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Monday Morning Update 11/4/13

November 2, 2013 News 20 Comments

From SNOMED Junkie: “Re: IHTSDO. Don Sweete, executive regional director of the Atlanta Region of Canada Health Infoway, has been named CEO of IHTSDO, the Denmark-based non-profit that manages SNOMED.” Verified. Don must have a graven image-like avoidance of being photographed since despite having held all these high-profile jobs, I can’t find a picture of him anywhere to include here (even on his LinkedIn profile, which is essential these days.)

11-2-2013 11-36-18 AM

From AthenAscendant: “Re: athenahealth. As a former employee, I heard from a colleague that some giddiness has been building regarding recent KLAS performance. She tells me that athenaCollector has established a lead on the score for Epic’s practice management suite and that athenaClinicals is within a fraction of a point of closing the gap with Epic’s Ambulatory EMR.” Unverified. I don’t know that athenahealth stands to gain a lot of Epic business in any case since it’s usually hospitals making those Epic decisions and they won’t give up integration to chase KLAS EMR scores.

From Nila: “Re: unstructured content. I’m curious what the HIStalk audience thinks when they hear that term.” Readers are welcome to leave a comment. What comes to mind for me is clinical documentation, discharge summaries, images, and scanned reports (internal or external). However, I’m not a fan of the term – a programmer would consider Shakespeare’s works “unstructured,” a somewhat derogatory label (i.e. structure is good, so anything that isn’t is bad) that in no way diminishes their usefulness or desirability to everybody else. Some parts of the unstructured information could be structured for portability and searching, but there’s nothing like seeing an actual picture or reading (or hearing) a clinician’s nuanced expression when trying to understand a patient rather than trying to understand a patient’s chart.

11-2-2013 11-29-12 AM

From Brandi: “Re: Health Tech Holdings. Rebranding all of their companies under the Medhost name.” Unverified, but it makes sense. The companies include HMS, Medhost, and Patient Logic. If they are changing, it’s a good time to stop writing MEDHOST in all capital letters. Overzealous marketing people convince companies to capitalize their names (and those of their products) for no reason, which sites like HIStalk ignore because it’s not proper journalism style and it’s also annoying. I’ll leave the all-caps version of the company name if it’s clearly an acronym (like HMS), but I’m going mixed case otherwise (Meditech, Medseek, etc.) Journalism style is also to strip off all of the copyright and trademark symbols the marketeers plaster on everything.

From David Copperfield: “Re: Siemens. Changing leadership in sales, marketing, services, cloud, and legal. This misdirection should keep the German brass looking for the pea for at least another year.” Unverified.

From Opie: “Re: funding rounds. We’re seeing some big numbers in HIT. Some of the recipient companies seem iffy.” The worst thing about big funding rounds is that they lock companies into their specifically stated strategies because that’s what the funders backed. Young companies need to learn from their inevitable early mistakes in strategy or vision as their customers tell them what they should really be doing and push the company into a different business than the ones they planned. If those companies are financially struggling but smart, they will figure it out over time and be better for it as Darwinism weeds out their less-capable competitors who don’t react to the realities of the marketplace. Companies flush with fresh VC money (along with the mandatory loss of control that comes with it) use the cash to charge hard and fast blindly down a path that is very likely not the best one, locking themselves into a strategies and products that were developed before the leaders have had the chance to figure out what they are doing. They can’t just change the plan since that would require telling the investors that they were wrong in the first place. The time value of money dictates finding hares rather than tortoises, but you can bet that the VC guys will deal themselves out within a few years either way. As a prospect, I’d be wary about doing business with a heavily funded but inexperienced company – their major motivator may be to sell the company rather than the product and you don’t really know what kind of company they’ll be when (and if) they grow up. I like what Steve Jobs had to say: “I hate it when people call themselves ‘entrepreneurs’ when what they are really trying to do is launch a startup and then sell or go public, so they can cash in and move on. They are unwilling to do the work it takes to build a real company, which is the hardest work in business. That’s how you really make a contribution and add the legacy of those who went before. You build a company that will still stand for something a generation of two from now.”

11-2-2013 5-38-19 AM

Poll results suggest keeping your expectations somewhere between modest and nonexistent if you’re a company with a hot new application but minimal experience working with hospitals. New poll to your right: which company’s stock would you buy if you had to invest in a healthcare IT vendor?

Listening: The Wrens, an amazingly literate but hard-luck New Jersey day jobber band that hasn’t released anything since 2002 but still has a reputation as one of the best live bands around. I’m playing this song a lot.

I’m changing the rules on the reader-contributed pieces I run as “Readers Write.” I’ve previously run just about any article as long as wasn’t commercial in nature so that any reader, regardless of employer, could express their point of view. I figured the potential negative reaction to lower quality submissions would set the bar to an adequate height. Unfortunately a lot of what gets submitted is PR-ghostwritten, company-friendly fluff pieces that are painfully basic for the HIStalk audience. I’m going to start politely rejecting those articles that don’t contain anything that the the average CIO wouldn’t already know or care about, Articles with personality and humor have a better chance of running, and I’ll always give special consideration to those submitted by providers, which unfortunately are rare.

Talk about scalability issues: only six people were able to successfully sign up for insurance via Healthcare.gov in its first full day of operation in which the administration claimed 4.7 million attempts.

I’m posting this on Saturday, so Monday morning readers will think I’ve erred in wishing luck to the hospital IT and vendor crews managing tonight’s fall-back to standard time. Setting the clocks ahead in the spring doesn’t usually cause as many problems as setting them back in the fall – it’s just not logical for time-dependent software applications to see an hour repeated, as I learned years ago when programming a repeat lab orders routine for my hospital’s order entry system (it mostly worked, but I did miss something that I shouldn’t have when the clocks fell back.) I like having daylight hours artificially manipulated to match the clock-bound schedules of most Americans, but it is a bizarre practice and it causes a lot of confusion if you live in Arizona or Hawaii or try to connect with someone there since they don’t observe DST and the rest of us are supposed to recall that fact.

11-2-2013 6-19-01 AM

Ray Murray (maxIT Healthcare) joins ESD as regional VP.

11-2-2013 6-35-32 AM 11-2-2013 6-36-42 AM

Todd MacCallum (TUC Managed IT Solutions) and Peter Schermerhorn (HealthMEDX) join Beacon Partners as regional directors.

ONC will convene a December 16 meeting of vendors interested in electronic patient identification and matching, with further details forthcoming. UPDATE: Per Lee Stevens, director of ONC’s State HIE Policy Office, the meeting isn’t just for vendors – also invited are HIE experts, state HIE leaders performing patient matching activities, HIE/HIT stakeholder associations, and privacy advocates.

11-2-2013 12-31-36 PM

Standard & Poor’s becomes the second financial rating firm to downgrade the bonds of Wake Forest Baptist Medical Center (NC), announcing its decision the day after the hospital reported a wider than expected $57 million operating loss following a disastrous implementation of Epic.

11-2-2013 12-32-37 PM

I mentioned that Travis from HIStalk Connect and I will be reporting from the mHealth Summit December 8-11 at the Gaylord National Resort just outside of Washington, DC. The folks there are offering HIStalk readers a $75 discount on the full access pass price ($675 general, $215 government, $200 student) if you register using discount code HISTalk (their spelling, not mine).

Here’s a decent SNL sketch skewering Kathleen Sebelius and Healthcare.gov from last week’s show.

11-2-2013 8-26-02 AM

It’s hard to fathom that a healthcare-related website (Healthcare.gov) can attract so much national and political attention, but it will make the November 11 cover of The New Yorker.

An interesting analysis of Healthcare.gov says the problem isn’t the Obama administration, which has successfully launched similarly complex sites under newer government agencies that were willing to fight to get the job done right. The problem, the author concludes, is HHS, which doesn’t have the competition that finally mercy-killed similarly walking dead organizations like Polaroid and Eastman Kodak:

Old organizations definitionally have a lot of longtime stakeholders. And in a sort of ecological process, those stakeholders have been selected for a certain amount of fitness for their environment, which is to say that they are good at doing things the way they have always been done, and they like things the way they are. They are averse to any sort of big change, and they will fight you with every tool at their disposal, from open warfare to passive-aggressively going through the motions on everything you ask them to do. That’s why organizations in crisis frequently need to fire the majority of their staffs to turn things around — and, more than once, an organization that has done so has found that it’s still stuck with the same corporate culture that wasn’t working before.

11-2-2013 11-47-08 AM

Lawyers file a class action lawsuit against Johns Hopkins Hospital over a gynecologist who is accused of wearing a pen-shaped video camera during his examinations, claiming that the doctor recorded up to 9,000 exams and stored them on 10 file servers. The doctor committed suicide earlier this year as investigators reviewed claims involving a variety of inappropriate behaviors. I was curious where you’d get a camera like that and the answer of course is Amazon, which offers the above 30 frames per second, HD-quality model with an 8GB memory card for $70. I saw YouTube video from it and the quality is not bad, although I can’t vouch for its use as alleged. You would think that the last thing a gynecologist would want to watch is movies of his own exams.

11-2-2013 10-42-27 AM

JD Power takes heat for awarding Samsung the #1 rating for customer satisfaction among tablet manufacturers even though Apple beat Samsung in every category except cost.

This is both depressing and uplifting. The California Department of Social Services orders closure of a filthy, unsafe residential care facility whose license had been suspended, so its employees simply walked out after the notice was posted on the door on Thursday and left 14 residents to fend for themselves. The uplifting part is that a cook, a janitor, and two caretakers stayed out of a sense of responsibility even knowing they wouldn’t be paid, finally calling 911 when they realized they couldn’t manage the residents until the Monday deadline for the residents to make new arrangements.

Sponsor Updates

Vince uncovers more great information about HBOC in this week’s HIS-tory. I was curious about former HBOC President and CEO John Lawless and I found that he’s retired in the mountains of North Carolina. I don’t know of anyone who has captured the kind of information Vince has, and the more time that passes since the industry’s early glory days of the 1970s and 1980s, the less chance it will ever be documented.


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

More news: HIStalk Practice, HIStalk Connect.



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November 2, 2013 News 20 Comments

News 11/1/13

October 31, 2013 News 7 Comments

Top News

Health and Human Services Secretary Kathleen Sebelius apologized Wednesday to Americans for the “miserably frustrating experience” caused by problems with the Obamacare website. Congressional leaders grilled Sebelius for 3-1/2 hours about the troubled website rollout and raised security concerns. The secretary said she felt confident the website would be updated and “optimally functional” by November 30.

Reader Comments

From C’mon Mane: “Re: Another Epic sale. Allegheny Health Network is ditching Allscripts Sunrise for Epic. The deal is worth many millions. They think there will be better connectivity as they put the private doctors out of business and hire hospitalists to run their programs.”

