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News 8/30/13

August 29, 2013 News 14 Comments

Top News

8-29-2013 10-22-15 PM

HHS and the Illinois attorney general announce that they will investigate the July 15 theft of four unencrypted Advocate Medical Group desktop computers that contained the medical information of 4 million patients, announced last week. An HHS spokesperson signaled the financial exposure the medical group is facing in describing the “high-profile actions that have sent clear messages to the industry that we expect full compliance with privacy and security rules.” Advocate admits that the information should never have been stored on the hard drives. Obviously encryption technology would be throwing off some impressive ROI right about now, which might be something to consider if your organization hasn’t implemented it.

Reader Comments

8-29-2013 10-23-30 PM

From Josephine: “Re: Banner Health. Names Ryan Smith CIO.”Unverified. Smith’s LinkedIn profile says he is still AVP of IT operations at Intermountain Healthcare, but updating LinkedIn is not everyone’s top priority when taking a new job

.8-29-2013 10-24-14 PM

From Ron Mexico: “Re: [executive’s name omitted]. Leaving Allscripts, heading to Fletcher Allen to increase its ROI on Epic.” Unverified, so I left the name off for now, even though it’s obvious because he already works at Fletcher Allen part time.

From HIS Junkie: “Re: Sutter’s Epic downtime. To deploy Epic over a broad environment you have to create a ‘Citrix monster.’ That’s a classic sledgehammer solution to a legacy problem, far more likely to fail than a state-of-the-art system that is truly Web developed and deployed. One would think a competent competitor could really leverage that … but then where’s the competent competitors?” Speaking of Sutter, here’s the official response to our downtime inquires from spokesperson Bill Gleeson:

Sutter Health undertook a long-planned, routine upgrade of its electronic health record over the weekend. There’s a certain amount of scheduled downtime associated with these upgrades, and the process was successfully completed. On Monday morning, we experienced an issue with the software that manages user access to the EHR. This caused intermittent access challenges in some locations. Our team applied a software patch Monday night to resolve the issue and restore access. Our caregivers and office staff have established and comprehensive processes that they follow when the EHR is offline. They followed these procedures. Patient records were always secure and intact. Prior to Monday’s temporary access issue, our uptime percentage was an impressive 99.4 percent with these systems that operate 24/7. We appreciate the hard work of our caregivers and support staff to follow our routine back-up processes, and we regret any inconvenience this may have caused patients. California Nurse Union continues to oppose the use of information technology in health care but we and other health care provider organizations demonstrate daily that it can be used to improve patient care, convenience and access. While it’s unfortunate the union exploited and misrepresented this situation, it comes as no surprise given the fact that we are in a protracted labor dispute with CNA.

HIStalk Announcements and Requests

8-28-2013 3-37-55 PM

inga_small Highlights from HIStalk Practice this week include: Physicians are split when it comes to publicly sharing Medicare payment data. New York physicians are required to consult an electronic prescription database before writing scripts for controlled substances. The benefits of a practice’s ACO participation reach beyond the patients covered by the ACO. MGMA offers online scheduling tools for its annual conference. More than 90 percent of office-based physicians accept new Medicare patients, which is about the same percentage that accept new privately insured patients. The AMA urges CMS to prohibit insurers from paying physicians less than contracted amounts when reimbursing providers with plastic or virtual credit cards. Doximity says it has more physician members than Sermo. I look at the Stage 2 dilemma, highlighting the recommendations of various professional organizations and offering my opinions, namely that CMS should keep the January 2, 12014 start date but extend the deadline for meeting Stage 2 requirements. You won’t find any of these stories – and others – on HIStalk so keep reading HIStalk Practice if you like staying current with happenings in the ambulatory HIT world. Thanks for reading.

8-29-2013 7-12-00 PM

Welcome to new HIStalk Platinum Sponsor InterSystems. The company is a global leader in software for connected care. Its products empower healthcare professionals with the information they need to make the best clinical and business decisions. HealthShare is a strategic platform for healthcare informatics, enabling information exchange and active analytics across a hospital network, community, region or nation. Cáche is the world’s most widely used database system in healthcare applications. Ensemble is a platform for rapid integration and the development of connectable applications. InterSystems has more than 35 years of experience as a trusted partner serving thousands of physicians, hospitals, and health systems around the world, including Johns Hopkins, Kaiser Permanente and Memorial Care; five statewide HIEs; and the national health systems of Sweden and Scotland. The company’s technology is also used by over 100 leading healthcare software vendors in their solutions, including 3M Health Information Systems, Epic, and GE Healthcare. Thanks to InterSystems for supporting HIStalk.

