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Monday Morning Update 2/25/13

February 23, 2013 News 7 Comments

From Grizzled Veteran: “Re: Stark Act/Anti-Kickback Relief. It’s scheduled to expire on 12/31/13. What are the thoughts on it being extended or not? What happens to hospitals and practices if it isn’t?” The floor is now open. Feel free to leave a comment stating and perhaps defending your opinion.

From CPAhole: “Re: CMS. Has anyone raised the issue of the CMS PQRS site being down for days at a time just when everyone is trying to submit and there is a 72-hour turn on submissions? CMS is trying to come up with a Plan B to fix their system.” Unverified.

2-22-2013 10-56-38 PM

From The PACS Designer: “Re: mobile ECG Monitor. TPD is intrigued by AliveCor’s FDA-cleared Heart Monitor & AliveECG app for the iPhone. An iPhone app that can benefit both the patient and the physician brings health monitoring to a new level of care. This app will be added to TPD’s List of iPhone Apps with the next update.”

From Marrioutta Here: “Re: HIMSS hotel. Just got a call from Marriott. There was an error in their website and they are overbooked. Moving folks 35 miles away and paying for the rooms.” At least when HIMSS e-mailed this week to tell me I was bumped out of the hotel I had booked in September they put me in another one that’s a little bit closer, a little bit cheaper, and newly added to the shuttle route. I don’t like the rooms as much from the description, but it’s walkable to the convention center and closer to restaurants. Some hospitals force employee groups traveling together to share rooms or pay the different for a single room themselves, which would probably greatly reduce the number of rooms required since it’s like a commuter highway – single occupancy is the rule.

2-22-2013 8-55-48 PM

The majority of poll respondents say they’re getting too much HIMSS-related vendor contact, although a solid 36 percent are happy with the volume and a disappointed 12 folks wish they’d get more. New poll to your right: what city would be your choice for holding the HIMSS conference?

2-22-2013 9-02-59 PM

Welcome to new HIStalk Platinum Sponsor MediQuant of Brecksville, OH. MediQuant offers Data Transition Management Solutions. Almost every healthcare organization keeps orphaned systems running just because someone might need access to the data they contain at some point. MediQuant’s DataArk active archiving solution allows those systems to be decommissioned with savings of up to 80 percent (using their data center or yours), providing ongoing easy access to clinical, financial, or ERP data. It’s always a pain to work down patient accounts after a system conversion and balance-forward conversions are notoriously risky (why junk up your new system with iffy data?), but DataArk customers can still bill those accounts, post payments, add notes, defend audits, and produce itemized statements with even easier access than the retired system offered. Clinical systems conversions are equally tricky with legacy data and chances are you’re not living in a “no lawsuits after discharge” bubble that allows walking away from years’ worth of patient data, so DataArk allows moving that historical information to its clinical repository module. Turn off the old system and the cash drain required for its upkeep. Other MediQuant products include FirstComply and AccuRules for medical necessity/ABN compliance. The company’s client base includes more than 700 facilities (examples: UPMC, Baptist Louisville, Dignity Health, Kettering Health Network, and West Virginia University Healthcare.) I’m rocking out to their Legacy System Blues by The DeCommissioners on their home page. Drop by Booth #5649 at HIMSS and say hello and thanks to MediQuant for supporting HIStalk.

On the Jobs Page: Demand Generation Specialist, Sales Effectiveness Consultant, Healthcare ECM Sales Executive, Account Manager – Government.

Listening: new from Nick Cave & the Bad Seeds, lush and powerful brooding from one of music’s most tortured geniuses. New live concert video here.

2-23-2013 1-36-36 PM

Want to win a $25 Amazon gift card and be sashed on stage at HIStalkapalooza? Tell us why you have a crush on Inga, Dr. Jayne, or Mr. H. We’ll pick the best entry for each crushee and recognize them on stage with an Inga’s Secret Crush, Dr. Jayne’s Secret Crush, or Mr. H’s Secret Crush beauty queen sash as a token of our mutual affection. Speaking of “crushed,” Inga is exactly that so far because all of the entries have been for me (Mr. H). I’m on standby to pledge my affection for her and Dr. Jayne if need be. Mrs. HIStalk assembled and packaged the sashes when they came in the mail last week and was less than thrilled when she got to the “Mr. H’s Secret Crush” one. I told her it was Inga’s idea.

Encore Health Resources will announce this week its Value-based Performance Improvement (VPI), an analytics software and services program developed with Catholic Health Initiatives that includes Meaningful Use reporting, population analysis, clinical analytics for care coordination, and financial analytics. The company says the program will transform EHR data to help organizations focus on quality and performance data at a low cost of entry. Components that can be implemented individually or fully include an analytics engine, an ETL tool, and dashboards.

2-23-2013 7-34-32 AM

Georgia Regents Medical Center (recently renamed from Georgia Health Sciences Medical Center) selects Besler Consulting’s BVerified – Transfer DRG tool to identify and recover transfer DRG underpayments. It automates the required review of the Medicare Common Working File and creates workflow tasks that guide the provider through follow-up steps.

Yavapai County, AZ admits that its printing of death certificates was delayed by more than a week due to computer problems following a software upgrade.

2-23-2013 1-39-44 PM

The longest article ever published in Time magazine is this week’s cover story on high healthcare prices, Bitter Pill: Why Medical Bills are Killing Us. The basic conclusion is that the US needs to set healthcare rates in a Medicare-type national system instead of letting the so-called free market do so. Most of the criticism is aimed at hospitals, so it’s worth a read even for those of us who working in them even though we were numbed long ago to $2 Tylenol tablets and $300 chest x-rays. The fact that the author couldn’t come up with recommendations less invasive or more likely to succeed than simply letting the government run all healthcare as it does the wasteful, political, and fraud-riddled Medicare program is a bit of a letdown.

2-23-2013 2-19-19 PM

Medical practice plaintiffs who filed a class action lawsuit against Allscripts for its decision to not enable the MyWay EHR for future MU stages or ICD-10  will learn Tuesday whether they can continue with their suit or will instead be forced to accept binding arbitration. If the complaint is certified as a class action, Allscripts will be required to provide the names of all MyWay customers to the plaintiff’s attorneys, who say all 5,000 MyWay physician users would then be automatically included in the suit. Attorneys for Allscripts have filed a motion to block the suit, arguing that the doctors signed a contract requiring their differences to be settled by binding arbitration. Some of the specific complaints, remembering of course that they represent only one side of the argument:

  • ”Our EHR is a piece of crap,” said an anesthesiologist and “buggy” according to others involved with the lawsuit, each of which paid up to $40,000 per physician to implement what they claim is a defective system.
  • Anesthesiologists claim they were promised a pain management module that was never developed.
  • A client who bought MyWay in June 2012 was assured by their Allscripts sales rep that the product would be enhanced to meet MU Stage 2 and ICD-10 requirements, with the company announcing otherwise four months later.
  • Users say MyWay, originally developed by iMedica as a client-server product, was sold by Allscripts as a cloud-based offering that performed poorly.
  • The lawsuit says that a “free upgrade” to the Allscripts Professional EHR isn’t an upgrade at all since it’s a different product and requires a complicated and costly conversion.

Facebook apologizes to a 104-year-old woman who found that she could not enter her real date of birth on her page. The company changed its date edits to allow birth years before 1910.

Robert Lorsch, chairman and CEO of PHR vendor MMRGlobal, briefs members of a congressional subcommittee on HITECH payouts and what he says is its failure to ensure standardization, interoperability, and PHR access. He demonstrated his company’s PHR product, telling the audience that it could be made available to all Americans for less than the money one large hospital would spend on an EMR. MMRGlobal has sent infringement letters to healthcare IT vendors and hospitals in the US and elsewhere claiming that they are violating the company’s patents that cover a variety of online services.

2-23-2013 7-50-04 AM

Vermont’s smallest hospital will lay off 15 employees, 10 percent of its work force, blaming cost pressures created by the Affordable Care Act and its new ACO relationship with OneCare Vermont. Officials with the 19-bed Grace Cottage Hospital defended spending $2 million on an EMR, saying ARRA money paid for it and it needed the system to participate in the ACO.

MedSnap releases an iPhone app for medication reconciliation that allows the provider to place a patient’s pills on a tray and use the phone’s camera to take a photo, which the app then analyzes to display the name and strength of each drug along with drug-drug interactions, drug-disease contraindications, and allergies based on the patient’s medical records. I would characterize this as brilliant. Future offerings include medication reminders and caregiver monitoring. The company is looking for volunteers for its Pill Mapping Project, whose submissions will improve its recognition database. Co-founders Patrick Hymel, MD and Stephen Brossette, MD, PhD founded MedMined, the infection surveillance software company acquired by Cardinal Health in 2006.

MModal and Intermountain Healthcare will jointly develop a speech-powered CPOE app for iOS devices. The app’s vocabulary will recognize terms related to the ordering of meds, labs, imaging, and nursing. They say it will be completed by fall.

2-22-2013 9-31-14 PM  2-24-2013 3-52-11 PM

Supporting HIStalk at the Gold level is ReadyDock. Everybody’s walking around hospitals carrying tablets these days, which means they’re also giving a free ride to microorganisms to spread from one patient to another. ReadyDock:UV is the world’s first solution for one-step disinfecting, charging, and securing of tablet PCs and iPads. It’s UV powered, which means no messy wiping down with disinfectant (and no voiding the manufacturer’s warranty by fluid contact). Tablets are often part of normal workflows and charging and disinfecting them needs to be equally user friendly. The device takes up a lot less space than a standard docking station, frees up power outlets, and eliminates a tangle of wires. You can see it yourself at HIMSS in Booth #3879. Thanks to ReadyDock for supporting my work.

I found this brand new ReadyDock video on YouTube featuring Louise-Marie Dembry, MD, MS, MBA, infectious disease professor from Yale-New Haven Hospital.

Thanks to a rumor report from reader Smarty Marty, we reported on February 13 that Aetna was rebranding its health and technology unit (ActiveHealth Management, iTriage, and Medicity) as Healthagen. The official announcement went out Friday.

2-22-2013 10-01-51 PM 2-22-2013 10-02-31 PM

First Databank promotes Bob Katter and Charles Tuchinda, MD to EVP following the recent promotion of Gregory Dorn to EVP/deputy group head of Hearst Business Media.

Wired profiles stealth startup Smart Scheduling, which identifies patients who are likely to be no-shows for their appointments based on past behavior. The company went through Healthbox’s accelerator program and connected with athenahealth to fine tune its algorithms. The application is being piloted by Steward Health, which uses athenahealth’s scheduling system. The software suggests the optimal time slot for a given patient based on the likelihood they won’t show up. Steward says the program is 95 percent accurate, allowing them to schedule around possible no-shows to hit their overall patient targets.

A mini-study in a Letter to the Editor in NEJM finds that about 12 percent of US physicians have attested to Meaningful Use under the Medicare program, making it likely that many practices will face financial penalties starting in 2015. Specialists have about half the adoption rate of primary care providers. Physicians working with Regional Extension Centers have only a slightly higher attestation rate at 16 percent.

2-23-2013 2-22-33 PM

The e-mail system of Ohio State University’s Wexner Medical Center was down for 42 hours through Friday morning, with “replaced infrastructure” identified as the culprit.

UCLA’s medical school is the subject of a snarky Los Angeles Times article that criticizes its cozy relationship with nutritional supplement manufacturer (and accused scam multi-level marketer) Herbalife, which donates a lot of money to the school and drops the school’s name at every opportunity to give its products the scientific credibility that nutritionals sorely lack. UCLA’s cellular and molecular nutrition lab is named for the company’s founder, or as the article says, “The lab is named after Herbalife’s founder, who died in 2000 after a four-day drinking binge — not the greatest advertisement for healthful, active living.” Several medical school faculty members serve on the company’s board, with one of them being paid $17.8 million over 10 years through his consulting firm in return for product endorsements that include his signature on the label. Both he and the company can make almost any exaggerated claim they want since nutritional products escape FDA oversight. The article concludes, “When torrents of cash fall upon people like Heber and Ignarro — especially when the payments promote interests fundamentally in conflict with their responsibilities for thorough, objective research — it’s proper to ask whether the recipients should be viewed primarily as university professors with an income source on the side, or as agents of industry exploiting their academic titles for show.”

Vince wraps up NextGen’s HIStory this week. He starts the long history of Meditech next time and welcomes your contributions.

HIMSS Conference

HIStalk’s Guide to HIMSS13
HIStalk’s Guide to HIMSS13 Meet-Ups
HIStalk’s Guide to HIMSS13 Exhibitor Giveaways

Sponsor Updates

2-22-2013 10-27-56 PM

  • At the HIMSS conference, HITPC member Gayle Harrell will present a session titled “Leading Change through Health Information Technology” on Monday, March 4 at 2:00 p.m. at Sunquest’s Booth # 911.
  • Edward Fotsch, MD (CEO, PDR Network) and Douglas Gentile, MD, MBA (CMO, Allscripts) will present “Turning Patient Portals into Major EHR Assets” on Wednesday, March 6 at 8:30 a.m. in Room 288 of convention center. The session will also be streamed live.
  • PatientPay is named by PYMNTS.com as a finalist for a 2013 Innovator Award in the Best Debit category.


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

More news: HIStalk Practice, HIStalk Connect.

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February 23, 2013 News 7 Comments

News 2/22/13

February 21, 2013 News 3 Comments

Top News

2-21-2013 10-18-36 PM

An article in The New York Times called “A Digital Shift on Health Data Swells Profits an an Industry” takes direct shots at the HITECH act, particularly emphasizing the “behind the scenes lobbying” that Allscripts, former CEO Glen Tullman, and other unnamed vendors employed to get it passed. It points out that Tullman was health technology advisor to the Obama campaign, a personal donor of $225,000 to Democratic political candidates, and a seven-time White House visitor after Obama took office. Cerner doubled its lobbying dollars to $400,000, with almost all of it going to Republicans.

Athenahealth’s Jonathan Bush weighed on “the Sunny von Bülow bill” that he says kept his stagnant competitors “alive for another few years.” In a seemingly random quote, the ED chair at UCSF Medical Center said Epic is “mediocre” on a good day but “lousy” most of the time, while a counterpoint from UCSF’s CMIO saying that most doctors there like it receives less-sensationalized coverage. The article also points out that Neal Patterson’s stake in Cerner is worth $1 billion and mentions that a letter from Steve Lieber of HIMSS urged President-elect Obama to set aside at least $25 billion to increase EHR adoption.

In other words, the article is all over the place. The only new material appears to be a handful of quotes that were allowed to run unchallenged, with everything else looking more like a set of Google search results than a thoughtful and balanced piece. Its conclusion is hardly startling: the federal government wastes enormous amounts of taxpayer dollars in scratching special interest backs and a few people get really rich as a result (fun fact: Glen Tullman is now running his solar energy company, reaping the benefit of another big federal spending program.) Far more interesting than the article itself are the reader comments:

  • My impressions of the vendors can be described in two words: Welfare Queens. The systems are glorified billing and scheduling systems. Vendors were "certified" before they actually created the upgrades that supposedly met MU criteria.
  • Regardless of how much customization you do to the form and how many drop-boxes there are for entering data, the result is medical records which look very similar from patient to patient, and omit nuances and details which are specific for individuals.
  • It is interesting that so many commenters complain about a lack of privacy (signing my life away on consent forms!!), while others complain because not all providers in the country have easy, fast access to their medical records.
    You must realize that these things are at odds, and affected more by HIPAA than limitations of technology.
  • EMR 1.0 = islands of information, designed for billing and documentation. EMR 2.0 = system of engagement – Key information summarized and shared. Saves time for the users. It’s coming!
  • Try telling countries like Canada, New Zealand, Netherlands and Japan that they should give up all of the EMR systems that are unusable despite the fact that the majority of their docs are using EMR systems today. Just because a few people in an article determined a system to be unusable doesn’t make it so.
  • The EHR has become the patient. It is sicker than you and more complicated, taking more time. You, the real patient, can just lay there waiting in a state of abject neglect.
  • There is a lot more to this movement than this article suggests — and it is good. "The clear winners are big companies" — yes, in some ways, but the even bigger winners are patients and the doctors who care for them. In my family, this record-keeping already has resulted in a life-saving developments.
  • In our office we have had three over 50 early retirements due to the EPIC system.
  • Think if America had as many electric outlet types as Europe (free markets!) This mishmash of EMR will take a generation to unravel and cries out for a centralized system & format.
  • I’m a primary care physician working at Kaiser Permanente. We’ve been using the Epic system for years. While it isn’t perfect, I’d never go back to paper … the real reason this system works for us is because we are an integrated system. If we weren’t, it wouldn’t work well at all. The real problem is lack of integration in US medicine.
  • Banks and many other industries already embrace efficient and effective computerized systems. Where your life is at stake, wouldn’t you want your doctor to have the same advantages as your bank?
  • This is a very one-sided article, and almost reads like a smear in some places.

For a counterpoint, see DrLyle’s post, The HIT Productivity Paradox — It’s Gonna Be OK.

Reader Comments

inga_small From Ms. HIM: “Re: X-Rays. Inga, did you report to someone at the facility that you were able to see the patient data in the hallway?” Ms. HIM is referring to my recent visit to a radiology practice that had patient data prominently displayed on several monitors in common areas. I did e-mail the CIO and included my stealthily-taken pictures. No response yet.

From Disappointed: “Re: HIStalkapalooza. I want to give kudos to Shannon at Thomas Wright Partners. I am unable to attend HIMSS due to a family thing, but she promptly and cheerfully changed my confirmation to my boss who had neglected to sign up (what can I say?) She also said if things changed and I was able to attend, she personally would ensure I would get in and gave me her cell phone number. What great service!!!” Medicomp is working with the same team (Thomas Wright Partners, Bzzz Productions, Istrico Productions) that brought you HIStalkapalooza 2011 in Orlando. They are indeed efficient and responsive. I had no qualms about putting my name on the event and leaving the details to them.

2-21-2013 9-25-51 PM

From Letter of the Law: “Re: Allscripts Meaningful Use Guarantee. Doesn’t sound like MyWay will meet Stage 2 MU or get 2014 ONC certified as a Complete EHR. Does this mean MyWay clients get a 12-month support credit or refund? Seems like the guarantee was written to be purposefully vague and has now mysteriously disappeared from the Allscripts site (convenient) except in the Investor area.” Allscripts told us they would respond, but they haven’t so far.

2-21-2013 9-31-51 PM

From Tom: “Re: Epic. An electrophysiologist wrote a satirical post about Epic and used screenshots to convey the problems he experienced. He says Epic contacted his hospital administrators and asked him to take the screenshots down. He is now concerned about legal ramifications.” It should be noted that the doctor sells software on the side, although it costs only a few dollars and is specific to electrophysiology. Still, Epic has made it clear in the past that it won’t tolerate posting screen shots, documentation text, or almost anything else publicly. I’m thinking I remember (but could be wrong) that they warn UGM presenters not to post their slides publicly if they contain anything that Epic might deem proprietary. Says the doc (with some of his preachy indignation removed):

I’m just a physician who uses their software … No software is perfect however and I think the Epic bosses should be more interested in using feedback and criticism from health care professionals to improve the program rather than spending their time worrying that a screenshot of their user interface is available on the web … these massive companies who have benefited enormously from our tax dollars have the nerve to threaten those who criticize their software and publish a few bland screenshots. Unfortunately though, with their cash reserves and cadres of lawyers, there is little that EP Studios (cash reserves = $0) can do to stop their bullying.

2-21-2013 10-04-37 PM

From Say What?: "Re: HIMSS in Cleveland. Surely you jest. What is moving 345 miles from its Chicago base going to do for HIMSS? At least Nashville made sense from a different geographic, cultural, and transportation point of view, as would Phoenix, San Francisco, or Seattle.”

From Richard: “Re: HIStalk. Thanks for one of the most concise, relevant online healthcare IT publications out there. Your work is an excellent balance of current news, pertinent insight, and subtle (or sometimes hot so subtle) humor. Please pass on my compliments to the entire HIStalk crew for their excellent contributions. P.S. I admire your team’s ability to present a meaningful contribution and at the same time party like college freshman at HIMSS.” I did indeed pass along your much-appreciated comments to the crew, which got me trapped in the e-mail crossfire as Inga and Dr. Jayne tried to one-up each other with their claimed partying capacity beyond freshman level. I stopped reading once they escalated to grad school.

HIStalk Announcements and Requests

inga_small This week on HIStalk Practice: MGMA introduces a Web-based tool that allows organizations to benchmark themselves against peers using national MGMA data. The RI REC offers EHR adoption assistance to specialists. Researchers devise an AI tool that may outperform physicians in making cost-effective clinical decisions. Michigan lawmakers consider legislation requiring a single universal prior authorization form for prescriptions. PCMHs deliver slightly better patient satisfaction and preventative care but may not result in cost savings. Dr. Gregg shares details of the meeting between Focus and Byproduct … heck, it’s a great story, so give it a read. Greenway Medical CEO Tee Green discusses the company and industry and makes some predictions for the future. Thanks for reading.

Maybe I’m the only one who didn’t know: Word, going back to the 2007 version apparently, has a “Save as PDF” option that’s easier than PDF print driver products like CutePDF or PDF995. And in another Andy Rooney meets Larry King kind of non sequitur, I heard programmers repeatedly pronounce two words oddly in a meeting today: DISplay and REfresh. I am monitoring further accent-switching occurrences.  

I got an e-mail today that HIMSS has kicked me out of my reserved hotel and put me in a lower-rated one because of “an oversold situation,” adding that they “wanted to inform you before you arrived in New Orleans.” How thoughtful, especially considering that I booked in September.

2-21-2013 8-54-49 PM

Welcome to new HIStalk Gold Sponsor Greythorn, whose healthcare IT practice places candidates in the specific high-demand market segments of Epic, Cerner, and ICD-10. Greythorn has offered specialty IT staffing solutions for more than 30 years. Check out their LinkedIn Epic and EHR Professionals group, or seek their folks out at HIStalkapalooza since they told me they’re going and I sense they’re a fun bunch. For clients, expect nice people, a big pipeline of candidates including international ones, and a zeal for understanding your business and your needs. Job candidates should read their Resume and Interview Tips document (“Questions to Be Prepared For” contains just about all of the HR-mandated behavioral interviewing questions I’ve ever asked). Stop by Booth #5358 at the HIMSS conference and pass along my thanks to Greythorn for supporting my work.

Here’s a “Working at Greythorn” video I found on YouTube.

HIMSS Conference Social Events

2-21-2013 1-05-34 PM

inga_small If you registered in advance, your official HIStalkapalooza invite should have hit your inbox Wednesday (check those spam folders!) Make sure you’ve arranged your schedule to be there in time for the Inga Loves My Shoes contest and the crowning of the HIStalk King and Queen. The highly coveted beauty queen sashes and prizes will return.

inga_small Speaking of sashes, we decided to give readers a chance to win one, along with stage recognition and a $25 Amazon gift card. All you have to do is declare Inga, Dr. Jayne, or Mr. H as your secret crush and explain why. We’ll choose the most convincing entries, so feel to free to lay it on thick and shamelessly in an obvious appeal to our vanity. Winners (who must be at HIStalkapalooza) will be sashed on stage with "Inga’s Secret Crush," "Dr. Jayne’s Secret Crush," or "Mr. H’s Secret Crush" as a token of our reciprocation.

Aventura is participating in a booth block party at the conference on Tuesday from 4:00 until 6:00 p.m., with beer and margaritas.

2-21-2013 6-33-14 PM

Speaking of Aventura, they’ve sent the best e-mail promotion so far with their serious-sounding “HIT Survival Handbook” that includes some dry humor. I forwarded the e-mail home from work just to run it here.

I always scan down the HIStalkapalooza attendee list to see who’s coming and what titles they hold. Eyeballing it, it looks like over 100 presidents/CEOs, 200 VPs, 24 CIOs, 13 CMIOs, and eight financial and equities people. That’s a fraction of the total invitations, so obviously many other titles were represented.

Here’s a list of our HIMSS-related pages and their downloadable/printable PDF equivalents that will tell you what our sponsors are doing at the conference:

HIStalk’s Guide to HIMSS13
HIStalk’s Guide to HIMSS13 Meet-Ups
HIStalk’s Guide to HIMSS13 Exhibitor Giveaways

Acquisitions, Funding, Business, and Stock

2-21-2013 10-29-21 PM

Shareholders of PSS World Medical approve the company’s agreement to merge with McKesson, clearing the way for a Q1 closing.

2-21-2013 10-28-51 PM

GetWellNetwork reports 30 percent growth in revenues and a 90 percent increase in orders from 2011 to 2012.

2-21-2013 10-30-07 PM

MedAssets reports Q4 results: revenue up 4.5 percent, adjusted EPS $0.27 vs. $0.32.


The New Hampshire Health Information Organization selects the Massachusetts eHealth Collaborative to provide executive director management services for the implementation of its statewide HIE, which will utilize Orion Health’s technology backbone.

2-21-2013 3-56-46 PM

NYU Langone Medical Center contracts with Accenture to support its ICD-10 implementation process.

Intelligent InSites wins a $543 million contract to implement to RTLS at 152 medical centers, as reported here previously. We interviewed President and CEO Margaret Laub last week.

2-21-2013 3-58-09 PM

Numera selects AT&T to be the wireless network and location services provider for Numera Libris, a mobile home health management and personal emergency response system.

2-21-2013 3-59-23 PM

Banner Health expands its portfolio of 3M products to include the 3M 360 Encompass System for computer-assisted coding and clinical documentation improvement.

2-21-2013 4-02-04 PM

Memorial Sloan-Kettering (NY) chooses Orion Health’s Rhapsody Integration Engine for communication and data sharing between the hospital’s different IT applications.

2-21-2013 4-03-30 PM

Phoenix Children’s Hospital (AZ) selects Allscripts Sunrise Financial Manager, Sunrise Ambulatory, and Allscripts Community Record.

Mid-Valley Hospital (WA) selects e-forms and electronic electronic patient signature solutions from Access to use with its Meditech Scanning and Archiving system.

2-21-2013 10-31-08 PM

Fairview Health Services (MN) will implement Strata Decision Technology’s StrataJazz for decision support, operating budgeting, strategic planning, and capital planning.


2-21-2013 6-04-10 PM

Avere Systems appoints Michael McMahon (CommVault) as VP of business development.

2-21-2013 6-05-43 PM

Tom Giannulli, MD (Epocrates) joins Kareo as CMIO.

2-21-2013 6-06-38 PM

VA CTO Peter Levin, who led the Blue Button initiative, announces his resignation.

2-21-2013 6-50-40 PM

As reported here last week. Health Catalyst names Brent Dover (Medicity/Aetna) as president.

Wolters Kluwer promotes Kevin Entricken from CFO of the Wolters Kluwer Health division to CFO of the parent company.

Harris Interactive names Matt Knoeck (TNS North America) SVP of healthcare and Sharon Albert (TJ Sacks) VP of marketing for its healthcare group.

Announcements and Implementations

The Rochester RHIO partners with area ambulance companies to allow physicians to see critical patient information gathered in the field during ambulance calls.

Medical equipment provider Skytron upgrades six of its customers to CenTrak’s clinical-grade RTLS technology.

SuccessEHS connects with MyHealth Access Network HIE (OK) to send clinical care documents from its EHR.

Aker Eye/Vision Source (FL) implements RTLS from Versus Technology.

The Joint Commission begins offering a PCMH certification for accredited hospitals and critical access hospitals.