10-30-2013 6-36-08 PM

From Jessica: “Re: AHIMA buzz. Had to pass along this wicked shot of our GM, Don Graham, introducing Freddy Krueger to his fist at the Billian booth at the AHIMA conference (where our theme was something along the lines of ‘laying your health market data nightmares to waste’).” Thanks for the great Halloween imagery.

HIStalk Announcements and Requests

inga thumb Just a reminder that Mr. H is still out of pocket so today’s post is all me. Well, me and my BFF, Dr. Jayne.

A few treats from HIStalk Practice this week include: CareCloud will integrate ZocDoc’s appointment booking app into its platform. Physicians are still uncertain how the ACA will impact their workloads or wallets. I’m looking for a few vendor types to participate in a survey.General practice physicians were 1.5 times more likely than specialty practice physicians to have been awarded a MU incentive payment in 2012. In 2011, office-based physicians using EHRs were more likely than non-EHR users to exchange clinical data electronically. My idea of a perfect Halloween treat is having new readers sign up for HIStalk Practice email updates, so thanks in advance. Thanks for reading.

Acquisitions, Funding, Business, and Stock

Merge Healthcare reports Q3 results: sales down five percent, adjusted EPS $0.07 vs $0.13.

10-31-2013 4-48-54 PM

MEDSEEK acquires the Madison, WI-based SymphonyCare, a provider of a population health and care management solution.

10-30-2013 12-09-43 PM

WebMD acquires Avado, a developer of patient relationship technologies, including a patient portal for messaging, reminders, and appointment scheduling tools.

CommVault files Q2 numbers: revenues up 20 percent, adjusted EPS $0.48 vs. $0.38, beating estimates.


10-31-2013 4-50-54 PM

TeraMedica names Nick Donofrio (Merge Healthcare) director of client services, taking over for Greg Strowig, who was promoted to COO.

Post-acute software provider Procura Group promotes Scott Overhill from VP of product management to president. Warren Brown, the former president, has assumed the role of chairman of the board and Bill Bassett (Deyta) joins the company as VP of product management.

10-31-2013 4-52-17 PM   10-31-2013 4-54-04 PM

Allscripts names Rich Berner (Caradigm) president of Allscripts International and promotes Stuart Miller to managing director of EMEA.

10-31-2013 2-53-31 PM

Deloitte names retired Air Force general and former Air Force surgeon general Charles Green, MD a director in Deloitte Consulting and CMO for Deloitte’s federal health practice.

CommonWell Health Alliance announces its board of directors, including Jeremy Delinsky (athenaHealth) as chairman, Rich Elmore (Allscripts) as vice chairman, Bob Robke (Cerner) as treasurer, Rod O’Reilly (McKesson) as secretary, Scott Schneider (CPSI), Justin T. Barnes (Greenway), and Keith Laughman (Sunquest).

Announcements and Implementations

San Diego Regional HIE changes its name to San Diego Health Connect and announces that Sharp Healthcare and Scripps Health have agreed to participate in directing the exchange.

Memorial Healthcare implements Hyland Software’s OnBase ECM solution integrated with its Meditech HIS.

10-31-2013 4-58-38 PM

Mille Lacs Health System (MN) goes live on GE Centricity at its physician clinics.

10-31-2013 5-00-27 PM

The eight-year-old nonprofit organization LCF Research, which is building New Mexico’s HIE, announces that it is now profitable and will be sustainable after its federal grant expires on January 1.

HCA deploys Ingenious Med’s impower platform to more than 4,000 hospital users nationwide.

10-31-2013 1-44-10 PM

Nuance Communications opens its mobile innovation center in Cambridge, MA to house its R&D employees dedicated to voice recognition, natural language, and user interface technologies.

Government and Politics

The Defense Health Agency plans to extend the life of AHLTA though 2018, signaling it will take that long to implement a new EHR.

The House passes a bill that would streamline the VA’s disability claims appeal process and would establish a 15-member commission to seek advice from veteran service organizations, technology companies, and the insurance industry.

Innovation and Research

A pilot demonstration for the ONC successfully demonstrates the use of patient privacy controls over shared medical records. The demonstration showed how externalized patient consent directives can be automatically fetched and applied during the exchange of EHRs.

About half of clinical decision alerts are overridden by providers and about half of overrides are classified as appropriate, according to a study published in JAMIA. The most common alerts to be overridden were formulary substitutions, age-based recommendations, renal recommendations, and patient allergies. While 53 percent of all overrides were classified as appropriate, the likelihood of overriding an alert varied widely by type. The authors recommend refining alerts in order to reduce alert fatigue.


10-31-2013 2-30-09 PM

Nuance introduces an intelligent virtual assistant that uses voice recognition technology to take directives for administrative tasks like ordering medications and labs. “Florence,” which will won’t be launched for another year, will understand the intent of a doctor’s request, actively listen, and respond with facts about how a particular medication or test may affect a patient. Think of the potential if Nuance could tweak this technology to work with spouses.


Healthcare providers outside of the US claim that functionality and support are the top reasons that Cerner Millennium PowerChart exceeds their expectations, according to a KLAS report. Respondents say that despite high costs and contracting concerns, PowerChart is part of their long-term plans.

The Michigan Health & Hospital Association Keystone Center reports that various patient safety and quality initiatives across the state’s 117 hospitals saved more than $116 million (less than one percent) in healthcare costs between 2011 and 2013.

The global market for cloud computing in healthcare is predicted to reach $3.9 billion in 2013, representing 21 percent growth over 2012.

A third (1,099) of Joint Commission-accredited hospitals achieve Top Performer status in the Commission’s annual report on quality and safety. That’s a 77 percent increase over the number of top performing facilities in 2012.

Sponsor Updates

  • The Advisory Board reports that YTD it has extended $1 million in skills-based volunteering to pro bono partners with participation from almost 100 percent of its employees.
  • Vonlay managing partner Aaron Carlock presents a session on portal strategies to improve patient care and business at next month’s HIMSS Midwest Fall Technology Conference in Milwaukee.
  • The Technology Services Industry Association recognizes TeleTracking Technologies  as a Certified Support Staff Excellence Center.
  • England’s Alder Hey Children’s and Liverpool Women’s NHS Trust share details of their implementation of Perceptive Software’s ECM integrated with Meditech.
  • Johnson Space Center will implement Fujifilm Medical Systems’ Synapse Radiology and Synapse Cardiovascular to support NASA’s in-flight and ground clinical care operations.
  • DIVURGENT employees raises $5,000 for Partnership for a Healthier American during its 2013 company retreat in Washington, DC.
  • Vitera announces the availability of Intergy Mobile 2.0 in the Apple Store.
  • Billian’s HealthDATA offers a Porter Research whitepaper on the evolution of consumer engagement in healthcare.
  • Emdeon releases an HTMS whitepaper on modernizing core administration systems and planning a system implementation.
  • CareTech Solutions website security expert James Hunter shares his expertise in a pre-conference education session at next week’s Greystone.Net Healthcare Internet Conference in New Orleans.
  • CTIA-The Wireless Association recognizes AirWatch with MobITS Awards for mobile device management, application development and platforms, and cloud storage and collaboration.
  • HealthMEDX implements INTERACT Tools into its Vision solution to improve early identification, assessment, documentation, and communication about changes in the health status of residents in skilled nursing facilities.
  • Intelligent InSites clients share how tracking software has improved healthcare delivery at their facilities.
  • Levi, Ray & Shoup hosts a secure printing webinar November 5 and 7.
  • Compuware is recognized as one of Michigan’s Healthiest Employers.
  • Vitera introduces Vitera Clinical Exchange, an electronic connection between Florida practices and the state’s online immunization registry, FloridaSHOTS.
  • Impact Advisors principal advisor Laura Kreofsky discusses the two most challenging areas for MU Stage 2.
  • ­­­RazorInsights announces its November conference schedule.
  • Meditech highlights the role of DrFirst in providing its customers e-prescribing functionality.
  • Wellcentive CMIO Paul D. Taylor, MD outlines three mission-critical pieces of network maturity to ensure value-based care.

EPtalk by Dr. Jayne

10-31-2013 5-08-12 PM

I got a chuckle earlier this week when Farzad Mostashari Tweeted about an article on using data to support accountable care efforts: “give MDs info on pts who need A1c, they look at you as though they’re drowning & you’ve just given them a baby.” The line comes from a piece about Memorial Hermann Physician Network (MHPN)and its work to use data to drive population health management.

The network has over 2,000 physicians and functions as an ACO under both Medicare and private-payer frameworks. MHPN is working to bridge the gap between claims-based data and EHR data and I don’t envy them. In working with those two data sources in my own organization, there are plenty of gaps. We continue to deal with practices and service providers that don’t bill in a timely fashion which can skew the claims data. I may have an ophthalmology report back from my colleague so I know I’ve satisfied the patient’s need for diabetic retinopathy evaluation, but the payer hasn’t seen a charge yet therefore the patient’s status is in limbo.

It continues to amaze me that practices can’t bill in a timely fashion even when they are using EHRs. I’m fortunate enough to have very good insurance not only from the patient perspective but from the provider perspective. It reimburses at the top of my fee schedule and also pays timely and accurate claims in a matter of days. As a patient I usually have a paper Explanation of Benefits in my mailbox within two days of when the payment check is cut to the provider, which typically happens within days of the claim. After my recent orthopedic surgery adventures, it took months to receive the first EOB. Based on some of the happenings in the office (such as being charged unnecessary copays during a global period and general disarray with scheduling) maybe I shouldn’t have been surprised. As lean as practices run though it surprised me they wouldn’t do everything possible to get their payments sooner.

In talking to some of my colleagues about the challenges of running an independent practice, it makes sense why so many have been purchased by hospitals and health systems during the last few years. Hospitals sell the vision that they are will deal with practice headaches including OSHA, CLIA, HIPAA, Human Resources, and a host of other issues. Although there are good organizations out there that get the job done, it feels more and more like physicians are being sold a bill of goods.

One of my residency colleagues is part of a small primary care group that was recently acquired. They had a successful EHR installation and were moving forward with Patient Centered Medical Home and other initiatives. Since the hospital medical group was on the same EHR as they were, they figured it would be a smooth transition once their data was migrated. Unfortunately the nightmare was just beginning. The employed physicians had done some significant customization to their version of the EHR, often damaging clinical workflow in the process. Required fields were added in a way that didn’t make sense with how physicians document.

Being a power user of the EHR previously, my friend questioned the way the group was using the system and who had been making the decisions to add the customizations. The group has a policy on change control and decisions are to be made by an IT Committee. Unfortunately its leader is a political appointee who is not actually a user of the system and his chief mode of management revolves around making sure there are no squeaky wheels. When the Compliance department asked for required fields to be added, he complied. When risk and legal made demands, he acquiesced. When specialists wanted fields hidden because they weren’t relevant to them, they vanished. Ultimately a system that could have been highly functional turned into a Frankenstein.

