SVP of sales there.


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

More news: HIStalk Practice, HIStalk Connect.

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December 1, 2012 News 12 Comments

News 11/30/12

November 29, 2012 News 7 Comments

Top News

11-29-2012 8-05-24 PM

The Office of the Inspector General finds that CMS has not implemented adequate safeguards to verify the accuracy self-reported EP and hospital data for the MU program. It also says that the audits CMS plans to conduct after the fact may not work, either. OIG recommends that CMS randomly select providers to provide supporting documentation for pre-payment; issue guidance detailing the types of documentation that providers should maintain to support compliance; and require certified EHRs to produce reports verifying the achievement of MU measures. Medicare hasn’t audited any of the $3.6 billion it’s paid out so far. Acting CMS administrator Marilyn Tavenner doesn’t like the idea of pre-payment review, saying it could “significantly delay payments to providers” and “impose an increased upfront burden on providers.”

Reader Comments

inga_small From Uncorked: “Re: MyWay switch. I’ve learned the upgrade that Allscripts is offering  its customers from MyWay to Pro does not include a detailed conversion of financial data, meaning users have to work the old balances in MyWay. Sounds painful.” The details on the MyWay to Pro upgrade are on the client-only section of the Allscripts Web site, so I can’t verify. However, since detailed conversion of financial data between disparate systems can be quite complicated and time consuming, maybe the balance forward option is actually the lesser of two pains.

11-29-2012 7-45-21 PM

From NoNamesPls: “Re: MD Anderson. To release an EMR RFP in January.” Unverified.

From Lucille Carmichael: “Re: Nuance. Planning to spin off Salar, which it acquired with its Transcend acquisition, possibly as early as Friday.” Unverified.

HIStalk Announcements and Requests

inga_small If your week has been anything like mine, you are still recovering from all your thankfulness last week. In case you missed any HIStalk Practice news, here are some highlights. ONC says the percentage of physicians e-prescribing on the Surescripts network through an EHR has jumped from seven percent in 2008 to 48 percent as of June 2012. Almost 10 percent of US residents now receive their healthcare through an ACO. The highest-rated EMRs in an AAFP-member survey are Praxis, Medent, Healthconnect, Amazing Charts, and SOAPware. Pediatricians lag other specialties in EHR adoption. Practice Wise’s Julie McGovern offers key points for selecting an EMR vendor. Dr. Gregg muses about corporate chaos and HIT. Thanks for reading.

On the Jobs Board: Marketing Programs Manager, Meditech Clinical Trainer, National Sales Director, Ambulatory Implementation and Deployment Managers — athenaclinicals.

Acquisitions, Funding, Business, and Stock

The mobile interactive health advice platform HealthTap acquires the health business of Avvo, including its directory and network of providers.

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Ginger.io, which analyzes sensor and patient-entered smartphone data to for the equivalent of a “check engine light” for patient populations, raises $6.5 million. The investor is Khosla Ventures, whose founding partner Vinod Khosla famously predicted several weeks ago that machines will replace 80 percent of doctors (some of his other investments include iPhone attachments for heart monitoring and diagnosing ear infections). Ginger.io is based on research conducted at the MIT Media Lab. The company acquired another startup, Pipette, earlier this year for its technology that claims to reduce hospital readmissions by reviewing patient-reported outcomes. Travis reported the acquisition on HIStalk Connect back in March, where he concluded,

Ginger is a company we are going to hear a lot more about in the coming years. They have a clear focus on learning about patient behavior and proactively trying to address potentially costly events. The main question will be how much money can Ginger make quickly from pharma research or how much money can it raise to sustain itself until the healthcare industry is ready to pay for services like this. Either way, this acquisition is good for mobile health startups and Rock Health.


Stormont-Vale Healthcare (KS) selects Hyland Software’s OnBase enterprise content management solution for integration with its Epic ambulatory EMR.

Yale-New Haven Hospital contracts with Mediware for its Transtem software for tracking the use of stem cell products in providing patient care.

OnFocus Healthcare adds 75 hospital clients of its OnFocus | epm software during the company’s fourth quarter.

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Pomona Valley Hospital Medical Center (CA) selects Dell and Siemens Healthcare to provide diagnostic image archiving and sharing services.

BJC Healthcare (MO) expands its use of the Surgical Information Systems perioperative information system to Saint Louise Children’s Hospital and Barnes-Jewish West County Hospital.

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Santa Clara Valley Health and Hospital (CA) awards CSI Healthcare a contract to support its Epic initiatives.

Beaufort Memorial Hospital selects the Medseek Empowered solution to expand its patient engagement initiatives.

St. Joseph Health System (TX) chooses GroupOne Health Source for EHR medical billing services.

Ophthalmic Consultants of Boston (MA) deploys MedAptus for professional charge capture in its office and ambulatory surgical center locations.


11-29-2012 1-30-21 PM

SPI Healthcare appoints Ken Christensen (Health PCP) SVP of operations.

11-29-2012 2-34-35 PM

CareTech Solutions names Robert M. Johnson (Palace Sports & Entertainment) CFO.

11-29-2012 6-29-52 PM

Joseph Kvedar, MD, director of the Center for Connected Health of Partners HealthCare,  signs on as a principal with Wellocracy, but will continue in his role at CCH. The new company will focus on personal activity trackers and motivation tools that integrate healthy activities into busy lifestyles, initially producing books. He’ll be joined by a self-help author, a personal trainer turned physician, and a media relations expert.

11-29-2012 6-45-31 PM

Bill Bria, MD (Shriners Hospital for Children) is named chief medical officer of business intelligence software vendor Dataskill.

11-29-2012 9-47-40 PM

Peter Henderson (PatientKeeper) joins social networking-based employee wellness vendor ShapeUp as COO.

Announcements and Implementations

Washington DC Mayor Vincent Gray announces the go-live of Direct Secure Messaging in the district using Orion Health’s technology platform.

RelayHealth announces that it will provide an open, vendor- and payer-neutral platform for patient identity management, patient consent management, and other technology services to enable a longitudinal patient record. The technology will allow providers to embed a cross-entity MPI into their native systems and enable patient identification across multiple systems.

11-29-2012 7-51-45 PM

Jennie Stuart Medical Center (KY) goes live on Ingenious Med’s Impower charge capture solution.

The Kansas HIN and ICA share patient data with the CDC’s Biosense public health tracking system.

Government and Politics

An opinion piece in The Wall Street Journal written by former US Senator George LeMiuex (R-FL) says the government is doing little to stop the estimated $100 billion per year that Medicare loses to waste, fraud, and abuse. He had proposed a credit card-like fraud prevention system that would stop questionable claims before they’re paid, but that’s the $77 million system developed by Northrop Grumman and Verizon that had stopped less than $8,000 in questionable payments in its first eight months. He concludes that the problem is “bureaucrats hiding in their own ineptitude.”

11-29-2012 3-09-34 PM 

CMS has paid more than 150,000 EPs and 3,238 hospitals $8.4 billion in MU incentives through the end of October.

CMS extends the Medicare MU attestation deadline for New York and New Jersey hospitals affected by Hurricane Sandy. Eligible hospitals must submit to CMS and extension application to extend the attestation deadline from November 30, 2012 to the spring of 2013.

11-29-2012 6-48-13 PM

HHS issues a guide for de-identifying patient data to meet HIPAA privacy rule requirements.


11-29-2012 8-44-55 PM

British troops in Afghanistan are using a portable 3D camera to assess battlefield injuries and send images around the world for second opinions.

Surgical Theater LLC sells its first 3D imaging surgical rehearsal platform. It generates statistical models from an individual patient’s scanned images, providing life-like feedback using flight simulator technology that allows the surgeon to practice the procedure hands on. The first customer is University Hospitals Case Medical Center (OH), which isn’t surprising since its co-originator is the chair of the hospital’s neurosurgery department and the product bears his name. FDA approval is pending. The co-founders are former members of the Israeli Air Force, with my reason for calling out that fact becoming more clear as you read further down the page.


The California Department of Public Health fines Prime Healthcare Services $95,000 after determining that Shasta Medical Center violated patient confidentiality when it shared a woman’s medical information with journalists and sent an e-mail about her treatment to several hundred hospital employees. The disclosures were made when the hospital was seeking to respond to a news story featuring the woman and the hospital’s alleged overbilling of Medicare.

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Philips moves from last place to first place in KLAS’s review of the MRI market.

11-29-2012 2-58-34 PM

A survey finds that promoting EHRs and mobile health are a low priority for voters compared to other healthcare issues. When asked where federal healthcare spending should be cut, 50 percent of voters said payments to providers should be reduced, while 42 percent said the government should spend less on healthcare IT.

11-29-2012 8-18-21 PM

Leapfrog Group’s second round of hospital safety ratings show significant swings in the months since the original report after it changes its methodology and uses newer data, with 103 hospitals moving from a C to and A, two changing from A to D, and an overall 8 percent moving at least two grades. Ronald Reagan UCLA Medical Center earned an F grade along with 24 other hospitals, while Cleveland Clinic took home a D. Predictably, the high-profile hospitals with the bad grades denounced the methodology when stung by local press coverage of their embarrassing results, claiming they’ve improved vastly in the 1-3 years since the information was collected.

The Bureau of Labor Statistics predicts that IT positions in healthcare and social assistance will account for about 28 percent of all new jobs by 2020.

A New Zealand sleep expert blames mobile devices for a 50 percent jump in sleeping pill consumption by young people, saying, “People go to bed with their iPhones and iPads and expect to be able to then go straight to sleep, but realistically, you can’t do that. You really need to put these devices down about an hour before you go to bed.”

11-29-2012 7-52-48 PM

I was interested in the answer Kobi Margolin gave to my interview question about why Israel produces so many healthcare IT companies that sell products to the US. He suggested reading Start-Up Nation, which describes the business climate there. I plan to do so, but from the Amazon reader comments, some of the reasons that the country is so successful despite being constantly at war, surrounded by enemies, and devoid of natural resources are: (a) mandatory military service that encourages innovation and forges early social networks; (b) Jewish tradition; (c) open immigration that encourages brilliant innovators to come there; (d) a tradition of young people traveling all over the world due to the small size of the country; (e) government policies and culture that supports entrepreneurism and the questioning of authority; (f) a flat hierarchical society; (g) acceptance of failure in the quest for success; (h) early maturity and lack of belief that people shouldn’t start businesses without a lot of experience, emphasizing instead agile, problem-solving generalists; (i) mashing up technology with other disciplines in fresh ways; and (j) great universities. In other words, pretty much exactly opposite what we have in the US except for the great universities part. If you’ve read the book, feel free to chime in.

An article in The Wall Street Journal raises the question of the ownership of data created by implanted medical devices like defibrillators. It’s your body, but only the device manufacturer (and possibly your doctor, if you see one regularly) can see what it’s emitting. A Medtronic spokesperson says, “Our customers are physicians and hospitals” and says demand is low and patients couldn’t make sense of their data anyway, but then admits that the company is thinking about selling its patient data to health systems and insurance companies. Another senior Medtronic executive calls the information it collects “the currency of the future.” The company has created a data unit specifically charged with creating a business around selling patient data, working the loophole that only providers are covered by the 17-year-old HIPAA regulations, not device manufacturers. One patient paid $2,000 to take a technician’s class for reading the reports, but still has to pay his cardiologist for a visit to get the data.

Remedy Health Media launches a service that will send electronic newsletters to patients with specific conditions under the name of their doctor, who pays the company for use of its patient data management system. The company says health reform gave them the opportunity, while advertising drug companies give them their profit. It’s a double-opt in service due to comply with spam laws, meaning patients need to sign up and then click a link on a welcome e-mail indicating their interest to receive further e-mails. Some of the company’s brands include HealthCentral, The Body, RemedyMD, and My Refill.

Attendees of an auction at a bankrupt and closed Pennsylvania hospital claim to have seen unattended medical and employee records and computers up for bid that were displaying patient information. The bankruptcy trustee claims the medical records were in roped-off areas and the computers had been wiped clean, but a bidder says that’s not the case.

An excellent article in the Toronto newspaper questions whether e-health will ever deliver a return on investment in Canada. It calls out the massive spending on eHealth infrastructure, implying that it’s a desperate shot at addressing the question, “Could the elderly bankrupt Canada?” but points out that for all the investment, Canada is still well behind most of the industrial world, with 80 percent of its physicians still using “a fax machine running full blast against a ceiling-high backdrop of manila files.” It says that Canada’s efforts are looking a lot like those of the UK, where ambitious and expensive programs tanked with little to show for it other than billions of taxpayer pounds transferred to consultants and contractors. A former deputy health minister had an interesting thought: instead of buying EHRs for everybody, which he says will cost more than the healthcare services they consume, he suggests providing them only for seniors and people with chronic disease since 1 percent of Ontario patients have been found to consume 50 percent of hospital and nursing home costs.

Weird News Andy wonders if this is where we’re headed. In England, sick babies are being put on “death pathways,” with the rather lurid newspaper article quoting one doctor who admitted that he took part in “starving and dehydrating ten babies to death in the neonatal unit of one hospital alone.” A hospital nurse calls it “euthanasia by the back door.” An investigation will determine whether hospitals earned bonuses for hitting death pathway targets.

Sponsor Updates

11-29-2012 9-57-58 PM

  • Nuance gives the $73 (at Walmart) Philips Digital Voice Tracer dictation recorder its highest rating for recording and voice recognition accuracy with Dragon Naturally Speaking.
  • 3M announces details of its 2013 Client Experience Summit, set for April 2-4 in Tysons Corner, VA.
  • Liaison Healthcare announces that four out of five global pharmaceutical companies use its integration and data management services.
  • The Orlando paper spotlights Kony Solutions and its “cutting edge” app development.
  • Levi, Ray & Shoup publishes a case study highlighting the benefits that Memorial Hermann Healthcare (TX) realized simplifying output management.
  • SuccessEHS integrates the Midmark IQvitals device with its EHR.
  • BridgeHead Software releases a white paper highlighting the crucial concerns of image availability.
  • Besler Consulting offers a free comprehensive summary of the Hospital Outpatient Prospective Payment System final rule.
  • API Healthcare offers five tips for payroll success in hospital mergers and acquisitions.
  • Informatica introduces a global messaging routing capability for the Informatica Ultra Messaging environment.
  • The Tampa Bay Technology Forum honors MedHOK with the 2012 Emerging Technology Company of the Year Award.
  • Ingenious Med releases software upgrades for its Web and mobile solutions that include a Virtual Superbill to improve charge capture.
  • Health Language Inc. releases new terminology mapping to support providers and EHR vendors meeting Stage 2 MU requirements for SNOMED-encoded problem lists.
  • iSirona releases Software Makes Sense, a five-part video series detailing the specific configurations and their advantages used by iSirona’s hospital customers to sync medical devices and EHRs

EPtalk by Dr. Jayne

Friday is the last day for HIMSS 2013 Interoperability Showcase submissions. Demonstrations must include health information exchange between at least three healthcare organizations.

Friday is also the last day for Eligible Hospitals and Critical Access Hospitals to register and attest for incentive payments in fiscal year 2012. CMS has a tutorial on YouTube which, strangely, enough seems to have been filmed in front of a green screen that wasn’t replaced by graphics, rendering it nauseatingly distracting.

Finally, a data breach that doesn’t involve a lost laptop or stolen hard drive. A resident physician terminated from the University of Arkansas for Medical Sciences kept patient lists and notes after being terminated in 2010. The resident began to produce the records during a lawsuit against the residency program, leading to a court order to prevent further release.

Discussions at RSNA reveal mixed opinions about releasing radiology results directly to patients. I think many providers would prefer to release only annotated results to patients – those results to which the ordering physician has added comments that explain the clinical significance of the radiologist’s interpretation. There are a lot of vague terms used by some radiologists (clinical correlation recommended, questionable presence of something, etc.) and that leads to fear of patients misunderstanding, which leads to fear of being transparent with results. If health systems are going to release without annotation, maybe they should require radiologists to document results at the 5th grade reading level: “Your chest x-ray looks like the chest x-ray of every other person who lives in your part of the country. I don’t see anything that doesn’t belong there.”


For those whose providers have embraced transparency and are offering patient portals and other engagement platforms, the Family Caregivers Video Challenge offers a chance to tell how health information technology or eHealth tools have helped manage a loved one’s care. Video submissions are due by December 10 and prizes worth $8,350 are at stake.

My hospital has been lucky that this hasn’t happened to us (yet). A NYU staffer inadvertently sends an e-mail that allows a student to accidentally “Reply All” to nearly 40,000 of his classmates. Thousands of students jump on the bandwagon, creating what some termed the “replyallcalpyse.” It’s only a matter of time before it happens here.



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

More news: HIStalk Practice, HIStalk Mobile.

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November 29, 2012 News 7 Comments

News 11/28/12

November 27, 2012 News 16 Comments

Top News

11-27-2012 1-34-54 PM

OIG includes “integrity and security of health information systems and data” as one of the top management challenges faced by HHS for 2013.

Reader Comments

11-27-2012 9-01-37 PM
From Image Is Everything: “Re: RSNA. As a vendor, some of us had to go to Chicago the Monday before Thanksgiving and work through the weekend. The trick was to take your spouse, since the Magnificent Mile had beautiful displays, shopping, tourists from around the world, and lots of nice people. The problem was Thanksgiving dinner – think the Chinese restaurant in ‘A Christmas Story.’” I accompanied Mrs. HIStalk to a Chicago conference a few weeks ago, the first time I’d been there since the wintry HIMSS conference of 2009. We had a pretty good time this trip – stayed at the Hyatt on the river, ate at semi-touristy places (XOCO, the Walnut Room, South Water Kitchen, and the Metropolitan Club in Willis Tower), bought Frango Mints, and tried to stay warm since the temperature dropped from the mid-70s the first day to the 40s the rest of the week, ruling out the architecture boat tour. I wouldn’t say Chicago is my favorite city (I think Seattle and San Diego probably top my list), but I at least liked it better than when snow and fellow HIMSS attendees were swirling around me.

11-27-2012 7-00-21 PM

From The PACS Designer: “Re: 3D printing. TPD has posted about 3D software solutions in the past, and now you’ll become aware of a retail 3D printer called MakerBot. This company reminds TPD of when Xerox was first to introduce a new way of high quality printing decades ago. MakerBot just opened the first 3D Photo Booth in NYC, its home base, and I’m sure when the photos are viewed, word will spread across the country quickly. Healthcare could benefit by employing this 3D solution to view images of the anatomy, especially the heart, by practitioners and patients undergoing treatment.” 

From Keystone: “Re: EMR. I’m involved with five practices being implemented and all are complaining that their efficiency is going backwards because of extra keyboarding. Do you think this is due to added documentation that they should have been doing all along, poor system design, or both? These are mostly primary care physicians and they are definitely seeing fewer patients per session. Also, do you know of bolt-on products to support dictation or other simpler input tools?” Readers, I’m sure Keystone would welcome your comments, which you can add at the end of this post.

From Cloud Dancer: “Re: PACS. Your blog is incredible! Was wondering about your coverage of cloud imaging solutions like Merge as well as other trends in PACS going cloud.” One thing I excel at is recognizing my innumerable limitations, among them being paucity of in-depth knowledge about imaging and lack of time to learn since I’m a full-time hospital employee. I could use an expert contributor if anyone is interested in taking HIStalk a bit deeper into that area. The other areas that people seem to want more coverage about include HIT-impacting federal policy activity, patient-centered technologies, and startups and other innovation. You might think it would be easy to find and engage experts to contribute to HIStalk, but it’s not – they’re either too busy or not all that interested in writing regularly since it’s harder than it looks.

