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Monday Morning Update 3/10/14

March 9, 2014 News 4 Comments

Top News


The Wall Street Journal reports that transcription and speech recognition software vendor MModal will file bankruptcy this week, loaded with $750 million in debt as a result of its leveraged buyout in August 2012 and facing declining sales. The company expects to work out a debt restructuring plan in advance that will allow some of its creditors to swap the money they are owed for equity in the reorganized company. UPDATE: MModal provided this statement in response to the HIStalk news item:

MModal is continuing discussions with certain of its lenders and bondholders regarding a range of financial restructuring options to enable the company to reduce its debt and enhance its financial flexibility. We believe these discussions have been constructive and we are working towards a resolution that has the support of our lenders which would provide a positive outcome for all of our stakeholders, including our customers, employees, and suppliers. We fully expect to continue operating in the ordinary course of business and providing our customers the high level of support they have come to expect from MModal. The company has solid revenue, strong operating margins, cash flows consistent with industry norms, a large customer base, and we are continuing to invest in the future. Our operations are strong and we are generating exceptional quality metrics and high customer satisfaction. We are executing on our vision to provide the healthcare industry’s most advanced clinical documentation solutions.

Reader Comments


From Caterwaul: “Re: readers during HIMSS. How many do you get?” Around 8,000 visits daily during the conference, peaking this year at 9,000 visits and 17,000 page views on Wednesday, February 26. For the month, it was 125,000 visits and 207,000 page views. The graph above covers the last 30 days.

From The PACS Designer: “Re: iPhone 6. Excitement is starting to build for the next generation of the iPhone, will feature for the first time a quad-core 64 bit processor along with iOS 8. Also expected at  launch is a heart rate monitor along with the much anticipated iWatch. It looks like Apple’s going for a big splash of new products in 2014.” Sometimes it feels as though the iPhone is like the iPod – a mature, somewhat commoditized market in which minor feature differentiation passes for innovation. Apple and competitors can do only so much in screwing around with the screen size and construction materials, so the real improvements have to come from the OS.

From Jeff: “Re: headlines. Is is possible to get the morning headlines and any M&A news in a daily email?” I hadn’t thought of doing that since I assume most readers just go to the site, but it’s possible. Weigh in on the reader survey if you’d like since that’s where my to-do list will come from.


From Olga: “Re: reader comments. I get the feeling that comments are filtered since controversial topics don’t always have many.” Comments are not filtered. I approve every one except these: (a) unverifiable claims that a specific person is quitting or being fired; b) repetitive, annoying diatribes posted by the same person using different names, as in the multiple anti-EMR identities of Not Tired of Suzy, RN; (c) comments trying to publicize a company or site. I should add that the Akismet spam filter automatically deletes comments that come from known spammer IP addresses or that contain questionable content, like a bunch of links. You might be surprised at some of the comments that I’ve rejected: claims that a specifically named CEO forced a female VP to attend an orgy, assertions of deviant behavior by well-known industry figures, and full-out personal attacks on people named in given post.

HIStalk Announcements and Requests


Half of the HIMSS conference attendees who responded to my poll said it was a good overall experience, with the remaining 25 percent each declaring it to have been either poor or great. New poll to your right, just for (anonymous) fun: how much money did you make from your primary job in 2013?

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Here are more mug shots. Theo, 18 months old, doesn’t seem to mind Dad’s mishap traveling home from HIMSS that will require Mom to fix the handle. To the right, Colleen says she has one wish for Christmas since nurses need high-capacity mugs.


Every year right after the HIMSS conference I ask readers to complete my survey telling me what they like, don’t like, and recommend for HIStalk. It only takes a few minutes and I plan my entire year from the feedback. You will make a difference, earn my gratitude, and be entered in a drawing for three $50 Amazon gift cards. Thank you.


I won’t overdo the DonorsChoose project updates, but I wanted to share an example of the student letters you receive when you fund a classroom project. This one from a second grader says, “Thank you for the nonfiction books. We use them for learning and reading stations. We love them.” Lots of charities do good work but spend too much of their donations on fundraising and salaries. DonorsChoose has amazing stats: 94.4 percent of donations go toward programs and services instead of overhead, the CEO is paid only $240K, and it earns an amazing score of 67.83 out of a possible 70 on Charity Navigator. I was jaded about charities having worked in wasteful hospitals until I did my homework and came up with DonorsChoose and Salvation Army. I don’t donate a penny until I check Charity Navigator because marketing overhead can be up to 90 percent for some causes that run TV ads.

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


Upcoming Webinars

March 19 (Wednesday), 1:00 p.m. ET. The Top Trends That Matter in 2014. Sponsored by Health Catalyst. Presenters: Bobbi Brown, VP and Paul Horstmeier, SVP, Health Catalyst. Fresh back from HIMSS14, learn about 26 trends that all healthcare executives ought to be tracking. Understand the impact of these trends, be able to summarize them to an executive audience, and learn how they will increase the need for healthcare data analytics.

Acquisitions, Funding, Business, and Stock


The private equity owners of payer-provider connectivity vendor Ability Network are seeking a buyer for the company, expected to fetch up to $500 million.

Government and Politics


Former White House advisor and oncologist Ezekiel Emanuel, MD, PhD (Rahm’s brother) writes a Wall Street Journal piece on the infighting involved in creating the Affordable Care Act. Everybody knows that HHS on one hand declares itself technologically innovative and its ONC organization demands that healthcare providers advance their technology prowess, while the CMS side of HHS’s house spends vast taxpayer fortunes on its primitive systems and the marginally competent bureaucracy required to maintain them. On bundled payments:

We presented the idea of phasing in bundled payments, especially for chronic conditions, to the rest of the White House reform team, where we found some strong support. But then we hit a brick wall. Many of our colleagues who worked for Medicare feared that creating the bundles would be too hard and warned that Medicare didn’t have the computer infrastructure to handle it. The arguments went back and forth, but the Medicare bureaucracy wouldn’t budge. Ultimately, the ACA authorized 10 demonstration projects that could be expanded if they worked—a good start, but a far cry from the more ambitious bundling plan many of us had hoped to see.

Delaware’s health department wants $87 million in FY2015 capital to upgrade its eligibility systems to meet Affordable Care Act requirements, adding that it’s too good of a deal to pass up since federal tax dollars will cover 90 percent of the cost. A Republican state representative isn’t impressed with the department’s plans. “We could have started our own endowment. It’s just staggering. This math is out of control. It’s extremely, extremely disingenuous to say this (Affordable Care Act) is saving us money.”

Innovation and Research

Engineering cadets from the United States Air Force Academy develop Neumimic as their capstone project, working with a local hospital to design a stroke recovery application based on Microsoft Xbox Kinect. The system allows patients to exercise specific muscle groups at home without a physical therapist.


It’s spring-forward time as I write this on Saturday morning. Thanks if you are one of the folks who will be babysitting hospital systems tonight to make sure everything works with the change to Daylight Saving Time.

The folks at SIS put together a hilarious video that parodies vendors preparing for the HIMSS conference. It contains quite a few inside references from HIStalk (like companies that claim “HIPPA” expertise). Leave a comment with those you notice since I’m sure I didn’t catch them all.


An interesting and scary use of big data: auto repossession companies are using vehicle-mounted recognition technologies to cruise the parking lots of malls and stadiums, capturing the license plate numbers, location, and timestamp of every car they pass. The information goes to a company in Texas whose database contains 1.8 billion scans that include the majority of American vehicles. The company is just beginning to realize the value of that information, planning to sell it to private investigators, insurance companies, and banks, who only need to match up the plate numbers to other state databases to know where any given person has been.


Somehow this local newspaper’s headline seems Onion-like.


Family members of deceased patients in China, like those in India, are increasingly turning violent toward the doctor or hospital involved, with 17,000 recorded incidents in 2010. An ED doctor in Guangdong province was forced last week to march with 100 friends and family members of a patient who died, accusing the doctor of malpractice. The hospital called police and he was released 30 minutes later.


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

More news: HIStalk Practice, HIStalk Connect.


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March 9, 2014 News 4 Comments

News 3/7/14

March 6, 2014 News 1 Comment

Top News


The Defense Health Agency, established in October 2013 as a successor to TRICARE, requests $1.6 billion to support its health IT systems in 2015. It also wants $91 million for R&D to develop a new EHR by 2017 and $68 million to integrate its systems with those of the VA. Meanwhile, the VA’s 2015 budget requests include $269 million for EHR development.

Reader Comments


From TooMuch Coffee: “Re: WA state healthcare insurance exchange. You mention that 15k applications are stuck in limbo. I agree that’s not great, but they have signed up around 500k successfully. The site basically works, unlike OR and HI sites.” I’ve written about Oregon’s struggling exchange, so here’s the story on Hawaii’s: it received $204 million in federal funding, went live two weeks late due to software problems, has enrolled fewer than 5,000 people (at a cost of about $46,000 each), and has already been declared unsustainable without ACA rule changes since few potential customers and insurers are interested and it’s supposed to be self-funding its $15 million annual operating budget with 2 percent of the take. Meanwhile, the US Government Accountability Office says it will audit Oregon’s exchange, which cost $304 million and hasn’t enrolled a single person without manual help.

From Concerned: “Re: UHN in Toronto. Can anyone confirm that they are replacing QuadraMed EHR with Cerner?”

From Nobody Knows: “Re: value-based risk contracts. Is there a resources that details which payers and providers are engaging in them vs. those doing fee-for-service? I’ve tried AIS, HIMSS Analytics, and Billian’s and so far, no dice. Even a high-level report would be nice.”

HIStalk Announcements and Requests

inga_small This week on HIStalk Practice: You won’t want to miss the summary of my chat with eClinicalWorks CEO Girish Navani, who shares his thoughts on the MU program, population health, and health information exchange, plus provides an estimate of the company’s valuation if it were to go public. Despite the growing number of  employed physicians, work still needs to be done to integrate physicians and develop performance-based reward programs. The pay gap between primary care providers and specialists narrowed in 2013. I recap some vendor announcements from last week and muse on various HIMSS sights and sounds, including the future of Practice Fusion; Allscripts and its new tag line; what’s driving Aprima’s recent growth; and, the hot topic of ICD-10. Thanks for reading.

This week on HIStalk Connect: Samsung unveils the Galaxy S5, which integrates with both its two new smart watches and its new activity tracker. Basis, the maker of the B1 activity tracker, is acquired by Intel for a rumored $100 million. The FDA is looking for a vendor to develop social media analytics tools.

On the Jobs Board: Chief Market Strategist – Healthcare, EHR Tester, Epic Activation Consultant.


Welcome to new HIStalk Platinum Sponsor CompuGroup Medical. You see the count of big global customer numbers in their graphic above and the owner-led and publicly traded company is expanding its US sales. Offerings include CGM Clinical (integrated PM/EHR), CGM DAQbilling (PM), CGM webEHR (EHR), CGM webPRACTICE (PM), and CGM Enterprise (PM/EHR for community health centers); LIS, outreach, and reference lab solutions; the eSERVICES Patient Portal, EMEDIX Reimbursement Solutions, and the SAM disease management platform. The new CEO of CGM US is Norbert Fischl, who has an interesting background as leader of the company’s Northern European region, managing director of a software company, McKinsey consultant, and an Internet entrepreneur. Thanks to CompuGroup Medical for supporting HIStalk.


Here’s another update on one of our DonorsChoose projects that was paid for by the top-of-the-page ads. The 35 freshman girls in the Illinois high school taught by Teach for America teacher Ms. Schwartz are using the notebooks and colored pencils we provided to create College Bound Journals. They will fill them with goals, thoughts about their futures, and information they gather about college campuses and majors. You can see in the photo sent by the teacher that they’ve already started.  

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More remote mug sightings.


Anne-Marie wasn’t able to get way from the family medicine practice she manages to attend the HIMSS conference, so she made her own mug. She says it’s not nearly as cool as the original, but I disagree.


It’s time for the once-yearly HIStalk Reader Survey. It’s quick and I use the results to plan the entire next year of HIStalk, so I would really appreciate your taking five minutes or less to give me some guidance. I’ll sweeten the pot by randomly drawing three responses to receive $50 Amazon gift cards. Thanks in advance – most of the good ideas I’ve put in place came from responses to this survey.

Upcoming Webinars

March 19 (Wednesday), 1:00 p.m. ET. The Top Trends That Matter in 2014. Sponsored by Health Catalyst. Presenters: Bobbi Brown, VP and Paul Horstmeier, SVP, Health Catalyst. Fresh back from HIMSS14, learn about 26 trends that all healthcare executives ought to be tracking. Understand the impact of these trends, be able to summarize them to an executive audience, and learn how they will increase the need for healthcare data analytics.

Acquisitions, Funding, Business, and Stock


MedAssets reports Q4 results: revenue up 4.1 percent, adjusted EPS $0.28 vs. $0.25, beating estimates on both.


Clinical prediction software vendor Health Outcomes Services completes a $5 million financing round. CEO Jim Wilson has worked for McAuto, EDS, and Cerner and was president of Craneware before joining HOS.



ArborMetrix appoints former CMS administrator and FDA commissioner Mark McClellan, MD, PhD (Brookings Institution) to its board.

3-6-2014 12-31-58 PM

Idea Couture hires James Aita (Medicomp) as head of healthcare solutions.

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Bart Foster, founder and CEO of self-service medical kiosk maker SoloHealth, is replaced by Chairman Larry Gerdes (both above.) The company’s CFO has also resigned and an undisclosed number of employees have been laid off. Gerdes sold transcription vendor Transcend Services to Nuance for $300 million in 2012. One of SoloHealth’s investors is healthcare IT long-timer Walt Huff, the “H” in HBOC, where Gerdes was an executive from 1977 to 1991.   

Tamyra Hyatt (McKesson) joins Azalea Health as VP of marketing.

Announcements and Implementations

3-6-2014 9-32-27 AM

The New York eHealth Collaborative and the Partnership Fund for NY call for applications for participation in the second class of the  NY Digital Health Accelerator, where 10 early- and growth-stage companies will each receive mentoring and $100,000 of investment capital.


North Dakota officials announce the official rollout of the state’s HIN, which will connect all of North Dakota’s hospitals by the end of the year.


The US Army deploys a software upgrade to its battlefield Medical Communications for Combat Casualty Care EMR, also known as the MC4 system, that includes an upgraded operating system, enhanced security, and patient safety improvements related to allergies and medication history.

Government and Politics

HHS includes $75 million in its 2015 budget for ONC, a $14 million increase over last year.

3-6-2014 1-30-21 PM 

ONC updates its Health IT Dashboard to include a Rand Corporation-prepared review of literature on the impacts of HIT, with a focus on MU functionalities.


Analysis of full-year 2013 MU attestation data by Wells Fargo Securities finds that 92 percent of hospitals stuck with the same vendor for at least two years. Meditech, Allscripts, and Siemens topped the list of hospitals that stayed the vendor course, Cerner and CPSI were average, and Healthland, McKesson, and HMS lagged. It also finds that small hospitals seem to be dropping out in big numbers by the third year, perhaps because they’ve paid their EHR costs in the first two years and don’t want to deal further with MU complexity.

Innovation and Research

3-6-2014 1-09-43 PM

Hospitalization rates declined at nursing homes that used after-hours telemedicine services, according to a Commonweath Fund-sponsored study. Researchers estimate that the use of telemedicine services could net Medicare a $120,000 savings annually per nursing home.



Azoi announces Wello, a $199 case that turns an iPhone into a monitor for blood pressure, ECG, heart rate, blood oxygen, temperature, and lung functions.


3-6-2014 12-47-31 PM

Epic, Orion, and Siemens earn the highest customer satisfaction scores in a KLAS survey on HIE solutions. Overall provider satisfaction with HIE solutions has dropped an average of eight percent since last year.

Becker’s Hospital CFO looks back at hospitals whose bond ratings have been downgraded by Moody’s Investors Services because of EHR-related budget problems: (1) Health East Care System (MN), which is spending $145 million on Epic; (2) Community Medical Center (MT), which is having cash flow problems after installing Cerner and NextGen; (3) Saint Luke’s Health System (MO), implementing Epic for $200 million; (4) Scott & White Healthcare (TX), seeing increasing costs with Epic; (5) Washington Hospital Healthcare (CA), having increased costs and a negative margin after implementing Epic; (6) Robinson Memorial Hospital (OH), with losses partially attributed to its Allscripts Sunrise implementation.


Bloomberg News calls Mount Sinai Hospital (NY) “a heart surgery factory with obscene levels of pay,” claiming the hospital coaches patients to feign heart attack symptoms in the ED to get their stents covered by insurance, earns referrals from doctors with financial ties to the hospital, and pays its head of interventional cardiology $4.8 million per year. The head of another New York interventional cardiology program summarizes, “You essentially have physicians combing the streets of Staten Island, Queens, Brooklyn, and Bronx looking for patients they can screen on a treadmill to feed into the cath lab, where the big reimbursement comes.”

In Canada, Pierre Le Gardeur Hospital cancels all elective procedures after experiencing an unspecified computer system problem.


Weird News Andy has his ear to the UK ground in noticing this story, in which the British public reacts to news that a marketing company used a 47 million-record hospital data extract to target Facebook and Twitter ad campaigns. Another company was found to have loaded the entire database to Google’s servers to create interactive maps. The Hospital Episodes Statistics database had been made available by the government to researchers and approved private companies. The government has a PR nightmare on its hands because de-identification is hard to describe to laypeople who react to “my hospital records are on the Internet.”

Sponsor Updates

  • Vonlay concludes an Epic engagement with Aspirus (WI).
  • Physicians Interactive and McKesson Patient Relationship Solutions will jointly deliver Coupons on Demand, which will provide clinicians access to online cost-saving offers for medications.
  • Kinston Pulmonary Associates (NC) will implement NextGen PM and EMR from TSI Healthcare.
  • InterSystems joins the Global Alliance for Genomics and Health.
  • Gastroenterology-specific EHR provider gMed will add medical content from Health Language to its system.
  • E-MDs releases details on its June 5-7, 2014 User Conference and Symposium in Austin, TX.
  • CIO profiles ICSA Labs, which is now the largest government-approved EHR testing and certification body.
  • Hardin Memorial Hospital (KY) reports improved clinical response times since integrating telemetry alarms with Voalte smartphones.
  • Divurgent raises $5,000 during HIMSS for the Florida Hospital for Children.
  • RazorInsights ONE-Electronic Health Record achieves Stage 2 ONC certification.
  • Daniel Flanagan, executive consultant for Beacon Partners, discusses in the company’s blog his recommendations to ensure a clearinghouse is ready for the ICD-10 transition.
  • MedAssets estimates that its latest National Sourcing Collaborative event will drive $5 million annually in added value for its participating clients.
  • Connance expands its patient-pay solution to include predictive analytics and additional platform reporting and consumer engagement functionality.
  • On the company’s blog, MEA | NEA CEO Lindy Benton explains the significance of electronic submission of medical documentation (esMD) and health information handler (HIH).

EPtalk by Dr. Jayne


One of my fondest memories from medical school is working the ER during Mardi Gras. I sewed up more than one reveler who didn’t really need anesthesia because they were already feeling no pain. I chuckled when one of my former classmates sent me this story about the germs residing on Mardi Gras beads. Who would have thought that beads that have been thrown around in the midst of public drunkenness might have germs? I wonder if there’s an ICD-10 code for that? Maybe there’s one for choking on the baby in the King Cake as well.

One thing I found lacking at HIMSS was the presence of wearable devices (other than on attendees). I didn’t see much vendor promotion or anything cool enough that I’d consider it (although watching people try to interact with Google Glass was pretty funny). I don’t have any experience with Fitbit, but after reading this article I heard about on Twitter, I might consider one just to have this app. The Sleep Tracker Hack, which emerged from the recent Netflix Hack Day, helps a viewer find her place after sleeping through streaming media. I just might know someone who has fallen asleep in the middle of re-watching “Grey’s Anatomy” for the last several weeks. Unfortunately the hack was part of an internal hackathon, so it may never see the light of day.

I believe in patient engagement and making health-related technology accessible to patients, but there’s such a thing as going too far. I was reading a piece about the Bellabeat Connected System that turns a smart phone into a fetal heart monitor. It also mentioned the Huggies “TweetPee” that sends a tweet when the baby wets its diaper. Seriously? Unless your infant has a urologic problem, I’m not sure tracking urination on social media will do much more than drive followers crazy.

One of my favorite HIMSS connections reached out earlier this week to ask if I would be willing to help mentor a physician who would like to join the CMIO ranks. When I first started out, I had no one to look to for advice, so I was happy to oblige. One of his questions was what I think is the most important CMIO function. I’m not sure I can pin down a single one, but one of the most important in my book is being able to be the peacemaker among IT, the operations folks, and the physicians. Certainly there are other constituencies, but those are the three that tend to be the most contentious.

I’m still surprised that nearly a third of health systems still don’t have a CMIO. The organization where my mentee works falls into that category, but at least they understand that they need to work towards filling that role even if they aren’t ready to admit they need an honest to goodness CMIO. Whether we’re called Medical Directors or Directors of Informatics or Physician Champions, we can still help organizations move forward.

His hospital is currently struggling with physician engagement and clinical oversight, so it makes sense that a physician would be uniquely positioned to assist. He’s not highly techy, but I think that’s OK – if we can master anatomy and pathophysiology, we can learn enough about networks and software to be meaningful participants. The key is knowing who our experts are and being willing and able to leverage them appropriately.

He’s worried that his hospital isn’t really ready to formalize physician leadership in the IT space. There have been comments made about fears that the CMIO “will come in and boss IT around because he’s a physician” or that he will preferentially take the physicians’ side in arguments. I’m encouraging him that even though his role is emerging,  he should ensure that  it’s well defined and that leadership is prepared to support him. Without those elements, the risk of frustration will be fairly high for all involved.

At this point, I think he’s wise to negotiate for a formal position, but I’d recommend going for something part time that lets him dip his toes in the waters of clinical informatics without locking in at an organization that might not be as ready to move forward as he thinks they might be. That will buy him some time to work on professional development and to build the skills he’ll ultimately need if he wants to make a career of this. I’ll keep you posted as I hear from him. I’m looking forward to remembering what it was like to be young and idealistic before the CMIO life started beating me down.


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

More news: HIStalk Practice, HIStalk Connect.



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March 6, 2014 News 1 Comment

News 3/5/14

March 4, 2014 News 7 Comments

Top News


FCC Chairman Tom Wheeler announces the formation of a task force that will seek ways to increase use of broadband to deliver telehealth, mobile apps, and telemedicine. Heading up CONNECT2HEALTHFCC will be Michele Ellison, a lawyer who runs the agency’s enforcement bureau. Wheeler said in the announcement, “We must leverage all available technologies to ensure that advanced health care solutions are readily accessible to all Americans, from rural and remote areas to underserved inner cities. By identifying regulatory barriers and incentives and building stronger partnerships with stakeholders in the areas of telehealth, mobile applications, and telemedicine, we can expedite this vital shift.”

Reader Comments

From Just Tim: “Re: MU stages beyond stimulus payments. What is the legislative basis to extend the MU program? MU requirements were supposed to run in conjunction with years in which payments were made, not years after penalties kick in. I’d certainly agree that if someone never got to Stage 3, they could reasonably be penalized on an ongoing basis. Otherwise, we’ve just created a large bureaucracy with the power to continue to push unfunded mandates.” Legal scholars and political junkies, the less legislative among us are calling.

From Dim-Sum: “Re: military EHR replacement. Word on the street is that the vendors of choice and partners are as follows. Six service integration (SI) firms will bid Epic. The team that is getting the most news is Leidos/Accenture/Harris. Cerner has a single exclusive SI partner (still doing research to see who that SI is). Allscripts cannot find a partner for their Sunrise. Meditech has the incumbent Northrop Grumman. McKesson walked away from GDIT/Vangent. Siemens has a yet to be named DoD giant. Competitive bids will require an investment by prime and sub software solution firm of about 1.5-2 percent of the total contract value. That means that to win a $5B deal with the DoD, the investment for resources, capabilities, compliance, and regulatory wherewithal (see FISMA, FedRAMP, DIACAP, 508, JITC etc) is $50 million USD. Good Luck beltway bandits and COTS EHR dreamers.” Unverified.


From Brenda: “Re: Washington’s insurance exchange. Add it to the list of those having issues. By the way, I’ve recommended HIStalk to countless people and I’m glad our company has been a sponsor for about a year now.” The Healthplanfinder exchange has 15,000 applications that are stuck because the user-entered information can’t be matched to the state’s Medicaid benefits database or contain incomplete information (hello, programmer edits?) I speculate that the state incurred the wrath of the grammatical gods when it combined “health plan finder” into a single word.  

3-4-2014 12-52-43 PM

inga_small From Charger: “Terrific correspondence from Orlando; much appreciated since I could not attend! I’m sure you have been deluged with coffee mug requests and are out of stock, but may I place an order for one upon receipt of any new inventory? I will gladly swap you one of my local Karl Strauss Brewery pint glasses in return.” Thanks for the generous offer, but sadly all the coveted coffee mugs are gone. Lorre and I are trying to convince Mr. H that the timing is perfect for the opening of an online store featuring HIStalk swag. Beauty queen sash, anyone?

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More mug sightings: Investor’s Chair contributor Ben Rooks, who obviously works standing up while looking at green ivy outside his San Francisco office; and Mike Jefferies of Longmont United Hospital, whose Spotify-HIStalk two-monitor setup looks a lot like mine. I still have a few more photos to run next time.


From Dr. Travis: “Re: Nordic’s new office. Thought this was very cool.” I had to clarify with Travis since this is a Midwestern, tailgating, and college thing that much of the country won’t understand: it’s a cornhole platform.  

From Ion Exchanger: “Re: HIMSS booth. You had traffic in your booth back in the hall. You should get another exhibitor to give you space free in return for drawing people.” That idea has come up on occasion, although not usually from people offering space. Our first-time exhibitor experience was good, especially since it was a low-rent, homebrew operation designed solely to give Lorre a way to say hello to interested readers and sponsors. I think I’ve decided to do it again in Chicago.


From Dr. Matt: “Re: QlikView. First there’s an Epic partnership and now I find at HIMSS that Health Catalyst offers QlikView on top of their data warehouse. Why are these big players using it?” I’ll let those organizations speak for themselves.

From Doctor N: “Re: HIMSS conference. It was my first one. Only the HIStalk people made me feel valued as a practicing physician. The insults, lack of humility, time away from my clinic, and the lack of vendor understanding of how medicine really works will keep me from returning soon. The sessions could have been done online and the networking conversations were shortened because everyone was in a hurry to get somewhere else. I believe I have seen the American medical industrial complex at its worst. I was surprised at the number of vendor folks who are physicians and how little they know about how we pay for healthcare: SGR (which will worsen matters for providers) and $156 billion being cut from Medicare Advantage plans. They have no clue that I’m not paid for population health and most docs in my community hardly even know the meaning of the term. It is like we are buying the horseshoe, barn, and saddle in the hope that we’ll get a horse for a present. HIStalkapalooza, however, did not disappoint!”


From Spelling CMIO: “Re: a tech solution to HIT spelling problems. As technology professionals, we ought to be able to bring our expertise to bear on the current plague of spelling confusion. I suggest we start to use regular expressions, like: HIM*S* and HIP*A* so that all variants can be brought under the welcoming umbrella of mediocrity. Heck, we could even bust out CM*S to obscure the failure to include ‘and Medicaid’ in the name of our favorite bureaucracy. We could even try E[Pp][Ii][Cc] to free the caps-lock crowd from their yoke of humiliation.” Scanning for “HIMMS” news stories turns up 56, which is pretty sloppy.


From Frank Poggio: “Re: ONC. Issued new 2015 test criteria while at HIMSS last week. They kept repeating that this new (and extensive at 242 pages) test criteria is ‘voluntary’ for vendors. Here comes another wolf in sheep’s clothing. Do you really think the 2015 Criteria will be ‘voluntary’? How can they generate a revised list of criteria that fixes bugs and not make it required? How can they add something critical to patient safety such as UDI and not make it required? Breaking out CPOE components has been something niche vendors have been asking for since the start. So will those vendors ignore it and stick with 2014 criteria? I have worked through dozens of tests with clients since the inception of ONC and every time they expand or make a test update it soon becomes mandatory by the authorizing testing labs … and with some ATLs sooner than others. I give the 2015 version at most four months before it becomes mandatory.”

HIStalk Announcements and Requests

Listening: new from the all-female, LA-based spacey rock quartet Warpaint, which sounds a bit like Cocteau Twins (and that’s a good thing). I’m also enjoying defunct, brilliant Irish pop band The Thrills.