A YouTube cruise turned up this video about InterSystems. I thought I knew the company pretty well, but I learned a lot about them.

On the Jobs Board: Staff Engineer (Java), Clinical Applications Consultant, Project Manager.

HIStalk Webinars

8-29-2013 6-19-55 PM

8-29-2013 6-37-06 PM

CareTech Solutions will present “Using Infrastructure and Application Monitoring to Assure an Optimal User Experience” on Thursday, September 19, 2013 at 1:00 p.m. Eastern. The presenter will be John Kaiser, senior director of the Pulse IT monitoring service. The abstract:

It’s time for hospital IT monitoring to mature – from reactive to predictive. Supporting the highly-complex healthcare technology environment with only individual monitoring tools or relying on an application vendor to identify system degradation is not the most effective means to providing users with a reliable, optimal IT experience. A comprehensive monitoring solution includes eyes on servers, network, application performance, and real user monitoring. CareTech Solutions will discuss an integrated approach to comprehensive monitoring of both the infrastructure and applications, with an emphasis on delivering a consistent solution based the hospital’s IT maturity level. The target audience is CIOs, CMIOs, CNO, IT directors, and IT analysts.

Acquisitions, Funding, Business, and Stock

8-29-2013 10-26-24 PM

The healthcare IT business unit of Tennessee-based Parallon Business Solutions, itself a subsidiary of Hospital Corporation of America (HCA), merges with Vision Consulting to form Parallon Technology Solutions, with Vision President Tim Unger taking the CEO role. Parallon Business Solutions has 24,000 employees and provides services to 1,400 hospitals and 11,000 non-acute care providers.

8-29-2013 10-30-05 PM

Carl Icahn boosts his stake in Nuance to 16.9 percent of the outstanding shares, according to an SEC filing Tuesday, saying he may want to talk to the company about adding his slate of nominees to the board. Above is the one-year NUAN share price in blue vs. the Nasdaq in red.


Blessing Physician Services will deploy Phytel’s population health management suite.

8-29-2013 1-29-50 PM

Rideout Health (CA) will roll out Perceptive Software’s Enterprise Content Management solution integrated with its McKesson Paragon HIS.


8-29-2013 1-32-48 PM

McKesson Specialty Health and the US Oncology Network appoints Michael V. Seiden, MD (Fox Chase Cancer Center) CMO.

8-29-2013 1-55-30 PM

Physician RCM provider MedData promotes Ann Barnes from president to CEO.

Announcements and Implementations

8-29-2013 8-38-08 AM

Australia’s Noarlunga Hospital activates Allscripts Sunrise Clinical Manager.

Novant Health (NC) reports that 343 of its physician clinics are now live on Epic’s PM platform and 316 are live on EHR. The five-year project was completed three years ahead of schedule and under budget.

Humana and Centene join Verisk Health as founding members of its pooled data initiative, which uses Verisk’s database of cross-payer information and analytics to identify illicit billing practices.

Hawaii Advanced Imaging Institute upgrades to RamSoft’s PowerServer RIS/PACS/MU radiology workflow application.

8-29-2013 9-10-36 PM

Home device manufacturer Bosch Healthcare and health content vendor Remedy Health Media announce a partnership to develop and sell products for remote patient monitoring.

Government and Politics

ONC opens the Behavioral Health Patient Empowerment Challenge to highlight existing technologies to help patients manage their mental health or substance use disorders.

