From Sal the Stockbroker: “Re: HIStalk. For seven of your 10 years I worked for a healthcare IT company and followed you religiously, even though you trashed our marketing a few times (we deserved it!) I still follow three years after I left IT. While dispensing news, opinion, rumors, and research, you all seemed almost like family. I will still follow, if nothing else but to see the latest Spotify playlist or WNA’s weekly clincher. Thanks to all of you, including Mrs. HIStalk for putting up with your insane work hours, loud music, and blogging obsession.” Thanks for the encouragement – it helps during those long, lonely evenings. Mrs. H probably knows my music only from the bass and drum beats since my room (office? study? den? All sound pretentious) is above the kitchen, although she works in that room only a fraction of the time I’m in mine — she’s often asleep in bed by the time I’m finished. I’ve started using headphones, though, since the sound is cleaner.
Happy 2013. It’s not even 9:00 a.m. Eastern time on New Year’s Day as I’m writing this and the web stats show that 30 people are reading HIStalk online right now. I figured everybody would be sleeping in, so it’s either early-rising go-getters or hard-partying folks who haven’t yet called it a night who are reading Ed Marx’s piece on creating a family plan.
My New Year’s Day plans including watching the Rose Parade with Mrs. HIStalk, the only televised parade I’m willing to watch with her since I have zero tolerance for dull scripted banter, endless product placements, anything related to Disney, and lip-synching, bottom-feeding pseudo-celebrities pitching lame TV shows that are, not coincidentally, airing on the same TV network that’s running the parade. (I repeatedly recite those observations while we’re watching the Thanksgiving and Christmas parades until we’re mutually relieved that I wander off to Netflix or the iPad.) The comes bowl games, which interest me for around 30 minutes until I go do something else, and then we always eat hot dogs as a New Year’s tradition since we were so poor when we were first married that we couldn’t afford anything else to eat on the folding card table and chairs that served as dining room furniture, which was fine because we didn’t have a dining room either. Then it’s back to work tomorrow and the inevitable HIMSS conference ramp-up that awaits through March once I get home each day.
Final December stats for the one reader who asks: 116,659 visits and 224,820 page views, up considerably from December 2011’s numbers.
HIStalkapalooza details and sign-ups will be up on January 19 or thereabouts.
Pain Clinic of Northwest Florida, Inc. files a lawsuit against Allscripts for pulling the MyWay rug out from under the practice, also seeking to have their complaint certified as a class action lawsuit. The wording of the complaint reads like someone dashed off an angry e-mail and their attorney just pasted it into a Word lawsuit template. It says MyWay was “buggy,” that Allscripts had little ability to bring it up to HITECH standards since they acquired rather than developed the source code, and the company made “fraudulent” statements insisting that the integration of MyWay was going great until the company “admitted defeat” in October 2012. It also claims that Allscripts told MyWay users they would be charged “thousands of dollars in fees” to get access to their own databases if they chose to walk away and that in some cases users were upgraded “without that user’s consent or knowledge” (how is that possible?) It’s easy to understand why the practice is upset – they bought MyWay four months before it was put on life support.
Welcome to new HIStalk Platinum Sponsor EDCO Health Information Solutions of Frontenac, MO. The company has been helping healthcare organizations and HIM departments manage their patient information for over 50 years. Its Solarity software creates a complete electronic patient record, indexing and reviewing documents in a single step using proprietary document recognition algorithms instead of bar codes to index documents faster and more accurately. The result is a streamlined HIM process, improved return on investment on EHR systems via increased efficiency and physician adoption, and reduced A/R days due to faster chart turnaround time. The IT people like the integration, while the finance department likes paying as an operating rather than a capital expense. The company also offers the SaaS-based Solcom electronic document management system that allows hospitals to eliminate paper, enjoy seamless viewing of scanned records, and build custom workflows to maximize efficiency, all of which contribute to proactive revenue cycle management, point-of-service information capture, use of remote coders, and a fully electronic chart. Check out the case studies from Allegiance Health, Health First, Ottawa Hospital, and others. Thanks to EDCO Health Information Solutions for supporting my work.
I found this video on EDCO Solarity. It’s a nice 70-second overview.
It’s a new year, so it’s time for the HISsies Awards to start up. What were the smartest and stupidest vendor actions of 2012? Which companies are the best and worst? What buzzwords are you sick of? If you had a pie, in which industry figure’s face would you like to throw it? And in the more serious categories, who’s your choice for Industry Figure of the Year and the Lifetime Achievement Award? It all starts with the nominations, from which the final ballot will be created. The nominations form is open and your civic duty calls.
This is a chance for you to spare me the frequent and frustrating after-the-fact dialog in which someone claims that I’m clueless or biased because their pet choice wasn’t included on the HISsies ballot. I patiently explain that had they and their like-minded peers spent 30 seconds filling out the nomination form instead of complaining, their preference might well have been on the ballot. It’s simple Civics 101 – the most-nominated choices go on the ballot. Don’t assume someone else will do your work for you in nominating your preference. Nominate now or forever hold your peace.
I’ll create the final ballot in a week or so. It goes only to readers who have subscribed to the e-mail updates, which prevents the admittedly fun ballot box-stuffing that happened during the first few years of the HISsies. Back then I was just happy that companies wanted a good-category win (“best vendor” or “best CEO”) enough to strong-arm their employees to vote for them.
Last year’s HISsies results are here if you need a refresher. I’ve done the Lifetime Achievement Award for two years and no repeat winners are allowed, so nominate someone other than John Glaser and Judy Faulkner.