Her new colleagues inundate each other with strings of emails complaining about the system and demanding the administration rip it out and find a new vendor. The EHR has become the scapegoat for a number of problems in the offices, many of which are simply due to poor management. The leadership won’t hit the problem head-on because they are part of the problem. Revenues are down yet many practices have a substantial charge lag. It appears the group doesn’t have a policy on how quickly providers must document their patient visits or when charges are submitted. There are no metrics gathered to show how poorly practices are performing and no accountability to force anyone to change.

I suspect my orthopedic practice is probably managed in the same manner. This brings me back to the quote about giving a practice reports to manage when they’re already drowning. How can we expect a practice to perform population interventions when they can’t finish their documentation? Why can some primary care physicians on a given EHR see forty patients a day and others balk at seeing sixteen? Practices need active (and often aggressive) management to be able to achieve the high goals that are being set out for them. It’s not going to happen automagically and certainly not without a tremendous amount of work.

Medical group management teams need to make sure their physician offices know how to crawl before they push them to run a marathon. Otherwise they’re just setting them up for failure. There is a great quote in the piece that I think I’m going to use to illustrate this point as I discuss these issues with my colleagues: Big data is just making the haystack bigger and not making the needle better. It doesn’t make sense to hand a practice a sheaf of reports to work when they can’t even answer the phones or keep up with refill requests. Why send communications encouraging patients to schedule appointments when the providers have a three month scheduling backlog?

Technology can do wonderful things but it can’t do everything. It doesn’t remove the need for management, structure, and accountability. It won’t replace the basics and we’ve all seen how technology can make dysfunctional processes even more so. If you weren’t billing timely in the pre-EHR world there’s no magic wand that will make it happen just because you implemented a system. Hopefully by now you have some chills running down your spine. After all, it is Halloween. Do you find poor practice management as horrifying as I do? Email me.


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

More news: HIStalk Practice, HIStalk Connect.

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October 31, 2013 News 7 Comments

News 10/30/13

October 29, 2013 News 9 Comments

Top News

10-29-2013 8-10-09 PM

CMS Administrator Marilyn Tavenner tells the House Ways and Means Committee on Tuesday that contractors for the HealthCare.gov website “have not met expectations” but that the  troubles were being resolved and the overall program was working, albeit slower and less successfully than hoped.

The problem-plagued rollout of the insurance marketplace website suffered another hiccup Sunday when the data center for HealthCare.gov experienced a connectivity issue, causing the website to shut down for several hours.

Reader Comments

From Swoop: “Focus groups. I’m wondering if you would be able to recommend any market research/focus group companies in the HIT vertical?” Readers, do you have any recommendations?

From Cookie Monster: “Re: AHIMA. We all thought ICD-10 would be hottest topic here. So far, I think the hot topic is clinical documentation improvement.” Cookie Monster also shared that several vendors were showing mobile versions of their products; one she particularly liked was a mobile clinical documentation app from HUFF DRG Review. If you are at AHIMA, tell us the buzz.

HIStalk Announcements and Requests

inga   Mr. H is busy with his day job this week, so I am flying solo. I have a feeling he’s a little behind on his email, too, so please be patient with him. If you have burning HIT issues to discuss in quick order, feel free to drop me a note. I especially love email that contains entertaining news, insightful commentary, and/or flattery. 

Acquisitions, Funding, Business, and Stock

10-29-2013 11-57-10 AM

Dell completes its $24.9 billion buyout by founder and CEO Michael Dell and the investment firm Silver Lake Partners. Michael Dell will own about three-quarters of the newly private company.

Alere turns in Q3 numbers: revenues up 9 percent; adjusted EPS of $0.59 vs. $0.43, beating analyst estimates. Net product and services revenue from Alere’s health information solutions segment fell less than 1 percent.

Kryon, a start-up focused on medial data analytics, closes $3 million in funding from Khosla Ventures.


A local newspaper reports that Highmark will replace the Allscripts system at West Penn Allegheny Health System with a $178.3 million Epic implementation. In 2011, West Penn Allegheny renewed a contract with Allscripts to provide its record system through 2018 for an undisclosed price; Highmark officials say they “reassessed” the contract after purchasing the hospital network in April. A West Penn Allegheny spokesperson added that the organization was “transitioning to Epic to meet the changing nature of our broader enterprise.”

10-29-2013 6-24-14 PM

Carilion Clinic (VA) selects Orion Health Rhapsody Integration Engine to connect its existing HIT infrastructure across 195 facilities.

Sinai Health System (IL) will implement Merge Healthcare’s VNA, radiology, cardiology, and imaging platform. Imaging Healthcare Specialists (CA) will also deploy Merge Healthcare solutions for RIS, PACS, VNA, and interoperability solutions.

10-29-2013 6-25-44 PM

Rush Health (IL) endorses the eClinicalWorks EHR solution for its 300 affiliated private physician members.

Prognosis announces several new customers including Rankin County Hospital (TX), Red Oak Medical Center (TX), Winkler County Memorial Hospital (TX), and three Jane Phillips Medical Center’s satellite hospitals in Oklahoma and Texas.

The VA Midwest Health Care Network selects Visage Imaging’s Visage 7 Enterprise Imaging Platform for diagnostic interpretation and referring physician image access.

10-29-2013 3-40-13 PM

Phelps County Regional Medical Center (MO) will implement standardized order sets from Motive Medical Intelligence.

10-29-2013 6-28-30 PM

Memorial Hermann Health System (TX) selects ClinIntell as it technology partner for ICD-10 physician education.

10-29-2013 6-29-28 PM

Emerson Hospital (MA) will replace its legacy surgical documentation system with Surgical Information Systems’ perioperative platform.

New York Methodist Hospital selects workforce management solutions from Kronos.


Telehealth solution provider AMC Health adds Hon S. Park, MD (Army Medical Department) as CMIO; J. Mark McConnell (Verizon) as SVP of sales, account management, and marketing; Joanne Russell (Optum) as VP of clinical operations; and, Frank Tucker (MicroHealth) as CIO consultant.

10-29-2013 11-48-15 AM

Mike Cromika, director of IT services at Baptist Healthcare and a HIMSS Kentucky Bluegrass chapter board member, died Monday at the age of 56. Condolences to his family.

10-29-2013 6-30-55 PM

Richard J. Gilfillan, MD, the former director of the Center for Medicare and Medicaid Innovation, is named president and CEO of CHE Trinity Health.

10-29-2013 4-22-43 PM

Bruce Bagley, MD, interim president and CEO of the AAFP subsidiary TransforMED, assumes the role of president and CEO.

10-29-2013 4-52-42 PM

CynergisTek names David Holtzman (HHS/OCR) VP of privacy and security.

Announcements and Implementations

10-29-2013 6-32-44 PM

AHIMA presents Truman Medical Centers (MO) its Grace Award for its innovative approach to using health information management to deliver high quality healthcare.

10-29-2013 6-33-57 PM

Montefiore Medical Center (NY) and Streamline Health sign an exclusive 15-year licensing agreement enabling Streamline to commercialize Montefiore’s clinical analytics platform.

FirstHealth of the Carolinas goes live with Wellsoft’s EDIS at Montgomery Memorial Hospital (NC) and Moore Regional Hospital (NC).

The Great Lakes HIE and Michigan Health Connect collaborate to share medical records between their HIEs.

10-29-2013 6-35-22 PM

France’s Hôpital Européen implements the first ICU alarm management system in Europe using medical device connectivity technology from Capsule Tech.

Sutter Health (CA) announces it will go live with the ICD-10 code set on May 31, 2014, though it will not start submitting claims with ICD-10 codes until October.

10-29-2013 6-40-13 PM

Baylor Health Care System (TX) upgrades to Allscripts Sunrise Clinicals 6.1.

Government and Politics

10-29-2013 6-51-55 PM

A Government Accountability Office report finds a large increase in MU incentive payments made to eligible hospitals and EPs in 2012 compared to 2011. EHs and EPs were awarded $6.3 billion in Medicare EHR incentives in 2012, compared to $2.3 billion in 2011. The percentage of EHs awarded payments jumped from 16 percent in 2011 to 48 percent in 2012.


Park Place International announces its Secure Access and Mobility (SAM) solution, a desktop virtualization offering for Meditech hospitals with VMware Horizon View.


An estimated 95 million US residents use mobile health applications, representing a 27 percent increase over last year.

Results from an ICD-10 HIMSS/WEDI pilot project indicate that healthcare coders were accurate only 63 percent of the time, on average, in their documentation from medical records. The study, which ran from April 2012 to August 2013, also found coders averaged two medical records per hour, compared to four per hour under ICD-9. Translation: there is still a lot of readiness work to be done.

10-29-2013 8-07-51 PM

Children’s Healthcare of Atlanta fires and sues its former corporate audit advisor for allegedly taking the hospital’s proprietary information, including PHI and license numbers of over 500 providers. Two days after announcing her resignation, Sharon McCray began emailing the proprietary information to her personal email account. When confronted, McCray stated the information was to be used “as backup records for her new employment with an unidentified employer to use as a reference.” Children’s fired McCray and has asked a federal judge to force her to return the information.

Sponsor Updates

  • Athenahealth will implement Safety Event Manager, a safety reporting solution from Quantros, allowing athenaClinical users to submit patient safety data as part of their EHR workflow to the federally sanctioned Quantros Patient Safety Center
  • Inc. names AirWatch, GetWellNetwork, HCI Group, Imprivata and iSirona  to its Top 100 Job Creators list.
  • Black Book recognizes McKesson’s RelayHealth RCM as the top-ranked RCM, based on customer satisfaction.
  • SuccessEHS will integrate the DataMotion Direct secure messaging service into its EHR platform.
  • HIStalk sponsors named 2013 Top 100 EHR companies based on revenues include Allscripts, NextGen, eClinicalWorks, McKesson, Merge, Vitera, Greenway, Optum, T-System, Aprima, e-MDs, ADP AdvancedMD, Kareo, Wellsoft, RazorInsights and SimplifyMD.
  • The Drummond Group tests and certifies the Summit Express Connect interface engine from Summit Healthcare for MU Stage 2.
  • Nuance introduces enhancements to its Clintegrity 360 platform that integrates clinical documentation improvement and CAC into a single process.
  • HCS will showcase its Interactant platform at this week’s LeadingAge Annual Meeting & Expo in Dallas.
  • DVIDS highlights the Naval Health Clinic Hawaii online system, which uses RelayHealth software for messaging, appointment scheduling, and medication refills.
  • Business Cloud News features Inland Northwest Health Services in an article highlighting the growing use of cloud services in healthcare.
  • Access integrates support for the Wacom STU-530 and STU-430 Signature Pads into its electronic patient signature offering.
  • Bottomline Technologies releases its Logical Ink solution for the iPad.
  • Greenway Medical Technologies is named a finalist for the 2013 Intel Innovation Award in recognition of its PrimeMOBILE app for Windows 8.
  • In an interview, eClinicalWorks CEO Girish Navani shares various observations and predictions for the industry.


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

More News: HIStalk Practice, HIStalk Connect.