A Washington Post article says that the Department of Veterans Affairs was paying bonuses to its disability claims employees despite a mammoth backlog, thereby encouraging them to game the system by pushing the tough claims aside to boost their numbers. It does point out that employees were handling high claims volumes even though the number of claims made the backlog grow.


inga_small Skyline Exhibits provides trade show stats that vendors might use to justify for exhibiting: (a) 81 percent of trade show attendees have buying authority; (b) the top reason for attending is to see new products; and (c) building brand awareness is the highest marketing priority for most exhibitors. Marketing execs may very well need to look for justification considering that a 10×10 booth at HIMSS costs about $4,000. Tack on drayage, shipping, travel, trinkets, and personnel and you’re at $20K in no time.

inga_small Coming to a baby shower near you: a smart sock from Owlet Baby Care that monitors a baby’s vitals and sleep position and includes a four-sensors pulse oximeter, an accelerometer, a thermometer, and a transmitter to send data to a smartphone or computer. The company’s cofounder says the device does not require FDA clearance, though a version that includes an alarm system for oxygen levels will. Owlet is seeking $100K in crowdfunding.

inga_small Here’s a story of interest to anyone in charge of their organization’s encryption efforts. UT Physicians (TX), the medical group practice of the UTHealth Medical School, notifies 600 patients of a potential data breach after the theft of an unencrypted laptop. Unlike similar thefts at other organizations, UTHealth has a comprehensive encryption policy that covers more than 5,000 laptops. The stolen laptop was overlooked, however, possibly because it was attached to an electromyography machine in the orthopedics department and is considered more of a medical device than a standard computer. The laptop included patient names, birth dates, and medical record numbers, but no financial information.

8-29-2013 9-18-32 PM

Researchers in Canada find that the use of RFID badges raised the handwashing compliance of nurses from 33 percent to 69 percent. Their study appears in the current issue of CIN (Computers, Informatics, Nursing). I wasn’t familiar with that journal even though it’s been around in various forms since 1983, but it looks decent.

Fourteen-hospital Baptist Memorial Health Care Corp. lays off 61 employees, including pharmacists and nurses, but urges them to reapply for 500 open positions, many of those newly created to support its Epic rollout.

If you’re a fan of evidence-based medicine or Coldplay, you’ll like this video, which was tweeted by Farzad Mostashari.

Spectrum Health (MI) fires several employees after one of them takes a picture of an ED patient’s rear and posts it to Facebook with a caption of, “I like what I like.” The health system fired the employee who took the picture and all of those who gave it a Facebook Like, including an ED doctor.

Marin General Hospital (CA) asks the FBI to investigate a possible scam that shut down the phones in labor and delivery and the ED last week.

8-29-2013 9-40-01 PM

Liviam announces its Facebook-like site for long-term hospital patients, which offers the CareStream timeline, a dashboard from which the patient can request help, a blogging tool, and an events calendar.

New York prescribers issuing prescriptions for pain meds must first check an online registry of pharmacy-reported filled narcotics prescriptions as of this past Tuesday, implemented to help curb the abuse of addictive drugs.

Sponsor Updates

  • Truven Health Analytics offers free access to Micromedex iPhone apps for customers outside the US and Canada. Truven also announces enhancements to its Unify Population Health Management solution, which is deployed in partnership with CareEvolution.
  • Iatric Systems announces that its Meaningful Use Manager and Public Health Syndromic Surveillance products have earned 2014 ONC HIT certification.
  • IHS names Merge Healthcare the leading provider of vendor-neutral archive solutions in the world and in the Americas.
  • iSirona adds Singapore-based telehealth services provider myHealth Sentinel as a reseller.
  • The Massachusetts eHealth Institute awards Aprima Medical a $101,000 grant to advance the interoperability of EHRs with the state’s HIE.
  • Besler Consulting releases a review of the FY2014 Hospital Inpatient Prospective System final rule.
  • InstaMed achieves Phase III CAQH CORE certification.
  • EClinicalWorks names HealthNet (IN) the winner of its Improving Healthcare Together video contest. Auburn Medical Group (GA) and Open Door Family Medical Centers (NY) took second and third places.
  • Aspen Advisors shares details of the ICD-10 preparation services it delivered to East Jefferson General Hospital (LA).
  • Dearborn Advisors discusses the need for healthcare organizations to optimize their EHRs in order to thrive in today’s regulatory climate.
  • API Healthcare highlights the importance of meeting the needs of an aging workforce.
  • pMD announces that its mobile charge capture solution will support iOS 7, which has a possible September 10 general availability.
  • Visualutions will resell Wellcentive’s Advance to FQHCs.
  • RazorInsights will showcase its ONE Enterprise HIS solution at the 15th Annual HIS Pros Buyer’s Seminar next month in Rosemont, IL.
  • Medicomp hosts its annual strategy update webinar September 18 and 19 and opens registration for MEDCIN U sessions November 3-5 in Reston, VA.