From Thankful: “Re: 10 years of HIStalk. I’m not sure I’d be as competent as I am now, as an HIT professional, without the 10 years of contributions from you and your team. I’m not one for trying to make people remember me; I’d rather do what makes sense at the moment. But in all honesty the HIStalk contributors are all getting nice words for your tombstones!” Thanks. It’s hard to believe I wrote the first HIStalk in 2003 and haven’t stopped. I doubt my tombstone gazers and obituary readers will care about HIStalk, so its eventual absence there probably means I need to find a more lasting and non-anonymous legacy.
From The PACS Designer: “Re: TPD’s List of iPhone Apps. Working on an update, so let me know of apps that readers might like.” The fitness apps I’m using at the moment are Half Marathon with Jeff Galloway (I’m training for spring 13.1, with my longest single run being this past weekend’s rather chilly 11 miles), and from the same developer, XFit Push Ups.
Two-thirds of poll respondents say Allscripts can’t successfully compete with Epic and Cerner. New poll to your right: are you confident that your doctors and hospitals can keep your medical information secure and private?
I’ve created a new Spotify playlist with what I’m listening to at the moment: The Shins, Sam Phillips, Everything But The Girl, Bob Mould, The Jayhawks, and quite a few more artists old and new. I firmly believe that you’re headed down the slippery slope to codgerly irrelevance if you just keep mindlessly listening to the same old songs or the musical equivalent of a minivan (unchallenging jazz, computer-assisted dance music, or soundtracks), so I’m always trying new stuff.
Greenway CEO Tee Green gives advice to entrepreneurs contemplating eventually taking their company public:
Think long term.
Structure your board and run its meetings like a public company would.
Bring in a CFO and general counsel with IPO experience and start quarterly reporting as practice.
Build relations with investment bankers and choose outside counsel they have worked with previously.
Choose reliable auditing and accounting partners.
Petroleum industry BI vendor Drilling Info Inc. names former QuadraMed CFO Dave Piazza as its CFO.
Allscripts files its SEC 8-K form for the departure of Diane Adams, EVP of culture and talent. She gets 12 months’ severance, her target bonus, a year of health benefits, accelerated vesting, and a retention bonus. She does even better if the company changes hands in 2013 – she’ll get two years’ salary and bonus.
Gibson General Hospital (IN) notifies 29,000 patients of the theft of an employee’s unencrypted laptop from their home, presumably an IT support person since the hospital stated that the employee’s job “requires around-the-clock access to the hospital’s electronic medical records system.”
Kentucky’s Cabinet for Health and Family Services is notifying over 1,000 Medicaid recipients that their information was exposed when an employee of Carewise Health, a subcontractor for the state’s Medicaid computer system HP Enterprise Services, fell for a telephone scam and gave an unknown hacker access to the employee’s laptop.
Congressman Brian Higgins (D-NY) uses the House floor to urge increased adoption of electronic medical records. Translation: keep the EMR-related dollars flowing to his district, with the specific bacon he brought home helpfully listed in the press release to impress the folks back home.
Brian Ahier posted this presentation from HHS CIO Frank Baitman that lists the department’s challenges for 2013.
Vince sends this HIS-tory of Quality Systems / NextGen, getting into the spirit of the company’s dental origins by throwing down a challenge to find all the tooth-related references he included (I counted five).
Happy New Year to everyone. History suggests that I’m going to be super busy from now until after the HIMSS conference, so if you need anything from me, now’s the time.
A year-long investigation by The Washington Postfinds that healthcare is among the sectors most vulnerable to hackers because it lags other industries in fixing known security holes, quoting one expert who said, “If our financial industry regarded security the way the healthcare sector does, I would stuff my cash in a mattress under my bed.” A physician user of OpenEMR, which was called out in the article for its security vulnerabilities, left this comment:
I maintain OpenEMR under Linux at my wife’s medical clinic. Behind two firewalls, not accessible over the public internet. We considered WorldVista, but that is written in MUMPS, and requires Windows clients (not on our network). WorldVista is more suited to megapractices like the VA system it was written for. OpenEMR has many problems, but being open source, the problems are being found and fixed rapidly. Software developers are encouraged to join the effort to improve it. Other alternatives include hugely expensive systems like Epic (which infests most local hospitals) and various Web-based services moving information over the public Internet (dangerous!) That is how Epic works – and anyone with two login/passwords to a megahospital system can get access to hundreds of thousands of patient records. Scary, yes – but if more barriers are added, time is lost and PATIENTS WILL DIE.
HIStalk Announcements and Requests
I don’t need an Official Red Ryder Carbine-Action, 200-Shot Range Model Air Rifle, but I could use some gifts that carry no danger of shooting my eye out: (a) sign up for spam-free e-mail updates, basking in the knowledge that doing to will make you eligible to vote in the upcoming HISsies awards; (b) support HIStalk’s sponsors by reviewing and possibly clicking their ads (now on your right), checking out their listings in the Resource Center, and using the couldn’t-be-easier Consulting RFI form to painlessly solicit consulting proposals; (c) connect our respective social ganglia on Facebook, Twitter, and LinkedIn; and (d) slip us news and rumors via the methods listed under the “Report News and Rumors” box to your right, which includes a new option: call my Rumor Line at 801.HIT.NEWS and leave a message, which thanks to Google Voice will be transcribed and e-mailed to me along with the original recording.
It’s almost New Year’s, so I’m setting my priorities for 2013. I’m looking for HIStalk-related projects or activities that would be more personally satisfying and society-benefiting than just making money, which doesn’t interest me all that much (obviously, since I work for a non-profit hospital). Thoughts?
Acquisitions, Funding, Business, and Stock
Awarepoint secures $4 million in new financing from an undisclosed investor.
McKesson says its $2.1 billion purchase of PSS World will be finalized in the first quarter.