Some random thoughts I had regarding the HIMSS conference:

  • I was surprised and happy that the vendors of much-hyped analytics and population health management products were restrained in their pitch. Many companies talked about those products, but I didn’t hear a lot of wild claims.
  • The terms “big data” and “cloud” weren’t repeated reverentially and annoyingly to the extent that might have been expected.
  • What is population health management, exactly? It will be whatever payers say it is, no different than “quality.”
  • I’m not impressed with “big data” when healthcare is woefully indifferent to “little data.” We ignore evidence-based medicine, warnings for inappropriate or duplicate tests and drugs, and quality measures. We are sloppy about monitoring our supply chain and controlling our labor and materials costs. We pay little attention to the free exchange of information we hold about patients. We don’t like the idea that patients themselves should see our digital secrets. We should be using the information we have to its fullest before trying to tackle giant databases containing even more insights that we’ll ignore. Speak up if your hospital is different.
  • I’m not sure if patient engagement was just a token HIMSS nod or a real movement. I don’t see stretched providers getting excited about engaging patients unless government or competitive pressures force them to. It was nice to see patient advocates at the podium, even if only sporadically.
  • People are beginning to realize that EHRs aren’t necessarily the center of the universe. Small vendors are creating specific applications that use the EHR, which makes them easier to develop, cheaper, easier to use, and easier to buy since any buyer’s remorse will be several zeroes cheaper than the EHR itself. A question to ask of the dwindling number of EHR vendors might not be what their system does, but what does it allow to have done by other sources? Those companies were in the hall.
  • The government has taken a lot of innovation out of the system with Meaningful Use and ICD-10. I said from the beginning that taking MU money means making the federal government your incessantly nagging partner, but with penalties following rewards it wouldn’t have mattered anyway. I got the sense that attendees were more interested in what HHS and ONC say than what vendors were telling them.
  • Financial uncertainty as well as a big implementation and optimization ramp-up business has increased the willingness of providers to pay a premium to use consultants since they don’t want to get locked into salaried employees for specific short-life tasks. Consulting companies seemed to be generating a lot of interest.
  • Hospitals, like every swollen, inefficient, and political bureaucracy, will do whatever it takes to protect their own interests. They have money and clout and they aren’t just going to happily reduce their profits, headcount, or ambitions to reduce overall healthcare spending. Integrating their acquisitions will be a target market.
  • HIMSS is always like a boat show, but this year I’m not sure many boats were sold.

Acquisitions, Funding, Business, and Stock


Telus Health acquires Med Access, a British Columbia-based vendor that claims its EMR is #1 in Canada with 4,000 users.


Clinicient, a provider of RCM and clinical solutions for rehabilitation therapy, raises $15 million in Series C funding from Catalyst Investors and names Rick Jung (Medsphere) chairman and CEO.

Castlight’s IPO could raise up to $140 million based on a revised filing made this week.



PatientPoint awards Xerox a $28 million contract to work with hospitals and physician practices to introduce PatientPoint’s digital check-in and population health management software and to provide training and support.

Denver Health selects Besler Consulting to assist in the identification of Medicare and Medicare Advantage Transfer DRG underpayments.

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UCSF Medical Center will implement Oneview Healthcare’s patient empowerment program at three Mission Bay hospitals.

The University of Miami Health System selects Lockheed Martin to manage its healthcare data, develop predictive models for risk identification, and build automated systems to give providers data at the point of care.

Florida International University’s faculty practice chooses PatientKeeper Charge Capture.

Citizens Medical Center (TX) selects MModal for transcription services and front-end speech recognition.

West Florida ACO will implement eClinicalWorks Care Coordination Medical Record.


Forbes names Epic’s Judy Faulkner as #520 on its list of “The Richest People on the Planet,” estimating her net worth at $3.1 billion.



Accretive Health appoints Patrick Funck (Segwick) SVP/CIO.

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HCI Group names Bill Bria, MD (Shriners Hospital for Children) as CMIO and Robert Steele (Sterling Healthcare Initiatives) as SVP of delivery operations.

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Greater Houston Healthconnect CEO Jim Langabeer, PhD resigns to return to his previous employer UT Health Science Center, with CTO Phil Beckett, MD named acting CEO.

Carolinas HealthCare System hires Nancy Olson, RN-C, MBA, PhD (Providence Health & Services) as its first chief nurse informatics officer.

Announcements and Implementations

inga_small WEDI, in partnership with EHNAC, will create a Practice Management Accreditation Program to review PM vendors in the areas of privacy, security, mandated standards and operating rules, and operational functions. While I am all for having minimum performance standards, is this really the best time to ask vendors to jump through one more hoop to remain competitive in the marketplace? It’s no surprise that we are seeing limited advances in product usability and innovation.


The local business journal profiles St. Francis Hospital (CT), which goes live on Epic next month following a two-year, $120 million transition. Above is VP/CIO Linda Shanley.

Summit Health (PA) implements Wellcentive’s population health management solutions and services.

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Ontario’s Group Health Centre goes live on Epic.

Wellmont Health System (TN) transitions to Epic in its physician offices and hospitals.


North Oaks Medical Center (LA) goes live with a two-way interface between Epic and the Masimo Patient SafetyNet remote monitoring and clinician notification system.

GetWellNetwork debuts GetWellNetwork Ambulatory, which is available on mobile and stationary devices and integrates with EHRs to provide personalized information, healthcare tools, and patient pathways.


CoverMyMeds launches an API that enables providers of EHRs, e-prescribing systems, and PM systems to offer an NCPDP standards-compliant electronic prior authorization solution.

John Gomez launches Sensato, which will offer healthcare privacy and security assessments, guidance, and tools.


UC Irvine Health deploys WANdisco and Hortonworks Hadoop data technology to provide real-time information for patient care. They run Allscripts Sunrise, I believe, and an unnamed data warehouse technology described in the announcement as one that “struggles with availability issues as well as the volume and variety of data it can handle.”

Government and Politics

inga_small The FDA is seeking a contractor to monitor social media chatter about drugs, medical devices, and other regulated products in order to track conversation shifts following FDA warnings. I found this move especially interesting in light of the heavy Twitter traffic during HIMSS and my realization of  the potential value of mined Twitter data. Now I’m wondering if anyone has figured out a way to combine data from social media chatter with old-school opinion polls from phone and mail surveys. That could be powerful.

ONC releases additional draft electronic clinical quality measures for review and testing for the possible inclusion in the MU and other federal programs.


The front-page story of the March 10 issue of Time says that Healthcare.gov had so many problems that the White House was ready to shut it down and start over right after its launch. It says that it’s not clear even now who was supposed to be in charge of the launch and that people knew upfront that the site’s design was flawed.

Speaking of Healthcare.gov, HHS says it will need $1.8 billion in FY2015 to run the federal health insurance exchange.


A three-year study finds that patient-centered medical homes do little to reduce costs, decrease utilization, or improve care, leading researchers to conclude, “Medical home interventions may need further refinement.”

The use of patient portals for secure messaging does not significantly change the frequency of face-to-face visits, according to a Mayo Clinic study. Weakness of the study are that portal messages were studied in a vacuum rather than in the context of all provider communication, it looked only at the number of visits rather than patient outcomes, and most of the study subjects were Mayo Clinic employees.


Baylor Regional Medical Center announces that it will not accept the Malcolm Baldridge National Quality Award following allegations that it improperly managed a neurosurgeon who is accused of botching surgeries while under the influence of drugs. An extensive profile in the Dallas Morning News paints a disturbing picture of a physician who was labeled a sociopath and serial killer by colleagues. We featured the story in September 2013 with this summary:

A Dallas news magazine recounts the fascinating tale of a newly licensed MD-PhD neurosurgeon whose incompetence left several patients maimed or dead while the state’s medical board couldn’t stop him from practicing. Colleagues called the doctor the worst they had every seen and said his skill level was no higher than a first-year resident as he kept inadvertently slicing arteries causing patients to bleed to death, and in one case the OR team had to forcibly remove him from the OR to prevent him from killing his patient. His marketing team and his 4.5 star Healthgrades.com rating brought in plenty of new patients to his loftily named practice, Texas Neurosurgical Institute. Surgeon readers will be horrified by this recap by a peer who had to clean up one of his messes: “He had amputated a nerve root. It was just gone. And in its place is where he had placed the fusion. He’d made multiple screw holes on the left everywhere but where he had needed to be. On the right side, there was a screw through a portion of the S1 nerve root. I couldn’t believe a trained surgeon could do this. He just had no recognition of the proper anatomy. He had no idea what he was doing.” The article blames the situation on malpractice caps, laws that hold hospitals liable for damages only if their intentions are provably malicious, and a nearly powerless medical board charged more with keeping licensure records and counting CE hours than watch-guarding patient safety.


Mike “PACSMan” Cannavo summarizes HIMSS14 from the imaging perspective in an Aunt Minnie article (simple registration is required.) He tells me that HIMSS rules even though RSNA is a bigger conference because, “The balance of power has definitely shifted from departmental solutions to facility-wide ones and IT and the CIO/CTOs make those decisions here.” Another of his observations:

HIMSS may, and probably will, command the lion’s share of the trade show budgets for VNA and cloud companies from now on. Considering there were more than two dozen vendors playing in this arena alone, plus the majors who showed various central data repository (CDR) solutions, this can affect other trade shows in terms of booth size and revenue. Given that attendance at most radiology-specific shows has been flat or declining and time spent at the shows has declined each year, HIMSS poses even more of a threat.

A group of former senators (Tom Daschle, Trent Lott, John Breaux) forms the noble-sounding Alliance for Connected Care, which will lobby Congress to protect the interests of its big-company members (Verizon, WellPoint, CVS, and Walgreens) as well as patients who benefit from telehealth services. In addition to seeking friendly governmental consideration, the group wants to lift geographic treatment limitations and build the case for telehealth as an effective care delivery mechanism. Surprisingly, HIMSS isn’t among its lengthy list of advisory board organizations. I’m always suspicious of the motivations of retired politicians anxious to make up for the income they lost while holding office, but in this case their announced intentions seem appropriate.

Brian Ahier got a one-on-one interview with National Coordinator Karen DeSalvo at the HIMSS conference. She says everybody has been focused on collecting information via EHRs, but now it’s time to allow patients to participate and acknowledge that “health is more than getting people to a doctor” since only 10-20 percent of outcomes can be attributed to the healthcare system. She clearly has a public health mindset as did her predecessor and she gets a “bravo” for that.


The CFO of Wake Forest Baptist Medical Center (NC) lists reduced Epic expenses as one element of its improved financial performance in which six-month operational losses were reduced from $49.8 million to $23.5 million. The hospital still has high expectations for Epic, saying in a bond ratings agency report, “Management believes that future financial performance must be improved from current levels, and continues to aggressively pursue both short- and long-term strategies to drive growth, reduce cost and leverage our investment in Epic.”

In England, a three-year-old cardiac surgery patient dies when the scheduling system of the hospital to which he was transferred fails to generate his follow-up appointments. According to the hospital’s pediatrics manager, “Samuel’s appointment request must have fallen through the cracks between the old and new system. The new system is now up and running as best as it can be, but as long as there is still humans entering the information there will always be room for error.”

Weird News Andy notes that Banner Health didn’t have a banner day when it inadvertently printed subscriber Social Security numbers on its health magazine’s mailing labels.

Sponsor Updates

  • Greenway Medical names Phreesia its Marketplace Partner of the Year.
  • Aprima Medical announces that over 1,500 former Allscripts MyWay customers have migrated to its platform.
  • PerfectServe introduces automatic electronic PHI filtering capabilities that remove ePHI from the body of messages sent to non-secure mobile devices.
  • Lisa Reichard, director of community healthcare relations for Billian’s HealthDATA, writes a fun blog post that includes her top 10 tales and takeaways from HIMSS14.
  • Extension Healthcare will participate in the AONE 2014 Annual Conference in Orlando March 12-15.
  • The Tennessean interviews Cumberland Consulting Group CEO Jim Lewis about the company.
  • Boston Software Systems offers a white paper that examines three steps to a successful migration. 
  • An HCS case study highlights Christian Health Care Center (NJ) and the benefits it realized following the implementation of HCS Interactant.
  • TriZetto Provider Solutions advises customers that it will continue to accept claims in print image, NSF, and legacy formats even after the ICD-10 implementation deadline.
  • E-MDs publishes video testimonials from multiple providers.
  • Clinithink’s VP of solutions Russ Anderson suggests leveraging the use of Clinical Natural Language Processing to control patient leakage.
  • Health Catalyst offers a white paper with keys to a successful data warehouse and analytics implementation.
  • Vital Images experiences significant growth across Europe, the Middle East, and Europe.
  • CommVault achieves certified integration with its Simpana 10 software and the SAP HANA platform.
  • TeleTracking Technologies, Hill-Rom, and GOJO will co-market integrations with the Hill-Rom Hand Hygiene Compliance solution.
  • Cornerstone Advisors reports that its staff has grown to 39, a 25 percent increase in the past year.
  • Divurgent will provide support to Medsphere clients in their MU, ICD-10, and value-based purchasing initiatives.
  • Gartner positions Qlik in the Leaders Quadrant of the 2014 BI and Analytics Platform Magic Quadrant report.
  • HIMSS Analytics names Allscripts its first Certified Educator of the EMR Adoption Model.
  • The Cleveland Clinic and Dell will offer Epic EMR consulting and implementation services to other health systems and practices.


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

More news: HIStalk Practice, HIStalk Connect



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March 4, 2014 News 7 Comments

Readers Write: Dr. Gregg’s “HIStalk: The Movie”

March 3, 2014 Readers Write No Comments

HIStalk: The Movie
By Dr. Gregg

dr gregg

It’s Oscar night tonight. I know this because in my house, that’s a pretty big deal; my wife is one of the most star-struck people walking the planet.

And, as it’s a night of glam and glitz and red carpets and such, it seems an appropriate time to announce the upcoming release of the star-studded extravaganza, “HIStalk: The Movie.”

No doubt you’ve heard the rumors… and it’s true! HIStalk is coming to the big screen. Featuring a cast of some of HIT’s biggest stars, including:

The one, the only – MR. H! Nobody tells it like the inimitable, and wholly inscrutable, Mr. HIStalk. Now he tells it like it is in full, glorious Technicolor with thundering DTS surround sound. Hear Mr. H blast the blatantly bland and debunk buffaloing bloggers. See him – fully facially pixelated – tear through HIT hype and tripe. Watch as he snags rumors from the ethers and exposes the raw underbelly of the simmering underworld of HIT.

The perpetually 28 year old party girl – Inga! Nobody glides through the HIMSS exhibition halls with more panache than the sultry Swede. Watch her dance the night away with HIT celebs Farzad, Jonathan, Ivo, and many more meaningfully-used macho men. Sporting in the finest footwear this side of the Champs-Elysées, she’ll dance her way straight to your hard drive.

The ever-running, always stunning – Dr. Jayne! Hear the good doctor call out unscrupulous C-suite commands for harmful cost-cutting. Watch her shoot down ill-considered patient care policies and lambast ludicrous Luddites. She’ll run a marathon of mischief as she bears the banner for CMIOs everywhere.

The million dollar mobile man – Dr. Travis! Once again riding the WiFi waves of justice, Dr. Travis will keep you in mHealth stitches as he exposes new tech that doesn’t deliver and sorts out the portably important from the connectedly comic.

The man – Lt. Dan! Need we say more?

The vivacious new HIStalk vamp – Lorre! Supremely smart and stunningly sassy, this demure little vixen will warm your digital hearts as she becomes HIT’s newest pin-up girl. We’ve no doubt that after the world sees her stunning debut performance that she’ll be adorning screensavers like no one since Farah Fawcett.

You’ll gasp in awe at the beautiful panoramic sets designed and painted by the hand of Regina Holliday.

You’ll be blown away by the homespun humor and heartwarming insights into all things HIT based upon Ed Marx’s award-winning story.

You’ll never forget the effortless flow and seamless style of Dr. Rick’s screen adaptation.

You’ll delight in the scintillating score by the lyrical genious, Dr. HITECH, founder of The American College of Medical Informatimusicology (ACMImimi.) Performed by the entire ensemble of illustrious ACMImimi fellows, you’ll hear health information rock like you’ve never heard it before.

Get out the popcorn and pull up your favorite easy chair for tonight’s Oscars, but get ready really enjoy them next year when “HIStalk: The Movie” will undoubtedly take home all the golden statues setting new standards for both Hollywood and HIT.

From the trenches…

"Never give up. And never, under any circumstances, face the facts.” – Ruth Gordon, Best Supporting Actress, “Rosemary’s Baby”

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

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March 3, 2014 Readers Write No Comments

Monday Morning Update 3/3/14

March 1, 2014 News 11 Comments


From Elizabeth: “Re: HIStalk mug. Thanks so much for the HIMSS coverage this year, as always. It was great that you had a booth because I’m pretty sure others would agree that the HIStalk gang are celebrities, albeit anonymous, in this space. I am sending you a little pic of my coveted HIStalk mug in its new home in snowy, cold NY. I think it fits in very well. It was by far my favorite takeaway from the conference, so much so that I wrapped it in a t-shirt from another vendor so it wouldn’t break on the flight home. I am happy to report that it remained safe and intact.” I can’t explain why I like seeing pictures of reader workspaces, but I do.


From Sipper: “Re: HIStalk mug. Big fan of HIStalk for many years, read it every day, loving my new mug!”

From Posit: “Re: HIMSS thoughts. Educational sessions were strayed, put together in silos, and not given by industry leaders but more by committee members trying to get placed on the HIMSS board. Educational content had nothing new. Hillary was dry, useless, and added nothing to the conversation of healthcare. The CIO Forum was the usual boy’s club, mostly just CIO wannabes as the majority of CIOs were out sunning themselves. The attendance count seemed to include anyone walking in the door. The HIMSS14 handbooks had many typos – sloppy work.”


From Dr. Info: “Re: HIMSS video. I saw this gem out of the corner of my eye and then had to endure many painful minutes of this insipid self-promotional video before it came around again for a quick photo for your blog. I’m probably the only person who watched the whole thing, including the producers and editors! Maybe they should just change the acronym already.” You would think HIMSS could spell its own name, especially when it was shilling its HIMSS14 TV informercials (“one-third of air time will be dedicated to our sponsors,” which puts even network TV to shame.)


From Eager Cleaver: “Re: cost of exhibiting at HIMSS. You should get someone with a modest-sized booth to anonymously provide all line-item costs to exhibit. Readers would be shocked.” I did this a few years ago and would be happy to do so again if a company would be willing to share. I would do it for the HIStalk booth, but it was tiny and we did everything on the cheap, so it’s not really representative. Meanwhile, money alone won’t buy you prime hall space, as booth selection is driven by HIMSS points, which is like your grocery store loyalty card with a lot more zeroes. The annual conference brought HIMSS $25 million in revenue, half its total take. Dues made up only 18 percent of its total revenue. According to its 2011 tax forms, Steve Lieber was paid $925K, so he’s surely well over the million-dollar mark by now. Also in the footnotes of the form: HIMSS owns 81 percent of MedTech Publishing (book value $8 million), which means if you get your industry news from Healthcare IT News, mHealth News, or Government Health IT, you’re getting it from the vendor-friendly, HIT-cheerleading HIMSS.

From GreenFlamed: “Re: Dragon Medical Network. v12.50.200.089 is not ready for prime time, especially in Virtual Desktop environments. It takes a crazy amount of support to sustain and keep your end users happy. The new service pack is riddled with bugs and the dictation box transparency feature is broken. We are facing a major Dragon buy-in and adoption crisis currently because it keeps crashing. Are there any other Dragon360 Network users out there using Dragon on a Virtual Desktop environment?”


Only 20 percent of respondents say their business card titles include a certification. New poll to your right: if you attended the HIMSS conference, how was it overall?

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Some of the classrooms we helped via HIStalk’s donation of proceeds from the big ad at the top of the page to DonorsChoose projects are already benefitting. Mr. Delperdang reports (and sends the photo above left) that his Mississippi high school students are using the inexpensive supplies we donated (remanufactured printer cartridges and a file cabinet, which he calls “a blessing”) to print and file assignments and college applications. Ms. Vega’s Illinois second graders have created a reading station from the set of non-fiction books we purchased, which she says is the most popular learning station in the classroom and that “even my students whom were afraid to speak and share ideas are now sharing their background knowledge with us.” Ms. Opatz’s Utah fourth graders have formed reading groups around the books we purchased for them (photo above right.) We funded a bunch of projects from the ad revenue and will be doing more, so stay tuned.


Oracle – like its CEO, Larry Ellison – rarely passes on the opportunity to exhibit boorish behavior. The company’s sloppy technical work reportedly assured the failure of Cover Oregon’s health insurance exchange, with the resulting outcry shaming Oracle into making a public promise to fix the problems it caused at no charge beyond the $90 million it was already being paid. The still-dysfunctional site isn’t likely to get better – Oracle has decided without explanation to pull 60 percent of its employees assigned to the project.


California’s health insurance exchange, fresh off a five-day system outage, says 14,500 people whose applications were partially completed in the days before the unplanned downtime will need to start over.


The General Accounting Office reviews the progress of the VA and Department of Defense in deciding to pursue their independent EHR plans and make them interoperable. They aren’t impressed: GAO says those organizations don’t have proof that it will be cheaper to run their separate systems than to create a single one. It also points out that despite the VA’s plan to pilot its system by September 2014 and the DoD’s intention to take its system live by the end of FY2016, neither have said what their systems will consist of, when they will be finished, or what they will cost. The report also says the VA and DoD are still fighting over control, with the federally mandated Interagency Program Office (IPO) having no power over funding and staffing. Both the VA and DoD, strangely enough, agreed with GAO’s recommendations that they perform a cost analysis, justify choosing the more expensive choice if that’s the case, create interoperability plans, and strengthen the control of IPO.


McKesson, bowing to shareholder pressure, reduces the pension of Chairman, President, and CEO John Hammergren from $159 million to $114 million, although one analyst says the company’s executive pension plan is still “the richest in corporate America.” Perhaps an earlier announcement of his forced impoverishment would have allowed him to escape the indignity of winning his second consecutive HISsie award last week for “Industry Figure In Whose Face You’d Most Like to Throw a Pie.”


It occurred to me while Mark Bertolini was delivering the HIMSS conference’s opening keynote address, his Aetna employees were setting up the company’s booth in the exhibit hall. Somehow that seems wrong. If it weren’t for HIMSS trying desperately (and unsuccessfully) to get people to stick around later into the week, they would have put the second consecutive keynoting Clinton (Chelsea next year?) in that spot as they have done with politicians in the past.


People have asked what my favorite conference giveaway was. I’ll go with the iPhone 5 cover from zCover. I wasn’t initially impressed because they had a tableful of them and they were packaged in plastic bags, to the point I was about to just toss it in the trash when I got home. It’s a really nice case that fits the phone perfectly (including little covers for each port) and a clip-on back that ties the package together. It has its own buttons that cover the ringer volume and home buttons that make them easier and more satisfying to use. I’m really glad I picked it up – it has replaced my rubber bumper cover.

It’s hardly news since Intermountain Healthcare announced that it was choosing Cerner as a partner last fall partly because it wasn’t confident about hitting Meaningful Use dates, but CIO Marc Probst says Intermountain will forego incentives and accept penalties for not being ready for MU2 in 2014.


Streamline Health Solutions promotes Richard Nelli to COO.


Greenway acquires PeopleLynk, which sends patient relationship messages based on EHR events.


Infor signs a letter of intent to acquire assets of GRASP Systems, including patient acuity, workload management, and patient assignment systems.

Ingenious Med launches its patient encounter platform One by Ingenious Med (IM1), providing care coordination and patient management to acute and sub-acute spaces.

Strata Decision Technology announces sales of its StrataJazz financial platform to Yale New Haven Health System (CT), Northwestern Medical Center (VT), and Southern Illinois Healthcare (IL).  


ONC and ANA will present a free one-day summit for nurses on March 21 at The Baltimore Washington Medical Center in Glen Burnie, MD. The agenda includes a keynote by Deputy National Coordinator Judy Murphy, a panel discussion about using health IT to exchange information, afternoon breakout sessions, and a town hall discussion. I recommend as a counterpoint to all of that healthy discussion a side trip to my favorite place in Glen Burnie, Ann’s Dari-Creme.


In Canada, New Brunswick doctors question their medical society for striking a deal that allows only one EHR – the one sold by a for-profit company co-owned by the medical society — to access the province’s databases. Only 240 of 950 eligible physicians have signed up ahead of the March 31 deadline to earn a 50 percent government subsidy, with only 34 of those actually using the mandatory Velante software. Doctors question whether the medical society’s motivation is business success rather than patients, while the province’s health minister says it may have to take over the system if too few doctors sign up. A similar situation exists in Nova Scotia, where the province gave Nightingale exclusive rights to provide a subsidized EHR that connects to the government’s information.

The VA creates a development portal that explains how to create mobile apps for its use.


CareSync wins the most promising startup contest at the HIMSS conference.

”How the Medical Establishment Got the Treasury’s Keys,” an interesting article by economics professor Uwe Reinhardt, recounts irrational and naturally inflationary creation of Medicare in the 1960s as flawed grand plan to reduce poverty:

To help implement that vision, these proponents reluctantly paid the price the providers of health care extracted in return for accepting the legislation: Congress surrendered to the providers the keys to the United States Treasury, full well knowing that this social contract could have only a short shelf life. One would assume that physicians and hospital leaders knew that as well. In other words, the proponents of Medicare who signed on to the deal were anything but stupid. When confronted by the health care sector with a harsh trade-off between their cherished vision for health care, on the one hand, and a sensible payment policy, on the other, they let their vision override economically sound payment policy. Millions upon millions of America’s senior citizens are indebted to them for a program that remains highly popular to this day.

Weird News Andy wonders, “Does the noise in my head bother you?” in reading of a British tourist hearing scratching noises inside her head that turned out to be a happy family of eight flesh-eating maggots. WNA also likes this story, in which stethoscopes were found to carry more bacteria (especially MRSA) than anything other than the fingertips of doctors. It’s probably not realistic that doctors who can’t be convinced to wash their hands would sterilize their stethoscopes. 

HISsies 2014 Winners

Sponsor Updates from Last Week

  • Sagacious Consultants launches Sagacious Dispatch for Epic customers with short-term projects for optimizing their EMR.
  • Orion Health launches Collaborative Care for ACOs.
  • MEDHOST joins CommonWell Health Alliance.
  • Shore Medical Centers (NJ) selects CareTech Solutions Clinical Service Desk for night, weekend and holiday support.
  • Truven Health Analytics introduces Micromedex Pharmacy Intervention and Micromedex Infection Prevention.
  • CynergisTek expands its collaboration with Iatric Systems to offer support and management of Iatric’s Security Audit Manager.
  • Premier reports 90 percent of respondents experienced at least one drug shortage in the last six months that may have caused a medication safety issue or error in patient care.
  • Aventura releases Roaming Aware Desktop Version 5.0.
  • Kaleida Health (NY) selects Orion Health’s Rhapsody integration engine.
  • Covisint receives full accreditation with the Direct Trusted Agent Accreditation Program from DirectTrust.com and the EHNAC.
  • iMDsoft announces its MetaVision for NICUs will be featured at the 20th annual Cool Topics in Neonatology conference.
  • DrFirst’s controlled substance e-prescribing software will be integrated into Greenway’s EHRs.
  • ADP AdvancedMD offers an ICD-10 transition program with preparation resources, product enhancements, and a revenue cycle financing program.
  • UnitedHealthcare announces that InstaMed’s online bill payment service myClaims Managers has grown to 50,000 participating care providers with $20 million in payments processed since July 2013.
  • Emdeon publishes an ICD-10 transition white paper.
  • API Healthcare, a GE Healthcare Company, launches Patient Classification, which matches provider skills to patients.
  • Nuance announces that eCopy ShareScan is integrated with NextGen Ambulatory EMR.
  • First Databank releases FDB AlertSpace for Siemens Soarian.
  • NextGen Healthcare and Cerner announce bilateral integration.
  • Infor offers a promotion package for eGate customers interested in migrating its Cloverleaf product.
  • Infor introduces PeopleAnswers Talent Science to assist healthcare organization to select, retain, and develop clinicians.
  • DrFirst’s Patient Advisor delivers $21 million in prescription savings opportunities for uninsured patients during its first three months.
  • Imprivata will integrate its two-factor authentication management capabilities with DrFirst’s EPCS Gold solution to securely prescribe controlled substances electronically.
  • Physician First ACO (FL) selects eClinicalWorks Care Coordination Medical Record.
  • ADP AdvancedMD announces general availability of its reporting suite AdvancedInsight for physician practices.
  • Central Valley HIE (CA) joins Inland Empire HIE expanding the reach of the Orion Health Collaborative Care within California to 48 central and southern California organizations.
  • Wolters Kluwer Health announces the beta launch of its integrated clinical decision support and workflow management platform POC Advisor.
  • Northeast Georgia Physicians Group achieves Stage 7 of HIMSS EMRAM with Allscripts TouchWorks.
  • Covisint offers three reasons to physicians to avoid PQRS penalties.
  • Etransmedia expands its RCM services with the acquisition of Medigistics.
  • Intel-GE Care Innovations and Caradigm partner to integrate remote patient monitoring and smart sensor technologies to improve care plans.
  • E-MDs launches a SaaS-based RCM service.
  • AT&T announces plans to expand Digital Life into the healthcare market.
  • Predixion Software announces availability of its predictive analytics software on the Windows Azure cloud platform.
  • Baylor Scott & White Health (TX) expands its use of AtHoc Critical Communications platform for IT outages, emergency preparedness, and clinical alerts.
  • Optum launches Optum One analytics platform.
  • Advocate Health Care (IL) selects PerfectServe as its enterprise-wide clinical communications platform.
  • Healthy Catalyst reports that 76 percent of organizations lack basic analytics for Meaningful Use measures in a recently published white paper.
  • Imprivata will integrate HIT Application Solutions’ Notifi platform with Imprivata Cortext, enabling secure communications for continuum of care.
  • The Health Centers of Family Health Care join The Guideline Advantage, which uses Forward Health Group’s PopulationManager platform.
  • Siemens Healthcare launches CareXcell a subscription based solution for population health management.
  • Memorial Hospital at Gulfport (MS) selects Health Catalyst’s Late-Binding Data Warehouse and Analytics platform to provide a unified view of clinical and performance data from their McKesson and Allscripts EHR applications.
  • Capsule Tech reports a 24 percent increase in revenue for 2013, with 1,650 healthcare facility clients worldwide.
  • University Hospitals (OH) will deploy PeriGen’s PeriCALM at UH MacDonald Women’s Hospital and UH Geauga Medical Center, which will include sending OB content into its Allscripts EHR.
  • NantHealth introduces NantHealth Clinical Operating System, developed after consolidating of several healthcare IT companies including iSirona.
  • Capsule Tech introduces SmartLinx Medical Device Information System for point-of-care data delivery.
  • North Memorial Health Care (MN) is awarded joint second place in the annual Healthcare Informatics Innovator Awards after incorporating Health Catalyst’s EDW platform and analytics solution.
  • EClinicalWorks, Greenway, ICA, InterSystems, Medfusion, Medicity, Optum, and Orion Health found Carequality, which will focus on interoperability between existing and emerging HIE networks.