HIStalk Announcements and Requests

11-27-2012 8-50-43 AM

inga_small I am back from my Thanksgiving break, which included a bit of holiday shopping. I was remarkably restrained in my purchasing, though I did note quite a few items for my letter to Santa. Topping the list: Christmas tree ornaments for the shoe lover.

11-27-2012 9-04-09 PM

Thanks for the nice comments folks have sent about the redesign of HIStalk Connect (the artist formerly known as HIStalk Mobile). Next up: a revamp of HIStalk Practice and HIStalk, which will have a different look that’s more appropriate to longer posts. I haven’t changed the appearance of the sites since 2007, so hopefully nobody will be too jarred by the change (me included).

Just in case you have any doubts about the financial literacy of the average American, check out the lines of people waiting to buy tickets for the $500 million Powerball lottery. These are the folks who couldn’t be bothered to play when the prize was only a couple of hundred million. Does that make sense? Do you suppose a lot of statisticians are plunking down their cash given the impossible odds of getting it back? Maybe the feds should run a lottery to help pay down the smothering national debt – it’s like a tax that nobody complains about.

11-27-2012 5-55-07 PM image

Welcome to new HIStalk Platinum Sponsor Innovative Healthcare Solutions. The 12-year-old Punta Gorda, FL-based company offers clinical and revenue cycle implementation services, with a focus on Epic and McKesson (ambulatory and inpatient EMR, STAR, Pathways, and Horizon, including upgrades and optimization.) They’ve been a Best in KLAS winner for the past two years in the Clinical Implementation – Supportive Work category. They also do assessment, optimization, testing, and strategic planning. Their approach is proven and cost effective, with the recognition that healthcare organizations are required to focus on both financial and clinical excellence for success. The principals have lot of industry experience – Robin Bayne was at McKesson for many years and Pat Stewart has been in healthcare for more than 30 years. Thanks to Innovative Healthcare Solutions for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

Healthrageous announces that Partners HealthCare participated in its recent $6.5 million round of Series B financing.

11-27-2012 9-08-13 PM

Hello Health, which offers an EHR platform that’s paid for by patients ($5 per month, according to its site) instead of doctors, secures $11.5 million in financing.

11-27-2012 6-25-21 PM

VisionMine launches a service and Web portal that will match small startups with big companies trying to solve specific technology problems. The company will grade startups for the review of the large companies and will coordinate introductions when there’s mutual interest.

Merge Healthcare files a lawsuit against orthopedics PACS vendor Medstrat, claiming the company’s false claims and unfair business practice have cost Merge tens of millions of dollars in revenue. The suit claims that Medstrat sent e-mails and advertisements to Merge customers implying that the company’s announced plan to seek strategic alternatives was an indication of instability, tagging one e-mail with the phrase, “Why go through more pain? Converting is simple.” MRGE shares closed Tuesday at $3.31, down more than 50 percent since February.


11-27-2012 9-02-58 AM

Valley Medical Group (MA) contracts with eRAD for its PACS and speech recognition solution.

Intermountain Healthcare (UT) signs an $11.7 million, multi-year contract for Siemens Image Sharing and Archiving.

Adventist Health System will expand its use of Cerner’s P2Sentinel solution for auditing clinician access to patient data.

11-27-2012 9-11-52 PM

Virtua (NJ) implements the Vergence and proVision identity and access management solutions from Caradigm.


11-27-2012 9-50-11 AM

Cadence Health (IL) names Dan Kinsella (Optum Insight) CIO and EVP, replacing the recently retired Dave Printz.

11-27-2012 1-24-59 PM  11-27-2012 1-23-57 PM  11-27-2012 1-23-05 PM

Orion Health names Tracey Sharma (Baxter) sales director, Sergei Maxunov (Bell Canada) senior solutions consultant, and Health Linkletter (EMIS) project manager of its Canadian eHealth team.

Announcements and Implementations

HIMSS honors the family practice of Jeremy Bradley, MD (KY) as a winner of the 2012 Ambulatory HIMSS Davis Award of Excellence.

Cerner and telecommunications information company Global Capacity partner to deploy Cerner Skybox Connect, a high availability private network for the healthcare industry.

11-27-2012 9-59-23 AM

Children’s of Alabama implements Accelarad’s medical image sharing network to enhance care coordination with referring facilities.

11-27-2012 10-04-07 AM

Jefferson Radiology (CT) deploys Repair, a remote MPI management service from Just Associates.

NextGen Healthcare and Microsoft launch NextGen MedicineCabinet, a free app for the Windows 8 platform for the management of personal medication records.

Nuance Healthcare announces Assure for Powerscribe 360 | Reporting, which uses clinical language understanding to QA radiology reports before they’re signed.

Medsphere marks its tenth anniversary by noting that more than 70 percent of its OpenVista customers have achieved Meaningful Use Stage 1 so far.

Wellcentive announces that its Advance Outcomes Manager population health management and analytics solution has earned NCQA certification.

11-27-2012 6-35-21 PM

GetWellNetwork and Sharp HealthCare (CA) develop and launch what they say is the first in-room collaborative patient whiteboard. It identifies care team members, tracks visits and family questions, provides a daily schedule and plan, and allows patients to communicate with their family members.

11-27-2012 6-54-44 PM

University of West Georgia in Carrollton, GA, whose graduates make up a third of Greenway’s employees, names its new sports stadium building “Athletic Operations Building, sponsored by Greenway, Inc.” and adds the company’s logo to the building.

Cerner lists all of its customers that have successfully attested for Meaningful Use Stage 1.

11-27-2012 7-55-29 PM

Chicago-based Valence Health, which offers population management and reimbursement risk management tools and services to providers, announces that its 2012 revenue will increase by 75 percent to over $30 million compared to 2011. The announcement mentions new hires Eric Mollman (Staywell Health Management) as CFO, Kevin Weinstein (ZirMed) as chief marketing officer, and Prasanna Dhungel as VP of product development.

The Panama City, FL paper writes up the expansion of local business iSirona,which also announces that Mercy Medical Center (IA) has contracted for its medical device integration in the OR.

Government and Politics

CMS awards a 10-year, $15 billion contract to eight vendors to compete to build various aspects of a virtual data center for the agency’s IT infrastructure, including claims processing and hosting services for a national data warehouse application.

CMS picks the Kansas City Improvement Consortium, the Health Improvement Collaborative of Greater Cincinnati, and the Oregon Health Care Quality Corporation to be the first organizations to participate in a Medicare claims sharing initiative to assess provider performance.

November 30 is the last day for eligible hospitals and critical access hospitals to register and attest for an EHR incentive payment in fiscal year 2012.

Tennessee’s Medicaid program requests $9 million to replace its obsolete IT system with the VA’s VistA.


The Madison, WI paper looks at the growth of Epic and its impact on the region. Epic left Madison several years ago for Verona, which has seen huge jumps in property values, but Madison has also benefited by increased demand for rental property and more employment opportunities. Madison city officials say Epic visitors are driving revenue to the hospitality industry, resulting in a 30 percent increase in city room tax receipts from 2010 to 2012.

11-27-2012 4-15-16 PM

A new KLAS report concludes that the top global radiology PACS vendors vendors are those offering meaningful and timely upgrades with expanded usability. Infinitt and Intelerad rated highly as innovators, along with DR Systems, McKesson, Novarad, and Sectra.

A Weird News Andy literature review notes that two new studies conclude that “flu vaccine is a heart vaccine” since people in the study who got a flu shot experienced 50 percent fewer cardiac events and 40 percent lower heart-related mortality. I’d need to review the original research to feel good about that conclusion, about which I’m skeptical otherwise.  

Also from WNA: in the UK, ministers are warned that a plan to implement “virtual clinics” powered by Skype will save billions of pounds immediately, but could leave less technology-savvy patients behind. The Health Minister expects video visits to reduce unnecessary hospital stays, saying that a third of patients can be managed without a face-to-face appointment, leaving more capacity for those who need to be seen in person.

WNA also notes this nugget: the Cincinnati-based TriHealth health system fires the 150 of its 10,800 employees who did not get a mandatory and free flu shot.

I’ve mentioned Italian brain cancer patient (and artist, engineer, and TED fellow, as it turns out) Salvatore Iaconesi several times for his “My Open Source Cure” appeal for treating his condition, much of which involves the struggle to share his records electronically with experts around the world who volunteered to help. CNN ran his story on its main page Tuesday morning. You should watch his newly published TEDx talk above on the challenges created by the medical establishment and his views on wellness and cures (the human being, not the “patient”). I don’t agree with everything he says, but he will definitely make you think, especially if you’ve been a patient with a serious condition. He is exchanging information with 15,000 people and 60 doctors and reviewing 50,000 strategies sent to him with the help of 200 volunteers.

MMRGlobal is awarded a fifth EMR-related patent, proudly proclaiming that despite having supposedly harassed companies into signing $30 million worth of license agreements for its newly-issued patents, the company is not a patent troll since the patented technology is part of products it sells itself. Or tries to, anyway – according to this month’s quarterly filings, the company’s total quarterly revenue was $346,000 with a net loss of $1.5 million, with current liabilities exceeding current assets by $8 million and only $42,000 cash in the bank as it seeks additional financing from its founder and anybody else willing to loan it money. OTC-listed shares are at $0.0147, valuing the whole enterprise at $7 million and obviously reflecting serious market doubt about the company’s banking the $30 million it claims to be owed for its newly created intellectual property portfolio.

11-27-2012 8-16-43 PM

Cleveland Medical Mart announces that it has signed Cleveland Clinic and GE Healthcare as tenants. HIMSS, which had signed on with a similar project in Nashville that went bust, has toured the facility, which is three-quarters complete and scheduled for a September 2013 opening.

The local paper in Edmonton, Alberta gets its hands on the expense records of the former CIO of the Capital Health region, whose boss there was found to have been reimbursed $350,000 for questionable expenses that included opera tickets and a butler. Donna Strating, who like her boss was billing $2,700 per day as a consultant, was reimbursed for large restaurant tabs, movie tickets, and snacks.

Sponsor Updates

11-27-2012 12-55-37 PM

  • Employees of Digital Prospectors supply 30 Thanksgiving meals to the New Hampshire non-profit Families in Transition.
  • MModal releases software updates to its Fluency for Imaging Reporting technology platform to support report creation and clinical documentation workflow.
  • Merge Healthcare makes its iConnect Enterprise Clinical platform available through EMC Select.
  • The GPO Yankee Alliance offers its healthcare members connectivity solutions from Lifepoint Informatics.
  • Frost & Sullivan honors Acuo Technologies with its 2012 Market Share Leadership Award in Imaging Informatics.
  • Visage Imaging announces a new video about its enterprise imaging platform, Visage 7 – Speed is Everything, at RSNA.
  • Frost & Sullivan awards TeraRecon its 2012 New Product Innovation Award in Medical Imaging Informatics.
  • Telus Health executives Francois Cote and Brendan Bryne are quoted in a newspaper article on the digital transformation in healthcare.
  • The Web Marketing Association awards Imprivata its 2012 WebAward for Outstanding Achievement in Web Development in the Best B2B Website category.
  • The Detroit Free Press recognizes CareTech Solutions with its fourth consecutive Top Workplace award in the large company category.
  • Frost & Sullivan awards Humedica the 2012 North American Health Data Analytics Customer Value Enhancement award.
  • BridgeHead Software releases a white paper outlining strategies for addressing concerns about image availability.


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

More news: HIStalk Practice, HIStalk Mobile.

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November 27, 2012 News 16 Comments

Monday Morning Update 11/26/12

November 24, 2012 News 6 Comments

11-23-2012 9-15-15 PM

From Non Sequitur: “Re: UNC. I told you I would submit the official Epic announcement when it was released. Since you have already mentioned this, it’s not really newsworthy.” Au contraire – it’s nice to get official verification, which apparently came from UNC Health Care System (NC) on November 19 with its Epic announcement. Cerner and Siemens were the also-rans. Assembly of the implementation team will start early in 2013, with 80-120 folks tapped to begin the rollout of Epic to UNC Hospitals, Rex Healthcare, Chatham Hospital, the UNC Physicians Network, and UNC Physicians & Associates.

11-23-2012 9-38-53 PM

From Max Headroom: “Re: CES Unveiled. The consumer electronics show had a lot of Fitbit-type companies, but the coolest and most Thanksgiving relevant was the HAPIfork from a Hong Kong company. The USB-connected fork tracks how many bites you eat over what time, with the premise that eating more slowly has more positive effects on metabolism. It even has a reminder to eat more slowly, so people can get alert fatigue from eating.” That sounds somewhere between creepy and  pretty smart, at least if you believe that eating slower means eating less and if you don’t eat a lot of fork-free sandwiches or soup. The fork records everything without being USB connected, then uploads to an online dashboard and to Facebook if you want (I guess that would be social net-forking). 

11-23-2012 8-29-06 PM

Welcome to new HIStalk Platinum Sponsor Acuo Technologies of Bloomington, MN. The company offers Universal Clinical Platform (a vendor-neutral archive) and clinical data migration solutions that let customers liberate their clinical content from departmental silos (including enterprise medical images). The result: putting patient information where it’s needed, with customers executing their own clinical strategies instead of meekly following those dictated by their technology vendors. It often makes sense to pursue a selective best-of-breed strategy for wound care, pathology, and neurosurgery, and Acuo’s technologies allow making data from those systems liquid while ensuring vendor independence and multi-site support. The benefits include lower TCO, built-in business continuity and recoverability, better network utilization, implementation of IHE-profile standards and vendor neutrality, and the ability to monitor system health via a single dashboard. Not to mention that the client owns both the data and the archive. The DoD chose Universal Clinical Platform a few weeks back to consolidate images from 62 Army and Navy PACS sites located around the world – UCP works with every major radiology and cardiology PACS. The company just released a white paper that describes how three of its hospital customers weathered Hurricane Sandy, along with an overview of the business continuity possibilities offered by UCP. If you’re at RSNA this week, drop by booth #7146 and tell the Acuo folks that you saw them mentioned in HIStalk. Thanks to Acuo Technologies for supporting my work.

From my usual YouTube cruise, here’s a video featuring customers talking about their Acuo implementation.

11-23-2012 8-46-54 PM

HIMSS and vendor user group conferences are those national meetings most commonly attended by poll respondents, with the other events lagging far behind them. New poll to your right, following up on a Dr. Jayne question: is transcription a commodity service that’s differentiated mostly on price? Feel free to click the poll’s Comments link after you’ve voted to editorialize your position.

11-23-2012 8-54-12 PM

I’ve been revamping HIStalk Mobile over the last several days. The site has a new look and a gradually changing name – HIStalk Connect. Travis is posting from the physician and entrepreneur perspective while Lt. Dan is handling the daily news posts. If your interests include startups, cool technologies, consumer health IT, and telehealth, you might consider becoming a regular contributor, a guest author, an interview subject, or a news tipster. I’ll have some new sponsors to announce shortly.

11-23-2012 8-58-33 PM

The First Minister of Wales opens Clinithink’s research and development center in Bridgend, emphasizing the government’s commitment to stimulate economic growth by supporting technology companies. That’s Rt. Hon. Carwyn Jones SM on the left, Clinithink CEO Chris Tackaberry on the right (he wrote a Readers Write article a week ago). The company offers the CLiX clinical language indexing engine for ICD and SNOMED that turns medical notes into coded data.

I create an eclectic music playlist every week in the hopes that folks who’ve been stuck in a musical rut going back to their college days (or since computers took over most musically related chores) will find something fresh to listen to. The one for this week includes a mix of genres and vintages: Soundgarden, Auf Der Maur, Zip Tang, Morrissey, Lana del Rey, and some cool surf tunes. Some of the tracks were recommended by readers. Let me know if anything speaks to you.

11-23-2012 10-36-47 PM

I was thinking about HP’s accusation that its recent acquisition target Autonomy had fraudulently misstated earnings, forcing it to write down $9 billion as announced last week. I’m beginning to be skeptical that Autonomy was the lone gunman. HP has been a train wreck in every conceivable way, so it seems suspicious that the company chose the day of a bad quarterly report to trot out excuses from an acquisition that closed a year ago. Peering deeper into the numbers, HP says the magnitude of the alleged accounting fraud was a few hundred million dollars, which caused it to pay $5 billion too much. That would seem to imply that the other $4 billion that was written down was because HP vastly overpaid (which was why companies better than HP had already passed on the deal). All of this happened before Meg Whitman took over as CEO (she was hired September 22, 2011), but the (literal) bottom line is that the company peed away $9 billion, with the only question being which aspect of HP’s due diligence stupidity (valuation or forensics) was at fault. It would appear that HP’s bragging rights for hiring (and most puzzlingly, retaining) the least-competent board of directors in the country remains unthreatened.

An NIH-funded project to match DNA samples from 100,000 volunteer Kaiser Permanente patients with their electronic medical record information is creating a “playground of incredibly rich data” that is already turning up medical discoveries. Researchers have discovered genetic variations that seem to influence the effectiveness of statin drugs. They’ve also found something that sounds like a like a palm reader’s life line – a specific genetic component whose physical length seems to correlate with lifespan.

Accretive Health writes $4,000 checks to 90 Minnesota patients who complained that the company harassed them with abusive medical collection practices.

A UK doctor blames the death of one of his patients on the practice’s EMR, saying he failed to notice that the patient had stopped taking proton pump inhibitors and died of a stomach ulcer as a result. The doctor says of the since-replaced system, “In a highly-charged meeting with a patient, when you’re discussing very important matters, I failed to notice the absence of a D on the computer screen. The systems fail to flag up under-use in an adequate way. It’s a hazardous system.”

Also in the UK, a patient dies after an erroneously programmed IV syringe pump delivers a 24-hour narcotic dose over just 12 hours. The nurse who set the pump admits that she isn’t sure that she understood the pump instructions another nurse gave her.

11-23-2012 10-22-34 PM

UC Davis Children’s Hospital (CA) tries its hand at crowdfunding, seeking donations for the purchase of specific items that range from $30 toys to a $12 million NICU wing. A “medical computer suite” costs $2,210 just in case you’re up for providing a stocking stuffer.

Decision support tools from Dallas-based cardiology software vendor Emerge Clinical Decision Solutions are chosen by the HeartPlace cardiology practice for use in 31 clinics and 25 hospitals. Software algorithms review patient symptoms and histories, with the company claiming that identification of some cardiac conditions is increased by 300 percent.

11-24-2012 7-05-09 AM

I noticed a drug study authored by a pharmacist from Cerner Research. That reminded me that Cerner mines and sells the patient information stored by its hosted EMR clients.

I’m annually amazed that RSNA convinces 60,000 people to leave their families Thanksgiving weekend to head off to chilly Chicago. If you are there, enjoy the conference.

The Milwaukee business paper takes a field trip to Children’s Hospital of Wisconsin to check out its $129 million Epic implementation. At 263 beds, that’s a truly Epic cost of almost half a million dollars per bed.