The Oregon Community Health Information Network (OCHIN) names Scott Fields, MD (OHSU – above) CMO, Jonathan Merrell (Cherokee Nation Health Services) VP of performance improvement, Tim Burdick, MD (Fletcher Allen Health Care) CMIO, and D’Angela Merrell (US Public Health Service) clinical improvement professional.
Announcements and Implementations
HIEs Healthcare Access San Antonio and Integrated Care Collaboration begin sharing patient information.
Mercy McCune-Brooks Hospital (MO) goes live on Epic.
Texas Health Harris Methodist Hospital Alliance (TX), which opened as a new 50-bed hospital in September, earns HIMSS Analytics EMRAM Stage 7 recognition. I interviewed Winjie Tan Miao, the hospital’s president, two weeks ago.
The NJSHINE (NJ) HIE gets a $1 million grant from the New Jersey Department of Health to connect seven hospitals.
Consumer Reportsrates the performance of 19 Wisconsin medical groups based on quality measurements for cancer screening, care of people age 60 and older, and treatment of patients with heart disease. ThedaCare Physicians and Marshfield Clinic earned the top spots.
The LSU hospital system notifies 416 patients that their information, including checking account numbers, has been stolen. A former billing department employee and six other people have been charged with identity theft after creating and passing counterfeit checks and ID cards from scanned check images stored in LSU’s computers.
Pittsburgh systems UPMC and West Penn Allegheny fight to acquire each other’s affiliated physician practices, leaving patients unaware of the change and sometimes forcing physicians to practice outside of Allegheny County beginning immediately without notifying their patients to satisfy non-compete clauses. The medical records stay with the practice, leaving the patient to figure out their options
University of Michigan Health System notifies 4,000 patients that their information may have been exposed in the theft of an unsecured PHI-containing electronic device from the car of an Omnicell employee.
Efforts by the Metropolitan Chicago Healthcare Council to create Chicago-area HIE may fail as just 18 of 30 targeted health providers agree to join. Money is a sticking point, with some hospitals being asked to pay six-figure annual fees to participate. Health systems are also concerned with the uncertain value of the exchange, especially at a time many are investing heavily in their own IT systems.
A third of providers say they have experienced varying levels of payment delays during the HIPAA 5010 transition, with clearinghouses causing 52 percent of those delays, according to a KLAS report.
Hospital CFOs look ahead to 2013 with concern, worried about:
The resources required to justify admissions
Possible payment and cash flow problems due to Medicare changes
Funding quality initiatives to support value-based payment systems
The high cost, questionable return, and change involved with technology implementation
Hiring more doctors
Trying to scale physician compensation to what the practice actually produces
Engaging physicians who practice only an outpatient setting
Managing growth by acquisition
Improving clinical documentation for patient safety and quality
A maternity hospital in a Nairobi, Kenya slum admits that it holds mothers of newborns as prisoners until they pay their hospital bills. The hospital is accused by one woman of having guards beat mothers who try to leave without paying. According to the hospital’s director, “We hold you and squeeze you until we get what we can get. We must be self-sufficient. The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers. They stay there until they pay. They must pay. If you don’t pay, the hospital will collapse.” The charge for a normal birth is $35, while a C-section runs $70 and the daily room charge is $5. A first-person report (from which the above photo came) is here.
Vonlay offers tips on how to quickly recycle an IIS application pool in a blog pos.
PeriGen hosts a Webcast on improving financial results in obstetrics January 16 and 30.
Shareable Ink’s President Stephen Hau discusses mHealth applications and how they can liberate physicians and data in a guest article.
Dennis Weissman, founder of Washington G-2 Reports, will deliver the keynote at the Lifepoint Informatics user conference Orlando March 21.
Liaison Technologies offers a white paper discussing the use of cloud-based data integration to overcome interoperability challenges in health systems.
API Healthcare executives participate in a giving back campaign.
Business NH Magazine names Digital Prospectors Corp a top small company to work for in New Hampshire.
Dave Caldwell of Certify Data Systems shares insights on the barriers and issues that need to be addressed in order for the healthcare industry to achieve widespread interoperability.
Besler Consulting will participate in next month’s HFMA MA/RI Annual Revenue Cycle Conference in Foxborough, MA and the Region 11 Annual Healthcare Symposium in Las Vegas.
Thomson Reuters includes 3M, AT&T, and Fujifilm on its list of the World’s Top 100 Most Innovative Organizations for 2012.
Saint Luke’s Health System (MO) shares how Philips Healthcare Consulting helped the organization build an eHealth strategy of regional outreach and physician-to-physician relationships to drive growth.
ZirMed releases its 2013 PQRS Suggested Measures and Monitoring tool.
EPtalk by Dr. Jayne
The use of Health Information Exchanges is one of my pet topics, particularly issues around governance. I’m happy to see ONC hosting one of their Town Hall meetings on the topic. It will be held on January 17, so there’s still plenty of time to sign up.
It’s always fun to get together with family over the winter holidays. This year’s hot topic among the Medicare set was the concept of Accountable Care Organizations. They wanted to know my opinion. Unfortunately, I had to give the answer of, “It depends.” Even though there are core principles for ACOs, there seem to be many different flavors out there.
Patients need to realize that a key driver of ACOs is slowing the growth of healthcare spending. Quality and meeting patient needs are also goals. For patients involved in ACOs that have a long history of managing quality and cost initiatives, there may not be much of a difference in care because referral relationships and practice patterns are already established. However, for health systems that have not been functioning in shared care models, there may be trouble ahead. There will be a significant learning curve for participating physicians and their care teams.