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

More news: HIStalk Practice, HIStalk Connect.


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March 1, 2014 News 11 Comments

From HIMSS 2/27/14

February 27, 2014 News 11 Comments


From Spelling Recognition: “Re: ‘documention.’ Is this a misspelling or or marketing gone wrong?” I suspect the former and dread the possibility of the latter.

From Born Free: “Re: HIMSS opening session. It was nice of the HIMSS chair to recognize physicians in the audience, but as soon as the recognized physicians sat down, the speaker then dissed them through sarcasm about their ego and the 6,500 physicians in his organization that think they know best. It was a little uncomfortable and not very wise considering HIMSS’s desire to add physicians to their membership rolls.” I missed the presentation since I was protesting having an insurance company millionaire talking about how healthcare should work. I don’t like having vendors as keynoters.


From IT Director: “Re: HIMSS. It was a pleasure to meet Lorre in the booth on Tuesday. If you are going to have a public face I can’t think of a better one! She was engaging and knowledgeable and fun to talk with even if just for a few minutes. I love the fact that you had a booth — that was a cool thing to do.” HIMSS booths are breathtakingly expensive, but it was worth it to be able to meet readers, sponsors, and passers-by (most of them on their way to bathrooms right by our booth given our tiny HIMSS clout and budget). It was great having Lorre there since as the only non-anonymous HIStalk team member since she kept me updated with who dropped by, what they had to say, and what it was like being on the show floor with the other exhibitors. That was all new to me – my only view of HIStalk is sitting alone in front of a PC all day and night. It was cool that other exhibitors brought celebrities to our booth, sent Lorre scones and fun giveaway items, and helped us figure out the exhibit process since we were clueless. I’ve asked Lorre to do a writeup on what it was like for her to meet readers, work the booth, attend the events, and accept our Sunquest Industry Pioneer Award.

From Brian Ahier: “Re: Ed Park of athenahealth at HIMSS. Gave the best presentation at HIMSS.”


I’m glad the HIMSS conference is over. I’ll be catching up over the next few HIStalk posts. Your comments about the conference, exhibits, companies, and educational sessions are welcome.

I have to say I’m already dreading going to Chicago for the conference next year. All I remember from last time is snow, surly unionized conference center staff, outdated hotels that cost at least double what they were worth, endless cab lines because of the weather, and wearing winter clothes. I like Chicago as a tourist, but not as a conference attendee. HIMSS loves it, of course, because the travel is easier for their people and they get to deal their home city some payola.


Here’s Lorre’s new BFF Bob Murphy, MD, CMIO of Memorial Hermann Healthcare System (TX), meeting people in our booth.

Orlando attendance set a record at an announced 38,828, although I don’t know how that number was derived. I assume all registrations were counted, including exhibitors and press, but I don’t know if HIMSS counted people sitting at home who paid $49 to watch streamed sessions on the Web. I know this: all event promoters like to provide optimistic attendance statistics and there’s no good way to audit their claims.


PeriGen was a booth neighbor and CEO Matt Sappern dropped by to say that “HIStalk is the only thing to read each day.”

This week on HIStalk Connect: Epic and Walgreens launch a wide-reaching interoperability partnership to rival CommonWell. HIMSS publishes the findings of its mHealth Technology Survey. Glooko unveils a population health tracker focused on improving care within the diabetic population.


Jennifer Dennard (@SmyrnaGirl) tweeted out this photo, saying she’s reading up on HIStalk while sipping from our mug now that she’s home from the conference. Our mug supply is exhausted other than a few we set aside for loyal readers who asked us to mail them one since they weren’t at the conference. I like Jennifer’s photo – if you took a mug home, send a picture of it in its new home.

I didn’t hear much about Hillary’s Wednesday keynote other than (a) it was extremely short; (b) like any skilled politician, she didn’t really say anything other than predictably lauding the work of the crowd that brought her there and kissing up to HIMSS. I would have been mad about waiting an hour or two to squeeze into the huge room for her talk given its lack of substance. Hillary’s rumored minimum speaking fee is $200K plus expenses, so she took home a big paycheck in addition to potentially impressing would-be Presidential voters who were apparently happy just to bask in her celebrity.

Hillary mentioned in her speech that corporations don’t have enough females on their boards. She didn’t define “enough” quantitatively.

HHS confirmed during the conference that neither ICD-10 nor Meaningful Use Stage 2 deadlines will change.


Hearst Health’s newly formed venture unit invests in Tonic Health, which offers an iPad-based data collection tool that counts Partners HealthCare and UCLA Health among its customers.


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

More news: HIStalk Practice, HIStalk Connect.


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February 27, 2014 News 11 Comments

News 2/21/14

February 20, 2014 News 6 Comments

Top News


Allscripts announces Q4 results: revenue flat, adjusted EPS $0.08 vs. $0.16, beating revenue expectations and meeting consensus earnings estimates.

Reader Comments


From Dr. Detroit: “Re: misspelling HIMSS. Once a vendor does it in four separate emails as this one did, they should be granted credentials as a certified ‘HIPPA’ consultant.”


From Stool Pigeon: “Re: fecal transplants. You’ve grossed out readers before, so you might find this interesting.” MIT launches OpenBiome, the country’s first stool bank, to collect samples to treat patients with C. difficile intestinal infections. At least it eliminates that awkward moment of asking friends and loved ones to sit and be counted.  


From Pathology MD: “Re: HIStalk pins. I am a loyal reader but can’t get to Orlando. I collect pins and really would like the 10-year HIStalk pin or both for my collection. I’ll pay.” Lorre and I were touched by this request for this request for the inexpensive giveaway that was her idea, so she’s sending the pins to this reader as well as another with a similar request (obviously I’m happy to pay the postage.) We have a limited number of these to give away in Booth #1995, so maybe they really will become collectible.


From Dr. J: “Re: men’s wear for HIStalkapalooza. My $99 boots arrived just yesterday.” I love these, especially because they have a big toe box unlike some of those pointed boots that surely cause digital damage. They are from Dude’s Boutique Online, which I see has a really cool crocodile and ostrich boot in cognac for only $198 on sale as long as you don’t mind leaving a trail of dead animals behind your purposeful stride. I’ve asked Dr. J which ones these are because I need a pair to make me look more rock and roll.

HIStalk Announcements and Requests


Welcome to new HIStalk Platinum Sponsor Netsmart of Overland Park, KS. Netsmart is the leader in coordinating care among behavioral health, physical health, and acute care hospitals. That’s important because severely mentally ill people die 25 years younger than the rest of the population and drive up Medicaid costs and other loss ratios. Netsmart links primary care initiatives with broader, coordinated care for the body and mind to reduce readmissions. Netsmart CareFabric offers clinical solutions (EHR, eRX, CPOE, consumer engagement, analytics, care coordination) and business solutions (PM, client banking, RCM.) The company’s products are used by 23,000 clients, including 450,000 providers and 40 state systems, to improve the quality of life for 25 million people each day. Its clients include mental health and addiction services agencies, health homes, psychiatric hospitals, private and group mental health practices, public health departments, social services and child and family health agencies, managed care organizations, and vital records offices. Thanks to Netsmart for supporting HIStalk.


Welcome to new HIStalk Platinum Sponsor Premier, Inc. of Charlotte, NC.  Premier (NASDAQ:PINC) is a leading healthcare improvement company that unites 2,900 hospitals and 100,000 other providers to transform healthcare. Premier enables better care and outcomes at a lower cost through integrated data and analytics, collaboratives, supply chain solutions, and advisory and other services. A recent offering is PremierConnect Enterprise, a cloud-based data warehousing and business intelligence offering that combines trusted information, collaborative development, and access to expertise to enable information-driven health systems. Premier’s database is among the industry’s most comprehensive with data covering one in four hospital discharges, 2.5 million real-time clinical transactions each day, and $40 billion in annual purchasing information, all used to connect, share best practices, solve important problems, and build new technologies. The company has been named among the world’s most ethical companies for six years in a row. Thanks to Premier for supporting HIStalk.


Ion IT Group is supporting HIStalk as a Platinum Sponsor. The Carthage, TN-based company offers strategic services, consulting, and outsourcing. Specific services include managed IT, security and risk assessment, business solutions, and infrastructure. It also offers the Vital Connect remote vital sign monitoring solution (weight, blood pressure, temperature, pulse oximeter, and blood glucose) that works via a mobile phone data collector. It also provides HealthX secure messaging based on the Direct standard, which enables the exchange of EHR reports, documents, images, and structured data, and Evault services for cloud-based backup, recovery, and end point protection. Thanks to Ion IT Group for supporting HIStalk.

inga_small A few highlights from HIStalk Practice this week include: proposed Stage 3 MU objectives that may impact EPs. The Colorado Health Institutes suggests that the use of technology may help mitigate a looming shortage of PCPs. EClinicalWorks CEO Girish Navani predicts it will only be a matter of time before all providers convert to EHRs. Results from teledermatology assessments are found to be nearly identical to results of in-person assessments. Dr. Gregg provides a thorough list of all the JUNK you’ll need to lug with you to HIMSS. Thanks for reading.

On HIStalk Connect: Industry insiders suggest that the Apple iWatch will predict heart attacks in time for wearers to seek help. Surgeons at Washington University in St. Louis test a pair of smartglasses that highlight hard-to-spot cancer tumors during surgery. Partners HealthCare’s bid to acquire South Shore Hospital is rejected because the Massachusetts Health Policy Committee believes that population health-based cost savings are exaggerated. Dr. Travis dives into the world of Big Data in an article that focuses on the patient and the various tools available for capturing and sharing patient-centric data.


HIMSS has been emailing a Groupon-like but even lamer “HIMSS14 Conference Deal” that purports to offer the recipient something of value for opening it. Most of those emails haven’t offered anything at all, only a pitch for a company buying the ad. That doesn’t sound like a a deal for anyone except HIMSS. Those with memories going back more than a couple of years may recall the gentle era when HIMSS didn’t overtly flog the wares of its members to its other members with spam that promotes webinars, white papers, and other promotional stuff that has nothing to do with HIMSS except they’re getting paid to talk it up with little evidence of objectivity or restraint.


I received this by email today, just in case you wonder where all your post-HIMSS conference junk email and cold calls come from. I don’t recall having an opt-out option when registering for the conference as an attendee.


You may be rocking your HIStalk temporary tattoo after stopping by our booth, but you can’t match Lorre, who will let her fingers do the HIStalking.

HIMSS guides for your last-minute perusal: Exhibitor Giveaways, Sponsor Activities, Sponsor Meet-Ups

HIStalkapalooza Timeline


The event will be memorable, with many surprises that I won’t spoil now. The roster of attendees, which unfortunately couldn’t include everyone who wanted to be there, is spectacular and nicely diverse, with a huge number of hospital people enjoying amazing food, lots of drinks including an all-new IngaTini developed by the lady herself, and party music until late. Don’t even think about bailing out for some other event if you have an invitation because you’ll be sorry Tuesday morning when you hear everyone talking about it.

  • Transportation to and from the Convention Center will start at 6:30 p.m. on Monday.
  • At the House of Blues, we’ll have a red carpet greeting, photographers, and interviews by Jennifer Lyle. Your photos will be available to pick up on your way out as a souvenir.
  • The band (Party on the Moon) will play a set starting at 7:00 as the appetizer buffet and bars are open.
  • The dinner buffet will start at 7:30.
  • We’ll open the stage part of the evening at 7:45 with the music of Ross Martin, MD of AMIA and The American College of Medical Informatimusicology and a welcome from Jennifer, Lorre, and the folks from Imprivata.
  • The “Inga Loves My Shoes” contest with Lisa Reichard and Ed Marx will start at just after 8:00.
  • We’ll crown the HIStalk King and Queen next with Dave Lareau, Bonny Roberts, and Jennifer Dennard.
  • Then come the HISsies awards, with Ross Martin and Missy Krasner of Box.
  • We’ll wrap up the stage part of the evening by around 8:45 and the band will play until 11:00.

HIMSS Conference Social Events

2-20-2014 11-27-39 AM

Verisk Health is conducting a service project supporting the Second Harvest Food Bank of Central Florida on Tuesday at 6:00 p.m. at the Rosen Centre Hotel. Participants can spend an hour helping to assemble 4,000 food packs for children who do not have access to school cafeterias during the weekend.

2-20-2014 11-33-03 AM

ICSA Labs will host an evening of cocktails and hors d’oeuvres from 6:00 to 8:00 p.m. Tuesday at the Hyatt Regency.  RSVP here.

Acquisitions, Funding, Business, and Stock


Merge Healthcare announces Q4 results: revenue down 17.2 percent, EPS $0.00 vs. -$0.19, missing expectations on both. Shares are up 15 percent in after-hours trading.


Vocera reports Q4 results: revenue up 6 percent, adjusted EPS $0.03 vs. $0.03, beating earnings expectations. The company also announces that two New York luxury hotels are implementing its solution for employee communication.

2-20-2014 10-39-54 AM

Healthwise and the Informed Medical Decisions Foundation announce their pending merger.


UnitedHealth’s Optum division acquires a majority stake in Audax Health, the developer of a consumer health management platform that was founded four years ago by the now 24-year-old Grant Verstandig.


ISirona retires its name following its January 2014 acquisition by NantHealth.



Saint Luke’s Health System (MO) selects Solarity technology from EDCO Health Information Solutions for scanning medical records at the point of care and remote indexing services.

Sanford Health (ND)  will spend $30 million to implement Intelligent InSites RTLS at several locations.



Farzad Mostashari, MD joins the board of patient engagement company Get Real Health.

2-19-2014 4-08-08 PM

CureMD announces the death of  President, CEO, and Co-Founder Kamal Hashmat, MD following a “tragic accident.” Co-founder and CIO Bilal Hashmat will replace him.

2-20-2014 11-48-36 AM

The Institute of Medicine names Duke University Health System President and CEO Victor Dzau, MD to a six-year term as president. He will replace Harvey Fineberg, MD, PhD, who has held the role for 12 years.

image image

Bill Spooner, SVP/CIO of Sharp HealthCare, announces his retirement after 32 years in the position. He will be replaced by Ken Lawonn, formerly SVP of strategy and technology at Alegent Health.

Announcements and Implementations

Sixteen health information organizations throughout the Midwest and Rocky Mountain states form The Mid-States Consortium of Health Information Organizations, with the goal of advocating for health information exchange across states and in rural areas.

HIMSS Analytics introduces the Continuity of Care Maturity Model to address the importance of information exchange, care coordination, interoperability, patient engagement, and analytics.

The president of Toshiba says the company will spend billions of dollars on mergers and acquisitions to boost annual sales in its healthcare division to $9.78 billion by March 2018.

Kaiser Permanente Colorado, the largest not-for-profit health plan in Colorado, will join the CORHIO HIE.


Deloitte Consulting launches ConvergeHEALTH by Deloitte, a business unit that supports data-driven transformation of healthcare using analytics, consulting, and collaboration with leading healthcare organizations.


A group of Mayo Clinic physicians launches Ambient Clinical Analytics and raises $1.1 million in funding on top of its original $16 million CMS grant. It will offer Mayo-developed mobile device tools such as surveillance alerts and an analytics-powered EMR viewer. It will be debuted at the HIMSS conference next week.

Government and Politics

CMS announces that it will offer end-to-end ICD-10 testing in summer 2014 to a small group of providers.

2-20-2014 1-39-23 PM

ONC selects 15 provider and administrator champions for its HIT Fellows Program.



Carilion Clinic identifies 8,500 patients at risk for developing heart failure using NLP and predictive analytics technology from IBM to analyze clinical data from the health system’s Epic EMR.

A HIMSS survey finds that 19 percent of health systems and physician practices experienced a security breach in the last 12 months and 12 percent had at least one reported case of medical identity theft.


Nashville attorney Michael Dagley, who represented Trinity Medical Center (ND) in its $106 million settlement with Cerner over its ProFit accounting software, indirectly accuses the company of over-promising on ProFit’s capabilities to earn the clinical systems business. He also warns hospitals that limitation-of-liability clauses may prevent hospitals from suing their vendor, saying, “Vendors will have in their contract, almost always, a limitation of liability. Which means you cannot sue us for any consequence of the software being defective, you can only get your money back for the software. The providers, a lot of times, do not understand the significance of that agreement. So now, they’re three months into it, they’ve bought the software, and they’ve lost $100 million. They pull up the contract, and the contract says you can get your money back for the software and they’re going, ‘That’s $300,000, but I lost $100 million!’” He suggests consulting KLAS rankings and talking to clients.

A study finds that few consumers pay attention to online physician reviews even though they’ve gained popularity.


The outgoing CFO of Nevada Regional Medical Center (NV), which is laying off employees and losing $575,000 each month, says, “The biggest expense we’ve had is Cerner’s fees.” Cerner agreed to lower its payments by $31,000 per month for six months and then add $2,000 per month for the remainder of the eight-year agreement (they get paid the same total amount, in other words.)

The local paper says that Epic may reach 10,000 employees by 2018, with much of the growth due to international expansion that will be run from Verona. The article lists “Epic’s 12 Principles” that it says are posted all over its campus:

1. Do not go public.
2. Do not be acquired.
3. Expectations = reality.
4. Keep commitments.
5. Be frugal.
6. Have standards. Don’t do deals.
7. Create innovative and helpful products.
8. Have fun with customers.
9. Follow processes. Find root causes. Fix processes.
10. Don’t take on debt, no matter how good the deal.
11. Focus on competency. Do not tolerate mediocrity.
12. Teach philosophy and culture


St. Vincent Hospital (IN) notifies 1,100 patients that their medical information is in unknown hands after a laptop attached to an EEG machine is stolen. The hospital issues the standard boilerplate in staying it has no reason to think the information is at risk, that it will offer free credit monitoring, and that it just might take a look at encrypting devices one of these days.

All-digital Banner Health (AZ) was all-paper Banner Health Wednesday as its Cerner systems go offline, forcing its hospitals in Arizona, Colorado, and Nevada to go to downtime procedures. The systems came back up Thursday afternoon.


I bragged on buying a cell phone charger to use at HIMSS so I can recharge my iPhone without tethering to a wall jack, but I should have waited: Jay at Lifepoint Informatics saw the mention and said the company will be giving them away at the HIMSS conference. Jay not only says the company is a proud HIStalk sponsor, he even posed the charger with their HIStalk booth sign from last year to demonstrate it. I would get to Booth #6069 early since this is a really nice giveaway.

If you are headed to Orlando, travel safely and I will see you there. If not, thanks for holding down the fort and feel free to take long lunches and leave early because your boss isn’t really working that hard at the HIMSS conference.

Sponsor Updates

  • Caristix interfaces the Mirth Connect interface engine to iNTERFACEWARE’s Iguana engine to provide point-and-click migration from one interface to another.
  • ScImage announces availability of a universal MPI translator for importing diagnostic images from disparate systems into its  PICOM365 system.
  • IMDsoft makes MetaVision AIMS available for anesthesia practices independent of any facility infrastructure and as a subscription-based license.
  • DataMotion enables 16 EHR systems to achieve 2014 ONC-ACB certification using its DataMotion Direct secure messaging service as “relied upon software.”
  • Ricoh Americas partners with InterSystems to develop new interoperable healthcare solutions, including the Ricoh Healthcare Camera, which allows clinicians to scan barcodes from a patient’s wristband and add information on the injury before taking pictures.
  • Surescripts certifies First Databank’s FDB MedsTracker for prescription routing in adherence with the NCPDP SCRIPT 10.7 standard required for MU Stage 2 certification.
  • Coastal Healthcare Consulting launches Wave, an implementation solution that encompasses project management, workflow analysis, design, building, testing, training, and go-live support.
  • EClinicalWorks deploys Array Network’s APV10650 appliances to consolidate its cloud-based application infrastructure into a smaller number of larger data centers.
  • Welch Allyn will use Accelero Connect from Iatric Systems to automate the capture and recording of vital signs into EHRs.
  • Bon Secours Medical Group (VA) VP/Chief Clinical Officer Robert Fortin discusses his organization’s move into population health management in an iHT2 article.
  • Apelon and Clinical Architecture partner to offer Clinical Architecture’s Symedical with Apelon’s professional services
  • Covisint and actuarial Milliman Inc. introduce the Covisint Predictive Analytics solution.
  • Liaison Healthcare completes interoperability testing of its Master Person Index and Patient Document Repository offerings with 70 test partners during last month’s 2014 IHE North American Connectathon.
  • University Medical Associates (OH) joins the Guideline Advantage quality improvement program, which leverages Forward Health Group’s PopulationManager toolset.
  • Orion Health reports that its statewide HIE customer count grew 40 percent in 2013 and its HIE customers increased by 200 percent. The company will open a  development center in Scottsdale, AZ later this year.

Sponsor Speaking Engagements at HIMSS

  • Brian Levy, MD, VP of global clinical operations for Wolters Kluwer Health’s Health Language division, will discuss leveraging analytics to capture the benefits of ICD-10 on Wednesday at 11:30 a.m.
  • Vital Images will feature VitreaView in a live case study at the Interoperability Showcase on Tuesday at 4:30 p.m.
  • Medhost will demonstrate YourCareCommunity in the HIMSS Interoperability Showcase (Hall F).
  • Ryan Witt, global manager director for Juniper Networks, will moderate a lunch and learn session Wednesday at 12:30 p.m. that will discussing managing network requirements to support new technologies.
  • Intelligent InSites customer Veterans Health Administration will share best practices in implementing RTLS in a Sunday pre-conference symposium.

HIMSS14 in Review
By Vince Ciotti

Since I spend my winters right here in sunny Florida next to Orlando, I thought I’d give readers of HIStalk the advantage of reading the very first report on HIMSS 2014.

  • The crowd was huge, way up from last year’s paltry 35,000 to about 40,000 this year. At an average of $800 each for registration fees, that gives HIMSS over $30 million. Maybe next year they’ll lower their annual membership dues.
  • Weather was near perfect, although a little on the warm side at about 80 degrees. Interestingly, that was the same temperature inside the hall as well as outside due to the large volume of hot air from all the demo dudes & dollies.
  • There were almost 200 booths from vendors new to HIMSS this year, with 195 of them featuring “Big Data” analysis and reporting. Conspicuously absent were major players NSA and Target.
  • Vendor booths were absolutely stunning. If you add the out-of-pocket costs for their thousands of marketing mavens and sales reps plus the fees charged for booths and floor space, it was possibly the single largest line item in healthcare costs outside of EHRs.
  • The multitudes of speakers had truly impressive PowerPoint files: amazing builds, animation, and other visual effects that must have taken many months of hard work away from providing user service & support.
  • 1,275 vendor booths featured banners that claimed they were “Best in KLAS” for one category or another. Indeed, KLAS’s own booth claimed they were rated as the very best source for evaluation of vendors’ true capabilities by… guess who?
  • It was hard to count the many new products and releases that were announced, every one of them far better than what clients are suffering with today. All of it was offered at special low pricing for HIMSS attendees who signed up early.
  • 417 consulting firms announced new divisions that specialized in Epic implementations, every one of them manned by senior employees (some actually in their 30s) with vast experience of more than one year each.
  • Keynote speaker Hillary Clinton surprised everyone when she praised the Affordable Care Act. Her only complaint was that it didn’t go far enough, and whoever becomes the next president really needs to try to improve healthcare even more.

Stay tuned next month — I may have an early report on HIMSS15 in Chicago.

Vince Ciotti is a principal with H.I.S. Professionals LLC.

Ten Tips for Making the Most of Your HIMSS14 Experience
By Jodi Amendola


  1. Build your plan around the trends or issues you’re most interested in, then mark the booth and educational sessions that address them.
  2. Include networking events in your plans.
  3. Building in scheduled breaks throughout the day. Real ones, not check-your-email breaks. Many vendors offer space to sit along with free refreshments.
  4. HIMSS14 is not the place to break in a new pair of shoes or to sacrifice comfort for fashion.
  5. Take advantage of apps such as the HIMSS14 Mobile Guide; a business card scanner; a personal health monitor; a friend locator; a restaurant and entertainment locator; and apps that let you confirm travel plans for the trip home.
  6. Re-invigorate a long-distance relationship over a cup of coffee or a meal and mine your contacts to reconnect with or get to know other colleagues better.
  7. Put away the smartphone. Considering how much time and money you’ve invested in being here at the best health IT conference of the year, that email can wait.
  8. Connect with the speakers by asking questions during the Q&A, introducing yourself, or connecting via Twitter or LinkedIn.
  9. Put a star in the margin of your notes (electronic or handwritten) next to any action item, then distill every session into one or two key takeaways.
  10. Share video or audio files of the sessions you found especially valuable with your colleagues and friends or give a talk about something you learned at your next staff meeting.

Jodi Amendola is CEO of Amendola Communications.

EPtalk by Dr. Jayne

I’ll keep it this post relatively short because I am completely overwhelmed by HIMSS preparations and a major calamity at the office. Let’s just say that nothing can prepare you for the chaos that ensues when a provider is arrested in the middle of the work week.

Since it was a solo provider and we had to close the office, I seriously toyed with the idea of using our patient portal to blast a message to the impacted patients, but the risk management department shot me down. I guess it’s better for the patients to sit and wonder what will happen with their care, at least in their eyes.

Inga and I have been hard at work finalizing our social plans for Orlando. We had a reader ask if I would be making a scheduled appearance at the HIStalk booth (#1995 for those of you playing at home.) Although I will definitely be stopping by to pick up my HIStalk tattoo and a Smokin’ Doc pin, I’ll be doing it anonymously. Feel free to swing by, however, and see if there are any sassy blonde physicians lurking about. I’ll probably be there to support some of our scheduled celebrity appearances. I’ll also be at the Medicomp Systems booth (#2703) to support some of my BFFs as they compete in Quipstar.

Most of the events we’re attending are those whose hosts generously agreed to allow us to invite all our readers. Inga and I also have a penchant for hitting the in-booth happy hours, so look for us during the cocktail hour in the exhibit hall as well. I’m trying to fit in some educational sessions in between cruising the booths and taking pictures of ridiculous costumes that the hired booth attendants are forced to wear. Be sure to have your cameras at the ready and feed us pictures of hot shoes, cool giveaways, and the wildest outfits you see.

We’ve also been hard at work identifying the recipients of some of the coveted HIStalk beauty queen sashes. Don’t worry, there is still a chance to win one for yourself by entering Inga’s shoe contest or aiming for the coveted HIStalk King and HIStalk Queen titles.

I look forward to HIMSS each year, but it’s bittersweet on some levels. While many of us are away, we will be depending on the rest of our colleagues in the trenches to keep the infrastructure running and the providers under control. Although a lot of vendor organizations freeze in time around HIMSS, the rest of the health IT world does keep turning.

Case in point: NCQA announces the opening of a public comment period for proposed changes to the HEDIS measures for 2015. Proposed new measures include one on overuse of colorectal and prostate cancer screening and another on appropriate use of antipsychotic measures in children. Those slated for retirement include glaucoma screening in older adults and cholesterol management for patients with cardiovascular conditions.


HHS release a model Notice of Privacy Practices in Spanish. Since over 38 million people in the US speak Spanish, it’s about time. The offerings include fillable forms that can be printed for patients and are designed for both provider organizations and health plans.

The hot topic of conversation in the physician lounge this week has been the publication of the final rule amending the 1988 CLIA regulations to allow patients and their designees to receive lab results directly from laboratories. Physicians are generally resistant to anyone releasing lab or test results directly to the patient. Most of the time they cite concerns that the patient will not be able to interpret the results or that they may be confused or even harmed by results that lack explanation.