As more Americans get fatter, so does their mental picture of what ideal weight should be. Sixty percent of people think their weight is about right despite CDC statistics showing that 69 percent of Americans are overweight. I theorize that foreign travel will suffer as junk food eating and expandable pants wearing Americans realize that they stand out like lumbering giants when immersed into a culture of svelte locals in Asia, Scandinavia, and almost everywhere else. I blame vanity sizing, where clothing manufactures make everything several sizes bigger than the label says so customers can pretend their mirrors are defective. Not appropriate post-Thanksgiving talk, I know.

Strange: an air conditioning technician files a $1 million negligence suit against Kingwood Medical Center (TX) after stinging bees cause him to plunge through the hospital’s skylight.

The re-domesticated Vince picks up where he left off with the HIS-tory of CPSI, founded by Denny and Kenny (one of them really was a rocket scientist). Vince thrives on memory-refreshing reader e-mails, so if you have interesting nuggets or current contacts from the sepia-toned HIT of yesteryear, he would enjoy hearing from you.


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

More news: HIStalk Practice, HIStalk Mobile.

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November 24, 2012 News 6 Comments

News 11/21/12

November 20, 2012 News 9 Comments

Top News

11-20-2012 8-06-30 PM

Nuance reports Q4 results: revenue up 28 percent, adjusted EPS $0.51 vs. $0.42, beating expectations of $0.48. In the earnings call, Chairman and CEO Paul Ricci said the company’s healthcare business will generate more than $1 billion in 2013, making the company one of the largest HIT vendors. He also said that the recent Quantim and JATA acquisitions will contribute $90-100 million in annual revenue.

Reader Comments

inga_small From Samantha Taggart: “Re: giving thanks. I am very grateful and thankful to all of you for doing what you’ve done for this (our/my/your) industry. Healthcare is a precious thing and I can’t imagine what HIT would be like today if you all hadn’t somehow provided the transparency and insight into what’s really going on in this industry. We ALL thank you so very much. Enjoy your holidays and feel very good about what you do.” On behalf of Mr. H, Dr. Jayne, Dr. Travis, Dr. Gregg, Donna, and Lt. Dan, a big thank you for the kind words. I will save this note for those days I find myself thinking I can’t possibly read one more thing about healthcare and technology. I am thankful that I lucked into the greatest job ever in HIT, that I work with such fun and smart people, and that people continue to read and support HIStalk week after week. Best wishes to all for a great holiday. I’m off for the rest of the week off to spend time with family and friends, eat too much food, watch some football, and perhaps buy a couple of pairs of new shoes.

From MDRX Scrooged: “Re: Allscripts. Everyone is expecting huge cost cutting if Allscripts is sold to a private equity firm, but what may not be expected is that the cost cutting will start in the next couple of weeks. Between 70 and 130 employees will be let go, mostly from services and engineering. Happy holidays to us!” Unverified. I’ve received a few rumors on where the possible acquisition stands, pretty much split between: (a) talks are at an impasse because the PE people won’t pay above $15 per share and the board won’t accept that offer with shares trading at $12.35, and (b) a deal has already been finalized but not yet announced. In other words, I don’t know any more than you do.

11-20-2012 6-47-24 PM

From Force Majeure: “Re: Allscripts. A practice that requested termination of its MyWay agreement was turned down even though its contract says Allscripts will comply with any CMS requirements to meet MU and any other standards, with the explanation that the practice was offered a free upgrade to Professional. What about costs for infrastructure, equipment, and possible lost productivity? The contract didn’t say they company will meet the requirements by making the customer switch products. They’re going to be flooded with these requests.” Unverified, but FM provided a copy of the purported e-mail above, where the company takes the position that moving a customer to a completely different product than the one they bought is contractually acceptable since it’s a free switch to a more expensive product. I think I’d probably side with the company legally, although as a customer I’d still be ticked that I have to spend money and energy because of the company’s business decision. Obviously your options as a customer are limited if you recently signed up for the five-year lease – you’re going Professional unless you’re willing to lose a lot of money (either by not collecting Meaningful Use money or in paying off your lease while buying a competitor’s product). I assume the leases work like they do for a consumer transaction – a third-party financing company buys the contract at a discount and handles the payment collection, meaning it’s not up to Allscripts to let customers out of their lease agreements. Leasing terms might make an interesting topic for Bill O’Toole in a future HITlaw column given this example.

From Nasty Parts: “Re: [company name omitted]. They were apparently shocked to see former employees working for competitors at MGMA and offered a bounty to current employees to identify them so they can be send cease and desist letters.” Unverified. I’m sure someone must have proof if this claim is accurate, so I’ll fill in the blank if someone will provide that proof.

HIStalk Announcements and Requests

I will most likely not do news this Friday unless I get bored since I doubt anyone would read anyway. Enjoy your holiday. I’ll be back at the keyboard Saturday as usual putting together the Monday Morning Update.

Acquisitions, Funding, Business, and Stock

11-20-2012 5-33-03 PM

Medical education firm Pri-Med, a division of Diversified Business Communications, acquires EHR provider Amazing Charts.

11-20-2012 6-12-45 PM

Shades of McKesson-HBOC: shares of the perpetually bumbling HP drop 12 percent Tuesday after the company announces that it will take an $8.8 billion write-down on its 2011 acquisition of British software vendor Autonomy. HP says Autonomy had cooked its pre-acquisition books by counting low-margin hardware sales as software income and claiming that resellers were customers. Details have been shared with US and British regulators to pursue criminal and civil charges. If HP is right, nice work by Deloitte, to whom it paid big money for pre-acquisition due diligence. The previously fired CEO of Autonomy denies everything, defers to Deloitte’s audits, and says HP destroyed the company’s value by raising prices and lowering sales commissions, adding that, “The difficulty was that the company [HP] needed a strategy, and I still couldn’t tell you what that is.” HP’s now-irrelevant Q4 numbers: revenue down 5 percent, adjusted EPS $1.16 vs. $1.17 but more dramatically –$3.49 vs. $0.12 including the write-down. The ugly five-year chart above plots HP shares (blue) against the Nasdaq index, indicating that you’d probably have been better off burning dollar bills to keep warm. Oracle was smarter: they passed when Autonomy made a “please buy us” pitch – see the hilarious Another Whopper from Autonomy CEO Mike Lynch post from September 2011 on Oracle’s site, placed there after Lynch denied trying to convince Oracle to buy his company. The always-feisty Oracle, in response to his denials, posted the PowerPoint slides Lynch used in the meeting, which seemed to jog his memory of the conversation.


The National Football League signs a 10-year contract worth $7-$10 million with eClinicalWorks to implement an EHR that can help the league research and treat player head injuries.

DoD awards Acuo Technologies a nine-year, $40 million contract for its vendor neutral archive solution.

11-20-2012 11-13-02 AM

Huntington Memorial Hospital (CA) selects the Merge PACS iConnect Enterprise Clinical Platform for its hospital inpatient EHR and its Huntington Health eConnect HIE.

Sharp HealthCare selects 3M’s 360 Encompass System for medical records coding, clinical documentation improvement, and performance monitoring across its four hospitals and affiliated medical groups.

Aurora Health Care (IL, WI) will deploy Humedica’s MinedShare analytics platform to support its ACO initiatives, improve coding accuracy, and develop ambulatory physician scorecards.


11-19-2012 7-23-45 AM

CareCloud hires Ralph Catalano (athenahealth) as VP of operations.

11-20-2012 8-56-21 AM

Health monitoring company Medivo appoints David B. Nash, MD (Jefferson School of Population Health) to its medical advisory board.

Announcements and Implementations

11-20-2012 11-14-34 AM

White Plume Technologies releases its AccelaMOBILEmobile charge capture product app.

11-20-2012 11-15-40 AM

McKesson will give $1 million in free Practice Choice EMR licenses to 100 small-practice physicians who practice in primary care, internal medicine, gynecology, or pediatrics and who have a history of providing unreimbursed care to low-income patients.

11-20-2012 5-43-37 PM

MedCentral Health System (OH) expands its system-wide use of the Surgical Information Systems solution to include anesthesia automation, perioperative analytics, patient tracking, and integrated tissue tracking.

11-20-2012 5-52-53 PM

NextGen Healthcare releases its 8 Series EHR content, which includes a new user interface, standardized framework for templates, and streamlined navigation.

Children’s Hospital Association goes live a contract with Baltimore-based mdlogix to provide an informatics platform that will support its Hospital Survey of Patient Safety tool.

Government and Politics

The GAO finds that CMS is behind schedule on the implementation of its Fraud Prevention System for analyzing Medicare claims data for fraudulent behavior.

11-20-2012 6-44-34 PM

CMS releases Meaningful Use Stage 2 spec sheets for EPs and hospitals.

The Tampa paper covers the power struggle between dueling startup HIEs, the state-run one and a local, for-profit HIE that has the Hillsborough Medical Association as a member. The article suggests that the organizations are fighting for the potential profits involved with selling HIE-collected de-identified patient data. The local HIE says the state HIE is not seeking physician input, noting that the average hospital doesn’t see most of the patient population and also generates only 10 percent of patient health records.

Innovation and Research

The Consulate General of Canada in Philadelphia will launch a healthcare IT accelerator in early 2013, hoping to increase growth opportunities for Canada-based companies as similar efforts have done for companies in Israel. The 4th Annual Canada-US eHealth Innovation Summit will be held November 28 in Philadelphia, featuring presentations from Canadian companies Caristix, EDO Mobile Health, Evinance, Input Health, HandyMetrics Corporation, Mensante Corporation, Memotext, NexJ Systems, Nightingale Informatix Corporation, Orpyx Medical Technologies, TelASK Technologies, and VitalSignals Enterprises.

11-20-2012 8-11-44 PM

A JAMA-published study finds that patients using a patient portal had a higher number of office visits and telephone encounters than non-users. The study, which reviewed the use of MyHealthManager by patients of Kaiser Permanente Colorado, concludes that just putting up a portal doesn’t reduce demand for clinical services, and in fact may have the opposite effect.


11-20-2012 5-45-23 PM

ADP-AdvancedMD introduces a charge capture app for EHR for use on the iPad and iPad mini.

Nurses at Phoenix Children’s Hospital create the Journey Board discharge teaching app, funded by a $5,000 donation from former hospital patients. It’s available free for Android and iOS.

11-20-2012 7-54-25 PM

Massachusetts General Hospital Emergency Medicine Network launches EDMaps.org, a national ED locator for travelers, and a new version of its EMNet findER app.


11-20-2012 11-52-23 AM

Key findings from the eHealth Initiative’s 2012 Report on HIE:

  • Support for ACOs and PCMHs is on the rise
  • Federal funding still supports many HIEs, raising concerns about their long-term viability
  • HIEs worry about competition from other HIEs and from HIT vendors offering exchange capabilities
  • Other challenges for HIEs include privacy, technical barriers, and addressing government policy and mandates
  • Support for Direct is growing, particularly to facilitate transitions of care and the exchange of lab results.

11-20-2012 5-49-42 PM

The National eHealth Collaborative publishes a five-tier framework of strengthening patient engagement strategies that includes steps entitled Inform Me, Engage Me, Empower Me, Partner With Me, and  Support My Community.


An Imprivata roundtable on the healthcare impact of technology and mobility featured Boston-area healthcare IT executives, with their discussion summarized in the eight-minute video excerpt above.

Weird News Andy says “This doc was da bomb.” A 60-year-old doctor and Occupy Wall Street protester who was fired by his hospital employer in 2007 for suspected stalking of a nurse is arrested when police find assault rifles and large quantities of bomb-making chemicals in his basement.

Sponsor Updates

  • MedAssets CEO John Bardis wins a Community Leadership Award for driving and supporting the volunteer activities of his employees.
  • Greer Contreras, T-System’s VP of revenue cycle coding, discusses revenue integrity and the need for organizations to have a holistic view of their revenue cycle processes in a guest article.
  • Compressus integrates MModal’s speech understanding solution into its MEDxConnect suite.
  • Vitera Healthcare introduces Hands-On Lab for virtual product training.
  • Shareable Ink is spotlighted for assisting The Center for Orthopedics (OH) capture MU data.
  • Zirmed releases a white paper on the use of technology to manage rising levels of patient responsibility.
  • PeriGen posts its November and December Webinar schedule.
  • David Caldwell, EVP of Certify Data Systems, discusses opportunities offered by HIEs that can enhance revenue and improve patient care in a guest article.
  • Besler Consulting’s CTO Joe Hoffman reviews challenges in complying with the CMS exclusion list during a November 28 Webinar.
  • Dell ships its PowerVault DL2300 appliance with CommVault Simpana 9 software for enterprise-wide data protection.
  • SCI Solutions recognizes Mountain States Health Alliance (TN) with its Most Innovative Use award for best adoption and implementation of its self-scheduling tool.
  • Levi, Ray & Shoup releases an enhanced version of its Enterprise Output Management software that includes mobile access and support for Windows 8.


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

More news: HIStalk Practice, HIStalk Mobile.

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November 20, 2012 News 9 Comments

Monday Morning Update 11/19/12

November 17, 2012 News 9 Comments

11-17-2012 8-41-47 AM

From Documented: “Re: Cerner Content360. Does this represent somewhat of a minor strategic shift for Cerner, or is just a re-branded aggregation of existing document imaging solutions (such as Cerner ProVision Document Imaging)? When I worked at Cerner (a few years ago), it was practically a cultural taboo to suggest the need for document imaging (especially clinically, as in meds ordering) because it stood in philosophical contradiction to CPOE and its closed-loop meds process. Anyway, I was just curious if any Cerner clients or other wise luminaries among the HIStalk audience knew much about it.”

From The PACS Designer: “Re: healthcare and Windows 8. In a past HIStalk post I covered Microsoft’s Healthcare in Silverlight software. Now, with the release of Windows 8, we get to see Microsoft Flexible Workstyle for Health utilizing Sharepoint for rounding and other data viewing. Partners HealthCare has an interesting case study demo that could generate an 80 percent reduction in desktop image management efforts.”

11-17-2012 8-33-10 AM

From HITEsq: “Re: Epic. Appears ready to file for review of the McKesson case. They filed an extension for their writ (i.e., the document where they asked the Supreme Court to take the case). Nothing is a sure thing, but my guess is this has a really good shot at being accepted. The Federal Circuit was really fractured and went in an unexpected direction. The Supreme Court is good at addressing these things.” This is the years-long legal battle over whether MyChart violates a McKesson patient portal patent. The appeals court’s decision in September troubled some legal experts who are uncomfortable with its interpretation that companies (Epic in this case) can be held accountable for “inducing infringement” even when the infringement itself hasn’t been proven.

11-17-2012 8-34-57 AM

From MT Hammer: “Re: MModal. Word on the street is that they have acquired transcription provider MxSecure. No official announcement.”

From Shhh: “Re: Epic. They must have finally chosen a new CFO – the job listing is gone from all the career sites.” I was slightly aware that Anita Pramoda was the company’s CFO, but I see from her LinkedIn profile that she moved on this year as a co-founder of California-based TangramCare (I guess she didn’t have to sit out a year). I can find next to nothing about that company except that it’s some sort of technology-enabled homecare provider. From a LA Craigslist job posting, she’s taken some Epic principles out West: the “do good” motto, the hiring of “brilliant people,” and the need for candidates to state their GPA in their application. The “who are we?” section says, “Healthcare today is conducted like a horribly inaccurate Markov chain. That is, each piece of healthcare is siloed from one another, at all times with incomplete information. None of pieces the mesh well, the left hand doesn’t know what the right hand is doing/has done. This results in inefficiency, inaccuracy and unbearable patient experiences. We wake up every morning working to solve this problem, make healthcare more affordable, and save lives.” Jim Sweeney, founder of Caremark, Bridge Medical, and CardioNet, is involved and talks about the company in the video above. He has an interesting point: hospitals were created to make it convenient for physicians to see patients, but being aggregated with other sick people isn’t so great for the patients.

11-16-2012 8-52-42 PM

Half of my survey respondents are indifferent to CHIME, while the remainder are equally split in seeing the organization as positive or negative. New poll to your right: which annual conferences do you routinely attend? Check all that apply and feel free to leave a comment.

Here’s new Spotify playlist of some odds and ends that might give you some new music ideas. On it: Toad the Wet Sprocket, Broken Bells, Veruca Salt, Neon Trees, and quite a few more. If you like country music, computer-generated dance tunes, classical, or jazz, you’re out of luck since I don’t listen to those.

Speaking of music, a reader sent a link to the early 1980s company promotion album You Respond to Everyone But Me: Songs for the EMT, which seems to be the only album dedicated to EMS. Stream some of the very well done country/bluegrass tunes and see if you agree with me that it’s way better than you would expect. I’m desk-drumming to #11 – EMS Express.

11-17-2012 6-09-05 AM

ONC publishes the Request for Comments for Meaningful Use Stage 3. The comment period will open this week on Regulations.gov and will end on January 14.

The Advisory Board Company’s e-mail policies are featured in an article about companies that encourage (or mandate) employees to stop checking e-mails after hours. CEO Robert Musslewhite, saying that “e-mail has gone too far and that is now impeding productivity,” also issued guidelines that include summarizing the topic in the subject line, limiting the number of recipients, and considering the use of instant messaging instead. The company imposed an e-mail moratorium over Labor Day weekend.

11-17-2012 9-08-10 AM

Lucile Packard Children’s Hospital (CA) provides iPads loaded with kid-friendly apps in all nine of its pediatric ED rooms. The unit’s director says that “one iPad is worth 10 milligrams of morphine.” Parents can also check e-mail and FaceTime with hospital specialists, guest services employees, and interpreters.

The Columbus, OH newspaper writes about Ohio hospitals that use EHR information to tailor their marketing campaigns to specific patient populations. At least one system (OhioHealth) admits that it screens out lower-income patients in mailings encouraging patients to schedule health maintenance visits.

11-17-2012 10-00-34 AM

CVPH Medical Center (NY) lays off 17 employees after losing $400,000 in September, but says the cuts would have been a lot more severe had it not banked $3.2 million in Meaningful Use money that was counted as revenue. 

A series of Greenway surveys finds that:

  • 76 percent of practices either aren’t sure about participating in an ACO or have decided they won’t participate, while 50 percent of hospitals say they have no ACO plans
  • 16 percent of practices will stop taking Medicare and Medicaid patients if payments are reduced
  • 39 percent of hospital CIOs say technology has improved the efficiency of their organizations
  • 45 percent of patients say they would change doctors if they’re kept waiting too long
  • Seven percent of patients say technology gets in the way of their interaction with their doctor vs. the 56 percent that believe it helps the physician improve their care
  • Patients view paper and electronic-based systems as equally safe and secure
  • More than half of consumer respondents believe it’s the government’s job to improve the healthcare system, with hospitals and physicians a distant second and third place respectively

From the Investor Day transcript from the CEO of Quest Diagnostics, parent of MedPlus (ChartMaxx, Care360 EHR):

…We are redirecting our EHR Information Systems business. We believe that business needs to be focused on helping Diagnostic Information Services. We believe there is an opportunity for that business to complement enterprise EMR strategies that companies like Cerner and Epic and that McKesson have, and we need to participate in helping them with them and be with them when they present their strategy to integrated delivery networks in hospital systems. And therefore, we’re focusing the plan in the business around that segment in the marketplace and having a proactive program to work with the enterprise EMR companies going forward.

11-17-2012 9-42-48 AM

The $5.99 BabyDoze smartphone app plays Doppler-recorded mother’s womb sounds that the company says are 98 percent effective in calming crying babies. Its author recorded his wife’s uterine sounds in 1985 with the help of hospital staff, selling the original version as an audio tape.