The subtleties of the ACO patient assignment regulations can cause situations where providers are ensnared by a single ACO. Patients also need to find out whether they will be able to continue to see all the providers from whom they receive care or whether they will have to change to specialists within the ACO. I also think it’s funny that when seniors are talking about ACOs and their benefits, they refer to the Affordable Care Act. When they’re talking about the negatives, they refer to Obamacare. They’re one and the same, folks.
With the holiday, it was a snow news week. Hopefully as people are trickling back into their offices things will pick up. In the mean time, please give your friends at HIStalk the best gift of all – send your rumors, newsy tidbits, and other reports our way.
From The PACS Designer: “Re: 802.11ac wireless. As we approach 2013, our wireless technology infrastructure will bring a key change that will excite users. The 802.11ac wireless specification is an upgrade to the new communications band called the 5 Gigahertz frequency spectrum. The currently crowded 2.4 Gigahertz frequency spectrum in 802.11n will still be usable as most of the new 5 Gigahertz routers being designed are backward compatible. The 802.11n routers installed everywhere today can remain in place, and the new 802.11ac routers can be placed at key points in the network to improve the overall speed of communications. The 5 Gigahertz spectrum is new and unused with a 1 Gigabit per second speed upgraded from 450 Megabit per second in 802.11n. This faster network technology will bend nicely with 1 Gigahertz Ethernet switches in use today.” The article brings up an interesting fact: the maximum theoretical 802.11ac speed is 3.5 Gbps, meaning that your 4G LTE smartphone could eat up your monthly bandwidth allocation in about two seconds.
Don’t be startled – you’re in the right place. I’ve given HIStalk a much-needed update. Even its formerly smoking doctor celebrity endorser has received a makeover, surrendering his reader-polarizing pipe while refusing (like a doctor clinging to paper charts) to abandon his favorite reflector headband thingy. I wanted to make the site easier to read, with the design itself being less of a distraction. We will all need a week or so to get used to it, I predict, at which time I may run a screenshot of the old design just to illustrate how much cleaner the new one is.
Speaking of the reformed smoker doc, thanks to the folks at Dodge Communications for designing the new logo. I asked CEO Brad Dodge if he could recommend someone for logo design and he volunteered to have the company create one, with SVP Brian Parrish taking the lead. I really appreciate that, and I think Brian did a really nice job in creatively accommodating my requests: (a) retain the doc figure and reflector; (b) use a typewriter-like font as a nod to reporting (c) keep it simple; and (d) come up with variants that work for HIStalk Practice and HIStalk Connect.
Allscripts is further damaging its beaten-down public image by suing NYCHHC for choosing Epic, at least according to 57 percent of poll respondents. New poll to your right, another Allscripts-related one since they’re making all the pre-Christmas headlines: can Sunrise successfully compete with Epic and Cerner, giving its reps something to wear other than a lapel pin featuring a white flag?
ONC posted its Patient Safety Action and Surveillance Plan for public comment late Friday afternoon. This is the report that address IOM’s November 2011 recommendations. The proposed requirements challenge vendors to regulate themselves in more structured ways as providers are encouraged to report the patient safety problems they observe. Some highlights:
Add certification criteria requiring EHR vendors to include in their products the capability for users to submit EHR-related safety problems using AHRQ’s Common Formats, which includes a new category of “Device with Health IT.”
Develop a code of conduct for EHR vendors that will hold them accountable for problems and require them to report their IT-related safety events through a Patient Safety Organization.
Require vendors to maintain records of complaints for review by certification bodies.
Train CMS surveyors to identify IT-related safety problems.
ONC will monitor events submitted to FDA’s MAUDE medical device problem database.
Use ONC’s standards and certification criteria to enhance patient safety, including incorporation of human factors and user-centered design.
Potentially add NIST-developed usability testing tool results as a certification requirement.
IOM’s recommendation for an investigative body such as the National Transportation Safety Board is acknowledged without a specific commitment, but CMS plans to advise state and accreditation surveyors on health IT-related adverse events and HHS may issue public notices for EHR-related safety problems.
Establish an ONC Safety Program to coordinate activities and analyze data.
Aprima announces that the first customer of its Aprima Rescue Plan has successfully moved from Allscripts MyWay and gone live on Aprima’s EHR. The announcement says that Crystal Community ENT (FL) had used MyWay for less than two months when it received notice from Allscripts that the product would not be enhanced to meet Meaningful Use and ICD-10 requirements.
SPi Healthcare names Louis Grujanac, DO (Accretive Health) as VP of HIM solutions.
Melissa Cruz, CFO of Progress Software and former CFO of Picis, announces her retirement.
RTLS vendor Versus Technology announces Q4 results: revenue up 77 percent, net income of $3,121,000 vs. $704,000.
In Singapore, Changi General Hospital develops an iPad-based “patient care communicator” that allows intubated patients to communicate with caregivers.
RelayHealth acquires Ahi Software, whose AHIQA patient access system is rated #1 in KLAS. It offers applications for registration, wait time tracking, eligibility, demographics verification, and patient responsibility estimation.
Park Place International recently participated in Meditech’s Adopt-a-Family program, which delivered food, gifts, and supplies to 53 families.
Weird News Andy is off on a sunny vacation, so I’m happy to step in. The Social Security Administration formally reprimands an employee for excessive workplace flatulence, saying he hasn’t supported his claim of an unspecified medical condition.
Vendor Clinician Compensation
I received the following responses from Vendor Middle Manager’s request relating to what vendors pay their clinical people. Some of those below were reported first hand, while others came from readers asking around. I appreciate the responses.
Epic subject matter experts developing clinical content: $150 per hour.
Informatics-certified RN: $70K.
RN consultant: $90-$120K with bonuses raising the potential to $110-160K. Stock options same as other employees receive.
EHR clinicians: $130-180K for work that’s 50 percent consulting and 50 percent design.