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October 29, 2013 News 9 Comments

Monday Morning Update 10/28/13

October 26, 2013 News 10 Comments

10-26-2013 4-13-54 PM

From FL IT Guy: “Re: HMA. CIO Ken Chatfield and two other IT VPs were separated Thursday night. I don’t know the details.” Unverified, but Ken’s bio has vanished from the for-profit hospital company’s leadership page. He took the job in 2010. HMA replaced its board a month ago and is reconsidering its planned $3.9 billion sale to Community Health Systems.

10-26-2013 2-16-06 PM

From Levon Helmet: “Re: interface engine selection. Consultant John Traeger put together a really great guide that includes a grading system. He presented to our user group conference and said he put the guide together because people are using dated questions on their RFPs that often lead to the wrong selection.”

From The PACS Designer: “Re: SAP and the cloud. TPD is very familiar with SAP AG and their database solutions from previous development experiences in healthcare. What is surprising for a stodgy company that SAP is the success they’ve had moving customers to the cloud. It wasn’t that long ago that they announced their desire to sell cloud solutions and they’ve already achieved over $1 billion in Hana cloud business.”

From Twitterpated: “Re: US CTO Todd Park. Hasn’t tweeted since the week before Healthcare.gov went live.” Todd’s last tweet was September 25. I don’t know if that means anything, but his tweets were somewhat regular at 5-10 per month before then, so his month-long absence is unusual. A Reuters article says that like most White House officials, nobody’s saying what is role was in developing Healthcare.gov and the White House has declined to make him available for interviews. A couple of influential Republican members of Congress seem to have him in their sights. Bizarre conservative columnist Michelle Malkin wonders, “What Happened to All of Obama’s Technology Czars?” in ripping the administration along with former US CIO Vivek Kundra, his replacement Steven VanRoekel, former US CTO Aneesh Chopra, David Blumenthal, Farzad Mostashari, and Todd Park. Where were all the critics when BearingPoint’s $500 million CoreFLS nearly shut down the Bay Pines VA hospital in Florida and was trashed after returning zero value to taxpayers? Affecting live patients seems to be more important than limiting sales of insurance policies.

10-26-2013 12-57-42 PM

It’s a toss-up for survey respondents trying to decide if private equity firms are a positive or negative industry influence. My opinion: sometimes the purely business decisions PE firms make aren’t pleasant for employees and sometimes even customers, but they’re trying to save companies in trouble or at least make them return more value to improve their chances of survival. Employees can find new jobs more easily than customers can choose new vendors, unfortunately. New poll to your right: would you buy hospital applications from a company that doesn’t have much hospital experience?

HIStalk Webinars

Two really good upcoming HIStalk Webinars will feature industry-leading CIOs speaking on interesting topics. I saw the rehearsal sessions for both and they are worth your time.

Marc Probst, VP/CIO of Intermountain Healthcare, will present “Fostering Innovation Through Appropriate Government Regulation” on Thursday, November 14 at 1:00 p.m. Eastern. I enjoyed learning about Intermountain and its informatics history as well as Marc’s thoughts about the government’s influence in setting standards and the need for innovation in healthcare. Marc’s presentation is sponsored by Sunquest Information Systems, which commissioned the initial version of this talk for one of its recent executive forums. 

Ed Marx, SVP/CIO of Texas Health Resources, offers “The Lost Art of Mentoring” on Thursday, November 21 at 2:00 Eastern. You know Ed from his “CIO Unplugged” writings on HIStalk, His mentoring posts resonated with many readers and Ed graciously agreed when I asked him if he would provide expanded thoughts on that topic. He will explain how mentoring saved his life, saved his marriage, and transformed his career. You’ve read Ed’s words on the page and now you can hear them live.

I started this Webinar series in the hopes that leaders like Marc and Ed would step forward to bring a new type of inspiring education to a wide audience. Not everybody speaks at conferences or attends them, and this is a way to put new ideas and new voices in front of HIStalk readers. It’s free, paperless, and  greener than flying in planes across the country to watch the same presentation on a screen in a big room. Let me know If you have non-commercial ideas to share on any topic (technology, care delivery, business, informatics, self-improvement, etc.) that would interest my audience. We’ll help by reviewing your presentation, taking you through a rehearsal, providing the online platform, moderating your session, making the recorded Webinar and slide PDFs available afterward, and of course hopefully assembling an appreciative audience. You’ll get exposure and a resume credential if you want those things, but mostly you’ll get the satisfaction of having given something back to the industry. A lot of people who are new to healthcare IT could benefit from your experience and wisdom.

10-26-2013 4-43-36 PM 10-26-2013 4-44-25 PM 10-26-2013 4-45-45 PM

The General Accounting Office appoints three new members to the Health IT Policy Committee: David Kotz, PhD (computer science professor, Dartmouth College); Devin Mann, MD, MS (assistant professor of medicine, Boston University School of Medicine); and Troy Seagondollar, MSN, RN (regional nursing technology liaison, Kaiser Permanente). They will fill positions as a privacy and security expert, researcher, and labor union member, respectively.

10-26-2013 1-54-41 PM

Anthelio Healthcare Solutions names Ken Roderman (Beacon Health Partners) as VP of sales.

HIStalk sponsors earning a spot on “100 Best Places to Work in Healthcare for 2013” are Aspen Advisors, CTG Health Solutions, The Advisory Board Company, iSirona, Health Catalyst, Santa Rosa Consulting, Divurgent, Innovative Healthcare Solutions, Encore Health Resources, Cumberland Consulting Group, Sagacious Consultants, Impact Advisors, Cornerstone Advisors Group, Imprivata, Iatric Systems, ESD, and Hayes Management Consulting.

10-26-2013 2-29-54 PM

10-26-2013 2-30-41 PM

St. Rita’s Hospital (OH) says it’s the pilot for Epic’s MyChart Bedside, a tablet-based app that gives patients and family members access to their health information, lab results, care plan, care team information with photos, and educational material.

10-26-2013 2-33-47 PM

HIT seed funder Rock Health perhaps unintentionally emphasizes the generational and cultural gap that exists between its youthful West Coast team and us experienced non-hipsters who work in hospital IT by quoting an R. Kelly song in a tweet pitching some kind of hackathon.

Bruce Friedman of Lab Soft News points out the potential conflict of interest in hiring QSSI as a major contractor for Healthcare.gov. “It’s owned by UnitedHealth Group which also owns United Healthcare … the general software contractor now for Healthcare.gov is owned by the holding company that also owns the largest health insurance company in the country, UnitedHealthcare. Does the fact that UnitedHealthcare seems to be not participating the healthcare exchange, as most other private insurance companies are doing, change the equation? For me, the answer is no.”

10-26-2013 3-57-36 PM

One person is really happy about Healthcare.gov – the entrepreneur who bought the domain Healthcare.com for $2 million seven years ago and who now runs a vaguely governmental-looking advertising site to get people to request insurance quotes. Clueless Web users have requested 100,000 insurance quotes there so far this month alone. The same guy also owns Healthcare.net and Healthcare.org, the latter of which went from zero visits to 60,000 on October 1 alone. He had originally planned to create a WebMD-like site, saying, “We are not healthcare guys, we are online marketers. But we knew that health care accounted for more than 26 percent of the U.S. GDP.” He says the feds made some dumb mistakes, like requiring visitors to register before searching for quotes. His site is probably giving more quotes than the one the feds put up, so maybe they should make him part of the tech surge. He might be the most brilliant domain squatter since Whitehouse.com was set up as a porn site until the government shut it down in 2004, depriving the electorate of the opportunity to see a whips-and-chains bearing Hillary Clinton leading Bill around by a dog collar right above the porn links.

10-26-2013 3-36-49 PM

Venture capitalist Michael Greeley has left Boston-based Flybridge Capital Partners, which he co-founded in 2001, to join VC firm Foundation Medical Partners. He holds board a board seat at Valence Health. Current HIT investments by Foundation Medical Partners include Explorys (healthcare big data), Predilytics (healthcare analytics), and Rise Health (population health registries). FMP’s previous HIT-related  investments include Humedica and Valence Health. Greeley says early-stage need to be experts in specific sectors, especially in healthcare, and he wants to work with the IT side.

Vince continues his HIS-tory of McKesson some some fascinating background on Peoria-based HBO (before they moved to Atlanta and became HBOC) that includes some first-hand reports as well as personal photos from HBO’s #14 employee, Dan Mowery. This is a labor of love for Vince, so if you enjoy his HIS-tory posts as much as I do, I’m sure he would appreciate it if you’d leave a comment to say so.


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

More news: HIStalk Practice, HIStalk Connect.


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October 26, 2013 News 10 Comments

News 10/25/13

October 24, 2013 News 11 Comments

Top News

10-24-2013 7-17-26 PM

Cerner reports Q3 numbers: revenue up 8 percent, adjusted EPS $0.35 vs. $0.30, falling short on revenue expectations. From the conference call:

  • Domestic revenue was up 8 percent, while global revenue increased only 1 percent.
  • The company sold its sixth French client and its first one in Brazil.
  • Cerner says that by the end of the decade, the EMR will provide just one feed into a population health management system, and the company is already selling solutions and services to customers who don’t use a Cerner EMR.
  • Cerner and Epic are distancing themselves further from their competitors, and Cerner says it is gaining momentum against Epic.
  • Cerner says its clients have acquired hospitals at six times the rate of Epic’s, giving the company more potential users.
  • Cerner has been approved by Apple as the only non-carrier company allowed to sell the iPhone, and it will offer an unlocked, no-plan iPhone for CareAware Connect, which can replace pagers and other communications devices.
  • Cerner says its work with Intermountain Healthcare will disrupt the industry and accelerate clinical computing by a decade, reducing healthcare costs by up to 20 percent. Projects include using Intermountain’s Care Process Models as an EMR-agnostic “clinical navigation system” and blending content with the EMR to provide activity-based costing as a resource management system.
  • EVP Jeff Townsend compared Epic to Kodak for its suggestion that Meaningful Use be delayed for five years, suggesting that both Epic and Kodak spent too much time selling profitable old technology and trying to delay the inevitably changing future.
  • An analyst noted that “Intermountain has a history of chewing up and spitting out vendors” and asked how Cerner can keep them happy. Townsend said Cerner will do an accelerated Millennium implementation so they can get to the “fun stuff” more quickly.
  • Cerner says it was chosen over Epic at Intermountain because of population health and the ability to influence cost, saying, “This is not a project. This is a decade, if not a two-decade-type relationship.”