EPtalk  by Dr. Jayne


It’s quite a challenge to try to keep up with Mr. H and Inga in finding newsworthy items each week for EP talk. Between our day jobs and our staggered publishing schedules, it’s easy to be scooped by another member of the HIStalk crew. In the spirit of mixing things up, we’ll be taking EPtalk in some new directions. I may write up an interesting product, discuss a recent journal article, or respond to something I’ve seen in social media. Since EPtalk runs with the news each week with a slightly different audience than Curbside Consult, I may do some multi-part pieces to allow reader responses to influence the next week’s piece.

Yesterday, @ONC_HealthIT tweeted a recent Wall Street Journal Health Blog piece that asked readers what doctors use as the basis for care decisions: business or financial considerations, fear of lawsuits, or doing what is best for patients. I was gratified that with over 1100 votes, 56 percent of respondents believe we want to do right by patients. The other two options tied at 21 percent.

I’ve spent a good part of my career working in emergency departments and urgent care situations. I have to agree that fear of lawsuits can be an important driver. Financial considerations are also important, but there are many nuances other than what this survey can capture. Case in point: at one of the hospital-owned urgent care centers where I moonlight, the leadership issues a monthly report that looks at our utilization. On the surface, this aims to encourage us to provide more cognitive medicine and perform less defensive medicine.

Although thoughtful practice is a nice goal, I’d be kidding myself if I thought the report was aimed at encouraging us to use our brains rather than tests. The fact of the matter is that our population is largely uninsured, with Medicaid and Medicare closely behind. The hospital has been hemorrhaging money for the last decade despite extremely good management. It’s largely due to payer mix and other external economic factors in the community. Across our department, the Family Medicine physicians have much lower service utilization than do the Emergency Medicine physicians, and I think it’s partly due to the way we see the patient population

As a family doc, I’m used to seeing patients quickly in the office, treating their self-limited problems, and moving on. There’s a relationship between the patient and the physician. We tend to think that if the patient is becoming worse or not improving, they’ll be back. We don’t feel that pressure to try to cover all eventualities while they are in front of us, although it’s become that way with the advent of the Patient-Centered Medical Home, Accountable Care, and other initiatives where every visit has become a preventive/full-service visit as we try to cram as much as humanly possible into each encounter.

I really try not to order tests if I can make the diagnosis based on clinical history and physical examination. Not just for cost reasons, but also because tests are not without risk. Even a simple urinalysis can give false positives that lead to unnecessary follow-up, including not only financial cost but the burden of patient anxiety.

I’m also not afraid to play the bad guy with patients when it’s indicated. I don’t care if your husband’s primary doc gave him antibiotics for his viral illness. Just because you came to the urgent care and have the same symptoms, you’re not going to get them from me. I don’t care if your copay was $50, it’s not the right thing to do. It’s likely you’ll mark me down on your patient satisfaction survey, but I’ve reached a point in my career where I simply care less about satisfaction scores than I do about quality care and antibiotic resistance. You’ll get my empathy, sympathy, and some symptomatic treatment, but no Z-pack for you.

My peers that trained in emergency residency programs tend to order more X-rays for vehicular trauma even if the clinical story isn’t that impressive. Maybe it’s fear of being sued or maybe it’s just the way they’ve been habituated from working in higher acuity and trauma centers rather than the ambulatory office. Maybe because there was that one case where they missed something and it came back at them later. It’s definitely harder to try to help a patient understand why decision support rules say it’s OK to not order an x-ray than it is to just shoot a film, and sometimes I order those films too. None of us is perfect and medicine still has some art to go along with the science.

The most interesting thing about the utilization reports, though, is that over the last year, they have done very little to drive any of physicians at the high end of the test ordering spectrum into a lower bracket. Right now, the only “incentive” provided is seeing your name on the report and where you fall against your peers. Some docs may consider these reports the way I see the physician satisfaction numbers – as something that’s not on the top of their list for the many things we have to worry about when we’re seeing patients. Others may need education or potentially something more tangible before their behavior will change.