Demo team physicians and nurses: $150-180K with half of the 20 percent bonus tied to sales success.
RN doing demos: $85K base with compensation structure than puts them over $125K on the low end.
Vendor CMO/CNO: $300K salary plus bonus of up to 40 percent.
Master’s degreed RNs in product management or consulting: $150-185K base with 20 percent bonus.
People celebrate a variety of holidays this time of year. Like most readers, I’m a Christmas and New Year’s guy, but I sincerely hope that whatever holidays, customs, and practices you and your family are observing bring you love and satisfaction. Business and IT stuff is important, but let’s face it, it’s not exactly inspiring material for your tombstone. I appreciate the people who are involved with HIStalk, my hobby of 10 years. That includes everyone who reads, e-mails, writes one-time or recurring guest posts, sponsors, and otherwise provides the many kinds of support that I need to keep it going when I’m questioning exactly why I’m spending most of my free time on the computer. On my side of the monitor are the people I trust with my most valuable asset – my reputation. That would be Inga, Dr. Jayne, Dr. Travis, Dr. Gregg, Lt. Dan, and Donna, all of whom work week in and week out to bring you the information you need. I’m so busy between my hospital job and my HIStalk job that I don’t always express appreciation to everybody involved in this thrilling and totally illogical 10-year run, but they don’t mean a bit less to me just because I don’t say so often enough. Enjoy your holidays, whatever they may be.
Allscripts shares closed Thursday at $9.14, down over 14 percent since Wednesday’s after-hours announcement that it would not pursue being acquired and instead will replace its executives and forge ahead. The company’s market cap is $1.6 billion. If you had invested $10,000 each in Allscripts and Cerner shares on January 1, 2000, you’d have $1,983 and $157,874, respectively. If you’d made the same investment five years ago, you would be holding $4,560 and $27,982. Obviously the company is hoping that Paul Black had enough influence in Cerner’s success to be able to replicate it at Allscripts. They’re bragging publicly on his background and Cerner’s success, which is odd given that Cerner is perhaps its most direct competitor.
From HITEsq: “Re: another patent troll. A Puerto Rico-based company, Ingeniador, is going after GE Healthcare and McKesson for violating a 2006 patent whose claims are as ridiculous as its title – ‘Publishing System for Intranet.’”” I did some digging and found that the “company” is a former Hewlett-Packard software engineer named Marcos Polanco, who developed a database management system for his employer and then sued them for royalties. Since then, he has sued everybody and their brother, including Microsoft, HP, Oracle, Lexmark, and SAP. He apparently bought the patent he’s waving around from an oil services company. He’s big on Puerto Rican enterprise, entrepreneurship, serving as COO of glucometer vendor iCare Medical, and filing ludicrous lawsuits.
From Top Chef: “Re: Paul Black. I knew him from his Cerner days. Good guy, very smart and affable. Guess he’s ready to jump into it again!” Glen and his loyalists had to be fired, of course, when the PE tire kickers passed on Allscripts, leaving the company desperate to change something (anything) to put the stench of a disastrous year behind it — missing Wall Street expectations; firing the Eclipsys supporters on its board and barely keeping Glen; caving in to a proxy fight by reluctantly adding three HealthCor-nominated board members; watching its share price drop nearly 40 percent in a single day; having word of its private equity courtship leaked publicly; choosing the worst possible time to announce the halt in MyWay development; and having its customers name it as the worst vendor in the country with their KLAS product ratings. Not to mention the final embarrassment of having the potential acquirers walk away from the smoking wreckage. Paul Black has his work cut out for him. I would like to see his first order of business be to drop the company’s ridiculous lawsuit against NYCHHC and provide an update on the Sunrise integration status, which was supposed to have gone to beta in June per Glen. I’m not convinced Sunrise is viable given lack of sales and what must be high R&D costs and a declining user base, so they need a strategy that doesn’t involve going toe-to-toe with Epic and also to re-introduce Sunrise Financial Manager, which got lost in all the juicy company turmoil. The PE guys would have trimmed the product line and headcount (7,000 employees seems like a lot), so with Glen out of the picture, those options are surely on the table. Unfortunately, they’ll have to make those decisions under Wall Street’s microscope and that’s hard. Here’s where you get the chance to play Monday morning quarterback like me: leave a comment with the 2-3 things that Paul Black needs to do first to get Allscripts on track.
HIStalk Announcements and Requests
I got my first Christmas present in the mail yesterday from a couple of my favorite gal pals: a daily shoe calendar for 2013. Each day looks better than the next!
Mr. H also gave me an early Christmas present with the refresh of the HIStalk Practice site, complete with a new logo (thank you, Dodge Communications) and a sleeker format. Take a peek and let us know what you think. This week’s HIStalk Practice highlights include a don’t miss year-in-review post by Joel Diamond, which I promise is the funniest read of the season. SRS’s EHR takes the top spot in a survey of ambulatory care specialists. The big winners and losers in KLAS’s Physician Practice Solutions categories. KLAS is criticized for favoring big vendors that subsidize KLAS operations. CareCloud names John J. Walsh CTO. Thanks for reading.
If the world ends today or if I decide that nobody will be reading on Christmas Eve, there won’t be a Monday Morning Update. I’m betting I’ll be right here over the weekend, though.
Acquisitions, Funding, Business, and Stock
Allscripts held a short investor conference call Thursday morning to go over the changes. You can listen to the recording here. My notes:
The company still won’t say whether it received any acquisition offers, only that it decided to continue as the current entity.
The CFO is aggressively looking at cost controls and productivity plans.
Black: “We’re not going to waste any time going to work.”
ICD-10 functionality is complete and Meaningful Use 2 is well underway.
“Disruptive, open technology,” common user experience, and single patient workflow.