Reader Comments

From Digital Bean Counter: “Re: million dollar question. Why hasn’t the government asked any of us health informaticists about fixing the Healthcare.gov website?” It’s not an informatics problem, so that would be pointless. Nobody in healthcare (nor in government contracting, apparently) has the experience needed to plan for the kind of scale Healthcare.gov needs and there’s nothing there at all related to informatics. It requires people who have built monster-sized e-commerce sites, the kind who live in the Silicon Valley instead of the beltway. It’s a shame that the site has turned into a political football – nobody seemed to mind when the VA, DoD, and HHS were burning through millions to billions of dollars in poorly planned and poorly managed IT projects and the website is only marginally related to Obamacare. Nobody can say anything about any topic these days without someone screaming about a perceived political agenda, and politics isn’t the same as the government, which is comfortingly inefficient and wasteful no matter which party is involved. I think I remember a stat that 50 percent of US government software projects are utter failures and a complete waste of taxpayer money and almost all of the rest don’t deliver the expected value.

From Alexis Nexis: “Re: expense reports gone wild. There’s no understanding of what someone on the road experiences:  a hotel room and bed, no ability to cook some eggs in the morning, no ability to pack a sandwich for lunch, doing laundry just on the weekend, etc. Not to mention the additional six to 25 non-billable hours of travel (above the commute between hotel and office) typically incurred every week by road warriors. I can assure you that there’s no road warrior getting rich off his meal expenses. I am quite surprised that snacks and coffee are being included. IRS guidelines view meal expenses as breakfast, lunch, and dinner. Shame on the commentator for not having negotiated a contract accordingly. And shame upon those contract administrators who insist upon receipts for when IRS guidelines don’t require them. To have to save my receipt for the toll on the highway or for my $7 of breakfast in the morning is ludicrous. It burdens everyone with additional unnecessary overhead. I routinely put into my contracts the IRS per diem rate for the locale. Perhaps we should wonder about what it is that makes healthcare in the United States the most expensive in the world without our getting the best return what we spend. I would suggest that it’s not the relatively incidental amounts being referred to. By the way, where could I sign up for that $200 an hour rate?” This is one of those “don’t sweat the small stuff” issues. Line item living expenses are annoying because you get into that pointless mental debate over whether a consultant who buys a $4 coffee on the way to the hospital every morning must be screwing you in other ways as well, and yet sometimes that same employer doesn’t give the consultant a clear picture of what work needs to be done or doesn’t have the required internal people lined up. At $200 per hour, that $4 coffee represents just over one minute of billable time, and I’ve seen consultants trying to find things to do for hours each day because they were just shown a cubicle and abandoned because nobody had the time to manage them.

From Bignurse: “Re: Yann Beaullan-Thong of Vindicet. You interviewed him a few weeks ago. The 2013 McKnight Technology Award in the Transitions category was awarded to a Vindicet client for implementing its patient management system. The organization says the system cut admission time to its skilled nursing settings to less than 1 hour.” Yann’s HIStalk interview from December 2012 is here. The company offers referral management and discharge managing systems.

From Boy Oneder: “Re: Epic’s Healthy Planet. It’s population health management and is robust – wellness, chronic disease registries, population outreach, high risk care management, and risk stratification algorithms.” I heard the term “Healthy Planet” and asked Boy Oneder what it was all about. Boy Oneder also says that Epic had documented clinical workflows in the Netherlands years ago in preparation for sales like the two that just happened to two large Amsterdam hospitals. I don’t think Epic is joking when it talks about world domination.

From Player: “Re: Epic hospital. You should interview a CFO, anonymously or otherwise, about how they looked at the cost justification for implementing Epic.” That would be fun. Volunteers?

10-24-2013 10-57-39 PM

From Boy Lee: “Re: innovative companies. You profiled some of them years ago.” I ran a series I called Innovator’s Showcase in 2011, which took a ton of work. I invited startups to apply to be profiled on HIStalk, but they had to have an original product, real customers, real revenue (although not too much of it), an a short time in business. I had three folks review their brief applications and we chose seven for the Innovator’s Showcase. We thought these had the best chance of success. None have failed as far as I can tell. They were:

Aventura (clinician computing experience)
Health Care DataWorks (analytics)
OptimizeHIT (which was connected to ImplementHIT in some way that confuses me to this day, which offers EHR training)
Caristix (HL7 and interfacing software)
Logical Progression (acquired by Bottomline Technologies – offered mobile documentation)
Trans World Health Services (benchmarking and analytics)
Health Nuts Media (learning games and educational material)

From DrLyle: “Re: your comments about physician-focused startups with no clue how to make solutions for doctors. I loved your answer. I just wanted to make sure the key word is ‘most’ and not ‘all.’ Some of us are actually making some good stuff that truly uses HIT to automate and delegate care, saving time for docs and improving quality for patients.” I was amused at the number of folks whose brains blocked all but the words they get emotional about, firing them up to argue about what they perceived as an anti-innovation rant. I very specifically mentioned only companies that don’t care about patients or providers and that are clueless, arrogant, insulting, and badly planned. If I were CEO of one of those I’d keep quiet, and if I was one of the better startups, I’d be happy that my unworthy competitors had been called out publicly. I’ve been the hospital IT guy who heard these pitches and I’m fairly certain most of my peers think similarly – don’t come knocking until you’ve done your homework. Hospitals may seem like local businesses that need help, but they are massive enterprises. Getting your fledgling product in the door means someone internal is going to have to go to bat for you, meaning their job is on the line if you can’t deliver. Do you have documentation, an implementation plan, around-the-clock support, and sound technology that isn’t dependent on your one Romanian programmer not finding a better contract?

I should mention that part of my rant came about is because I resent any company (big or small) that barges into healthcare without showing respect for patients and the people who have been involved in taking care of those patients all along. Healthcare is a vendor’s Vietnam, as Misys or Sage or any number of other half-hearted former dabblers can explain. They saw themselves swooping in from other industries with massive firepower and a hearts-and-mind campaign that would ensure a quick and painless surrender by the peaceful, primitive locals. A handful of years later, their thoroughly defeated and demoralized salespeople and executives were climbing over each other’s backs desperate to squeeze onto that last available helicopter ride to safety.

10-24-2013 9-02-13 PM

From Lazlo Hollyfeld: “Re: Healthcare.gov. At least the CD version is slated for a ‘16 release.” The Onion is brilliant as usual in its satire about Healthcare.gov.

HIStalk Announcements and Requests

inga_small Some goodies you may have missed this week on HIStalk Practice include: Practice Fusion defends its practice of emailing patients to request physician reviews. Parents want to email their pediatricians and they want it to be free. The Rothman Institute will implement White Plume ePASS. Female doctors provide better quality care than their male counterparts. A physician is charged with breaking and entering after she broke into an office, set up a temporary practice, and began seeing patients. Hayes Management Consulting VP Rob Drewniak outlines a process to prevent breaches with HIPAA compliance. Dr. Gregg offers a Top 10 and a Bottom 10 List on HIT adoption. Linda Fischer, EMR manager for Boulder Community Hospital Physician Clinics, discusses her Greenway Medical EMR implementation, including details on the selection process, EHR data migration, obtaining physician buy-in, and quality care initiatives. In lieu of sending Halloween candy, please treat me to your email address to subscribe to the latest HIStalk Practice updates. Thanks for reading.

Here are a couple of on-the-spot interviews Bonny and Catherine of Aventura conducted at ACEP13 in Seattle last week. They just turned on the video recorder and let the folks say whatever they wanted about IT.

From an ED physician:

Technology is struggling to match what physicians and other clinicians actually want to have happen. When people say all the time, “Is this a great system?” then yes, it’s a great system, but not in this particular setting. There’s many, many, many times a mismatch between what the clinicians want to have done and what the technology can do. There’s innocence on both sides. That’s what my experience has been with this technology. This innocence of mismatch, where the technical people are extremely good at what they do, the hospital people and clinicians are very good at what they do, but this matching of the two is really not working nearly as well as everybody thinks it is. As an example of why there’s this disconnect between documentation and clinicians is my assessment of a patient begins way before anybody thinks it does. It begins when I hear that patient screaming out of the corner of my eye as he’s brought in. I’m not documenting then. I’m not even seeing the patient yet, but that’s when my assessment begins. When I walk into the room, the smells and everything, that’s all part of my assessment, but many times that does not get documented.

From a resident:

I’m a fourth-year EM resident. Our workflow is that we will typically sign up for patients at the doctor’s station and go and see the patient, which takes about five to 10 minutes. Then come back, put our orders in, see other patients, and then we’ll frequently come back and either document or dictate in between patients. Aventura seems like a good application. Friendly, very fast. Sounds like it would be helpful.

Acquisitions, Funding, Business, and Stock

10-24-2013 7-18-05 PM

Microsoft turns in Q1 numbers: revenue up 16 percent, EPS $0.62 vs. $0.53, beating expectations.

10-24-2013 11-01-16 PM

McKesson files Q2 numbers: revenue up 10.7 percent, adjusted EPS $2.08 vs. $1.79, beating expectations on both. Technology Solutions revenue was up 7.7 percent although software revenue was down 9 percent. The company also announced that it will acquire a majority stake in Germany-based drug wholesaler Celesio for $8.3 billion “to form a global leader in healthcare services.” John Hammergren, asked about whether the company will keep the technology business, waffled by saying results are good and there are no plans to change the mix, but MCK isn’t married to any particular strategy and has a responsibility to revisit that decision constantly.

10-24-2013 11-01-56 PM

Covisint reports its first quarterly results after its recent IPO: revenue up 19 percent, adjusted EPS –$0.08 vs. –$0.15.

10-24-2013 11-02-46 PM

Hospital health information management provider IOD Incorporated acquires ApeniMED, a Minneapolis-based company offering healthcare interoperability solutions.

10-24-2013 11-07-48 PM

Accelera Innovations secures a $200 million equity investment agreement from Lambert Private Equity. I’ve never mentioned Accelera even once on HIStalk and I admit I’ve never heard of them. Their website looks like something kid with FrontPage might have created in 2002, playing annoying music (unless you’re an “Arrested Development” fan, in which case you’ll enjoy Europe’s “The Final Countdown” because it will remind you of a G.O.B. magic trick ) following someone loudly and pedantically reciting a company pitch. Frankly, I’m struggling to believe the accuracy of the story that someone invested $200 million in this operation.

10-24-2013 7-18-58 PM

Quality Systems reports Q2 results: revenue down four percent to $118 million, EPS $0.22 vs. $0.31, missing analyst estimates on both. CEO and President Steven T. Plochocki says the results are indicative that the reorganization plan put in place during fiscal 2013 is beginning to gain traction. He also notes that revenue, bookings, and system sales were up from the first quarter.

10-24-2013 4-58-37 PM

The Wellness Network acquires hospital patient education software company Logicare.

10-24-2013 7-36-43 AM

Cureatr, which offers secure messaging solutions for providers, secures $5.7 million in Series A financing.

Miami Children’s Hospital signs a deal to allow HealthFusion to offer South Florida pediatricians an MCH-specific version of the company’s iPad-based MediTouch EHR that will connect to the hospital’s systems.


10-24-2013 10-36-56 AM

Trinitas Regional Medical Center (NJ) selects EDCO Health Information Solutions to implement Solarity technology and indexing services for medical records scanned at patient discharge.

Elmwood at the Springs Healthcare Center (OH) selects VersaSuite for EHR/PM for its long term acute care facilities.