2-21-2013 10-33-07 PM

SCI Solutions launches Readmission Minimizer to track and monitor post-discharge processes.

The Utah Health Information Network offers Direct secure messaging labeled as cHIE Direct, using technology from Secure Exchange Solutions.

2-21-2013 9-59-07 PM

Enovate announces two new products, the e5000 telemedicine cart and colorful peds-oriented Emagination Stations.

2-21-2013 10-34-16 PM

Humetrix introduces cross-platform capability for its iBlueButton app that allows consumers and patients to exchange clinical information at the point of care regardless of which smartphone they use.

2-21-2013 10-35-08 PM

Kareo launches a free cloud-based EHR that can be used as a standalone application or integrated with the company’s PM and billing services. It was developed using technology acquired from Epocrates, which exited the EHR business a year ago. Kareo notes that the EHR is “advertisement free” and says it will provide support and updates at no charge. The company hopes that the free EHR offering will attract more clients for its PM and billing service products.

Government and Politics

2-21-2013 10-36-08 PM

ONC is accepting applications from those interested in serving on a new workgroup, the HITPC Food and Drug Administration Safety Innovation Act Workgroup,  that will provide recommendations for a risk-based HIT and mobile device regulatory framework.

2-21-2013 10-37-00 PM

Worth a read: The Advisory Board Company publishes “How Stage 2 Raises the Bar on Stage 1 Organizations.” Like everything Advisory Board, it’s fluff-free and to the point.

Innovation and Research

Researchers from the University of Cincinnati find that physicians using an EMR are more likely to order routine screening tests for women.

Processing a prescription drug order through a CPOE system decreases the likelihood of error with that order by 48 percent according to a study supported by AHRQ. Researchers say the findings suggest CPOE can substantially reduce the frequency of medication errors in the inpatient setting, but it is unclear whether that translates into reduced harm for patients.

2-21-2013 9-46-43 PM

Christiana Care Health System is awarded a $10 million grant from CMS’s innovation grant program for its Bridging the Divides program that uses predictive analytics to target patients who would benefit from intervention. CMIO Terri Steinberg, MD, MBA (above) tells me that analytics can be run against the patient’s entire data set even if it originates from a different health system. I may follow up for more information.


2-21-2013 1-40-54 PM

Healthgrades says Dayton, OH, Phoenix, AZ, and Milwaukee, WI have the lowest risk-adjusted hospital mortality rates in its list of America’s Best Hospitals 2013.

Express Scripts sues Ernest & Young and one of its former partners for stealing trade secrets and corporate data to boost E&Y’s healthcare business. The lawsuit claims Donald Gravlin, who was working on the Express Scripts-Medco merger, entered an Express Scripts facility several times  to forward confidential company e-mails to his personal account.

Black Book Rankings releases the results of a survey to identify the top hospital EHR vendors based on client satisfaction. Winners include:

  • CPSI (under 100 beds)
  • Cerner (100-249 beds)
  • Epic (academic teaching hospitals and major medical centers)
  • Cerner (healthcare systems, hospital chains, integrated delivery networks)
  • Picis (ED)

UnitedHealth Group announces the creation of 1,000 new jobs in North Carolina by its UnitedHealthcare and Optum businesses.

2-21-2013 6-49-09 PM

Weird News Andy waxes poetic on the news that Cornell researchers have created a realistic 3-D printed human ear. WNA says, “Poems are make by this fool right here, but only Cornell can make an ear.”

WNA finds this item both odd and sad: a suspended Johns Hopkins gynecologist accused of secretly taking photos of hundreds of his patients using a pen camera commits suicide.

Sponsor Updates

  • Aspen Valley Hospital (CO) shares how it increased front office payments and cash on hand and reduced administrative time and costs by using InstaMed solutions in a case study.
  • Covisint extends its cloud identity services to include small and medium-sized organizations.
  • US Secret Service Special Agent Erik Rasmussen and Trustwave SVP Nicholas Percoco will lead a keynote address on cybercrime at next week’s RSA conference.
  • Halfpenny Technologies adds Altosoft’s BI dashboard to its ITF-Hub solution for clinical laboratories. 
  • API Healthcare offers a Webinar series focused on effective employee recruitment and retention.
  • HealthMEDX expands its support of LeadingAge, a non-profit committed to providing care and services to the aging.
  • eHealth Technologies releases a zero-footprint, Web-based image viewer that uses the eUnity platform of Client Outlook.
  • Informatica releases Cloud Spring 2013, the latest release of its integration and data management applications, and will hosts a February 25 Webinar to introduce its features.

EPtalk by Dr. Jayne


Clinicians can now diagnose leprosy (Hansen’s disease) more than a year before patients are symptomatic. The new test uses a smart phone, a test strip reader, and a single drop of blood. Each determination will cost $1 or less.

This week President Obama announced an initiative to map the human brain, citing the Human Genome Project as a precedent. The brain is a fascinating thing and I’m excited about the role that information technology will play in making it a reality. Even better was the adrenaline rush I got since I read the announcement while I was hopped up on cold medicine watching “The Bourne Legacy.” Hopefully the CIA isn’t waiting in the wings to create neurologically engineered killers with the resulting data.

I’ve enjoyed the reader comments about travel arrangements for HIMSS. I apparently waited too long to book my hotel room (silly me for thinking three months in advance was enough) so I am arriving a day later and leaving a day earlier than I’d have liked. The idea of having to split between two different hotels to cover the entire stay was not very appealing. The comments about venues for future HIMSS meetings are spot on as well. I mentioned the HIMSS rotation to a dental colleague today and learned that there IS something worse than HIMSS returning to Chicago: The Chicago Dental Society Midwinter Meeting, which is held every February in the Windy City. The schedule of events lists a Fashion Show Luncheon. I wonder if they feature parkas, boots, and mittens?

Twitter served up an item from @ONC_HealthIT celebrating a physician who built his own EHR in response to budget cuts. A read of the actual article reveals that “eventually he turned to Cerner.” Unfortunately Meaningful Use has stifled grassroots innovation like building a custom EHR for your practice. I also like the line about practice administrators scanning paper test results into the EHR. If they actually have practice administrators feeding the scanner, I can recommend some additional overhead cost cutting for them.


In addition to the paper mail and tchotchkes enticing me to various booths at HIMSS, I’ve started receiving e-mail invitations to focus groups. Today’s gem promised to “present 4 innovative clinical strategies that leverage technology to reduce cost and improve all quality metrics.” Wow! They improve all quality metrics? That’s impressive. Even more impressive is the honorarium offered: a “Personalized tour of Walgreens Flagship Location – TBD.” Sheesh.



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

More news: HIStalk Practice, HIStalk Connect.

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February 21, 2013 News 3 Comments

News 2/20/13

February 19, 2013 News 16 Comments

Top News

2-19-2013 7-43-22 PM

Allscripts reports Q4 numbers: revenue down 10 percent, EPS –$0.14 vs. $0.14. The company’s reported revenue of $350.9 million fell short of expectations of $368 million on weaker sales and a deferred revenue provision, while the loss of $0.14 per share missed expectations of a positive $0.20 per share. President and CEO Paul Black says both the quarterly and annual results “did not meet our expectations.” Shares are up 6 percent in after-hours trading due to higher-than-expected bookings. From the conference call:

  • Reception to the MyWay to Professional program “has been strong.”
  • Two Sunrise acute care agreements have been signed so far this year, one of them with an existing client.
  • The four key areas of focus are client alignment, unlocking competitive advantage, reducing costs, and reporting consistent financial results.
  • Two-thirds of developers will be located in either Raleigh, NC or Boston after office consolidation.
  • The company plans to expand its hosting business.

Reader Comments

From UAHN Rocks: “Thanks for all the great work you to.  I am writing to share a video made by patients, clinicians, and executives from The University of Arizona Health Network’s Diamond Children’s hospital to celebrate the amazing work that they do to improve the lives of children in the community. UAHN is in the midst of an enterprise implementation of Epic, covering Diamond Children’s as well as all of our adult and outpatient facilities, with a go-live later this summer.” The video contains a medley of music, so keep playing, including a big finish with the magnificent Electric Light Orchestra at 3:00.

2-19-2013 8-26-57 PM

From HIMSS Bound and Gagged: “Re: flights to New Orleans. Costs are out of control, causing us to scale back our attendees. Have you heard anything?” According to Travelocity, the round-trip cheapest flights are $1,767 (Chicago), $1,142 (Atlanta), $1,582 (Los Angeles), and $1,687 (New York). Those include some really crappy connections as well, like going through Denver from New York. I seem to recall that the HIMSS post-Katrina booking of New Orleans in 2007 had similar problems, where flights were not sufficient to get people in and out. HIMSS was supposed to have narrowed down its conference cities to just three – Orlando, Atlanta, and Las Vegas – if I’m remembering right from a few years ago. All three are easy to get to, cheap, and have endlessly available hotels, restaurants, cabs, service workers, etc. Then came the charitable addition of New Orleans (whose infrastructure clearly wasn’t up to the challenge despite the HIMSS pitch) and the hometown reach-around to Chicago (where everything, especially union member surliness, cost twice what it would have in those other three cities and it was cold and snowy besides). Both were HIMSS low points in my opinion, yet here we are going back to New Orleans this year and Chicago in 2015. The best city (San Diego) and the cheapest (Dallas) were dropped from the rotation years ago. I’m pretty sure that if HIMSS actually listened to its members, or even asked them for that matter, they would not favor returning to New Orleans or Chicago even though those cities are perfectly fine for personal travel. I booked my flight on January 23 and was griping about paying $300 and now it’s over $1,300. If you don’t already have a flight, aren’t within driving distance, and aren’t a fan of Amtrak or Greyhound, you’re screwed.

HIStalk Announcements and Requests

inga_small In case you missed it we published the HIStalk Guide to HIMSS13 over the weekend. More than 130 vendors (all of whom happen to be HIStalk sponsors) provide details on the products and services they will be featuring this year. We also created HIStalk’s Guide to HIMSS13 Meetups, which includes contact information on about 30 vendors that are not exhibiting but happy to schedule meetings with interested folks. Finally we developed HIStalk’s Guide to Exhibitor Giveaways to help you find the best swag.  When you chat with these vendors, please tell them thanks for supporting HIStalk.

2-19-2013 3-15-25 PM  2-19-2013 3-14-20 PM

inga_small I accompanied a family member to get X-rays yesterday and stood outside in the hallway during the actual scan. While waiting, I was able to read all sorts of patient-specific information on two different monitors, as well as on the computed radiography reader (Mr. H tells me that’s the name of the thingy on the left.) Why worry about privacy, right?

2-19-2013 7-13-45 PM

Welcome to new HIStalk Platinum sponsor Legacy Data Access of Marietta, GA. It’s refreshing that the company’s mission is not only easy to describe, but is even contained in its name. Legacy Data Access provides customers with access to all of that data that’s locked away in their retired legacy applications. The company eliminates the hassle and cost of keeping the old app running solely for occasional lookups or reports. Clients don’t need to pay apps vendors for support, maintain aging servers, chew up big chunks of their disaster recovery plan, and tie up high-level talent keeping an abandoned system running after Legacy has moved data from that old system to a shiny new database and given users a slick Web-based front end and extemporaneous reporting tool for their inquiries. Think of LDA as a retirement home for apps, which might include revenue cycle systems (clients still get receivables functionality), PM/EHR, nursing documentation, and ancillaries. LDA can even provide a Legal Medical Record. Some of the company’s customers are UCSF, Parkland, Stanford, Trinity Health, and others that are so recognizable that it would be just name-dropping on my part to continue reciting them. If your IT stroll down memory lane includes Carecast, Invision, STAR, MedSeries4, Series 2000, ESI, Premis, EMstat, Midas, or others whether they’re on LDA’s list or not, they can help. Once an app is ready for full retirement, LDA will move everything to its LegacyVault, where information will be available indefinitely (like in the case of a lawsuit). Move on to your new-system life by letting LDA help you move gracefully away from the old one. Thanks to Legacy Data Access for supporting HIStalk.

HIMSS Conference Social Events

2-19-2013 3-41-24 PM

inga_small At least in my mind THE social event of HIMSS is HIStalkapalooza. Here are a few vital details for those attending:

  • Invitations will go out starting Wednesday. Make sure to check your spam filters. We’re inviting twice the usual number of folks, so the odds of getting an invitation are favorable.
  • Medicomp is once again sponsoring HIStalkapalooza and they know how to throw a party, as those of you who attended the 2011 event at BB King’s in Orlando can attest. Guests will be greeted on the red carpet and handed a Hurricane Inga or Typhoon Jane. How’s that for hospitality?
  • The Inga Loves My Shoes contest is back by popular demand, so pack your best zapatos. Since HIStalkapalooza is at the Rock ‘N’ Bowl, we will have a category for Best Bowling Shoes, as well as Hottest Men’s and Women’s Shoes.
  • We will again crown a HIStalk King and Queen for the best-dressed guests, so bring your bling. We’ll also recognize the Best Bowling Attire for those opting for the ten pin look. If you haven’t figured out what to wear, here is a tip: nothing says sexy like a bowling shirt, except maybe sequins and a tux. I expect to see plenty of stilettos and Farzad-inspired bow ties. Feel free to leave your company-logoed shirt in the hotel room.
  • The party starts at 6:30 and the contests (followed by the HISsies) will begin about 7:30. Our esteemed judges will begin selecting contest finalists as soon as the doors open, so don’t be late.
  • After the HISsies, the Zydeco band and the fast-paced bowling tournament get going. Bowling teams currently include keglers from athenahealth, Bumrungrad International Hospital, CareCloud, Clinical Architecture, Northrop Grumman, Orion, SuccessEHS, and Vitera.
  • The party goes on until 11:30, so join us late after your fancy dinner at Emeril’s.

Acquisitions, Funding, Business, and Stock

2-19-2013 7-44-04 PM

Liaison Technologies acquires Ignis Systems, a provider of clinical data integration solutions for lab and radiology orders and results.

Allscripts discloses in a regulatory filing its plans to close 12 offices and implement other changes to reduce costs associated with product development. The company estimates that it will spend $10 million for employee severance, $16 million for relocation costs , and $3 million for lease exit costs.

2-19-2013 7-44-52 PM

Merge reports Q4 results: revenue up 1 percent, adjusted EPS –$0.13 vs. $0.04, missing consensus earnings estimates. The company also announced that its board has unanimously rejected the valuation placed on the company in strategic alternatives proposals and will instead continue to execute its own plan. In the conference call, the company pointed out strongly increased bookings, increasing subscription revenue, increased acceptance of its iConnect enterprise archive, and growth in specialty areas such as cardiology and orthopedics.

2-19-2013 7-04-07 PM

Social network platform vendor iMedicor acquires HITS Consulting Group (HITS CG) and the data mining firm ClarDIS. The company also appointed HITS CG CEO Henry Denis president and ClariDIS Founder and President Joshua Brimdyr as COO.

Clinical research services vendor Quintiles announces plans for a $600 million IPO. The company was taken private by Bain and TPG in 2008 for $3.8 billion and is $2.4 billion in debt. The founder, Bain, and TPG each own shares worth around $500 million.


Triad Healthcare Network (NC) will implement Alere Accountable Care Solutions for its HIE.

Cardiovascular Care Group selects McKesson’s Paragon HIS for use at its Bakersfield Heart Hospital (CA) facility.

2-19-2013 10-05-45 PM

Pioneers Memorial Healthcare District (CA) will deploy Medseek’s self-service portal tools.


2-19-2013 1-56-31 PM

Kimberly Labow (NaviNet) joins ZirMed as VP of marketing.

2-19-2013 5-08-38 AM

Clinithink appoints Russ Anderson (Availity) VP of product management.

2-19-2013 5-11-27 AM

Roland L. Surprenant (Allscripts) joins Patient Safe as a regional VP.

2-19-2013 8-44-45 PM

Hal Andrews (Mainland Morgan & Co.) joins nTelagent as CEO, replacing founder Earl Winter, who remains on the board.

The SSI Group names Terry Pefanis (Healthtech Holdings) as CFO and promotes Mary Hyland to VP of regulatory affairs/chief privacy officer.

Brian Graves (Picis) joins Connance, Inc. as VP of marketing and communications.

HCA Gulf Coast Division (TX) names Carl Vartian, MD to the additional role of CMIO. He will continue as chief medical officer of Bayshore Medical Center (TX).

Alan Huffman (Healthcare Management Systems) joins Shareable Ink as VP of engineering.

Announcements and Implementations

2-19-2013 6-54-40 PM

Benjamin Russell Hospital for Children (AL) goes live on the Versus Advantages Asset Tracking solution, which includes two-way HL7 integration to Four Rivers Total Maintenance System.

2-19-2013 9-01-11 PM

Data analytics and natural language processing vendor Health Fidelity is awarded a National Science Foundation grant to develop technology to identify patient cohorts using EHR data. 

Government and Politics

2-19-2013 6-56-21 PM

HHS names Marshfield Clinic Research Foundation the winner of its Million Hearts Risk Check Challenge for its Heart Health Mobile app and awards the Foundation $100,000 for maintenance and updates.

2-19-2013 9-40-49 PM

CDC releases Solve the Outbreak, a free iPad game.


2-19-2013 7-50-22 PM

Palomar Health will announce this week that it’s the first customer of a new wireless vital signs monitor for tablets and smartphones. The phone-sized, wrist-attached ViSi Mobile by Sotera Wireless will send continuous information on heart rate, blood pressure, and oxygen levels directly to the electronic medical record, allowing non-invasive monitoring from any hospital location.

2-19-2013 9-18-40 PM

Bayada Home Health Care issues 4,000 Samsung Galaxy Tab tablets to its professionals following a 20-person pilot project. They’re using SwiftKey Healthcare ($3.99), which speeds up documentation with an on-screen keyboard, terminology dictionary, and auto-fill capability. More than two-thirds of Bayada’s nurses who use SwiftKey said they would rather document on the tablet instead of on the laptop or on paper. It doesn’t work on iOS devices, though, since Apple doesn’t permit third-party keyboards.


HIMSS will lease 25,000 square feet in Cleveland’s Global Center for Health Innovation (just renamed from Medical Mart at the request of its tenants) to be used for exhibition, education, and demonstration as well as the HIMSS Innovation Center, presumably replacing its planned presence at the defunct Nashville Medical Trade Center project.

2-19-2013 7-58-47 PM

I think I remember a reader’s earlier question about Epic’s Meaningful Use Stage 2 certification status (it involved a claim that they wouldn’t be ready, as I recall). Both EpicCare Inpatient and Ambulatory are now listed on CCHIT’s site as being certified for the 2014 criteria.

2-19-2013 10-10-14 PM

A bomb scare-triggered lockdown this week at Natividad Medical Center (CA) proves the value of its electronic medical record in an emergency. According to the hospital assistant administrator, “We have an electronic medical record, so we are able to see where the patients are and what kind of service they need.”

A Black Book Rankings provider poll finds that up to 17 percent of physician practices may be planning to change EHRs in the next year, which it blames on vendors who are too busy selling and implementing their products to address unmet client needs. Of those practices contemplating a change, more than half said they would prefer a hosted solution. Specialists expressed strong dissatisfaction with their current systems, with more than 70 percent of ENT, immunology, orthopedics, gastroenterology, ophthalmology, urology, and nephrology practices saying their current EHR doesn’t meet their needs.

A trauma center in India implements a new system that eliminates readability issues with physician documentation and reduces the time required to document 30,000 accident cases per year. The self-developed, template-based new system is solely for “medico-legal cases,” i.e. it’s not for patient care, but rather to document cases that may eventually initiate a lawsuit.

Sponsor Updates

  • SCI Solutions adds 93 hospitals in 2012, achieves sequential sales growth of 37 percent, and maintains an attrition rate below two percent.
  • Ping Identity showcases its next-generation cloud and mobile identity management solution during next week’s RSA conference in San Francisco.
  • Greenway’s PrimeSUITE (V17.0) receives 2014 ONC HIT certification as a complete EHR. The company will also integrate the Physicians Interactive eCoupon voucher and coupon distribution system into  the system.
  • Covisint releases its Direct solution that provides secure, scalable point-to-point email-like messaging. 
  • ICA selects Health Language from Wolters Kluwer Health to support its HIE platform.
  • MedAptus VP of Client Services Rick Little shares details of MD Anderson Cancer Center’s use of MedAptus for charge capture.
  • NIH experts validate PeriGen’s fetal heart rate interpretation, which was presented this week at the Society of Maternal Fetal Medicine in San Francisco.
  • Aspen Advisors becomes a Premier CHIME Foundation member.
  • iSirona will be featured in the Interoperability Showcase at the HIMSS conference after passing the interoperability requirements at IHE North America Connectathon.
  • Beacon Partners will offer a session entitled “Habits of Highly Meaningful Users” at the HIMSS conference on March 6.
  • Healthpac will embed PatientPay’s online bill management services into its practice management system.
  • ICA and Futurix Health partner to offer payers, ACOs, and providers enhanced data analytics and benchmarking tools coupled with ICA’s interoperability and informatics platform.
  • DynaMed and Isabel Healthcare partner to allow mutual customers linkage from Isabel’s differential diagnosis tool to DynaMed’s evidence-based clinical information resources.
  • An Iatric Systems video describes the company’s vision for comprehensive healthcare IT integration.


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

More news: HIStalk Practice, HIStalk Connect.

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February 19, 2013 News 16 Comments

News 2/15/13

February 14, 2013 News 12 Comments

Top News

2-14-2013 9-55-50 PM

Massachusetts General Hospital spinoff and EHR query platform vendor QPID chooses a timely Valentine’s Day launch. I interviewed President and CEO Mike Doyle earlier this week about the company.

Reader Comments

2-14-2013 10-12-54 AM

inga_small From DrLyle: “Re: LinkedIn. Looks like I have more stalkers than you.” DrLyle and a few other folks sent me notes saying they were among the millions in the top five or even one percent of LinkedIn users with the most viewed profiles in 2012. DrLyle, by the way, posed an interesting question: is there value in paying LinkedIn for one of the professional versions? I defer to readers since I have no interest in paying $20 to $75 a month for premium options.

inga_small From Geographically Challenged: “Re: HIMSS13. Will you be attending this year’s HIMSS13 Annual Conference in Las Vegas from March 3-7?” Note to vendors and PR firms pitching for media time: messaging is far more effective when you get the name of the city correct. Not to mention that we already suspected that HIMSS13 would be held this year. Maybe it was a trick question.

2-14-2013 7-49-34 PM

From Skunk Baxter: “Re: Stanford Hospital CIO. She is out.” Carolyn Byerly’s LinkedIn profile shows that she just started a new job as managing partner with Platinum Advisory Services, LLC.

HIStalk Announcements and Requests

inga_small A few highlights from HIStalk Practice over the last week: CMS provides guidelines for EPs for avoiding the 1.5 percent PQRS penalty in 2015. CVS dominates the retail medical clinic market. Athenahealth earns a spot on FastCompany’s list of the World’s Top 10 Most Innovative Companies in Healthcare. SRS CEO Evan Steele discusses Thoma Bravo, EHR usability, and Meaningful Use. Thanks for reading.

inga_small Coming soon: HIStalk’s Guide to HIMSS 2013, which includes essential details on over 100 vendors, all of which in a remarkable coincidence happen to be our lovely sponsors. You won’t want to miss it if you need the scoop on who to contact to schedule meetings or where to find the best booth giveaways.

2-14-2013 6-28-12 PM

The always-creative folks at Vonlay steered me to a humorous Dear Abby-type blog post they’re running in honor of Valentine’s Day, but I was more amused by the graphic on their main page.

I’ve been getting several calls at the hospital each day from vendors pitching their HIMSS presence, more than I remember in previous years. They’re easy to spot on Caller ID, so I just let them go to voicemail and delete them later. Today a company (I’ll be nice and not name them) left a lengthy voice mail, with the rep (badly) reading a canned script that ended with, “we’re scheduling meetings with people” (nothing like making a prospect feel special). Worst of all, she was reading it over her speakerphone. I pictured her as a bored phone sex operator.

2-14-2013 8-18-45 PM 2-14-2013 8-26-44 PM

Welcome to new HIStalk Platinum Sponsor Halfpenny Technologies. The Blue Bell, PA company specializes in data interoperability, such as laboratory information systems communicating with EHRs, health plans, or each other (reverse reference labs). Point-to-point interfaces push data around inefficiently and without normalization, making them a sitting duck for Halfpenny’s ITF-Hub, which serves as air traffic controller to manage the flow of orders and results among all participants (hospitals, independent labs, HIEs, health plans, practices, and public health). Everybody knows you can’t do much of anything for a patient without lab results. The company has been around since 2000, having worked with more than 200 EHR vendors since then and embedded its technology into some of their products as well. They offer portal and mobile access, which of course makes docs happy, especially the ones who aren’t using EHRs. Their CMIO will tell you how Meaningful Use Stage 2 affects the clinical lab. Drop by HIMSS Booth #5223, tell the folks you read about them here, and drop subtle hints about signing you up for some swell prizes. Thanks to Halfpenny Technologies for supporting HIStalk.

On the Jobs Board: Project Manager – Government, Business Intelligence Architect, Software Product Development Manager, Requirements Engineer.

HIMSS Conference Social Events

Send us your event details if it’s a good one (i.e, free food and drinks at minimum) and you promise that all HIStalk readers are welcome to attend, even if they work for your most hated competitor as a given reader might well do. Don’t blame us if throngs eat you out of cocktail weenies and tortilla roll-ups. I would be especially interested in companies serving really good beer as I ran across a couple of conferences ago.

2-14-2013 6-03-40 PM

Jardogs will host a happy hour on Monday, March 4 and Tuesday, March 5 from 5:00 to 6:00 pm in Booth 4659. Dr. Jayne and Inga have noted this in their schedules.

Acquisitions, Funding, Business, and Stock

Allscripts adopts a majority voting policy for directors and announces that its annual stockholder meeting is set for May 21. We’re not astute financial analysts who actually know what that accomplishes, so Ben Rooks of the Investor’s Chair has promised to render his opinion.


2-14-2013 11-50-52 AM

Vanderbilt University Medical Center (TN) will implement TeraMedica’s Evercore Clinical Enterprise Suite for vendor neutral archiving. 

SCL Health System selects the technology platform of Lumeris for its accountable care initiatives.

Community Memorial Hospital (CA) contracts with Cymetrix for revenue cycle services.

2-14-2013 5-58-55 PM

DeKalb Health (IN) selects e-MDs Solution Series for its 19 providers.

2-14-2013 6-00-03 PM

Bali Royal Hospital in Indonesia selects Wolters Kluwer Health’s UpToDate as its evidence-based clinical decisions support system.

2-14-2013 6-01-29 PM

Mee Memorial Hospital (CA) will use Access-eforms on demand and e-Signature technology with its Meditech Magic Scanning & Archiving system .


2-14-2013 6-04-31 PM

PeriGen names Thomas J. Garite, MD (American Journal of OB/Gyn) chief clinical officer.

2-14-2013 8-04-55 PM

Nancy Ham (McKesson / MedVentive) is named CEO of Aetna’s Medicity subsidiary. She replaces Brent Dover.

2-14-2013 8-07-17 PM

Brent Dover (Aetna / Medicity) is named president of Health Catalyst, which will announce his hiring on February 19. Brent says the irony isn’t lost on him that he left an HIE company to lead an analytics vendor, while Nancy Ham left an analytics vendor to replace him at the HIE company.

Announcements and Implementations

2-14-2013 6-16-08 PM

Baylor University Medical Center (TX) goes live on Allscripts Sunrise Clinical Manager.