“There will be no substitute for results” and “we need to move quickly.”
Question: who will lead the product refresh effort? Answer: Cliff Meltzer, who will continue as EVP of solutions development.
Question: since the company stopped giving guidance, how’s the quarter going? Answer: we’ll benefit from the clarity around the company’s direction. The lack of clarity this year was a misstep.
Question: was the board’s decision to stay independent unanimous? Answer: the board doesn’t comment on their deliberations. There were no dissents on Glen stepping down.
Question: is customer attrition running in line historically? Answer: I don’t have the number, but retention is steady in all facets of the business.
Question: Glen said earlier this year that the company brought on 400 employees to work on integration. Was it money well spent and are customers happy with functionality? Answer: Not all of our clients are happy and we won’t rest until 100 percent are. I won’t be happy until we don’t need a sales force because they’re beating down our doors and our fax machines are burning up with orders. R&D spend will continue at the current level.
Question: what’s the order of strategic initiatives? Answer: solidify the client base; review expenses; step up revenue, engineering, and operations to keep surprises to a minimum.
Question: was there a precipitating event that led to the changes? Answer: just the completion of the strategic review.
Question: what areas other than product innovation and R&D will be emphasized? Answer: increase emphasis on application hosting, add managed services for the large ambulatory clients, review why home health and patient flow solutions don’t seem to produce as well as the market would suggest is possible.
Question: how will the executive suite shape up? Answer: I expect to bring folks in, but review talent and promote from within if possible. I will bring in people I’m comfortable with working with and those I’ve worked with in the past.
Question: what’s the lowest-hanging fruit? Answer: the large number of doctors using the systems regularly are the mother lode and the company will build around that core.
Terms of Paul Black’s deal to take over Allscripts include a three-year contract for $1 million per year in salary and a $1.5 million annual bonus target with the 2013 payout guaranteed; a $1.25 million signing bonus; $3 million in shares vesting over three years; $3 million in incentive-based shares; $2.5 million in service-based restricted shares vesting over four years; and $2.5 million in a performance-based equity award. If he quits or is fired, he gets two years’ of severance including his bonus target (total of $5 million) and an extra year of vesting. Glen Tullman and Lee Shapiro get a parting gift that includes a year’s salary, their target bonuses, and acceleration of vesting. If the company sells itself within a year, they’ll get two years’ salary plus their target bonus.
HealthEast’s (MN) board of directors approves the $135 million purchase of Epic, which will replace seven platforms.
The US Navy and Army award Dell, BRIT Systems, and Acuo Technologies a $45 million contract to create a Unified Clinical Archive for PACS to be used by 49 medical facilities.
Meadowlands Hospital Medical Center (NJ) and Urban Health Plan (NY) choose eClinicalWorks Care Coordination Medical Record and EHR solutions to advance their ACO initiatives.
Colorado Springs Health Partners will implement the Professional Charge Capture solution from MedAptus for inpatient professional services coding and billing.
Hometown Health (NV) will deploy MedHOK’s care management, quality, and compliance platform.
SAIC wins a one-year, $17 million contract to support the Coast Guard’s Integrated Health Information System, which is the name of its implementation of Epic.
Harris Corp. names Vishal Agrawal, MD (McKinsey and Co.) president of Harris Healthcare Solutions.
Bob Hajek (Humanscale) joins Divurgent as a VP of client services.
PatientSafe Solutions names Frank Pecaitis (GE Healthcare) SVP of sales and Bruce Eklund (AHM) SVP of operations, also promoting Joseph Condurso from president/COO to president/CEO.
Tom Bang (A-Life Medical, Cardinal Health) is named CEO of post-acute care systems vendor BlueStep Systems. Former CEO Roy Rasband will move to the CTO role.
Announcements and Implementations
The 500-member American College of Medical Coding Specialists votes to join AHIMA.
The Texas Organization of Rural & Community Hospitals announces the Phase 1 go-live of its TORCH HIE at Wilbarger General Hospital (TX). It uses the CollaborNet interoperability solution from Holon Solutions.
Government and Politics
HHS’s Office of Inspect General advises hospitals that they are not violating anti-kickback statutes when they provide community physician practices a free interface to support exchanging orders and results.
Charles Boustany, Jr. MD (R-LA), chair of House Subcommittee on Oversight, sends a letter to HHS Secretary Kathleen Sebelius asking her to provide the department’s policies on archiving electronic messaging. Whistleblowers have alleged that HHS’s political appointees are intentionally using instant messaging to avoid leaving a discoverable record of their communication with department employees.
The government’s Space and Naval Warfare Systems Center, charged with developing a Department of Defense database for tracking medical examinations for officer candidates, is found to be $7 million over budget and may never deliver a working system. Administration of the contract, which was issued an Alaska firm under a government requirement that Alaska native companies receive preferential treatment, has been taken over by the General Services administration.
Innovation and Research
Yet another healthcare IT accelerator fans to life, this time in Miami. Project Lift Miami will offer 10 to 15 startups seed funding, office space, and mentoring in a 100-day program.
Microsoft is working with the military to offer Kinect-powered home physical therapy treatments to injured soldiers and veterans using the ReMotion 360 software from InfoStrat. Microsoft is also working on a Kinect-based based system for conducting online group therapy sessions for patients with post-traumatic stress disorder.
The Wilmington, DE VA hospital rolls out a visitor way-finding kiosk system that features a talking avatar named Val, which stands for “Veterans Affairs locator.” The system, which also allows visitors to pre-plan their visit online, was developed by LogicJunction.
A public radio station profiles Syracuse-based startup Simple Admit, which allows patients to complete their forms online before their provider visit.
Griffin Technology offers the AirStrap Med, a $90 sling case that makes it easier to use an iPad during rounds.