Rush Health (IL) endorses athenahealth’s EHR and PM services for its 300 affiliated private physician members.

The State of California Office of Health Information Integrity selects iBlueButton from Humetrix for its HIE pilot.

The Berlin Visiting Nurse Association (CT) will replace McKesson Homecare with Brightree’s home health platform.

Children’s Hospital of Philadelphia signs a five-year contract with OnPoint Medical Diagnostics for its MRI Quality Assurance software.

VA Midwest Health Care Network chooses Visage 7 Enterprise Imaging Platform enterprise viewer for regional diagnostic interpretation and image access throughout its 11 hospitals. The organization also chooses Medicalis for enterprise workflow and Acuo for its vendor-neutral archive.


10-24-2013 10-24-23 PM

Athenahealth names Amy Abernethy, MD, PhD (Duke University Medical Center) to its board.

Vermont IT Leaders elects Paul Harrington (Vermont Medical Society) chair of its board.

Announcements and Implementations

Care at Home (CA) deploys AtHoc’s Home Care Alerts emergency mobile solutions.

Spectrum Health (MI) automates the exchange of patient information via CCD between its HealthMEDX post-acute care EMR and its Cerner and Epic platforms.

HIMSS names Texas Health Resources a winner of the 2013 Enterprise HIMSS Davies Award of Excellence for its use of HIT. CIO Ed Marx is a regular contributor to HIStalk.

10-24-2013 11-39-02 AM

Boston Children’s Hospital launches Wired Informatics to provide enterprise-grade NLP solutions for hospitals and other healthcare entities and introduces its flagship product Invenio, which extracts and leverages knowledge contained in clinical notes.

10-24-2013 4-57-34 PM

Partners Healthcare’s Center for Connected Health launches Wellocracy, a clinically-based source of self-help technologies for consumers, including health and fitness trackers and mobile apps.

Government and Politics

10-24-2013 12-49-20 PM

Finally some good news from the government: every dollar invested to investigate and prosecute healthcare fraud returns at least $20, based on data collected from 2008 to 2012.

A bipartisan group of House lawmakers introduces the Sensible Oversight for Technology  which Advances Regulatory Efficiency (SOFTWARE) Act  that would clarify regulations for mobile medical apps, EHRs, and other HIT technologies. The legislation builds on the FDA’s final guidance on mobile healthcare apps.

Healthcare.gov contactors tell a Congressional panel that it’s not entirely their fault the site doesn’t work as well as hoped – the government should have supervised them better and tested more thoroughly before setting the go-live date. An SVP of Canada-based CGI stuck with the story that user volume was greater than expected and said it was CMS’s job to do end-to-end testing, not the company’s. Andy Slavitt of Optum, which owns contractor QSSI, said the government decided late in the game to require users to create an account before viewing insurance plans and the company’s function for that didn’t work well in the site’s first few days. Rep. Anna Eschoo (D-CA), who represents the Silicon Valley, said blaming user volume is a “lame excuse” that “really sticks in my craw,” adding that Amazon doesn’t crash the week before Christmas.

10-24-2013 11-16-37 PM

John Halamka’s conclusion about Healthcare.gov: “… Nine women cannot create a baby in a month. There is a minimum gestation period for IT projects and our policymakers should learn from the lessons of the Health Insurance Exchange and re-calibrate the timelines shown in the graphic above [the CMS reform timeline] so that everyone is successful.” Or as one of my hospital programmers always told me years ago when pressed to make a delivery date, “You can take the cake out of the oven any time you want, but don’t blame me when you don’t like it.” 

10-24-2013 11-17-57 PM

The VA’s Office of the Inspector General finds that three ED patients died at the Memphis VA after receiving substandard care, one because the doctor violated policy by hand-writing an order for a drug to which the patient was allergic, a situation that CPOE would undoubtedly have warned about.

Innovation and Research

10-24-2013 11-19-02 PM

The Merck | Heritage Provider Network Innovation Challenge offers $240,000 in total prizes for creating tools that help people with heart disease or diabetes follow their care plans. Submissions are due November 10, 2013.

A peHUB article called “Disrupting healthcare – on whose terms?” says that companies with no healthcare background who jump into healthcare IT investments have a big performance disadvantage. It concludes, “These data clearly show a massive advantage for firms with healthcare expertise when making healthcare investments. And why shouldn’t they? Don’t we assume, for instance, that energy investors do better at energy investments vs. those firms without any energy focus or experience? Healthcare is at least as complex and regulated an ecosystem as energy and yet it repeatedly experiences cycles of outsiders driving up investor frenzy.”


Verizon Enterprise Solutions releases Converged Health Management, a remote patient-monitoring platform that allows patients to use biometric devices to capture vital signs and automatically transmit details to their providers.


10-24-2013 12-09-56 PM

Providers rely on telephone calls, letters, and face-to-face conversations more than any other method to communicate with patients, despite the increased use of newer technologies such as text messaging, social networking sites, portals, and emails.

10-24-2013 11-20-46 PM

HIMSS announces keynote speakers for the mHealth Summit in December: FDA Commissioner Margaret Hamburg, Qualcom CEO Paul Jacobs, Denmark’s Minister of Health, and Nobel Peace Prize Winner Muhammed Yunus. I’ll be reporting from the conference, as will Travis from HIStalk Connect. HIStalk will have a microscopic, sparsely furnished booth in the exhibit hall because they were nice enough to give us one, which will be capably manned (or womanned) by the fabulous Lorre.  She may have nobody to talk to since I’m not certain the mHealth Summit draws a lot HIStalk readers, but if you’re going, find our micro-booth (#1305, right beside a slightly larger booth and company called AT&T) and say hello. 

10-24-2013 8-33-51 PM

More on the summary of KLAS’s report on McKesson Paragon, which concluded that the product isn’t ready for big hospitals in important areas (like clinical functionality and an integrated ambulatory system) and has experienced a pretty big drop in KLAS scores since 2010, but customers seem satisfied to wait for the three-year roadmap to bring it up to their expectations. The graphic above shows that 32 large hospitals bought Horizon replacements in 2012, with 10 each choosing Cerner and Epic and 11 choosing Paragon, with cost being a big driver for the Paragon wins. Among smaller Horizon hospitals, Epic was the big winner, probably through acquisition if I had to guess since I doubt those hospitals could afford Epic otherwise except though an affiliate agreement. Allscripts, Meditech, and Siemens didn’t get a single Horizon replacement deal, with the most startling fact in that statement being the inability of Meditech to execute in what should be a receptive market.

10-24-2013 10-30-03 PM

Brian Stowe, the former Epic project manager charged with taking sexually explicit photos of passed out women (of whom six of the eight were his Epic co-workers,) pleads guilty to taking photos and video of a 17-year-old girl asleep in his bed and will be sentenced  in January to a minimum of 15 years in prison. He still faces 62 felony counts.

10-24-2013 8-59-19 PM

A thief breaks into the offices of AHMC Healthcare (CA), making off with two unencrypted laptops on which was stored the information of 729,000 patients. The hospital has expressed a sudden interest in encryption, which the near-certain $1.5 million fine might have covered. Apparently hospitals are unable to muster the technical expertise and financial motivation to encrypt computers until after they’ve been inevitably burned and fined, so it costs them even more. Police arrested a vagrant for the theft on Wednesday, but the laptops are still missing.

10-23-2013 10-28-08 AM

inga_small After reading Tweets and news stories about all the folks who have been able to find more affordable healthcare coverage options on the Healthcare.gov website, I decided to once again attempt the application process. Unfortunately I did not get farther than the second screen, which contained a lot of gibberish. I guess I’ll give Jeff Zients, Verizon, and all the newly recruited techies a bit more time to fix things.
Weird News Andy says he is singing “La Cucaracha” to himself as he enjoys this story: cockroach farming is booming in China as the country finds them both delectable as a culinary treat and miraculous as a a basis for drug development, with hospitals using them to treat burns and a pharmaceutical manufacturer claiming its cockroach syrup cures ulcers and TB.

Sponsor Updates

  • NVoq announces the general availability of its SayIt 8.2 release.
  • Strata Decision Technology hosts 400 attendees in Chicago this week at its annual summit.
  • Wolters Kluwer Health introduces Lippincott’s CoursePoint, a digital course solution for nursing education.
  • DocuTAP will integrate Wolters Kluwer Health’s Health Language applications into its EMR solutions for the urgent care environment.
  • Intelligent InSites will hold its InSites Build 2013 conference October 29-30 in Fargo, ND.
  • Greythorn will offer an October 29 webinar on Radiant implementation and optimization.

EPtalk by Dr. Jayne

Let’s face it, consultants are a fact of life in our industry. Most of us are trying to do more than we possibly can with the staff we have in place. We’re trying to cope with an ever-changing regulatory landscape. We’re feeling the squeeze between immovable deadlines and vendors who aren’t delivering required code as early as we want them to. Sometimes we can’t hire new FTEs quick enough or we may not have anyone with the skill sets needed to help us stay compliant. And so, we turn to consultants.

A reader mentioned last week that his or her company was not in favor of paying meal and incidental expenses for consultants and asserted that the consultant’s employer should pay those expenses since it is already charging a hefty per-hour fee. The comment sparked several replies, so I decided to reach out to some of my friends who are consultants to see what they think. I’ve been on both sides of the story as I’ve hired consultants and been one, but I’ll hold on my thoughts for now.

Most of the consultants I talked to this week feel that their clients have a skewed view of what consultants actually are paid. Even though a consulting firm or vendor may charge $200 or $300 an hour, it’s unlikely that the individual field consultants are taking home even a third of that. Although many senior consultants do quite well, many junior consultants spend up to 50 weeks a year away from home. Divide the pay by the hours away from home and family and the paycheck starts to look even less great.

Companies have to cover for the time that their consultants are engaged in non-billable activities such as training, staff development, continuing education, and maintaining competency with EHR vendor software. Increasingly clients are refusing to pay for consultant travel time (or imposing ridiculous travel caps that don’t even cover flying time) and that has to be covered as well. One consultant I’ve used repeatedly tells the story of going to a small town in a remote western state, where he had to take four flights (to stay under the client’s air fare cap) and then drive four hours to get there. The total travel day was close to 18 hours and then of course he had to get home. The client had a three-hour round trip travel cap. I’m pretty sure the client knows they’re a four-hour drive from the nearest airport.

One of my favorite niche firms works with a single EHR vendor and maintains a very small group of consultants. All of them are nurses and the CEO is a nurse as well. Most of them continue to maintain their licensure and attend CNE so they can stay current with clinical topics. It makes them extremely effective and I’m happy to pay a higher per-hour fee for them because I know I’m getting the quality input I need for projects that need both nursing or other clinical expertise and a high degree of vendor-specific knowledge. I’m also happy to pay more for a small firm that I know runs lean and has little administrative bloat because I know they pay their workers well.