Our health system releases results to patients without physician review after 96 hours, so physicians have had to get on the ball and notify patients in a timely manner because the patients are going to receive their results if they are enrolled on the patient portal. There are a couple of tests that are restricted (like HIV and sexually transmitted infection labs) due to state privacy laws, but pretty much everything else in the lab or radiology realms is fair game.

Personally, I think it’s about time that other organizations have to start jumping through all the hoops that providers do with all the different rules that continue to be propagated. In this case, they only require the release of information within 30 days. Let’s make them release within three days like the rest of us and see how they do.


I’m off to pack. Including a half marathon in my weekend plans has definitely added to my fashion worries. If you happen to be at Walt Disney World in the wee hours of Sunday morning, keep an eye out for me as I run through Cinderella’s Castle in bling that even Inga would envy. Otherwise, my next report will be from the HIMSS opening reception.


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

More news: HIStalk Practice, HIStalk Connect.


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February 20, 2014 News 6 Comments

News 2/19/14

February 18, 2014 News 3 Comments

Top News


A SANS-Norse white paper investigating Internet traffic reports that 94 percent of healthcare organizations have been cyberattacked, with 72 percent of the compromised ports belonging to provider organizations. About a third of those compromised providers are practices with fewer than 10 doctors.The biggest target in healthcare is radiology imaging and teleradiology systems, often because nobody bothers to secure network-attached devices such as printers and cameras that are shipped as insecure and can be discovered by Internet search of IP addresses.

HIStalk Announcements and Requests

Listening: new from St. Paul & The Broken Bones, powerful Alabama Shakes-like soul music that would be equally at home at a Saturday night bar or a Sunday morning church.

Inga put together our guide to exhibitor giveaways, pointing out the sponsor swag that will be available.

HIStalk’s Booth #1995 at HIMSS

It’s a small starter home in a sketchy neighborhood, but it’s ours and it’s paid for. Drop by Booth #1995 and say hello to Lorre. Here’s what we’ll be doing there other than possibly regretting spending the money.


We will be giving away temporary HIStalk tattoos for folks who are somewhere on the continuum between “I sort of like reading HIStalk occasionally” and “I would disfigure my body permanently for HIStalk using actual needles and ink.” Take a photo of the creative anatomical feature on which you’ve applied it and I’ll run it.

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We’ll have our first HIMSS conference lapel/lanyard pin as well as our “10 Years of HIStalk 2003-2013” commemorative pin. You’ll be kicking yourself for not picking one up when these babies are selling for $500 on eBay in a few years. As Lorre says, “I know they aren’t iPads, but consider my budget and come and get them anyway. You will look cool and make me feel good. I may even have items left over from the sponsor event and will selectively dole those out to people who go out of their way to entertain me.”

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Dignitaries will be on hand in the booth to say hello, including DOCtalk contributor Dr. Gregg Alexander (Monday, 1:00 to 2:00 p.m.); CIO Unplugged’s Ed Marx (Tuesday 9:30 to 10:30 a.m.); and Memorial Hermann CMIO Bob Murphy, MD (Wednesday 10:00 to 11:00 a.m.) If your celebrity status warrants a spot on the HIStalk rental carpet with these supporters, contact Lorre. We appreciate it.

HIMSS Conference Social Events

Send us your event details if it’s a good one (i.e., free food and drinks at minimum) and you promise that all HIStalk readers are welcome to attend, even if they work for your most hated competitor as a given reader might well do.

Tuesday from 4:00 to 6:00 p.m. Patientco, in partnership with Georgia.org , will host a reception in booth 4021 with drinks and hors d’oeuvres.

Presidio will offer light hors d’oeuvres and drinks at its reception in Booth 3129 on Tuesday from 4:00 to 6:00 p.m.

inga_small Hopefully not a foreshadowing of things to come: I received an email from my HIMSS hotel confirming my stay. Unfortunately the reservation appears to be in the name of Chad Somebody. While I am sure Chad is a lovely person, spending a few nights in a hotel together is not my idea of an appropriate first date. The HIMSS reservation service told me to check directly with the hotel. The hotel tells me there is not a reservation in my name, just in my new friend’s name with my confirmation number. Really, who has time for figuring out such nonsense? Chad: if you are reading this, feel free to drop me a note so maybe we can have a Skype date before heading to Orlando.

2-18-2014 6-56-16 AM

inga_small On Monday we posted our rundown on the many free treasures you can collect while cruising the exhibit hall. I plan to schedule my day around the best offerings, starting with coffee at First Databank (1965); a cake pop from PerfectServe (5293); registration for a few high-tech goodies like an iPad from Santa Rosa Consulting (5689), a Fitbit from GetWellNetwork (2219) or one of several other vendors, or a tablet from Versus Technology (3673); freshly baked cookies from T-System (2071); bottled water from CTG Health Solutions (944); and afternoon cocktails at RelayHealth (1665) and Vital Images (1677). I am leaving out details on a couple of dozen other great giveaways but be assured I will do my best to sample all the hospitality the exhibit hall has to offer.

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Mr. H (@HIStalk), Dr. Jayne (@JayneHIStalkMD), Lorre (@Lorre_HIStalk), and I (@IngaHIStalk) will be Tweeting throughout the conference to keep readers posted on the latest happenings, so be sure to give us a Twitter follow.


The band for the evening will be Party on the Moon. They sound good if you like cover bands more than I do, which Imprivata’s events people insisted is the case after hiring them without asking for my input. They’re probably right.

This year I’m feeling like those unheralded Woodstock organizers whose event was more popular than they could handle. I issued the invitations I was given as best I could, but huge demand left 1,000 or so folks — the majority of those who registered, in fact — without one. It feels like at least 500 of those have emailed me pleading for tickets I don’t have, except my own single ticket, which I’m considering just giving to someone else and hitting a bar instead. Next year I’ll either run the event my way or I won’t do it at all.  

Upcoming Webinars

February 19 (Wednesday), 1:00 p.m. ET. What is the Best Healthcare Data Warehouse Model for Your Organization? Choosing the right data model for your healthcare enterprise data warehouse (EDW) can be one of the most significant decisions you make in establishing your data warehousing and foundational analytics strategy for the future. The strengths and weaknesses of three primary data models will be discussed.

Acquisitions, Funding, Business, and Stock


Cerner shares touched off an all-time high Tuesday, dropping a bit by the market’s close but still rising nearly 1 percent to $60.74. A $10,000 investment in 1990 would be worth $3.4 million today.


2-18-2014 1-48-56 PM

North Mississippi Medical Center selects Wellsoft’s EDIS.

ColumbiaDoctors (NY) will deploy Wellcentive’s population health management solutions.

2-18-2014 1-52-35 PM

Blessing Hospital (IL) adds Allscripts dbMotion population health management and Allscripts Sunrise Financial Manager to compliment its existing Sunrise Clinical implementation.

Greater New York Hospital Association contracts with Premier, Inc. for advisory services and for Premier’s Population Advisor suite, which includes population health analytics solutions from Verisk Health.

2-18-2014 1-54-49 PM

BJC HealthCare (MO) selects ZeOmega’s Jiva population health management software to enhance  care coordination and patient engagement for patients in the BHC ACO.


2-18-2014 8-33-35 AM

SA Ignite hires Jeff Galowich (Initiate Systems) as president.

2-18-2014 8-59-04 AM

Kindred Healthcare (KY) names C. Scott Blanchette (Vanguard Health Systems) CIO, replacing the recently retired Richard E. Chapman.

2-18-2014 1-55-40 PM

Health Catalyst appoints Bryan Oshiro, MD (Loma Linda University School of Medicine) chief medical officer.

Announcements and Implementations


Carroll Hospital Center (MD) upgrades from McKesson Horizon to Paragon. According to the hospital’s interim CIO Jennifer Moore, Carroll stayed with McKesson because project costs were “significantly lower than if we had gone to find another vendor for a new product.’ Jed Rosen, MD, chief of surgery and CMIO, said Horizon is “a product that was a conglomeration of multiple database programs that were squished together … to add functionality on a piecemeal basis. We used to bounce around through several programs to access information, whereas now we can open one program and get everything at a glance.” He didn’t mention why they bought Horizon since that was pretty obviously the case.


Voalte will offer an Android-based version of its Voalte One mobile communications platform running on Motorola MC40-HC devices.

Caradigm and Microsoft will demo at the HIMSS conference a Windows 8.1 tablet-based platform that lets clinicians launch apps such as an EHR session from a clinical desktop and switch back and forth among them. It was developed with UPMC’s commercialization arm and includes Caradigm’s single sign-on and context management, the former Sentillion products.


Nordic Consulting moves into expanded space in Madison, WI. The four-year-old company reported $81 million in revenue in 2013 and has 400 employees, 350 of them Epic consultants and two-thirds of those being former Epic employees. Most of them live in areas other than Madison. It also took in $38 million of investment funds.

QPID Healthcare announces the release of Q-Guide, its procedure decision support application developed with Mass General Hospital and its physician organization.

Government and Politics

The FDA posts a final rule requiring medical device manufacturers to electronically submitting reports on adverse events beginning in August 2015.


Black Book Rankings names CPSI the top ranked inpatient EHR vendor for hospitals under 100 beds based on customer satisfaction

The HEALTHeLINK HIE (NY) estimates that use of the exchange contributed to $1.3 million in cost savings over a six-month period due to the reduction of unnecessary and duplicate CT scans.

Hospitals often underestimate the costs associated with EMR implementations, according to a study published in JAMIA.The most commonly underestimated line items are training, project planning, staff backfill, and system testing.


In Australia, opening of the new, paperless Fiona Stanley Hospital is delayed by six months due to an overly ambitious IT implementation schedule that will cost an extra $151 million. The government expects to spend another $25-50 million to get its systems ready. According to West Australia’s under-treasurer, “You never build stuff that you can buy off the shelf; you never build bespoke stuff that then has to be integrated with generic products; you change your business processes rather than changing the systems to suit the business processes. You never do big bang because big bang goes boom.”

In England, NHS postpones go-live date of a planned national medical records data sharing project after doctors and patients express concerns that it wasn’t made clear how patients could opt out or how their data might be used commercially without their knowledge.

A Bloomberg Businessweek article points out that more than half of ACOs don’t include hospital members. According to the CEO of Amarillo Legacy Medical ACO (TX), “Hospitals, they want to do your robotic surgeries, your heart catheterizations, your PET scans, your MRIs—all the expensive items. We actually felt that hospitals were part of the problem.” Another ACO CEO adds, “If we make people a whole lot healthier, they’re not going to go to the hospital. You’re going to need 20 percent or 25 percent less hospital beds, which means 20 percent are going to close. If we’re successful, the hospitals are going to get killed.”


US News lists its “100 Best Jobs of 2014” based on growth, salary, stress, and work-life balance. The The top 10:

  1. Software developer
  2. Computer systems analyst
  3. Dentist
  4. Nurse practitioner
  5. Pharmacist
  6. Registered nurse
  7. Physical therapist
  8. Physician
  9. Web developer
  10. Dental hygienist


The local newspaper interviews Paul Clark, MD, CMIO of Concord Hospital (NH). “I think this whole concept of population management is really where things are heading. In the past, it was all about the person in front of me at the moment. Now it’s about, ‘Am I providing the best care for all my diabetes patients? Are we making sure we’re preventing readmissions? Are we taking care of everyone’s hypertension?’ Systems need to be made to account for those population measurements.”

The New York Times highlights India’s launch of a spacecraft bound for Mars that cost only $75 million, less than the expense of making the Hollywood movie “Gravity.” NASA’s launch of a similar spacecraft a few days later cost $671 million. It points out GE Healthcare’s research there to develop low-cost medical innovations.

Sponsor Updates

  • The National Testing Program for ICD-10 readiness of HIPAA transactions extends certification Greenway SuccessEHS.
  • SimplifyMD version 14.0 achieves 2014 Edition Complete EHR Ambulatory ONC HIT Certification from ICSA Labs.
  • HIT Application Solutions will integrate its Notifi platform with Merge Healthcare’s Merge RIS and market the product under the name Merge Notifi.
  • Medhost launches YourCareCommunity, which incorporates features of and HIE and an enterprise MPI.
  • Coastal Healthcare Consulting introduces Catalyst to rapidly respond to healthcare organizations in urgent need of assistance.
  • Frost & Sullivan recognizes Allscripts with the 2013 North American Frost & Sullivan Award for New Product Innovation Leadership for its open API.
  • NewCrop, an e-prescribing service provider, enables CoverMyMeds prior authorization capability.
  • Greenway is awarded three patents which work together to advance population health through automated medical research.
  • Porter Research publishes a case study highlighting its work with Covisint.

Sponsor Speaking Engagements at HIMSS

  • InterSystems highlights featured presentations in the InterSystems theater (2741).
  • Imprivata posts the Imprivata Theater schedule (2541).
  • CTG offers multiple in-booth sessions (944) featuring industry experts and discussions of hot HIT topics. Also, CTG and Erie County Medical Center (NY) co-present an educational session February 25  at 1:00 p.m. on “Improving Western NY’s Population Health Using Patient Centered Medical Home.”
  • HealthMEDX participates as the first LTPAC EMR in the HIMSS Interoperability Showcase.
  • The HCI Group leads two CHIME CIO focus groups on the complexities of ICD-10 and on the total cost of ownership for enterprise systems.
  • Craneware’s Kathy Schwartz presents during the HIMSS Supply Chain pre-conference Symposium February 23 from 10:00-11:00 on costs, quality, and outcomes.


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

More news: HIStalk Practice, HIStalk Connect.


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February 18, 2014 News 3 Comments

Monday Morning Update 2/17/14

February 15, 2014 News 1 Comment

2-15-2014 6-39-12 AM

From The PACS Designer: “Re: Another smart glasses solution. Researchers at Washington University it St. Louis have developed a solution that can help surgeons find all cancer cells. The technique uses custom software that makes cancerous cells glow blue by using a molecular imaging agent to give the cancer a unique color that can be viewed with special glasses.”

2-15-2014 4-45-37 PM

From Mark in Marketing: “Re: HIStalk interview tips. Refreshing! I work in marketing and even I hate marketing people.” I send people I’m going to an interview (or their handler) a tips sheet so they don’t waste my time, so Mark was complimenting me on that as he prepped his client. I’m really lucky because people want to be interviewed on HIStalk, so I get to make the rules in favor of readers. The bad interviews I’ve done weren’t for lack of trying. Some of my guidelines are:

  • I only interview CEOs because readers want to hear from the top person in a company who can talk about the broad strategic landscape, not a VP of sales pitching product.
  • Get on a landline, not a cell phone, and on a handset rather than a speakerphone. People never know how crappy they sound on a cell phone. It takes me an extra 1-2 hours to finish an interview transcription when the person ignores this advice, so now I just stop the interview and tell them to get on a landline or we’re done.
  • I use the CEO’s background to decide whether I’ll do an interview because if the person seems boring, it doesn’t matter how non-boring their company is.
  • Marketing and PR people can join the call, but can’t speak. I also don’t want to hear long pauses as the marketing people thrust boilerplate under the interviewee’s nose trying to get them to read it verbatim.
  • I don’t provide questions in advance and I don’t allow review after the fact. CEOs earn should be able to earn their paycheck without having someone else reviewing their every word for accuracy or intent.
  • I’m an industry person, so I won’t be asking the usual dumb reporter softball questions. It will be a conversation and I’ll ask whatever I think is interesting.
  • My first question is always an invitation to tell readers a little bit about the interviewee and the subject, the emphasis being “little bit.” I emphasize this strongly because in one interview, the executive spent literally 10 minutes answering that question, leaving me little time to ask anything else.
  • Nobody wants to read a company pitch, so put a lid on that and speak honestly about the industry as a whole.

2-15-2014 5-46-14 AM

Two-thirds of poll respondents say “Best in KLAS” products aren’t really the best ones. New poll to your right: does your business card list any certification credentials after your name? That means CPHIMS, CHCIO, PMP, etc. rather than educational credentials or professional licensure. 

My language pet peeve du jour: companies whose announcements say they have “more than 500 customers” or “more than 200 employees.” Either give us an exact number (“we have 502 customers”) or, better yet, just round down and skip the “more” part (“we have 500 customers”) and trust us not to think less of you because you have two fewer customers. Inga’s example was a company whose press release said its product is installed in “more than 87 hospitals.” Others: using the almost never necessary word “currently”; saying “utilize” instead of the simpler and equivalent “use”; using “leverage” for anything other than physics or finance topics; and using the non-word “anymore.”

2-15-2014 10-12-05 AM

Here’s something you need even if you don’t know it, especially with the HIMSS conference coming up when your phone’s battery will drain quickly trying to lock onto a cell signal. This little $30 gadget is an external charger for your smartphone. Charge it up and you can then recharge your iPhone 2-3 times, even while on the go (like on the exhibit hall floor). I used mine this week to recharge my phone when I lost electricity. Many choices exist, ranging from lipstick-sized models to big boys.

2-15-2014 4-07-20 PM

Here’s another thank you note from a teacher who HIStalk readers helped with a grant. I confess this was my favorite project of the several I funded – buying a lectern and supplies for the very poor school’s first National Junior Honor Society ceremony.

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

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Upcoming Webinars

February 18 (Tuesday), 1:00 p.m. ET. Epic 2012 Training and Support: Building Your Team. Sponsored by MBA HealthGroup. The webinar will present a case study of creative staffing solutions for an Epic 2012 upgrade at an academic medical center, describing the institution’s challenge, its out-of-the-box solution, and the results it obtained working with a consulting firm.

February 19 (Wednesday), 1:00 p.m. ET. What is the Best Healthcare Data Warehouse Model for Your Organization? Choosing the right data model for your healthcare enterprise data warehouse (EDW) can be one of the most significant decisions you make in establishing your data warehousing and foundational analytics strategy for the future. The strengths and weaknesses of three primary data models will be discussed:

HIMSS Rundown

  • Our sponsor social event will be Sunday evening.
  • Lorre will be in our tiny HIStalk Booth #1995 all week saying hello and giving away fun trinkets. Stop by on your way to (or preferably from) the restroom, which is conveniently co-located.
  • HIStalkapalooza will be Monday evening.
  • We will use Lorre’s Twitter to tell you about cool stuff Inga, Dr. Jayne, and I find in roaming the exhibit hall, such as interesting giveaways or fun comestibles (the cake pops and freshly baked scones sound good).
  • Our HIMSS Guide describes what our sponsors will be featuring (and giving away).

For overachievers already plotting your candidacy for HIStalk King or Queen at HIStalkapalooza next Monday evening, our judges (Bonny Roberts, Dave Lareau, and Jennifer Dennard) have put together some tips for you. Bonny provides an overview:

Since the secret is out, I can hardly be “Mr. H’s Secret Crush” two years in a row. Fortunately, I will be hitting HIStalkapalooza with another goal in mind:  crowning this year’s King and Queen! Many of you may be wondering, “How do I win?” Granted winning may be tough, but being in the running is EASY. 

  1. Arrive at the House of Blues on Monday night dressed to the nines. 
  2. Be sure to catch the eye of one of three esteemed judges. Don’t worry, we will be sashed and easy to locate. 
  3. Strut, preen and smile!

Speaking of HIStalkapalooza, these are the folks bringing it to you.

2-15-2014 7-09-31 AM

Imprivata is the primary sponsor, meaning they are writing a check with lots of zeroes and doing all the planning. Make sure to thank them. It’s a huge financial and logistical commitment given the visibility and size of HIStalkapalooza.

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The support of HIStalkapalooza’s co-sponsors (Greenway, Hill-Rom, Nordic, RFIDeas, and VMware) allows us to provide some really nice extras that you’ll appreciate at the event. Three of these five, like Imprivata, are also HIStalk Platinum sponsors and I appreciate them even more (Greenway, Nordic, and VMware.)

2-15-2014 6-44-46 AM

The Valley Hospital (NJ) decides to upgrade from Meditech Magic to 6.1 instead of choosing other finalist Epic, giving the company a win in a bed size (450) that usually goes to Epic or Cerner.

I told ReadyDock Founder Dave Engelhardt last year that he should create a video showing how the company’s mobile device disinfection system works. He’s doing that, but in the mean time, he whipped up a little HIMSS promo video that’s fun. They will also disinfect your device in your booth at the conference, which would be even more fun if there was a way to show what’s growing on it beforehand since I see them used in the bathroom all the time.

The US Patient Office grants a cloning patent to a Korean researcher whose work was found to be criminally fraudulent 10 years ago, in essence granting him a  broad patent for something that doesn’t exist. The Patent Office says its system operates on an honor code and its examiners can’t verify patent claims, adding that while it was aware of the researcher’s history, the patent application complied with all laws.

2-15-2014 7-42-58 AM

Vermont lawmakers are upset that the state’s new 25-bed psychiatric will open this summer using a combination of paper and electronic medical records. The state couldn’t reach an agreement with the incumbent EHR vendor and also noted that the product didn’t have an integrated pharmacy module. It then tried to piggyback the hospital on Fletcher Allen Health Care’s Epic system, but decided it wasn’t worth the $3 million upfront cost and $600,000 in annual maintenance. The state is preparing an RFP and will use its old systems in the mean time. Legislators are also unhappy that the hospital will cost $20 million per year to operate.

2-15-2014 7-45-25 AM

Federal technology magazine FCW profiles the VA’s telemedicine program, which delivered 1.7 million episodes of care in 2013 and is growing 22 percent per year. According to a VA executive, “It’s not just a question of saying, have we got the telecommunications and have we got the clinical model? We then have to think about how we have to train the clinicians to be able to do it. We have to think about how we have to put help desk support for both patients and clinicians in place. The volume of care we’re providing is such that we’re providing care that’s mission critical, and we roll it out with that in mind.” The article also mentions that Alaska’s tribal health system is a big telemedicine user and its CIO expects the EHR to run telemedicine services directly at some point, but for now the system’s 28 EHRs don’t communicate with each other. According to the CIO, “Our goal is to make telemedicine and EHRs look like one system to the clinician.” Another issue with the VA’s national rollout is that broadband service isn’t available everywhere and 45 percent of the VA’s patients live in rural areas.

2-15-2014 8-12-12 AM

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The local New Hampshire newspaper profiles two acclaimed doctors who are retiring in their mid-60s. Peter Mason, MD isn’t a fan of professional communication via email and says the electronic chart is full of unnecessary insurance-mandated information and boilerplate notes, concluding, “We’ve lost the narrative of the medical record.”Mark Nunlist, MD of White River Family Practice (above) saw the value of the team approach and technology when he realized he wasn’t reminding patients to get tetanus shots. Now the practice is looking for population health management software and trying to find $25,000 to improve its EHR interface with Dartmouth-Hitchcock’s systems. The practice, an eClinicalWorks user, won the 2013 Ambulatory HIMSS Davies Award and will be recognized at the HIMSS conference.

2-15-2014 8-51-01 AM

In Canada, Alberta Health Services blocks Web streaming video after employees watching the Olympics slow down its network. Interim CIO Penny Rae’s email to AHS’s 95,000 employees says, “We do not have unlimited Internet bandwidth capacity. Since we have a limited ability to prioritize the Internet traffic, video streaming competes for the same resources as a clinical or business system would. When large amounts of video are streaming through the Internet gateway, all applications that depend on that are at risk of slowdown. Patient care is our priority and we need to ensure that our core services have the capacity they need to run as expected. You can help by catching up on the Olympic coverage from home and refraining from using the Internet for personal use … Thanks for your understanding of this and in the meantime, we join you in cheering on our Olympians! GO CANADA GO!”

A Greek news portal reports that Papageorgiou General Hospital will install a cell phone blocking system in its OR to prevent surgeons from talking on their phones while operating.

In Ireland, at least five hospitals may lose 20 percent of their funding for failing to comply with requirements that limit lavish executive salaries.

Not healthcare related, but bizarre: a former state judge in Alaska sues the state’s bar association, saying its members hazed him mercilessly after noticing that his 2007 appointment letter from Governor Sarah Palin thanked him for his “pubic service” and suggested that his appointment was sexually motivated. He says the typo caused him to experience stress and medical problems and caused him to lose his re-election bid the next year. The bar association has asked the Supreme Court to order the former judge to submit to a psychological exam to determine if he’s fit to practice law.


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

More news: HIStalk Practice, HIStalk Connect.


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February 15, 2014 News 1 Comment

News 2/14/14

February 13, 2014 News 9 Comments

Top News

2-13-2014 1-15-27 PM

inga_small ONC reports that RECs have “far exceeded” their goal to support the adoption and use of HIT by 100,000 small practices, CHCs, and rural and public hospitals, while continuing to support providers to reach MU. The “exceeded” goal must involve something other than the 100,000 figure since only 85,000 PCPs had met the MU milestone by the end of November.

Reader Comments

From No Love: “Re: vendor management organizations. I would be interested in hearing feedback from healthcare organizations that contract with them to manage their consulting needs. Our consulting firm spends endless hours meeting client needs. Through vendor management groups, sometimes months go by before we hear anything about the candidates presented if we get a response at all. I’m amazed at the lack of management, coordination, communication, and relevant industry knowledge that the representatives of some of these firms possess. The only thing we are doing is populating the databases of these vendor management groups with contact information for great consultants.”


HIStalk Announcements and Requests

2-12-2014 2-58-17 PM

inga_small A few things on HIStalk Practice this week that you may love: ICD-10 implementation costs for physician practices could be almost three times higher than estimates from 2008. Fifty-one Northeast Georgia Physicians Group clinics win Stage 7 Ambulatory awards from HIMSS Analytics. HealthPoint Medical Group becomes the first practice to earn NCQA Patient-Centered Specialty Practice Recognition. Proposed legislation repealing the SGR formula eliminates future MU and PQRS penalties, provide technical assistance for small practices, and require EHR interoperability. Its the season for love, so show me some by signing up for email updates when checking out these stories. Thanks for reading.

Listening: Year of the Rabbit, a one-album (2003) band formed by Ken Andrews, a former member of my current favorite band, Failure (which reunited after a 16-year absence for a live show Thursday night in LA).

Those who are new to healthcare IT may wonder why significant news (which is only about 2 percent of total even in a good week) is so scarce this week. Reason: companies save up their big announcements until the HIMSS conference, which starts next weekend, hoping to draw traffic to their expensive booths. What nearly always happens instead is that their announcements get lost because every vendor is equally unimaginative. For me, the newsworthiness bar is raised a lot during the conference because I’m busier, meaning I won’t mention announcements that I might have this week or next because I don’t have time. Less-earthshattering announcements have a better chance of getting exposure if held until the week after the conference, when there’s nothing left to write about.

Just a reminder: we’ll have our first-ever HIStalk booth (#1995) at the HIMSS conference. Our price range and lack of HIMSS clout means it will be a microscopic, sparsely furnished patch of rental carpet in Booth Siberia near the restrooms, but for intrepid seekers, Lorre will be dispensing trinkets and the occasional visiting celebrity will be on hand to say hello. Lorre will also be tweeting out reports from Inga, Dr. Jayne, and me about who has cool giveaways and which booths are interesting, so follow her if you want to know who is giving chair massages or serving margaritas at 10 in the morning.


2-13-2014 6-51-24 PM

I’ll have more information about the HIStalkapalooza schedule, entertainment, food, and co-sponsors next week. The basics are that buses will run a circuit between the convention center’s Hall F and the House of Blues from 6:30 until 11:30 p.m. We’ll have a full dinner buffet and open bar. Entertainment will include music outside, a live band, our usual red-carpet entrance with video and still photographers, and several activities inside the HOB. There will be IngaTinis and spiffed up ladies wearing hot shoes. Beauty queen sashes will be donned. Handling the HISsies awards will be Ross Martin, MD of AMIA and Missy Krasner of Box. We’ll have the winners of three big categories on hand to accept their awards in person – Most Effective Provider HIT Executive, HIT Lifetime Achievement Award, and HIT Industry Figure of the Year. The long-range weather forecast is looking good so far with highs around 80 degrees. Stay tuned and use hashtag #histalkapalooza if your level of anticipation warrants tweeting.

People who apparently don’t read HIStalk keep emailing to ask if they can bring guests. Answer: no, unfortunately, but we turned down 900 people and it wouldn’t have been fair to hold spots for an undetermined number of guests. Print your invitation and bring it along since the nice registration folks will let you in only if you were invited.

In case you’re wondering what HIStalkapalooza is all about, here’s the official Medicomp video from last year’s event in New Orleans. That’s Jennifer Lyle from Software Testing Solutions deftly handling the red carpet interviews, a role she will reprise this time.

HIMSS Conference Social Events

Send us your event details if it’s a good one (i.e., free food and drinks at minimum) and you promise that all HIStalk readers are welcome to attend, even if they work for your most hated competitor as a given reader might well do.

2-13-2014 7-35-19 AM

EHealth Initiative will host a Mardi Gras cocktail reception sponsored by Elsevier Clinical Solutions Monday, February 24 from 6:00 to 8:00 p.m. at the Rosen Centre Hotel. Register here.