The bottom line, though, is that defensive medicine is alive and well regardless of steps towards tort reform, provider education, and other interventions. I’ve been doing some thinking about the other 21 percent as well. I’d liked to have seen the “financial considerations” choice expanded to include other options but you’ll have to tune in to the next post for those thoughts.


I’ll still throw in the occasionally newsy tidbit especially if it involves both shoes and technology. A new CT scan technology by CurveBeam called pedCAT shows what the foot and ankle actually look like when weight bearing. I was fascinated by the YouTube clip from the Royal National Orthopaedic Hospital. Since I was hobbling around this afternoon due to a loose heel on my favorite pair of pointy-toed mules, it’s a sure bet that my scan would have more than one ICD-10 code associated with it. I’m leaning toward “Unspecified soft tissue disorder related to use, overuse and pressure” and “Grief reaction” since I ultimately had to pronounce said mules dead at 6:59 p.m.


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

More news: HIStalk Practice, HIStalk Connect


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August 29, 2013 News 14 Comments

News 8/28/13

August 27, 2013 News 10 Comments

Top News

8-27-2013 8-23-29 PM

8-27-2013 8-24-07 PM

Two Kansas HIEs, one covering Kansas City and the other serving the rest of the state, risk losing their federal grant money if they can’t agree on data exchange terms by the state-imposed deadline of September 30 (already extended from July 30). LACIE and KHIN could be forced to shut down by the end of the year if they haven’t worked out their differences by then. KHIN doesn’t want the network to share data with insurance companies that aren’t KHIN members, while LACIE says the agreement would prohibit organizations that are connected to an ACO from accessing the network’s data. At issue is aggregated information that could be used for non-patient care purposes. The Kansas HIE board voted to shut itself down in September 2012 and let the Kansas Department of Health and Environment take over its duties, which means the state is in charge. Kansas has no secondary data use policy.

Reader Comments

8-27-2013 8-26-55 PM

From Joyce: “Re: Mission Hospital, Asheville, NC. Laying off 70 workers, which is big news in a small town where healthcare supports the local economy.” The 730-bed hospital will cut the CEO’s salary by 26 percent, slash management salaries from 13 to 20 percent, eliminate merit increases, implement a three-month PTO freeze where time off is not accrued for worked hours, reduce its 403(b) matching, and reduce the employee wellness incentive. The hospital’s CEO made $480K in 2010, while the CIO was paid $349K. That’s the problem with hospitals – they provide growth to their local economy, but much of that is paid for by federal taxpayers in the form of unsustainably rising national healthcare costs. Building an economy based on healthcare won’t work, which politicians seem reluctant to admit since hospitals employ a lot of people and write nice political donation checks.

8-27-2013 5-37-48 PM

From HealthPlans: “Re: WellPoint. AJ Lang is no longer with the company, an internal employee tells me.” A WellPoint spokesperson confirms that Andrew J. Lang, senior VP of application development since December 2008, is no longer with the company.

8-27-2013 6-23-03 PM

From Mennonite Rockstar: “Re: BIDMC IT security after the Boston bombing. I had the impression they rearranged the setup of their homegrown application’s security from reading the Fast Company article. Perhaps Mr. HIStalk can get Halamka to clarify?” John says that his IT shop made no changes to their applications, but did tweak their audit log reports to allow the hospital’s compliance department to monitor the specific situation.

Acquisitions, Funding, Business, and Stock

8-27-2013 1-34-24 PM

Group purchasing organization Premier Inc., owned by 181 hospitals, health systems, and other healthcare organizations, files plans for an IPO of up to $100 million in common stock. Premier had $869 million in net revenue for the fiscal year that ended June 30, up 13 percent from the prior year.

8-27-2013 6-12-32 PM

Merge Healthcare Chairman Michael Ferro, Jr. resigns and is replaced by board member Dennis Bell. Ferro, Merge’s top shareholder, has indicated that he may eventually explore ways to boost shareholder value, including taking the company private. MRGE shares were unchanged on the news.