North Memorial Health Care (MN) reports a 75 percent reduction in unnecessary early-term deliveries using Health Catalyst’s Adaptive Data Warehouse technology.

2-14-2013 6-18-03 PM

Integration and data management services provider Liaison Technologies announces that its healthcare division grew 83 percent and its headcount more than doubled in 2012.

The CalHIPSO Regional Extension Center launches service offerings that include Meaningful Use tracking, EHR readiness, and eligibility registration attestation.

Cleveland Clinic (OH) signs up for the CliniSync HIE, joining the previously announced University Hospitals Health System.

Perceptive Software announces an upgrade to its Perceptive Search applications, the first since it acquired the technology last year. It searches documents, e-mail, websites, intranets, databases, social networking sites, and local computers.

Government and Politics

2-14-2013 10-09-38 PM

President Obama calls out patent trolls in a Thursday afternoon Google Hangout session dubbed Fireside Hangout. “They don’t actually produce anything themselves. They’re just trying to essentially leverage and hijack somebody else’s idea and see if they can extort some money out of them.”

Innovation and Research

2-14-2013 6-24-26 PM

NeuroCare Tech launches BrainAttack, a $5.99 decision support app for evaluating ED stroke patients as candidates for tPA.

2-14-2013 7-47-20 PM

The free Qpid.me service allows potential romantic partners to share their sexually transmitted disease status directly from the medical records of their doctors. Concerns about the site are that practices won’t have the time to send patient records if it really takes off, not to mention that once those records arrive at the company’s servers, patients are no longer protected by HIPAA.


Four Rivers Total Maintenance Systems integrates Versus Technology’s RTLS within its asset management software.

A study’s questionable conclusion claims that Microsoft’s Kinect videogame controller could reduce healthcare expenses by $30 billion by replacing expensive telemedicine systems (which of course Skype and other video chat tools can do for free). Kinect’s advantage is that it can be used hands-free in a sterile field, but I haven’t seen a lot of telemedicine originating in the OR. One of the study’s two authors works for Microsoft.


Patient Privacy Rights provided links to its federal Form 990 for 2010 and 2011 in response to the inquiry from Alert Reader. They’ve been there all along on the “Why Donate” page. UPDATE: my mistake, they apparently were just added from the reader’s inquiry. I didn’t see any smoking guns if that was the expectation – the organization took in around $105K in donations in 2011 (half what it received in 2007-2009), spent a small amount on its one FTE, and the rest went to professional fees and office and travel expense. Deb Peel was paid nothing.

2-14-2013 10-12-25 PM

Froedtert Health (WI) warns that a virus that penetrated an employee’s computer may have exposed the information of 43,000 patients to unknown parties.

2-14-2013 9-46-05 PM

A San Diego publication profiles Chris Van Gorder of Scripps Health, a former beat cop turned hospital security guard and now CEO who is determined to reduce unnecessary variation to cut costs. According to the article, “Van Gorder trusts that sharing financial information, especially on costs, along with data on treatment and outcomes, will usually lead doctors to the best-outcome-at-lowest-cost decisions.”

People always send me funny stuff because they know I’m a sucker for it, and the video above from customer engagement and total cost of ownership services vendor PeerIntel is good one, with the smarmy doc playing it straight all the way. I notice the hospital name is actually that of the company’s R&D VP, described on its site as a “scruffy Armenian.” The other bios are pretty funny, too, with the marketing guy’s saying that he came to the company due to “a series of (now-broken) promises” by the top guys. The company used to be called Katalus Advisors. I interviewed Chairman Jeremy Bikman in October 2011.

A laid off MedQuist director shares her experience in “losing my job to technology” as speech recognition technology replaces transcriptionists.

2-14-2013 8-12-27 PM

The second spokesperson for Heart Attack Grill in Las Vegas dies of, you guessed it, a heart attack. He weighed only 180 pounds, a wisp compared to his 575-pound predecessor. The restaurant fries in pure lard, sells beer and cigarettes, offers a 10,000 calorie burger, and  provides free meals to patrons weighing over 350 pounds. Their employees are scantily clad “nurses” that critics say places it in the Hooters-created category known in the trade as “breastaurants.”

I see that passengers on the Carnival Triumph are suffering bad food, long lines, and rude fellow passengers. Sounds about like our experience on a week-long cruise on Triumph a few years back, except ours was just a normal cruise. Everybody’s fretting about underfed passengers, but nobody seems worried about the 1,000 foreign crew members working around the clock in miserable conditions trying to keep passengers safe, comfortable, and norovirus-free for their princely wages of maybe $150 per week, not to mention that tips will be few this time. As the ambulance chasers and sensationalistic news reporters line up to prod the vacationers into a state of righteous indignation (even though they’re already receiving a nice package of reparations from Carnival), someone should raise some money to help the crew, who will probably get nothing for what they’ve been through.

Scotland’s NHS hospital employees, like ours, share passwords, post questionable information in Facebook, curse in e-mails, and install unauthorized software on their hospital devices, according to disciplinary records.

Weird News Andy says this woman really did have a HERnia, in the form of a baby girl. A 44-year-old woman complaining of bloating is X-rayed by hospital doctors, who are startled to find a full-term baby in her womb. They did a C-section and she’s now a first-time mom.

Sponsor Updates

  • NextGen Healthcare adds ITelagen as a VAR.
  • VersaSuite participates in this week’s Rural Health Care Leadership Conference in Phoenix.
  • TrustHCS representatives will speak on ICD-10 readiness during the April AHIMA ICD-10 CMS/PCS and CAC Summit in Baltimore.
  • SuccessEHS sponsors a February 28 Webinar on the patient-centered EHR and quality improvement.
  • CIC Advisory offers suggestions on implementing and adopting a health IT safety program.
  • CardioNet and AirStrip partner to develop and co-market an integrated solution for mobile patient monitoring.
  • Agilum Healthcare Intelligence publishes a case study on business intelligence strategies for small and mid-sized hospitals.
  • AdvancedMD offers a guide to improve patient experience with EHRs.
  • Intellect Resources posts a  Gotye parody video about recruiters.
  • Imprivata adds Aura Healthcare as a VAR to resell its single sign-on solution.
  • Best of Staffing recognizes CSI Healthcare for its outstanding reviews from clients and job-seekers.
  • Data Trade Solutions will offer nVoq’s SayIt speech recognition technology to its physician clients.
  • NorthWise Services (UK) partners with Merge to offer clinical trial services.
  • Wellcentive participated in the 2013 IHE North America Connectathon earlier this month.

EPtalk by Dr. Jayne

The Workgroup for Electronic Data Interchange survey remains open through next Wednesday. Any individual associated with health care organizations (vendors, health plans, providers, etc.) may participate. I’m a little offended that they listed providers last and even after health plans, but I took the survey anyway.


Speaking of surveys, a senior at Washington University in St. Louis conducted one on hip replacement prices. As part of a research project on healthcare costs, Jaime Rosenthal called 100 hospitals (two in every state) and asked for cash prices for a hip replacement surgery for her fictional grandmother. Despite pushes for transparency, only half the hospitals could provide an estimate and those that did ranged from $11,000 to $125,000.

A related commentary discusses the disparities in “sticker price” of health care and tells the story of the automobile window sticker, stating, “A 2013 hip replacement looks a lot like a 1954 Buick.”

2-14-2013 6-35-00 PM

Just when I thought I had seen it all, Dr. Mostashari’s bow tie opened its own Twitter account yesterday. You can follow its exploits @FarzadsBowtie while “Putting the Bow-Tie in Health IT.” I’ve had crushes on some famous people, but never on one whose apparel had its own social life. What’s next: @IngaHistalksShoes?

Speaking of shoes, Inga beat me to the punch with the chocolate shoes, but they’re too good not to mention here as well. My favorite is the red stiletto with the dark chocolate filigree, although the pink with white polka dots is cute too. Maybe a certain someone will take the hint.


If not the shoes, I’m definitely liking this lovely ring from MF Jewelry, created from your own EKG tracing. 

2-14-2013 6-37-44 PM

Considering my recent piece on handwritten thank you notes at the hospital, Inga sent over this ER doctor’s note that’s been circling the Internet. Now this is meaningful use of a handwritten note. Kudos to New York Presbyterian’s fine and caring staff member.

I’m starting to put together my serious (i.e. “non-cocktail party”) agenda for HIMSS. I was a little bitter to see that Inga and I were not invited to the #HITchicks Tweetup event on Monday. I can’t think of more fun #HITchicks than us. I’m hoping to see some new and innovative things rather than more of the same. Have something that I shouldn’t miss? E-mail me.



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

More news: HIStalk Practice, HIStalk Connect.

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February 14, 2013 News 12 Comments

News 2/13/13

February 12, 2013 News 5 Comments

Top News

2-12-2013 7-01-56 PM

Greenway announces Q2 results: revenue up 12 percent, EPS $0.00, missing both revenue and earnings estimates substantially, guiding fiscal year earnings to the low end of the range on lower revenue. Shares were down eight percent in Tuesday’s after-hours trading. From the earnings call:

  • The company is moving rapidly to a recurring revenue model, with revenue recognition changes hurting short-term results
  • 750 providers were added in the quarter, up 30 percent year over year
  • Training and consulting revenue dropped 35 percent because large accounts pushed training out into January
  • The company’s new RCM platform is in its early stages, but has over 300 customers

Reader Comments

inga_small From Judy: “Re: our HIMSS promo.  I thought about you. We’ve secured 25 New Orleans merchants to offer discounts to HIMSS attendees wearing our Iatric Systems branded slap bands. Merchants range from restaurants to spas  to jewelry to clothing and to two stores specializing in shoes and boots. You can wine, dine, shop, tour, and spa in between all the HIMSS activities.” Judy had me at shoes and discount, but wine and spa, too?  Look for the bands in the LeSack hotel drop Sunday night or at the Iatric booth.

inga_small From Alberta Gator: “Re: HIStalkapalooza. I am assuming I did not make the cut for HIStalkapalooza since I didn’t get an invite. It’s OK. I’ll still bring sexy shoes in your honor.” Don’t fear: the invites have not yet been sent even though the registration has closed! The official HIStalkapalooza invitations will be e-mailed to several hundred of our BFFs around February 18. And I can’t wait to see all the sexy shoes. If you didn’t sign up, sorry, but we’re full.

2-12-2013 7-56-26 PM

From The PACS Designer: “Re: Selective Disturbance App. Our fellow HIStalker Inga has helped a developer name a new mobile app by calling it ‘Selective Disturbance.’ It will be on TPD’s List of iPhone Apps with the next update.” I asked Inga what this was about and it turns out she helped choose the rather brilliant name attached to the app, which lets you selectively set a “Do Not Disturb” status by groups of individual contacts, so maybe you let your child get through 24×7 but block casual acquaintances during work hours.

From Ralph Samuelson: “Re: Allscripts. I am not sure how it is for everyone, but the company is allowing everyone in my group (programming for one of the legacy products) to stay on until August 1. We have until then to relocate or find another job outside the company. I probably can’t move, but I am grateful I have some time to consider my options.”

From Alert Reader: “Re: revisiting old announcements. How about Deborah Peel saying they would post Form 990 on the Patient Privacy Rights website, which was in HIStalk on January 3, 2011?” I’ve invited her to respond.

From Code Monkey: “Re: old systems vs. new. The experience haven’t changed since the early 2000s. Example: our hospital got reports that several patients weren’t seen within several hours after admission. That’s the responsibility of residents, who are entered as consulting physicians. The chief resident opened 10 tickets with no response from the application team saying that patients were disappearing from our portal lists. We had just applied a McKesson Horizon patch, so we checked the new Perl audit feature, which showed a new routine called ChopConsult, which started with: ‘Temp fix to remove [root@hcilink perl]# cat ChopConsult #Temp fix to remove consulting physicians beyond 8 from ADT.’ If you have more than eight consulting physicians, sorry, you now have zero. I use this as an example that many of these systems are hacked together and stability is an issue, without even looking into the database design. Pay no attention to what’s behind the curtain (or cloud).”

2-12-2013 7-24-10 PM

From Smarty Marty: “Re: Aetna. Will brand its Accountable Care Solutions assets (Medicity, iTriage, ActiveHealth, PracticeiQ) under the Healthagen name, possibly to separate these solutions from their core commercial insurance business. I found this when I went looking for the Medicity booth on the HIMSS website and could not find anything. Medicity’s website has brief information about it in the Events section.” Aetna quietly acquired Healthagen, which developed the iTriage consumer health app, in December 2011. Above is what is apparently the placeholder web page for the new Healthagen organization, with the four company names listed at the bottom. The Healthagen HIMSS exhibitor listing has three of the company names, omitting PracticeiQ.

HIStalk Announcements and Requests

2-12-2013 9-09-55 AM

inga_small I wonder how many other people got this same e-mail from LinkedIn? I felt incredibly special for about 30 seconds until Mr. H told me he got the same notification. I knew it had to be bogus / a marketing ploy / a waste of my time when LinkedIn sent me the same notice for my personal LinkedIn account.

2-12-2013 6-11-16 PM

We acknowledge and appreciate the support of Deloitte, a brand new Platinum sponsor of HIStalk. The company is, of course, a premiere, worldwide professional services firm headquartered right here in the USA (New York) with a strong healthcare IT presence and a list of awards to prove it. Deloitte’s provider practice supports organizations working on tough problems:  quality improvement, ICD-10, business intelligence and analytics, system implementation and optimization, disease management, and HIEs. You can keep up with big-picture developments by reading updates from Paul Keckley, PhD, executive director of the Deloitte Center for Health Solutions. A bunch of us who’ve been around awhile know Mitch Morris, MD, who leads the company’s health IT practice, and I’ll be talking to him soon about industry trends. Thanks to Deloitte for supporting HIStalk.

I always hit YouTube to see what I can find out about a new sponsor and my search for Deloitte turned up a winner: a brand new report on the 2013 health outlook.

HIMSS Conference Social Events

Going to HIMSS? We’ll post social events that are (a) interesting, and (b) open to all HIStalk readers who care to attend. Send yours to be listed.

Alego Health will host a cocktail reception on Tuesday, March 5 from 3:00 to 6:00 p.m. at their booth (#141). They’ll have hurricanes, beer, wine, an infused hydration station (what the heck is that? sounds like an IV), and some nice food that includes mini po’ boys.

Acquisitions, Funding, Business, and Stock

2-12-2013 9-35-06 PM

Enterprise HIS vendor RazorInsights announces $11 million in Series A funding from Bluff Point Associates. One of its customers was announced in the press release – Alliance HealthCare System (MS). CEO Reed Liggin mentioned the upcoming investment in my February 8 interview.

Teleheath company INRange Systems raises $1.6 million for its remote medication management device that administers single doses of meds to patients and transmits adherence data to physicians and pharmacists.

2-12-2013 7-11-25 PM

Employees of the Barcelona, Spain office of Picis (Optum / UnitedHealth Group) say they will go on strike beginning Thursday to protest the amount of severance they’ll receive as the company moves most of their jobs to India. According to the employee spokesperson who contacted us, “First, the UHG negotiators don’t have a firm plan to transition Picis development and support to India and we’ve asked them to let us help sort out how to successfully do it. Second, the compensation package is drastically lower than what we could win in court.” Spain’s legally-mandated employee benefits are extensive, but the employees say most companies that move jobs to India provide more than the minimum separation benefits. UPDATE: the response from Optum: “Picis Spain is engaged in good faith negotiations with employees at its Barcelona office, as it evolves its local workforce to better align with changing customer needs. We don’t anticipate any business disruption and hope this issue can be resolved fairly and quickly.”


2-12-2013 9-38-52 PM

Greater Baltimore Medical (MD) will implement Amcom Software’s Mobile Connect smartphone texting solution with their existing Amcom communications system.

The Michigan Department of Community Health Medical Services Administration awards Cognosante the Medicaid IT Architecture State Self-Assessment contract.

Tanner Health System (GA) selects Besler Consulting to conduct a transfer DRG underpayment recovery audit.

2-12-2013 9-39-49 PM

Arnot Ogden Medical Center (NY) will implement Merge Healthcare’s cardiology solution suite to capture, manage, and display multi-modality cardiac images, along with hemodynamics and ECG data.

Southeastern Health (NC) expands its relationship with eClinicalWorks to include the company’s Care Coordination Medical Record.

Dignity Health Medical Foundation (CA) chooses MediRevv for A/R management services.


2-12-2013 8-08-15 PM

Trinity Health CEO Joseph Swedish is named CEO of WellPoint, the country’s second-largest insurer, replacing former CEO Angela Braly.

2-12-2013 8-11-43 PM

Russell Branzell (Colorado Health Medical Group) is named president and CEO of CHIME.

2-12-2013 5-53-01 PM

Athenahealth COO Ed Park joins the board of directors of analytics vendor Kyruus.

2-12-2013 5-54-35 PM

Vitera Healthcare Solutions hires Kermit Randa (Surgical Information Systems) as EVP of sales and marketing.

2-11-2013 4-01-26 PM

TransforMED, the AAFP subsidiary that supports practices transitioning to PCMHs, announces the retirement of president and CEO Terry McGeeney, MD.

2-12-2013 10-51-04 AM  2-12-2013 10-45-44 AM  2-12-2013 10-53-16 AM

MedeAnalytics promotes Steve Lerch to SVP/GM of the provider business unit, Scott Paddock to SVP/GM of the payer business unit, and Sal DeTrane to CFO.

2-12-2013 11-07-47 AM

Hello Health names Barry Holleman (Cardinal Health) COO and VP.

2-12-2013 2-08-59 PM

Aspen Advisors promotes Jody Cervenak to principal.

2-12-2013 3-42-20 PM

CVS Caremark appoints Brian Tilzer (Staples) SVP/chief digital officer.

2-12-2013 8-38-27 PM 2-12-2013 8-39-39 PM

Health Care DataWorks promotes CFO Jeffrey Wilkins (left) to CEO, replacing founder Herb Smaltz (right), who will continue to serve as board chair.

Announcements and Implementations

2-12-2013 3-59-04 PM

Over 60 ACOs from 15 states form the National Association of ACOs, which will focus on helping organizations to increase the quality of care and improve health in their communities.

2-12-2013 3-57-34 PM 

The Mount Sinai Medical Center (NY) reports that its Epic EMR has resulted in improved quality of care for patients, including a 56 percent reduction in Medicare readmissions and improvements in quality measures such as discharge instructions for patients and antibiotic administration prior to surgery.

The Huntzinger Management Group assists Hanover Hospital (PA) in its successful Stage 1 MU attestation.

API Healthcare introduces its Talent Management Solution to improve employee engagement while addressing the industry challenges of healthcare reform and an aging workforce.

SimplifyMD launches its simpleStart program that will allow practices to move from EHR demo to live clinical use on the same day.

Mobile platform application development provider Kony Solutions announces support for the BlackBerry Z10 and Q10 smartphones.

Stilwell Memorial Hospital (OK) goes live on Medsphere OpenVista.

Government and Politics

The government’s healthcare fraud prevention and enforcement efforts recovered $4.2 billion in FY2012, up from last year’s $4.1 billion. Over the last three years, fraud and abuse investigations recovered $7.90 for every dollar spent.

2-12-2013 3-44-50 PM

President Obama re-nominates Marilyn Tavenner as permanent administrator for CMS.

Anybody who follows the VA/DoD EHR saga knows that the story changes weekly, flip-flopping on whether they’ll write new separate systems, write one new system, buy off-the-shelf applications, or just patch together what they have. Sometimes DoD has one story and the VA another, illustrative of just how vast the gulf is that separates their philosophies. Secretary of Defense Leon Panetta spoke of the “one EHR" project in the past tense a week ago, saying definitively that the departments were giving up on that idea in favor of just getting their respective systems to talk to each other. Not so fast, says VA CIO Roger Baker, now clarifying that the integration project is a stopgap toward the original goal that will continue. All I know is that whatever they do will be horrifically expensive and behind schedule, especially on the DoD side that has paid contractors billions to develop AHLTA,  and all the conflicting announcements have made me lose interest yet again. The OSEHRA community is talking if you can understand what they’re saying, meaning you’d better speak VA geek talk and appreciate decades-old VistA history, which I do on occasion. Some of those pontificating speculate that DoD will end up buying Epic, looking back to 2011 when five Wisconsin Congressmen (including eventual Republican VP nominee Paul Ryan) lobbied for the home team.

ONC’s Doug Fridsma participates in a Google + Hangout.

2-12-2013 8-03-54 PM

Federal Health Architecture releases version 4.0 of its open source Connect HIE-enabling platform. It supports higher message throughput, larger files, newly support server environments, and improved logging.

2-12-2013 8-18-44 PM

HIMSS urges HHS to stick to the October 1, 2014 implementation date of ICD-10, saying it will reduce the cost of prior authorization, enable Meaningful use, improve population health, reduce waste, and save money.


2-12-2013 8-44-05 PM

UC Irvine says medical students given free iPads with digital textbooks are scoring 23 percent higher on exams than students in previous classes, also noting that the students have formed their own technology group and developed 19 healthcare-related iPad apps in a 10-day Med App Jam. The iMedEd program was named a 2012-2013 Apple Distinguished Program this week.


2-12-2013 3-34-32 PM

Cerner, Epic, and Siemens earn the highest ratings in ICD-10 preparedness according to KLAS, while Allscripts and Meditech score lowest. Among firms providing ICD-10 consulting, The Advisory Board earns top marks for high-quality roadmaps and best-practice sharing among firms providing ICD-10 consulting, while Deloitte has the most engagements. The majority of the market is looking to 3M and computer-assisted coding technology to aid in the transition.

2-12-2013 6-46-02 PM

Here’s the latest cartoon from Imprivata. 

A local medical center in Rhode Island pitches a move to the Amazing Charts EMR to earn Meaningful Use money, adding that health services board members with medical backgrounds could help with the conversion. Several audience members objected, saying they don’t want board members seeing their medical information. The board deferred the EMR decision until its next meeting.

New Jersey Economic Development Authority approves creation of a life sciences and healthcare IT accelerator that will offer the usual seed money, boot camp, mentorship, and pitch showcase.

In Canada, Saskatchewan’s privacy commissioner is investigating three cases in which health authority employees inappropriately accessed the electronic medical records of their co-workers, including one where an employee found that her name had been replaced with a vulgarity and “RIP” at the end.

A Houston medical student files suit against his school, claiming it illegally viewed his hospital medical records and expelled him based on a physician’s speculation that he had tried to commit suicide.

Weird News Andy speculates that perhaps not all things go better with Coke. Like cardiac arrhythmia, for example, in a 30-year-old mother of eight in New Zealand whose death was ruled by the coroner as being partially caused by her 2.2 gallon per day Coca-Cola habit. The sugar water liver had damaged her liver, caused all her teeth to rot out, and addicted her to the point that she experienced withdrawal symptoms when her supply ran out. Her family says they thought Coke was OK because the bottle carries no warnings, while the company complains that the coroner himself wasn’t really sure that Coke killed her.

Sponsor Updates

  • Emdat posts its spring trade show and conference schedule.
  • Hayes Management Consulting posts case studies of some of its projects.
  • HealthCare Anytime and ICA partner to leverage ICA’s interoperability technology with HealthCare Anytime’s patient portal.
  • Informatica’s Chief Product Officer Girish Pancha participates in this week’s Pacific Crest Emerging Technology Summit in San Francisco.
  • Truven Health Analytics adds enhanced reporting functionality and flexibility to the latest versions of its pharmacy intervention and infection prevention products.
  • Unity Health System (NY) executives will share details of how they leveraged public and private HIEs to enable a community diabetes collaborative during a March 21 Webinar hosted by dbMotion. 
  • Capario realizes double-digit revenue growth from its provider base in 2012 and increased adoption of its portal application.


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

More news: HIStalk Practice, HIStalk Connect.

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February 12, 2013 News 5 Comments

Monday Morning Update 2/11/13

February 9, 2013 News 15 Comments

2-8-2013 9-24-20 PM 2-8-2013 9-25-14 PM

2-8-2013 9-22-56 PM

From Potsie: “Re: McKesson reorg. The customer announcement is attached. They’ve said they won’t force Horizon customers to convert to Paragon, but now with Pesce over both Paragon and Horizon, the writing is on the wall. I’ve also heard they’re encouraging Horizon employees to take jobs at Relay, which would seem to be scaling back by attrition rather than by layoff.” The customer e-mail from McKesson Technology Solutions EVP/Group President Pat Blake says RelayHealth will expand to over 1,000 employees, but more germane to Potsie’s comment, Paragon, Horizon Clinicals, Revenue Cycle, and Managed Services will be combined in a new organization called Enterprise Information Services, with Jim Pesce from the Paragon business (above left) serving as president. Rod O’Reilly (above right) will become SVP of strategy for MTS.  

From Ellingham: “Re: HIStalkapalooza. How can readers have missed the announcements? Presbyopia?” Beats me, but Inga and I get e-mails every day from people who swear they’ve study HIStalk intently each day without seeing the large HIStalkapalooza announcements I’ve run three times now. Maybe they’re not really HIStalk readers and just want an invitation, but I think they’re conditioned by the rags and other sites that trumpet non-newsworthy stories with a come-on headline and 10 paragraphs of padded prose that I would have summarized in one sentence without missing anything important. Skim HIStalk and you’ll miss stuff for sure. It takes me a lot of time to write in a way that wastes a lot less of yours. That’s why I guarantee that if you’ll give me 5-10 minutes of attentive reading each day, you’ll know more than almost everybody in the industry. 

An HIStalkapalooza menu update for readers who asked: Chef Brad confirms that he will have vegetarian and gluten-free items available.

2-9-2013 7-55-47 AM

The HIMSS conference will enjoy a net attendee gain this year compared to last if you believe that my poll is statistically reliable. Doing the math suggests an attendance of 33,450 based on last year’s count, but of course New Orleans can’t match Las Vegas as a draw. New poll to your right, from CHIME’s comments about ONC’s patient safety plan: should the federal government issue a national patient identifier?

2-9-2013 3-56-52 PM

Nuggets from the athenahealth earnings call Friday:

  • Jonathan Bush says the company reduced physician documentation per encounter to less than five minutes.
  • He acknowledges that athenahealth has low physician visibility and the Epocrates acquisition will be a way of promoting the company’s other businesses given its 90 percent awareness.
  • He said “athenaCoordinator had a rough year,” referring to the care coordination platform developed from the July 2011 Proxsys acquisition. He did not specifically reference the announced March 6 layoff of 36 employees from that group, but said the Proxsys system had to be rewritten from scratch, which hurt sales, and getting pre-certifications from payers is hard because each has different rules.
  • The company has integrated six products into athenaNet through its “More Disruption Please” program and plans to add another 25 in 2013, but is collecting no fees from those vendors.
  • They will launch athenaResearch next month to use the company’s database to provide insight back to clients.
  • While the company has developed turnkey rip-and-replace programs, they don’t push them because the data in the EMRs of clients isn’t reusable, or as Jonathan Bush said, “We’re going to get better at delivering it and develop the confidence to make promises that we’re good at delivering it more convincingly where we’re just going to have to get better at explaining to people why their Flock of Seagulls EMR is going to go to the same place that their Flock of Seagulls vinyl albums went.”
  • The company says they may dabble in the inpatient EMR business after reviewing a vendor’s implementation manuals and concluding, “That’s it? That’s what all the fuss is about?” and raised the possibility that athenahealth could replace the EpicCare ambulatory part of an Epic implementation and interface to Epic’s inpatient systems.