A study finds that goofing off at work every now and then may improve work performance. Top-performing subjects in a four-hour simulation session of piloting military drones were found to have been distracted 30 percent of the time by their smartphones, having a snack, or reading something nearby.


Vince and Mrs. Vince have been re-honeymooning in Europe, so he compares how technology has changed in the 40 intervening years. He has returned and his regularly scheduled HIT programming will do likewise next week.

Sponsor Updates

11-17-2012 5-30-46 AM

  • Jardogs recently attended the University of Iowa’s Engineering Career Fair. That’s recruiter Nicole Baer meeting with a student above. The company offers FollowMyHealth patient access solutions that include the Universal Health Record and patient kiosk.
  • Intelligent Medical Objects releases its IMO Terminology Browser for Android smartphones.
  • We missed a sponsor who made the Inc 5000 in our list last week. Toledo-based ESD, which you may remember as the force behind HIStalkapalooza in Las Vegas earlier this year, was recognized for its three-year revenue growth of 172 percent.
  • Award-winning IT staffing firm Digital Prospectors is raising funds for Hurricane Sandy victims. The company will match donations and chip in $5 for each Facebook share and $1 for each Facebook like.
  • An article by Emily Ruffing of Lifepoint Informatics describes ways that laboratory information systems can be integrated with EMRs.
  • Nordic Consulting, the KLAS-ranked #1 Epic service provider and the largest Epic-only consulting practice in the country, publishes a guide for Epic-certified consultants interested in joining the Madison, WI-based company.
  • SayIt Clinical Notepad from nVoq,  a cloud-based iPad speech-to-text app that allows users to capture quick patient notes on the go for later addition to the EMR, is available on iTunes.
  • Liaison Technologies, the Atlanta-based cloud integration and data management leader, is recognized by the Deloitte Technology Fast 500 as one of the fastest growing companies in North America.
  • Bottomline Technologies recently held its Healthcare Customer Insights Exchange in Sausalito, CA with its experts and customers providing insight about mobile technologies, process automation, payment solutions, and advanced forms management. The company offers a case study of Alamance Regional Medical Center’s move to a Logical Ink-powered tablet-based patient registration solution.


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

More news: HIStalk Practice, HIStalk Mobile.

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November 17, 2012 News 9 Comments

News 11/16/12

November 15, 2012 News 10 Comments

Top News

11-15-2012 5-46-14 PM

Sixty-nine percent of US primary care physicians report using EHRs, up from 46 percent in 2009, while about a third of doctors say their patients have the ability to e-mail the practice and have online tools to request appointments, referrals, and prescription refills. The study of 10 “high-income” countries also finds that despite health reform initiatives, a high percentage of physicians in all countries complain of untimely access to information from hospitals and specialists.

Reader Comments

11-15-2012 7-06-04 PM

From Mango Mel: “Re: UNC. As you mentioned, they are going Epic.” I heard that rumor again today from an excellent source. If it’s true, that gives Epic all of the big hospitals in the Triangle area of North Carolina, which is almost all of the beds there now that they’ve recently added Duke and the just-announced WakeMed. Other NC users of Epic are New Hanover, Vidant, and Novant.

From The SFTreat: “Re: GE Healthcare layoffs. True – a number of staff from the Seattle office are gone.” We’ve run several rumors suggesting that the layoffs were going to happen Wednesday. A Boston article says the company confirmed that 10 percent of its Vermont workforce has been let go, but the company declined to give specifics. Our GE contact said that fewer than 50 employees were impacted and no office closures or product retirements were involved. According to the official response:

“In fact, GE HCIT is maintaining its focus on the needs of integrated care delivery, and in conjunction with our strategy, we are making choices to redeploy some portions of our resources and capital into new areas of product and service innovation. While these types of decisions are never easy in the near term, we are confident that they are necessary to meet the current and future needs of our customers.”

From Candace: “Re: research and think tank institutions for healthcare technology. What do you think of IDC Health Insights? Can you recommend other research centers? I’m a recent college graduate doing a research project.” I don’t have any experience with any of them, so I’ll open the floor to readers willing to help. Don’t they sound like swell places to work, though, just sprawling back at your desk thinking in a swanky office park?

From DeanInsider: ”Re: rumor of doctor resignations. Not the case. Dean is pleased to have become an Accountable Care Organization and has always put patients first.” I assumed that was the case, but several hospitals have announced layoffs they’re blaming on PPACA. The latest: Wake Forest Baptist Medical Center, which will eliminate 950 positions. A local professor there says hospitals must plan for at least one year of lower payments, reductions in federal grants, and the high cost of EHRs.

HIStalk Announcements and Requests

HIStalk Practice highlights from the last week include: MGMA members give Medicare the highest marks among seven top payers. The country will be short 52,000 family physicians by 2025. An 87-year-old doctor who charges $5 an office visit says he didn’t select his profession for the money. Physicians must participate in PQRS in 2013 to avoid 2015 penalties. A list of the worst passwords for 2012. Rob Drewniak of Hayes Management Consulting discusses the need to educate board members on the ACA and its implications for their organization. Dr. Mostashari, by the way, gave Rob’s post a thumbs up. If Dr. Mostashari is reading HIStalk Practice and you aren’t, maybe it’s time to consider what you’re missing. Thanks for reading.

We ran a link to the draft Meaningful Use Stage 3 rules earlier this week, but just to be clear, this is a draft document not yet available for public comment even though its title is “HITPC Stage 3 Request for Comment.” You’re seeing it as it came from the Policy Committee.

Inga’s been a good girl this year, so here’s her Christmas list for your consideration: (a) sign up for spam-free e-mail updates to HIStalk, HIStalk Practice, and HIStalk Mobile; (b) friend, like, and connect with us on all the social not-working sites; (c) send us news and rumors; (d) review and impulsively click some of the much-appreciated sponsor ads to your left, search and navigate to their details in the Resource Center, and send your consulting RFI viral with the RFI Blaster; (e) tell other folks you read our sites because when it comes to our marketing channels, you’re all we have; and (f) give yourself one of those wrapping-your-arms-around-yourself hugs and pretend it’s Inga since it will take her awhile to get to each reader personally. I’m just happy reading down the list of 2,850 impressive folks who have signed up for Dann’s HIStalk Fan Club and thinking how cool that is. That’s the first place I look when considering somebody’s request for an HIStalk-related favor.

On the Jobs Board: Workflow Automation Project Manager, Technical Trainer, Product Analyst, User Interface Engineer.

The most common grammatical crutches I have to edit out of the interview transcripts I run, sometimes in truly startling numbers: (a) “really”; (b) “sort of”; and (c) starting sentences with “so” like someone telling a bar stool yarn. I was at a doctor’s presentation today and counted the number of times she said “sort of” and was up to 79 in the first 30 minutes before I tired of the exercise. I’m not annoyed, just sorry that the power of what she was saying was needlessly diluted by subconscious speech tics.

Acquisitions, Funding, Business, and Stock

11-15-2012 9-38-00 AM

CACI will acquire Emergint Technologies, a provider of HIT services and analytics solutions.

WellStar Health System pays $20,000 for the trade name, trademark, and other assets of the bankrupt Center for Health Transformation, the for-profit healthcare think tank founded by Newt Gingrich. WellStar intends to convert it to an independent, nonprofit collaborative of 20 non-competing health systems in the Southeast, focusing on sharing ways to improve quality and reduce costs. 

Salt Lake City-based Remedy Informatics gets a $6 million investment from Merck. The registry and research informatics company is headed by Gary Kennedy, so I assume it’s related to the former RemedyMD. I interviewed him in early 2007 and was pretty impressed, although the hospital-type database products seem to have been de-emphasized in favor of the life sciences ones.


11-15-2012 7-10-33 PM

WakeMed Health & Hospitals (NC) will invest $100 million over five years to implement Epic.

The DoD and VA award Document Storage Systems an EHR integration subcontract.

Oakwood Healthcare (MI) renews its multi-year IT outsourcing contract with CareTech Solutions for $120 million.


11-15-2012 11-08-18 AM

Harry Jacobson, MD, former vice chancellor for health affairs at Vanderbilt and CEO of Vanderbilt University Medical Center, joins digiChart as chairman, replacing G. William Bates, MD, who was recently named chairman emeritus.

11-15-2012 11-26-46 AM

Net Health systems, a provider of IT systems for wound care, hires Kelley J. Schudy (Allscripts) as VP of sales.

Announcements and Implementations

11-15-2012 5-35-45 PM

The National Basketball Association will use Cerner’s HealtheAthlete health management platform for all of its teams.

11-15-2012 1-12-48 PM

The LSU Interim Hospital and 11 clinics are live on the Greater New Orleans HIE, which will connect to the state-wide Louisiana HIE by the end of the year.

11-15-2012 1-13-42 PM

The Pennsylvania eHealth Collaborative signs up 3,449 providers for DIRECT messaging, exceeding the federal government’s goal of 1,000.

Lakeland Regional Medical Center (FL) goes live on Cerner clinical applications with implementation assistance from Healthcare Clinical Informatics.

Elsevier announces the launch of Health Care: The Journal of Delivery Science and Innovation. It will focus on applied healthcare IT and health reform. Founders and co-editors are Amol Navathe, MD, PhD (Brigham and Women’s, Harvard Medical School, Wharton School) and Sachin Jain, MD, MBA (Boston VA, Harvard Medical School, and Merck).

North Mississippi Health Services (MS) wins a Baldrige Award. 

Innovation and Research

11-15-2012 6-23-40 PM

Got a flair for design and patient-friendly medical information? ONC and VA are running a Health Design Challenge for creative types who can make CCD/Blue Button information easier for patients to understand. Three prizes are offered in each of four categories (Best Overall Design, Best Medical/Problem History Section, Best Medication Section, and Best Lab Summaries) ranging from $1,000 to $16,000. The deadline is November 30.


11-15-2012 7-03-28 PM

A CapSite study finds that almost one-third of hospitals plan to invest in patient flow solutions within the next two years. Leading vendors include TeleTracking, McKesson, Epic, and Meditech, while the vendors most often being considered are listed in the graphic above.

Speaking of CapSite, a HIMSS webinar this Friday afternoon will cover “The CapSite Acquisition and What It Means to You.”

Bill Hersh provides an update on the clinical informatics subspecialty for physicians. Details are being worked out about the grandfathering and initial exam process, but Bill says the first candidates will sit for their test in October 2013.

Allscripts responded to our reader’s question about whether MyWay users will be released from their contracts if they decline the company’s offer of a free upgrade to Professional.

“Allscripts is providing a free upgrade, and the contract does not allow for cancellation of current leases. Allscripts is dedicated to working with our clients to help them succeed, and we believe the upgrade provides the right benefit for the long term.”

11-15-2012 6-41-32 PM

Weird News Andy says this never happens to him while listening to NPR. A former Doctor of the Year ED doc faces a long list of charges after hitting several cars in a parking lot while allegedly under the influence of drugs and alcohol with NPR cranked up loud in her Outback. She says her accelerator got stuck on her way to Whole Foods to buy a Thanksgiving turkey, but police found pills and prescriptions she had written for herself.

WNA labels this story “Hello Terry Schiavo.” Scientists performing a functional MRI on a man who has been in a vegetative state for 10 years find brain wave patterns that suggest he is answering the questions they’re ask him. The scientists believe the patient is aware of who and where he is.

Sponsor Updates

11-15-2012 8-17-00 PM

  • Leslie Kelly Hall, SVP for policy at Healthwise, joins a panel discussion on patient engagement framework at next week’s National eHealth Collaborative Webinar.
  • Visage Imaging will demo its Visage 7 processing technology, including work-in-process capabilities, at this month’s RSNA meeting.
  • Merge Healthcare will unveil its mobile and Internet platform for patients during RSNA.
  • Greater Baltimore Medical Center (MD) reports a reduction in paper output and waste since deploying Access Intelligent Forms Suite and Wacom STU-500 signature tablets.
  • TeraRecon previews a pay-as-you-go option for use of its iNtuition advanced visualization tools by physicians who perform aortic repair procedures.
  • Kareo offers tips for increasing practice revenue in its November newsletter.
  • The Canadian Health Informatics Association awards TELUS Health Solutions its Corporate Citizenship Award for achievements in health and technology to improve patient outcomes.
  • McKesson will combine its Episode Management software with the Prometheus Payment model to support large-scale bundled payment programs.
  • DrFirst will embed Halfpenny Technologies’ Integrated Technology Framework for CPOE and results delivery within its Rcopia e-prescribing platform.
  • White Plume Technologies’ Laura DeBusk and MED3OOO’s Cindy Cain will discuss the impact of ICD-10 on operations, compliance programs, and cash flow in a November 29 Webinar.
  • Aprima will integrate Alpha II claim scrubbing technology into its EHR and PM solutions.
  • HIStalk sponsors earning a spot on the 2012 Inc. 5000 List of America’s Fastest Growing Companies include Beacon Partners, Culbert Healthcare, Cumberland Consulting, Digital Prospectors, eClinicalWorks, Enovate IT, Etransmedia Technology, Greenway, GetWellNetwork, Hayes Management Consulting, Kareo, Iatric Systems, Impact Advisors, Ingenious Med, iSirona, maxIT Healthcare, MED3OOO, MEDSEEK, Passport Health, Virtelligence, and Vocera.
  • HIStalk sponsors included on Deloitte’s 2012 Technology Fast 500 ranking include Etransmedia Technology, Greenway Medical, MModal, MedAssets, NexJ Systems, and Vocera.
  • Sandlot Solutions unveils the final results of eHealth Initiative’s 2012 Annual Survey of HIE Initiatives.

EPtalk by Dr. Jayne

The American Academy of Family Physicians releases a summary of the 2013 Medicare Physician Fee Schedule. Increases will only occur if Congress takes its annual action to block the reduction that is scheduled for January 1.


AAFP also publishes (subscription only) its 2012 EHR User Satisfaction Survey. Of 3,088 viable responses (as in previous years, several hundred responses were excluded because respondents said they did not use EHR or didn’t identify their systems) 31 vendors account for 92 percent of the systems. The highest counts (over 200 responses) were reported with Allscripts, Centricity, eClinicalWorks, Epic, and NextGen. As someone who has been documenting with EHRs for more than a decade, I find some of their survey questions suspect. For example, “This EHR helps me see more patients per day (or go home earlier) than I could with paper charts.” They certainly didn’t control for the dramatic increase in federal, regulatory, and payer scut work that has added to the bottom line of my work hours. Even if I was on paper, I’d be seeing fewer patients and going home later just for that reason.

The authors recognize that “practice size is independently related to satisfaction,” noting that except for a few systems, the majority of “large practice” vendors fall towards the bottom and “small practice” vendors hit near the top of satisfaction scores. The cutoff for vendor inclusion was 13 responses, so there is question on whether they are statistically significant. Some of the highest ranking systems are relatively untenable in enterprise environments, so I feel for administrators whose physicians will be marching into the office with the article in hand, demanding that Cerner be de-installed in favor of Praxis, SOAPware, or my favorite: Point and Click EHR.

Another doomsday prediction finds that we’ll need 52,000 more family physicians by the year 2025. I can almost guarantee that if you figure out how to pay them what a cardiologist makes, you’ll get them.

A good friend sent me a link to the “Jane and the Doctor” YouTube video. It’s an oldie but a goodie if you haven’t seen it. For those of you in the implementation trenches, know that you are not alone and there are many others of us who hear the same tired complaining from physicians all day long.



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

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November 15, 2012 News 10 Comments

News 11/14/12

November 13, 2012 News 7 Comments

Top News

11-13-2012 5-20-42 PM

ONC releases the draft of the proposed Stage 3 Meaningful Use rule.

Reader Comments

11-13-2012 12-52-14 PM

From Minnie Mouse: “Re: NextGen User Group meeting. Over 4,400 attendees have descended on five Disney resorts in Orlando.” The NextGen folks sent over a few pics and we are running a Twitter feed box with meeting updates. The company honored the winners of its innovation awards Monday evening, which included the Flemington, NJ-based Hunterdon Healthcare Partners (above) as Grand Champion. Attendees tweeted positive comments about the food, the presenters, and the enhancements being previewed.

From SideWays: “MyWay contract. Will Allscripts let MyWay users out of their contract if they choose not to migrate to Allscripts Professional?" We’ve asked Allscripts for clarification.

From Peter Potamus: “Re: Allscripts. John Gomez has been consulted by some PE companies asking for guidance and insight into MDRX, and possibly the idea of his returning as CEO. He is getting tremendous pressure to step up, take the helm, and reinvent the company as he did during his early tenure at Eclipsys. I wish he would take it on, but so far he has been resistant. In the Sunrise XA days, he galvanized the client base, rallied the employees, and delivered all he said he would, inventing the App Store, Helios, Objects Plus, and much more.” I’m going to keep my response guarded since Allscripts is publicly traded. I have reason to believe that one or more of the PE companies with an interest in bidding for Allscripts may have approached John for advice that may or may not have included discussion of a possible role if the acquisition moves forward. That’s hardly surprising – if I were a PE guy, l would be calling up departed executives such as John, Jay Deady, Phil Pead, Bill Davis, and maybe even John McConnell for an arm’s length opinion about what they think needs to change to make the company successful. They could also read the advice of the HIStalk Advisory Panel. Or yours, if you’d care to leave a comment – I have a lot of readers who are VCs, equities analysts, etc. so make me proud by showing them how insightful you are.

11-13-2012 6-13-43 PM

From Stock Doctor: “Re: cartoon. Thought this was amusing.” I like it.

11-13-2012 7-51-34 PM

From Country Lane: “Re: Geisinger. I’ve heard rumors that they will release a commercial product aimed at the ACO market.” Geisinger Consulting Group offers software-related services, but I don’t know if the health system is selling software directly. It doesn’t seem like their core competency, but that doesn’t mean they aren’t doing it.

From G.E. Smith and the SNL Band: “Re: GE Healthcare IT. Layoffs coming, the third large one this year. The Centricity Business line is rumored to be heavily impacted again. Software development for various imaging product lines will likely also be cut. Tragic for employees, unfortunate for customers. In any competitive industry, failure to innovate=death. In this case, GE Healthcare has chosen assisted suicide at the hands of Epic and other more agile competitors.” Unverified.

From Fly on a Wall: “Re: GE Healthcare IT. Rumor has it they’re dumping people (layoffs Wednesday) and capital to prepare for a potential acquisition of a large healthcare IT company that McKesson was rumored to be acquiring last week.” Unverified. The subjects of the McKesson rumor that appeared here were athenahealth and Greenway. Monday’s stock market action gave no hints that ATHN is in play (shares were down in a down market), but GWAY shares rose 2 percent on no news other than a management overview. That’s interesting, but probably means nothing.

11-13-2012 6-12-31 PM

From HITEsq: “Re: American Hospital Association. They’re very litigious, with dueling complaints filed in federal court with SSI Group. SSI Group seeks declaratory judgment that the UB-04 codes are not valid copyrights or that any protection ‘is extremely thin.’ AHA filed suit against SSI Group for copyright infringement.”