Federal HIT provider Systems Made Simple projects 2013 income of $260 million, up from $167 million in 2012.

8-27-2013 7-55-39 PM

The strategic venture arm of Canada’s TELUS makes an unspecified investment in Rockville, MD-based Get Real Health, which offers the InstantPHR personal health record. Three of the company’s seven executives came from US Web, while two were Microsoft HealthVault developers.


8-27-2013 1-38-39 PM

Southern Prairie Community Care ACO (MN) will deploy technology from Sandlot Solutions to manage patient health information and give providers access to data  at the point of care.

8-27-2013 1-41-15 PM

HealthproMed (PR) selects eClinicalWorks EHR for its two-location FQHC.

Greenway Medical will develop an HIE for more than 500 physician members of the Denver-area Rose Medical Group, Rose Medical Center, and their patients.

8-27-2013 1-43-04 PM

Grady Health System (GA) selects Strata Decision Technology’s StrataJazz for cost accounting, operating budgeting, and capital planning.

PinnacleHealth will use Care Team Connect’s integration and rules engine to integrate biometric data from Honeywell monitoring devices with other patient health data.

8-27-2013 8-29-51 PM

Palmetto Health (SC) chooses 3M 360 Encompass System for automated coding, clinical documentation improvement, and performance monitoring.

8-27-2013 7-48-52 PM

The National Football League signs a 10-year agreement for the ININITT Smart-NET PACS, which will allow the medical images of players to be viewed remotely or from mobile devices on the sidelines.


8-27-2013 1-47-01 PM

QHR Corporation, a Canada-based HIT company, names Owen Haley (Allscripts) chief commercial officer.

8-27-2013 1-48-08 PM

Tony Scott (Microsoft) joins VMware as CIO.

Cumberland Consulting Group adds Joseph Serpente (McKesson) as director of business development.

Announcements and Implementations

PeaceHealth’s Peace Island Medical Center (WA) goes live on Epic September 1.

inga_small Emdeon launches a self-service testing exchange solution for ICD-10, allowing providers and channel partners to submit ICD-10 test claims and receive claim status feedback. The Emdeon Testing Exchange for ICD-10, which Emdeon purports is the first of its kind in the industry, requires no additional software and is a free service to Emdeon providers, channel partners, and payer customers. Sounds like a great service that would be even more valuable if more payers were ready and if providers already had ICD-10-ready software updates from their vendors.

8-27-2013 12-34-57 PM

Greenway presents Innovation Awards to Boulder Community Hospital Physician Clinics (CO), Regional Obstetrical Consultants (TN), and Albuquerque Health Care for the Homeless (NM) at its PrimeLEADER user conference in Washington, DC.

8-27-2013 12-54-01 PM

Sonora Regional Medical Center (CA) goes live on Cerner September 4.

8-27-2013 8-11-45 PM

Vocera announces enhancements to its secure messaging platform that include on-call scheduling, new smartphone clients, an improved Web console, and server enhancements.

8-27-2013 12-58-10 PM

inga_small I came across this tweet today. Ah, athenahealth, I don’t think you can convince me that switching EHRs is as easy as switching from Time Warner to AT&T U-verse.

Innovation and Research

8-27-2013 8-31-56 PM

University of Florida researchers are developing a scoring model that will use hospital EHR information to identify inpatients most likely to experience an adverse drug event, allowing those patients to be more aggressively monitored. The result will be rolled out to 13 hospitals for validation in the study’s second year.


8-27-2013 7-43-43 PM

An Ohio surgeon wearing Google Glass during a surgery broadcasts the procedure over the campus network, also using it to consult with a colleague.



inga_small Apple is rumored to be planning a trade-in program for iPhones in an attempt to increase the percentage of units it sells directly. What Apple is really trying to do is get  more people like me to walk into their retail stores and spontaneously drop $50 on the latest, greatest cool Apple accessory. The speculation is that Apple will tie the trade-in value to the cost of an upgraded iPhone and offer an amount less than the open market value or what third-party companies like Gazelle would pay. I’m not due for a discounted upgrade any time soon, but my 16GB iPhone 5 is almost filled up. Maybe I’ll be one of the nerdy folks queuing up in line at the Apple store the first day the newest iPhone is released, supposedly in late September.