2-9-2013 2-09-27 PM

Medical facilities are necessarily extensive at Kumbh Mela, a Hindu pilgrimage held every 12 years in India that is drawing 30 million people as the largest human gathering in history. The military-like clinics were set up in two months and will be gone by the end of March. Medical records are basic and scrawled on paper. A team from Harvard School of Public Health created an iPad-based system for documenting the chief complaints and medications of the thousands of emergency patients seen each day. It also transfers data to a server to help detect public health outbreaks such as diarrhea. As stated by Logan Plaster, managing editor of Emergency Physicians Monthly:

So far the Harvard team has gathered more than 15,000 patient records, an impressive number by any research standards, and arguably the largest public health dataset ever gathered on a transient population. Their findings have been stable and predictable; most complaints are of cough and cold, and most prescriptions are for anti-inflammatory drugs, like ibuprofen. That’s good news to everyone’s ears as millions of new pilgrims enter Allahabad in preparation for February 10, the holiest bathing day on the calendar.

In China, a doctor’s social network warnings about a particular medication used in children causes shares of the drug’s manufacturer to drop 10 percent in a week, losing $160 million in value. It turned out that the doctor was wrong, having incorrectly recalled government literature. He has only 2,000 followers, but his message was reposted by a Chinese celebrity to his 26 million followers. The doctor apologized and clarified several times, but his original message continued to spread. Public relations analysis determined that a company’s response to publicly disseminated incorrect information must be issued within eight hours to be effective and must be distributed online rather than via traditional media.

The State of California fires SAP Public Services from its state employee payroll and medical benefits computer project after the new system was found to be making errors at 100 times the rate of the 1970s-era system it was supposed to replace. The project is years behind schedule and costs have piled up at triple the original estimate, with $371 million spent so far. SAP Public Services has been paid more than $50 million after the state fired BearingPoint three years ago.

An employee of Xerox/Affiliated Computer Services and an accomplice are indicted in Kentucky for using patient information collected in managing CVS’s Medicare Part D prescription plan to file fraudulent tax returns.

2-9-2013 4-17-39 PM

In England, the CEO of Royal Berkshire Hospital reports to the hospital’s board that implementation of its $47 million Cerner Millennium system need an extra $6 million to cover staff time required to navigate through patient scheduling screens that take up to 15 minutes per appointment. He warns that Millennium-related expenses will cause the hospital to move from a financial surplus to a loss for the year. According to the executive, Millennium crashes regularly, including this past Tuesday when it was down all day and the hospital had to revert to paper. The hospital’s 2013 implementation costs are projected at $10 million vs. its budget of $4 million due to unplanned manual data correction and extra staff time. The CEO said in a prepared statement to the Council of Governors, “The level of issues the trust faces having implemented Cerner Millennium is a significant drain on management capacity, despite robust risk mitigation plans. This has a significant impact on the trust’s financial performance and cash position, being the key driver between a surplus and forecasted deficit.”

Tennessee health department officials trying to manage a September meningitis outbreak were forced to develop an electronic workaround to their usual manual hospital data collection process due to the urgency of the situation. The agency had to convince hospitals to give it electronic access to their systems given restrictive federal privacy laws. Vanderbilt University Medical Center was identified as “becoming a substantial hindrance to our investigation” because its permission lagged that of all other area hospitals. The health department is considering proposing legislation to give it easier access in an emergency.

2-9-2013 3-07-00 PM

ORNGE, the air ambulance service of Ontario, is under fire for paying its physician CEO $4.6 million over two years. Taxpayers also paid questionable expenses that included European travel with $2,400 per night hotel rooms, a $1,200 dinner, limousines, minibar champagne, in-room movies, and trips with his girlfriend, who he had promoted to VP of the organization.

The CEO of the public healthcare system in Maricopa County, AZ defends her $125,000 salary increase, saying her $500,000 salary is “always the lowest of any hospital CEO in the entire state, even the little-bitty hospitals.” The board chair voted against the increase, saying the CEO has done a great job, but, “A $125,000 raise in a year when we give our janitors maybe a 1 percent raise or lay off people? It just doesn’t make sense.”

Beth Israel Deaconess Medical Center (MA) pays its former chief of anesthesia $7 million and will name its pain clinic after her to settle her charges of gender discrimination. Carol Warfield, MD says the former surgery chief, along with former hospital CEO Paul Levy, forced her out when she complained about being ignored in meetings. The Boston Globe says the hospital probably wanted to avoid reopening anything related to Levy since the woman’s attorneys had already claimed that the inappropriate relationship Levy had with a hospital employee was evidence that he ignored workplace rules.

A Truthout article says EMR adoption poses new challenges to lesbian, gay, bisexual, and transgender (LGBT) populations who will have to decide whether to share their status without knowing how that information will be handled digitally. One advocate says she doesn’t want to have to bring up her status in every medical encounter, saying, “I’m out to everyone, but I don’t want to have to come out to doctors over and over again.” Ares of EMR concern: (a) questions ask status like “gay” or “bisexual” instead of specifically identifying a patient’s relationships, since “sexual orientation is not useful medical information”; (b) EMRs should be able to identify same-sex partnerships instead of just checking “married”; (c) a label of “transgender” is not sufficient without more details; and (d) equal protection is not guaranteed in all states and an EMR-related outing can create problems. In an interesting twist on the tired HIE argument of “unconscious patient in the ED while on vacation” example, LGBTs say that their shared information could be a disaster in LGBT-hostile areas or facilities. An IOM study was mentioned whose conclusion was that the best course of action is to allow LGBTs to self-identify and opt out of answering related questions.

2-9-2013 2-15-19 PM

A hospital in Australia will discipline five employees, one of them a nurse, for posting in information to Facebook that it says violated patient confidentiality. The nurse posted the nursing home photo above, which she labeled as, “Randomly stripping for the oldies at work.” She also posted a patient’s pelvic x-ray showing an embedded object with the caption, “Take a guess what this is kids!”

2-9-2013 4-48-44 PM

Weird News Andy summarizes this story thusly: “I’ve heard of butt-dialing, but not answering.” A Sri Lankan prisoner who is startled by guards demanding to search his cell shoves a cell phone and two hands-free accessories into his rectum. The guards are surprised to hear a cell phone ring during the search, followed by the prisoner’s complaints of back pain. They take him to the prison hospital, where he tells doctors that his pain was caused by guards beating him. When the doctors reviewed x-rays and announced plans for surgery, he produced the contraband voluntarily.


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

More news: HIStalk Practice, HIStalk Connect.

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February 9, 2013 News 15 Comments

News 2/8/13

February 7, 2013 News 8 Comments

Top News

2-7-2013 7-09-40 PM

The VA and Department of Defense give up their contentious, expensive, and multi-year effort to develop a common EMR, deciding instead to keep their existing VistA and AHLTA systems and settle for a common user interface and unstated interoperability. They plan to launch a pilot in the summer of 2013 with a general rollout in 2014. The now-abandoned project, begun in 2011 with the declaration that VistA and AHLTA were outdated and lacking functionality, was supposed to have been completed in 2017. According to Secretary of Defense Leon Panetta:

We recognize that bringing together two large bureaucracies, trying to make those bureaucracies work together to form a seamless support system for all service members and veterans is not an easy challenge … It’s been inefficient for service members to have to hand-deliver records from one system to another when they get out of the military. It doesn’t make a hell of a lot of sense … Our goal had been to complete this effort by 2017 … our worry is, how long is it going to take to get to that goal? And what is going to be the price tag to get to that goal? And how many times is it going to be delayed? …  Rather than building a single integrated system from scratch, we will focus our immediate efforts on integrating VA and DoD health data as quickly as possible, by focusing on interoperability and using existing solutions. This approach is affordable, it’s achievable, and if we refocus our efforts, we believe we can achieve the key goal of a seamless system for health records between VA and DoD on a greatly accelerated schedule. We’re now directing our departments to do just that.

The reaction of Rep. Mike Michaud (D-ME), ranking member of the House veterans committee:

We have just witnessed hundreds of millions of dollars go down the drain. I’m disappointed that our nation’s two largest government agencies – one of which is the world’s foremost developer of high-tech machines and cyber-systems – could not come together on something that would have been so beneficial to those that served.

Reader Comments

From Billy East: “Re: McKesson Provider Technologies. Major re-org, with changes in leadership over Horizon Clinicals and other changes in Analytics and Relay divisions.” Unverified.

From Printgeek: “Re: McKesson. Has rolled its Physician Practice Solutions business into its RCM business along with Medisoft, Lytec, Practice Partner, Practice Choice, and now MED3OOO.” Unverified. The e-mail include the departure of an executive I won’t name at the moment, along with predictions of product sunsetting that are speculation at this point. I’ve seen no announcements, changes in the company’s Web pages, or updates to the LinkedIn profiles of those named.

2-7-2013 6-37-31 PM

From Tar Heal: “Re: UNC Health Care. Rolling out its Epic plan.” Not only did UNC avoid choosing a gimmicky name for its Epic project, they created a project logo that incorporates Epic’s identity along with their own. Go-live is planned for the spring of 2014.

2-7-2013 7-28-00 PM

From Primus: “Re: HIPAA. It’s halfway between sad and embarrassing when folks who lecture on HIPAA spell it incorrectly.” They hedged their bets by sometimes spelling it HIPPA, sometimes HIPAA.

HIStalk Announcements and Requests

2-7-2013 7-53-24 AM

inga_small My BFF Dr. Jayne and I are already working on our HIMSS party calendar. She has tasked me with securing the invites while she works on the logistics of how to attend the most events in a limited amount of time. We are partial to soirees that are open to all HIStalk readers, such as Divurgent’s summHIT Balcony Party on Sunday, March 3. If your organization is sponsoring an event that is open to all of our readers, we are happy to mention it on HIStalk and of course add ourselves to the attendee list.

inga_small A few must-read items from HIStalk Practice from the last week: CAGH launches an EFT enrollment tool that allows providers to enroll with multiple payers through a single online process. The Boston Globe profiles eClinicalWorks and its new patient engagement inititative. The percentage of medical claims filed electronically has nearly doubled between 2002 to 2011. Denial rates for established office visits range from 44 to 65 percent. HIT adoption by FQHCs is associated with significant improvements in care. Brad Boyd of Culbert Healthcare Solutions offers thoughts on practices shifting to a core vendor prior to ICD-10 implementation. Dr. Gregg wonders if Meaningful Use is getting lost in translation. I like to think of myself as a gal who doesn’t require much to keep her smiling: a hot pair of shoes, a nice glass of wine, and a few new HIStalk Practice readers every month. Make me smile. Thanks for reading.

What we like: (a) people who subscribe to our e-mail updates on HIStalk, HIStalk Practice, and HIStalk Connect; (b) connecting with readers via Facebook, LinkedIn, and Twitter; (c) seeing nice stats indicating that readers are interested in the ads of our sponsors and are clicking them for more information, as well as checking out the Resource Center and Consulting RFI Blaster; (d) getting rumors and news online, by e-mail, or on the Rumor Line telephone, with details to your right; and (e) getting support for what we do from readers, contributors, and sponsors. All of us (Inga, Dr. Jayne, Travis, Lt. Dan, Donna, and I) do this part time after work, and that wouldn’t be possible without help of a variety of types, for which we say thanks.

On the Jobs Board: Healthcare Industry Solutions Director, Software Product Development Manager, Senior Applications Engineer, Director of Marketing.

2-7-2013 8-01-34 PM

I keep getting e-mails asking for HIStalkapalooza details that I’ve already spelled out on HIStalk twice, so here’s one final notice for the skimmers: registration is still open. Sign up and then read HIStalk and watch your e-mail for details – please don’t e-mail me with questions or requests because I barely have time to sleep as it is (not to mention I would be spending time replying to people who don’t read HIStalk anyway). So far it looks like maybe 100 or so presidents and CEOs have signed up from my quick scan down the list. My favorite attendee title: “CEO Wife/Mistress” (should we hold one spot or two?)  while one (male) attendee volunteered that, “I am willing to wear high heels just to get in.” The event draws the most interesting crowd of anything at HIMSS because not only are HIStalk readers smarter, funnier, and sexier (scientific proof available on request), we get a stimulating mix of internationally known executives, CIOs, CMIOs, trench warriors, consultants, clinicians, investment bankers, sponsor people, and government officials who know their stuff and also know how to have a good time. I’m also happy to report that next year’s HIStalkapalooza in Orlando is already sponsored, as is the 2015 version in Chicago.

HIStalkapalooza sponsor Medicomp Systems will once again host its Quipstar game show in the HIMSS exhibit hall, offering fun competition, tee shirts, prizes, and cold drinks (beer and Ingatinis are mentioned, and I had the former last year). Register to play here. The grand prize is super cool: two business-class airfares to Bangkok, a 10-day stay in Medicomp’s corporate apartment, and two executive physicals at Bumrungrad International Hospital. Thai food is among my favorites and it’s shockingly cheap there, which just might be reason enough to go. Check out a disguised Inga at 0:25 in the video from last year above.

Acquisitions, Funding, Business, and Stock

2-7-2013 8-25-48 PM

Athenahealth reports Q4 results: revenue up 26 percent, EPS $0.29 vs. $0.26, beating earnings estimates by $0.01.

2-7-2013 9-10-31 PM

Analytics vendor Health Data Vision raises $2.8 million in Series A funding.

Nuance reports Q1 results: revenue up 28 percent, EPS –$0.07 vs. $0.03, falling short on revenue and earnings. Shares are down more than 15 percent in after-hours trading. On the earnings call, Chairman and CEO Paul Ricci said reduced transcription volumes due to increased EMR adoption and the company’s own Dragon Medical software will hurt the company’s healthcare growth until business picks up for its computer-aided coding and clinical documentation offerings.

Mobile health technology provider Diversinet Corp. is awarded two US and Canadian patents related to “bring your own device” security .


2-7-2013 3-15-29 PM

Vancouver-based Fraser Health contracts for dbMotion’s interoperability platform.

2-7-2013 3-17-50 PM

Mercy Health System (MO) selects MModal Fluency for Coding workflow platform for its network of 26 hospitals and clinics.

Huron Valley Physicians Association (MI) chooses e-MDs as a preferred EMR partner for its 700 members.

The OneBlood, Inc. (FL) blood center licenses Mediware’s HCLL Transfusion software.

The HealtheConnections RHIO (NY) selects Mirth’s HIE technology.


2-7-2013 6-42-28 PM

Rose Ann Laureto (UNC Health Care) is named CIO of ProMedica (OH).

2-7-2013 3-13-41 PM

Acusis promotes KB Anand to CEO.

2-7-2013 7-23-33 PM

Hearst Media extends the responsibilities of First Databank President Gregory Dorn, MD, MPH to deputy group head of Hearst Media, where he will oversee business-to-business services in the automotive, electronic, and finance industries along with the company’s healthcare brands MCG (the former Milliman Care Guidelines), First Databank, Zynx Health, and Map of Medicine. I interviewed him in September 2012.

2-7-2013 3-09-52 PM

Health Catalyst appoints John Haughom, MD (PeaceHealth) CMO and SVP.

AHIMA hires Deborah Green (LaVie Care) as EVP/COO and promotes Denise Froemming to EVP/CFO.

Announcements and Implementations

QuadraMed will offer Q-Matic’s self-service technology for managing patient flow through its enterprise Access Management suite.

2-6-2013 12-59-45 PM

EClinicalWorks will invest $25 million over the next year to enhance and expand its patient engagement tools in its healow business unit.

2-7-2013 3-27-44 PM

OSF HealthCare System goes live on sharing its seven-hospital Epic information with other participants in the Central Illinois HIE using ICA’s CareAlign exchange platform.

Cogdell Family Clinic (TX) implements scanning technology from EDCO Health Information Solutions to eliminate its paper-based medical records.

Truven Health Analytics launches HIE Advantage Analytics for the analysis of HIE utilization and population management.

ICSA announces a mobile app testing program to help enterprises determine if their supported apps are properly protecting sensitive data.

Government and Politics

CMS will develop a new records systems to facilitate quality reporting for long-term hospital care.

2-7-2013 7-44-38 PM

Good question. Adobe won a VA prize in 2010 for a slick Blue Button project using Adobe Air. It would be fun to revisit old announcements occasionally to see which turned out to be fluff, BS, or wishful thinking.

2-7-2013 8-07-30 PM

CHIME’s comments on ONC’s proposed patient safety plan emphasize that methods of matching patients to their data are inconsistent and a growing problem with HIEs, although it fell short of providing the obvious but politically deadly solution of a national patient identifier. CHIME also expressed concern that patient safety event data collection might take a lot of provider time and urged ONC to turn implementation of the patient safety plan to an organization that isn’t under direct government control.

ONC’s Farzad Mostashari throws down the gauntlet to the minority of EHR vendors that aren’t forthright in their pricing, that write unfair contracts, and that hold customer data hostage to prevent them from moving to another system, warning that if those vendors don’t step up, “We will go back to the regulatory process.”

2-7-2013 8-21-20 PM

Secretary of the Army John McHugh visits the National Center for Telehealth and Technology in Joint Base Lewis-McChord, WA. It offers video chat-based mental health consultations to soldiers in remote locations.

2-7-2013 9-32-21 PM

Senator Robert Menendez (D-NJ), new chair of the Senate Foreign Relations Committee, acknowledges that he tried to intervene in a billing dispute between CMS and his largest political donor, a Florida ophthalmologist who was ordered to replay $8.9 million for overbilling Medicare for an eye drug. The Senator, who also admitted to inappropriately using the doctor’s private jet, tried to convince CMS that the billing rules were confusing.


A national survey finds that the most-hated job in America, as scored by those holding the position, is IT director. Sales and marketing director came in at #2, product manager at #3, senior web develop #4, technical support analyst at #8, and marketing manager rounding out the list at #10. Companies should probably be concerned if their sales and marketing executives are that miserable.

AHRQ and CMS announce a new EHR format for children’s health that includes recommendations for child-specific data elements such as vaccines, prenatal and newborn screening tests, growth data, and child abuse reporting.

A study in Health Affairs finds that care costs averaged $88 less per episode when delivered via an online clinic versus traditional settings, with strong effectiveness indicators and a 98 percent “would recommend” consumer rating.

A county commissioner and Tea Party leader in Michigan casts the lone dissenting vote in considering the health department’s request for new Medicaid billing software, explaining, “My worry is that if it’s part of (electronic health records or EHR)—which is Obamacare. I’d like to make sure our information is not being collected. You’d be selling your health care and your liberty to Big Brother. We should make darn sure this is not part of the EHR system … I feel our records would be better off kept in private hands.” 

2-7-2013 6-06-57 PM

A KLAS report finds that ED physicians believe best-of-breed ED systems offer better clinical decision support, usability, and documentation accuracy compared to enterprise ED systems. The highest-ranked best-of-breed vendors are Wellsoft, Picis, T-System, and Medhost, while Epic takes the top spot among enterprise vendors.

2-7-2013 9-42-01 PM

The ECRI Institute Patient Safety Organization looks at HIT-related safety events, identifying five problem areas:

  • Inadequate data transfer between systems
  • Entering data on the wrong patient
  • Making data entry mistakes
  • HIT system bugs
  • Configuration errors

Security analysts find a vulnerability in Internet-connected devices manufactured by Honeywell that could allow hackers to take control of large-business environmental systems, some of which they identified as belonging to hospitals. Hacking the device could also provide direct access to a hospital’s network since they are often direct connected via Ethernet.

2-7-2013 9-02-36 PM

World-renowned Johns Hopkins neurosurgeon Ben Carson, MD (played by Cuba Gooding Jr. in 2009’s “Gifted Hands: The Ben Carson Story”) makes his fellow presenter President Obama squirm at the National Prayer Breakfast with his suggested alternatives to Obamacare: “We spend a lot of money on health care, twice as much per capita as anyone else in the world, and yet not very efficient. What can we do? Here’s my solution. When a person is born, give them a birth certificate, an electronic medical record, and a health savings account to which money can be contributed pre-tax from the time you’re born to the time you die.” He also said that the government is fiscally irresponsible and needs to place more emphasis on education.

Santa Clara Valley Medical Center (CA) is fined $100,000 after patient dies after going into cardiac arrest without receiving treatment for nine minutes. The patient’s monitor leads had become disconnected and the technician called for a nurse via overhead page at 1:27 a.m., but the nurse said she didn’t hear it. The hospital, thankfully, says it has developed a better way to notify nurses. Google tells me that Vocera’s headquarters building is less than two miles from the hospital in San Jose and the hospital is a Vocera customer, so that’s probably a much better solution than waking patients up with middle-of-the-night overhead pages that could be missed.

Twelve patients file suit against North Shore University Hospital (NY), claiming that medical records face sheets were stolen and their information used to file fraudulent tax returns, charge credit cards, and open cell phone accounts since 2010. The suit claims that a theft ring operated for more than a year, but patients weren’t notified.

The top 10 executives of non-profit Carolinas HealthCare System (NC) each earned more than $1 million in 2012, including $4.76 million for the CEO.

2-7-2013 6-50-03 PM

I was amused that Dr. Jayne uses the word “pop” below in referring to fizzy sugar water, which I know is a regional term since I’m fascinated by stuff like that (calling the midday meal “dinner,” referring to a rubber band as a “gumband,” declaring the side of the road to be a “berm” instead of a curb, etc.) Then I remember that there’s an Internet, meaning someone has devoted their very existence to studying the “pop” phenomenon, so that’s the graphic above. The yellow parts of the country call it “pop,” the blue say “soda,”and the purple refer to it generically as “Coke” (although my favorite is the unlisted variant I always heard from my Southern relatives, “Co-Cola.”)

2-7-2013 9-05-06 PM

Perhaps this OB-GYN shouldn’t have chastised her tardy patient on Facebook. The hospital has reprimanded her and is reviewing her posts after reports that some may have contained patient information. I would add that she should be reprimanded for starting a sentence with “so,” an appallingly lame and unnecessary verbal crutch that seems to be ubiquitous these days.

Sponsor Updates

  • SuccessEHS says it has doubled in size since January 2011 with the hiring of 295 new employees.
  • Surgical Information Systems demonstrates interoperability for each IHE profile at the 2013 IHE Connectathon.
  • Forbes recognizes iSirona, Kareo, and Ping Identity on its list of the country’s most promising privately-held, high-growth companies.
  • Levi, Ray & Shoup opens a branch office in Westchester, IL.
  • Elsevier launches the MEDalternatives database, which gives users access to drug cost savings options through access to information on alternative therapies.
  • Vocera donates its communication technology to MedShare (GA), a non-profit that recovers and redistributes surplus medical supplies and equipment to developing countries.
  • Access hosts a February 12 Webinar profiling Norman Regional Hospital (OK) and its use of Access products to advance paperless initiatives.

EPtalk by Dr. Jayne

HIMSS alert: For those of you who may be out cavorting with vendors or clients in the Big Easy, a recent study shows that mixing alcoholic drinks with diet pop may lead to higher blood alcohol levels than using regular pop. The study was small with only 16 participants and attributes the effect to diet pop moving more quickly through the stomach.

Speaking of vendors, clients, and cocktails: CMS released the final rule on the Sunshine Act this week. Starting March 2014, pharmaceutical and medical device must report payments to providers for consulting fees, honoraria, gifts, food, entertainment, travel, and charitable contributions. There will be a 45-day review period for physicians to ensure the accuracy of any information submitted. The rule is 287 pages long and it’s already been a long day, so anyone who wants to send me highlights is welcome. Instead of stale pickup lines accompanying offers to buy me a drink, I’m sure I can look forward to, “Hey baby, what’s your NPI?”

I’ve received lots of reader comments on my recent piece regarding hospital budget cuts and administrative ridiculousness. Some of my favorites:

  • “I thought it was bad when they stopped emptying our trash daily and told us all food-type trash needed to go to the kitchen and that if any varmints or bugs appear, each department would be charged for pest control.”
  • “They started vacuuming during the day because it is cheaper. So you are on conference calls or any type call and along comes the high-powered vacuuming. Also lights have been dimmed, so you practically need a flashlight.”
  • “My most ridiculous administrative experience occurred smack dab in the middle of the current recession. Senior management felt our product was so critical they decided to raise prices. I could only shake my head in amazement and easily forecast the impending carnage to come… and did it ever come! Our competitors had a field day as clients dropped us like a bad habit!

Keep the stories coming. I really do enjoy reading your comments and knowing that our hospital isn’t the only one that has totally lost its collective mind.

ICD-10 challenge: I had a patient present this morning with eye pain which she attributes to staying up all night reading Fifty Shades of Grey. The best part of the encounter was that my scribe had never heard of it, and watching his face as the patient tried to explain what the book was about was priceless. I guess I’m stuck with a nonspecific code for exposure to other specified factors. Any suggestions?



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

More news: HIStalk Practice, HIStalk Connect.

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February 7, 2013 News 8 Comments

News 2/6/13

February 5, 2013 News 7 Comments

Top News

2-5-2013 6-26-04 PM

Cerner announces Q4 results: revenue up 15 percent, EPS $0.67 vs. $0.55, beating estimates of $0.64. Shares rose five percent in after-hours trading Tuesday. The company’s market cap is $14.3 billion. From the earnings call:

  • Q4 bookings were just over $1 billion, a record
  • System sales were $252 million of the $710 million in revenue
  • Thirty percent of the bookings came from non-Millennium clients
  • The company says it had nearly double the number of new HIMSS EMRAM Stage 6/7 users as its closest competitor, presumably Epic
  • It claims that Epic is pushing back on Meaningful Use Stages 2 and beyond because it will be challenged to meet them
  • EVP Jeff Townsend said the industry needs to step up to the challenges of interoperability, including use of a patient identifier
  • The company says it thinks even Epic clients that have paid a lot of money can be convinced to change systems if their reimbursement is threatened due to quality problems
  • The company signed four deals worth $40 million or more, with the showcase being LA County
  • Neal Patterson said the market is really a choice between two companies, presumably Cerner and Epic
  • The company says 85 percent of its customer base has completed Stage 1 attestation

Reader Comments

2-5-2013 6-14-35 PM

From Mike Tomlin: “Re: Rich Goldberg. He is leaving McKesson/MED3OOO to run marketing for GE reseller Virtual OfficeWare.” Unconfirmed, but the source is good and his departure would not be surprising given McKesson’s recent acquisition of MED3OOO.

From Bean Enumerator: “Re: Brigham and Women’s CIO position. Not filled yet.” A reader reported on January 30 that Joe Schmitt was taking the job, but that was not verified. The opening remains posted.

2-5-2013 7-46-15 PM

From MedWreck: “Re: Innovation Institute. Color me skeptical.” St. Joseph Health (CA) launches for-profit The Innovation Institute that will include includes an incubator, shared services, and an investment portfolio. The primary motivator seems to be to commercialize the intellectual property of large academic medical centers. The only hospital member named is St. Joseph Health, which provided almost all the institute’s executives, including former St. Joseph Health SVP/CIO Larry Stofko, who will run the Innovation Lab. Larry let me know about the Institute’s formation last summer, at which time I mentioned it and his new job there.

2-5-2013 7-18-05 PM

From Incredulator: “Re: HIMSS e-mail blast. A customer forwarded this e-mail they received from a company pitching their HIMSS booth. Check out the last line.” It’s easy to doctor a forwarded e-mail, so I’ll assume that’s the case since surely the company whose identifiers I’ve blurred wouldn’t be stupid enough to end an otherwise button-down e-mail blast with a puzzling grand finale. Although if they did, I’ll be interested to see if they own up to it as either a horrific faux pas or an overly bold attention-getter.

HIStalk Announcements and Requests

We did a good interview with Vocera Chairman and CEO Bob Zollars on HIStalk Connect.