Upcoming Webinars

February 18 (Tuesday), 1:00 p.m. ET. Epic 2012 Training and Support: Building Your Team. Sponsored by MBA HealthGroup. The webinar will present a case study of creative staffing solutions for an Epic 2012 upgrade at an academic medical center, describing the institution’s challenge, its out-of-the-box solution, and the results it obtained working with a consulting firm.

February 19 (Wednesday), 1:00 p.m. ET. What is the Best Healthcare Data Warehouse Model for Your Organization? Choosing the right data model for your healthcare enterprise data warehouse (EDW) can be one of the most significant decisions you make in establishing your data warehousing and foundational analytics strategy for the future. The strengths and weaknesses of three primary data models will be discussed: enterprise data model, independent data marts, and late-binding solutions.


Acquisitions, Funding, Business, and Stock

2-13-2014 3-14-37 PM

Welltok, developer of the CaféWell Health Optimization platform, raises $22.1 million in Series C funding. IBM was an investor and and will work with Welltok to build a Watson-powered application that will guide consumers through health questions.

2-13-2014 3-20-47 PM

Specialists on Call, a provider of specialty physician teleconsult services, closes $32 million in financing.

2-13-2014 3-21-38 PM

GetWellNetwork reports 86 percent revenue growth in 2013, as well as the addition of 50 new client facilities and a 60 percent increase in employees.


The Seniors Wellness Group of Michigan selects WRS Health to provide EMR and PM solutions for its 170 skilled nursing facilities.

Meritage ACO (CA) will implement CareInSync’s Carebook evidence-based mobile care coordination platform and expand its use of the Mobile Care Navigation Network.

Philips Healthcare will provide home monitoring technology to the home care program of Partners HealthCare (MA), including alert and medication dispensing systems.



2-13-2014 11-16-59 AM

Catholic Health Initiatives names Rand Strobel (UW Medicine Valley Medical Center) CIO of its Franciscan Health System region.

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LDM Group hires David Green (Eli Lilly) as VP of payer market solutions, Wes Galbo (A&K Global Health) as VP of product management, and Jim Rockel (The Breakaway Group) as senior director of business development.

2-13-2014 5-18-11 PM

Consultant and former Cerner EVP Jack Newman is appointed to the University of Kansas Hospital Authority.

MedHOK appoints Troy Smith (Computer Science Corporation) COO.

Announcements and Implementations

Memorial Medical Center (IL) upgrades to the Carestream Vue PACS and Vue for VNA.

2-13-2014 7-09-46 AM

Hilo Medical Center (HI) and its outpatient clinics launch the East Hawaii Patient Portal.

The Tiger Institute Health Alliance (MO) and Lewis and Clark Information Exchange (MO) begin sharing patient information.

2-13-2014 11-57-15 AM

Scribes STAT, which offers scribe programs and EMR implementation services, rebrands as Essia Health and appoints Matthew J. Kirchner (Medtronic) president and CEO.

2-13-2014 4-10-20 PM

University of Michigan startup AlertWatch earns FDA marketing clearance for its anesthesia monitoring system.

2-13-2014 4-41-55 PM

AirStrip launches an Innovation Marketplace program to push evidence-based research results into clinical practice, extending its initial partnership with Palomar Health that resulted in the development of AirStrip ONE.

2-13-2014 5-32-06 PM

Box says healthcare was its fastest-growing sector of 2013, up 400 percent.


Government and Politics

A group of 111 lawmakers urges HHS Secretary Kathleen Sebelius to reform the auditing system for Medicare claims, citing a massive backlog of more than 460,00 claims and an audit system that gives contractors an inventive to deny claims.

A Congressional panel investigates how the government is safeguarding MU funds following the recent indictment of Shelby Regional Medical Center’s (TX) former CFO for falsely attesting to MU.



2-13-2014 10-42-29 AM

Epic ranks number five on Glassdoor’s annual report on the “25 Highest Rated Companies Hiring Interns.”

John Lynn did a Google+ Video Hangout with Elsevier CMIO Jonathan Teich, MD, PhD this week on the topic of clinical decision support.

Farzad Mostashari gives HIStalk and HIStalk Practice kudos (a Farzie, actually) because on both sites we questioned the validity of a physician EMR survey performed by MPI Group and Medical Economics. The magazine loaded up the hype machine in screaming out its questionably obtained conclusions, calling it “physician outcry” that will “shake the health information technology sector.” However, the survey’s methodology was this: “Physicians were invited to respond to an online questionnaire.” Who was invited and from what information sources were there names obtained? How were the questions worded? Was participation limited to those invited or were haters emailing each other the link to pile on? Did anyone follow up with respondents to verify their identities? What was the response rate? What was the spread by geography, practice setting, and specialty? Online surveys are self-selecting and therefore are close to worthless, which is why I almost never run their results. The same publication did a “Top 100 EHRs” report a few weeks ago in which they contacted 549 vendors to ask them to self-report their annual revenue, received only 56 responses back, and then just winged it with phone calls and Web searches to finally SWAG it to the magic number of 100 EHRs (since Americans only like round numbers.) Plenty of sites and publications jumped all over both “studies” with their own catchy and uncritical headlines, desperate for eyeballs and hoping readers won’t question the value or validity of their story.

2-13-2014 7-09-36 PM

Pittsburgh-based hospital and insurance operator Highmark lays off 132 employees, 120 of them from its insurance business’s IT department, but says it will add 96 IT jobs in the next few months. Highmark acquired West Penn Allegheny Health System in April 2013 for $604 million, but that system is losing ground to UPMC, which says its hospitals won’t accept Highmark’s members after their contract runs out at the end of this year.

Weird News Andy opines that this pharmacist put the “harm” in “pharmacist.” A Tennessee pharmacist is charged with attempted murder after visiting his wife’s hospital room and injecting her with an unknown substance.

Sponsor Updates

  • HMFA extends the “Peer Reviewed by HFMA” standard to The SSI Group’s billing product.
  • ICSA Labs extends 2014 Edition Modular EHR ONC Health IT Certification to ChartMaxx, the enterprise content management solution from Quest Diagnostics.
  • RelayHealth Financial achieves full EHNAC HNAC accreditation for the 14th consecutive year.
  • Four Ellis Medicine (NY) primary care locations deploy PCMH transformation management and analytics tools from Arcadia Healthcare Solutions to earn Level 3 NCQA PCMH recognition.
  • The Drummond Group certifies Merge Healthcare’s Merge PACS, iConnect Access, and Merge RIS for MU under the 2014 criteria.
  • Consulting magazine recognizes Aspen Advisors with its 2014 Small Jewel award based on the company’s growth, culture, and accomplishments
  • Accreon partners with LCN Services to deliver technical integration services to hospitals and healthcare providers.
  • Predixion Software releases Predixion Insight 3.2.
  • SimplifyMD offers up to $5,000 for customer referrals.
  • Virtelligence posts its list of 2014 events.
  • Medhost officially adopts the EHR Developer Code of Conduct.
  • Truven Health Analytics announces the global availability of its Micromedex Pharmaceutical Knowledge solution to improve research for non-hospital environments.
  • Optum Labs, the healthcare research initiative created by Optum and the Mayo Clinic, adds seven new partners with interests in public health, pharma, and the biosciences.

EPtalk by Dr. Jayne


Saturday was National Girl Scout Cookie day. I admit I look forward to the time every year when the cookie order forms go up on the sides of people’s cubes or on the doors of those lucky enough to have doors. Office policy prohibits solicitation for fundraisers other than United Way, but employees can hang them as “decorations” in their personal work spaces as long as they don’t talk about them. Most of our readers know that Inga and I enjoy a nice glass of wine, so I was thrilled when I came across this article about pairing wine and Girl Scout cookies. I’m definitely going to try some port with my Samoas this year. Another site recommended Madeira to go with Tagalongs – another option to consider.

Speaking of my BFF, we’ve been working hard to put together our HIStalk Ladies’ Social Schedule for HIMSS. On Monday, we hope to hit an event or two prior to HIStalkapalooza. For those of you who didn’t receive invitations this year, there are a couple of other good events, including the Perceptive  party at Margaritaville that is open to readers. Tuesday night is extremely packed, so we can’t promise that we’ll make it to every event we have on the schedule. If you attend any evening vendor events, feel free to be our roving reporters and share your opinion of the social scene.


I wanted to attend the IBM SmarterCare lunch on Monday, but it’s apparently full. Sunday is looking pretty light as well, so if you have an event where sassy bloggers are welcome, please let us know. On the other hand, it might be a good thing that Sunday is low key since I’ll be running the Disney Princess Half Marathon in the morning. I’m raising funds for Children’s Miracle Network Hospitals and have an outstanding princess costume, so it should be a lot of fun. It starts bright and early at 5:30 (possibly dark and early depending on how you look at it) so I might be dragging later in the day. It’s also influencing my choice of hot shoes since I know I want something comfortable — suggestions are welcome.

Now that I have the fun social items out of the way, I’ll share a bit about my week as an end user. In two words, not great. I do beta testing for our EHR vendor, so I keep a local install of the application on my laptop. I ran into some issues applying a recent patch and needed some assistance. You know it’s bad when they ask, “Do you have any patient data in here that you really need?” I actually didn’t since it was full of test patients, but forgot to specify that indeed I did have a lot of provider-specific macros, defaults, and short cuts saved. That little tidbit would come back to haunt me later.

The analyst who was helping me out seemed very thorough and eager. He camped out in my office trying to fix it. Unfortunately, since it wasn’t an actual laptop problem, I wasn’t eligible for a loaner. I made do with my iPad and a Bluetooth keyboard. Although it’s a great setup for taking notes in meetings, I missed the full functionality of a laptop as well as all my files and data.

After nearly two full days’ of work, he had the database back up and running. I was ready to log in and get back to work since I owed the vendor some quick feedback on a new feature.

Unfortunately, I couldn’t log in. The analyst had changed my password to “something easier” but didn’t tell me what it was. After tracking him down and finding out it was changed to “password,” I changed it back and started testing. That’s when I found my macros and defaults were gone.

I called him on it and was informed that he had to do a “clean install” and it was all removed. It would have been nice to have that discussion while he was working on it rather than being surprised. I could have exported them somewhere that would be easy for me to pull them back in, but wasn’t given that chance. It felt like a patient must feel when they wake up from surgery to find that a slightly different procedure was performed than the one discussed.

I finished up my testing despite the challenges and got ready to email our vendor. The Desktop looked strange, but couldn’t put my finger on what it was. Not resolution, not font. After 15 minutes of digging, I figured out that the ClearType text settings had been manipulated. Why in the world would an analyst need to change my font appearance?

That was only the tip of the iceberg, however. Everywhere I turned I found something that was altered – window layout, window organization properties, default folders for searching, and more. He even renamed my C: drive. It took another 20 to 30 minutes to get everything back just the way I like it.

This isn’t the first time I’ve had an analyst adjust settings while they were working on my machine. Sometimes it makes sense, like when they extend the screensaver lockout interval so they don’t have to keep logging back in while they’re watching an upgrade). That’s OK as long as they change it back. This guy was all over the place however.

I asked our IT department if there is any policy on analysts adjusting end user settings. The answer was no. I would add creating such a polity to my to-do list if it wasn’t already so full that I’ll never complete it.

Does this happen at other places? Do you have a policy or is everyone kept on an institutional standard? Email me.


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

More news: HIStalk Practice, HIStalk Connect


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February 13, 2014 News 9 Comments

News 2/12/14

February 11, 2014 News 12 Comments

Top News

2-8-2014 3-16-29 PM

I’ve confirmed with several sources that Epic will soon offer consulting services beyond implementation work, very much as described in the original rumor report from EpicConsulting. Epic employees with at least four years’ experience will be allowed to live somewhere other than Verona to take on more post-live consulting work. My sources say the consultants will offer work that isn’t strictly even in the systems domain, such as implementing clinical programs and doing Lean Six Sigma work for clients. Many questions remain: (a) how will this decision affect Epic’s relationships with consulting companies?; (b) how will Epic price its services?; (c) will skilled Epic people really want to stay with Epic, or just leave as they’ve been doing to take higher-paying jobs with consulting companies?; (d) is Epic going this route because customers want it, to try to reduce project cost by offering lower-priced consulting, to avoid losing experienced employees, or because they know implementation work will eventually dry up and the market will move toward other services?

Reader Comments

2-11-2014 5-02-30 PM

From Anonymous Health System CIO: “Re: HIStalk RFI Blaster. I recently used your RFI Blaster to solicit consulting company proposals. I have found your sponsors who responded to be capable and professional. Compliments to these companies that have good skills and follow-through: Aspen Advisors, Encore Health Resources, Impact Advisors, Leidos, Lucca Consulting, and Santa Rosa Consulting.” I created the RFI Blaster as suggested by a CIO who wanted an easy way to give HIStalk Platinum Sponsors a chance to earn his business. Filling out the short online form blasts your request out to companies of your choosing, and I specifically didn’t make “contact telephone” required since not everybody wants to be called about their request. I appreciate the report and the shout-out to the sponsors who were good to deal with.

From Jay: “Re: Melanie Pita, chief product officer and general counsel of Prognosis Innovation Healthcare. Has left the company.” Unverified, but her bio has been removed from the company’s executive page.

HIStalk Announcements and Requests

2-11-2014 1-45-27 PM

inga_small We’ve posted our annual guide to HIMSS meet-ups, which includes details on how to connect with HIStalk sponsors that are not exhibiting but are available for one-on-one meetings. We will publish our full HIMSS14 guide this weekend, which includes details on over 100 vendors (all which happen to be sponsors). Look for our guide to exhibitor giveaways next week so you’ll know where in the exhibit hall to find the best free coffee, fun trinkets, and cookies during the day and of course cocktails before heading out on the town.

inga_small Speaking of HIMSS, I’ll be participating in Medicomp’s Quipstar HIT Quiz show Tuesday, February 25 at 3:00 p.m. and looking forward to having a big crowd in the live studio audience. Even though I came in last when I played a couple of years ago, I agreed to give the game another go because Medicomp is making a generous donation to my favorite charity.

2-11-2014 4-27-51 PM

Fans of the Smokin’ Doc now have another reason to drop by HIStalk’s HIMSS Booth 1995 and say hello to Lorre, who will selectively dole out these potentially collectible (probably not) HIStalk pins from her treasure trove of cool things that were in our price range.

2-11-2014 4-50-33 PM
2-11-2014 4-41-31 PM
2-11-2014 4-43-04 PM
2-11-2014 4-44-16 PM

I mentioned that I agreed to run a new short-term ad at the top of the HIStalk page only so I could donate most of the proceeds to the DonorsChoose charity that helps financially strapped classrooms (to which I’ve donated personally for years.) I fully funded the following projects totaling $2,870 on behalf of all HIStalk readers this week, all projects submitted by Teach for America teachers because I respect that organization’s work just as much as I do that of DonorsChoose. I’ll be funding more projects shortly thanks to the sponsors who have booked the ad space: VMware, InterSystems, GetWellNetwork, Aspen Advisors, IngeniousMed, Billians HealthDATA, and Greenway. Above are excerpts from some of the notes the teachers sent in response to the help we as readers provided to their students. We funded:

  • $604 for a New York City eighth grade teacher for a podium and certificates to create a National Junior Honor Society ceremony for her students in the poorest Congressional district in the US
  • $506 for a Glendale, AZ teacher to provide interactive math stations for her sixth graders
  • $255 for a La Place, LA teacher, whose second grade class is meeting in a trailer after their school flooded last year, to expand their Listening Learning Center of read-along books
  • $234 for a Baltimore teacher who needs a Chromebook to access learning websites that offer classroom practice
  • $226 for a Chicago teacher whose elementary school students need non-fiction books that the school can’t afford
  • $201 for a North Charleston, SC classroom whose high-poverty, at-risk students need white boards and supplies for interactive activities
  • $185 for a Jackson, MS elementary school class for write-and-wipe markers and erasers
  • $187 for a Rosedale, MS high school for toner and a file cabinet for printing college applications and practice standardized exams
  • $167 for notebooks and pencils for a Chicago teacher’s 35 freshman girls to create College Bound Journals
  • $185 for a Memphis teacher’s need for pencils for her third graders
  • $249 for a Salt Lake City, UT teacher’s need for fourth-grade books

2-11-2014 4-49-29 PM

A reader notified a friend who happens to be a DonorsChoose executive team member that I was donating on behalf of HIStalk readers. That DonorsChoose executive donated to a project of her own choosing in honor of HIStalk’s readers, which is pretty cool.

2-11-2014 5-53-49 PM

Welcome to new HIStalk Platinum Sponsor PDS. The Madison, WI-based company, founded in 1986, offers an ITIL-compliant, 24x7x365 Patient Portal Support Service Desk to assist patients with Epic MyChart, Medseek, and other patient portal systems. PDS offers HIPAA-trained analysts, transparent service, and a first-call resolution rate above 90 percent. Check out their site to see a list of health systems PDS supports across the country and to read a success story from Bon Secours Health System. Thanks to PDS for supporting HIStalk.

HIMSS Conference Social Events

Send us your event details if it’s a good one (i.e., free food and drinks at minimum) and you promise that all HIStalk readers are welcome to attend, even if they work for your most hated competitor as a given reader might well do.

Physician Technology Partners is hosting a dinner Tuesday, February 25 at Roy’s Fusion Cuisine to introduce a new Epic MyChart implementation and help desk solution. RSVP online or by email.

2-11-2014 5-06-04 PM

Perceptive Software will host an event at Jimmy Buffet’s Margaritaville at Universal CityWalk on Monday, February 25 from 8:00 to 11:00, with shuttle service provided to and from the major hotels. They will have food, drinks, and a live Caribbean band. RSVP here.

Upcoming Webinars

February 12 (Wednesday) 1:00 p.m. ET. Healthcare CO-OPs and Their Potential to Reduce Costs. Sponsored by Health Catalyst. Presenters: David Napoli, director of performance improvement and strategic analytics, Colorado HealthOP and Richard Schultz, VP of clinical care integration, Kentucky Health Cooperative. Consumer Operated and Oriented Plans (CO-OPs) were established by the Affordable Care Act as nonprofit health insurance companies designed to compete in the individual and small group markets. Their intended impact was to provide more insurance options for consumers to pay for healthcare.

February 13 (Thursday), 12 noon ET. Advancement in Clinician Efficiency Through Aware Computing. Sponsored by Aventura. In an age of information overload, a computing system that is aware of the user’s needs becomes increasingly critical. Instant-on roaming for virtual and mobile applications powered by awareness provides practical ways to unleash value from current HIT investments, advancing efforts to demonstrate meaningful use of EHRs and improve clinical efficiencies. The presenters will review implementation of Aventura’s solution at Orange Coast Memorial Medical Center.

February 18 (Tuesday), 1:00 p.m. ET. Epic 2012 Training and Support: Building Your Team. Sponsored by MBA HealthGroup. The webinar will present a case study of creative staffing solutions for an Epic 2012 upgrade at an academic medical center, describing the institution’s challenge, its out-of-the-box solution, and the results it obtained working with a consulting firm.

February 19 (Wednesday), 1:00 p.m. ET. What is the Best Healthcare Data Warehouse Model for Your Organization? Choosing the right data model for your healthcare enterprise data warehouse (EDW) can be one of the most significant decisions you make in establishing your data warehousing and foundational analytics strategy for the future. The strengths and weaknesses of three primary data models will be discussed: enterprise data model, independent data marts, and late-binding solutions.

Acquisitions, Funding, Business, and Stock

2-11-2014 3-41-59 PM

Nuance Communications reports Q1 results: revenue flat, adjusted EPS $0.24 vs. $0.35, beating estimates.

2-11-2014 3-44-45 PM

Employee health management site Castlight Health, co-founded by US CTO and athenahealth co-founder Todd Park, files for a $100 million IPO that values the company at $2 billion. Castlight reported a net loss of $62.2 million last year on revenues of $13 million.

2-11-2014 3-45-20 PM

The Advisory Board Company announces Q3 results: revenue up 13 percent, adjusted EPS $0.26 vs. $0.28, missing estimates.

Virtualization technology vendor Sphere 3D will acquire V3 Systems, which offers desktop cloud management solutions.

2-11-2014 5-51-53 PM

I wondered why Meditech was so late in posting its Q3 SEC report since I’ve been watching for it for months and now I know: the company reports that it improperly recognized revenue and is figuring out how to keep its auditors and the SEC happy. In the mean time, the company can’t issue new stock or complete its filings. Meditech isn’t publicly traded, but still has to comply with SEC rules. The issue sounds relatively minor and accidental – revenue was recognized in cases where the company’s implementation employees didn’t complete all the contractually required visits. Customers paid and the work got done, but 100 percent of visits must be completed to book the revenue. The company refreshingly concludes:

We are less embarrassed than you might think. There is no question of fraud or malfeasance here. We acknowledge we should have been following the revenue recognition rules as specified by our own policy, but one of the reasons we have auditors is to find issues like this promptly. They didn’t do it. However, because of the urgency of resuming our SEC filings, we’ve decided to put our unhappiness with them into abeyance at this point, and deal with that later. From an operational point of view, there should be absolutely no effect on the company, other than the additional expenses we are incurring with the auditors and the outside analysis firm to fix the problem (not to mention the huge amount of extra work our accounting and implementation staff are undergoing to provide the required information). The cash is still in the bank, free to be used – the only question is how the revenue was supposed to be reported on our filings. Customers should not be affected in any way. Our plans for the future remain the same.


Christus Health selects Wellcentive’s population health management platform.

2-11-2014 3-49-36 PM

MaineHealth chooses MediQuant’s DataArk active archiving system.

Privia Medical Group (VA) will implement athenahealth’s PM, EHR, patient communication, and care coordination services for its 154 providers and affiliated ACO.

2-11-2014 3-48-15 PM

Blanchard Valley Health System (OH) will deploy Merge Healthcare’s VNA interoperability and cardiology solutions.

Humana will implement CoverMyMeds to allow physicians to submit drug prior authorizations directly to Humana via an online portal.

Georgia Physicians for Accountable Care selects eClinicalWorks Care Coordination Medical Record.

Dean Health Plan (WI) chooses Health Language for terminology management.


2-11-2014 10-58-17 AM 2-11-2014 10-59-01 AM

AtHoc names Mary-Lou Smulders (Oracle) VP of marketing and Matthew Gloss (Mellanox Technologies) general counsel.

2-11-2014 3-51-52 PM

Healthfinch hires Sanaz Cordes, MD (Cogent Healthcare) as COO.

2-11-2014 6-22-22 PM

Kevin Fickenscher, MD, formerly of Dell and AMIA, is named president of health services for remote patient monitoring company AMC Health.

2-11-2014 7-25-50 PM

LDM Group names Paul Hooper (Emdeon) as VP of retail innovations and product commercialization.

Announcements and Implementations

Ontario’s Hôpital Montfort uses Summit Healthcare’s InSync and SST for dictionary migration to Meditech 6.0.

Healthcare Access San Antonio, Holon Solutions, and the Texas Organization of Rural and Community Hospitals will connect area hospitals, clinics, physician offices, and other providers to a regional HIE across 22 South Texas counties.

Memorial Health (CO) launches its $30 million Epic implementation.

Athenahealth announces that it has integrated drug monographs from its Epocrates acquisition into athenaClinicals.

Government and Politics

2-11-2014 6-40-49 AM

CMS and ONC introduce Randomizer, a tool that allows providers to exchange data with a test EHR in order to meet measure #3 of the Stage 2 transitions of care requirement.

2-11-2014 7-00-50 PM

ONC launches a challenge to develop a Javascript/HTML-based, easily understood Notice of Privacy Practices that can be incorporated into websites. Submissions are due by April 7 and the winner gets $15,000.

2-11-2014 7-38-53 PM

CMS announces that Healthcare.gov won’t accept new insurance enrollments this weekend because the Social Security computer system has a planned 62-hour maintenance downtime starting Saturday, which is also the deadline for applying for coverage that will become effective March 1.

Innovation and Research

A screening program for abdominal aortic aneurysms integrated into an EHR reduced the number of unscreened at-risk men by more than 50 percent within 15 months, according to a Kaiser Permanente study.

Penn Medicine (PA) announces that it will work with analytics vendor Teqqa, LLC to provide real-time antibiotic sensitivity information to physicians via a mobile app as part of its antimicrobial stewardship program. Penn received equity in Teqqa as part of the agreement.


2-11-2014 6-06-51 PM

I may have missed this article from a week or so ago even though I see Inga picked it up on HIStalk Practice. Walgreens clinics will use ePASS software from Inovalon (formerly MedAssurant) that prompts its clinicians to ask patient-specific questions based on data from 100 million patient visits and records of the patient’s own behavior. The software will suggest problems that the patient might have, walk the clinician through asking questions, and then create a SOAP note that goes back to the EHR. The same software is integrated with Greenway, NextGen, and Allscripts.


The local paper highlights the struggles of United Hospital District (MN) in implementing Meditech. Administrators blame internal workflow problems for registration-related pains and interface issues for difficulties exchanging data between Meditech and the hospital’s NextGen system.

2-11-2014 4-10-45 PM

A TV station in Hawaii reviews the cost of implementing Siemens Soarian at taxpayer-supported Hawaii Health Systems Corporation (HHSC), originally budgeted at $50 million but now estimated at $109 million. The health system’s regional CEO says IT and support staffing estimates were so far off that headcount had to be doubled. The hospital workers’ union expressed concern that a Siemens employee serves as HHSC’s CIO, saying, “It’s like the wolves watching the henhouse,” but the health system responded that it hired another consulting firm “to oversee Siemens.” Siemens responded that the scope of the work of the original $29 million contract hasn’t changed, but HHSC keeps asking for more modules, services, and staffing that weren’t in the contract.

2-11-2014 7-12-55 PM

A survey of 1,000 physicians finds that 70 percent don’t think the HITECH program was worth its cost, 45 percent say EHRs have made patient care worse, and 43 percent say EHRs caused them to lose money. A third say they doubt their current EHR will even be around in five years. A key fact was omitted in the press release – what was the survey’s methodology? In other words, how were respondents selected; how were the questions presented; what was the demographic, specialty profile, and practice type of respondents, etc.? The findings are pretty big news if the survey’s methods were sound.

John Lynn hosted a Google+ video hangout on cloud technology and data centers that can be streamed from his site.

OCR files a HIPAA complaint against a Las Vegas hospital and Dignity Health, claiming the hospital used its medical records to contact former patients to get them to switch to the health plans the hospital accepts. The hospital denies the charge, saying its contacts were intended to be “informative.”

2-11-2014 7-29-24 PM

OK, who proofed this press release’s headline?

Sponsor Updates

  • HealthLogix from Certify Data Systems passes numerous Integrating the Healthcare Enterprise profile tests at the 2014 IHE North America Connectathon.
  • TeraMedica will debut its zero-footprint universal viewer for its Evercore vendor-neutral archive at the HIMSS conference.
  • ICSA Labs issues Passport’s CareCertainty service 2014 inpatient module ONC Health IT Certification.
  • Arcadia Healthcare CEO Sean Carroll discusses the struggles facing hospitals in a Boston Business Journal article.
  • MedAptus releases a risk severity toolkit to help provider groups with coding of patients covered under risk-based contracts.
  • Memorial Healthcare (MI) uses Iatric Systems Meaningful Use Manager to access data for a Meaningful Use audit.
  • An API Healthcare-commissioned survey reveals that the majority of Americans age 30 and older are concerned with the impact of healthcare reform on the quality of patient care and staffing at hospitals.
  • Providers have collected more than $10 million in CMS reimbursements over the last five years using the Covisint PQRS submission process.
  • Richard W. Zollinger, II, MD shares how Capario has helped his practice to accelerate cash flow, improve profitability, and remain independent.
  • Sandlot Solutions launches a channel partner program for healthcare consultants, software vendors, and payers.
  • iHT2 announces the details of its San Francisco summit on population health management and analytics.
  • FeedHenry and AirWatch partner to offer a joint solution that enables enterprises to quickly and securely create and manage multiple apps and devices.

By Brian Weiss

2-11-2014 6-42-42 PM

REST is a techie thing. It’s another way for computers to talk to each other. Another flavor of API (application programming interface.)

What matters in this context is not how it works or why it’s better or worse than anything else, just that it’s a very well established and widely deployed standard that software developers are using today (and have for the past few years) to develop applications that work over the Internet, like smartphone applications that reflect data from Web servers in the cloud or Web servers that talk to each other.

FHIR uses REST as its technical underpinnings to do the same kinds of things that HL7 has always done — enable the exchange of healthcare information (patient clinical summaries, lab orders end results, etc.) between systems.

When most people say, "We’re using HL7," they usually mean HL7 version 2 messaging, which defines a format for one system to send healthcare information to another over a network. It’s a point-to-point communication (think email) between two systems, though often there is a specialized message router that sits in between to help translate the variations in the message format that each side understands.

The Meaningful Use (MU) regulations have ushered in broad use in the US of a newer generation of HL7 standards focused on something called CDA — clinical document architecture. In CDA, what gets transferred between systems is a document (think word processor file) that contains the same kind of information as HL7 v2 messaging, but using XML format. XML is a document format that is used a lot on the Internet when data is exchanged in document format. The HTML exchange between browsers and web servers today is a form of XML.