8-27-2013 1-27-55 PM

8-27-2013 1-31-06 PM

Cerner and Epic are winning three-fourths of all new large-hospital EMR deals, according to a new KLAS report on clinical market share. Cerner and Epic dominate in community hospitals, though McKesson Paragon and Meditech are gaining some traction. Biggest net customer losers for 2012 were McKesson and Siemens, while Epic was the only vendor that didn’t lose any customers. Allscripts, GE Healthcare, and QuadraMed had no wins at all.

8-27-2013 11-57-20 AM

inga_small HIMSS opens registration for its annual conference February 23-27 in Orlando. Aetna CEO Mark Bertolini will deliver the keynote address bright and early Monday, while Wednesday afternoon’s keynote speaker is still TBA. The Thursday afternoon keynote is “world class blind adventurer” Erik Weihenmayer, who unfortunately may not be enough of a draw to prevent weary crowds from making a mass exodus Thursday morning.

8-27-2013 7-23-01 PM

A California Nurses Association press release claims that Sutter Health’s Epic system went down Monday at its Northern California hospitals following an eight-hour upgrade-related downtime on Friday. A union spokesperson was quoted as saying, “This incident is especially worrisome. It is a reminder of the false promise of information technology in medical care. No access to medication orders, patient allergies and other information puts patients at serious risk. These systems should never be relied upon for protecting patients or assuring the delivery of the safest care.” While the union did not issue an equally passionate press release extolling the virtues of paper charts, it did throw in unrelated shots at management for urging nurses to enter patient charges correctly, apparently preferring that Sutter not bill what it’s owed even though those funds allow it to generously pay unionized nurses.

8-27-2013 8-05-52 PM

The Gainesville, FL newspaper profiles 12-employee RegisterPatient (now using the name Ingage Patient)and its CEO Jana Jones, who was formerly CEO of BCBS of Tennessee subsidiary Shared Health. According to the company’s site, the product offers appointment scheduling, alerts, registration, secure messaging, check-in, health education, a PHR, care plan integration, renewal requests, and electronic referrals.

8-27-2013 5-50-52 PM

This photo by @Nurse_Rachel_ is surely embarrassing Sinai Hospital of Baltimore as it lights up Twitter. Nobody should be surprised that hospitals and doctors do whatever pays them the most; to expect otherwise is naive.

Weird News Andy says, “Nurse, doctor, what’s the difference?” A draft VA policy would eliminate the requirement that advanced practice nurses, including nurse anesthetists, be supervised by physicians. Take a wild guess at how the American Society of Anesthesiologists feels about that.

WNA also notes an AARP report warning  that 20 years from now, aging baby boomers won’t have enough family members to take care of them because of increased longevity, fewer children, and a high divorce rate. Family care is worth an unpaid $450 billion per year

Technical problems with the site Sunday and early Monday forced me (for reasons too hard to explain) to remove Vince’s HIS-tory of Cerner in the Monday Morning Update and simply link to it instead. Here it is again. Meanwhile, the site is now running on a supercharged new server that will better handle the readership growth. I’ll probably appreciate that more after I’ve caught up for all the sleep I lost over the weekend as the web hosting people fixed the inevitable problems.


Sponsor Updates

  • Imprivata introduces OneSign ProveID Embedded for use within virtual desktop environments.
  • GetWellNetwork announces the call for presentations for its seventh annual user conference June 3-5, 2014 in Chicago.
  • Frost & Sullivan recognizes Merge Healthcare with the 2013 North America Award for Product Leadership in Interoperability Solutions for its iConnect Enterprise Clinical platform.
  • Wakely Consulting Group will process data from Truven Health MarketScan Research Databases through its Wakely Risk Assessment Model to help health plans meet HHS requirements for risk adjustment and reinsurance.
  • Jason Fortin, senior advisor at Impact Advisors, discusses MU deadlines.
  • The HCI Group is named to the Inc. 5000, coming in at #3 with 24,545 percent revenue growth in the past three years.