2-5-2013 10-02-06 PM

Welcome to new HIStalk Platinum Sponsor Cornerstone Advisors Group. The five-year-old Georgetown, CT-based professional services firm, in its own words, “provides high-value consulting, advisory, implementation, and staffing services to the healthcare delivery middle and lower market segments at a fair and reasonable price” around its core principles of partnership, integrity, commitment, and value (remember “value” because it’s coming up again). The company took the #1 spot in “Planning and Assessment” and #2 in “Vendor Selection” in the 2012 Best in KLAS awards, with its customers scoring it with a sweet 98.4 and 96.1, respectively, also giving Cornerstone stellar marks for value with a 9.0 in the all-important “Money’s Worth” score in both categories. Cornerstone’s leaders and associates are former Big Six consultants, CIOs, and physicians, and I notice that President and Founder Keith Ryan has a distinguished industry history on the front lines as VP/CIO of Stamford Health (CT) and Elmhurst Memorial Healthcare (IL) as well as having held executive positions with top consulting firms, not to mention that I notice he is an HIStalk Fan Club member, which carries a lot of weight (with me, anyway). I’ve seen the company’s revenue and FTE numbers by year and it’s a steep curve up, earning it a spot on the Inc. 5000 with 431 percent three-year growth. Some of its clients include HCA, William Backus, Chilton Memorial, and Finger Lakes. If you need help with advisory, implementation, or staffing services, consider giving Cornerstone Advisors Group a chance to earn your business. I appreciate their support.

Acquisitions, Funding, Business, and Stock

Oak Investment Partners invests $40 million in xG Health Solutions, an independently operated venture that will market intellectual property and expertise developed by Geisinger Health System, including healthcare IT optimization, consulting services, population health data analytics, and care management. We announced the news on January 11 when phony-named reader Jerry Aldini forwarded a copy of the internal announcement.

2-5-2013 6-25-23 PM

CTG acquires etrinity, a provider of IT services to the healthcare market in Belgium and the Netherlands.

2-5-2013 6-29-43 PM

Michael Dell will regain control of the fading company he founded as Dell announces plans to be taken private in a $24 billion leveraged buyout that also includes taking a loan from Microsoft. The company plans to move its focus from low-margin and low-demand PCs to enterprise services, which worked for IBM years ago as it moved away from hardware. That same strategy hasn’t done much for HP, which is now discussing breaking the company up in hopes of finding shareholder value hidden somewhere in its diverse offerings. The Dell change could be good for its healthcare consulting folks, most of whom were brought on board with its 2009 Perot acquisition that included the former JJ Wild.

Startup eLuminate Health announces plans to open its headquarters in Leawood, KS and create 200 jobs over the next five years. The company offers a network for imaging and surgical providers to provide transparent pricing, clinical quality, and customer satisfaction ratings for consumers (sounds pretty much like an Angie’s List for elective surgery). CEO Tami Hutchison came from Cerner, which you probably guessed given the company’s location and line of business.

Speech technology vendor Vestec raises $1.5 million in capital from V. Raman Kumar, founder and former CEO of MModal. The company offers a speech recognition engine and a Natural Language Understanding system, with a text-to-speech engine planned. The products seem to be small-vocabulary systems for specific voice commands for use in devices such as TVs, GPSs, and PBX-type setups, although Kumar says he’ll help the company move into healthcare.


CHRISTUS Continuing Care (TX) selects HEALTHCAREfirst’s homecare, hospice, and CPO solutions.

MDH Radiology chooses Sectra’s Breast Imaging PACS, Merge Healthcare’s CADstream, and other tools to create a national telemammography solution.

2-5-2013 3-17-22 PM

MD Anderson (TX) chooses Oracle Health Sciences applications  and Oracle technology for an organization-wide analytics initiative to develop personalized cancer treatments.

CMS awards Emdeon a contract to define the process for testing new HIPAA and ACA transaction standards.

Kentucky Medical Services Foundation and UK Healthcare sign a five-year agreement for Opportunity AnyWare, the business analytics platform from Streamline Health Solutions.

2-5-2013 3-19-19 PM

Kalispell Regional Medical Center (MT) selects EDCO Health Information Solutions for its day-forward scanning technology and services.

Middletown Community Health Center (NY) chooses EHR, PM, and EDR (dental) solutions from SuccessEHS for nine service locations and two mobile health units, announcing plans to go live within 90 days. 

2-5-2013 10-25-25 PM

Parkview Health (IN) selects ProVation Medical from Wolters Kluwer Health for gastroenterology procedure documentation and coding.


2-5-2013 7-04-20 PM

Kasey Fahey joins Direct Recruiters as project coordinator in its healthcare IT practice.

Announcements and Implementations

Covisint launches Covisint Healthcare, an integrated solution for analytics across multiple systems and stakeholders that includes enhanced data capture and reporting, real-time admission and discharge notifications, and patient outreach and scheduling.

2-5-2013 6-41-23 PM

Reading Hospital (PA) goes live on its $150 million Epic implementation.

Four hospitals of Bassett Healthcare Network (NY) go live with Epic.

LHP Hospital Group (TX) implements McKesson Paragon at five hospitals.

Cox Medical Center Branson (MO) completes activation of T-System’s PerformNext Care Continuity solution to facilitate patient transitions and improve communication and access to clinical data.

2-5-2013 6-50-48 PM

ZirMed launches Clinical Link, a nationwide provider-to-provider information exchange platform.

2-5-2013 6-53-53 PM

Awarepoint Corporation launches Bed and Bay Sensor for precise tracking of mobile equipment and patient and caregiver interactions in locations with tight bed spacing such as the ED and PACU.

Government and Politics

2-5-2013 6-46-11 PM

The VA solicits bids for a pilot program to test how advanced clinical reasoning and prediction systems can use its VistA patient data to improve care, efficiency, and outcomes.

Brian Ahier reports that a new federal law will be published this Friday that will require drug, device, and medical supply managers to publicly disclose gifts given to physicians or teaching hospitals. The Physician Payment Sunshine Act, part of the Affordable Care Act, charges HHS with collecting information about consulting fees, gifts, honoraria, food, entertainment, and travel from companies that are covered by any federal health program.

Innovation and Research

2-5-2013 2-53-03 PM

The Washington Post looks at the burgeoning field of geomedicine, which uses geographic information system technology to correlate environmental conditions with health risks. One example is an inhaler device from Asthmapolis that is equipped with Bluetooth to track when and where patients use their inhalers.

2-5-2013 7-28-35 PM

A Germany-based company develops an intelligent armchair that contains health-monitoring technology that constantly measures the health of its occupant, also displaying the user’s historical health measurements via a tablet PC to the TV using Bluetooth. A virtual health assistant uses the information to develop and monitor a personalizes health plan, for which the chair transforms into a rowing machine. The company plans to add mental games to encourage participation and increase alertness.

2-5-2013 8-39-58 PM

Fast Company covers the just-concluded MIT Health and Wellness Hackathon, which focuses on commercially viable products. Some of the entrants: an app that encourages HIV/AIDS patients to take their meds, a sensor-based home monitor for congestive heart failure, an endometriosis surgery app for patients, home Parkinson’s monitoring tools built into gloves and a coffee cup, a blood pressure pill bottle reminder, and a diet tracker for epileptics.


I don’t see the point of “pass a test, earn some paper” certifications like the ones offered by HIMSS and some for-profit companies, but this one really puzzles me. HIMSS introduces CAHIMS, designed for “emerging professionals” with less than five years’ experience in healthcare IT. I would be doing all I could to try to hide my newbie status on my resume rather than proudly waving around a paid-for certificate that boasts of my relative inexperience.

2-5-2013 8-26-50 PM

Baltimore-based startup Parallax Enterprises, founded by a physician who is also a military pilot and an Air Force major, raises $1 million to develop a heads-up display of surgical checklists. I’m intrigued that Jeff Woolford, MD has booked 1,000 hours in the single-seat, low-level combat A-10 Thunderbolt II tank killer, which is ugly, slow, low-tech, cheap, and scary as heck for the pilot but the most reassuring sight imaginable for ground troops, at least those on the same side. I’ve seen live exhibition flights of just about every modern-era US warplane and the A-10 was the most memorable. Hats off to Dr. Woolford for his service as a Wart Hog driver over Afghanistan.

Former HealthStream executive Luther Cale offers 33 Ways to Reboot Your Life, free on Amazon through midnight Wednesday. Judging from the “Look Inside” feature, you won’t get much out of it if you don’t believe in non-traditional medical techniques like spiritual psychotherapy and healing tonics.

Unverified rumors claim that Cerner and McKesson will open up interoperability between their systems to try to compete with the Epic juggernaut, with a potential announcement planned for the HIMSS conference. I’m skeptical that two large, publicly traded competing companies would agree to such cooperation, so if you have details, please share.

2-5-2013 9-12-13 PM

Seattle-based Carena launches its CareSimple program, offering Webcam-based virtual visits with one of its 15 physicians and nurse practitioners for limited conditions for a cost of $85 or for $5 with a family membership of $35 per month.

Texas Medicaid tries to revise its “pay and chase” policies after a TV station’s investigation finds that taxpayers were charged for $705 million over three years for orthodontics. The state is holding the payments of 91 dentists suspected of fraud.

Sponsor Updates

  • MedAssets pledges support to employees who serve in the National Guard and Army Reserve.
  • Chris Tackaberry, co-founder and CEO of Clinithink, shares details of how Clinithink came about and the challenges along the way in an interview. 
  • SimplifyMD reports that 100 percent of its customers choosing to file for MU attestation have completed the process.
  • The Advisory Board Company hosts senior policy makers on Capitol Hill to discuss efforts to improve care under new Medicare value payment programs.
  • Cerner will integrate Gateway EDI’s claims and remit systems with its PM solutions.


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

More news: HIStalk Practice, HIStalk Connect.

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February 5, 2013 News 7 Comments

Monday Morning Update 2/4/13

February 3, 2013 News 10 Comments

2-3-2013 8-45-21 AM

From HIStalk Fan: “Re: HITPC/HITSC testimony of Karen Van Wagner, executive director of North Texas Specialty Physicians. The Pioneer ACO shares results of its community HIE.” She talks about successful efforts to increase EMR usage (eCW, Allscripts, NextGen) and the results of the exchange (Sandlot Solutions), which was launched in 2006. She says traditional healthcare IT isn’t providing cost and quality improvements because it focuses on retrospective data, often from claims databases, and the optimal solution involves both retrospective and current clinical information. They did a discharge transitions project study that exceeded targets for PCP follow-up, having discharge summaries available for the follow-up PCP visit, and readmissions. Her specific recommendations to the government: (a) simplify consent and disclosure rules; (b) expedite adoption of IHE standards; (c) require laboratory diagnoses to delivered by LOINC standards; (d) require hospital EMRs to send a “just admitted” notice to community providers via their own EMRs; and (e) require pharmacy systems to communicate with HIEs and provide their information at no charge.

Hospitalist DZA MD left an insightful comment on my Time Capsule article about doctors getting lost in the barrage of generally useless information cluttering up EMRs. Excerpting:

Anything that is templated has exactly zero clinical information value to me. I don’t care if Osler himself dropped in “dyspnea improved,” “no diarrhea” … If I want to know the validity of that kind of thing, I will look at the narrative part of the nursing note … The only data I look at that actually represents signal is the vital signs and lab data. The rest of the discrete data is noise … The narrative and visual graphics (including graphic displays of lab and vital signs data) are for us (clinicians). The templated stuff is for the suits and insurance grifters. QED.

2-3-2013 9-27-06 AM

From The PACS Designer: “Re: Microsoft Office 365. Microsoft is making a dramatic switch by selling its enhanced Office products in the cloud. They are calling it Office + Office 365, and will be offering a monthly subscription service with pricing based on business size and features selected by the customer. It’s a big gamble on users satisfaction with cloud services which as we know can experience interruptions in service at inappropriate times of the business cycle.” The good thing about Office is that the once-touted Office killers, especially Google Apps, are vastly inferior flops. The bad thing is that home Office users aren’t likely to lock themselves into a $100 ongoing subscription for something they formerly bought or stole once, although it’s a pretty good deal if you have a bunch of PCs since the home license covers up to five (less likely now that everybody’s using iPads and phones instead of extra PCs). And, you can temporarily load and run it to a non-licensed PC. I think it can work – antivirus software moved subscription software for home users to the mainstream, not to mention that Microsoft can just jack up the price of the box version to move people toward the cloud-based offering,  which would also kill the bootleg business (possibly their primary motivation). It won’t help that Office 365 had an outage almost immediately after its launch, allowing the boxed software users to work merrily along while the leasers couldn’t even get to Outlook.

From Godzilla: “Re: [hospital name removed]. Filing suit against [vendor name removed]. Unhappy with the products, implementation, and project management.” A hospital media spokesperson replied on the record to my inquiry, “Nothing could be further from the truth. Inaccurate on all counts.”

From Unbeatable: “Re: [vendor name removed]. Laid off 31 developers and outsourced all work to India and the Ukraine. The Chicago office lost the largest number of staff.” I’ll see what I can find out.

From IndustryBnkr: “Re: OptumHealth. Rick Jelinek is leaving as CEO to pursue another opportunity outside the company, with Larry Renfro taking over.” Unverified, but his former “About Us” page has been deleted. He took the CEO job a year ago.

2-3-2013 9-52-42 AM

From HITEsq: “Re: MMR. Made good on its threats to sue someone for patent infringement in January, going after Walgreens. MMR’s theory is that displaying a list of your prescriptions infringes on its patents. I seem to remember having access on Walgreens before 2005 when the MMR patent was filed.” Patent trolls love the US system because (a) the Patent Office is overwhelmed, they don’t have the knowledge required to understand highly technical patent requests, and will approve just about anything and let the courts sort it out later; and (b) lawyers are so expensive that mounting a legal defense can bankrupt a defendant even when they are clearly right since our legal system requires the winner to pay their own legal costs. Unfortunately lawyers often morph into politicians and are predictably loathe to bite the hands (as inserted into the pockets of others) that once fed them and may again, so we are required to be collectively complacent about the status quo.

Speaking of despicable patent trolls, let us hear from our new hero, Lee Cheng, Newegg chief legal officer and extortionist squasher. 

2-3-2013 12-07-09 PM

In related patent troll news, billionaire bad boy Mark Cuban endows “The Mark Cuban Chair to Eliminate Stupid Patents” at the Electronic Frontier Foundation, which he funded because, “Dumbass patents are crushing small businesses. I have had multiple small companies I am an investor in have to fight or pay trolls for patents that were patently ridiculous.” Mentioned in the article is Acacia Research, which I’ve railed about here many times, which claims to own the process of sending medical images over the Internet.

2-3-2013 8-54-45 AM

Yale-New Haven Hospital (CT) went live with Epic on January 31. Above: Sue Fitzsimons, RN, PhD (SVP, patient services); James Staten (EVP, finance); Marna Borgstrom (CEO); Daniel Barchi (CIO, health system and medical school); Lisa Stump (VP, Epic project); Peter Herbert, MD (chief medical officer); and Richard D’Aquila (president and COO).

2-3-2013 8-59-17 AM

The stock-pickers among us like Cerner and athenahealth just about equally. New poll to your right: did you go to the HIMSS conference last year, and are you going this year?

Speaking of those stocks I listed, I decided to see how they’ve done in the past year: athenahealth (up 40 percent), Allscripts (down 45 percent), Quality Systems (down 57 percent), Cerner (up 34 percent), and Merge (down 49 percent).

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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2-3-2013 10-18-18 AM

Psychology scientists from Brigham and Women’s Hospital perform an interesting study in their research into “inattentional blindness.” Radiologists were asked to examine the CT scans of five patients and click on whichever of the 10 known nodules they could find. The final case included a gorilla image that was 50 times the size of the nodule, which 20 of the 24 radiologists did not notice even though eye-tracking instruments showed they had looked right at it. I don’t see this as necessarily bad – a lot of the work in medicine is tuning out the noise to focus on what you’re looking for. However, it does reinforce the idea that in general it’s good to get a second opinion from someone less focused on the problem at hand, and if you’re a patient or lesser expert, you still might detect the forest that the tree-obsessed people have missed. It may also touch on confirmational bias, where people tend to place higher value on information that matches what they already believe (like brains not containing gorillas).

A New York Times op-ed piece observes a “casual lack of transparency” in that drug and device companies make sure that only positive studies are published, with the trigger being Johnson & Johnson’s recalled artificial hip that was marketed despite known problems that the public wasn’t told about. It observes two attempted fixes that have failed: (a) the FDA requires new clinical trials to have summaries posted on a federal site, but an audit found that 80 percent of the trials ignored the requirement and no fines have been levied; and (b) the medical journal industry promised to publish only pre-registered studies, but an audit found that more than half of published articles involved trials that weren’t registered correctly and one-fourth covered studies that weren’t registered at all.

2-3-2013 12-10-37 PM

Good luck explaining healthcare pricing to the public. A graduate student’s gallbladder removal was billed at $60,000 by an out-of-network provider. His insurance paid what it defined as a reasonable rate: $2,000. The average commercial price is $12,292, while Medicare would have paid $958. An advocacy group stepped in and the surgeon accepted $340. The article says the Affordable Care Act does nothing to limit out-of-network fees, which are almost always a surprise to patients since buildings and white coats don’t come with “I’m in your network” labels. I’ve known people burned by in-network EDs that used out-of-network doctors or lab companies, and of course nobody volunteered that information, not that you really have a choice in the ED anyway. The comments left on the New York Times article are fascinating and often insightful. The graphic above is from a new AHIP report.

A foundation employee of Fairbanks Memorial Hospital (AK) is charged with diverting $12,000 in donations that had been collected online via PayPal.

GE Healthcare is working with the VA to develop surgical robots that can locate, sterilize, and deliver instruments.  

2-3-2013 12-03-36 PM

Meditech files its annual report. For the year, revenue was up 9.7 percent, EPS $3.55 vs. $3.41. Neil Pappalardo owns nearly 39 percent of the company, holding shares worth around $650 million. CEO Howard Messing’s shares are valued at around $18 million. Share values are probably low given that the company is not publicly traded – I just used the most recent per-share acquisition price, but if the company were to be sold or IPO’d, the value would probably be a lot higher.

Nuggets from the McKesson earnings conference call late last week:

  • Technology Solutions revenue was flat
  • Margins of the Technology Solutions numbers was hurt by a required revenue recognition change for the System C UK business McKesson acquired in 2012
  • RelayHealth and the payor software business contributed more than half of the profits of Technology Solutions
  • More legacy customers than expected have either already moved to Paragon or have committed to do so instead of moving to competitor systems
  • The Paragon ED solution is close to being generally available
  • Both Horizon and Paragon will support Meaningful Use Stages 2 and 3


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

More news: HIStalk Practice, HIStalk Connect.

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February 3, 2013 News 10 Comments

News 2/1/13

January 31, 2013 News 9 Comments

Top News

1-31-2013 5-38-58 PM

McKesson announces Q3 results: revenue up one percent, non-GAAP EPS $1.41 vs. $1.40, missing earnings expectations of $1.63 and guiding earnings slightly down for FY2013. Operating costs rose 10 percent, while technology solutions revenues were flat.

Reader Comments

1-31-2013 7-52-02 PM

From AphexTwin: “Re: Allscripts. Laid off five percent of its workforce (350 people) in testing and development roles. All remote development staff are being forced to relocate or be terminated.” An Allscripts spokesperson provided this response:

We internally announced the creation of R&D Centers of Excellence to enable us to better serve our clients, reduce complexity, and save costs. By making this move, we’re aligning with industry best practice and will be more agile in delivering results for our clients. Many team members will have the opportunity to relocate and some to work remotely. Unfortunately, there will be some team members whose positions will be adversely impacted, and they will be offered a severance package. In addition, we anticipate there will be Development jobs created in the North American locations with the majority of those in our Raleigh and Boston locations.

1-31-2013 7-59-22 PM

From The PACS Designer: “Re: iPad with Retina display. Apple keeps making the iPad more brilliant and powerful with the announcement of the iPad with Retina display. This new version also has 128GB of storage and a selling price of $799. The communications options now include both Wi-Fi and iPad with Wi-Fi+ Cellular as added features.”

HIStalk Announcements and Requests

1-31-2013 1-31-00 PM

Highlights from HIStalk Practice this week include: Epic, Allscripts, and eClinicalWorks accounted for 42 percent of all EP MU attestations through October, 2012. iPractice Group confirms that it has ceased operations. AMGA says it now represents 430 group practices and 130,000 FTE physicians. The HIStalk Practice Advisory Panel shares details of their practices’ social media policies and privacy and security measures. As always, thanks for reading.

On the Jobs Board: Director of Marketing, Epic Experienced Providers, Product Marketing Manager.

January, which isn’t quite over yet as I write this, will set an HIStalk record for the most monthly visits ever at 140,000, up 25 percent over January 2012.

1-31-2013 5-58-58 PM

Welcome to new HIStalk Platinum Sponsor VitalWare, a market leader in healthcare intelligence and regulatory compliance. The Yakima, WA company’s offerings include VitalView (ICD-10 planning and status between hospitals and vendors), VitalSigns (supports real-time retrospective coding to ICD-10 for starting efforts now to estimate impact on reimbursement and cash flow), VitalCoder (next-generation coding and revenue cycle resource), the just-announced CDM Navigator (charge master maintenance), and ICD-10 consulting and implementation. The company also offers VitalVendors, a vendor ICD-10 readiness rating system that’s part of the HIMSS ICD-10 Playbook. A guest post by Founder and CEO Kerry Martin provides a sobering update on the stage of vendor readiness for the October 1, 2014 ICD-10 compliance date. Thanks to VitalWare for supporting HIStalk, which thanks to its support will be fully ICD-10 ready.

Acquisitions, Funding, Business, and Stock

CommVault announces Q3 numbers: revenue up 24 percent, non-GAAP EPS $0.39 vs. 0.27.

Aetna announces Q4 numbers: revenue up 16 percent, EPS $0.56 vs. $1.02.

1-31-2013 7-53-01 PM

CPSI announces Q4 results: revenue up 14 percent, EPS $0.83 vs. $0.59, falling short of consensus estimates of $0.88. Shares are down nearly nine percent in after-hours trading.


1-31-2013 5-09-37 PM

Wenatchee Valley Medical Center (WA) and Central Washington Hospital select NextGate’s EMPI and provider registry systems.

Huron Valley Physicians Association (MI) chooses eClinicalWorks EHR for its 600 providers.


1-31-2013 5-11-06 PM

AHRQ Director Carolyn Clancy, MD announces plans to step down.

1-31-2013 5-20-26 PM

API Healthcare expands General Counsel Hayden Creque’s role to include vice president of human resources.

Announcements and Implementations

The VA completes integration and testing between VistA and Authentidate’s Electronic House Call and Interactive Voice Response telehealth systems.

1-31-2013 5-12-14 PM

The 24-bed Melissa Memorial Hospital (CO) completes implementation of its EMR.

1-31-2013 5-14-12 PM

Piedmont Newnan Hospital (GA) goes live this week on Epic.

Welch Allyn will distribute the EarlySense proactive patient care solutions to US hospitals.

1-31-2013 3-28-53 PM

Good Samaritan Hospital (NY) goes live on Epic March 9.

1-31-2013 3-30-19 PM

The University of California at Irvine uses the dbMotion interoperability platform to connect with  the Orange County Partnership RHIO.

Quantum Health integrates the Healthwise Care Management Solution into its Patient Information Virtual Integration Tool to provide real-time healthcare education to its members.

Stellaris Health Network (NY) goes live on PatientKeeper Charge Capture at five of its clinical practices group.


Government and Politics

The VA enhances Blue Button to give patients access to their Continuity of Care Document and the VA’s OpenNotes provider documentation.

Innovation and Research

1-31-2013 7-31-36 PM

A University of Washington graduate student develops FoneAstra, an Android phone app that monitors the pasteurization of donated breast milk. It’s being tested in South Africa. Other versions are used to ensure that vaccines remain refrigerated in developing countries.


1-31-2013 7-54-51 PM

Lt. Dan summarizes what the BlackBerry10 announcement means for mHealth and healthcare on HIStalk Connect.

University of Missouri-Kansas City’s Innovation Center will launch the partially federally funded Digital Sandbox KC IT accelerator on Friday, with officials from Cerner and other businesses on hand.


Fifty-seven percent of Canada’s primary care physicians are using EMRs, which is almost double 2006’s adoption rate. Almost half routinely e-prescribe compared to 11 percent six years ago.

KLAS and EHI, a UK-based HIT research firm, partner to improve transparency and performance measures for the UK health technology market and to cross-market their research products.

Michael Dell’s family foundation donates $50 million to build Dell Medical School in Austin, TX.

The Minnesota Supreme Court rules that calling a doctor “a real tool” on a doctor rating site is protected speech.

1-31-2013 6-54-01 PM

Here’s an example of how technologically backward healthcare is. A body shop in Canada has been receiving faxed medical information for three years because its fax number is one digit different from that of the local health center. Says the body show owner, “In this day and age, why are they still using fax machines? It seems odd to me.”

I’m fascinated that this happens regularly in India. Twelve angry relatives of a teen who died after a bicycle accident trash the ICU and beat doctors and security guards. Medical residents then go on strike to demand better security and the arrest of the family members, which requires patients to be diverted and surgeries to be cancelled when only 20 doctors remain to care for 300 inpatients.

WNA thinks a hospital parody video makes him wonder whether ACO stands for Abridged Care Organization. Fox Business News says the video “mocks how health reform can make more money for doctors and hospitals” by showing staff blocking the admissions department door, handing out stacks of cash, and giving free laptops to employees. I didn’t see it that way – it looked like fun way to get the ACO idea across to otherwise learning-indifferent employees. The hospital says the video was a contest winner. Fox claims the video was “leaked,” which apparently means “posted to YouTube under the hospital’s name and still there but copied to Fox’s servers and covered with self-promoting graphics to make it look like the result of crack investigative reporting.”

Sponsor Updates

  • ESD joins ANIA as a Gold Level member.
  • dbMotion hosts a February 7 seminar in Dallas on connecting communities through clinical integration.
  • Laura DeBusk from White Plume Technologies will co-present an ICD-10 session at the Becker’s Hospital Review Fourth Annual Meeting in Chicago in May.
  • 2012 highlights for Aspen Advisors include the addition of 26 clients and the development and deployment of a population HIT planning methodology, a data governance maturity model, and an EHR value realization maturity model.
  • DynaMed showcases how Memorial Hermann Healthcare System (TX) utilizes technology to allow physicians to practice evidence-based medicine in a journal article.
  • Emdat Mobile usage has quadrupled from January 2012 with the rapid adoption of smartphones.
  • Lucca Consulting Group posts new client, consultant, and trainer testimonials on it website.
  • Macadamian CEO Frederic Boulanger says he is impressed with the new BlackBerry 10 and the company has developed 10 apps for it.
  • Truven Health Analytics announces that staff members Eboney White and Jillian Thomas have been presented with the unique credential of Accredited Health Care Fraud Investigator.
  • CareTech Solutions added five Service Desk clients in 2012 and experienced a 75 percent uptick in the use of its help desk services overall.