From Karl Marx Brothers: “Re: ONC. It would seem like a good time to look at the return on investment of ONC. In 2009, this office had a budget of $67 million. I am told that in FY 2012 the budget was over $2 billion. While I understand some increase was needed, this seems excessive in a time where a balanced budget is becoming increasingly important. Do we really need masses of beltway bandit consultants working on HIE interoperability issues, such as communicating lab results, that were solved 10 or more years ago?” According to FY2013 budget documents from February 2012 (the only documents I found), ONC requested 191 FTEs and $66.3 million for 2013, up $5 million from 2012.

From EpicBuzz: “Re: HCA. One HCA hospital went live on Epic earlier this year and now Epic is quietly assembling an implementation team to begin rolling out more facilities. Can they be successful with this huge win? As a former Epic employee, they already seemed stretched to meet customer needs – I was working 70+ hour weeks when I left. This large of a commitment will be a test of their strength for sure.” HCA hasn’t confirmed plans for further Epic rollouts beyond the pilot, or at least the several HCA people I asked said they didn’t know anything about it. Epic is the only vendor that has demonstrated an ability to rapidly ramp up without apparently loss of quality, but HCA has a couple of hundred hospitals and that would indeed provide the ultimate test of turning thousands of brand new liberal arts grads into healthcare IT experts via a short company training program. I don’t think the already-stretched Epic-certified talent bank can even begin to handle a multi-year HCA rollout if it happens, so that probably means a salary war to lure people over. That might throw some disarray into Epic’s carefully managed centralized contractual control over people seeking new opportunities without a waiting period. I don’t have enough fingers to count the percentage of US patient volume that Epic will have if indeed it does land the HCA whale. 

11-13-2012 7-54-51 PM
Photo: Michael Henninger/Post-Gazette

From Grizzled Veteran: “Re: UPMC. How is this possible?” UPMC reports Q1 revenue of $2.5 billion, up $39 million, but the real eye-opener is its $300 million net revenue swing from –$120 million a year ago to $180 million. Kaiser Permanente also turned in good quarterly numbers, with $12.7 billion in revenue vs. $11.9 billion and operating income of $561 million vs. $320 million. KP’s net non-operating income got a huge pop from investments, swinging from a $365 million loss last year to a positive $242 million in Q3.

From MadisonHIT: “Re: Dean in Madison. I’ve heard indirectly that they are laying people off and blaming Obamacare because 100 doctors are leaving because ACA doesn’t let them place patients first. Supposedly this is a nationwide occurrence since the election. Anyone hearing anything similar?” I haven’t heard that, but I’m all ears.

HIStalk Announcements and Requests

I’m running “Morning Headlines” early each weekday on HIStalk, a quick summary of the handful of most important news items you should know about. You won’t get an e-mail blast – just go right to the site. If you’re in a hurry or need a quick smartphone HIT news check while eating breakfast at your hotel, this is the place.

Acquisitions, Funding, Business, and Stock

11-13-2012 7-47-56 PM

A Reuters report quotes unnamed sources who say that three private equity companies placed bids last Friday to acquire Allscripts: Carlyle Group, Blackstone Group, and TPG Capital. The sources said that Allscripts is asking for a premium to the current share price and a deal isn’t guaranteed for that reason. It also said that Bain Capital declined to bid because of unreasonable price expectations and company management turmoil. Shares closed Tuesday at $12.32.

11-13-2012 3-55-50 PM

EarlySense Ltd., a maker of patient monitoring sensors, completes a $15 million Series E financing round.

11-13-2012 5-06-35 PM

Emdeon reports Q3 loss of $15.2 million, which represents a 341 percent decline over a year ago. Revenue was up 5.3 percent to $297 million. Emdeon attributes the loss to increased interest expenses and costs associated with the company’s acquisition by Blackstone a year ago.

InterSystems opens an office in Riyadh, Saudi Arabia to support its TrakCare EMR system.

QualComm Life announces availability of its cloud-based health device connectivity solution in Europe.


11-13-2012 3-57-14 PM

Lake Health (OH) selects Accelarad’s SeeMyRadiology.com imaging management and storage solution.

11-13-2012 3-58-22 PM

Orlando Health contracts with Phytel for its Atmosphere population management suite, including the Outreach, Insight, Coordinate, and Transition products.

11-13-2012 3-59-31 PM

Erie County Medical Center (NY) selects Merge Healthcare’s iConnect Enterprise Archive and iConnect Access for real-time access to images and information from Meditech.

Medina Regional Hospital (TX), Red River Regional Hospital (TX), Ward Memorial Hospital (TX), and First Street Hospital (TX) choose Healthland Centriq, adding to the company’s total of more than 70 rural Texas hospital customers.

Central Washington Hospital (WA) selects patient privacy monitoring tools from FairWarning.


11-13-2012 1-14-58 PM  11-13-2012 1-13-39 PM

Zynx Health announces that President and CEO Scott Weingarten, MD (left) has resigned to return to Cedars-Sinai Health System. He will be replaced by First Databank President Greg Dorn, MD (right), who will run both of the Hearst organizations.

11-13-2012 5-08-45 PM

Awarepoint names Vanguard Health Systems Vice Chairman Keith B. Pitts to its board of directors.

11-13-2012 3-50-41 PM

Apprio names H. Allen Dobbs, MD (HHS) CMIO.

Announcements and Implementations

McKesson renames Horizon Surgical Manager to McKesson Surgical Manager to convey that the product is not specifically tied to the Horizon product line.

FDA issues Cerner 510(k) pre-market clearance for its Cerner FetaLink+ mobile fetal monitoring solution for the iPad and iPhone.

Piedmont Healthcare and WellStar Health System (GA) create the Georgia Health Collaborative, a partnership which includes 10 hospitals and over 700 physicians. The organizations will remain independent, but will partner to share best practices and create innovations and cost reductions through economies of scale.

Intelerad will offer Nuance’s PowerScribe 360 voice-enabled reporting radiology system to customers of its imaging solutions.

Galaxy Health Network will offer its 400,000-member physician network iMedicor’s SocialHIE, a NHIN Direct-powered secure messaging service that the company calls “the social network for healthcare professionals.”

Steward Health Care System (MA) expands its use of Craneware’s Chargemaster Corporate Toolkit and InSight Audit across 10 hospitals.

Over 1,000 physicians across 422 practices have joined Michigan Health Connect and are using Medicity’s iNexx Referrals app.

The Upper Peninsula HIE goes live on ICA’s CareAlign CareExchange interoperability platform.

An article in the Sarasota newspaper profiles Voalte, including its $6 million in recent funding, the planned tripling of its headcount and physical space, and hints of major new sales in 2013. It says the smartphone hospital communications system vendor is doing $10 million in business annually. Sarasota Memorial Hospital nurses are sending 600,000 text messages and 6,000 telephone calls through the system each month.

11-13-2012 6-21-49 PM

Visage Imaging’s mobile viewing app has been enhanced to support the iPhone 5/iOS 6. It’s available in the Apple App Store.

Government and Politics

HHS announces the first class of the HHS External Innovation Fellows, who will spend the next six to 12 months building systems and infrastructure to solve such issues as the acceleration of clinical quality measures for the Affordable Care Act, building technology to withstand natural disasters, and devising electronic tracking and transport systems for the national transplant system. 

Innovation and Research

11-13-2012 8-20-34 PM

A Detroit TV station covers research commercialization at University of Michigan, including a profile of real-time patient monitoring software vendor AlertWatch. AlertWatch, used by UM Hospitals and awaiting FDA marketing approval, was developed by a UM doctor who also invented the pulse oximeter.


The president of New York’s public hospital system says it will cost more than $300 million to repair damages from Hurricane Sandy. Full restoration of the hard-hit Coney Island and Bellevue Hospitals will take two to three months.

Here’s a time lapse video of the audience filing in for Monday’s opening session at NextGen UGM 2012 in Orlando.

11-13-2012 9-04-34 PM

London-based Future Lab Group launches the FlipPad, a medical grade, ruggedized case for the iPad that’s being piloted in several NHS hospitals.

11-13-2012 8-15-46 PM

Bart Harmon MD, chief medical officer for Harris Healthcare Solutions and former Military Health System CMIO, writes a Forbes Veterans Day editorial on the use of healthcare IT to deliver care “both in the field and when they return home.”

In Greece, several hospitals lose their connection to the outside world when protesting students break into the data center and disable servers.

Employees and patients of Cincinnati Children’s Hospital create a video dubbed to Flo Rida’s “Good Feeling.”

Steve Sinofsky, the president of Microsoft’s Windows division and one-time CEO heir apparent, is leaving the company just a few weeks after the launch of Windows 8.

11-13-2012 8-44-49 PM

Guaranteed doctor blood pressure raiser: Lawsuit Settlement Funding Company hires a marketing company to help it find medical malpractice victims. The company offers malpractice plaintiffs quick-approve loans of up to $250,000 as an advance against their potential court winnings.

The son of a woman who died after knee surgery at a Massachusetts hospital files a HIPAA complaint, saying that rounding students visited her room without the family’s permission. He also tries to file homicide charges against the hospital and doctors, but police said it’s a civil matter. The son’s song tribute to Fenway Park is played before Red Sox home games, while his mother starred in the song’s video along with William Shatner just before she died.

11-13-2012 8-49-34 PM

One Medical expands to Boston, offering concierge medicine for $199 per year whose consumer-friendly experience includes online appointments and e-mail contact with physicians. Unlike most organizations of that type, they accept insurance.

11-13-2012 3-17-10 PM

inga_small A Chinese man sues his former wife after she gives birth to an “incredibly ugly baby.” He initially accused the mother of having an affair since the baby did not resemble either of them, but later found that his wife’s beauty was due to the $100,000 in plastic surgery she had prior to their marriage. The judge ordered the woman to pay her ex $120,000 for tricking him into marrying her. I hope she hits up the plastic surgeon for a loan in exchange for all the free publicity.

Sponsor Updates

11-13-2012 6-06-25 PM

  • Transplant solutions vendor OTTR Chronic Care Solutions exhibited at last week’s National Marrow Donor Program conference in Minneapolis. That’s Joy Nock above.
  • Five care management solutions providers featured in a recent market report use consumer health education tools from Healthwise.
  • Versus offers a Webinar  that highlights the use of Versus RTLS by Northwest Michigan Surgery Center.
  • MedHOK enhances its care management, quality, and compliance system by incorporating HTML5.
  • Informatica introduces Cloud Winter 2013, which includes enhancements in master data management and end-user integration.
  • Prognosis Health Information Systems will integrate Health Language’s provider-friendly terminology and Language Engine into its EHR suite.
  • Frost & Sullivan recognizes Humedica for its innovative approach to clinical data analytics and the value it provides to clients.
  • Emdeon exhibits its Edge payment solution suite and offers educational sessions during this week’s National Health Care Anti-Fraud Association conference in Anaheim, CA.
  • T-System’s VP of Revenue Cycle Management Compliance Greer Contreras discusses the value of relevant clinical documentation to ensure proper reimbursement in a guest article. 
  • UK HealthCare (KY) licenses Vendor Selection, Systems Implementation, and Program Management Methodologies from Fulcrum Methods.
  • Merge Healthcare updates its Merge Eye Care PACS to support video and the DICOM OPT standard.
  • The Nashville Chamber of Commerce and Entrepreneur Center recognizes Cumberland Consulting and Emdeon with 2012 NEXT awards for their significant growth in revenue and employees.
  • BridgeHead Software’s file archiving data and storage management systems for PACS is successfully tested by Fujifilm.
  • The Huntzinger Management Group streamlines its services offering to include RCM offerings from both its Advisory Services and Managed Services segments.
  • CareTech Solutions introduces CareWorks, an out-of-the-box content management system for smaller hospitals.
  • Brad Levin and Malte Westerhoff, PhD of Visage Imaging were featured in an Imaging Biz article called “The High-performance, High Speed Enterprise Viewer.”
  • Worcester Business Journal awards eClinicalWorks top honors for its employee rewards and recognition.


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

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November 13, 2012 News 7 Comments

Monday Morning Update 11/12/12

November 10, 2012 News 22 Comments

11-10-2012 8-48-39 AM

From Winston Zeddemore: “Re: EHR incentive program. Purely from the perspective of economic stimulus, by any measure, the EHR incentive program is a complete failure. After nearly four years since the bill was signed, they’ve paid out only a third ($8.36B) of the $25B set aside for EHR adoption.” Thanks to our recalcitrant and justifiably skeptical doctors for finally forcing government to stop making it rain like a defensive back in a strip club. Economically, we now know that EMRs are even a tougher sell than we thought – thousands of dollars in bribes still isn’t enough to convince doctors to spend more of the one resource they have (time) to benefit everybody but themselves. However, it’s fairly early in HITECH and the money is flowing freely now, so eventual success aside, your argument holds true – HITECH as a quick-jolt stimulus program hasn’t worked out, but for a positive reason — its intended recipients were held to high standards before the taxpayer-written checks were mailed out. That’s another good thing  – the biggest concern about a stimulus-funded EHR program was that it would move too fast, causing doctor headaches and possibly harming patients along the way because of shoddy implementations of historically poor-selling products as everybody elbowed their way to the feed trough. As distasteful as HITECH is to many (me included), it’s working better than many other ARRA-funded boondoggles.

From Geek Chic: “Re: open source code for integration. Have any of your readers used an open source engine for HL7?” Leave a comment if you can help our inquisitor. Readers have mentioned using the Mirth engine in the past.

From The PACS Designer: “Re: RIS-teria. TPD has coined a new name for problems surrounding radiology information systems. While a RIS does a reasonable job of scheduling patients for studies, it is less efficient in dealing with the subsequent information flow. With the increased demand for better information to improve efficiencies, the RIS is lagging behind other systems due to the lack of adequate application programming interfaces (APIs). RIS-teria results from department managements quarreling on where to place new API’s, and who is going to provide the necessary funding. One solution is to do an upgrade to a RIS/PACS from the same vendor who can provide the necessary API software to communicate with other systems.” 

From RIP_IDX: “Re: GE Healthcare. Significant layoffs coming to GE Healthcare in Burlington this week (probably Wednesday). Not sure if it is going to be limited to just the BTV office or across GE-HCIT. Rumor is Centricity Business will be hit hard. Haven’t heard if imaging (also based in Burlington) will be impacted. In a completely coincidental move, employees have been reminded of the corporate policy prohibiting them from talking to the media.” Unverified and hopefully untrue. We’re getting close to that Thanksgiving to New Year’s period where companies show their hand as desperate, cold, and clueless by sending employees packing during the holidays.

From MaxIT Numbers: “Re: MaxIT. Bought by SAIC for $473 million. Last quarter’s revenues were $52 million, or $208 million analyzed. That’s a buyout multiple of 2.3 times yearly revenue. How many consulting firms saw this number and are considering selling? Does this multiple seem off to anyone besides me? They must be generating huge margins at the expense of their customers.”

11-9-2012 7-24-43 PM

Two-thirds of respondents believe that patient empowerment and mobile apps can will change the healthcare system. New poll to your right, requested by a reader: what’s your general opinion of the College of Healthcare Information Management Executives (CHIME)?

Here’s my latest Spotify playlist in case you’re interested exploring new music (although some of the “new” music is actually old but little appreciated). Examples of what’s on it: Metric, Chevelle, Hammers of Misfortune, Fitz and the Tantrums, The Czars, Curved Air, Marmalade, Hole, and After Forever. It spans more than 40 years and several genres, connected only by the thin thread of my common appreciation.

11-10-2012 8-58-34 AM

Some nuggets from the Allscripts earnings call Thursday:

  • Glen Tullman said drastically reduced earnings were caused by prospects delaying decisions because of the rumors that Allscripts was trying to sell itself, and also because of clients were waiting for new product releases. Ambulatory sales were hurt by the acquisition rumors and MyWay announcement. Professional services revenue slipped due to fewer sales and upgrades, but maintenance revenue increased. He repeatedly referred to the sales-impacting issues as “noise.”
  • The company had one new Sunrise sale in the quarter. The buyer was a three-hospital, 214-bed system.
  • Reaction to the MyWay announcement was “pretty positive.” Glen declined to give the MyWay customer count, but said it’s in the thousands.
  • Glen: “You’ve got some old systems out there that are harder to connect and harder to upgrade, and you’ve got a slew of new technologies starting to hit the market. That’s when whole sectors change. I think that’s our opportunity.”
  • Allscripts hasn’t seen lengthening sales cycles in ambulatory as other companies have said they’re experiencing.
  • The company expects “the vast majority” of MyWay users to move to Professional by the October 13, 2013 signup deadline.
  • Glen: “I think this is a big focus for us whether it be analytics, whether it be care coordination, whether it be interoperability, connectivity, and mobility. All of those will absorb a higher and higher percentage of our R&D budget, which continues to grow. And we think that we will have significant advantage. Some of our competitors are locked into architectures that don’t allow for the kind of innovation that we can bring. And with our open ecosystem that we’re creating, with all the third parties starting to develop on that platform, we think we can extend significant competitive advantage as those folks developed for us.”

11-9-2012 8-51-22 PM

A survey of “digital health entrepreneurs” by venture capital firm InterWest finds that the top three barriers to healthcare innovation are reimbursement (27 percent), government (19 percent), and Epic and Cerner (14 percent). The heel-nippers may pout that well-established and successful vendors won’t voluntarily move out of their way, but they’re also envious: companies they wish they had founded include AirStrip, Castlight, ZocDoc, Epic, and Google. The graphic above is their prediction of which of their brethren will be the next to go public.

11-10-2012 7-45-23 AM

A wood products company becomes the first business in Maine to use telemedicine in the workplace, offering its diabetic employees video consultations with the co-director of the diabetes center at Tufts Medical Center. The program gives employees access to specialists who aren’t available in the company’s rural location and eliminates the high co-pays that most employees couldn’t afford.

11-10-2012 7-58-14 AM

Massachusetts-based hospital drug supplier Ameridose, a sister company to the compounding pharmacy whose products have been linked to a national outbreak of fungal meningitis, lays off its 800 employees as the FDA reviews the company’s sterility practices. The director of the Massachusetts Board of Pharmacy has been fired for failing to investigate a sterility complaint against the compounding pharmacy. It’s an interesting juxtaposition of headlines on Ameridose’s site (above).

11-10-2012 8-03-30 AM

Nashville-based Dalcom Communications Systems, which sells a wireless patient communication and nurse alarm system, renames itself to Amplion Clinical Communications after raising $3.75 million in financing to expand sales.

Sen. Orrin Hatch (R-UT) raises concerns with HHS Secretary Kathleen Sebelius that Quality Software Services, Inc., which was awarded a contract worth up to $145 million to create an eligibility system for the federal health insurance exchange, has since been acquired by Optum, part of UnitedHealth Group. QSSI’s annual sales were $13 million before the deal. The federal official overseeing implementation of the health insurance exchanges resigned in June to take an Optum EVP job.

11-10-2012 8-11-08 AM

Release of information vendor HealthPort merges with competitor Discovery Health Records Solutions. The Atlanta-area companies will operate under the HealthPort name. HealthPort sold its IT-related businesses, which included the former Noteworthy Medical Systems, to Germany’s CompuGROUP for $24 million in November 2010.