CDA is part of version 3 of HL7, which is a very broad framework that describes the underlying theoretical model for how data should be represented and encoded, regardless of whether it’s communicated via messages like HL7 version 2 or CDA documents (version 3) or other formats. There is thus a version 3 messaging protocol that replaces the version 2 messages, but it hasn’t caught on much, especially in the US. So as a practical matter, HL7 version 2 usually means point-to-point messages and HL7 version 3 usually means CDA documents.

HL7 data interchange today for most people is either version 2 messaging or version 3 CDA documents. The specific flavor of CDA called out in Meaningful Use Stage 2 today is termed C-CDA, which stands for consolidated CDA, so named because it "consolidated" various CDA-derived standards that came before it.

Though I speak on behalf of nobody other than myself and am not taking sides, there is a oft-cited position that HL7 standards historically have been a bit too formal and academic and also too open to varying interpretation. Even if both sides of an exchange are using HL7 v2 messaging or HL7 v3 CDA documents, there’s still a lot of work to do (one integration at a time) to ensure that what the receiver understand is what the sender intended.

FHIR is also part of HL7 v3, only instead of using XML documents like CDA does, it uses REST interfaces.

FHIR looks like it has passed the "shiny new object to get excited about" phase and is being worked on actively by many vendors and other clinical data interoperability stakeholders. Relative to the early stage of its lifecycle that it is currently in, FHIR has significantly more momentum than any previous HL7 standard. In addition to using REST (which makes it a great way to exchange healthcare data for things like mobile applications), the folks working on FHIR are doing their best to learn the right lessons (good and bad) from past generations of HL7 standards.

It will be a while before we can know for sure if FHIR delivers on its promise and even longer before we know for sure what it means for the evolution from the entrenched HL7 v2 messages or the currently MU-mandated CDA documents. Some of that probably depends on if, when, and how future editions of MU mandate the use of FHIR, but also how quickly it achieves critical mass of application developers.

I think for most HIStalk readers who work at healthcare providers and non-vendor stakeholders, FHIR is more something to be aware of than something that requires action right now. In the software development side of vendors and consultants (and IT groups within other healthcare interoperability stakeholder organizations,) more concrete action is required to learn FHIR, work on prototypes, and participate in some of the connectathon testing between servers and applications that are taking place.


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

More news: HIStalk Practice, HIStalk Connect.


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February 11, 2014 News 12 Comments

Monday Morning Update 2/10/14

February 8, 2014 News 16 Comments

2-8-2014 3-16-29 PM

From EpicConsulting: “Re: Epic going into the consulting business. What’s being said internally at Epic is that the program will be limited to employees with 4+ years of experience, it will provide some location independence, and the intention is to undercut in price most of the Epic consulting industry. It’s an attempt to give Epic employees less incentive to quit, sit out their one-year non-compete, and then come back doing the same job making twice the pay for half the hours. Epic has talked about doing this for years, formerly calling it Ongoing Services, but hasn’t actually gone this far until now. Consulting firm reaction has been, ‘Why would you want the same person who dug you into a hole to be the one to dig you out?’ but can they compete when Epic sells services at $75 per hour and they’re billing $150? Would a CIO pay double for a non-Epic voice? Will hospitals gain negotiating power with another option in the market? Fun question, too: will KLAS rate Epic’s consulting and will companies like Nordic, Sagacious, etc. score higher than Epic itself?” All unverified, but interesting.

From Please Please Me: “Re: HIStalkapalooza. I’ve never requested an invitation, so I’ve never been refused. But it sounds like fun and you guys are great to do that – don’t let the poor souls who don’t get in discourage you.” Inga reminded me that despite reader Gary’s insistence that he didn’t get an invitation for three years straight, we sent one to every single person who registered in 2013 and 2011, and I’m pretty sure we invited everyone in 2012 as well. Gary either didn’t register in time those years or his company’s spam filter trashed our emailed invitation, which happens a lot (and creates extra work for us because people always email us wanting individual assistance.) Demand this year was unprecedented – it will be the largest HIStalkapalooza yet, but around 900 more people asked for invitations than we have available. And to address the most commonly asked question, sorry, but we have no way to accommodate guests even though I’m sympathetic to those who want to attend with a spouse or friend – we’ve already had to turn away hundreds of loyal HIStalk readers.

2-8-2014 8-38-18 AM

Two-thirds of poll respondents haven’t been promoted in the last two years. New poll to your right: generally speaking, are the vendors and products named in the “Best in KLAS” report really the best ones? You won’t win favor for your position by simply clicking yes or no, but you might if you click the Comments link after voting to explain your rationale.

2-8-2014 9-02-48 AM

I mentioned that I decided to run an occasional ad at the top of the HIStalk page only so I can donate most of the proceeds to the DonorsChoose, which supports teachers whose classrooms need help buying books and supplies or paying for educational projects. I’m indifferent at best toward most charities (including hospitals) because they are inefficient, ineffective, and overly generous with executive compensation, but years ago my research led me to DonorsChoose and it has become (along with the Salvation Army) my charity of choice. I’ll be funding the first projects this week and updating the HIStalk giving page so we as readers and sponsors can feel good about the results – you’ll be able to see project details, status, photos, and the teacher’s letter of thanks and description of the outcome. I’m really excited about this. You are making it possible by reading HIStalk, for which I am grateful.

Listening: Blondfire, a Michigan-based dreamy indie pop brother-and-sister band that has new album coming out Tuesday.

2-8-2014 2-08-04 PM

Welcome to new HIStalk Gold Sponsor MEA | NEA of Norcross, GA. The company’s cloud-based solutions allow health plans and providers (both medical and dental) to electronically request and deliver images and documents that would previously have been printed and mailed. FastAttach improves revenue cycle management by allowing providers to submit documents to support their electronic medical claims via a Windows-based application that’s compatible with all practice management and revenue cycle systems. FastAttach also allows providers to quickly and securely respond to RAC and other audits through the company’s participation in Medicare’s Electronic Submission of Medical Documentation program (esMD) using the CONNECT gateway to send scanned images, print capture, screen capture, uploads, files, and mobile capture. Thanks to MEA |NEA for supporting HIStalk.

HIMSS Conference Social Events

Send us your event details if it’s a good one (i.e., free food and drinks at minimum) and you promise that all HIStalk readers are welcome to attend, even if they work for your most hated competitor as a given reader might well do.

2-8-2014 10-36-25 AM

Nordic is sponsoring an open house at King’s Bowl Orlando, International Drive, Tuesday from 6-8 p.m. Email to sign up.

Upcoming Webinars

February 12 (Wednesday) 1:00 p.m. ET. Healthcare CO-OPs and Their Potential to Reduce Costs. Sponsored by Health Catalyst. Presenters: David Napoli, director of performance improvement and strategic analytics, Colorado HealthOP and Richard Schultz, VP of clinical care integration, Kentucky Health Cooperative. Consumer Operated and Oriented Plans (CO-OPs) were established by the Affordable Care Act as nonprofit health insurance companies designed to compete in the individual and small group markets. Their intended impact was to provide more insurance options for consumers to pay for healthcare.

February 13 (Thursday), 12 noon ET. Advancement in Clinician Efficiency Through Aware Computing. Sponsored by Aventura. In an age of information overload, a computing system that is aware of the user’s needs becomes increasingly critical. Instant-on roaming for virtual and mobile applications powered by awareness provides practical ways to unleash value from current HIT investments, advancing efforts to demonstrate meaningful use of EHRs and improve clinical efficiencies. The presenters will review implementation of Aventura’s solution at Orange Coast Memorial Medical Center.

February 18 (Tuesday), 1:00 p.m. ET. Epic 2012 Training and Support: Building Your Team. Sponsored by MBA HealthGroup. The webinar will present a case study of creative staffing solutions for an Epic 2012 upgrade at an academic medical center, describing the institution’s challenge, its out-of-the-box solution, and the results it obtained working with a consulting firm.


I’m hearing buzz about REST and FHIR Web-based programming coming from various vendors and from ONC. It sounds important for future healthcare IT development and interoperability, so I decided to look up the concepts since I don’t know anything about them. This is my cartoonish, stick-figure understanding that certainly could use more informed (but simple) explanation from knowledgeable readers about what it means in healthcare and who’s using it.

REST (representational state transfer) is the architecture that runs the Internet, where your browser sits there waiting for you to enter data or click a button and then something cool happens. Applications developed using RESTful programming respect the fact that the Internet works perfectly fine without individual programmers screwing around with tricky or proprietary techniques. Your browser knows how to process your Amazon order even though you don’t know or care how Amazon’s servers are set up, the Firefox people didn’t customize their browser to work with Amazon.com, and Amazon didn’t develop its site so that it only works with Firefox. REST-built systems can interact with each other with minimal overhead. It’s pretty much the opposite of how most healthcare applications were built, in other words, since it presumes that all boats are equally floated when applications work and communicate in a common way using existing infrastructure and methods, making life easier for programmers and users alike.

FHIR (fast healthcare interoperability resources, pronounced “fire”) is an HL7 framework that further defines REST for specific building blocks for developing healthcare applications. Applications developed using FHIR are theoretically easier to develop and support, are inherently interoperable, and follow Web standards.

I’m not as interested in the technical underpinnings as the possible benefits. REST and FHIR concepts are new to healthcare IT and probably aren’t ready for prime time. I can understand why vendors would be cautious about chasing trendy standards that not only threaten their proprietary existence but also could go out of fashion faster than the Harlem Shake, but it’s still an interesting design that could make life better for everyone (including patients and providers) if everybody used it.

This is the cue for an reader who is unbiased, technical enough to understand what all this means strategically, and blessed with the ability to describe it simply (but not simplistically) to enlighten the rest of us who just want stuff to work.

iHealth 2014 Report

2-8-2014 9-07-37 AM
2-8-2014 9-06-52 AM

The only conference I attend regularly is HIMSS for a variety of reasons  — cost, time required, and often because I don’t even know when or where a given conference is being held with enough lead time to plan. I always invite readers to provide a summary of their experiences.

Here’s ADG’s writeup of AMIA’s iHealth conference:

iHealth 2014 was a good excuse to get away from the cold and snow of wherever you were and come to Orlando for some warm rain. Farzad Mostashari in particular was seen immediately after the PBS-style fireside chat of the four previous national coordinators without a bowtie and in the company of a couple of cute kids. Getting the four on the same stage was a logistics coup and they were immensely personable. The two with the initials “DB” — David Brailer and David Blumenthal — cheerfully referred to each other as DB1 and DB2. Their themes included the coming penalties for non-compliance with MU, and DB1’s very sharp insights, which included the observation that he expects FDA regulation of EMRs within “single digit” years. Their advice to the current ONC coordinator Karen DiSalvo seemed to be a version of “buckle up.” DB1 in particular was praised by the others for his sharp organizational and entrepreneurial skills in getting the office started on the right foot.

We came to Orlando to get practical advice (and to get out of the cold, see above) and there is some comfort that all are struggling — large and less-large, academic and less-academic — with rapid change. Most noticeable was a sharp divide between the academics and the operational types, with the academics suggesting that if you do the right things, the “regulators will catch up,” which is an actual quote. The operational types knew that regulators will deny payment for any failure to cross the T and dot the i and that their organization would be out of business for lack of money by the time the regulators “caught up” to the “right thing.” There was a terrific dinner hosted by AMIA for recent diplomates of the board of Clinical Informatics, and we discovered we all have frighteningly similar backgrounds and tastes. Blackford Middleton, chair of the board of directors of AMIA, gave an excellent short toast. There were no grand insights, but lots of one-on-one incremental gains from each other, and HIStalk was mentioned at least a couple of times from the stage(s).

2-8-2014 9-54-04 AM

Jim Hansen of Lumeris / Accountable Delivery System Institute knows I like what we call “Judy-isms,” little nuggets of cynical wisdom from Epic’s Judy Faulkner. He culled these from last week’s HIT Policy Committee meeting:

  • “Be careful about prescriptive standards. If there was a usability committee for the iPhone, there wouldn’t be one.”
  • “We see a huge international move to EHRs without incentive money. We can’t test it here, but would it have happened anyway?”
  • “With regard to Meaningful Use and providers saying, “I paid for an EHR, therefore you as the government owe me,” I think of girls on dates and I don’t think that’s a good idea.”

2-8-2014 2-33-17 PM

Brian Ahier provides the full text of the SGR Repeal and Medicare Provider Payment Modernization Act that proposes to move the Meaningful Use program into the Merit-Based Incentive Payment System.


From athenahealth’s Friday earnings call:

  • Jonathan Bush talked up athenaCoordinator for Enterprise, “our first truly hospital-facing service” that will tie together the company’s services for pre-certification, pre-registration, scheduling, and population health management. It will cost hospitals 1 percent of revenue.
  • “The on-ramp that is turning out to be Epocrates” will be enhanced to include secure text messaging, a provider director, and clinical decision support tools and the rollout of Epocrates Prime that will allow non-physician secure messaging participants and referral capability.
  • New company locations include Austin, Atlanta, and San Francisco.
  • Sales to small hospitals, the only underperforming area, will be better supported by teams that include operational analysts rather than just a single salesperson.
  • Bush, responding to an analyst’s question about how cost-shifting to patients will affect the company, said, “As long as they don’t become uninsured self-payers and they keep their financial selves tangled up in impossible-to-understand bureaucratic health plans, which is now the law of the land, it doesn’t hurt us.”
  • Bush says the company may need to create a patient-facing division because patient portal use is low industry-wide.
  • In describing the company’s patient engagement efforts, “The goal is to just do everything possible for the doctor over the cloud, to the patient, at home where they get better answers to clinical questions. Like tell me about your diet and your life and all the things you need to know for the doctor, all your smoking, your seatbelts, your sex life. All those things are much easier to talk about at home or in private than sitting in the freaking waiting room, or worse, on that butcher paper with your knickers off. So we’re going to use the social good created by all of our increasingly sophisticated patient outreach to be way better than we are.”
  • Enterprise Coordinator will include the patient facesheet from athenaClinicals and clicking on the patient’s name, even by a practice that doesn’t use athenahealth, will launch a session of the hospital’s EHR.
  • Bush described the company’s future strategy as, “The goal here is to get into the front door and the back door of the hospital and work our way through the wards and departments with cloud-based services that allow them to virtualize, get business from more places, and focus more of their resources on actual clinical care. Other places we need to go is we need to go to patients. So every patient in America needs to have something in their wallet and something on their wrist, some sort of 2D barcode or in their iPhone that says, ‘This is me. Zap this thing and pull me up on athenaNet if I’m unconscious.’ So that’s some sort of patient outreach. I don’t know if it’s a partnership with the big dogs out in California, the Facebook or whatever — maybe I have to meet the Zuck, who knows. And then the other one is to get into the finance side. So health plans have been largely kind of strapped down and held still by regulation. They can’t be responsive to their customers. They need new ways of underwriting healthcare and a partner that could bring a claimless healthcare network where nobody sends a claim or receives a claim. All of this is instantaneous intelligence built into the wire. That should be us.”
  • In summarizing 2013, Bush said, “That wraps up a fantastic year. And over the last few days, we have given out beautiful crystal things, checks, and stock options. And if that wasn’t enough, we gave a few people hangovers so that they knew that what they had done in 2013 and then we took all their needles and returned them to 0. And we noticed last night that you all got excited about how the year went and the stock went up. And we want you to know that we have turned our needles with you to 0. We have a very long way to go and it is only to us about how we journey. There will be a healthcare Internet and we will be the ones who have created it. ”

Speaking of athenahealth, ATHN shares jumped 25 percent on Friday, the second-largest percentage gain on the Nasdaq, after Thursday’s earnings announcement, valuing the company at $6.5 billion. A $10,000 investment five years ago would be worth $52,000 today.

CMS extends the deadline for EPs to attest for MU 2013 by a month to March 31, 2014.

2-8-2014 3-50-08 PM

The White House Office of Science and Technology Policy announces that several drug chains have pledged to support or expand their use of the Blue Button initiative to allow patients to access their prescription information: Walgreens, Kroger, CVS Caremark, Rite Aid, and Safeway. Walgreens, always the technology leader in retail pharmacy and arguably in healthcare, says it will adopt BlueButton+ guidelines to allow customers to share their data and use third-party health applications.

2-8-2014 4-14-28 PM

The Federal Trade Commission approves a settlement with IP-based video camera vendor TRENDnet over a software vulnerability that allowed anyone to view a camera’s live feed over the Internet without a password. One marketed use of the secure video systems is monitoring hospitalized patients.

In England, a privacy group criticizes West Suffolk Hospital after it reports 20 documented breaches since 2010, including seven in 2013. All of breaches last year involved paper records that were filed or mailed incorrectly.

Weird News Andy includes an actor’s name pun in titling this story, “He’s a Lauriette.” A German doctor diagnoses a patient’s cobalt poisoning caused by a broken artificial hip after recognizing its symptoms from an episode of the TV series “House.” The doctor says he’s not thrilled at being called “the German Dr. House” since he finds rude behavior unacceptable, but concedes, “It’s important to be nice, but you don’t get patients healthy just by being nice.”

Sponsor Updates

2-8-2014 3-14-17 PM

  • Clinical Architecture announces Symedical for the iPad, which provides mobile access to map administration.
  • John Gomez of JGo Labs is working with investment bankers interested in investing in healthcare IT companies with $5 million to $30 million EBIDTA, a proven business model, and good revenue growth. He’ll be available to meet with interested companies at HIMSS. 


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

More news: HIStalk Practice, HIStalk Connect.


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February 8, 2014 News 16 Comments

News 2/7/14

February 6, 2014 News 6 Comments

Top News

2-6-2014 8-50-45 PM

Athenahealth reports Q4 results: revenue up 48 percent, adjusted EPS $0.57 vs. $0.29, beating analyst expectations for both and sending ATHN shares up 19 percent in after hours trading Thursday. Above is the one-year performance of ATHN (blue) vs. the Nasdaq (red).

Reader Comments

2-6-2014 11-18-52 AM

From OnTheFringe: “Re: KLAS. Sponsoring a Best in KLAS TweetChat Friday. Oh my, I think I might have a few beers and fire up my Twitter account.”

2-6-2014 11-49-01 AM

inga_small From Faithful Sponsor: “Re: HIStalkapalooza attire. While I did not make the cut to attend HIStalkapalooza 2014, one of my executives did and I wanted to touch base to see what the theme was this year.” Let me start by saying that no one is sadder than Mr. H and me that we were not able to accommodate all our faithful readers and sponsors due to capacity limitations. The only HIStalker more sad than us is probably Dr. Jayne, who was unable to score an invite for her “+1,” a gentleman that Dr. Jayne assures me  is terrific, even if he did just cancel his HIStalk subscription over the perceived snub. Next year I am proposing we rent Soldier Field so we have plenty of room for anyone (though I suppose we might need to wear snow suits.) As for this year, we will once again be seeking contenders for the Inga Loves My Shoe contest, so please bring your A game. Overachievers who are able to pull off the whole package may be in the running for HIStalk King or Queen. If that’s not specific enough, here’s a good rule of thumb: leave the “just off the exhibit floor” company golf shirt in your hotel room and come adorned in something fun, flirty, and suitable for sipping Ingatinis. You’ll see some long gowns, a tux or two, plenty of cocktail dresses, and the occasional pair of blue jeans. It’s going to be fun.

From Gary: “Re: HIStalkapalooza. Rejected third year in a row. I have concluded that this is a hand picked, very political event, your own version of the Good Ole Boy network.” Every year I swear I’ll never do another HIStalkapalooza because of the endless complaining about who gets invited and the time and energy it takes to wade through hundreds of emails begging for (or demanding) invitations, insistence on bringing uninvited guests, or asking me to personally repeat event details that have already appeared several times in HIStalk. The event is a really nice, free party for maybe 1,000 people and neither the sponsor nor I get anything out of it except a ton of work, but somehow we end up being the bad guys when demand for invitations exceeds supply. The invitation process is clear and hasn’t changed since 2008: employees of non-profit providers (hospitals, practices, universities – hardly “political”) who request invitations come first. This year a huge number of providers signed up, leaving around 1,000 others without spots no matter how cool they are or how much I like them. It’s no different than a popular show or sporting event – not everybody is going to get a seat. Next thing you know scalpers will be lined up outside of the House of Blues.

Speaking of HIStalkapalooza, every year at least 40 percent of those invited don’t show up. This year I’m keeping a database of no-shows who don’t let me know in advance so that I can give someone else their spot – that will be the last HIStalkapalooza invitation they’ll get. A few invitees have already emailed to say their plans have changed and I really appreciate that.

From Reader: “Re: HIStalk. Thank you again for the wonderful service you offer our healthcare industry. So many of us wake up each morning to stay informed to the latest news via HIStalk. I am amazed at how well your content remains timely, fresh, and complete. We hope to see you at HIMSS, where we will release the next generation of our solution. Wishing you continued success in 2014.” Thanks. I don’t usually have enough time to watch demos at the HIMSS conference, but I will try to swing by at least briefly and anonymously.

From Silent: “Re: Epic. Going into the consulting business. This will greatly disrupt the current vendor marketplace.” Unverified.

From WildcatBelievers: “Re: The University of Arizona Health Network’s Diamond Children’s Hospital. Went live on Epic in November, recently put together this fantastic video with special guest band American Authors to celebrate the tremendous and impactful work they are doing to improve the lives of the children of Arizona.”

HIStalk Announcements and Requests

A few HIStalk Practice highlights from the last week include: Epic, eClinicalWorks, and Allscripts own 30 percent of the physician EMR market. Physician practices are far from ready for ICD-10. HHS finds that few health centers have the capacity to meet MU data sharing objectives. Reimbursements remained flat in 2013 for existing patient visits and declined for new patients. EHR alerts show promise in changing physician behavior when treating obese and overweight children. Dr. Gregg recommends taking time to step across the divide to reinvigorate your viewpoint. Culbert Healthcare’s Brad Boyd offers tips for optimizing clinical documentation. Thanks for reading.

2-6-2014 9-43-34 PM

Welcome to new HIStalk Platinum Sponsor CitiusTech, a leading healthcare technology services and solutions provider with 1,400 professionals (including 500 certified in HL7) serving over 50 leading healthcare organizations. The company has grown 55 percent year-over-year for the past five years and has won awards for being a great place to work. Its BI-Clinical healthcare business intelligence and clinical decision support system has been deployed at over 1,200 provider locations, with pre-built clinical, financial, operational, and regulatory reporting apps and 600 pre-built KPIs. Services include software product engineering, professional services, QA and test automation, and technology consulting. Specific practice areas are Meaningful Use compliance, interoperability, BI, consumer health, care management, and cloud and mobile health.  The company serves all healthcare markets – vendors, hospitals, medical groups, medical device companies, HIEs, health plans, and pharma. Thanks to CitiusTech for supporting HIStalk.

Here’s an overview of CitiusTech.

HIMSS Conference Social Events

Aventura, Nordic Consulting, Avent, and IHS Consulting will host the Row 1800 block party from 4:00-6:00 p.m. on Tuesday, February 25. All will be serving food and drinks and Aventura will feature a magic show at booth 1831. All hated competitors are welcome.

Upcoming Webinars

February 12 (Wednesday) 1:00 p.m. ET. Healthcare CO-OPs and Their Potential to Reduce Costs. Sponsored by Health Catalyst. Presenters: David Napoli, director of performance improvement and strategic analytics, Colorado HealthOP and Richard Schultz, VP of clinical care integration, Kentucky Health Cooperative. Consumer Operated and Oriented Plans (CO-OPs) were established by the Affordable Care Act as nonprofit health insurance companies designed to compete in the individual and small group markets. Their intended impact was to provide more insurance options for consumers to pay for healthcare.

February 13 (Thursday), 12 noon ET. Advancement in Clinician Efficiency Through Aware Computing. Sponsored by Aventura. In an age of information overload, a computing system that is aware of the user’s needs becomes increasingly critical. Instant-on roaming for virtual and mobile applications powered by awareness provides practical ways to unleash value from current HIT investments, advancing efforts to demonstrate meaningful use of EHRs and improve clinical efficiencies. The presenters will review implementation of Aventura’s solution at Orange Coast Memorial Medical Center.

Acquisitions, Funding, Business, and Stock

2-6-2014 9-37-29 PM

Private equity firm Thoma Bravo acquires supply chain solutions vendor Global Health Exchange.

2-6-2014 1-27-57 PM

Praesidian Capital invests $8.3 million in Etransmedia Technology.

2-6-2014 1-29-56 PM

Alere announces Q4 results: adjusted revenue up two percent, ajusted EPS $0.68 vs. $0.55, beating estimates. Net product and services revenue from Alere’s health information solutions segment was flat.

2-6-2014 1-30-53 PM

Bottomline Technologies will pay $8 million for Rationalwave Analytics, an early-stage predictive analytics company.

From Cerner’s earnings call:

  • The company signed 25 contracts over $5 million in the quarter
  • President Zane Burke says half of the market will reconsider their EHR supplier in the next few years, most of them will choose Cerner or Epic, and Cerner’s win rate against Epic has doubled in the past three years.
  • Cerner says it replaced 18  ambulatory competitors in signature accounts.
  • It says it sold an HIE to a 600-bed Epic hospital because Epic was “was unable to effectively connect to other systems.”
  • The company says providers are consolidating and Cerner hospitals are buying smaller ones at quadruple the rate of Epic hospitals.


2-6-2014 1-31-50 PM

FirstHealth of the Carolinas selects Truven Health Unify for population health management.

2-6-2014 1-32-56 PM

Bozeman Deaconess Hospital (MT) will implement Merge Healthcare’s VNA and interoperability solutions.

Metro-North ACO (PR) selects eClinicalWorks Care Coordination Medical Record to advance its physician-led ACO objectives.

Adventist Health System selects HealthMEDX to automate Adventist Care Centers, its long-term care division.

2-6-2014 1-39-21 PM

Genesis Medical Center (IA)  will implement Wolter Kluwer Health’s ProVation Medical software for cardiology procedure documentation and coding.

Covenant Health Systems (MA) adopts MedeAnalytics’ analytics platform to manage population health for its employees.

Athens-Limestone Hospital (AL) selects Besler Consulting to assist in the identification of Medicare Transfer DRG underpayments.

Providence Health & Services and Swedish Health Services (WA) will implement care transition and utilization review solutions from Curaspan Health Group, as well as Xerox’s Midas+ Care Management platform.


2-6-2014 1-03-52 PM

Axiom EPM hires David Janotha (Loyola University of Chicago Medical Center) as VP of healthcare.

2-6-2014 8-59-17 PM 2-6-2014 9-01-32 PM

Parallon names Scott Armstrong (OptumInsight) SVP and Wendy Penfield (Intellect Resources) as AVP, both in revenue cycle consulting services.

2-6-2014 9-06-26 PM

Surgical supply chain software vendor Solstice Medical hires Todd Melioris as CEO.

Announcements and Implementations

2-6-2014 1-44-43 PM

Geisinger Health System (PA) deploys Courion’s identity and access management solutions.

St. Luke’s University Hospital Network (PA) implements Get Real Health’s InstantPHR patient portal, which will be connected to Caradigm’s HIE platform.

HIMSS announces a Latin American version of its annual conference that will be held September 18-19 in Sao Paolo, Brazil.

Government and Politics

The Army and Air Force contract with a division of Goodwill Industries to scan and transmit to the VA the service treatment records of veterans discharged this year.

2-6-2014 8-43-51 PM

The DoD and VA collaborate to develop a way for the VA to review the scanned images of the DoD electronic medical records of disability claimants.

2-6-2014 10-16-45 PM

Farzad Mostashari tweets out a section of the proposed SGR bill that would roll Meaningful Use and PQRS incentives into a new value-based payment system that would start in 2017.  Additional language would require EHRs to be interoperable.

The former CFO of Shelby Regional Medical Center (TX) is indicted for Medicare fraud, charged with falsely attesting that the hospital met Meaningful Use requirements for 2012. The hospital was mostly paper-based, but ordered its software vendor (eCareSoft) and employees to manually enter information into the EHR months after discharge to earn $786,000 in incentive payments. The hospital was part of a now-defunct for-profit chain that collected $18 million in Meaningful Use payments before being dismantled after reports of serious patient care issues.

The governor of Massachusetts apologizes for the state’s dysfunctional insurance exchange website as a non-profit research firm finds the site loaded with “technical infrastructure and data stability problems.” The governor says that contractor CGI, which was also responsible for Healthcare.gov, was  not reliable and relieved CGI overseer University of Massachusetts Medical Center of further responsibilities.


New York officials report that the state’s online database for drug prescriptions has reduced doctor shopping by 75 percent since its August 2013 implementation.

The World Health Organization postpones the rollout of ICD-11 until 2017, two years later than planned.

Sponsor Updates

  • AirWatch opens an Australian headquarters in Melbourne.
  • Allscripts announces the general availability of Sunrise Version 14.1.
  • Jed Shay, MD shares how his use of AdvancedMD’s EHR and PM services have contributed to improved cash flow, productivity, and patient tracking.
  • T-System files a patent application for an ICD-10 feedback feature that helps clinicians document for ICD-10 without an interruption in workflow.
  • Huron Healthcare will integrate predictive analytic technologies from Connance into its revenue cycle solutions.
  • Russell Green, VP of research operations and engagement manager for Porter Research, discusses the mixed messaging of HIEs in a blog post.
  • Kelsey Creveling from Sagacious Consultants clarifies changes in the Safe Harbor regulation in a blog post.
  • MyCatalyst will use Liaison Healthcare’s Data Management platform for its myCatalyst Provider Portal and Population Health Reportal solutions.