EPtalk by Dr. Jayne

Earlier this month, Virginia Senator Stephen J. Martin introduced SB 1275, “Medical data in an electronic or digital format; limitations on use, storage, sharing, & processing.” As a medical informaticist, all I can ask is what was he thinking? It would prohibit anyone who stores medical data in an electronic or digital format from participating in the Nationwide Health Information Network; performing analysis or statistical processing on medical records for purposes of diagnosis or treatment, including population health management; processing medical data within Virginia where a majority of the patients do not live in Virginia; and storing data on more than 10,000 patients in a single database, It also prevents providers who refuse to implement EHRs from being penalized and prohibits Virginia from authorizing or operating a health information exchange. I’d be interested to hear from anyone in Virginia who can tell us more about what’s really behind this besides anti-ARRA posturing. It’s been sent to committee where it will likely die, but still makes for good cocktail party conversation (at least among HIT folks).

It’s about time: Medicare will look at the facility fees charged by ambulatory medical practices. Many feel that these hospital-owned practices are driving up the cost of health are with this billing practice. Many of the groups in my area are now doing this. It’s not only annoying, but also feels dishonest.

Lots of buzz this week about the HIPAA update and the impending September compliance date. Looking forward to reading hundreds of pages of fun during my free time, whenever that is.

Although I thankfully don’t have any direct reports, before our recent hiring freeze I was often asked to interview potential employees for other managers. I’m going to keep this list of bizarre interview questions tucked away for when administration figures out we’re dangerously short-handed on some of our teams.


Bad news for Inga: an increasing number of young women are having issues with their feet that require surgery. Some blame is being placed on genetics, but the phenomenon is at least partially attributed to high heels and pointy-toed shoes. She’s always telling me I’m too conservative in the shoe department, so maybe for HIStalkapalooza I’ll be more inspired this year.



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

More news: HIStalk Practice, HIStalk Connect.

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January 31, 2013 News 9 Comments

News 1/30/13

January 29, 2013 News 10 Comments

Top News

1-29-2013 6-31-49 PM

Medecision, which just announced plans to lay off 83 employees, acquires Cerecons, a provider of care coordination, population management, and quality outcomes and reporting applications for ACOs.

Reader Comments

1-29-2013 7-10-48 PM

From Greenway Rep: “Re: iPractice Group. During the last few days, we did learn that iPractice Group, one of Greenway’s resellers, ceased operations effective last Friday, January 25. This reseller represents a very small percentage of our provider base. We look forward to continue working with these sites, which will have the option to either transition to another Greenway partner or choose to work directly with us for implementation and/or support services.” Greenway confirmed that iPractice Group has ceased operations, as reported by reader Nasty Parts this past weekend. The company claimed to have almost 1,000 provider clients, so the impact to Greenway remains to be seen. The CEO of the three-year-old iPractice blamed its closure on poor Q4 sales. The company moved into a new headquarters building in October 2012 that was more than triple the size of its former location, increased headcount by 800 percent to 70 employees since 2011, and acquired a competitor in 2011. Greg Bolan, who runs the healthcare equity research arm of brokerage firm Stern Agee, credited HIStalk with the initial rumor in an investor flash note, also expressing concern about the impact on Greenway’s sales. Greenway was among the ten biggest percentage decliners on the NYSE Tuesday, with shares dropping 7.7 percent.

From Tom: “Re: [inpatient vendor name omitted]. Is laying off 75 percent of its staff. All IT staff gone, most implementation and some development staff gone.” Unverified, so I’ve left the vendor’s name off for now. Usually someone leaves a comment saying, “Yep, that’s my company and it’s true,” so we’ll see.

1-29-2013 9-52-49 PM

From Mrs. Te’o: “Re:  Joe Schmitt, previous CIO of Steward Health Care. Will be named new CIO of Brigham and Women’s.” Unverified, but the forwarded second-hand e-mail insists that’s the case.

1-29-2013 8-11-15 PM

From CIO Tracker: “Re: Barry Blumenfeld, MD, MS. Leaving as SVP/CIO of MaineHealth less than 60 days after bringing Epic live at the main hospital. The planned rollout to seven member hospitals is being pushed back while the main hospital consumes all resources. The CIO is a casualty of exceptionally wide scope without commensurate resources.” CIO Tracker provided a genuine-looking memo purporting to be Barry’s notice to staff that he’s leaving as of January 30, but I’ve heard that he actually left early. They’re looking for an interim CIO, rumors say.

From The Amish Avenger: “Re: GE/IDX. I want to pare back its use for scheduling and registration and use the EMR instead. I keep hearing that GE/IDX isn’t selling well and has had job cutbacks. What can I expect to see? Fewer code updates? Less support?” I’ll step aside and let readers chime in.

1-29-2013 7-29-58 PM

From Danbury Whaler: “Re: Norwalk Hospital. Getting swallowed up by Western Connecticut Health System. Rumored layoffs of 200+.” Norwalk signed the affiliation agreement last week. Layoffs weren’t mentioned, but are certainly likely.

HIStalk Announcements and Requests

1-29-2013 7-02-37 PM

The window for expressing interest in attending HIStalkapalooza is closing. Sign up now if you’re interested in a March 4 evening of food, drink, HISsies, bowling, and Zydeco music.

1-29-2013 7-53-01 PM

Welcome to new HIStalk Platinum Sponsor Dearborn Advisors, LLC. The Chicago-area professional services firm, founded in 2001, is a trusted advisor to clients who need help with clinical systems strategy, adoption, and deployment. Its services fall into three groups: strategy and value, clinical, and engagement and project management. All of those help clients maximize the return on investment of their clinical systems. The company’s consultants are experts in Allscripts, Cerner, Epic, GE, McKesson, Meditech, and NextGen, while the company maintains a close working relationship with Epic and Meditech. I’m impressed by the quality of their blog posts, such as this one on medication management. You surely know some of their executive team members if you’ve been around the industry for a while: Rick Mager, Jay Toole, Sally Akers, Bruce Bowers, John Brill, and quite a few more highly experienced people, with a significant number of them clinicians. Thanks to Dearborn Advisors for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

1-29-2013 6-32-50 PM

Intuitive Health, which offers a platform that connects providers with at-home patients and their personal health devices, raises $3.8 million.

Informatica’s Q4 results: revenues up three percent; non-GAAP EPS of $0.41, down from $0.47 last year. The consensus EPS estimate was $0.37.

Roper Industries announces Q4 results: revenue up 10 percent, EPS $1.44 vs. $1.23, beating expectations on earnings while falling short on revenue. Chairman, President, and CEO Brian Jellison said the integration of Sunquest, which the company acquired this past summer, is on track, with Sunquest being a strong performer with high single-digit growth. The company’s CFO did note in explaining a tax rate adjustment, “Sunquest as a US-based company generates most of their earnings in the United States, which is the highest tax rate in the world.”

1-29-2013 10-06-41 PM

Lexmark announces Q4 results: revenue down nine percent, EPS $0.10 vs. $0.94. Its Perceptive Software unit was the bright spot, reporting revenue that increased by 40 percent over 2011.

1-29-2013 9-40-18 PM

Startup Ringadoc, which offers after-hours triaging of physician calls for $50 per month with no contract, raises $1.2 million in seed funding. I believe that’s a reflector thingy in its logo.

Philips announces that it will exit the consumer audio and video business to focus on home appliances and healthcare.

1-29-2013 10-08-03 PM

Margo Hendrickson, athenahealth VP of human resources, responded to our query about the company’s announced plans to lay off 36 employees of its Birmingham, AL office on March 6. That office is the site of the former care coordination platform vendor Proxsys that athenahealth acquired in July 2011:

“As a high growth company, we are always looking to apply efficiencies to the way we work. While it is incredibly difficult to let people go from what otherwise is a growing employee base, our intent and commitment to shareholders is to align investment with business growth opportunities. This focused set of employee restructuring will allow us to achieve several critical business scaling and financial objectives that otherwise we would struggle to meet. At athenahealth, we are committed to ongoing team growth; in the past year alone the Company has grown its US employee base 28 percent, adding a total of 473 new employees to its US total of 2,140.”


1-29-2013 2-55-23 PM

Sidra Medical and Research Center in Qatar selects Amcom’s emergency notification and call center solution and Omnicell’s G4 automated medication management system.

1-29-2013 6-34-33 PM

Scripps Health (CA) will implement Wolters Kluwer Health’s ProVation Order Sets software as its electronic order set solution.

Pioneer Medical Group (CA) signs an agreement with McKesson’s MED3OOO division to jointly own and operate an advanced management services joint venture.

1-29-2013 3-03-12 PM

Holyoke Medical Center (MA) expands its relationship with eClinicalWorks to include the eCW Care Coordination Medical Record for advancing ACO and PCMH objectives.

1-29-2013 3-04-18 PM

University of Virginia Health System will deploy MModal Fluency Direct and MModal Catalyst for Quality to speech enable its EHR systems.


1-29-2013 3-06-17 PM

HealthTech Holdings hires Tom Mitchell (MModal) as VP of marketing for its HMS, MEDHOST, and PatientLogic companies.

1-29-2013 3-15-34 PM  1-29-2013 10-26-32 AM

HIMSS recognizes James L. Holly, MD (UT Health Science Center) with its 2012 Physician IT Leadership Award and Robin S. Raiford (The Advisory Board Company) with its 2012 Nursing Informatics Leadership Award.

1-29-2013 6-39-08 PM

MedAssets appoints Keith L. Thurgood (US Army Reserve) president of its Spend and Clinical Resource management segment.

1-29-2013 3-22-52 PM  1-29-2013 3-24-36 PM

Streamline Health adds  Richard D. Nelli (OptumInsight) as SVP/CTO and Herb Larsen (Edifecs) as SVP of client services. Streamline also announces the resignation of SVP/COO Gary Winzenread.

1-29-2013 3-26-59 PM    1-29-2013 3-31-53 PM

HL7 appoints Joyce Sensmeier (HIMSS) and Walter Suarez, MD (Kaiser Permanente) to its advisory council.

1-29-2013 8-35-45 PM

Randy Gaboriault, VP/CIO of Christiana Care Health System (DE), is named by Computerworld as a 2013 Premier 100 IT Leader.

Former Barnabas Health (NJ) SVP/CIO Joseph Sullivan is named “client in residence” by management print services vendor Auxilio.

Announcements and Implementations

1-29-2013 3-33-16 PM

CPSI announces the formation of TruBridge, LLC, a wholly-owned subsidiary that will provide business services, consulting services, and managed IT services to rural and community healthcare organizations.

Intelligence InSites announces integration of its real-time intelligence platform with ScheduleAnywhere, an online employee scheduling software from Atlas Business Solutions.

1-29-2013 10-00-13 PM

Gottlieb Memorial Hospital (IL), part of Loyola University Health System, goes live with Epic.

TriZetto announces that BCBS of Tennessee is using its benefits solution to offer value-based insurance benefits to members.

Government and Politics

ONC publishes research to help providers putting HIEs in place, including findings on query-based exchange, HIE-driven notifications and subscription services, provider directory solutions, master data management, and consumer engagement and consumer-mediated exchange.

The operator of the leading cord blood bank settles FTC charges that it lacked policies and procedures to protect patient information in a 2010 breach involving unencrypted computer equipment stolen from an employee’s car containing the information of 298,000 patients. The company avoided a financial penalties by agreeing to improve IT security and to conduct a security audit every other year.


1-29-2013 10-09-18 PM

State auditors cite University of Iowa Hospitals and Clinics for not encrypting laptops. The hospital responded by saying it encrypts “where technically possible,” but the state official refused to back down, saying, “If it’s not technically possible, then they need to tweak the system a bit so that it is technically possible.”


1-29-2013 7-41-27 PM

This patent troll story doesn’t involve healthcare, but it provides a good lesson. A fake company set up by a lawyer who bought some old patents and created a business based entirely on suing big companies for infringing on its claimed patent on online shopping carts finally gets its butt kicked, courtesy of online retailer Newegg. The company had shaken down big online retailers, demanding a percentage of annual revenues. Victoria’s Secret and Avon had already been ordered to pay $18 million and one percent of their annual online revenue, while Amazon had paid the patent troll an amazing $40 million. Newegg, which has vowed that it will never settle with a patent troll, successfully had the company’s patents invalidated on appeal. You have to admire Lee Cheng, Newegg’s chief legal officer (above):

”We basically took a look at this situation and said, ‘This is bullshit.’ We saw that if we paid off this patent holder, we’d have to pay off every patent holder this same amount. This is the first case we took all the way to trial. And now, nobody has to pay Soverain jack squat for these patents … Just think about the dynamic if you’re a juror … Everyone wants to go home. It’s not their money. Defense oriented jurors are more likely to compromise and say, ‘Maybe we’ll just split the baby. Maybe we’ll just give them $2.5 million and call it a day.’ … We’re competing with other economies that are not burdened with this type of litigation. China doesn’t have this, South Korea doesn’t have this, Europe doesn’t have this. Just in our experience, we’ve been hit by companies that claim to own the drop-down menu, or a search box, or Web navigation. In fact, I think there’s at least four that claim to ‘own’ some part of a search box … Then they pop up and say, ‘Hello, surprise! Give us your money or we will shut you down!’ Screw them. Seriously, screw them. You can quote me on that.”

1-29-2013 10-02-19 PM

Guam Memorial Hospital says a software bug introduced by its vendor NTT Data caused it to underbill drugs by $1.9 million since May 2012. It found the problem as part of a financial improvement initiative and says NTT Data has confirmed and fixed the bug.

Zoll Medical says it’s the first defibrillator vendor to promise that it will share patient data from its devices, providing tools that allow other vendors to share the information it collects for patient care, such as in emergency medicine.

A small town in Australia loses its Internet connectivity for the third or fourth time in a month, with some of the previous outages having lasted days. Merchants can’t charge credit cards, but the medical clinic brings up more pressing problems: “We receive all our pathology results, specialist letters and discharge summaries through the Internet. If a patient comes to us needing treatment after they have just been discharged from hospital and we don’t know what they need or what they’ve had done, that’s a real problem.”

HIT incubator Rock Health rolls out a single online employment and internship form for applying to work at any of its 49 portfolio companies.

Weird News Andy finds this story amazing: researchers at Texas Heart Institute are building replacement human hearts from pig hearts, saying animal organs “reanimated” with human stem cells can be used in emergencies. The lead scientist also predicts being able to reverse aging at some point, storing stem cells from patients while they’re healthy as replacements for when they aren’t. She says she’s regularly called Dr. Frankenstein.

Sponsor Updates

  • Intellect Resources offers tips for job seekers hoping to get the attention of online recruiters.
  • Infor Healthcare and NTT DATA host a February 13 webinar to discuss Lawson Financials and the effective interaction between legacy and new technology systems.
  • CommVault announces details of its fifth annual WTG Customer Seminar March 13 in Boston.
  • Truven Health Analytics hosts a January 31 Webinar highlighting coverage challenges under the ACA.
  • First Databank releases the FDB State and Federal Controlled Substances Module, which facilitates the e-prescribing, dispensing, tracking, reporting, and claims processing of controlled substances.
  • Vitera Healthcare Solutions will give practices using its Vitera Stat PM/EHR product access to DiagnosisOne’s CDS content and patient education materials at the point of care.


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

More news: HIStalk Practice, HIStalk Connect.

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January 29, 2013 News 10 Comments

Monday Morning Update 1/28/13

January 26, 2013 News 12 Comments

1-25-2013 2-09-37 PM

From Optumized: “Re: Optum’s acquisition of Humedica. Confirmed by Lazard Capital Markets.” I appreciate that the update from Steven Halper, managing director of equity research, credited HIStalk as the original source (as I, in turn, should thank Embers and another couple of readers who tipped me off). A Boston Business Journal article says the acquisition is valued by an insider in the hundreds of million dollars. I interviewed Humedica President and CEO Michael Weintraub a year ago. I notice that the Boston paper is getting credit for breaking the news with its Friday afternoon article even though I ran and confirmed it Tuesday evening with the help of readers.

From False Positive: “Re: Farzad’s rebuttal that talks about ‘cynical critics.’ Who are they? How does he know that they don’t like paper?” The cynical critics, at least those constantly seeking attention, are easy to spot because they sing only one loud and sustained note. When I read an emotional, overwrought restaurant review on Yelp, I always click that person’s profile to see if they have a mix of positive and negative reviews and ignore them if not. Likewise, I twit filter the monotonic EMR whiners and cheerleaders alike, placing a lot more value on the 80 percent who don’t flaunt their blinders publicly. Farzad was right about the RAND study – they said their original projections about EMR savings were wrong because EMR adoption was less than expected and payment incentives are still screwed up. The job of EMRs is to support reform, not to create it. He’s also right that those cynical critics haven’t written smug and pedantic articles extolling the virtues of paper medical records, so they’re leaving us to breathlessly anticipate their suggested alternative. And if they’re intentionally avoiding EMR-using doctors and hospitals for their own care, they aren’t blowing that horn either. What they should be criticizing is the healthcare system that created the current batch of EMRs that conform precisely to its ridiculousness.

1-25-2013 3-41-10 PM

From The PACS Designer: “Re: TPD’s List. The recent update of TPD’s List of iPhone Apps that added a HIStalk Sponsors section has created new interest amongst them to recognize their iPhone apps. Vitera informed us about an app (above) that provides healthcare providers access to their Intergy EHR solution enabling anytime, anywhere access to schedules, tasks, patient records, and e-prescribing. Humetrix alerted us to several iBlueButton apps they developed with HHS. These new apps will be added to the next TPD’s List update.”

From Ear-Ground Continuum: “Re: MEDecision. Huge downsizing – they let 83 people go last month with another round this week and next.” Unverified. Recent comments on Glassdoor are certainly interesting. UPDATE: Verified by a reader’s link.

From Nasty Parts: “Re: Greenway reseller iPractice Group. Closed its doors today. Sources say cash flow problems despite strong sales, so the board pulled the plug.” Unverified. I e-mailed the company but haven’t heard back.

1-26-2013 11-44-38 AM

Speaking of the RAND study, more readers think it was naïve rather than biased (and yes, RAND should be capitalized, at least if you buy the idea that it’s OK to make up acronyms solely to create a conveniently pronounceable word, in this case Research ANd Development.) Anyway, new poll to your right: if you had to buy a vendor’s stock, which of the five listed would you choose?

Several readers (me included) expressed an interest in hearing more from Robert D. Lafsky, MD, whose guest articles always contain an impressive mix of medical knowledge, wry cynicism, and grammatical excellence (he always e-mails me when he finds my mistakes, and the threat of incurring his gentle wrath caused me to double-check the spelling of RAND). He has agreed to elevation to regular contributor under the nameplate The Skeptical Convert, with his first installment running this weekend.

Here’s a new Spotify playlist of what I’m listening to: new Aaron Neville, The Cardigans, 4 Non Blondes, Alabama Shakes, Imperial Teen, and a few more.

1-25-2013 5-25-24 PM

Welcome to new HIStalk Platinum sponsor The McHenry Group, an executive search firm focused entirely on the healthcare software and services vendor market. TMG’s team of search consultants averages more than 11 years with the company, having placed over 2,000 candidates since 1991. TMG has developed the industry’s largest candidate database of hard-to-find talent, including the hidden candidate market. The company conducts videoconference interviews with every candidate and forwards the videos of the strongest to the client for their review which moves things along faster and gives a better fit, enabling TMG to offer an extra-long 12-month replacement guarantee. TMG has filled positions for CEO, COO, CMO, CMIO, SVP, business development, sales VP, and informatics roles for companies such as RelayHealth, McKesson, Orion Health, and Health Language. They have conducted searches across the entire US as well as for non-US companies building their US operations. Featured business development stars are experts in clinical software, Meaningful Use, and payor technology, while project manager and implementation candidates are available in EMR, multi-hospital implementations, and client services. TMG provides well-screened candidates, ethical search consultants, and a promise to understand the client’s business needs. Thanks to The McHenry Group for supporting HIStalk.

Athenahealth files notice with the State of Alabama that it will lay off 36 employees at its Birmingham office on March 6. The company has not announced what types of workers are affected, although Birmingham was the location of Proxsys, the care coordination systems vendor athenahealth acquired in 2011 to boost its athenaCoordinator product.

Compuware turns down the $2.3 billion buyout offer of Elliott Management Corp and says it will instead spin off Covisint as originally planned.

1-25-2013 2-34-11 PM

Weird News Andy says this is better than die-alysis. A kidney patient in China who can’t afford dialysis treatments has lived for 13 years so far by dialyzing himself three times each week using a machine he built from kitchen tools and old medical equipment. He recently declined the Chinese government’s offer of free dialysis that was extended after his story was picked up worldwide, saying the hospitals are too far away and too crowded. He’s not worried that two of his friends died after trying a similar setup.

WNA also likes the RP-VITA iPad-controlled medical robot that just received FDA approval.

Farzad Mostashari can bask in the knowledge that he’s a big enough name to be featured in a CAP News parody (it’s like The Onion, but not as well done). I think they probably chose him randomly for the article Toilet Sizes Expand to Meet Needs of Obese Nation, quoting him in describing a new HHS standard called “Ass Cheek/Toilet Seat Ratio.”

1-26-2013 8-51-03 AM

Gartner says Big Data has reached the Trough of Disillusionment stage of its ingenious Hype Cycle, of which I’ve been a long-time fan. If the author is correct – and I would say she is – the previously Big Data-fawning press will start running negative articles, which is OK since once that negativity has been purged, it’s on to the Trough of Enlightenment, where organizations whose interest is more than fad-chasing start delivering results. A Wall Street Journal blog post on the Gartner item quotes Aurelia Boyer, CIO of New York Presbyterian Hospital, who says they’re using Hadoop with natural language processing to analyze millions of patient records to find, for example, how many of them have mentioned a gunshot wound.

A study looks at why patients may think doctors who use clinical decision support are less capable. Apparently patients worry more about doctors using non-human tools rather than having a doctor who seeks external advice.

New Hanover Regional Medical Center (NC) goes to paper downtime procedures for seven hours Thursday when its Epic system goes offline due to an AT&T regional outage.

An online publication HITECH article elicited interesting comments. Granted some of them veer into death panel nut job territory, but they’re still fun to read and some are insightful.
  • “EMRs encourage doctors and nurses to cheat and lie. EMRs have made medical records inaccurate and unreliable. When I read medical records nowadays, I often can’t tell what the hell happened.”
  • “In an EMR, every URI is an average URI.”
  • On the use of surgical case templates: “… worked out with the hospital risk management department to describe what should happen, and entered in the EMR with one click of a mouse. What actually happened? No one can tell.”
  • “The response calling this idiocy a step in the right direction apparently fails to get the point, which is that EMRs make crappy doctors look like decent ones by giving them the same well-written notes as the good ones.”
  • “It seems to me that this isn’t exactly the unintended consequences of EMR; it’s the unintended consequences of the government incentivizing bad EMR by incentivizing the wrong things:  the ACA encourages rapid adoption of immature or awkward technologies without clear benefits; medicare, medicaid, ACA, and the employer-provided health insurance tax exemption incentivize egregious billing practices. EMR and provider companies respond to the incentives; the problem isn’t the software per se, but the incentives. There’s no inherent reason why an EMR system should require more data entry on the part of doctors, or why the data entry should take longer than updating a paper chart. Systems could be designed that work better and provide consumer benefits, but they aren’t appearing because the system incentives really aren’t designed to serve the customer.
  • A physician on not customizing template-created notes: “I like to think most of us are pretty honest, and this doesn’t feel like a lie, more like the best that can be done with the time available and the limits of the EMR. I don’t know if I am only humoring myself about the honesty. I do know the job can’t be done except by the copy and paste method.”
  • “This article misses a key point. If they’re fine falsifying electronic records, why wouldn’t they be comfortable falsifying written records? Moreover, electronic records are easier to falsify, but they’re also easier to catch.”
  • “I think physician associations need to reemphasize that documentation by exception is not appropriate for physicians, perhaps even take it a step farther and officially declare it outside the standard of practice. The great potential benefit of EMR’s (along with the requirement that they be able to produce data in a standard format) is that medical charting will stop being primarily about stories and start being primarily about data. This will not only make treatment of patients more scientific, it will energize evidence-based medicine. Right now, about half of medical treatment is done despite no evidence of efficacy. Of course, if the data is unreliable, we have GIGO. So the use of charting by exception leading to bad data is a huge problem.”
  • “EMR’s are the vehicle for corporate and government direction of medical care. I predict that within 5 years, it will be illegal to provide medical care to a patient unless it is through an Electronic Medical Record … this idea will be advanced as important to preventing waste, fraud and abuse.”
  • “Simply put, doing a thing, and documenting the doing of a thing, are two separate, and not particularity related skills (I would figure that journalists would understand this better than anyone), and it is unlikely that a person who is good at the former is also good at the latter, and when we ask him to do both, this is what we get. Cheer up, we could get the people who do amazingly good documentation to do the surgery. I suspect that would be much worse.”

I’m scooping Weird News Andy on this story: a drunken Englishman is hospitalized after the paramedics he called found his frigid sexual partner dismembered in a snowy field. The partner was a snowman; the man’s injury involved frostbite of his manhood, which nearly required amputation.

It’s NextGen Part 3 from Vince this week as he covers Opus Healthcare Solutions.

Sponsor Updates

  • SimplifyMD is running cartoons and videos looking at the humorous side of medical practice at “Easy Street Family Practice.”
  • Nuance announces that the electronic medical records systems used by hospitals and clinics in the United Arab Emirates will be voice-enabled using Dragon Medical.


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

More news: HIStalk Practice, HIStalk Connect.

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January 26, 2013 News 12 Comments

News 1/25/13

January 24, 2013 News 9 Comments

Top News

1-24-2013 9-15-30 PM

Quality Systems (NextGen) reports Q3 results: revenue up two percent, EPS $0.26 vs. $0.36, missing analyst estimates on both. The company reported a 29 percent drop in system sales revenue as operating expenses rose six percent. The earnings call transcript is here. The results were announced before Thursday’s market open, with shares closing down only 0.16 percent by the market’s close.

Reader Comments

1-24-2013 5-53-24 PM

From Kojak: “Re: Intuit Health changes. Medfusion founder Steve Malik is retiring in June and Sanjiv Waghmare is taking over as Intuit Health’s new GM.” The e-mail announcement was attached. Malik (above) was named president of the Intuit Health Group when Intuit purchased Cary, NC-based portal vendor Medfusion for $91 million in 2010. Waghmare is a VP of product marketing.

From WHIMSSical: “Re: booth demo stations. PowerPoint or video? Should vendors use PPT since nobody can hear the video?” I say video and/or a live demo backed by a credible and engaging demonstrator, but perhaps also a fast-paced and highly graphical looping PowerPoint on a big projection screen as a billboard to grab attention as attendees streak by. Readers, what would get your attention?

From Doc Tari: “Re: Allina. Did know if you heard Allina having a bit of restructure. CMIO Shrift left to Cleveland and now CIO over all the IS areas.” 

1-24-2013 6-34-08 PM 1-24-2013 7-18-27 PM

inga_small From Carrie Prejean: “Re: HIStalkapalooza. What exactly does one wear to HIStalkapalooza this year? Bowling shoes? I want to come prepared because I am determined to win the ‘Inga Loves My Shoes’ contest!” When I first heard that this year’s bash was going to be in a (very cool) bowling alley, I was also perplexed on the proper attire. We are fine-tuning things, but suffice it to say that just about anything will go. We will once again have a red carpet, so arriving in stiletto heels and sequins will be totally acceptable. Alternatively, if you own a vintage bowling shirt, this could be the time to pull it out of the back of the closet. The shoe contest will include categories for those partial to high fashion as well as those who choose to adorn more functional bowling shoes. We will also be crowning a HIStalk King and Queen based on their total fashion package. Winners will be awarded amazing prizes, so don’t show up in your “straight off the exhibit floor” attire, especially if the look includes a company logo’d tee shirt.