A poll finds that only a third of health system leaders are confident in their organization’s readiness for Meaningful Use Stage 2.
An interesting vision of how clinical documentation could be performed by the rounding teams of academic medical centers, offered by by John Halamka on his blog:
The entire care team jointly authors a daily note for each patient using a novel application inspired by Wikipedia editing and Facebook communication. Data is captured using disease-specific templates to ensure appropriate quality indicators are recorded. At the end of each day, the primary physician responsible for the patient’s care signs the note on behalf of the care team and the note is locked. Gone are the "chart wars", redundant statements, and miscommunication among team members. As the note is signed, key concepts described in the note are codified in SNOMED-CT. The SNOMED-CT concepts are reduced to a selection of suggested ICD-10 billing codes. A rules engine reports back to the clinician where additional detail is needed to justify each ICD-10 code i.e. a fracture must have the specifics of right/left, distal/proximal, open/closed, simple/comminuted. You can imagine that the moving parts I’ve described are modular components provided by different companies via cloud hosted web services (similar to the decision support service provider idea).
Medical device manufacturers are blaming the Affordable Care Act’s 2.3 percent tax on their products for industry layoffs, but economists say companies were already bloated in a slow market and would have had to cut jobs anyway. The manufacturers‘ trade group is trying to have repeal of the tax included in fiscal cliff negotiations, but the President says he’s not a fan of that idea.
Pediatric patients at Geisinger Medical Center (PA) receive iPad-based visits from Santa Claus in the hospital’s “Santa Cam” program.
Weird News Andy summarizes this story as “Good news, bad news.” A 27-year-old cystic fibrosis patient receives a long-awaited lung transplant, but then dies of lung cancer 16 months later. The lungs she received were from a donor who smoked heavily, which is apparently the case in 40 percent of lung transplants. The hospital trust has apologized for not disclosing that fact in their explanation of the risks involved, saying that patients almost always want whatever lungs they can get.
Sunquest hosted a December 7 fundraiser to provide foster children with Christmas gifts. The cookout, Hostess Twinkie raffle, and company donation raised over $7,000 for Aviva Children’s Services.
CTG Health Solutions launched its Holiday Military Appreciation Campaign for military family members of its employees, sending gift packages both to those serving and to their families. The company also continued its tradition of taking the money that would have been spent on customer greeting cards and instead donating it to Operation Homefront, which provides support to military families.
Cornerstone Advisors establishes Cornerstone CAres, a charitable giving program funded by employee contributions and matching company donations. Its first project was to help employees of long-time client Chilton Hospital (NJ), which was severely impacted by Hurricane Sandy. Receiving the donation was Chilton VP/CIO Mark Lederman (above).
SIS employees raised over $12,000 to purchase gifts and supplies in support of Embracing Arms home for girls, The Empty Stocking Fund, the Secret Santa Ministry, and Toys for Tots.
Liaison Technologies shares its 2013 forecast for cloud adoption, business integration, and managed services.
Levi, Ray and Shoup offers a white paper on enhanced document printing and viewing in the healthcare industry.
A White Plume blog post called “Healthcare’s Wake-Up Call for 2013-2014” warns of the urgency needed to prepare for PQRS, MU2, ICD-10, and HIX.
Fulcrum Methods provides details of how it helped NorthBay Healthcare successfully attest for Meaningful Use.
Raymond Fabius, MD, chief medical officer of Truven Health Analytics, warns employers that moving to an exchange-only health benefits model based on cost alone.
Business NH Magazine names Bottomline Technologies a “Best Company to Work For” for the fifth consecutive year.
Northwest Michigan Surgery Center shares how its implementation of Versus Advantages IR/RFIF RTLS has helped it perform as one of the nation’s top ambulatory surgery centers.
Medseek will incorporate the Healthwise Patient Engagement solution into its health content offerings.
InteliChart and RelayHealth develop a health information exchange platform that integrates with InteliChart’s suite of connectivity solutions and provides bi-directional exchange between the ambulatory and hospital settings.
Humedica and Pfizer announce a multi-year strategic alliance to use Humedica’s de-identified healthcare data to improve drug effectiveness.
EMRConsultant offers a free survey for practices interested in improving efficiency and reducing expenses.
Modern Healthcare names MedAssets as the largest revenue cycle company.
EPtalk by Dr. Jayne
CCHIT will develop an IT framework for Accountable Care Organizations, hoping to identify the infrastructure needed. An advisory panel is being formed to develop the framework, which will ultimately lead to additional CCHIT certification programs.
ONC seeks applications for two new consumer-focused HIT FACA Workgroups: the HIT Policy Committee’s Consumer Empowerment Workgroup and the HIT Standards Committee’s Consumer Technology Workgroup. Applications are due by January 14, 2013.
As if this week’s predicted apocalypse isn’t enough, a recent article cites ICD-10 as causing shock, awe, and fear. Seriously, people, we’ve known it’s been coming for years, and warning of “apocalyptic-type scenarios” is a little much. Remember Y2K? A staffer at UnitedHealth Group is quoted as saying that use of both ICD-9 and ICD-10 together will cause “mass hysteria.” Guess what? Using both will be reality for many of us, because not all payers are switching over. There’s no requirement for non-covered entities or those using paper claims to change.
I received a fair amount of feedback on my recent discussion of the Meaningful Use smoking status measure.
From Under the Mistletoe: “Dr. Jayne, you are not a hair splitter at all, and I think these descriptors are absurd. This is the calculation we always use: pack years. Certainly closer to quantifiable, not perfect, but I am really disappointed in what you described from SNOMED. How disappointed was I? Well, I could say ‘extremely,’ or would you prefer on a 1 to 10 scale with 10 as the worst possible – a 10?”