EPtalk by Dr. Jayne


The pre-HIMSS mail bonanza has started. It seems a little earlier than last year. Today’s winner is GCX Mounting Solutions, whose “scratch and win” card fell victim to the Postal Service’s automated mail handling machines. A fair number of mailings arrive mangled every year. I wonder if the marketing and promotional companies ever consider doing a test mailing to make sure their items will arrive as intended?

Several vendors have shared invitations to their client appreciation parties and I’m looking forward to writing them up. I haven’t heard from very many EHR vendors, so either they don’t want sassy women in fabulous shoes to attend or they’re just behind. Inga will be sharing invitations from those vendors willing to open their events to HIStalk readers. I appreciate their willingness to let everyone share in the fun. After slogging through 500,000 square feet of exhibit space and 1,200 exhibitors, the opportunity to unwind and partake of a cocktail is more than welcome.

Something I’ll be on the lookout for in the exhibit hall: devices that use the new Corning antimicrobial Gorilla Glass. When I think about all the devices I come into contact with each day in the hospital compared to the variable handwashing behavior of some of my colleagues, it seems like a good idea. I see more people wiping down equipment at the gym than I see on the wards and that’s not a good thing. I haven’t seen any evidence-based reports on how well it works, so if you have any inside scoop, let me know.

The World Health Organization is postponing the rollout of ICD-11. Originally slated for 2015, it will be delayed until 2017. Hopefully this will quiet those voices advocating that we skip ICD-9 and go straight to ICD-11. ICD-10 was approved in May 1990 and first came into use in 1994, so based on the historical timeline, the United States should be ready for ICD-11 in 2038. Thank goodness I’ll be retired by then.


Several readers emailed about this week’s Curbside Consult on wearable tech. One mentioned the lack of interest in a mobile healthcare enterprise device. Manufacturers are focused on selling directly to the masses, but it would seem like there is a place for enterprise devices in the Accountable Care or HMO spaces. Another lamented the lack of integration among devices — “I feel like a nurse with 50 devices being a kangaroo.”

When I was in residency, we used to refer to the group of pagers that you had to wear when you were on call as the Batman Utility Belt. There was the on-call pager, the code team pager, and your personal pager. You also had to carry the elevator keys (because who wants to run up 17 floors when a patient needs CPR?) Throw on a bulky cell phone, and if you were extra lucky, the labor and delivery pager, and you were ready to go. I almost forgot – some also had a Palm Pilot, although I was partial to the Pocket PC.

We’ve certainly come a long way. Some of us are down to one device if we work in a BYOD environment. I’m still toting a corporate phone and a personal phone, but it certainly could be worse. Have you been able to shed the utility belt? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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February 6, 2014 News 6 Comments

News 2/5/14

February 4, 2014 News No Comments

Top News


Castlight Health files plans for an IPO that values the company at $2 billion. The employee health management software company was formed in 2008 with now-US CTO Todd Park as a co-founder.

Reader Comments

2-4-2014 1-26-07 PM

inga_small From Jack Flash: “Re: Dick Derrick. The HCIT world will miss the smiling face of Dick Derrick of eClinicalWorks, who announced his retirement after 40 years in our business.” Dick was kind enough to share with Mr. H and me that he remains “addicted” to HIStalk and will continue reading in between his travel, volunteering, and family time. He also asked us to send his best to his industry friends.

HIStalk Announcements and Requests


Supporting HIStalk as a Platinum Sponsor is Aperek (pronounced uh-PARE-ik) which you may remember as Mediclick (with earlier roots in Global Software) since the healthcare-only, all US-based company changed its name along with introducing new products in November 2013. The Raleigh, NC-based company offers highly ranked solutions for supply chain, financials, mobile, technology, spend aggregation / contract management, and implant tracking. CEO Mike Merwarth explained in my interview last week that 80 percent of a hospital’s supply expenses are managed by clinical people rather than materials management professionals (particularly in the OR, where high-dollar implant products are used) and thus aren’t touched by typical ERP packages. A new Aperek solution is Pulse, an iPad app designed for clinicians who record implant item usage in the OR. Hospitals are looking at the supply chain and thus to Aperek to get their costs under control. Thanks to Aperek for supporting HIStalk.

HIMSS Conference Social Events

inga_small Send us your event details if it’s a good one (i.e, free food and drinks at minimum) and you promise that all HIStalk readers are welcome to attend, even if they work for your most hated competitor as a given reader might well do. Inga and Dr. Jayne especially like free cocktails and are happy to give your company a shout-out if we have the chance to stop by.

2-4-2014 10-17-40 AM

Divurgent will be sponsoring a Havana Nights themed event at the Funky Monkey (International Drive) Sunday night at 8:00 p.m. on Sunday. Click here to register.


Upcoming Webinars

February 5 (Wednesday) 1:00 p.m. ET. Healthcare Transformation: What’s Good About US Healthcare? Sponsored by Health Catalyst. Presenter: John Haughom, MD, senior advisor, Health Catalyst. Dr. Haughom will provide a deeper look at the forces that have defined and shaped the current state of U.S. healthcare. Paradoxically, some of these same forces are also driving the inevitable need for change.

February 12 (Wednesday) 1:00 p.m. ET. Healthcare CO-OPs and Their Potential to Reduce Costs. Sponsored by Health Catalyst. Presenters: David Napoli, director of performance improvement and strategic analytics, Colorado HealthOP and Richard Schultz, VP of clinical care integration, Kentucky Health Cooperative. Consumer Operated and Oriented Plans (CO-OPs) were established by the Affordable Care Act as nonprofit health insurance companies designed to compete in the individual and small group markets. Their intended impact was to provide more insurance options for consumers to pay for healthcare.

February 13 (Thursday), 12 noon ET. Advancement in Clinician Efficiency Through Aware Computing. Sponsored by Aventura. In an age of information overload, a computing system that is aware of the user’s needs becomes increasingly critical. Instant-on roaming for virtual and mobile applications powered by awareness provides practical ways to unleash value from current HIT investments, advancing efforts to demonstrate meaningful use of EHRs and improve clinical efficiencies. The presenters will review implementation of Aventura’s solution at Orange Coast Memorial Medical Center.


Acquisitions, Funding, Business, and Stock


Cerner announces Q4 results: revenue up 12 percent, adjusted EPS $0.39 vs. $0.34, meeting analyst expectations.


ZappRx, developers of a mobile e-prescribing platform, secures $1 million in additional funding.

2-4-2014 1-30-39 PM

Imprivata confidentially submits a draft registration statement with the SEC to conduct an IPO.

2-4-2014 1-31-32 PM

Streamline Health Solutions completes its acquisition of Unibased Systems Architecture.

2-4-2014 1-32-26 PM

Endo Health Solutions completes the divestiture of HealthTronics to Altaris Capital Partners for total consideration of up to $130 million.

BlueStep Systems, a clinical platform provider for the long-term and post-acute care market, merges with  BridgeGate Health, a system integration provider.


2-4-2014 1-34-40 PM

Spectrum Health (MI) selects PerfectServe’s Clinician-to-Clinician and DocLink platforms for direct and secure clinician communication.

The 14-hospital Baptist Memorial Health Care System selects Voalte smartphones for system-wide caregiver communication.



2-4-2014 8-02-56 AM

HIMSS awards CACI International’s Keith Salzman, MD its 2013 Physician IT Leadership Award.

2-4-2014 1-36-23 PM

AT&T appoints Eric Topol, MD ((Scripps Health) chief medical advisor.

2-4-2014 1-37-24 PM

CTG Health Solutions hires Linda Lockwood (Encore Health Resources) as its advisory services solutions director.

2-4-2014 11-29-53 AM

HIMSS names Pauline M. (Hogan) Byom (Mayo Health System) the recipient of the 2013 SHS/HIMSS Excellence in Healthcare Management Engineering / Process Improvement Award.


Colette Weston (ADP AdvancedMD) joins Aviacode as VP of client services.

Emdeon hires Randy P. Giles (Coventry Health Care) as CFO/ EVP of finance, replacing Bob A. Newport, Jr.

Announcements and Implementations

The University City Science Center in Philadelphia begins accepting applications for its Digital Health Accelerator, which will provide up to $50,000 in funding and other benefits for as many as six companies in the digital health or HIT sector.

2-4-2014 1-40-14 PM

Fleming Island Surgery Center (FL) goes live with Anesthesia Touch from Plexus Information Systems.

Bread for the City (DC) and the Family and Medical Counseling Service (DC) implement The Guideline Advantage, a quality improvement program that leverages population health management tools from Forward Health Group.

Government and Politics

CMS authorizes laboratories to provide patients with direct access to their lab reports, rather than requiring patients to obtain results from their physicians.

2-4-2014 9-49-33 AM

A veterans advocacy group calls on the VA and DoD to take aggressive steps to reduce the remaining backlog of 400,000 disability claims, deliver on the long-promised joint VA/DoD EMR, to standardize VA claims forms, and to encourage VA raters to process claims correctly the first time.


Innovation and Research

2-4-2014 12-56-58 PM

Hospitals rank cost reduction as their top innovation priority, according to a HIMSS/AVIA survey on healthcare provider innovation. The report also reveals that chief innovation officers are not yet mainstream roles within hospital and health systems, though 64 percent of organizations with annual revenues of at least $5 billion have a chief innovation officer. Though dedicated funding for innovation is modest, providers are making progress implementing innovative solutions related to population health management, patient follow-up, predictive analytics, clinical decision support, and care coordination.


2-4-2014 1-17-48 PM

HIMSS expects more than 1,200 exhibitors at this year’s conference and will offer longer exhibit hall hours with more overlap between education sessions and no mid-day break.

Weird News Andy titles this story “A Shot for a Shot.” A startup invents a device that it claims can stop bleeding from a gunshot wound in 15 seconds. It injects dozens of tiny sponges into the wound, or as the article breezily written for those skimming rather than actually reading, “like a tampon for bullet wounds.”


Sponsor Updates

  • PACS blogger Dr. Dalai banters with Brad Levin of Visage Imaging about the latter’s suggestion that a savvy hospital IT department could assemble its own PACS system from off-the-shelf components.
  • NCQA certifies that Verisk Health’s Quality Intelligence solution contains HEDIS Certified Measures that are ready for 2014 HEDIS reporting.
  • Oracle Health Sciences will integrate medical speech recognition technology from Nuance Communications with its e-clinical software.
  • MedHOK achieves NCQA certification for its HEDIS Certified Measures in 360Measures.
  • TriZetto launches a collaborative care solution powered by Wellcentive to facilitate payer/provider collaboration in accountable care initiatives.
  • PeriGen introduces Category II Management Algorithm, a free web-based tool to support the management of patients in labor during FHR category II.
  • Coastal Healthcare Consulting introduces Convergence, an offering that combines NextGate’s Enterprise Master Index with Coastal’s project implementation.
  • HIMSS selects InterSystems HealthShare as the official health informatics platform for the Intelligent Hospital Pavilion at the HIMSS14 conference.
  • Gartner positions Informatica as a leader in its January 2014 Magic Quadrant for Enterprise Integration Platform-as-a-Service report, based on ability to executive and completeness of vision.
  • Elsevier introduces MethodsX, a concept methods journal that provides researchers a home for their unpublished works, allowing them to receive public credit and citations.
  • First Databank commences publishing of an initial draft of New York State Acquisition Cost drug prices.
  • CareSync is selected as a finalist in the Community category for the 2014 SXSW Interactive Awards for its efforts in building meaningful communities for patients, their families, and care teams.


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

More news: HIStalk Practice, HIStalk Connect.


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February 4, 2014 News No Comments

Monday Morning Update 2/3/14

February 1, 2014 News 18 Comments

2-1-2014 8-49-01 AM

From The PACS Designer: “Re: Apple’s solar iPhone. As we head deeper into 2014 ,you will be hearing details on the next generation of iPhones. The rumored solar iPhone 6 that will be introduced in second half of 2014 will use the tough sapphire outer casing as a solar panel. Apple was granted a new solar touch screen patent that will allow the solar panel to operate without the need of a boost converter, thus providing optionality in the use of a power charge or a solar charge.” I was on the fence between the iPhone 5 and the Samsung Galaxy last time. Now that I’ve used an Android tablet at a fraction of the cost of the Apple equivalent, I think my next phone will be a Samsung. Apple seems to be moving into that mature product phase where everything gets more features and interesting tweaks without blazing any new ground. I’m not willing to pay a premium for that.

2-1-2014 8-33-08 AM

1-31-2014 3-22-30 PM

From Country Girl: “Re: Stage 2 quality measures. In 2014, quality measures did change for both EP and EH regardless of where you are in the attestation  stages. More measures have to be reported and they must also be tied to the national quality goals. This information was published in the Stage 2 rule, not in December. However,  many of the measures are aligned with PRQS for reporting guidelines. The final rules on PQRS was published in December and the reporting requirements came out December 31. As a result, it appears some vendors are still working on their reporting methodology to incorporate the changes. The problem for many organizations will be understanding where the data has to be recorded in the system to pull properly for reports. We are having trouble getting this information from the vendor as well. If you are trying to attest in the first quarter and don’t have the requirements, you could find the reports do not accurately capture your measures when you get the 2014 reports.”

1-31-2014 8-26-34 PM

From HIMSS EHR Association: “Re: Stage 2 quality measures. The required format for electronic submission changed for hospitals (EHs) in November, and in January for physicians (EPs). These changes, as well as Spring 2013 versions of the quality measures which are required for electronic submission, will require further development and implementation at the same time that EHR developers are pushing hard to implement the 2014 certified edition for their customers. More generally, there have been many changes to the methods, requirements, and process to submit CQMs electronically over the last year, and they continue changing. Some changes were promulgated in other CMS rules, such as the annual hospital and physician payment rules, and other changes were not part of rulemaking. And this does not take into account all of the significant changes that have occurred in certification over the last year, as well as additional updates to the CMS quality programs using electronic CQMs. In part because of the extent of these changes, CMS is permitting manual attestation on clinical quality measures for meaningful use in 2014, as has been done through 2013, not just for those in their first year. The EHR Association has been in dialog with CMS on issues with the requirements over the past several months. We understand that CMS will be issuing a CQM submission Tip Sheet within the next couple of months. We welcome any further discussion and explanation of these facts, in order to help our customers understand the current requirements for reporting CQMs to CMS.”

1-31-2014 3-23-26 PM 

From Frank Poggio: “Re: CCHIT and certification. It’s a movie I’ve seen many times. A member organization wants to push the industry forward and generate some revenue, so they get in bed with regulators. Members get upset and view the association as part enemy, so the association wakes up and drops out of the program they helped start. CCHIT had the best tools and knew healthcare, so their interpretation of test rules and steps was sometimes different from the other ATLs. It was clear to me that they were overwhelmed. This had to be a money-losing effort for them given the Stage 2 (2014) complexity and the expanding complexity coming with the new 2015 Test Edition. Interestingly, all the remaining ATLs are non-healthcare companies and are learning the healthcare nuances as they go along. That should make for some interesting results.” Certification was created to reduce the risk of buying an EHR, which it arguably hasn’t done since the biggest risk isn’t misjudging functionality that you can plainly see or lack of interoperability that you don’t care about, but rather the possibility that your vendor will stop delivering high-quality enhancements and support. Which ironically some have because they are off chasing the government’s other “optional but not really” programs, Meaningful Use and ICD-10. Plenty of certified EHRs have unhappy customers, inadequate R&D budgets, and crappy support. You’ll see a bunch of them opt out of not only certification, but the EHR market in general as the HITECH teat dries up and those with no particular healthcare allegiance wander off seeking greener pastures.

From Albi Qeli, MD: “Re: EHRs. As a computer friendly practicing physician, I find the current vintage EHR software not only inadequate, but disgusting. The fundamental problem is that the software is not designed around physicians and patients’ requirements. Current systems try to replicate the paper forms that they are trying to replace, thus recreating a very faulty system and adding a few other defects to it. Add in the mandates and the penalties, and EHR has now become a dirty word. In every other field of human endeavor, computers solve specific problems and increase productivity. In a physician’s office, the EHR creates new problems (hackable, insecure, expensive, unwieldy, data silos) and increases staff requirements. All in the name of progress. People like me might be able to solve some of the practical and technical issues, certainly in order to have a workable efficient record keeping system for use in my own clinic. But such a system would not satisfy Uncle Sam.” As I’ve said many times, medicine is the only area in which the highest-paid resource is expected to perform data entry into a system whose benefit to them personally is coincidental at best. The EHR at its worst is a manual entry black box recorder for the government and insurance companies. Doctors who took HITECH money as a bribe to impulsively buy and use EHRs they now hate hasn’t helped push the market in a doctor-pleasing direction. Today’s systems reflect the financial reality for insurance-accepting practices — your customer isn’t the patient and you aren’t the boss. It would be interesting to review the systems used by cash-only practices, assuming they use any at all.

1-31-2014 2-38-55 PM

1-31-2014 2-50-47 PM

From One Tin Soldier: “Re: Best in KLAS. We won but weren’t included in your list.” The company in question didn’t actually win Best in KLAS, but it’s confusing enough to warrant an explanation. That title is reserved for products listed in the first two pages of the “Best in KLAS 2013” report, which lists solutions that “lead the software and services market segments with the broadest operational and clinical impact on healthcare organizations,” however KLAS defines that. Less rationally, the same report also includes Category Leaders 2013, defined above, but those don’t earn the title of Best in KLAS. Allscripts is the only vendor I’ve seen so far to incorrectly label a Best in Category win as Best in KLAS (had they included the word “in” after “named,” the headline above would be correct.) All of this is needlessly confusing – KLAS should use the term Best in KLAS for only the award, not as the title of a report that also includes other results. Either that or extend the Best in KLAS label to the category winners as well. The way they are using that title now seems a bit fuzzy, but then again some folks say that about the entire KLAS process. 

Upcoming Webinars

February 5 (Wednesday) 1:00 p.m. ET. Healthcare Transformation: What’s Good About US Healthcare? Sponsored by Health Catalyst. Presenter: John Haughom, MD, senior advisor, Health Catalyst. Dr. Haughom will provide a deeper look at the forces that have defined and shaped the current state of U.S. healthcare. Paradoxically, some of these same forces are also driving the inevitable need for change.

February 12 (Wednesday) 1:00 p.m. ET. Healthcare CO-OPs and Their Potential to Reduce Costs. Sponsored by Health Catalyst. Presenters: David Napoli, director of performance improvement and strategic analytics, Colorado HealthOP and Richard Schultz, VP of clinical care integration, Kentucky Health Cooperative. Consumer Operated and Oriented Plans (CO-OPs) were established by the Affordable Care Act as nonprofit health insurance companies designed to compete in the individual and small group markets. Their intended impact was to provide more insurance options for consumers to pay for healthcare.

February 13 (Thursday), 12 noon ET. Advancement in Clinician Efficiency Through Aware Computing. Sponsored by Aventura. In an age of information overload, a computing system that is aware of the user’s needs becomes increasingly critical. Instant-on roaming for virtual and mobile applications powered by awareness provides practical ways to unleash value from current HIT investments, advancing efforts to demonstrate meaningful use of EHRs and improve clinical efficiencies. The presenters will review implementation of Aventura’s solution at Orange Coast Memorial Medical Center.

1-28-2014 4-38-58 PM

A HIStalkapalooza update: registration has closed and invitations will go out on Tuesday. Demand was high, so unfortunately more than half of those who signed up will be getting a “sorry, we’re full” email instead. We always give priority to providers, who registered in overwhelming numbers. Please don’t email Inga or me if you didn’t get an invitation because there’s no secret stash of them for us to hand out no matter how much we like you.  

1-31-2014 1-02-30 PM

Eighty percent of poll respondents check their work email in the evening and on weekends, with 20 percent checking it at least hourly. New poll to your right: when were you last promoted?

My latest grammar peeves: (a) people who start sentences, especially written ones, with the word “so”; (b) the bizarre omission of the word “of” following “couple,” as in, “So I had a couple beers.”; (c) rampant overuse of pointlessly emphatic words such as “really,” “actually,” and “frankly,” which I excise by the dozens from some interview transcriptions.

1-31-2014 9-16-47 PM

Welcome to new HIStalk Platinum Sponsor InteHealth. The Malvern, PA-based employee-owned company connects patients, doctors, hospitals, and health plans cost effectively. InteHealth Exchange is a cloud-based, vendor-agnostic integration platform that is flexible and extensible; rapidly deployable; comes complete with a clinical data repository, data map library, and a messaging and alerts engine; and is MU2 ready. The company’s certified patient portal allows patients to view their records, make payments, schedule visits and tests, receive reminders, request refills, and share and download information. It is Stage 2 certified, integrates with 100 EHRs, has full CCD capability, and connects to the Direct exchange. The physician portal allows remote access and eliminates faxing and calling nursing and medical records for information. Hospitals can use InteHealth Exchange to solve problems related to information management, ACO care delivery, and discharge management. The company’s solutions are used by 1,900 sites and 20,000 physicians each year, processing 82 million transactions. Thanks to InteHealth for supporting HIStalk.

2-1-2014 7-03-12 AM

TeraMedica is supporting HIStalk as a Gold Sponsor. The company’s Evercore Clinical Enterprise Suite connects and manages a healthcare system’s digital image infrastructure all the way from the modality to the EHR and clinical desktop. It is vendor neutral, flexible, and scalable as an enterprise archive that manages both DICOM and non-DICOM (photos, videos, PDFs) clinical content. Its architecture features a scalable database, parallel application services running on enterprise-scale servers, n-tier storage, image storage and distribution rules, and tools to migrate legacy data, all architected to handle the explosion in imaging volume that’s coming, all with a lower total cost of ownership and true vendor independence. Thanks to TeraMedica for supporting HIStalk.

I found this YouTube video describing Duke’s TeraMedica VNA setup that’s integrated with Epic. It’s a very good overview of image management by Christopher Roth, MD, assistant professor of radiology and director of imaging informatics strategy at Duke Medicine.

1-31-2014 2-01-58 PM

Starting this week, you’ll see a single, short-term ad for various companies at the top of the HIStalk page, to the right of the logo. I’ve always turned down requests for “special” ads like this, but I agreed under these terms: (a) I’ll donate a big chunk of the proceeds to DonorsChoose to support students and teachers in need, reporting back here the projects that we (as HIStalk readers) funded as a result; and (b) it will be single ad that will run for only three days at a time so we don’t get tired of looking at it. Companies always want a burst of extra exposure for specific events, especially right before the HIMSS conference, and I can live with that since it will support classrooms.

2-1-2014 9-00-54 AM

2-1-2014 8-57-01 AM

Here’s a photo tweeted out by AMIA VP Jeff Williamson from iHealth 2014. This is like one of those fan convention photos of all the “Star Trek” captains together, only for a different variety of nerd: former National Coordinators Brailer, Kolodner, Blumenthal, and Mostashari. I would welcome a report on the conference if you attended. Orlando is in the low 80s every day, so I’m sorry to have missed seeing all of those informatics people in shorts and tee shirts.

A rumor suggests that Apple’s iOS 8 will include Healthbook, a fitness tracking app that will not only measure steps taken and calories burned, but also blood pressure, heart rate, and blood glucose (although the rumor doesn’t say how it would collect glucose levels.) The app will supposedly allow the user to enter medication schedules to allow the iPhone to issue reminders. All of that is related to the upcoming iWatch wearable computer. Apple has hired several health experts in the past year and has met with the FDA on undisclosed topics.

2-1-2014 8-51-02 AM

Athenahealth chooses Austin, TX for its R&D office, pledging to create 600 jobs that will pay an average salary of $132,000. The company will receive $680,000 from the city and $5 million from the state in incentive payments over 10 years to occupy the Seaholm Power project that’s under construction on West Cesar Chavez Boulevard. 

Vince Ciotti is one of the most hilariously cynical people in healthcare IT, so even he recognizes the irony in this HIS-tory episode in which he lustily guzzles the Epic Kool-Aid right at the factory. Epic fans will not be surprised that Judy invited Vince to present some industry history to several thousand Epic employees too young to remember it. This is a great episode that also includes a fun fact: one of Judy’s early mentors was Neil Pappalardo of Meditech, so when she started Human Services Computing in 1979, she targeted only large hospitals to avoid stepping on Meditech’s turf.


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

More news: HIStalk Practice, HIStalk Connect.


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February 1, 2014 News 18 Comments

News 1/31/14

January 30, 2014 News 6 Comments

Top News

1-30-2014 8-32-06 PM

The Department of Defense opens bidding to replace all of its EHR systems, saying the new system will use off-the shelf technologies running on ONC-approved standards. The VA solicited bids Tuesday for the next step in its replacement of VistA. Evidence is scant that the two groups plan to work together to implement a single EHR systems as mandated by the President and Congress, with their only obvious common ground being a willingness to separately enrich the usual government contractors with massive taxpayer dollars.

Reader Comments

From Silversand: “Re: MU Stage 2 CQM measures. In meeting with our vendor, we were told they can’t submit them electronically yet because the standards changed in December and their software hasn’t been updated. I can’t find anything on a standards change. Is this true? Are other vendors running into the same issue? I would love to know what your readers think.” So would I (cue readers to chime in.)

From Ockham: “Re: vendor market share. KLAS estimates by bed size, i.e. ‘Meditech has 18 percent of hospitals over 200 beds.’ This is meaningless. It should be expressed as the number of beds in all hospitals using a system, which would be easy to calculate using information from HIMSS Analytics. Having a lot of beds means having a lot of clinician users, which pushes product development. Epic blasted into a leadership position is because having 400 hospitals that are large and larger trumps having 2,000 hospitals that are small (Meditech).” That’s true, as long as your product is suitable for large hospitals and you have the competence to sell it to them. Epic’s timing was perfect because soon those big, Epic-using hospitals will have bought all the smaller ones and replaced their incumbent systems, putting Epic in hospitals that couldn’t have afforded or supported it on their own. It’s like the political system – you’ll see all kinds of parties on the ballot, but only two of them get a significant number of votes.

HIStalk Announcements and Requests

inga_small A few HIStalk Practice highlights from the last week include: physicians prefer smartphones to tablets to perform most professional tasks. Practice Fusion offers free Google Chromebooks to new users. CMS reminds EPs of pending deadline to attest to MU for the 2013 Medicare EHR incentive program. In part three of our series, HIT vendor execs share details about technologies on their company’s roadmap for the next 12-18 months. Thanks for reading.

1-30-2014 6-59-18 PM

Welcome to new HIStalk Platinum Sponsor Optimum Healthcare IT. The Jacksonville Beach, FL-based full-service consulting firm provides expert consultants at competitive rates. Services include EHR deployment (all major vendors); integration services (interface development and integration engines); staff augmentation (program directors, project managers, application builders and testers, clinical experts, analysts, security experts, trainers); security and identity management; and regulatory guidance (Meaningful Use, ICD-10.) The company provides small-business flexibility with large-business stability, but without the high cost. Thanks to Optimum Healthcare IT for supporting HIStalk.

Upcoming Webinars

February 5 (Wednesday) 1:00 p.m. ET. Healthcare Transformation: What’s Good About US Healthcare? Sponsored by Health Catalyst. Presenter: John Haughom, MD, senior advisor, Health Catalyst. Dr. Haughom will provide a deeper look at the forces that have defined and shaped the current state of U.S. healthcare. Paradoxically, some of these same forces are also driving the inevitable need for change.

February 12 (Wednesday) 1:00 p.m. ET. Healthcare CO-OPs and Their Potential to Reduce Costs. Sponsored by Health Catalyst. Presenters: David Napoli, director of performance improvement and strategic analytics, Colorado HealthOP and Richard Schultz, VP of clinical care integration, Kentucky Health Cooperative. Consumer Operated and Oriented Plans (CO-OPs) were established by the Affordable Care Act as nonprofit health insurance companies designed to compete in the individual and small group markets. Their intended impact was to provide more insurance options for consumers to pay for healthcare.

February 13 (Thursday), 12 noon ET. Advancement in Clinician Efficiency Through Aware Computing. Sponsored by Aventura. In an age of information overload, a computing system that is aware of the user’s needs becomes increasingly critical. Instant-on roaming for virtual and mobile applications powered by awareness provides practical ways to unleash value from current HIT investments, advancing efforts to demonstrate meaningful use of EHRs and improve clinical efficiencies. The presenters will review implementation of Aventura’s solution at Orange Coast Memorial Medical Center.

Acquisitions, Funding, Business, and Stock

1-30-2014 5-46-59 PM

GNS Healthcare, a provider of big data analytics products and services, completes a $10 million Series B financing round led by Cambia Health Solutions.

1-30-2014 5-49-51 PM

VMware reports Q4 results: revenue up 20 percent, adjusted EPS $1.01 vs. $0.81., beating earnings estimates.