Sponsor Updates

11-9-2012 8-41-27 PM 11-9-2012 8-42-07 PM

  • A four-part series by Karen Baker, MHS of the nonprofit Healthwise celebrates National Health Literacy Month with a discussion about how to engage patients in healthcare decisions. The organization took a team of 18 of its content producers to a scriptwriting camp led by an advertising copywriter, an actor, and a filmmaker to encourage them to break the rules in developing material that not only supports evidence-based medicine and behavioral change theory, but in a way that gets patients involved using plain language and taking the patient’s point of view. According to Healthwise Founder and CEO Don Kemper, “Medical gobbledygook robs people of their autonomy. Without understanding, they have no real say in their care. Plain language gives them back their say.”
  • Besler Consulting will exhibit at HFMA’s Region 9 conference in New Orleans this week, demonstrating its cloud-based BVerified solutions for transfer DRG, IME, excluded provider screening, and revenue integrity auditing.
  • CSI Healthcare IT revamps its job portal, which lists its several dozen open positions (direct hire, consultant, and contract to hire) for candidates with expertise in Cerner, Epic, McKesson, and Meditech.
  • An interesting blog post by Henry Sabia of Software Testing Solutions on the changing no-man’s land between the EHR and laboratory information system: “It seemed to me the consensus was that ‘LIS’ won’t be about one system doing everything. Thought leadership sees it as a spectrum of systems working together. Ironically, GenLab and Microbiology functions may leave the typical LIS applications to become part of the general EMR, but Blood Bank and Anatomic Path will most likely fall under the ‘specialty’ category and will require standalone systems. Seems to me that we will always have separate systems, but a game of Red Rover is happening with some of our functionality. The EMR/CPOE has called GenLab and Micro over. Will be interesting to see if/how they make it to the other side. Regardless of where GenLab and Micro may live, the need for functional and volume testing will be more demanding than ever. EHRs, EMRs, interfaces, and data integration are here to stay. Add new acronyms like LOINC and HIE, and the picture only increases in complexity.”
  • Velocity Data Centers President Steve Jacobs offers four concerns about healthcare IT moving to the cloud: data security, service levels, performance, and energy efficiency.


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

More news: HIStalk Practice, HIStalk Mobile.

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November 10, 2012 News 22 Comments

News 11/9/12

November 8, 2012 News 4 Comments

Top News

11-8-2012 5-13-39 PM

Allscripts reports Q3 results: revenue down 1 percent, EPS $0.23 vs. $0.24 excluding special items, missing consensus revenue estimates by 4 percent but beating adjusted EPS estimates by a penny. Earnings were down by more than 50 percent on asset write-downs and slipping margins. CEO Glen Tullman confirms earlier reports that the company is evaluating strategic alternatives, adding that the company will not comment further on the issue and will not issue financial guidance for the next quarter.

Reader Comments

From Curious in Cleveland: “Re: Lyman Sornberger, executive director of revenue cycle management at Cleveland Clinic. Two confidential informants confirm that he’s out – any idea why? I’m a loyal reader and ex-Epic. Judy had me scared stiff to report anything to any blog, so this is a real thrill for me even if you don’t publish it.” Unverified. We’ll see if anyone confirms. I get basically no reports from anyone at Epic, so you’re not alone there.

From Coyote: “Re: McKesson. Half verified – they will acquire Greenway and athenahealth.” Unverified and unlikely given that those are two publicly traded vendors of competing systems with market caps totaling more than $2.5 billion. However, experience has taught me to at least mention even bizarre rumors just in case they happen to come true. If this rumor is accurate, it would easily be the most bizarre. Color me even more skeptical than usual.

HIStalk Announcements and Requests

11-5-2012 12-43-17 PM

This week’s HIStalk Practice highlights include: CMS adds a couple of new hardship exemptions for the e-prescribing rule. As more hospitals buy physician practices, facility fees for routine office visits are expected to increase Medicare spending $2 billion a year by 2020. The number of physicians in independent practices is predicted to drop to 36 percent by 2013. Occasional HIStalk  contributor Lyle Berkowitz, MD earns a spot on the list of Top 25 Clinical Informaticists. The most commonly deferred Stage 1 menu objectives by EPs include providing patients with a summary of care at transitions, using EHRs for reminders, and reporting data to public health agencies. NYeHC Executive Director David Whitlinger provides an overview of his organization and its initiatives. Stop by HIStalk Practice to get the latest ambulatory HIT updates, and while you are there, check out a few of our sponsor offerings and sign up for e-mail notifications. Thanks for reading.

On HIStalk Mobile, the talented and knowledgeable Lt. Dan is putting up several news items each day, while Dr. Travis has written an immediately popular post called Where I Would Invest. We don’t want to overload your inbox with the news posts, so you’ll get notification only of Travis’s longer posts if you sign up for updates. Thanks to HIStalk Mobile’s sponsors: 3M, Access, AT&T, Imprivata, Kony Solutions, Truven Health Analytics, Vocera, and White Plume.

11-8-2012 6-47-17 PM

Welcome to new HIStalk Platinum Sponsor Clinovations. The advisory practice of the DC-based company targets ambulatory and inpatient provider organizations, non-profits, and federal and state government. Their expertise includes patient safety, quality, and all phases of electronic medical records implementation. I mentioned Pitt County Memorial as one of the North Carolina academic medical centers running Epic and I’ve learned two things about that since yesterday: (a) Clinovations provided go-live support, EMR optimization, and physician engagement services for their implementation; and (b) the hospital changed its name earlier this year to Vidant Medical Center, with the 10-hospital system now going by the name of Vidant Health. I first connected with Clinovations a few weeks ago when I interviewed CEO Trenor Williams, MD, recommended to me by Travis from HIStalk Mobile, who knows him. More than half of the company’s 100 employees are clinicians, Trenor told me. In fact, read the interview to get a feel for how the company works (hint: they’re big on upfront optimization planning, wringing value from EMR implementation, and using data to improve care delivery). Thanks to Clinovations for supporting my work.

On the Jobs Board: Systems Engineer, Epic and Cerner Resources, Senior Certified Epic Analyst, Senior Quality Engineer. HIStalk Platinum Sponsors post their jobs for free, while everybody else watches enviously because they aren’t allowed to post jobs there at all.

11-8-2012 7-41-58 PM

It’s unfortunately unfashionable to divert one’s attention from self-absorbed activities to take a moment to think about members of our military, living and dead, whose sacrifices (ranging from modest to ultimate) provide us with the illusion that the world is full of caring people who wish us no harm. Sunday is Veterans Day, the eleventh day of the eleventh month that is set aside to honor every man and woman who has served this country in uniform. It’s a real shame that most cities don’t bother to have Veterans Day parades any more, but chances are you know a veteran or will see someone in uniform this weekend who would be grateful for nothing more than a nod and a “thanks for your service” instead. If you served, thank you. If not, thank them.

Acquisitions, Funding, Business, and Stock

11-8-2012 5-12-54 PM

Cerner will acquire Anasazi Software, Inc., a provider of behavioral health technology.

11-8-2012 9-04-55 PM

Accretive Health’s Q3 numbers: revenue up 2 percent, EPS $0.03 vs. $0.07. They signed some new revenue cycle management deals despite being run out of Minnesota for harassing ED patients to pay up. Amusing: their AR days jumped from 48 to 56 due to “delayed payments from a few customers.” They must not have strong-armed their own customers like they did those of their hospital clients, although they did take “action relative to the resources that were local in the market and focused on the clients in those areas,” i.e. fired their Minnesota employees once the company got the boot from there.

11-8-2012 9-06-55 PM

A Reuters article says that Merge Healthcare has attracted the interest of at least five private equity firms as it contemplates taking itself private. Named as suitors Thoma Bravo LLC, GTCR LLC, Welsh Carson Anderson & Stowe, Francisco Partners, and Avista Capital partners. Sources say the company hopes to have offers by today (Friday).

For-profit hospital operator Vanguard Health Systems announces that it will consolidate its IT operations in San Antonio. They will move to the Inner City Reinvestment/Infill Policy zone, which sounds great for corporate tax credits but lousy for night shift computer operators.


11-8-2012 11-13-52 AM

SAIC subsidiaries maxIT Healthcare and VCS close a combined $102 million in contracts from several North American hospital and clinics.

Summit Radiology Associates (NJ) selects Merge Healthcare’s radiology suite.

The DoD awards Evolvent Technologies a $20.5 million contract to build additional coding, database uses, and mobile applications into AHLTA-Theater.


11-8-2012 7-53-38 AM

Lakeland Regional Health System (FL) names J. Scott Swygert, MD chief quality officer and CMIO.

11-8-2012 2-55-02 PM

Vermont Information Technology Leaders appoints John K. Evans (Strategic Alliance Advisors dba s2a) president and CEO of its statewide HIE.

Announcements and Implementations

Wellmont Health System (TN) will begin file building for its Epic implementation in January and will phase its go-live throughout 2014.

11-8-2012 8-21-12 AM

The 17-provider Reedsburg Physicians Group (WI) goes live next week on GE Centricity EMR.

11-8-2012 9-07-52 PM

Park Nicollet Health Services (MN) goes live with Levi, Ray & Shoup’s VPSX software solution for document and printer management.

RamSoft will integrate MModal’s Speech Understanding technology into its PowerServer RIS/PACS, PACS, and Tele Plus Systems.

Government and Politics

11-8-2012 10-27-38 AM

CMS releases updated reference grids for Stage 1 and 2 MU requirements, including details on how MU objectives align with EHR certification criteria.

HRSA (Health Resources and Service Administration) offers a November 16 Webinar called Patient Charting and Documentation in an Electronic Health Record for Nurses and Allied Health Professionals, with presenters that include practicing nurses.

11-8-2012 9-09-52 PM

El Camino Hospital (CA) considers a legal challenge after voters narrowly pass Measure M, which will limit the pay of its executives to twice the governor’s annual salary, or around $350K. CEO Tomi Ryba, CFO Michael King, and CMO Eric Pifer, MD would all see major pay cuts if the legality of the measure is upheld. Meanwhile, an SEIU-UHW union steward admits that the union proposed the measure only because hospital officials declined to meet with its leadership in last year’s labor negotiation in which the union was unhappy that its members were no longer being offered free healthcare (that perk has since been reinstated).

Innovation and Research

A study published in the Journal of General Internal Medicine finds that clinical decision support tools in EHRs can help reduce the inappropriate use of antibiotics for acute respiratory infections.

Chicago startup MetisMD offers radiology second opinions for $75 (report review) to $250 (MRI, CT, PET, mammography, nuclear medicine, echocardiograms). Patients get a copy of their study, upload it to the company, and get a written report and a conversation with the radiologist within 1-2 days.


11-8-2012 6-27-29 PM

Healthcare venture capitalist Lisa Suennen says healthcare reform will create business opportunities for companies offering tools that can help manage chronic care and that keep people out of hospitals. She mentions one of her investments, SeeChange, which pays patients if they get annual blood work and agree to follow customized prevention guidelines that are generated from a mash-up of the lab results, personal health record information, and claims data. She says hospitals and insurance companies are vulnerable to marginalization if they are slow to react to the changes:

We are going from fee-for-service to not-quite-fee-for-service, in a pretty broad way, where you are paying fixed amounts for cases. Hospitals don’t know how to deal with that. The profit now will come from being efficient instead of being prolific. So they will need tools and programs and analytics to help them make that transition. The other area is the whole “retailization” of insurance. There is a huge, fundamental shift in the business, as individuals are driven more and more to buy their insurance from exchanges. Insurance companies don’t sell that way. They don’t have good brands from a consumer-satisfaction standpoint; in fact they have some of the worst brands in the world. So organizations that work on consumer brands are coming into the marketplace.

11-8-2012 8-40-18 PM

Motorola Solutions rolls out the HC1 Headset Computer, a self-contained wearable computer with a boom-mounted viewer that simulates a full-sized monitor, a two-way headset, and the ability to respond to voice or head-movement commands. It came out too late for making a fashion statement at AMIA.


Aprima announces that it has settled the lawsuit brought against it by Allscripts, which had claimed that the wording of Aprima’s advertised “MyWay Rescue Upgrade Program” violated state and federal laws. Aprima agreed to changed its advertising, but will continue to market its product to users of the Allscripts MyWay EHR. Allscripts previously announced that MyWay will not be upgraded to handle ICD-10 or Meaningful Use Stage 2, but customers will be offered a free conversion to its Professional product.

11-8-2012 6-39-47 PM

Athenahealth Chairman, CEO, and President Jonathan Bush appeared  on CNBC Thursday morning in a discussion about healthcare reform.

You’re going to get more rules and innovation anyway when the healthcare costs are going up faster than GDP. Everyone is going to force some innovation. In this next stretch, it will come from the government … Medicare first and the commercial health plans are falling nervously behind the tank that is Medicare … If you’re a buyer of healthcare, an employer or consumer, you’re going to see two things. You’re going to see some markets where hospitals rally around and buy up doctors. We’ve seen half the doctors in the country become employed in the last three years in preparation for this. And then jack up commercial rates and say, “I got this huge group of Medicaid rates coming in, I’m going to jack up” … we saw this in Massachusetts, the first state that did this. Commercial rates went up 50 percent for the same coverage over a five-year period just for the commercial side … The hospitals bought all the doctors and said, “You can’t have any of us unless you go up.” There will be others who figure out how to get cheaper. They’ll get more efficient. They won’t need to raise rates. And then the third group will be the ones who go bust … they’re supposed to go bust. Please, no bailouts for the hospitals that go bust.

Here’s a new video on the Texas approach to a statewide HIE that involves 12 local HIEs.

11-8-2012 9-12-22 PM

Heisman winner runner-up and Indianapolis Colts rookie quarterback Andrew Luck signs his first big endorsement deal … with Riley Hospital for Children.

A new study finds that doctors, like most people, are subconsciously biased against the two-thirds of Americans who are overweight. If you’re obese, your best bet for compassion is to find a fat female doctor, the study results suggest.

FDA urges that providers writing prescriptions write neatly, minimize the use of abbreviations, and consider using e-prescribing instead. The practitioners being addressed are veterinarians.

inga_small This is nuts: genital injuries send 16,000 men and women to the ER each year.

Bizarre: a California couple lose a real estate fraud lawsuit when the husband, the director of pathology and clinical laboratories of Community Regional Medical Centers, admits that he faked the death of his wife, a former National Raisin Queen. The purchaser of their horse ranch, an anesthesiologist, says the couple faked her death to increase the value of their property to $2.3 million. The wife, a former waitress, changed her name from Genevieve Sanders to Genevieve Marie de Montremare and claimed to be a physician and French-born royalty. Their transgressions will cost them $1.55 million.

Sponsor Updates

  • API Healthcare CEO J.P. Fingado offers insight on how the results of the presidential election will affect the healthcare workforce.
  • Prognosis maintains its 100 percent success rate among its eligible clients achieving and attesting for MU.
  • GetWellNetwork launches Transformative Health, an online publication covering the intersection of patient engagement and technology.
  • 3M hosts a Webinar on the critical need to start ICD-10 education now.
  • White Plume offers advice on creating interoperability in preparation for the ICD-10 deadline in a blog post.
  • The IT director and a senior systems analyst from Henry Mayo Newhall Hospital will lead a November 14 Webinar on their use of solutions from Access to create a paperless admissions and bedside consent system, send completed forms automatically to their Meditech system, and maintain electronic registration and clinical activities when the hospital system is down.
  • Shareable Ink hosts a Webinar on preparing anesthesiologists to qualify for MU.
  • An article by T-System VP Greer Contreras highlights the need for physicians to describe their thought process when documenting to help prevent denial of payment.
    Bottomline Technologies publishes a case study that highlights Alamance Regional Medical Center (NC) and the efficiencies it has gained since implementing the Logical Ink e-form solution.
  • The Canadian Health Informatics Society honors Orion Health and eHealth Saskatchewan as Project Implementation Team of the Year for the successful integration of Orion Health’s Clinical Portal with four eHealth Saskatchewan applications.
  • Liaison Healthcare’s Gary Palgon, VP of healthcare solutions, discusses cloud-based solutions for big data during this week’s 12th Annual BMS IT Symposium in Princeton, NJ.
  • Robin Mitchell, MD (WA) shares how her practice has improved patient care by leveraging EMR support services from INHS in a company profile.
  • Ingenious Med becomes one of the most downloaded apps for Android.
  • SAIC subsidiaries maxIT Healthcare and Vitalize Consulting Solutions will exhibit at the NextGen User Group Meeting next week.
  • Fulcrum Methods recognizes new Meaningful Use-EP Tracker users, including Duke  Private Diagnostic Clinics (NC), Greenville Hospital System (SC), Lucile Packard Children’s Hospital at Stanford (CA), Physicians Medical Group of Santa Cruz County (CA), and University Hospitals-Cleveland (OH).
  • IT staffing company Digital Prospectors Corp ranks #9 on “Top 100 Private Companies for 2012” by Business NH Magazine.
  • Besler Consulting will participate in the HFMA Region 9 conference in New Orleans November 11-13.
  • Carl C. Jaekel of Santa Rosa Consulting offers five ingredients for successful ICD-10 activation in the company’s team blog.
  • Jason Fortin, a senior advisor with Impact Advisors, weighs in on meeting Stage 2 menu objectives.
  • MModal’s chief scientist Juergen Fritsch discusses ways for healthcare organizations to obtain a holistic view of patients’ health in an article published in the Allscripts Newsletter.
  • The latest version of Imprivata’s OneSign technology includes Fade to Look walk-away security for shared workstations, No Click Access for Citrix XenApp, and support for Epic 2012.
  • Florida State University student Bill Blough takes first place and a $1,500 prize in iSirona’s e Code-A-Thon competition.
  • Bottomline Technologies hostted a November 8 Healthcare Customer Insights Exchange to foster collaboration between healthcare organizations using its technology.
  • Wellcentive highlights Borgess Health (MI) and its use of Wellcentive’s Advanced Outcomes Manager solution for population health management and clinical analytics. 

EPtalk  by Dr. Jayne

I worked double shifts in the emergency department this week as a result of another physician defection. In case there’s any question, I can attest to the fact that the front-line physician shortage is very real, especially if patients are on Medicaid or are uninsured. Out of an entire day’s work, only two patients actually belonged in the ED – a child with a laceration and an adult with a fully dislocated finger. There were multiple patients there for medication refills, work notes, and plenty of malingering.

I think stationing a Boy Scout with a first aid kit outside the door of the hospital would have not only have provided great cost savings, but also also would have helped patients learn that many of their conditions could be treated at home with basic first aid training and a little common sense. Until we figure out how to educate patients on these things, we will continue to have unnecessary ED visits.

Other countries seem to do a better job with this. A friend who lives in Germany keeps telling me about the baby nurse that comes to her home to do basic parenting and health education (how to handle fever, why babies are fussy, what to do when your child falls and hits his/her head, etc.) Having something like that here would be fabulous. However, that would require what many interpret as government intrusion and it would certainly require government funding, so I don’t see it happening here anytime soon.

Here are some pearls of wisdom from last night’s adventure:

  • Influenza season is here. If your child has a fever, doping them up on Tylenol and sending them to daycare to infect everyone else is a bad idea.
  • When your child shoves something in her ear, do not try to get it out with a cotton swab. You will jam it in further. What I could have removed quickly and painlessly has now become a procedure that requires us to sedate your child and quadruple your hospital bill. And BTW, please do not call an ambulance for this.
  • Pain in a wrist you broke 10 years ago is not an emergency condition. I will screen you and send you home.
  • Asking me to diagnose a rash that is no longer present is just silly.
  • When you’re a homeless guy who just wants a warm place to hang out and a sandwich, it’s best not to strip naked and sexually harass the nurses and physician. We will call security. But if you keep your clothes on, we’ll board you for a little while.