1-24-2013 6-43-11 PM

From RFP: “Re: MD Anderson. Posts an EHR RFP.” The RFP strongly suggests that prospective bidders attend the pre-proposal conference on Wednesday, January 30 just in case you want to thrown your electronic hat into the ring.

From Slim: “Re: Optum. I read your update confirming that Humedica was bought by Optum. Wouldn’t it have to be announced since Optum is part of UnitedHealth Group, which is publicly traded?” I’m not an expert, but I believe SEC disclosure requirements cover only “material events,” meaning companies must file an 8-K form only if a merger, loss of a key customer, or policy change could reasonably be expected to impact share price in the company’s subjective judgment. UnitedHealth Group’s market cap of $58 billion and annual revenue of $111 billion would make all but a huge acquisition non-material.

1-24-2013 7-41-12 PM

From Bill O’Plenty: “Re: SB 1275. Crazy law introduced in Virginia.” Virginia State Senate Bill 1275, introduced January 14, would prohibit any organization that stores electronic medical information from (a) participating in the Nationwide Health Information Network; (b) performing analytics on multiple patient records for diagnosis, treatment, or population health management; and (c) processing medical data within Virginia if most of the patients represented live out of state. It also mandates that providers cannot be penalized for refusing to implement EHRs, that patient consent for electronically storing their information is valid only for healthcare coverage purposes, and that the state is prohibited from starting or operating an HIE. I e-mailed the office of the bill’s sponsor, Republican Senator Stephen H. Martin, to ask what he’s trying to accomplish with the bill, but I haven’t heard back. Senator Martin is running for lieutenant governor, which could ironically pit him against Democrat Aneesh Chopra, former White House CTO and advocate for all the items that the bill would prohibit, so perhaps he’s just trying to pick a fight.

From Wearing Dad’s Suit: “Re: Epic’s non-compete. Does it cover this?” Applicants for the head football coaching job posted on the University of Wisconsin’s HR website include a Walgreens pharmacist whose only relevant experience was as a season ticket holder, a Fedex driver who said he’d take $60K to lead the Badgers, and a financial analyst with Epic whose college athletics experience consists of having been a practice player for Tulane’s basketball team. I give our young Epic friend credit for trying even though he lost the $2 million job to a more experienced candidate who responded to the online posting, Utah State Coach Gary Andersen.

HIStalk Announcements and Requests

The latest highlights from HIStalk Practice include: Epocrates says its app has helped clinicians avoid more than 27 million adverse drug events. Farzad Mostashari, MD highlights some of the ONC’s 2012 achievements. Pharmaceutical companies and other businesses embrace advertising opportunities within cloud-based EMRs. E-visits may be as effective as in-person office visits for uncomplicated ailments. Dr. Gregg describes a day in the office in the Year 2063 (quite fun.) You know the drill: catch up on all the latest ambulatory HIT news, click on a few sponsor ads to find a goodie or two that might improve your life, and sign up for the e-mail updates. Thanks for reading.

On the Jobs Board: Cerner Experienced Providers, Product Marketing Manager, Healthcare Strategy Communications Specialist, Project Specialist.

Acquisitions, Funding, Business, and Stock

1-24-2013 5-56-29 PM

Healthcare social networking site iMedicor acquires iPenMD, which offers a digital pen solution to capture clinical data. iPenMD apparently bought the intellectual property of nextEMR this past July per a reader’s rumor report.

1-24-2013 6-03-35 PM

Merck Global Health provides $6 million in growth capital to eHealth Technologies, a provider of continuity of care solutions.

1-24-2013 6-04-22 PM

Praesidian Capital invests second lien debt capital in eTransmedia Technology to replace debt and fund growth.

1-24-2013 8-34-24 PM

Revenue cycle systems vendor Recondo Technology receives a $20 million growth investment from private equity firm Bregal Sagemount.

1-24-2013 6-25-07 PM

Healthcare Growth Partners releases its 2012 HIT Market and M&A review that summarizes capital markets, M&A, and capital raising activity for the healthcare IT and services sector.


1-24-2013 4-02-46 PM

Tampa General Hospital (FL) selects Merge’s CTMS for Investigators solution for enterprise management of clinical trials.


1-24-2013 3-50-34 PM  1-24-2013 3-51-42 PM

Huron Consulting Group adds Jim Agnew (Navigant Consulting) and Jeffrey McLaren (VHA, Inc.) as managing directors in its Huron Healthcare practice.

1-24-2013 3-53-51 PM

HIMSS promotes Thomas M. Leary to VP of government relations, taking the place of Dave Roberts, who was elected to the San Diego Board of Supervisors.

1-24-2013 1-39-04 PM

Iatric Systems promotes Frank Fortner from SVP of software solutions to  president.

1-24-2013 6-09-34 PM

The Northeast Business Group on Health honors Truven Health Analytics president and CEO Mike Boswood at its 18th Annual Tribute to Leadership.

1-24-2013 3-56-46 PM

Clinical data integration provider Apixio hires Jonathan Murray (Aetna) as chief business development officer.

1-24-2013 6-12-51 PM   1-24-2013 6-14-16 PM

Intellect Resources announces triple-digit growth in 2012 and announces several promotions and hires, including the promotion of Eileen Dick to VP of technology and Cindy Orr to VP of go-live services.

1-24-2013 9-11-26 PM

Robert Rowley, MD (Practice Fusion) is named medical advisor for personal health care vendor LifeNexus.

Announcements and Implementations

CareCloud and HealthTronics partner to combine CareCloud’s PM product with HealthTronics’ UroChart EHR and meridianEMR urology-specific EHR platforms.

1-24-2013 9-22-42 PM

Fletcher Allen and Dartmouth Hitchcock Medical Center (above) announce the creation of OneCareVermont, the nation’s first statewide ACO that includes 13 hospitals and hundreds of primary care physicians. We announced their plans in September.

Three Ontario hospitals go live on PatientKeeper Physician Portal, Mobile Clinical Results, and NoteWriter, including Alexandra Marine & General Hospital and two hospitals in the Huron Perth Alliance.

The RFID in Healthcare Consortium and Intelligent Hospital.org recognize six organizations for their advanced use of healthcare technology solutions.

GE Healthcare introduces Centricity Practice Solution 11.


Winthrop Resources is conducting a survey on cloud solutions and bring-your-own-device practices. If you’d like to take about 10 minutes to help them out, the survey is here.

HIMSS finds yet another way to offer preferential treatment for its higher-ranking provider members whose purchasing influence makes its vendor members salivate. Healthcare Transformation Project offers “exclusive access” to services, meaning of course that someone has to be excluded (like the rest of us dues-paying members). For example, invitation-only HTPers get “up-front VIP seating at the HIMSS13 Keynote Address by President Bill Clinton” (I was going to insert a cigar joke, but decorum prevailed). The Transformers who are willing to spend $295 of their employer’s money to attend its annual forum at the HIMSS conference get to hear a bizarrely HIT-unrelated group of political speakers – former Florida Governor Jeb Bush, Democratic political strategist Donna Brazile, and former Nixon speechwriter Pat Buchanan. HIMSS says that “participants will make commitments that will translate goals into meaningful and measurable results in their own organization or community,” so we can all look forward to seeing how those work out for patients. Meanwhile, HIMSS offers vendors a bunch of expensive ways to get in or near those decision-making faces, with $50K buying you a podium speaking slot and free tickets for prospects who would be impressed by Pat Buchanan.

Cerner and Sporting KC take heat for failing to keep their promise to build a $35 million youth soccer complex in return for the $200 million in taxpayer-funded incentives they received to build their professional soccer stadium and Cerner office buildings. The youth fields were supposed to in use by now, but work hasn’t started.

1-24-2013 8-41-55 PM

Spain’s leading newspaper says it was duped when it ran a fake photo of Venezuelan President Hugo Chavez in his hospital bed, which the paper was told had been taken illicitly by a hospital nurse. The image, widely panned as unconvincing, turned out to be a screen shot of a YouTube surgery video from 2008 featuring an acromegaly patient being intubated.  

The local TV station covers the use by Georgetown University Hospital (DC) of the iPad-based patient data collection system from Tonic Health that replaces paper forms in the doctor’s office. The story says other Tonic users include Mayo, UCLA, the VA, and Kaiser. The company says the product integrates with EHRs via HL7 or can send a CCD record. It offers a free version with limited functionality. Founder and investment information is here.

1-24-2013 9-28-26 PM

As tweeted by @Cascadia: a Virginia medical practice charges patients for using its patient portal, billing $125 per year for Gold access to make appointments and refill requests, while the $250 per year Platinum plan adds three electronic visits. That’s the opposite of every other industry, where free online services encourage customers to do it themselves without tying up an expensive employee. This is like banks offering free teller service but charging for ATM access, or maybe McDonalds adding a drive-through surcharge.

A Texas judge orders the deposition of two partners of a CPA firm accused by a medical practice of failing to secure the accounting system it installed in the practice, which the practice says allowed an employee of the practice to embezzle $1 million over five years.

Weird News Andy says this man wears his nose on his sleeve, also wondering if he will pick his nose in public. British scientists are using a man’s own cells to grow a new nose to replace the one he lost to cancer. They have two noses underway (“just in case someone drops one,” the researcher said) and the patient will chose one of them to be implanted under the skin of his arm until it’s ready to transplant.

I had a feeling where WNA’s story was going when I saw his best-ever headline, “Nothing like having a cold one after work,” but I still nearly choked on my soda when I saw the story, in which a male hospital nurse is arrested on suspicion of having sex with the body of a deceased patient.

Sponsor Updates

  • Nuesoft Technologies CEO Massoud Alibakhsh discusses data security and Nuesoft’s technology platform in the video above.
  • Awarepoint celebrates its tenth anniversary and recaps key successes.
  • GetWellNetwork Founder and CEO Michael O’Neil delivered Thursday’s keynote address on interactive patient care technologies at the IPC Symposium at Hasbro Children’s Hospital (RI).

EPtalk by Dr. Jayne

Your tax dollars at work. On Tuesday, the US Supreme Court rejected an attempt to reopen Medicare claims that are more than two decades old. The hospitals assert that CMS miscalculated payments between 1987 and 1994 that were intended to compensate their treating large numbers of low-income patients. Based on the fact that it took my local academic medical center over a year to settle the bill for a routine eye care visit, it doesn’t surprise me that it takes years for hospitals to figure out they’re missing money.

Attention vendors: Mayo Clinic releases a new list of the top reasons for visiting US health care providers. Maybe you should use this as a starting point for your primary care office visit templates rather than some of the bizarre things I sometimes see on your screens. Granted the data is from Olmsted County, MN, but it looks surprisingly similar to my clinic roster this week except for the absence of “flu” and “freaking out that spouse has the flu.”

I received my first HIMSS-related mailing today. It was so underwhelming I can’t even remember who it was from. When I went to dig it out of my recycling bin, I couldn’t find it – which means it was nondescript as well. Great job, marketing team!

A wise man once told me to always spend a small amount of time “looking for your next gig” because things are constantly shifting in the world of medicine. For those of you who think the same way, ONC is looking for a policy advisor “who knows meaningful use policy backwards and forwards.” I was curious, so I checked out the link and got the best laugh of the day. The low end of the salary range is $123,758. Leave it to the federal government to specify it down to a bizarre dollar amount.

I had lunch with four of the smartest women in the world today. Three have been my boss in the past while the fourth who taught me everything I know about billing. Here’s a shout out for leaders who not only know their fields but “get it” as far as motivating employees to excellence. Thanks for keeping me grounded and reminding me that although I currently work in chaos, I can always count on your listening ears. And your unbiased opinions when I text you pictures of shoes I’m thinking of buying. And your assistance with crafting the “Typhoon Jayne” cocktail for HIStalkapalooza. Salud!



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

More news: HIStalk Practice, HIStalk Connect.

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January 24, 2013 News 9 Comments

News 1/23/13

January 22, 2013 News 5 Comments

Top News

The Nebraska Health Information Initiative, Kansas HIN, and Missouri Health Connection connect their exchanges to share Direct secure messages across state lines.

Reader Comments

1-22-2013 10-01-20 PM

From Embers: “Re: Humedica. Being bought by Optum, I’ve heard. I wonder what will become of the Allscripts deal that frankly brought Humedica some business, but also had them running in circles (true for anyone dealing with Allscripts in the past few years)? Also, the new Optum research center in Cambridge is gathering steam and they are putting together a nice team to be a healthcare think tank. Hope you had a nice few days off – my imagination puts you on the podium with Obama and not sipping drinks by the pool.” A couple of readers told me they’ve heard that clinical data vendor Humedica has been acquired, one of them specifically saying it happened last week with no public announcement planned. Wednesday morning update: I’ve confirmed via a reader that the company has been sold to Optum. I’m happy to say that my mini-vacation consisted of the latter and not the former, as I took Mrs. HIStalk out of the country for some magnificent and rare downtime sprawling under 80-degree blue skies, swaying palms, and very small paper umbrellas that didn’t protect our white-to-red skin but did make our tropical drinks look even more fetching. I’m paying for the break today after getting home in the early morning, heading off to work just five hours later, and now sitting here with no break or bedtime in sight after 17 hours of non-stop catching up.

1-22-2013 6-57-28 PM

1-22-2013 6-55-10 PM

From EHR Watchdog: “Re: MedLink. See attached. Unfortunately customers can’t reach the company as its top two executives are being investigated by the SEC. The company’s EHR is certified and customers are no doubt trying to figure out what to do. One physician has a contractual requirement that records for his 6,000 patients will be available digitally, but he’s having to go through them one by one to either print or save to an external device as he shops for another EHR after spending thousands of dollars on MedLink.” The reader attached the SEC’s October 2012 complaint against Medlink and its two executives, Ray Vuono and Jameson Rose. It claims the company filed a Form 10-K audit report bearing the name of an auditing firm that had in fact not audited the company’s books, with that same SEC form bearing the electronic signature of one of the company’s directors who had not reviewed the form or authorized that his signature be attached. Lastly, the SEC claims an investor asked to have his check returned, but the company deposited it instead. In the SEC’s words, MedLink “purports to be a healthcare information technology company” and Vuono is “a recidivist securities law violator.” I know what that word means because Raising Arizona is one of my all-time favorite movies.

1-22-2013 7-23-52 PM

From Iconic Reader: “Re: Allscripts. The smoking doc, at least the reflector part of his attire, is apparently the model for the isolation icon in an Allscripts product!” I give them the nod for going old school, with a doc sporting a reflector thingy and a nurse wearing a starched white cap with a red cross on it.

From Pinky Toe: “Re: vendor shakeup. The vendor is Allscripts. Major reorg in the development group, which includes product management and testing, in which 200+ remote employees are being required to move to Raleigh, Chicago, or Burlington VT or face termination. This move not initiated by Paul Black, but he has sanctioned. This is a RIF, but instead of calling it a RIF, management is calling it a consolidation of resources to ‘centers of excellence.’” More convincing (but also unverified) were reader declarations that the vendor referenced in a reader’s earlier comment about employee layoffs is in fact NextGen, but I don’t have confirmation on anything since companies rarely announce or confirm personnel actions.

From Ben Dover: “Re: NextGen. Cutting personal days for employees, sent out the week of January 16 but backdated to January 1, which means employees who took personal days for the holiday will be back-charged for vacation.” Unverified, but the source is non-anonymous and has a copy of the internal communication. The backdating, which adds a bit of sting to the slap in the collective employee face, seems indicative of either an impulsive management decision or inability to get the corporate act together.

1-22-2013 10-03-32 PM

From THB: “Re: Edward Hospital & Health Services. Merging with Elmhurst Memorial Healthcare to create a $1 billion system that would be among the largest in the Chicago area. Edward is going through an Epic implementation.” Verified in a Tuesday announcement. I interviewed Edward VP/CIO Bobbie Byrne a year ago. Edward seems to be the dominant would-be partner, so I expect the Epic implementation will continue and Elmhurst will drop Meditech.  

From Idol Observer: “Re: Greenway’s announcement of meeting ONC 2014 criteria as an EHR Module. According to the announcement, they only met two criteria, a safety-enhanced system and a quality management system. The first requires the vendor to simply name their testing methodology for the features already required by the 2011 feature – no programming is required. The second is to just identify the quality management system being used, with no programming required there either. In other words, it’s just meaningless PR that will get physicians even more confused.” I get lost in all the certification minutiae, so I’ll defer to Frank Poggio.

From Rand Reader: “Re: the recent Rand report. It said EMRs remain costly without good outcomes because doctors haven’t re-engineered their workflows to accommodate electronic systems. Why would they want to do that when the change could be averse to safe care? Just an idea for your next poll.” My opinion is that many doctors will never accept EMRs because to do so would implicitly accept the idea of process standardization and repeatable processes everywhere, and doctors are trained to be confident in their individual abilities and wary of any process that doesn’t involve their own brains and hands. Patients are usually on the side of doctors since everybody likes to think they’re getting extra-special treatment and not being managed by a corporate algorithm. I don’t know that either side has proved its point convincingly.

From Just Wonderin: “Re: ONC’s HIT Safety and Surveillance Plan of December 21. The ‘public comments’ solicited by HHS are not so public after all since they are not being presented for the public to see. Is it because HHS and ONC don’t want the public to see the comments offered by the Cerner and Epic ilk?” It appears that comments can be submitted only via e-mail.

HIStalkapalooza 2013, Sponsored by Medicomp

1-22-2013 8-02-29 PM

1-22-2013 7-56-06 PM

1-22-2013 7-55-27 PM

1-22-2013 8-59-24 PM

HIStalkpalooza will be Monday, March 4, 2013 at Rock ‘n’ Bowl, New Orleans, LA. Medicomp CEO Dave Lareau, one of the coolest guys I know, wanted to bring you some real New Orleans flavor for Medicomp’s return as HIStalkapalooza sponsor. He’s ably assisted by the ultra-professional crew who engineered the 2011 event: Patrice at bzzz productions, Shannon and Cindy from Thomas Wright Partners, Anthony from Istrico Productions, and of course the Medicomp stars like Roy and James that you saw on the stage and at the Quipstar event on the HIMSS show floor.

Medicomp sponsored the 2011 event at BB King’s in Orlando (video is here, although I doubt anyone has forgotten that bash). They said then they wanted to return this year, so naturally I’m super happy to have them back and expecting them to rise to the challenge of a superb 2012 HIStalkapalooza in Las Vegas courtesy of ESD (I still play their video every now and then because it’s so cool).

Rock ‘n Bowl is equal parts bowling alley, dance hall, live music venue, and old-school Cajun-Zydeco shrine, which sounds kind of low-brow until you notice that it has earned a 4.5 average review on both Yelp and Tripadvisor. Beats the heck out of a cookie cutter hotel ballroom or a Disney-like fake Cajun place. It’s a big place even though the layout makes it hard to tell in pictures. Some details:

  • Buses will take HIStalkapaloozans from the convention center to Rock ‘n’ Bowl and back to the key hotels.
  • You’ll be offered the chance to once again execute your perfect red-carpet strut while having an Ingatini thrust into your parched palm and being surrounded by industry glitterati.
  • You will have the option to sip (or guzzle) the aforementioned Ingatinis and Typhoon Janes, not to mention just a lot of drinks in general. The ladies are providing guidance on how they want their namesake potions prepared (I’ll bet there’s a lot of alcohol involved), so details on those will come later.
  • You’ll be entertained by Brian Jack and the Zydeco Gamblers, with instructors leading you in Zydeco dance lessons if you so choose.
  • You’ll be fed you authentically and well with red beans and rice, jambalaya, crawfish etouffee, and retro bowling alley food like pizza, wings, and fried seafood. No tray-passed mini-quiches or two-per-person drink tickets here, folks.
  • Inga will be overseeing our usual shoe and attire contests, best bowling shirt judging, and some other categories I’m not privy to but that I expect will result me spending excessive money on beauty queen sashes and prizes. She can chime in later on the particulars.
  • The inestimable Jonathan Bush will once again preside over the not-to-be-missed HISsies awards at 7:30, the role he created at the first HIStalkapalooza in 2008 and has held since. I have it on good authority that the people you chose for all of the important and serious awards (Industry Figure of the Year, Lifetime Achievement Award, etc.) will be there, which would be quite an assemblage of industry talent.
  • There will be a fun bowling tournament, but since I haven’t bowled since college (translation: I’ve never bowled sober nor seen any reason to) I’ll let Medicomp explain how that will work later. I know some of Medicomp’s partner companies will be hosting individual lanes, so I’m sure we’ll have some fun folks there.
  • You will have networking opportunities like crazy given the remarkable number of CEOs, VPs, investment bankers, press, and lower-ranking but generally amiable grunts like me who’ll be hanging around and lowering their guard to conduct frank and possibly slightly slurred conversations. Deals will be made, jobs will be offered, and a variety of propositions will be extended and considered. A good time will be had by all.

The registration page is now open. Since demand always exceeds supply, registration puts your name on the “I want to come” list. If we have enough capacity, everybody on the list will get an invitation in mid-February. If not, then I’ll have to channel my velvet rope bouncer technique in choosing who gets an invitation (providers and long-time HIStalk supporters get picked first, then I just try to make it interesting by employer and role). Every HIStalk reader is important to me, so I sure hope we can squeeze everybody in since it’s your night.

Acquisitions, Funding, Business, and Stock

1-22-2013 10-10-31 PM

Kareo raises $20.5 million in series F funding led by Stripes Group.

1-22-2013 10-09-55 PM

Shares in Scotland-based revenue software vendor Craneware jump after the company said it expects half-year revenue to increase by seven percent.

1-22-2013 10-11-09 PM

Compuware reports Q3 results: revenue up two percent, EPS $0.12 vs. $0.10. The company says its Covisint HIE business grew 30 percent. The board says it will make a decision shortly about an unsolicited takeover offer of $11 per share, equal to the current share price.


1-22-2013 6-23-52 AM

King Saud University in Saudi Arabia contracts with Cerner to provide Millennium to two of its hospitals.

Lowell General Physician Hospital Organization (MA) selects HDS, athenahealth’s healthcare data management service for population-based cost and quality data analysis and reporting.

The New Mexico Health Information Collaborative will implement Orion Health’s HIE platform for its statewide exchange.

1-22-2013 3-09-01 PM

Henry Mayo Newhall Memorial Hospital (CA) selects Accent on Integration’s Accelero Connect platform to integrate its Philips IntelliVue patient monitors with its Meditech HIS and EDM solution.

Hong Kong and Tsuen Wan Adventist Hospitals select First Databank’s International Drug Knowledge.

El Camino Hospital (CA) chooses data warehouse and analytics solutions from Health Care DataWorks.


1-22-2013 3-24-15 PM  1-22-2013 3-25-26 PM

Mobile health provider Glooko hires Rick Altinger (Intuit Health) as CEO and Dean Lucas (Epocrates) as VP of product development. Glooko, which Dr. Travis included in a recent review of tools for diabetics, just received FDA 510(k) clearance for its mobile logbook device.

1-22-2013 3-27-40 PM

Amplion Clinical Communications names Tom Stephenson (Health Management Systems) president and COO.

1-22-2013 5-40-06 PM

Wendy Penfield (RealMed) joins Intellect Resources as VP of consulting services.

1-22-2013 3-31-25 PM

The Carroll County Chamber of Commerce (GA) names Greenway Medical founder W. Thomas Green as its 2012 Entrepreneur of the Year.

1-22-2013 9-23-59 PM

Rich Boehler, MD (MedeAnalytics) is named president and CEO of St. Joseph Healthcare (NH).

Announcements and Implementations

HIMSS awards 10 scholarships to students enrolled in HIT and management system degree programs.

1-22-2013 9-15-06 PM

Kansas City area hospitals form the Cerner-hosted Lewis and Clark Information Exchange (LACIE), originally created by Heartland Health.

Wheeling Hospital (WV) deploys PeriGen’s PeriCALM Plus in its obstetrical department.

1-22-2013 3-38-03 PM

UNC Health Care’s Rex Hospital (NC) implements Merge Hemo to automate cath lab processes into its EHR.

1-22-2013 3-39-57 PM

UPMC Beacon Hospital (Ireland) implements BridgeHead Software’s integrated backup solution for Meditech.

Neighborhood Health Plan and Partners HealthCare (MA) will provide $4.25 million in grants to 49 community health centers to expand HIT systems, train on Meaningful Use and medical coding, and train and build capacity for performance improvement.

HealthSparq launches its consumer health shopping platform (patient reviews, cost estimator, provider search, and social media forum) to health insurers.

1-22-2013 9-28-57 PM

The Government of Cantabria, Spain will deploy the initial phase of a European-wide e-health service from Texas-based Prodea Systems.


Brian Ahier and a couple of privacy experts will discuss the new HIPAA rules in a Google Hangout streaming video session on Wedneday, January 23 (which is “today” for most readers) at 2:00 p.m. Eastern.

1-22-2013 5-46-13 PM

KLAS looks at clinical decision support tools and finds that more providers are turning to third-party order set and care plan vendors. Key findings:

  • Almost half of providers using third-party products previously tried to build a solution from scratch.
  • Among providers using third-party order sets, half use for reference content only because of an inability to move built pieces into the EMR.
  • Most providers would like more ability to customize medication alerts.

Sponsor Updates

  • SRS reports a 94 percent increase in revenues from 2011 to 2012 and the addition of 56 new employees.  
  • AT&T Healthcare’s Christine Furjanic will speak at the Western Physicians’ Alliance (NV) January 29 seminar on accountable care.
  • Orchestrate Healthcare expands and relocates its corporate headquarters to Carbondale, CO.
  • Greenway Medical Technologies, Inc., announces that Greenway PrimeSUITE 2014 (17.0) is compliant with the ONC 2014 Edition criteria and has earned certification as an EHR Module.
  • Shareable Ink reports 300 percent year-over-year growth and a twofold increase in employees since January 2012.
  • PatientPay CEO Thomas Furr offers advice on managing practice A/Rs and cash flow in a guest articl.
  • API Healthcare announces a 60 percent increase in year-over-year sales bookings and record bookings in the fourth quarter of 2012.
  • T-System will offer the PayRight Health Solutions patient collection system with its RevCycle+ solution.
  • CynergisTek and managed security service provider Solutionary partner to offer outsourced security monitoring.


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

More news: HIStalk Practice, HIStalk Connect.

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January 22, 2013 News 5 Comments

Monday Morning Update 1/21/13

January 19, 2013 News 10 Comments

From Jean Valjean “Re: Vendor shake-up. A major EHR vendor plans to dismiss between 10 and 20 percent of its workforce aimed at development, product management, marketing, and testing groupings. Employees also say the organization is taking initial measures to remove all personal days and compelling employees to use vacation time. Morale is very low and several key employees are leaving on their own. Issues stem from the recent appointment of a key executive whose management style is unknown.” This email contained just enough details (which I removed) to identify the company. However, the accusations are incredibly vague, though if any of it is true, employees may recognize their employer. If you can identify the company and want to share some verifiable details, drop me a note.

1-19-2013 6-06-01 PM

A dozen health systems earn a spot on Fortune’s 100 Best Companies to Work For 2013, including Southern Ohio Medical Center (29), Meridian Health (39) , and Mayo Clinic (41). I liked the perk offered by Methodist Hospital System (67): every employee received a $200 debit card to recognize their efforts and to promote the hospital’s ICare philosophy.