Unfortunately, the health system I work for has what can only be described as Enron-style accounting and they are constantly late in paying the consulting invoices even when all supporting documentation is provided in a neat and timely package. I wish the accountants understood the value of these consultants – they are super busy and don’t need my business to stay afloat and I’m afraid eventually they’ll stop working for me because it is simply too much of a bother.

Due to the size and scope of some of our projects, I’ve had engagements with the 800-pound gorillas of the consulting world as well. Although there have been a handful of consultants that have tried to take advantage of expense policies, the majority have been fair in what they submit for reimbursement. For those who have been a little too cavalier with their spending, it’s been fairly easy to address it with management. I haven’t yet run across anyone operating like the George Clooney character in “Up in the Air” where he pushes his expense reports to maximize his airline mileage. If you’ve ever been a road warrior and haven’t seen the movie, I’d recommend it.

The best defense against ridiculous expense reports is negotiating a good contract with the consulting firm. Know what you are willing to pay for, but be fair. Know what typical hotel rates are in your area and make sure you are allowing your consultants to stay somewhere that you would consider staying yourself. I’ve heard horror stories (and seen pictures) of “client recommended” hotels that I can’t imagine a hospital administrator would expect his own family to accept. If you have a corporate discount, make sure consultants have the codes, and if there is a limit to the number of rooms that can be booked at the corporate rate, that they book well in advance.

As far as meal allowances, they seem fair for the companies I’ve worked with. I don’t begrudge my consultants the coffee and snacks they submit because they’re working their tails off for me. Some of them can deliver in a week what my IT department takes a month to deliver, so the expense is well worth it. One of our IT buildings is away from the main hospital campus and there aren’t any close restaurants. I always have lunch delivered for the consultants so they don’t have to waste time trying to find food and worry about their logistics. But when I negotiate engagements, that is taken into account and their maximum daily meal reimbursement is adjusted accordingly. If you don’t want to pay for alcohol because you’re a faith-based organization, write it into the contract or hire a consulting firm that doesn’t allow alcohol to be submitted.

As I’ve mentioned before, I did a fair amount of consulting while I was building my CMIO skills and still do a couple of jobs a year with the full permission of my hospital. Ethics and professionalism are what keep consultants from abusing the system. Having been in those shoes, if I find someone milking it, I’m going to send them packing. On the flip side, I’ve been abused by clients and it’s never pleasant. At one site where I was engaged for a couple of months, my “handler” would routinely book my schedule with 10-hour days containing back-to-back meetings that didn’t allow for restroom breaks, let alone lunch breaks. I would hit the local supermarket before going on site and stock up on granola bars, fruit, and drinks. The same client didn’t even have cups or utensils in the break room, so I had to travel with my own mess kit if I brought restaurant leftovers.

Another client scheduled a business dinner after a full work day. The agenda was for me to meet with providers and address their concerns regarding an upcoming implementation. It was at a fairly expensive celebrity chef restaurant and I was looking forward to it. However when the bill arrived, the client asked for separate checks and made me pay for my own. Needless to say that blew my expense account for the day (actually three days’ worth) and I had to cover it out of pocket. Had I been on my own that evening, I probably would have had a turkey sandwich and a handful of grapes. Maybe some chips if I was feeling wild and crazy. Most of would agree these examples are pretty extreme, but unfortunately I’m not the only one who has had those experiences.

If you’re looking to cut down on consulting expenses, look at whether you really need consultants on site. Those who work projects remotely don’t submit meal or travel expenses and often they are more productive when your staff isn’t interrupting them or trying to pick their brains on unrelated projects. One consultant friend keeps me laughing with stories of his prowess at slaying scope creep since his client’s analysts are hell-bent on involving him in work that has nothing to do with his engagement just because they know he has the skills. He could probably deliver his analytics build faster if he was working from his bachelor pad than sitting in your cube farm among squeaky chairs, gossipy employees, and those who bring colds and flu to the office.

That’s another thing – nice clients have a plan for when consultants get sick or have family emergencies. They are understanding. They don’t make you feel bad when your daughter breaks her arm and you have to accompany her to the operating room (true story from a former grad school roommate.) They may even offer to have a physician evaluate you and make sure you aren’t near death alone in your hotel room after you get food poisoning at a dinner they catered. I’ve written prescriptions (with appropriate examination and documentation, of course) to treat minor illnesses and helped consultants get care after sports injuries. Just because they’re consultants doesn’t mean they’re invincible.

If clients really have a problem with consultant expenses because they object to having to pass them on to patients, I recommend they look at their own policies as well as consulting policies. One hospital where I’m on staff provides a 64-ounce mug to each new employee, who can then fill it with free beverages throughout the work day. Although it was instituted as a staff perk, I can’t help but wonder what the patients think as they see staff slurping their way through the day from mugs that are less than clean. You can bet that’s being passed onto the patient bill, as are the employee health care expenses from obesity and diabetes since I rarely see people filling up with diet pop, that’s for sure. Then there’s the lost productivity for the trips to refill.

While we’re at it to cut costs and save healthcare, let’s cut out frivolous marketing, overkill signage, and anything having to do with “centers of excellence.” I bet we could lower some hospital bills right there. But let’s not take it out on consultants who are working hard on our behalf.

What do you think about consultants and their expenses? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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October 24, 2013 News 11 Comments

News 10/23/13

October 22, 2013 News 1 Comment

Top News

The HIT Policy Committee may miss its end of year target date to deliver MU Stage 3 recommendations and begin work on Stage 4, according to the committee’s vice chair Paul Tang, MD. Eleven ONC committees and workgroups, including the Policy Committee, canceled meetings during the shutdown; Tang says his committee is shifting its schedule of deliverables out a month.

Reader Comments

10-23-2013 6-17-35 AM

From Friend of Bob: “Re: BOB EDIS. Physicians’ voices were heard again at ACEP. A record breaking number of ED physicians attended ACEP13, over 7,000 reported. Wellsoft noted that at this year’s Scientific Assembly most attendees had a deep knowledge of BOB EDIS functionality and integration capabilities. This echoes the KLAS Specialty Report EDIS 2013: Revealing the Physicians Voice issued earlier this year.”


Acquisitions, Funding, Business, and Stock

10-23-2013 6-13-48 AM

DMH International, parent company of Touch Medical Solutions, signs a definitive letter of intent to acquire 100 percent of Virtual Physician’s Network, a provider of an online scheduling platform for surgeons.

VMware reports Q3 numbers: revenue up 14 percent, adjusted EPS $0.84 vs. $0.70, beating analyst estimates of $0.82 and in line with revenue expectations.

CTG reports Q3 numbers: revenue down five percent, EPS $0.23 vs. $0.23. The company says its healthcare business declined from last year because “a number of hospital clients are holding off on system investments” due to sequestration-related reimbursement concerns.

Lexmark reports Q3 numbers: revenue down three percent, EPS $0.95 vs. $0.94. Revenue for Lexmark’s Perceptive Software segment grew 38 percent.


10-23-2013 6-25-15 AM

Rochester General Health System (NY) will replace its existing enterprise content management system with Perceptive Software’s Content and Perceptive Capture solutions across its hospitals, ambulatory care centers, and physician offices.

10-23-2013 6-28-08 AM

St. Joseph Hospital (CA) will implement secure texting and on-call scheduling solutions from Amcom Software.

10-23-2013 6-29-06 AM

FirstHealth of the Carolinas (NC) selects MModal’s front- and back-end speech recognition, transcription, coding, and clinical analytics for its EHR systems.

10-23-2013 6-30-09 AM

Boston Children’s Hospital (MA) selects Strata Decision Technology’s StrataJazz for decision support and cost accounting.

10-23-2013 6-32-00 AM

Johns Hopkins Medicine (MD) will integrate Vital Images’ Universal Viewer into Epic.


10-23-2013 6-32-57 AM

Availity names Stephanie Kovalick (GE Healthcare) VP of portfolio operations.

Navicure appoints Sheridan B. Johnson chief compliance and security officer.

10-23-2013 6-34-30 AM

Population health analytics provider Rise Health names Michael Previti (Merge Healthcare) EVP of sales.

Announcements and Implementations

Meditech and Vitera Healthcare Solutions connect to the Surescripts network to provide their users with Direct secure messaging capabilities integrated with their EHRs.

10-23-2013 6-35-24 AM

Confluence Health-Central Washington Hospital & Clinics implements Merge Hemo from Merge Healthcare to automate their cath lab processes.

10-23-2013 6-36-48 AM

Summit Health (PA) deploys Nuance’s Clintegrity 360 Computer Assisted Coding and Clinical Document Improvement solutions for ICD-10 readiness.

Center Point Counseling (WI) installs ForwardHealth Group’s PopulationManager technology.


10-22-2013 10-38-31 AM

Most providers express optimism about McKesson Paragon’s ability to deliver in large hospital settings despite current functionality gaps, according to a KLAS report. In 2012, Paragon secured 11 of the 32 larger hospitals migrating from Horizon; 131 large Horizon hospitals have not yet selected a replacement platform.

10-22-2013 11-31-12 AM

Individuals are far more likely to die or suffer complications at hospitals receiving the lowest Healthgrades rating according to the report, Healthgrades American Hospital Quality Outcomes 2014: Report to the Nation.

The Physicians Foundation issues over $3 million in grants to medical society foundations and healthcare organizations to assist almost 10,000 physicians select and implement EHRs.

An Arizona woman says she is the victim of identity theft four months after a University of Arizona Medical Center-South employee posted a workplace photo on Facebook that inadvertently included a computer screen with the woman’s personal information. The photo was removed after 30 minutes when a manager noticed the violation. The hospital’s privacy officer was notified of the incident, as was the patient. The woman recently notified the police after someone used her personal information to apply for food stamps. She also retained a lawyer, saying the incident has “been a nightmare,” that she is afraid to be home, and her life is at stake. Not to diminish the seriousness of the violation, but I can probably think of one or two things more nightmarish and life threatening than a breach of my PHI.