I did have some downtime in the wee hours of the morning and tried to keep up on the massive stream of social media and correspondence that was flowing my way. One of my Tweeps mentioned that BlackBerry 10 looks “promising.” Unfortunately, the hospital firewall blocked my attempts to read the article. but I did find a blurb on YouTube. Anyone seen it and have good intel? It sounds like it has a slick camera feature that lets you go back in time to modify faces when someone blinks.


Inga’s not-so-secret admirer Dr. Lyle Berkowitz makes Modern Healthcare’s list of Top 25 Clinical Informaticists. Of all the honorees, he’s got one of the best-looking head shots. Being an anonymous blogger, I know I will never make the list, but it’s fun to see lots of HIStalk friends on it.

I ran across another first-hand account of the evacuation of NYU Medical Center, this time from a medical student. It depicts situations which would make great scenarios for your next disaster preparedness drill.

There have been lots of good tweets coming from attendees of the AMIA 2012 Annual Symposium. Lots of thoughtful ponderings on “real” interoperability and what data elements really need to be tracked across disparate care settings. Not a lot of photos, though. If you were there and have some good ones to share or general thoughts about the meeting, feel free to send them along.


Speaking of meetings, the NextGen Annual Users Group Meeting starts Sunday in Orlando. Hope to see some good pics and tweets from readers who are enjoying the warm weather and getting in some quality time with The Mouse.


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

More news: HIStalk Practice, HIStalk Mobile.

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November 8, 2012 News 4 Comments

News 11/7/12

November 6, 2012 News 1 Comment

Top News

11-6-2012 6-13-42 PM

ECRI Institute’s “2013 Top 10 Health Technology Hazards” report includes several patient issues that are IT-related or potentially IT-solvable: alarm hazards (#1); IV infusion pump errors (#2); data mismatches in clinical IT systems (#4); interoperability failures between IT systems and medical devices (#5); and caregiver distractions due to mobile devices (#9). The nonprofit organization’s report, which contains good assessment tools and recommendations, is available as an immediate and free download with registration.

Reader Comments

11-6-2012 6-20-18 PM

From Ron Strachan: “Re: Community Health Network in Indianapolis. I’m happy to report that we’re live on the final wave of Epic sites. Community is an Enterprise customer and now has four hospitals and over 200 sites of care live on EpicCare. The install started in April 2011.” Congratulations to the team there and to the CIO, which happens to be Ron. Epic “waves” of ambulatory go-lives within an organization are like an army’s push into enemy territory – cause for concern beforehand, but worth celebrating after the careful planning pays off.

From Karl: “Re: for Inga and Dr. Jayne. Beware … you are about to lose substantial time and money too.” The Pinterest page is shoe porn for the ladies, or possibly for cash-eager healthcare providers who specialize in treating the foot and leg damage that some of the more bizarre models surely cause. But as they say, it’s better to look good than to feel good.

From Tarheel Ingenue: “Re: UNC Health Care. Named Epic vendor of choice on Friday.” Unverified, but hardly surprising given that not only is Epic getting just about every big-hospital deal, they have several of UNC’s academic hospital neighbors as customers (Duke, Wake Forest Baptist, Pitt County in Greenville, and probably others I’m forgetting.)

11-6-2012 8-08-49 PM

From JB: “Re: soft drinks. Mayor Bloomberg isn’t the only one banning the sale of sugary drinks.” Children’s Mercy of Kansas City, MO will stop the sale of all sugar-containing drinks on January 1, including sugar-loaded faux healthy fruit juices. The hospital cafeteria emphasizes healthier food choices, encourages purchase of fruits and vegetables, and plans to trash their deep fryers by 2015. They will also switch all IVs from dextrose to normal saline starting in 2015 (OK, I made that part up). This is an admirable step in trying to lead by example. Outsourced food service departments of hospitals are big-time nutritional offenders in serving whatever is easy and cheap, although in their defense they’re selling what people unfortunately want. It would be interesting to see how many overweight people suck down sugary drinks regularly, which are surely the least-satisfying calories you can take in. Put your finger a third of the way up the side of a soda can – that’s how far the 140 calories’ worth of sugar would pile up if you removed the colored water.

HIStalk Announcements and Requests

inga_small I plan to get comfy on the couch tonight in front of the TV to watch the election returns. Hopefully by the week’s end I can unhide a few of my more politically passionate Facebook friends whose various posts have raised my blood pressure in recent weeks. I’ll then be happy to ignore all politics for awhile – at least until Bill Clinton keynotes at HIMSS.

We like reading tweets from conferences, so we’re offering sponsors a free tweet box from their annual user meetings. The one from Imprivata’s HealthCon is running to your right.

Speaking of meetings, AMIA’s seems to be going well judging from the tweets. Your report is welcome since we aren’t there.

Acquisitions, Funding, Business, and Stock

11-6-2012 11-32-56 AM

NexJ pays $5.5 million to acquire Broadstreet Data Solutions, a provider of data management, analytics, and mobile solutions.

11-6-2012 8-12-00 PM

Shareholders of Streamline Health Solutions vote to convert $5.7 million in convertible notes to preferred stock in order to reduce company debt and reduce interest expense.

11-6-2012 5-27-44 PM

Hearst Corporation, whose holdings include Zynx Health and First Databank, will acquire Milliman Care Guidelines LLC, a provider of evidence-based clinical healthcare databases.

11-6-2012 11-34-08 AM

Tenet Healthcare subsidiary Conifer Health Solutions, which provides business process management services to 500 hospitals, acquires Dell’s revenue cycle management business for hospitals and healthcare systems.

11-6-2012 8-12-33 PM

Vocera reports Q3 results: revenue up 27 percent, EPS $0.07 vs. -$0.25, beating estimates on both and raising earnings guidance.

As we reported earlier, McKesson announces that it will acquire Emendo Ltd., the New Zealand-based vendor of the CapPlan hospital capacity planning solution. Its customers are in New Zealand, Australia, the UK, and Canada, with some US hospitals signed since it began marketing here through partners in 2010.


11-6-2012 5-35-28 PM

Legacy Health (OR) contracts with Explorys for its platform and enterprise performance management applications to power Legacy’s PCMH and ACO initiatives.

11-6-2012 5-33-56 PM

Altru Health System (ND) selects Perceptive Software’s content and process management solutions to complement its Epic patient registration, HIM, and patient finance processes.

Baptist Health (AR) chooses the Patient Access Intelligence and Revenue Cycle Intelligence solutions from MedeAnalytics.

First Choice Health Centers (CT) signs with eClinicalWorks for its six-location community health center organization.

11-6-2012 8-15-02 PM

Coosa Valley Medical Center (AL) selects Merge Healthcare’s iConnect Enterprise Clinical platform, including Merge PACS, iConnect Access, and iConnect Enterprise Archive.

HomeTown Health buys McKesson’s CareEnhance-Review Manager Enterprise technology to increase the accuracy and efficiency of medical necessity review and documentation among its network of rural hospitals and providers.


11-6-2012 8-53-53 AM

Kaiser Permanente promotes President and COO Bernard Tyson to chairman and CEO, replacing the retiring George Halvorson.

11-6-2012 5-38-25 PM

Stuart Nelson, MD (US National Library of Medicine) joins Apelon as chief innovation officer.

11-6-2012 5-39-32 PM

The TriZetto Group hires Jeffrey Rose, MD (Ascension Health) as CMIO.

11-6-2012 11-19-30 AM

The Georgia CIO Leadership Association names Emory Healthcare CIO Dee Cantrell its CIO of the Year.

11-6-2012 7-08-21 PM

Tony Fonze, CIO of Carondelet Health Network (AZ), is named president and CEO of Carondelet’s St. Joseph’s Hospital of Tucson.

Announcements and Implementations

11-6-2012 5-41-04 PM

NYU College of Nursing and Rubbermaid Medical Solutions combine resources to develop and enhance clinical technology solutions for nursing education that will  include scholarship programs, telemedicine projects, and educational initiatives.

11-6-2012 12-01-28 PM

The executive director of HealtheConnections reports that about 1.2 million people in central and northern New York are now connected to its HIE.

First Databank releases the ICD-10 code set within its FDB MedKnowledge clinical decision support drug knowledge.

nVoq and Mi-Corporation will collaborate to deliver voice-enabled versions of commonly used templates for the home health and long-term care industries and will develop additional voice-enabled e-Forms for other healthcare settings.

11-6-2012 6-37-35 PM

One of my Advisory Panel members mentioned using Vendormate to review the financials and sanction record of prospective vendors. The healthcare-specific company recently announced Medzo, an online service that matches the needs of buyers with seller offerings, potentially eliminating the RFI process. Vendormate’s network covers 70,000 companies, 660,000 provider-vendor relationships, and 48,000 users. Hospitals get free access and vendors get a free basic listing in Medzo.

Government and Politics

A Masachusetts law went into effect this week that prohibits employers from requiring nurses to work overtime.

Innovation and Research

A Rand Corporation study finds that physicians with fewer than 10 years of experience account for 13.2 percent higher overall costs than physicians with 40 or more years of experience.


11-6-2012 12-41-13 PM

GE Healthcare issues a field safety notice to physicians warning of a potential defect in its Centricity PACS imaging systems that could result in the loss of images when sending exams from one Centricity PACS to another.

11-6-2012 5-56-24 PM

Eleven vendors own 80 percent of the HIE market, according to a new KLAS report. Epic, ICA, and Siemens MobileMD earned the top scores for overall connectivity and satisfaction, though scores for all HIE vendors except Cerner have declined over the past year.

Social workers in British Columbia are startled when their computers display the home page of the US Department of Homeland Security and an entry form labeled “Co-Conspirator.” Their new, problem-plagued software was modified from Homeland Security’s system by a contractor at a cost of $194 million and counting. The government shut down an $89 million student information system last year after giving up that its problems could be fixed.

Strange: a doctor tells a British couple who aren’t having any luck conceiving that the problem might be the husband’s laptop, which he props in his lap for several hours each evening to use Facebook. Three months after the husband starts using a table instead of his lap, his wife becomes pregnant.

Sponsor Updates

11-6-2012 6-00-26 PM

  • The Sandy Relief Drive of SRS generated almost $5,000 in employee donations, which the company then matched in purchasing supplies for affected employees. The balance of the money will be donated to the Red Cross and Governor Christie’s Relief Fund.
  • GetWellNetwork completes its 350th interface in US hospitals.
  • CHMB (CA) partners with Ingenious Med to expand its RCM service offerings to hospitalists.
  • Intelligent InSites announces that its software platform integrates with the ultra wide band RTLS from PLUS Location Systems.
  • iSirona offers a $1,500 prize to the winners of a Code-A-Thon programming challenge at Florida State University.
  • ICSA Labs calls for qualified EHR technology developers of both complete EHRs and EHR modules to participate in a pilot program for the 2014 Edition certification criteria.
  • Orion Health CEO Ian McCrae discusses the growth of his company and its approach to software integration in a video interview.
  • Imprivata is ranked 26th in the medium company category of 2012 Top Places to Work in Massachusetts.
  • eClinicalWorks receives full NCQA certification as a CAHPS PCMH survey vendor to conduct NCQA HEDIS surveys.
  • Philips SpeechMike Premium earns a perfect score of six dragons on Nuance Communication’s recording accuracy test for assessing compatibility with the latest version of Dragon Naturally Speaking.
  • Dawn Mitchell and Kathy Krypel of Aspen Advisors will co-present break-out sessions at next week’s HIMSS Midwest Fall Technology Conference in Des Moines, IA.
  • Eye Health Services (MA) selects SRS EHR for its 21 providers and 11 locations.
  • Quality IT Partners sponsored the 13th Annual Scott Hamilton CARES Initiative Gala and hosted a patient from the Cleveland Clinic Taussig Cancer Institute last week.


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

More news: HIStalk Practice, HIStalk Mobile.

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November 6, 2012 News 1 Comment

News 11/2/12

November 1, 2012 News 6 Comments

Top News

11-1-2012 11-27-36 PM

AHA and four hospital systems file suit against HHS, claiming Medicare isn’t paying for reasonable and necessary care as required by the Medicare Act. The issue: Recovery Audit Contractors are second-guessing physicians long after an inpatient stay, claiming that patients should have been treated as outpatients and demanding that payment be returned. The RAC gets a nice bounty for denying the hospital’s payment, the hospital gets next to nothing.

Reader Comments

11-1-2012 10-30-43 PM

From Lee Shapiro’s Shoe Lifts: “Re: Allscripts General Counsel Jackie Studer. Has she left? Her pic and bio are gone.” She’s gone, sources tell me. Unrelated to her departure, the company announces results next week, and I have this feeling that they’re trying hard to get a PE deal ready to announce before then for reasons you might speculate.

From Michael: “Re: RazorInsights. Thanks for the mention. I wanted to confirm our customer attestation numbers – 83 percent have achieved Stage 1 Meaningful Use as of today and several outstanding filings are being finished up by clients.”

From Bucket Head: “Re: Sandy. We have about 50 clients in private practices on the East Coast without power and/or Internet. In our world, the big deal for them was finding a safe home for vaccines. If you have $50K (or more!) of stock in your fridge, it’s not like the milk. A couple of our customers will be without power for five to 10 days at least, so we’re expecting to turn on virtual servers in our offices for them to access. We have three or four customers on the Jersey shore from whom we’ve heard nothing and haven’t returned a call, text, or e-mail.”

11-1-2012 2-51-36 PM

From Evan Steele: “Re: Temporary command center, post-Sandy. We are settled into our ‘MCC’ (Marriott Control Center) and everyone not at the MCC is working virtually from home, a friend or relative’s house, or office with Internet access. We have 42 servers (physical and virtual) in a co-location facility, so everything is available and every SRS’er with an Internet connection has access. We are doing a great job keeping pace with support requests considering our less than ideal circumstances.” Evan, who is CEO of the Montvale, NJ-based SRS, reports that his company’s headquarters remains without power. Access to remote servers and a cloud-based phone system has enabled staff to continue working, either from a local Marriott hotel conference room or from home. Thumbs up to technology and adaptability.

From Millerbarber: “Re: Infinitt. The NJ-based PACS vendor has been down for two days.” Unverified.

From Lead Sinker: “Re: NYU. Servers are down, basically underwater. We have an enormous go-live scheduled for 12/2 – not sure how this will affect that date.”

11-1-2012 11-25-24 PM

From Capo Crusader: “Re: NYU Langone admitting that its generator was old and poorly located. I hope everyone is OK, but I smell lawsuits with this admission. With all that has been written about Katrina, how can a hospital this size not be better prepared?” The hospital says it spent millions of dollars after Hurricane Irene on backup power improvements that included a flood-resistant pump house, sealed fuel tanks, and rooftop generators, but they apparently overlooked the fact that the electronic system driving it is located in the basement that flooded. At least the staff behaved admirably: four NICU respirator babies were carried down a nine-flight stairwell in the dark while a nurse manually bagged them to keep them breathing as volunteers and medical students lit their way with flashlights.

11-1-2012 10-44-38 PM

From Ex-McK: “Re: McKesson. Moral compass broken at the top. We highlight to the company that employees are breaking the law to ensure that the bottom line is met, renting ambulances to ensure we can sneak our profits through.” A purported e-mail from McKesson Chairman and CEO John Hammergren lauds employees of one of the company’s distribution centers for renting ambulances to make deliveries to New York, which prohibited non-emergency vehicles from using bridges.

HIStalk Announcements and Requests

Wondering what you may have missed on HIStalk Practice over the last week? Highlights: an AHIMA-published article suggests that cloud-based computing and smart mobile platforms are making ambulatory EHRs more affordable and attractive to physicians. CMS names 24 qualified vendors for the 2013 PQRS program year. Digichart’s founder and CEO assumes title of chairman emeritus. An Impact Advisors consultant provides recommendations to measure EHR success. NYeC Executive Director David Whitlinger gives an overview of his organization, its goals, and current success. Dr. Gregg (and his dog) fantasize what the world would be like if HIT had started with a grand plan. All I have to say is that if you aren’t reading HIStalk Practice, your HIT news world is incomplete. Thanks for reading.

11-1-2012 7-37-52 PM

We have a new contributor on HIStalk Mobile who I’m calling Lt. Dan since he (like me) works full time in the industry and probably wouldn’t find his employer to be receptive to the idea of his writing potentially controversial material under his own name. Lt. Dan is and industry pro who will be posting several news items each day, adding to the excellent analysis and commentary from Dr. Travis. We’ll also be revamping the site’s design shortly with a more modern look, and most likely renaming it to indicate broader coverage than I originally anticipated (we’re now writing about telehealth, startups, consumer health, and social media). In addition to the expanded coverage, Travis will be on the ground at the mHealth Summit December 3-5 in the DC area, of which HIStalk Mobile is a media partner, so you can expect lots of information from there. How you can get involved with HIStalk Mobile: subscribe to the spam-free e-mail updates, follow our tweets, write a guest post, and tell us who we should interview. Most of all, read HIStalk Mobile and participate by sending us interesting news and rumors.

11-1-2012 7-43-28 PM

Speaking of HIStalk Mobile, thanks to new Founding Sponsor Imprivata, which offers Cortext, an easy-to-use mobile app that replaces outdated texting and paging with HIPAA-compliant messaging for smartphones (Android and iOS) and PCs. Imprivata now supports both HIStalk and HIStalk Mobile at the highest levels that I had available, which I appreciate.

On the Jobs Board: Senior Certified Epic Analyst, Healthcare Analyst – Security Tester, Community Health Center Sales Executive, System Software Engineer.

A lot of readers dropped by in October, in fact more than in any month in the almost 10 years HIStalk has been around, for reasons unknown: HIStalk had 130,254 visitors and 241,599 page views.

The weather’s cooling down, leading to the bane of the cubicle dweller: where are you supposed to hang your coat?

Acquisitions, Funding, Business, and Stock

11-1-2012 11-32-59 PM

Merge Healthcare announces Q2 results: revenue up five percent, EPS $0.01 vs. $0.06 a year ago, missing analyst estimates by $0.02.

11-1-2012 6-11-46 PM

Carestream Health acquires Genesis Digital Imaging, a developer of software for diagnostic imaging systems.

11-1-2012 11-34-57 PM

Meditech’s Q3 numbers: revenue up 7.8 percent, net income up 4.6 percent.

11-1-2012 11-34-00 PM

Greenway announces Q1 results: revenue up 28 percent, EPS $0.00.


Intermountain Healthcare (ID) selects SA Ignite’s MU Assistant for EP Meaningful Use automate attestation of EPs using Intermountain’s proprietary EHR.

Medical Mutual of Ohio chooses the mobile application development platform and Mobile Health Plan application from Kony Solutions to provide members with account management, access to physicians, electronic ID cards, and claims information.

Health Fidelity will use the terminology solution of Intelligent Medical Objects in its Reveal natural language processing service for extracting data from unstructured medical narrative information. IMO will use Reveal for its solutions.

Alameda County Medical Center (CA) engages MedAssets to oversee several cost reduction projects involving physician preference items, supply and services sourcing, and workforce management.


11-1-2012 12-08-50 PM
Cerner appoints Justin Whatling, MBBS (BT Health) senior director of strategic consulting for its European advisory practice.