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

More news: HIStalk Practice, HIStalk Connect



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August 27, 2013 News 10 Comments

Monday Morning Update 8/26/13

August 25, 2013 News 1 Comment

From Todd: “Re: FDA security guidance. FDA has published radio frequency guidance for wireless medical devices that includes information about authentication and encryption to prevent hackers from gaining control. FDA has a draft out for comment that includes a requirement that vendors develop a plan to apply operating system updates and patches to address security flaws.” It’s strange (or typical government efficiency) that a document that went to draft in January 2007 finally gets published years afterward. The cybersecurity draft came out in June.

From Digital Bean Counter: “Re: Optimity Advisors. Anyone have experience working with them?”

From Keith: “Re: EHRs. If they aren’t medical devices, why is the vendor reporting to the FDA and recalling its care controlling system?” Picis announces a Class 2 recall of its ED PulseCheck emergency department information system due to a problem printing entered notes along with prescriptions. My guess is that Picis (part of OptumInsight) commendably reports through FDA even though they aren’t required to since I’ve seen their entries in the MAUDE database over the years. Demands for FDA oversight would be reduced to almost nothing if vendors reported and tracked software defects with the same enthusiasm as they do unpaid invoices.

Most poll respondents don’t think the FDASIA report will improve IT-related patient safety since it limits its scope to a user reporting mechanism and other forms of post-marketing surveillance. New poll to your right: when a vendor requires you to register before downloading a white paper you want to see, what do you do? I will, as the poll maker, unprofessionally expose my bias in stating that I think hiding advertising material behind a lead-gathering signup form is both stupid and insulting. We hospital people are smart enough to figure out how to contact you if your material inspires us to further action; we aren’t fans of being cold called as punishment for being willing to give your material a look. Do the sales and marketing people a favor and ignore their faulty advice. I always sign up with phony information, inserting the vendor’s own phone number in the required slot.

I  ran a reader’s question in Friday’s news asking for hospitals that have switched from Cerner to Epic. Readers provided these: Aurora, Legacy Health Portland, Children’s Dallas, University of Utah (underway), Rex Healthcare, Loma Linda, and Lucile Packard (underway). I appreciate the information, which then led me to another question as it often does: have any hospitals voluntarily switched from Epic to Cerner?

XIFIN, which offers revenue cycle solutions for laboratories, radiology,  and pain management, acquires PathCentral, a vendor of cloud-based digital anatomic pathology vendor with big-name customers such as Johns Hopkins, Mass General, and University of Southern California.

A medical assistant / IT administrator at an orthopedics practice is arrested for stealing a pre-signed blank prescription form from the the practice’s EMR and writing himself a prescription for Percocet.

The Washington Post profiles Altruista Health, a 75-employee Reston, VA company that offers predictive algorithms that identify a provider’s highest-risk patients. I ran a Readers Write article by CEO Ashish Kachru in December 2012.

URAC and the Leapfrog Group announce the second annual Hospital Website Transparency Awards, which recognizes websites that portray quality measures honestly and contain information that’s actually useful instead of the far more common marketing BS (stock photo photogenic doctors, community chest-puffing, and unsubstantiated claims that locals are incredibly lucky to have a world-renowned medical facility in a town too small to even have a mall.)

Wisconsin Statewide Health Information Network says it will go live soon, running on the Medicity platform.

A 178-respondent CIO survey performed by SSi-SEARCH finds that the average CIO makes $286K, but despite greatly increasing workload and responsibility, receives single-digit annual salary increases. Still, almost 60 percent of respondents say their pay is satisfactory. They report that people- and team-related issues are both their biggest challenge and their biggest accomplishment. Only 11 percent of the CIOs aspire to a non-IT role, but those who do are interested in a COO position despite responses indicating that it’s tough for a CIO to be recognized as a strategic leader outside the IT realm.

An Allscripts promotional video filmed at Sarasota Memorial Hospital (FL) celebrates the hospital’s 15 years on Sunrise and features VP/CIO Denis Baker.

New York City is piloting NYC Macroscope, which aggregates EHR data into a public health surveillance database that will allow city officials to monitor the health of the population in near real time. Their only concern is that its data is, by definition, limited to those patients who receive medical care, so the city will still need to conduct traditional survey-based surveillance. Data exchange has been established with 3,200 providers in the NYC Primary Care Information Project, which uses eClinicalWorks and distributes queries through the Hub Population Health System.