1-30-2014 5-50-35 PM

CommVault releases Q3 results: revenue up 20 percent, adjusted EPS $0.54 vs. $0.39, beating estimates on both.

1-30-2014 5-51-15 PM

Quest Diagnostics announces Q4 results: revenue down one percent, adjusted EPS $1.03 vs. $1.01, beating estimates on both.

1-30-2014 6-57-56 PM

McKesson announces Q3 results: revenue up 10 percent, adjusted EPS $1.45 vs. $1.44, beating revenue expectations but missing expected earnings of $1.84. CEO John Hammergren said the results of Technology Solutions was disappointing (revenue up 6 percent, margins 8.55 percent) because the company had to  “take action in response to the anticipated timeline for Meaningful Use 3 and to size our organization in Horizon Clinicals appropriately” and took a $42 million restructuring charge to reduce headcount.

1-30-2014 9-07-20 PM

CPSI anounces Q4 results: revenue up 7 percent, EPS $0.90 vs. $0.83.


1-30-2014 5-52-06 PM

Texas Children’s Hospital selects OpenTempo’s scheduling and workforce management solution.

1-30-2014 5-53-53 PM

Valley Health (VA) selects Capsule Tech to integrate medical devices in operating rooms with Epic EMR.

1-30-2014 6-52-22 PM

Greater Regional Medical Center (IA) implements PeriGen’s PeriCALM fetal surveillance system.


1-30-2014 5-57-54 PM 1-30-2014 5-58-50 PM

Cumberland Consulting Group promotes Greg Varner and Mike Penich from principals to partners.

1-30-2014 5-59-52 PM

Community Health Network (IN) names Ron Thieme, PhD (AIT Laboratories) chief knowledge and information officer.

1-30-2014 6-00-48 PM 1-30-2014 6-01-34 PM

Population health management vendor Welltok hires Michelle Snyder (Epocrates) as chief marketing officer and Vance Allen (Pearson eCollege) as CTO.

1-30-2014 6-03-05 PM 1-30-2014 8-03-22 PM

Charles Denham, MD, accused by the Department of Justice of accepting $11.6 million in kickbacks from CareFusion to promote its skin disinfectant product at the National Quality Forum, resigns from the board of The Leapfrog Group. The DOJ has assessed a $41 million fine against CareFusion; Denham says the allegations are false. There’s a healthcare IT connection: when Dennis Quaid started limelighting  for patient safety after his newborn twins were overdosed with heparin at Cedars-Sinai (he had breezy good intentions, but minimal knowledge even for an actor), HIMSS put him on stage at the 2009 conference and inexplicably donated to his foundation. Dennis apparently found another shiny object and merged his foundation a year later with Texas Medical Institute of Technology, which was founded and run by Chuck Denham (who didn’t live in Texas, but instead in a $14 million oceanfront estate in Laguna Beach, CA.) Denham claimed that TMIT’s “national research test bed” involved 60 percent of US hospitals, although few people seemed to have heard of it. the other healthcare IT connection is that CareFusion sells Pyxis drug dispensing machines and Alaris smart IV pumps, just in case your hospital feels the urge to buy something from a company willing to bribe its way to the bedside.

1-30-2014 7-46-27 PM

Microsoft’s board is rumored to be preparing to name Satya Nadella, VP of the company’s cloud and enterprise group, as CEO as soon as Friday. The board is also discussing the possibility of replacing Bill Gates as their chairman with an unnamed candidate. Nadella would be the company’s third CEO following Gates and Steve Ballmer.


Announcements and Implementations

More than 800 hospitals and 6,000 medical groups are participating in the eHealth Exchange, a group of government and non-government organizations that agree to support interoperability standards to exchange information.

1-30-2014 6-05-42 PM

Scott & White Memorial Hospital (TX) goes live on Epic.

1-30-2014 9-03-23 PM

Greater Baltimore Medical Center (MD) goes live with the PatientRoute Systems patient flow solution.


1-30-2014 6-08-25 PM

Members of the governing board for the UK’s Croydon University Hospital raise concerns that the hospital’s new Cerner system has led to increased waiting times and has lost patient information. Despite Cerner’s assurances that the system issues have not harmed patients, at least one board member expressed doubts:

You say that no harm has occurred, but while we’ve had no direct incident so far, patient care has definitely suffered. You talk about increased waiting times and there’s a risk that harm may occur because of the difficulty in getting in touch with clinicians who actually know what is going on with the patient. I’m very concerned from a quality point of view that our main provider has a serious problem with its information systems.

1-30-2014 6-09-11 PM

CCHIT announces that it will no longer offer ONC testing and certification and will change its business model to become a certification consulting firm. CCHIT recommends that its customers work with ICSA Labs for future testing and certification services.

Federal prosecutors charge former Allscripts director of internal audit Steven M. Dombrowski with insider trading, alleging that in 2012 he used a secret account in his wife’s name short MDRX shares ahead of a poor financial report, netting him $286,000.

1-30-2014 8-51-35 PM

The Wall Street Journal describes the analytics challenges of Memorial Hospital of Gulfport (MS), which can’t get much useful information from its separate inpatient and outpatient EHRs now, but hopes things will improve after a Cerner go-live in March followed by implementation of Health Catalyst analytics afterward. The hospital selected Allscripts EHR/PM in 2009.

In Israel, the health ministry launches a medical data sharing project for health fund clinics and hospitals.

1-30-2014 9-39-59 PM

Recently released documents from the antitrust lawsuit against St. Luke’s Medical Center (ID) reveal that its merger with Saltzer Medical Group could have raised pricing for outpatient visits by 60 percent and increased insurance rates by about 30 percent. Last week a federal judge ordered St. Luke’s to divest itself of Saltzer, saying the acquisition would give the health system an unfair bargaining position with insurance companies.

1-30-2014 6-12-56 PM

Epic is unseated for the first time since 2008 as the top overall vendor the 2013 “Best of KLAS” awards, with athenahealth leading the pack. Winners (with links to HIStalk sponsors) include

Athenahealth athenaCollector (practice management 1-10 physicians)
Athenahealth athenaCollector (practice management 11-75 physicians)
Athenahealth athenaCommunicator (patient portal)
CareTech Solutions (IT outsourcing, extensive)
CareTech Solutions (IT outsourcing, partial)
Cerner (application hosting)
Cerner CommunityWorks (community HIS)
Cornerstone Advisors (planning and assessment)
Cymetrix (extended business office)
Dolbey Fusion Speech (speech recognition)
Epic Care Everywhere (HIE)
Epic EpicCare (acute care EMR)
Epic EpicCare Ambulatory (ambulatory EMR 11-75 physicians)
Epic EpicCare Ambulatory (ambulatory EMR >75 physicians)
Epic OpTime (surgery management)
Epic Radiant (radiology)
Epic Resolute (patient accounting)
Epic Resolute/Prelude/Cadence (practice management >75 physicians)
Epic Willow (pharmacy)
Impact Advisors (clinical implementation principal)
J2 Interactive (technical services)
McKesson ERP Solutions (financial/ERP)
Merge Healthcare Cardio (cardiology)
Precyse (transcription services)
PwC (revenue cycle transformation)
QlikTech QlikView (analytics)
Quest Diagnostics ChartMaxx (document management)
Rays (teleradiology services)
Sagacious Consultants (clinical implementation supportive)
Sectra PACS (PACS)
Siemens Novius Lab (laboratory)
SRSsoft EHR (ambulatory EMR 1-10 physicians)
Thornberry NDoc (homecare)
Unibased USA RMS (enterprise scheduling)
Wellsoft EDIS (emergency department)
ZirMed (claims and clearinghouse)

Weird News Andy says this doctors has it. A New Zealand doctor spearfishing with friends is attacked by a shark, fights it off with a knife, stitches his leg wound on the beach, and heads to a bar for a beer. He goes to the hospital for more stitches only after bar employees notice him bleeding onto the floor.

1-30-2014 7-33-22 PM

WNA uses his less-cynical alter ego “Wonderful News Andy” in this story of medical dedication. A neurosurgeon working at an Alabama hospital is called to a cross-town hospital to perform emergency brain trauma surgery. His route is blocked by snow-related traffic, and as his cell phone signal fades, the second hospital’s neuro intensive care unit nurse hears him say, “I’m walking.” Which he did, covering six miles in a trek of several hours and then heading straight to the OR with the patient, who had a successful outcome.

Sponsor Updates

  • HIStalk sponsors winning KLAS Category Leaders 2013 awards include Siemens (Soarian Clinicals), GE Healthcare (Centricity Perioperative Anesthesia), Merge Healthcare (cardiology hemodynamics), Elsevier (CPMRC), Wolters Kluwer (Sentri7, MediRegs Comply/Track), PatientKeeper (Physician Portal), 3M (360 Compass, Codefinder), Allscripts (EPSi), Phillips (IntelliSpace Portal), lifeIMAGE (image exchange), GetWellNetwork (interactive patient system), iSirona (DeviceConX), MedAptus (Pro Charge Capture), Passport (IntelliSource), TeleTracking (Capacity Management Suite), McKesson (EnterpriseRX Outpatient), Xerox (Midas+ Solutions, financial ERP implementation services), Fujifilm (Synapse RIS), Craneware (Bill Analyzer, Chargemaster Toolkit), Imprivata (One-Sign), API Healthcare (Staffing and Scheduling, Time and Attendance), VMware (vSphere), Emdeon (eligibility services), Encore (go-live support services), and Aspen Advisors (ICD-10 consulting).
  • McGraw-Hill Professional partners with RelayHealth to make the AccessMedicine online medical platform available to providers.
  • AirWatch adds a professional certification level to its Enterprise Mobility Certification Program.
  • Besler Consulting publishes a white paper focused on Medicare Transfer DRG underpayments.
  • AT&T sponsors a series of articles that explore how hospitals and health systems are addressing the care continuum in their strategic and operational plans.
  • ReadyDock founder and president David Engelhardt discusses when and how to clean and disinfect mobile devices in a blog post.
  • Extension Healthcare founder and CEO Todd Plesko explains the future of secure messaging app in a blog post.
  • Passport Health posts a white paper discussing the benefits of front-end patient financial patient triage.
  • A Virtelligence case study profiles Allina Hospitals and Clinics (MN), which implemented Epic with support from the company’s consultants.
  • SimplifyMD publishes proof statements highlighting various successes and stats as of the end of 2013.
  • QPID offers a case study highlighting Massachusetts General Hospital, which saw improvements in clinician productivity, higher throughput in the GI suite, and improved outcomes by avoidance of adverse events following the implementation of QPID’s automated record review.
  • Predixion will provide academic institutions with the free use of Predixion analytics software for students and teachers of data science.
  • NVoq highlights what’s new in its version V8.3.
  • Culbert Healthcare Solutions discusses the optimization of Epic work queues in a company post.
  • LifeIMAGE offers a series of customer testimonials highlighting their use of lifeIMAGE technology for image sharing.

EPtalk by Dr. Jayne

Mr. H published a rumor earlier this week about CCHIT leaving the EHR certification business. As many HIStalk rumors are, it was confirmed a few days later. CCHIT cites the complexity of testing and changing federal requirements as contributing factors. They plan to move into the consulting business.

This seems to be the big news of the week, which isn’t surprising considering we’re in the run-up to HIMSS. Major vendors aren’t going to be announcing much of anything, and instead will be saving any upcoming news for release at the big show.

I guess I’m also not surprised to see CCHIT exiting the testing business. Keeping track of the constantly changing testing criteria can’t be easy. I can barely keep track of the provider-based Meaningful Use requirements and the ongoing parade of CMS Frequently Asked Questions that cause ongoing re-interpretation of how we need to comply. If you haven’t seen the testing criteria, I’d recommend taking a look – they make some of the most complex projects I work on look like a cakewalk by comparison.

I know some of the people who participated on our ambulatory vendor’s certification testing team. The process sounds like it’s about the same level of fun as going through med school, trying to make sure you know everything, and then being an intern and having the worst call night ever – sleepless, stressed out, and having to deal with endless minutiae. I would imagine that being on the other side and having to deal with an ongoing parade of vendor teams who are similarly at their wits’ end may not be the most satisfying or stress-free job.

I’m not sure about the direction they’re taking. It seems like the consulting world is already saturated with Meaningful Use advisors, stakeholders, and other thought leaders. They plan to have a “series of summits and events to support that work,” but I’m not sure who will attend. Most of us in the trenches don’t have the budget to attend conferences and meetings we attended in the past and want to keep attending, let alone add other meetings to the docket.

The first CCHIT Summit will be held on Wednesday during the HIMSS conference. It will feature several former National Coordinators reviewing health IT during the last decade. It will be followed by an audience participation session to discuss what role health IT should play in the next decade. If they keep the CCHIT Summit events as part of existing conferences, they will definitely increase their chances for meaningful participation.

Along with the change in mission, CCHIT has restructured its board of trustees and will be replacing the CCHIT commissioners with stakeholder advisory groups. CCHIT was a leader in EHR certification and it will be sad to see them go, but I’d bet they’re not the only one that exits the business. At this point, there are fewer EHRs certified for MU2 than there were for MU1, and as more vendors abandon the Meaningful Use arms race, there won’t be as many products going through the process.

What do you think about CCHIT leaving the certification business? Leave a comment or email me.


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

More news: HIStalk Practice, HIStalk Connect.


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January 30, 2014 News 6 Comments

News 1/29/14

January 28, 2014 News 3 Comments

Top News

1-28-2014 6-24-30 PM

The VA opens procurement for VistA Evolution workgroup coordinators, the next step in replacing VistA Web with a single VA-DoD EHR viewer that supports mandated interoperability requirements. The solicitation was posted on January 27, leaving just nine days for interested companies to assemble and submit proposals by the February 6 due date.

Reader Comments

1-28-2014 1-19-03 PM

From Green Stamp: “Re: Dave Henriksen. Left Carestream Health, as you mentioned last week, and has moved on to NexTech Systems as president and CEO.” Dave’s LinkedIn profile confirms his new position with the PM/EHR vendor.

1-29-2014 3-05-40 AM

1-29-2014 2-46-58 AM

From Believe Me: “Re: CCHIT. Exiting the ONC certification business.” Unverified, but reported by more than one reader. CCHIT hasn’t responded yet. UPDATE: Verified, from an update on CCHIT’s site. CCHIT says ONC 2014 Edition certification requires a lot of testing and its federally-driven business is unpredictable, so it won’t accept any new applications for certification and recommends using ICSA Labs instead. CCHIT will change its business model to become a certification consulting firm and will partner with HIMSS to “provide both counsel and thought leadership to the health care provider and HIT vendor communities” that will include summits starting at the HIMSS conference, apparently still operating as a non-profit.  The most recent Form 990 I could find was from 2011, at which time it was paying Chairman Karen Bell $409K, Executive Director Alisa Ray $250K,  and five other employees over $100K. It would seem to me that given CCHIT’s genesis, mission, and name, it should just go away rather than trying to morph itself into the already overcrowded thought leadership business. It probably would if HIMSS wasn’t riding in on a white horse to save it, not surprising given that HIMSS formed CCHIT (along with partners AHIMA and NAHIT) in 2004.

1-28-2014 5-55-21 PM

From Hit Newbie: “Re: CMS. The MU attestation portal is having issues to Healthcare.gov. It’s laughable that there is still no API or portal designed for the volume. CMS says it won’t allow appeals for late attestations due to website downtime.”

From Bill Pare: “Re: HIMSS travel site. I notice that the login page is not encrypted. I find that ironic.” HIMSS uses a travel portal from nuTravel. I checked the company’s documentation and it says the registration page is encrypted with 128-bit SSL, but the HIMSS travel registration page is not encrypted.

HIStalk Announcements and Requests

1-28-2014 4-38-58 PM

HIStalkapalooza registration has closed with quite a few more requests than we have capacity. Imprivata will email invitations Tuesday, February 4.

Listening: new Dum Dum Girls, lo-fi jangly indie pop.

1-28-2014 5-39-46 PM

Welcome to new HIStalk Gold Sponsor Treehouse Resources. The company connects qualified Epic consultants with clients interested in hiring them at market-leading rates with hassle-free paperwork. The free, five-minute signup for consultants allows them to privately review opportunities that meet their career and life balance goals, even optionally becoming a W-2 hourly employee of Treehouse. Treehouse checks references and approves the consultants, then clients review the consultant profiles, arrange interviews, and let Treehouse manage the invoicing and billing. The company’s model (which is kind of like Angie’s List or Match.com) focuses on efficiency and doesn’t require recruiters or salespeople, meaning consultants make more money and clients pay some of the lowest rates in the country. At the moment, 487 consultants (of 1,100 who requested to participate)  and 88 clients have signed up. You most likely know the principals behind Treehouse, Glenn Galloway and Mike Tressler, both previously with Healthia Consulting and longtime friends of HIStalk. Thanks to Treehouse for supporting HIStalk.

Upcoming Webinars

February 5 (Wednesday) 1:00 p.m. ET. Healthcare Transformation: What’s Good About US Healthcare? Sponsored by Health Catalyst. Presenter: John Haughom, MD, senior advisor, Health Catalyst. Dr. Haughom will provide a deeper look at the forces that have defined and shaped the current state of U.S. healthcare. Paradoxically, some of these same forces are also driving the inevitable need for change.

February 12 (Wednesday) 1:00 p.m. ET. Healthcare CO-OPs and Their Potential to Reduce Costs. Sponsored by Health Catalyst. Presenters: David Napoli, director of performance improvement and strategic analytics, Colorado HealthOP and Richard Schultz, VP of clinical care integration, Kentucky Health Cooperative. Consumer Operated and Oriented Plans (CO-OPs) were established by the Affordable Care Act as nonprofit health insurance companies designed to compete in the individual and small group markets. Their intended impact was to provide more insurance options for consumers to pay for healthcare.

February 13 (Thursday), 12 noon ET. Advancement in Clinician Efficiency Through Aware Computing. Sponsored by Aventura. In an age of information overload, a computing system that is aware of the user’s needs becomes increasingly critical. Instant-on roaming for virtual and mobile applications powered by awareness provides practical ways to unleash value from current HIT investments, advancing efforts to demonstrate meaningful use of EHRs and improve clinical efficiencies. The presenters will review implementation of Aventura’s solution at Orange Coast Memorial Medical Center.

Acquisitions, Funding, Business, and Stock

1-28-2014 8-26-12 PM

Secure messaging provider TigerText raises $21 million in a Series B round. Its secure, industry-agnostic solutions sends encrypted messages that self-destruct after a preset time.

1-28-2014 4-42-11 PM

Perceptive Software reports adjusted revenue growth of 70 percent in Q4.

1-28-2014 4-43-20 PM

Patient engagement provider Relatient closes its first round of funding led by former AIM Healthcare Services president Jim Sohr. The company sends health-related messages including reminders for appointments, outreach, collections, and surveys.

1-28-2014 4-43-59 PM

Covisint reports Q3 financials: revenue up one percent, adjusted EPS -$0.10 vs. -$0.09.

1-28-2014 4-44-39 PM

Informatica reports Q4 results: revenue up 18 percent, adjusted EPS of $0.49 vs. $0.41, beating analyst estimates on both.

Apple reports Q1 numbers: revenue up 5.7 percent, EPS $14.50 vs. $13.81, beating expectations but releasing disappointing current-quarter guidance. Shares dropped 8 percent Tuesday on the news. Sales of the Mac and iPad beat expectations, but iPhone sales fell short and iPod sales were down more than 50 percent year over year. Analysts variously blamed smartphone sales, lack of new products, slow growth in China, and the inability of the iPhone 5c to create a strong low-cost entry in the smartphone market.


Kaiser Permanente Announces Data Warehouse Project

1-28-2014 4-45-15 PM

1-28-2014 4-46-05 PM 1-28-2014 4-46-33 PM

Health Catalyst closes $41 million in Series C funding led by Sequoia Capital and announces plans to invest $50 million in product development over the next 24 months. Investors also include customers Kaiser Permanente and Partners HealthCare.

I spoke to CEO Dan Burton and President Brent Dover before the announcement.

Burton says Kaiser will roll out Health Catalyst’s data warehouse platform for all 38 of its hospitals. “While we have worked with other large health systems – earlier in the year we signed with Partners in Boston and Providence – but Kaiser is almost in a class by itself in terms of size and scale. The nature of the first project is system-wide, a terrific test of the scalability of our platform.”

Burton says Kaiser will initially use Health Catalyst for two projects. “They have a specific need for system-wide access to a subset of data around transplant patients,” he explained. Dover added that Kaiser is working on a specific project for diabetic patients in Colorado. “Kaiser is reaching out to diabetic patients. They were going after patients using spreadsheets and complex SQL extracts. They told us Health Catalyst builds a cohort in 180 seconds when it used to take 180 days. This allows them to proactively go after patients for population health management.”

Eleven of Health Catalyst’s customers, including Kaiser, are Epic clients. I asked Burton why Kaiser chose a third-party tool over Epic’s Cogito data warehouse and reporting platform. “In our experience, it’s an apples to oranges comparison,” he said. “Cogito offers basic functionality from a data storage perspective that could meet rudimentary needs. We’re offering a data warehouse as a platform for transformation from an advanced clinical apps perspective.” Dover added, “When I worked at Medicity, customers always asked for analytics tools. No client really knows what they want to analyze – it’s a never-ending list. The market demands an incredibly flexible platform. We have 17 case studies and none of them have anything to do with each other – it’s what each of them needed to improve quality and cost.”

I asked Burton about the $50 million in product development to create 200 advanced clinical applications. “A couple of our longstanding customers, Texas Children’s and Stanford, worked on specific areas to identify inefficiency and variation of care in heart failure and asthma patients, showing where the variation existed, what needed to change, and tracking progress, even tracking the return on investment of the improvement. At a CEO level, said they need to target 20 applications per year over the next five years to measurably and meaningfully bend the cost curve to allow them to not only survive, but thrive and lead. That opened our eyes that what our clients are seeking is a roadmap. We decided to become a company that offers hundreds of analytic applications so we can be a long-term partner to help these health systems transform themselves.”


Vermont IT Leaders will incorporate Orion Health’s Rhapsody Integration Engine into its statewide HIE that runs on Medicity.

VHA selects Xerox to automate its healthcare claims pricing process.

Allina Health (MN) chooses Strata Decision Technology’s StrataJazz for cost accounting.


1-28-2014 9-37-23 AM

VMware names Chris Wolf (Gartner) CTO for the Americas.

1-28-2014 3-20-49 PM

Culbert Healthcare Solutions promotes Gibran Cotton to director of GE and Allscripts consulting.

1-28-2014 6-59-09 PM

Halifax Health (FL) promotes Tom Stafford to CIO.

1-28-2014 5-38-08 PM

Brian Ahier was interviewed last week in studio on WFED, Federal News Radio, where he talked about health IT and ONC’s recent annual meeting. He also gave a nice plug for HIStalk as the best place to keep up with healthcare IT news.

Divurgent hires Jeff Powell (AT&T) as client services VP and Anthony Jones, Shaun Sangwin (Vascular and Interventional Physician Partners), and Justin Stefano (MedSys Group) as regional client services directors.

Announcements and Implementations

1-28-2014 6-48-07 PM

Walter Reed National Military Medical Center (MD) implements AtHoc Interactive Warning System for mass notification and interactive hospital communications.

Long-term care provider Levering Management (OH) deploys the COMS Interactive Daylight IQ product suite covering disease management, care guides, and nursing assessments.

1-28-2014 11-43-27 AM

HIMSS announces that the ONC’s Karen DeSalvo, MD will offer opening remarks at 8:30 am, Thursday, February 27, the closing day of the HIMSS conference.Too bad the mass exodus of attendees will begin Wednesday afternoon.

1-28-2014 6-51-04 PM

OhioHealth O’Bleness Hospital goes live on McKesson Paragon.

Memorial Hospital (MS) goes live on Cerner March 15 and will later implement analytics software from Health Catalyst.

1-28-2014 6-00-09 PM

1-29-2014 4-08-03 AM

Hearst Corporation announces the creation of Hearst Health, a new brand that encompasses its healthcare information businesses that include First Databank, Zynx Health, MCG, Homecare Homebase, and Map of Medicine. It also involves a new startup fund, Hearst Health Ventures, and Hearst Health Innovation Lab, which will prototype internal and external health IT projects. The innovation lab will be run by Chief Innovation Officer Justin Graham, MD, MS, previously CMIO of NorthBay Healthcare (CA), who joined the company in July 2013.

1-28-2014 6-06-18 PM

Mobile Heartbeat announces Mobile Heartbeat CURE, a smartphone-based location and communications application for clinical teams.

1-28-2014 7-19-13 PM

Mobile charge capture vendor pMD will announce Wednesday a partnership in athenahealth’s More Disruption Please program in which its product will be integrated with athenahealth’s billing and practice management systems.


1-27-2014 2-07-13 PM

A Commonwealth Fund study finds that practice EHR adoption rose considerably from 2009 to 2012, but solo physician practices lag in use of functions such as electronic data exchange with other providers. Practices associated with IDNs had the highest rate of technology adoption.

Black Book names its #1 HIE vendors in several categories: Covisint (payer/insurer based); ICA (core HIE); Cerner (inpatient EHR); Allscripts dbMotion (ambulatory based); and Infor (complex technology services).

1-28-2014 7-32-35 PM

Microsoft will rename its SkyDrive could storage to OneDrive after losing a trademark battle with British broadcaster BSkyB.

1-28-2014 8-13-07 PM

Concierge medicine provider PlushCare launches an Indiegogo campaign to create its service and to provide children with immunity to measles. It’s a confusing combination, but donors who are California residents get email, telephone, and video visits, and as a bonus, recognition for immunizing a child. The company says two Stanford MDs will diagnose and treat simple illnesses or injuries the same day. The tech guy is Ryan McQuaid, former product head for AT&T ForHealth.

1-28-2014 7-45-43 PM

Something’s fishy here: a Canadian company called Kallo Inc. claims to have sold the Republic of Guinea $200 million US worth of healthcare software that includes systems for hospital, telehealth, and pharmacy. The fishy part is that the company’s shares trade OTC for $0.15, valuing the entire company at $46 million, with shares having dropped almost 30 percent on the news of the big sale.

Weird News Andy is breathless over these stories. Researchers find that use of mouthwash raises blood pressure and increases the risk of heart attack, although the study involved only 19 patients and the increase in diastolic blood pressure was small. Another group of researchers finds that dogs can be trained to smell cancer in the same way they can sniff explosives or human scents, leading to the possibility of creating instruments that can detect the same odors to sense cancer.

Sponsor Updates

  • Madison Memorial Hospital (ID) reports an annual benefit of $327,658 following the implementation of Craneware’s Chargemaster Toolkit and Pharmacy ChargeLink.
  • Wolters Kluwer Health and Laerdal Medical introduce vSim for Nursing, an online learning solution that simulates curriculum-driven patient scenarios.
  • 3M Health Information Systems releases an enhanced version of its Code Translation Tool to convert ICD-9-based custom problem lists into ICD-10 coded problem lists for import back into a provider’s existing EMR.
  • Forbes names Kareo to its annual list of “America’s 100 Most Promising Companies.”
  • Sandlot Solutions will offer the White Pine Systems SPINN patient engagement platform to its HIE and ACO clients.
  • InstaMed reports it enables payers to achieve the highest levels of electronic payment adoption with its fully integrated Claims Settlement Complete.
  • Physicians’ Choice (CA) discusses in a case study how it uses Capario to process more than 24,000 claims a month.
  • In a case study, Bozeman Deaconess Hospital (MT) shares how Quantros Safety Event Manager improved patient safety and satisfaction.
  • Nuance Healthcare reveals details of its Conversations Healthcare 2014 conference April 6-9 in Phoenix.
  • Alan Lundberg, Informatica’s principal marketing manager for emerging products, blogs about the value of business intelligence in business operations.
  • SCI Solutions launches Provider Network Manager, a technology platform and service for health systems to create better managed affiliations with independent and employed providers.
  • Bethesda Magazine spotlights GetWellNetwork founder and CEO Michael O’Neil, who discusses the creation of his company.
  • Novation awards Paragon Development Systems (PDS) a VAR agreement for hardware and IT services.
  • BlueTree Network co-founder Reggie Luedtke shares four healthcare trends to be excited about in a Forbes article.
  • CCHIT certifies that Healthwise Patient Education EMR Module version 10.0 is compliant with the ONC 2014 Edition criteria as a Modular EHR.


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

More news: HIStalk Practice, HIStalk Connect.


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January 28, 2014 News 3 Comments

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Reader Comments

  • Rock: Great answers, you did the AFMS and KAFB ED proud. I will miss working with you!...
  • Rich Hammond MD: I am a newer doctor (just finished fellowship) and I have different thoughts. I don't understand why the clinical record...
  • Robert D. Lafsky, M.D.: OK I don't want to be a shill for Epic, but in that environment I can easily look now at all the documents in time order...
  • Not from Monterey: "There’s no reason other than navel-gazing narcissism to tell a breathlessly anxious world – whether in the break ro...
  • Kermit: Thanks for referring to the "US healthcare non-system". The US has a healthcare industry, not a healthcare system (excep...

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