11-1-2012 1-17-55 PM

The US Chamber of Commerce names Peter Tippett, MD, CMO of Verizon and VP of its incubator, as the recipient of its first Leadership in Health Care Award for his efforts to advance health HIT innovation.

10-31-2012 11-42-29 AM  10-31-2012 11-43-26 AM

As a reader leaked to us a couple weeks ago, Pulse Systems co-founders and brothers Basil and Alif Hourani resign their posts as CEO and CTO, respectively. CFO Jeff Burton takes over as president and CEO. The French technology company Cegedim purchased the company two years ago for $61 million.

11-1-2012 6-41-25 PM

PerfectServe names Cary Smith (Allscripts) as VP of sales for the western region.

11-1-2012 10-14-18 PM

Avalere Health names Protima Advani (The Advisory Board Company) as VP of its healthcare networks practice.

11-1-2012 7-06-37 PM

CHIME President and CEO Rich Correll will move to a COO role with the organization, saying CHIME’s board worked with him to develop an operational management role required by its growth. They’re seeking an experienced CIO to replace Correll as “ambassador to the industry.”

Announcements and Implementations

UPMC expands its telemedicine services to rural hospitals.

11-1-2012 11-38-34 PM

Sparrow Hospital (MI) rolls out Epic’s MyChart for patient use on mobile devices.

Wellcentive announces the release of Proactive Data Quality, which allows healthcare organizations using its population health management system to detect data delivery and mapping issues.

Siemens Healthcare expands its relationship with TIBCO Software, which provides the business process management technology used by Soarian. Siemens says it will use TIBCO’s next-generation technology to provide Soarian customers with on-the-fly analysis of current and historical data to allow them to become what TIBCO calls the Event-Enabled Enterprise.

Brown & Tolan Physicians (CA), a Medicare Pioneer ACO, goes live with Humedica’s MinedShare analytics platform.

11-1-2012 11-03-22 PM

UK sensor vendor Toumaz starts the first US pilot of its disposable, continuous wireless vital signs sensor at St. John’s Health Center (CA). Patients in any location can be monitored with the Sensium system, eliminating the need for them to be kept immobile in the ICU.

11-1-2012 11-41-49 PM

In Michigan, Beaumont Health System and Henry Ford Health System announced months ago that they expected to merge in some fashion. They’ve signed the papers to start discussions on the merger details, which would create an organization with $6.4 billion in annual revenue and 42,000 employees. Both use Epic.

MMRGlobal, which always puts out bizarre press releases that make it sound like a big company instead of a minimally known PHR vendor, decides that lawsuits pay better than trying to sell a personal health record. The company was awarded a vague patent for a method of giving patients access to their electronic medical records. That was on Wednesday. By Thursday, the company was sending threatening letters to hundreds of EHR vendors, demanding that they start paying licensing fees.

Innovation and Research

MIT researchers develop a system for disambiguating the senses of words used in physicians’ freeform notes in EHRs. The researchers say their method, which identifies relationships between words while also drawing correlations between words and syntax, is 75 percent accurate and thus markedly better than previous methods.

A study in Ireland finds that 40 percent of handwritten ICU orders contain an error, although “error” was loosely defined to include missing pager numbers and illegible signatures. Articles like this always alarm laypeople who can’t distinguish between “preventing an error” vs. “preventing patient harm.” It’s like saying that 99 percent of drivers make at least one error per day while intentionally not mentioning that most of those are of no consequence whatsoever and are thus not worth a prevention effort.


11-1-2012 12-58-41 PM

inga_small Researchers from the engineering and media arts schools of Drexel University design the Belly Band, which contains an antenna that allows remote monitoring of pregnant patients. The band, which does not require batteries or electricity, transmits radio signals to indicate changes in the shape of the uterus and can be picked up with an ultrasound. Maybe once they complete work on all the functional aspects Dr. Jayne and I can advise on the fashion design.


The National Health Information Sharing and Analysis Center (NH-ISAC) activates a 24/7 emergency response system to support healthcare critical infrastructure protection, mitigation, response, and recovery. The response system is intended to address situational awareness, facilitate information system, and provide incident response support.

Lake Health (OH) performs a routine EMR audit and subsequently fires several employees for inappropriately accessing a patient’s health information.

11-1-2012 3-12-27 PM

Cleveland Clinic and GE Healthcare join 25 companies that have committed to lease space at Cleveland Medical Mart, raising the building’s committed tenancy to 50,000 of its 95,000 leasable square feet.

11-1-2012 11-43-22 PM

Exeter Hospital (NH) is denied a court order that would have prevented the state HHS from accessing the hospital’s electronic medical records as part of an investigation into a hepatitis C outbreak. The hospital argued that such access would violate state and federal laws, but the court said the state proved its need to review the records and has proven it will do so in a professional manner. The cause of the outbreak is suspected to be a contract radiology technician who is accused of stealing fentanyl syringes and replacing them with ones contaminated with his blood. After being fired from UPMC for exactly that offense, he went on to work in 10 hospitals, including Exeter, since UPMC didn’t report him for fear of not being able to prove he did it even though they had caught him red-handed.

Bellevue Hospital Center (NY) evacuated about 500 patients Wednesday after fuel pumps for its backup generators failed. Despite pumping out 17 million gallons of water, the basement remained covered in two and a half feet of water.

British Medical Journal institutes a new policy that require researchers and drug companies who submit drug clinical trials articles to make all patient-specific data used in the study available to individual researchers on request. Drug companies are notorious for shining the most favorable light possible on questionable data, so this change will allow independent researchers to double-check their conclusions. BMJ hopes other journals follow suit.

Weird News Andy captions this article as “Starving for Cash.” Two-thirds of NHS hospitals in the UK have earned bonuses for following the Liverpool Care Pathway, which can require them to stop providing food and water to terminally ill patients. The Department of Health says the protocol ensures that dying patients are treated with dignity, while opponents say the practice is “euthanasia by the back door” that is sometimes employed without involving the patient’s doctor or family.

Sponsor Updates

  • Allscripts CMO Toby Samo, MD discusses improving public health with EHRs in a blog post.
  • East Bay Eye Specialists (CA) will implement the SRS EHR.
  • ICSA Labs seeks qualified candidates to help pilot test the test procedures and test tools for the 2014 Edition Certification.
  • Greater Baltimore Medical Center (MD) creates a paperless admission and consent process using Access e-Signature and signature tablets.
  • Huron Consulting Group releases a case study that highlights how it helped the University of Arizona Health Network improve its RCM operations.
  • OTTR Chronic Care Solutions will participate in the National Marrow Donor Program Council Meeting next week in Minneapolis.
  • The Nashville Technology Council recognizes Passport Health Communications as Technology Company of the Year for 2012.
  • MedVentive hosts a November 15 Webinar on critical technology needed to support ACOs.
  • Intelligent InSites will host the InSites Build 2012 conference on November 14-15 in Fargo, ND. Speakers include President and CEO Margaret Laub and AMIA President Kevin Fickenscher, MD,

EPtalk by Dr. Jayne


The HIMSS/AMDIS Physician Community issues a call for posters for the 3rd annual Physicians’ IT Symposium to be held Sunday, March 3, 2013 at HIMSS in New Orleans. The deadline is November 30. Selected presenters must also submit a 5-7 page technical paper after the conference.

CMS offers a second chance to physicians who missed the June 30 deadline to file for a Medicare ePrescribing hardship exemption to avoid the 2013 penalty. They will now have until January 31, 2013.

I’m always having issues with Medicare patients who don’t want their insurance information on lab requisitions and other key paperwork because CMS still uses the Social Security number as its patient identifier. CMS is seeking provider input on new Medicare ID cards that would remove the SSN to reduce the risk of identity theft. Its survey will be available until November 7.

Nashville-based Entrada raises $1M in new equity. Its products, which integrate with a variety of EHR platforms, allow dictation into the EHR through synchronization to the appointment list. I heard some buzz at MGMA that they also have a fax-related product, but I haven’t seen it yet (hint, hint).

Physician Edward Pullen MD shares his frustration with the Washington State Electronic Death Registry System.


Dr. Travis from HIStalk Mobile shared this story about Walmart boosting domestic medical tourism. As of the New Year, its employees will have access to heart and spine surgeries at health systems like Cleveland Clinic, Geisinger Medical Center, Mayo Clinic, and others. Additional companies that are negotiating bundled rates for employees include Boeing Co., PepsiCo, Lowe’s Companies, and HCR ManorCare. Personally I’d like my employer to negotiate a deal here.


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

More news: HIStalk Practice, HIStalk Mobile.

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November 1, 2012 News 6 Comments

News 10/31/12

October 30, 2012 News 5 Comments

Top News

10-30-2012 8-08-07 PM

From Velveteen Rabbit: “Re: NYU Langone and Sandy. My cousin is a neuro fellow at NYU Langone. Was in the middle of surgery when all power flickers and then goes out. Closed via flashlight and then patient was transferred to another hospital.” Sounds like an episode of MASH. A backup generator failed at the height of the hurricane, forcing NYU Langone Medical Center to evacuate at least 215 patients to other hospitals. Other facilities forced with forced evacuations include Coney Island Hospital (NY) and Palisades Medical Center (NJ). Numerous hospitals relied on backup generators and many facilities reverted to paper systems when EHR access was lost. Billionaire and Home Depot co-founder Kenneth Langone was an inpatient in the hospital bearing his name (courtesy of his $200 million gift) at the time and had to be evacuated with everybody else. A board member says the hospital knew its generators were old and poorly located; they’re planning to spend $3 billion to upgrade the facility.

Reader Comments

From Halsey A. Fredrick: “Re: Allscripts. The Mountain Lakes data center attempted and failed to move to generator power Monday evening. Approximately 50 Sunrise customers were down for at least seven hours, including those hosted at the company’s other data center in New Jersey. Some reportedly came back up overnight, some were still down as of Tuesday morning.” Unverified, but HAF forwarded a purported company e-mail update indicating that power was being restored. As any of us who have run IT during a weather disaster can vouch, backup generators work maybe 50 percent of the time, and that’s assuming you’ve been diligent to test the cutover regularly and have stockpiled an adequate supply of diesel fuel.

From Inspired but Concerned: “Re: Connected Health Symposium in Boston last week. I listened to great speakers and met people with truly great ideas, but few will address the elephants not in the room (i.e., Epic and Cerner). Conferences focusing on eHealth and connected health have a grassroots feel of empowering patients and consumers, but I rarely see big vendors participating unless it’s incognito to get new ideas. Providers are increasingly becoming part of IDNs and ACOs that use those large vendors and their non-open, non-easily integrated systems. Will consumer-based healthcare IT and their innovators suffer against these big vendors and providers?” My cynicism is predictable, but I’ve always said that these conferences and their self-selecting, charged-up evangelists are buying the illusion that patient empowerment is increasing when it’s really not. Few examples exist where customers have convinced big businesses to change their ways, especially when those changes threaten their profits, and I can’t think of even one where it happened when those customers had little buying power discretion and in fact aren’t even paying with their own money. It’s going to take a lot more than some feel-good conferences attended by the same familiar faces and featuring demos of the latest cool app to change healthcare, if in fact it can be changed at all. Healthcare reform may end up making it worse, as the massive consolidation it has triggered means a lot more physicians are now just another cog in a faceless corporate wheel whose bargaining power just went up several notches through market-dominating mergers (Partners Healthcare, which puts on the conference you attended, is a good example of using size and brand name to command high prices). In that regard, their choice of IT systems is way down on my list of concerns.

From BK: “Re: hospice-specific EMRs. What’s a good source of information? Most seem to be focused on the in-home aspect and we’re a 50-bed inpatient unit not affiliated with any major hospital or health system.” I know the names of a few companies that offer hospice EMRs but I’m not familiar with any of them, so I’ll ask readers to jump in.

Acquisitions, Funding, Business, and Stock

10-30-2012 5-13-42 PM

Online physician communication platform vendor QuantiaMD closes a $12 million expansion round.

10-30-2012 5-14-31 PM

Hospice and home health software provider Homecare Homebase lands a $75 million senior secured credit facility to refinance debt and fund a dividend payment to shareholders.

10-30-2012 3-53-57 PM

Deloitte Consulting acquires Recombinant Data Corp., a provider of data warehousing and clinical intelligence solutions.

10-30-2012 3-54-47 PM

CommVault Systems reports Q2 results: revenue up 21 percent, EPS $0.29 vs. $0.17.

McKesson announces Q2 numbers: revenue up

10-30-2012 3-56-33 PM

Relexion Health, developer of interactive software that uses Microsoft’s Kinect system to help physical therapy patients, raises $4.25 million in seed funding.

10-30-2012 6-03-50 PM
McKesson says in its earnings conference call that Technology Solutions had flat revenue in Q2, but performed a bit better than expected. The MedVentive acquisition provides a technology asset that will bring other McKesson products together to manage populations, the company says, while its MED3OOO acquisition will allow the company to add capabilities to its market-leading revenue cycle management business. CEO John Hammergren hinted that McKesson might work with athenahealth given that a third recent McKesson acquisition, PSS World Medical, sells athenahealth’s products and appears to still hold some portion of the $96 million worth of ATHN IPO shares (at today’s price) that it acquired in 2007 and partially sold in 2008-2009. Hammergren also said that McKesson has experienced some attrition of its Horizon customers who declined to migrate to Paragon because of functionality shortfalls, but the company is on track to deliver the ambulatory capabilities Paragon users need.


The American Association of Endocrine Surgeons selects ArborMetrix to provide clinical performance analytics for its national clinical outcomes registry.

10-30-2012 5-18-08 PM

The hospital board of governors for Fulton County Hospital (MO) approves a $1 million contract for Healthland’s EMR.

Eastern Connecticut Health Network signs a multi-year agreement with MedAssets for its RCM solutions and process improvement consulting services. Also contracting with MedAssets is Sharp HealthCare, which will implement its Spend and Clinical Resource Management solutions, including group purchasing services.

Mountain States Health Alliance (TN) selects Streamline Health Solutions and its OpportunityAnyWare solution for business analytics and automated workflow.

Resurgens Orthopaedics (GA) chooses Merge Honeycomb as its patient image archiving and long-term disaster recovery solution.

The Ohio State University Wexner Medical Center chooses lifeIMAGE for medical imaging sharing.


10-30-2012 3-42-10 PM

InTouch Health, an acute care telemedicine provider, elects Siemens Healthcare exec John Glaser to its board.

10-30-2012 11-31-58 AM 10-30-2012 11-33-22 AM

AirStrip Technologies adds Todd Cozzens (Sequoia Capital, Picis) and Keith Pitts (Vanguard Health Systems) to its board, with Cozzens named as chairman.

10-30-2012 3-46-10 PM

CommVault Systems promotes Brian Carolan to VP/CFO. He replaces Louis Meceli, who was named SVP of finance.

10-30-2012 3-47-25 PM

The Dallas Business Journal names T-System CFO Steven J. Armond as CFO of the Year in the technology segment.

10-30-2012 3-14-15 PM

SPi Healthcare appoints Brian Mitchell (GE Healthcare) as SVP of sales.

Announcements and Implementations

The Asian Centre for Liver Diseases & Transplantation announces an agreement with UPMC to develop a transplant center in Singapore. The facilities already share medical and technological expertise, including telemedicine and EMR.

10-30-2012 8-17-44 PM

Saint Agnes Medical Center (CA) goes live on Cerner.

Document Storage Systems and GetWellNetwork bring two VA hospitals live on GetWellNetwork’s interactive patient system integrated with the VA’s VistA.

IBM partners with the Cleveland Clinic (OH) to enhance the medical knowledge of its Watson supercomputer.


Government and Politics

The Indian Health Service is building a PHR populated with data from existing IHS clinical, administrative, and billing systems.

10-30-2012 3-35-23 PM

CMS publishes the final 2014 clinical quality measures for MU reporting.

10-30-2012 7-00-18 PM

AHRQ will conduct a 14-month, $800,000 observational study at six Vanderbilt University Medical Center clinics to look at how EHRs affect workflow at various phases of implementation. The work might have had more applicability had AHRQ chosen a more typical site than Vanderbilt, which developed its own ambulatory care model and EHR.

10-30-2012 7-23-31 PM

Wells Fargo Securities has updated its list of hospital EHR attestations by vendor. Small-hospital vendors CPSI and Healthland, along with Cerner, top the list of attestations as a percentage of customers. Trailing the pack are GE Healthcare, QuadraMed, NextGen, and McKesson (interestingly, three of those four are publicly traded companies, and QuadraMed was too until it was taken private in 2009). Also interesting: we’ve talked recently about upstart RazorInsights and I see they’re right in mid-pack with 30 percent.

Innovation and Research

A study finds that whole-genome sequencing will cost the US healthcare system $25 billion annually by 2021 even with steadily dropping prices, with the virtual certainty that the cost of those tests and the patient demand for treatment of conditions they suggest will dwarf the relatively small savings they create from earlier treatment of a few specific conditions.


10-30-2012 6-13-07 PM

Dale Sanders (SVP of Healthcare Quality Catalyst and also holding senior roles with The Advisory Board Company and Cayman Islands National Health System) develops a HIMSS EMRAM-type model for measuring a hospital’s analytics capabilities. The Healthcare Analytic Adoption Model, he says, is the key to delivering value from the country’s big EMR investments.

Robert Schwab, MD, chief quality officer for two Texas Health Resources hospitals, adds a new Meaningful Use-related verse to his “Go-Live Ballad,” recorded live at the National CXO Summit last week in Dallas.

Cerner CEO Neal Patterson and his wife celebrate his company’s record quarter by buying the $100,000 grand champion market steer at the Junior Premium Livestock Auction in Kansas City.

A Colorado hospital’s lawsuit claims that it hired WebMD Health to evaluate its wellness programs, only to find that the company used its confidential information to launch a competing service.

inga_small A Texas woman is charged with aggravated assault with a deadly weapon after striking a man in the eye with her high-heeled shoe in a fight among 17 female employees of the Hot Body strip club. The man may lose his eye; the deadly weapon’s condition is unknown.

Sponsor Updates

10-30-2012 2-35-30 PM

  • Steven Waldren, MD MS, director of the AAFP Center for Health, explores the HIT environment during Care360’s Nov. 14 webinar.
  • Access releases case study videos featuring employees from Texas Regional Medical Center (TX) and Henry Mayo Newhall Hospital (CA).
  • Billian’s HealthDATA introduces its healthcare sales and marketing portal, which includes over 3,900 data points on more than 40,000 US healthcare facilities.
  • Emdeon launches its EDGE solution to detect inaccurate healthcare claims and prevent inaccurate payments.
  • TELUS Health Solutions reviews the financial and strategic implications of attestation timing for Stage 2 MU in its fall newsletter.
  • The Phoenix Business Journal profiles Desert Ridge Family Practice (AZ) and its effective use of NextGen’s EHR.
  • InterSystems recognizes 3M Health Information Systems with its Breakthrough Applications award for the 3M 360 Encompass system.
  • Kony Solutions announces that its KonyOne mobile application development platform now supports Microsoft’s Windows 8 operating system.
  • CIC Advisory launches its new website.
  • T-System CEO Sunny Sanyal discusses overcoding and upcoding in the ED in a guest article in a Dallas healthcare publication.


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

More news: HIStalk Practice, HIStalk Mobile.

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October 30, 2012 News 5 Comments

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

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