1-19-2013 8-47-01 PM

inga Speaking of great employers, Mr. H is taking a few days off so I am flying solo. I’m not sure whether he is sitting on a beach with an umbrella drink or skiing down a mountain, but I am sure he is putting together a few new Spotify playlists for your music diehards. I don’t have a playlist to share, but I can recommend Lincoln and Zero Dark Thirty if are interested in hitting the movie theater.  Especially Zero Dark Thirty, which stars Jessica Chastain as a very smart, tough, and attractive CIA operative committed to finding Osama Bin Laden. Really, who doesn’t love a smart, tough, attractive woman? I’ll also mention for the HIMSS-attending fun seekers that we will be sharing details of HIStalkapalooza this week, including a link to request an invite.

United Airlines did not make the Best Companies list, but offers a nice perk by providing free health services at several of its hubs, including a just-opened employee health clinic at Chicago’s O’Hare airport. It’s one of five Walgreens-managed facilities available for all employees.

1-19-2013 8-53-00 PM

athenahealth announces it will offer an anesthesia-specific billing solution for hospitals and independent practices.  MedOasis will provide the capabilities for anesthesia coding, charge-entry, contract management, and compliance.

The VA again awards HP Enterprise Services a $543 million contract for RTLS, three months after IBM contested the original award granted in July. The GAO upheld the protest, saying the VA had made several prejudicial errors in evaluating the original offers from HP, IBM, and four other vendors. The VA re-opened the bid process in October and again selected HP to equip 152 medical centers.

1-19-2013 8-57-54 PM

Audax Health, which recently signed a strategic alliance with Cigna to develop a digital engagement platform, raises $21 million through a mix of debt, options, and other securities. The company also names four new executives including Optum alums Doug Celebi, MD (SVP of informatics) and Brian Dolan (chief customer solutions officer).

1-19-2013 8-58-46 PM

Saint Anthony’s Health Center (IL) will offer emergency tele-neurological services in partnership with Specialists On Call.

1-19-2013 9-01-36 PM

The local business journal profiles UCSF Medical Center and its $160 million Epic EMR, which went live in June. The reporter includes a few details that UCSF would likely rather forget, such as the project taking a year longer than originally estimated and costing $100 million more.


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

More news: HIStalk Practice, HIStalk Connect.

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January 19, 2013 News 10 Comments

News 1/18/13

January 17, 2013 News 4 Comments

Top News

1-17-2013 8-57-34 PM

HHS Secretary Kathleen Sebelius announces the final omnibus rule that substantially changes HIPAA regulations for the first time in 15 years. It (a) expands HIPAA’s reach to business associates such as contractors who will now be directly liable; (b) increases penalties to a maximum of $1.5 million per violation; and (c) clarifies the HITECH breach notification requirements. Patient provisions include (a) the right to request their own information in electronic form; (b) allowing cash-paying patients to instruct providers to not share their treatment information with their insurance company; and (c) limiting the use and sale of a patient’s information without their permission. The 563-page document has considerable detail including a discussion of feedback received, so feel free to leave a comment with nuggets you run across.

Reader Comments

From Digital Probe: “Re: headline. One of the rags ran a headline all day saying Health Information Exchange over a story about health insurance exchanges.” Indeed they did, and they’ve since quietly corrected their mistake, I see. I’m slightly mystified by their confusion, but even more so at their running a lengthy article on health insurance exchanges in an IT publication intended for a provider audience who I can’t image cares one iota about them.

From Android Powered: “Re: TPD’s list of iPhone apps. Anybody want to share their list for Android?”

1-17-2013 5-51-39 PM

From Boy Gary: “Re: Anthem CA Blue Cross. Their electronic eligibility system is down, so they e-mailed providers telling them to e-mail subscriber and patient information to check eligibility. They’re asking for the subscriber’s Social Security number to be sent by unsecured e-mail.” That’s such a bad idea that I’ll overlook their less-egregious omission of the apostrophes in the possessive occurrences of “subscriber’s.” They get credit for at least putting a manual step in place to help providers get paid.

From The PACS Designer: “MakerBot at CES. An addition to MakerBot’s product line that TPD posted about was introduced at the Consumer Electronics Show in the form of a 3D plastic design system. The MakerBot Replicator 2X 3D printer uses melted plastic to form objects based on available 3D pattern software. So, for example you want a new coffee mug, you use your pattern design software to create the desired result. Maybe one of our adventurous readers will buy the Replicator to design a new shoe for Inga!” Pretty fascinating – the $1,749 device can replicate household hardware parts, antiques, and who knows what else.

From Lumpy Rutherford: “Re: former NextGen President Pat Cline. He has resigned from the QSI board effective immediately and on his LinkedIn page lists himself as CEO of newly incorporated Delaware corporation Lightbeam Health Information Systems. I don’t know the connection, but I suppose you could draw conclusions.” Indeed you could. I was interested in the corporation’s other officers, but couldn’t turn them up on Delaware’s corporations page (at least not without paying).

HIStalk Announcements and Requests

1-17-2013 2-58-51 PM

inga_small My inbox has been filling up with inquiries about HIStalkapalooza. Here’s what I can share for now. We will post a link to the invite sometime in the next couple of weeks, so keep reading HIStalk. We will again have the Inga Loves My Shoe contest as well as a crowning of the HIStalk King and Queen for best attire. Translation: if you needed a legitimate excuse for splurging on a new outfit, you now have one. However, you might want to wait for more details on the event because it may influence your final selection. The date again is Monday, March 4 at 6:30 p.m.

inga_small The latest goodies from HIStalk Practice include: the HIStalk Practice Advisory Panel discusses the various resources they use when purchasing HIT system to compare vendors and products. Bruce Henderson of Aetna Accountable Care Solutions suggests some factors that practices should consider before committing to an ACO model. Rob Drewniak of Hayes Consulting Management overviews and defines data governance. SRS CEO Evan Steele expresses concern about the future of the EHR incentive program. Proposed legislation would provide SBA loan guarantees for the purchase of clinical IT systems. A study suggests that projected primary care physician shortages could be eliminated if practices used EHRs and shifted more care to non-physician providers. EHR adoption by family physicians is expected to exceed 80 percent by the end of 2013. Most physicians don’t find online physician ratings helpful, though the vast majority believe their own ratings are at least partially accurate. Thanks for reading.

I’m taking a short beach break, leaving Miss Inga in charge of the Monday Morning Update. You can occupy your time by (a) connecting with us via our non-Catfished social not-working profiles; (b) porting intently and clicking methodically over the ads to your right from the folks who underwrite your HIStalk habit, if such a thing exists for anyone but me; (c) signing up for spam-free e-mail updates; (d) reviewing more in-depth sponsor information and filling out a two-minute form to solicit consulting help; and (e) evangelizing to your colleagues who won’t see our slick marketing campaigns and ads since we don’t have any. Seriously, you are the best.

On the Jobs Board: Product Marketing Specialist, Expert Solution Consultant – Revenue Cycle Specialist, Healthcare Vertical Solutions Director, Sr. Applications Engineer – EMR.

Acquisitions, Funding, Business, and Stock

1-17-2013 9-07-11 PM

PE firm Primus Capital Funds invests in Emmi Solutions, a provider of patient engagement solutions.

MIT Media Lab spinout Atelion Health will commercialize one of the lab’s project, a care coordination system that’s being tested at Boston Medical Center, Joslin Diabetes center, and Mayo Clinic.

1-17-2013 8-16-40 PM

Cleveland-area data archiving vendor MediQuant, which says its revenue is growing at 45 percent per year, moves into a larger space for its 40 employees and the 10 additional it plans to hire this year.

A hedge fund shareholder of Compuware criticizes the company for “intentionally dragging your feet” by not yet responding to a $2.3 billion December 18 takeover offer from Elliott Management Corp. Just after it received that offer, Compuware announced plans to conduct an $200 million IPO of its Covisint HIE business unit by the end of March.


Centra Health (VA) selects Wolters Kluwer Health’s ProVation software for cardiology procedure documentation and coding.

HP Enterprise Services announces that it has been chosen by the VA for a $543 million, five-year, 152-hospital RTLS contract, being issued the bid again after competitor protests of last year’s award. Subcontractors are CenTrak, Intelligent InSites, and WaveMark.


1-17-2013 5-19-49 PM

The Society of Health Systems and HIMSS award Dean Athanassiades, senior director of software customer services for Philips Healthcare, the 2012 SHS/HIMSS Excellence in Healthcare Management / Process Improvement Award for leadership in implementing synergies between the process improvement and IT professions.

1-17-2013 5-22-01 PM

Symphony Health Solutions names Frank Lavelle (Siemens Medical Solutions, Medquist) CEO.

1-17-2013 5-22-53 PM

Doug Cusick (HP, IBM) joins Clinovations as a partner, tasked with leading the expansion of the company’s payer, life sciences, and technology service lines.

1-17-2013 6-23-14 PM

Dann Lemerand is promoted to EVP of strategic alliances for The HCI Group.

Announcements and Implementations

Greenway Medical Technologies unveils its interactive Developer Portal and API to facilitate creation of apps that interoperate with Greenway’s EHR and PM platform.

Siemens Healthcare offers consulting services for value-based purchasing, preventable readmissions, and healthcare-acquired conditions.

1-17-2013 9-13-14 PM

A Dell-sponsored study finds that the family medicine residency program of Tallahassee Memorial HealthCare (FL) saved $600,000 and enhanced productivity by implementing the company’s Mobile Clinical Computing solution, which includes desktop virtualization, single sign-on, and strong authentication.

Government and Politics

1-17-2013 5-28-23 PM

ONC selects four winners of its Health Design Challenge to develop patient-friendly designs for printed health records to help patients better understand and use their EHRs. The winners shared $31,000 in prize money.

ONC publishes several reports on HIEs.

1-17-2013 8-44-01 PM

In the UK, Secretary of State for Health Jeremy Hunt calls on NHS to become paperless by 2018, making it “the most modern digital health service in the world.” The physician’s union replied, “The biggest challenges to making the NHS paperless by 2018 are down to funding, resources, prioritization, and the choice of systems in secondary care. Although there may potentially be some efficiency savings, technology will not necessarily create huge cost savings. As well as ongoing hardware and software funding, sufficient resources will be required to support evolving training, IT support and admin support.” Other goals the Secretary set: (a) every patient will have online access to their own records by March 2015; (b) referrals will be paperless; (c) patient records held in different locations will be linked; and (d) records will follow patients throughout NHS and social care.


1-17-2013 8-11-40 PM

A NIH-funded University of Pittsburgh study of four skin lesion apps finds that three of them weren’t very good at diagnosing a test set containing 53 images of lesions known to be cancerous. The apps incorrectly concluded that 30 percent of the lesions weren’t cancerous. The fourth app, which sends the image to a dermatologist for review, missed only one of the samples. The conclusion is to not trust unregulated apps with important medical decisions.


The Leapfrog Group retracts the “F” grade it gave to Texas County Memorial Hospital (MO) after the hospital complains that its score was based on incorrect data. The 25-bed hospital opted not to participate in Leapfrog’s survey because it did not have the resources required to complete the 80-page questionnaire. It says Leapfrog applied “questionable methodology” and used information that was not confirmed by NQF or independently assessed for reliability and validity. The hospitals has retained legal counsel. 

Siemens Health Services CEO John Glaser, who served as an ONC senior advisor helping craft Meaningful Use in 2009 while still VP/CIO at Partners HealthCare, agrees with several member organizations in calling for a slowdown of its rollout. He says, “The pace is too damned high. People are just cramming this stuff in.” Johns Hopkins Vice Provost for IT/CIO Stephanie Reel says the “one size fits all” approach is causing headaches for specialists and the Meaningful Use program needs to be evaluated for effectiveness, saying, “To keep moving ahead with such an aggressive strategy strikes me as foolish. We don’t know what’s working and what’s not working.” Obviously pushback is escalating.

1-17-2013 7-20-08 PM

Sporting Kansas City, partly owned by Neal and Cliff of Cerner, parts ways with its charity partner, Lance Armstrong’s Livestrong. ESPN says Livestrong cancelled the stadium-naming deal because the soccer team owed it money, while Sporting KC takes advantage of the Dope Pedaler headlines by loudly announcing the breakup with perfect timing. Livestrong’s name gets yanked down from the Livestrong Sporting Park sign and it loses its percentage of the gate, worth $8-10 million over six years.

An article in a security magazine says Australian security researcher have found “dangerous, unpatched flaws” in the Philips Xper cardiovascular imaging system that allow them free access to patient information. The researchers said they weren’t able to connect with someone at Philips, so they got in touch with the Department of Homeland Security and the FDA instead. They claim Homeland Security told them the agency was taking over all aspects of software vulnerabilities related to medical devices and software. Philips says the flaw is present only in old versions of its software. The researchers also played around with an iPad-based patient monitoring and found problems.

Lurie Children’s Hospital of Chicago sues a web design firm, seeking the return of the $859,000 it paid the company to design a site to promote its new $915 million hospital.

1-17-2013 7-42-26 PM

The Dallas paper profiles Robert Abbate, DO, who started One Touch EMR, an iPad-based EMR.   

A reader once swore she would never read HIStalk again if I mentioned the term “fecal transplant” again, so here’s a sad but necessary wave goodbye to her from Weird News Andy, who subtitles the story “May I borrow some Grey Poopon?” A study finds that the unsavory procedure works better than antibiotics for treating diarrhea due to C. Diff. WNA adds, “When they figure out how to put them in a pill, maybe,” which I might argue is even more disturbing.

Sponsor Updates

1-17-2013 9-18-44 PM

  • Columbia Valley Community Health (WA) chooses Access Evolution for creating and managing paperless forms and workflow.
  • Craneware offers VP-and-above healthcare finance executives a chance to win a $250 Amazon gift card if they answer a 10-question Executive Industry Survey by February 5.
  • HMS will participate in the HFMA Region 11 conference in Las Vegas January 27-30 and the THA 2013 Annual Conference February 13-14 in Austin.
  • dbMotion shares the agenda for its February 7 seminar in Dallas on connected healthcare.
  • Emdat adds Carmichael Business Systems, Northland Business Systems, and Integrated Data Technology as resellers of its digital dictation software.
  • The Advisory Board Company offers an infographic  that addresses accountability gaps and best practices for improving teamwork among frontline staff.
  • The City of Springfield (OH) renews its contract with MED3OOO for EMS billing services through January 31, 2014.
  • The US Army Network Enterprise Technology Command issues CommVault a Certificate of Networthiness for its Simpana 9 data and information management software.
  • Santa Rosa Consulting’s Carl Jaekel discusses issues practices will need to consider to accommodate PCMHs in a blog post.
  • T-System offers its T Sheets flu documentation template free to hospitals to help EDs manage the national flu epidemic.

EPtalk by Dr. Jayne

Every day is a good day to be anonymous, especially for the HIStalk team. Sometimes I marvel that I haven’t been outed at the office. I and am grateful that apparently I have enough of a filter so that my superhero identity isn’t revealed. I do have to be especially vigilant to ensure I’m logged into the correct Facebook and Twitter accounts so I don’t inadvertently post as the “wrong” me.

I’m just one of thousands of physicians using social media and was excited to see this article in the Annals of Internal Medicine. The authors sent hypothetical social media situations to various state medical boards to evaluate whether there was consensus on which situations might lead to a disciplinary evaluation. Not surprisingly, the riskiest posts included misleading clinical or credentialing information, using patient images without permission, and inappropriate contact with patients such as contacting them on dating sites. There was low consensus for sharing clinical anecdotes (as long as confidentiality was maintained) and for “showing alcohol use without intoxication.”


I do have some latent Victorian sensibilities, so I’m not sure photos of anyone drinking belong on Facebook. I have been friended by some of my colleagues and I think that either they have forgotten that their posts are visible to the workplace or perhaps they simply don’t care. Working for a conservative non-profit, I’d be a little concerned that those posts could someday be an issue (if not for the current workplace then for a potential or future employer.)

Many organizations have social media policies or codes of conduct, but it’s not a bad idea to find out if there are “informal” policies in play as well. Is it frowned upon for subordinates to “friend” their supervisors? Is there a difference between connecting on Facebook and connecting on LinkedIn? What about posting to social medial during typical business hours? Depending on an employee’s role and career goals, some of these are less than appropriate.

Having TMI (Too Much Information) seems to have become the norm. I’m not advocating for a return to the days of inkwells and quill pens, but I do miss having a little mystery in the world. I don’t need a photo of your lunch every day, unless of course if includes an awesome martini. If you have pictures of those, feel free to e-mail me.



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

More news: HIStalk Practice, HIStalk Connect.

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January 17, 2013 News 4 Comments

News 1/16/13

January 15, 2013 News 9 Comments

Top News

1-15-2013 8-26-57 PM

AMA submits comments to ONC urging that Meaningful Use Stages 1 and 2 be evaluated before committing to a Stage 3. It says its members most often express five concerns: (a) passing requires a 100 percent score; (b) the core measures are inflexible with regard to practice patterns and specialties; (c) the program needs to be independently evaluated; (d) EHR certification should place more emphasis on software usability; and (e) healthcare IT infrastructure barriers prevent data sharing. AMA wants three years between stages to give EHR vendors time to prepare – one year for making the rules, one for product development, and one for implementation.

Reader Comments

From EHR You Experienced?: “Re: Johns Hopkins Epic motivation for clinicians. Funny.” It is, but I can’t for the life of me figure out why people keep writing Epic in all capital letters. It’s just plain wrong.

HIStalk Announcements and Requests

Need a new Spotify playlist? Here you go. Beach House, Christian Mistress, Young the Giant, The Maldives, and others ranging from popular to obscure (mostly the latter since I strenuously resist musical monotony).


Just for you Smokin’ Doc fans, I’ve had the old logo turned into smaller ones of various sizes and shapes featuring just the doc himself, which I’ll be using regularly here and there. I may even place him permanently at the top of the page since people keep lamenting his apparent demise, which is simultaneously endearing and disturbing. However, just to be clear: (a) I don’t smoke a pipe or anything else and never have; (b) he doesn’t look like me; and (c) you won’t find many doctors wearing reflector thingies on their heads unless you time travel back to the 1960s – they’ve gone electronic.

Acquisitions, Funding, Business, and Stock

1-15-2013 7-09-32 PM

Twelve-employee Flatiron Health raises $8 million in a Series A funding round led by Google Ventures. The company, which is running a private beta of its oncology analytics platform, was started by the two founders of media buying platform vendor Invite Media. They sold that company to Google for $81 million in 2010.


Primary Partners (FL) contracts with telemonitoring provider AMC Health for remote monitoring of discharged patients using biometric devices.

1-15-2013 5-05-06 PM

Springhill Medical Center (AL) selects Omnicell for automated medication solutions and business analytics.

Holland PHO (MI) chooses Wellcentive Advance for aggregating and analyzing patient information from multiple EMRs and systems into a central repository to meet BCBS Michigan’s OSC program guidelines.

HealthEast (MN) chooses RelayHealth to power an enterprise HIE that will help coordinate care across its four hospitals and 14 clinics.

Health Services for Children with Special Needs (DC) selects care and claims systems from TriZetto.

1-15-2013 8-29-03 PM

Norwegian American Hospital (IL) chooses revenue cycle solutions from HealthWare Systems.

Aetna and Centene Corporation choose readmission predictive analytics software from Predixion Software.


1-15-2013 5-06-41 PM  1-15-2013 5-07-30 PM  1-15-2013 5-08-35 PM

KLAS appoints John Halamka (Beth Israel Deaconess Medical Center), Wright Lassiter (Alameda Medical Center), and Denni McColm (Citizens Memorial Hospital) to its advisory board.

1-15-2013 5-09-22 PM

Kareo hires Rob Pickell (Strategy for HireRight) as its first chief marketing officer.

1-15-2013 5-10-33 PM

HIMSS and the American College of Clinical Engineering recognize Paul H. Frisch (Memorial Sloan Kettering Cancer Center) with the ACCE-HIMSS Excellence in Clinical Engineering and Information Synergies Award for demonstrating leadership in promoting synergies between IT and clinical engineering.

1-15-2013 5-12-09 PM

Merge Healthcare Chief Medical Officer Cheryl Whitaker, MD leaves the company to pursue new ventures.

1-15-2013 5-57-07 PM

Mike Quinto (Quantros) joins PatientSafe Solutions as regional sales VP.

1-15-2013 7-26-29 PM

Former consultant and National Quality Forum SVP/COO Laura Miller joins HP as client principal in the public health sector.

Announcements and Implementations

1-15-2013 2-41-49 PM

Optum and Mayo Clinic launch Optum Labs, an open, collaborative research and development facility focused on improving patient care. Participants in the project will have access to Optum and Mayo’s information assets and technologies, including de-identified clinical and claims data.

White Plume Technologies adds AccelaPQRS, powered by Wellcentive, to its solutions suite. Its smart workflows and customized rules capture eligible encounters that allow users to transmit their denominators and numerators to Wellcentive’s registry.

An independent study finds that PeriGen’s PeriCALM Patterns can accurately screen fetal monitoring strips in real time, with its findings matching that of three experts from National Institutes of Health 97 percent of the time. Clinicians can also use the software retrospectively to test new hypotheses on stored fetal heart rate information. I interviewed CEO Matt Sappern in September.

1-15-2013 6-13-54 PM

Here’s a new cartoon from Imprivata.

1-15-2013 7-19-28 PM

US Rep. Tom Price (R-GA) visits Roswell-based revenue cycle vendor MediStreams.

MModal announces a partner certification program for vendors using its Fluency Direct speech recognition and natural language processing technologies.

Henry Schein MicroMD enhances its PM/EMR automated solutions line with tools for dashboards, patient marketing, data backup, electronic payments, statements, websites, PDR information, and third-party collections.

Government and Politics


CMS expands the MU program to include physicians who assign their reimbursement and billing to critical access hospitals.

1-15-2013 6-28-05 PM

William Zurhellen MD, a solo practice pediatrician in the New York City area, petitions the White House to move EHR strategy away from facilitating payment to a national approach for improving outcome and costs. His petition has 123 signatures so far of the 25,000 needed to put it in front of the President. We interviewed him on HIStalk Practice three years ago, where he explained why he wrote his own Unix-based EMR and why he’s not a HITECH fan. “The entire ARRA is a trade for information. We’ll give you money to put in records, but in return, we want you to supply us with performance data. Performance does not equal quality.” A reader reports that a recent CCHIT meeting, he received applause from at least half the audience when he announced, “Certification should focus on improving care. Anything else is a waste of time.”

Innovation and Research

Joe Kiani, founder and CEO of patient monitoring systems vendor Masimo, launches a patient safety conference and calls for fellow vendors to share their monitor information. He envisions a “superhighway of patient data” that can be analyzed by algorithms to provide an early warning of patient problems that will reduce 200,000 preventable deaths that occur under a provider’s care. Promising to share were Circuit Board, GE, Cerner, Smith Medical, SonoSite Fuji, Surgicount Medical, and Zoll Medical. Other solutions discussed were patient checklists, medical mistakes, and hospital overuse of blood from blood banks. Bill Clinton delivered the conference keynote and patient safety expert Peter Pronovost, MD, PhD also presented.

1-15-2013 7-56-57 PM

Conor Delaney, MD, a surgeon at University Hospitals Case Medical Center (OH) is profiled in an article about Socrates Analytics, which he founded to develop a system for University Hospitals that analyzes hospital information to support quality improvement efforts.


1-15-2013 5-52-30 PM

The Raleigh-area business paper covers the departure of Diane Adams, VP of culture and talent of Allscripts. We detailed her severance package here when it was first filed, but the paper recaps: a year’s salary in cash, her annual target bonus in cash, a year of health benefits, partial accelerated vesting, and other potential bonuses. She gets an extra year’s salary if the company sells out within the next year. She made $1.9 million in 2011 for her job, described as “building a values-based, high-performance environment where people, learning, and fun are the priorities.” It would be interesting to hear from those people whether they enjoyed $1.9 million worth of learning and fun.

1-15-2013 3-10-04 PM

HIMSS Analytics reports that in the last five quarters, the number of US acute care hospitals achieving EMRAM Stage 5 or Stage 6 has increased more than 80 percent and the number reaching Stage 7 has grown 63 percent, suggesting that HITECH has spurred the increased implementation and meaningful use of EHRs.

A routine compliance audit by Samaritan Medical Center (NY) uncovers what it says is illegal activity by a sheriff’s department RN who was authorized to review the electronic medical records of inmates, but who was found to be checking out the records of other patients as well.

Pennsylvania’s Department of Vital Statistics warns parents to check the birth certificates of their newborns after a vendor’s newly implemented records software was found to be pulling in incorrect names for the father.

1-15-2013 8-09-18 PM

Northwestern University (IL) will spend $1 billion to replace its women’s hospital, planning to tear down an existing structure that preservationists are trying to have designated as a protected landmark.

1-15-2013 8-35-21 PM

Weird News Andy finds this story odd: the VA hospital in Buffalo notifies hundreds of patients from 2010 to 2012 that they may have been exposed to HIV or hepatitis because nurses misused insulin pens by correctly discarding the used needles, but re-using the same pen on multiple patients.

Strange: a Washington psychiatric hospital loses its accreditation because of an unsecured karaoke machine. State inspectors said the cord presented a patient safety hazard, no doubt remembering an event from a month before in which one patient at the hospital strangled another in karaoke-unrelated incident.

Sponsor Updates

  • HealthMEDX customer Asbury Methodist Village (MD), which recently won an award for its use of technology to improve care transition from long-term care to other settings, is featured in a video from Leading Age and the Center for Aging Services Technologies.
  • John McCullough, associate VP of clinical applications for Wake Forest Baptist Medical Center (NC), reviews his organization’s partnership with Intellect Resources, which provided Wake Forest with strategic planning services prior to its go-live.
  • Steve Besch, senior systems analyst for Ingenious Med, discusses PQRS and the need for program participation in 2013 to avoid penalties in 2015 in a blog post.
  • TrainingWheel introduces its mobile solution for automating help desk issues and support tracking.
  • TrustHCS offers advice for the C-suite on preparing for ICD-10 and Meaningful Use in a blog post.
  • Velocity Data Centers breaks down how it builds data centers in 90 days and publishes a time-lapse video documenting the start-to-finish process.
  • VersaSuite will participate in the Rural Health Care Leadership Conference in Phoenix February 10-13.
  • Arian Bichsel, director of client support for Allscripts, shares strategies to reduce hospital readmissions.
  • API Healthcare discusses the use of payroll and HR software to drive down the cost of care, boost efficiencies, and improve clinical outcomes.
  • Infor recognizes NTT DATA as its 2012 Infor Lawson Service Partner of the Year based on its 250+ successful implementations of Lawson’s ERP software.
  • Informatica sponsors GovernYourData.com, a vendor-neutral online community and resource center for data governance.
  • ICSA Labs and IHE USA partner to provide industry-accepted certification to complement existing testing of IHE integration profiles.
  • The Colorado Health Insurance Cooperative selects Emdeon subsidiary HTMS to provide strategic planning and operational roadmap for the development of a consumer-owned health insurance plan.


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

More news: HIStalk Practice, HIStalk Connect.

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January 15, 2013 News 9 Comments

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Reader Comments

  • Jay Alicea: A great and timely read....
  • Stephanie Marlowe: I'm interested in the future that Google is promising. It is interesting that they over all have the biggest say in tech...
  • : Judy is not happy that there is a negative perception about Epic’s technology that is creating market pressure for the...
  • C Harris: Re: ONC. A "steady ship" can also be one that is lying at the bottom of the ocean. ONC reportedly has over 150(!!) emp...
  • Kathy L.: Very wise words - as always. Wish that more execs understood this way of thinking. ;)...

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