Sponsor Updates

  • RazorInsights’ ONE Ambulatory EHR achieves ONC certification and secures 2011 compliance as a Complete EHR.
  • EDCO Health Information Solutions will present a session on point of care medical records scanning at next week’s AHIMA Product World meeting in Atlanta.
  • T-System names six winners of its fourth annual T-System Client Excellence Awards, which recognize emergency care facilities and physician groups that effectively use T-System solutions to improve clinical, financial, and operational outcomes.
  • Emdeon will add full-color printing capabilities for printed communications to its Payment Network during the first quarter of 2014.
  • Clinicians at Georgetown Hospital System share how their use of Aventura has saved them time and increased productivity and job satisfaction.
  • A local paper profiles Jones & Sciortino Orthopedics (MO) and its use of eClinicalWorks to achieve Meaningful Use.
  • Clinicians with Mercy and HealthEast Care System (MN) share how the use of Humedica’s clinical analytics platform from Optum have provided their organizations with health insights to improve treatment outcomes, care coordination, and quality.
  • Information analysis firm IHS ranks Perceptive Software’s Acuo VNA the world’s market share leader among independent software vendors with 42.3 percent of total studies managed.
  • Chilmark Research recognizes Medicity as a top-tier HIE vendor in its 2013 evaluation of the HIE market.
  • HIStalk sponsors earning a spot on Capterra’s Top EHR Software list include: eClinicalWorks, McKesson, Allscripts, e-MDs, NextGen, NueMD, Vitera, and ADP AdvancedMD.
  • Beacon Partners hosts a webinar on the steps healthcare organizations should take to form a patient-centered medical home.
  • Quantros demonstrates the QPrecision release of its safety event management solution at next week’s ASHRM Annual Conference in Austin, TX.
  • VitalWare embeds Atigeo’s xPatterns Clinical Auto-Coding into its CDiDocuMint application.
  • CommVault introduces a content-based retention solution that enables enterprises to reduce storage requirements by keeping only data that is important to the business.
  • MModal releases the Fluency Flex Mobile app for iPhones, allowing doctors to record clinical notes during patient encounters for integration within EHRs.



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

More news: HIStalk Practice, HIStalk Connect.

smoking doc

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October 22, 2013 News 1 Comment

Monday Morning Update 10/21/13

October 20, 2013 News 15 Comments

10-20-2013 6-28-06 AM

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

10-19-2013 2-36-03 PM

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

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

10-19-2013 3-46-16 PM

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

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

10-19-2013 2-27-00 PM

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

10-19-2013 2-40-16 PM

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

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

10-19-2013 3-48-35 PM 

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

10-19-2013 3-04-35 PM

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

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

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

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

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

10-19-2013 4-49-35 PM

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

10-20-2013 6-55-09 AM

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

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

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

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

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

10-20-2013 8-02-13 AM

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

10-20-2013 7-21-58 AM

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

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

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

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

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 20, 2013 News 15 Comments

News 10/18/13

October 17, 2013 News 2 Comments

Top News

10-17-2013 8-40-26 PM

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

Reader Comments

10-17-2013 1-09-42 PM

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

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

HIStalk Announcements and Requests

10-17-2013 5-46-56 PM

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

10-17-2013 6-59-48 PM

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

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

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

Acquisitions, Funding, Business, and Stock

10-17-2013 6-14-23 PM

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

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

10-17-2013 9-02-48 AM

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

10-17-2013 7-14-52 PM

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


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

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

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

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

10-17-2013 8-44-20 PM

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

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

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

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

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

10-17-2013 8-45-28 PM

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


10-17-2013 4-29-12 PM

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

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

Announcements and Implementations

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

Government and Politics

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

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

10-17-2013 1-51-48 PM

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

Innovation and Research

10-17-2013 7-10-10 PM 

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


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

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

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


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

10-17-2013 7-47-45 PM

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

10-17-2013 8-47-11 PM

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

10-17-2013 7-28-08 PM

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

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

Sponsor Updates

10-17-2013 12-27-57 PM

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

EPtalk by Dr. Jayne


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

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

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

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

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

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

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

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

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 17, 2013 News 2 Comments

News 10/16/13

October 15, 2013 News 3 Comments

Top News

10-15-2013 10-09-26 PM

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

Reader Comments

10-15-2013 9-13-05 AM

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

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

HIStalk Announcements and Requests

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

Acquisitions, Funding, Business, and Stock

10-15-2013 10-57-32 AM

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

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

10-15-2013 10-12-17 PM

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


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

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

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

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


10-15-2013 3-12-46 PM

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

10-15-2013 9-27-43 AM

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

10-15-2013 8-36-53 PM

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

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

Announcements and Implementations

10-15-2013 10-14-04 PM

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

10-15-2013 1-40-27 PM

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

10-15-2013 10-15-26 PM

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

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

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

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

10-15-2013 10-17-02 PM

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

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

Government and Politics

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

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

Innovation and Research

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

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


10-15-2013 11-22-36 AM

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

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

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

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

10-15-2013 10-19-55 PM

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 15, 2013 News 3 Comments

Monday Morning Update 10/14/13

October 12, 2013 News 7 Comments

10-12-2013 3-18-30 PM

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

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

10-12-2013 1-57-15 PM

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

10-12-2013 1-12-24 PM

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

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

10-12-2013 3-19-29 PM

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

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

10-12-2013 3-20-51 PM

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

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

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

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

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

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

10-12-2013 2-51-27 PM

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

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 12, 2013 News 7 Comments

News 10/11/13

October 10, 2013 News 5 Comments

Top News

10-10-2013 7-03-28 PM

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

Reader Comments

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

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

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

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

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

HIStalk Announcements and Requests

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

10-10-2013 5-40-57 PM

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


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

Acquisitions, Funding, Business, and Stock

10-10-2013 7-07-01 PM

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

10-10-2013 7-07-53 PM

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

10-10-2013 7-08-29 PM

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


10-10-2013 7-10-50 PM

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

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

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

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

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


10-10-2013 10-55-45 AM

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

10-10-2013 5-37-36 PM

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

10-10-2013 6-37-20 PM

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

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

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

Announcements and Implementations

10-10-2013 7-12-12 PM

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

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

10-10-2013 11-39-15 AM

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

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

10-10-2013 5-38-56 PM

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

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

Government and Politics

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

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

Innovation and Research

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

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


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

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

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

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

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

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

Sponsor Updates

10-10-2013 12-13-51 PM

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

EPtalk by Dr. Jayne


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

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

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

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

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

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

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 10, 2013 News 5 Comments

Morning Headlines 10/10/13

October 9, 2013 Headlines 1 Comment

ACO veterans share lessons from the trenches at MGMA

Stephen Nuckolls, CEO of Costal Carolina Health Care, led a discussion on lessons learned from his organizations ACO experience during this weeks MGMA conference. Inga attended the conference and offers her own insights over on HIStalk Practice.

Early detection of heart failure gets the big data treatment in NIH study with Geisinger Health, IBM

Geisinger Health System, IBM, and Sutter Health have been awarded a $2 million NIH grant to study how data analytics might help primary care doctors detect heart failure earlier than is currently possible.

Advice to the Next National Coordinator

Boston,MA-based Beth Israel Deaconess CIO John Halamka, MD offers his advice to the next National Coordinator for Healthcare IT. He remembers Blumenthal’s era as the "regulatory era," and Mostashari’s as the "implementation era." He says the next coordinator will need to "consolidate our gains" during a period that will likely include a significantly smaller budget.

Shinseki wants a budget for the VA

As more and more bills are passed during the government shutdown funding special programs, VA secretary Eric Shinseki has requested funding to continue paying disability benefits beyond their November 1 expiration. 

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October 9, 2013 Headlines 1 Comment

News 10/9/13

October 8, 2013 News 5 Comments

Top News

10-8-2013 7-28-00 PM

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

Reader Comments

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

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

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

HIStalk Announcements and Requests

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

Acquisitions, Funding, Business, and Stock

10-8-2013 7-17-51 PM

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

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


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

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

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

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

10-8-2013 7-33-50 PM

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

In Brazil, Hospital Israelita Albert Einstein chooses Cerner Millennium.


10-8-2013 3-40-00 PM

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

10-8-2013 3-51-08 PM

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

10-8-2013 3-57-23 PM

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

10-8-2013 5-40-50 PM

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

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

Announcements and Implementations 

10-11-2013 7-14-30 PM

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

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

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

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

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

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

10-8-2013 4-49-11 PM

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

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

10-8-2013 5-32-04 PM

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

Athenahealth announces its readiness for Meaningful Use Stage 2.

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


10-8-2013 7-38-52 PM

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

10-8-2013 6-11-43 PM

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

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

10-8-2013 7-39-44 PM

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

Sponsor Updates

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 8, 2013 News 5 Comments

Monday Morning Update 10/7/13

October 5, 2013 News 2 Comments

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

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

10-5-2013 4-21-58 PM

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

10-5-2013 9-01-10 AM

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

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

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

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

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

10-5-2013 4-18-37 PM

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

10-5-2013 4-26-57 PM

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 5, 2013 News 2 Comments

News 10/4/13

October 3, 2013 News 6 Comments

Top News

10-3-2013 5-38-48 PM

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

Reader Comments

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

HIStalk Announcements and Requests

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

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

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

Acquisitions, Funding, Business, and Stock

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


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

10-3-2013 6-03-42 PM

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


10-3-2013 3-41-21 PM

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

10-3-2013 5-14-25 PM

MaineHealth names interim CIO Andy Crowder as CIO.

10-3-2013 5-30-19 PM

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

10-3-2013 5-33-17 PM

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

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

Announcements and Implementations

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

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

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

Government and Politics

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

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

Innovation and Research

10-3-2013 10-13-22 AM

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


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

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


10-3-2013 1-02-38 PM

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

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

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

Sponsor Updates

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

EPtalk by Dr. Jayne

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

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

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

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

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

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

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 3, 2013 News 6 Comments

News 10/2/13

October 1, 2013 News 16 Comments

Top News

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

10-1-2013 4-21-38 PM

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

Reader Comments

10-1-2013 4-48-54 PM

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

10-1-2013 4-50-16 PM

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

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

HIStalk Announcements and Requests

10-1-2013 3-48-00 PM

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

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

Acquisitions, Funding, Business, and Stock

10-1-2013 4-51-58 PM

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

10-1-2013 4-53-21 PM


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

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

10-1-2013 4-54-54 PM

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


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

10-1-2013 4-56-00 PM

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



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

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

10-1-2013 3-00-40 PM

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

10-1-2013 1-51-22 PM

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

10-1-2013 10-28-26 AM

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

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

10-1-2013 1-53-10 PM

SRS names Peter Bennfors (Asset Control) CFO.

10-1-2013 4-04-17 PM

Infina Connect names Mark Hefner (Allscripts) as CEO.

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

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


Announcements and Implementations

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

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

10-1-2013 11-16-19 AM

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

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

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

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

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


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

10-1-2013 5-00-02 PM

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

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

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

10-1-2013 9-23-52 AM

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

10-1-2013 9-38-46 AM

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

10-1-2013 1-39-59 PM

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

10-1-2013 10-00-15 AM

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

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

Here’s an Intermountain video describing its Cerner selection.

Sponsor Updates

10-1-2013 4-06-10 PM

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 1, 2013 News 16 Comments

Monday Morning Update 9/30/13

September 28, 2013 News 12 Comments

9-28-2013 3-13-26 PM

9-28-2013 3-15-26 PM

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

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

9-28-2013 5-27-33 PM

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

9-28-2013 5-28-13 PM

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

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

9-28-2013 1-19-31 PM

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

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

9-28-2013 4-04-13 PM

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

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

9-28-2013 5-21-11 PM

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

9-28-2013 5-29-36 PM

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

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

9-28-2013 4-31-58 PM

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

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

9-28-2013 2-38-08 PM

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

Sponsor Updates

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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September 28, 2013 News 12 Comments

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