Mr. H hinted to one correspondent that I may have been “cranky” when I wrote that piece, which I guess is true. Like a reported 77 percent of physicians, I’m at least somewhat pessimistic about the future of medicine and exhibit a higher degree of pessimism after a day of seeing patients. When you’re dealing with parents who can’t figure out how to pay for a $4 antibiotic for their child (and who bring her to the ER because they don’t have Tylenol at home), some of the things we do in the informatics office seem pretty ludicrous.
HIMSS created a word cloud showing the educational offerings for the upcoming HIMSS13 meeting in New Orleans. In response, I offer up my own.
A Wells Fargo Securities analysis of EHR attestation data finds a surge in the number of hospitals and practices qualifying for Meaningful Use money, which it expects to continue through the February deadline. It also notes that Epic is starting to dominate in all measures, leading in the number of physicians that have attested in with a success rate of 35 percent and representing 21 percent of the total attestations. Athenahealth was also noted as performing at an above-average rate, with neutral numbers for Allscripts and slightly negative numbers for Quality Systems. I ran the cumulative percentages by vendor and found that 80 percent of attesting providers are represented by just 22 of the 391 vendors listed: Epic, Allscripts, eClinicalWorks, NextGen, GE Healthcare, McKesson, Greenway, Cerner, Practice Fusion, athenahealth, Vitera, e-MDs, Community Computer Service, Eyefinity, Amazing Charts, Compulink, BioMedix Vascular Solutions, MedPlus, Medflow, Aprima, Partners HealthCare, and MedInformatix.
From The PACS Designer: “Re: X-rays using your phone. Two engineers from California Institute of Technology have developed a microchip that can produce images inside objects without using the normal radiation method. The circuits operate with existing mobile phone technology but use the terahertz operating region to produce the viewable image for the phone. Terahertz radiation can penetrate through the body without damaging the tissue it passes through.”
From Vendor Middle Manager: “Re: clinician compensation. Can you ping the vendor community on the levels of compensation (salary, bonuses, options, etc.) being paid to clinicians? It’s hard to find out because of inherent reluctance to disclose compensation and the variety of titles that don’t reflect true roles. It would be great to hear anonymous examples of physician and nurse compensation with the primary role specified (doing demos, designing user interfaces, developing content, etc.)” I’ll collect and anonymously report your responses if you would care to either e-mail me or use the anonymous Rumor Report.
From Mini Me: “Re: iPad Mini. I’m interested to know how doctors are using the iPad Mini.” Me, too. If you are a clinician using an iPad Mini or an IT person involved in its rollout for clinical use, let me know why you chose the Mini and how it’s being used.
Acquisitions, Funding, Business, and Stock
Investment firm Elliott Management offers to buy Compuware for about $2.4 billion, a 15 percent premium over last week’s closing price. Elliot, which owns 8 percent of the company, says Compuware’s “execution, profitability, and growth have meaningfully underperformed.” Above is CPWR’s five-year share price (blue) vs. the Nasdaq (red). Compuware filed for a possible IPO of its Covisint Corp. unit last week and could conduct the IPO in three to six months.
Revenue cycle software provider Recondo Technology acquires eHC Solutions, an Indianapolis-based developer of EDI solutions.
pMD releases a mobile version of its patient handoff product.
PatientSafe Solutions (formerly IntelliDot) raises $13.3 million in equity financing, about half of the amount it is seeking, raising its all-time financing total to $83 million. The company offers bedside scanning solutions for medications, specimens, and breast milk along with documentation and caregiver messaging.
Rideout Health (CA) selects McKesson’s Paragon HIS as its financial and clinical solution.
ARcare (KY/AR) selects SuccessEHS PM/EHR for its 45 community health center locations.
MemorialCare Health System (CA) will implement the KnowledgeEdge Enterprise Data Warehouse from Health Care DataWorks.
Trustees of St. John’s Medical Center (WY) decide to spend $240,000 to buy eClinicalWorks as a replacement for McKesson Practice Partner, which it has been running for five years. They say Practice Partner is not user friendly and makes it difficult to document office visits.
The Premier Healthcare Alliance names Gary S. Long (Surgical Information Systems) chief sales officer.
CCHIT adds Janet M. Corrigan (National Quality Forum) and Grace E. Terrell, MD (Cornerstone Health Care) to its board of trustees and promotes Executive Director Alisa Ray to CEO.
The National Quality Forum names Christine K. Cassel, MD (American Board of Internal Medicine) president and CEO effective mid-summer 2013.
James D. Morris (Western Digital) joins Harris Corporation as group president of the Integrated Network Solutions business, which includes Harris Healthcare Solutions.
The SSI Group appoints Brian Campbell SVP of sales and Tom Myers chief strategy officer. Both will maintain their roles with MedWorth, an SSI subsidiary.
Meditech promotes Carol Labadini to associate VP for development, implementation, and support of Meditech’s ambulatory solution and Hoda Sayed-Friel to EVP of strategy and marketing.
Billing company PatientFocus adds Philip Hertik (Windsor Health Group) and Lucius E. Burch, IV (Burch Investment Group) to its board of directors.
Ormed names Bill Hockstedler (Connance, Inc.) VP of sales and marketing.
Imprivata names Carina Edwards (Nuance) as SVP of its new Customer Experience Group.
Informatica names Margaret Breya (HP) chief marketing office and EVP.
Announcements and Implementations
New Horizons Health Systems (KY) goes live on Healthland Centriq EHR.
Hutchinson Clinic (KS) exchanges CCD from its Allscripts EMR to the Kansas Health Information Network using the ICA CareAlign Exchange platform.
Orion Health announces the release of Orion Health Mobile, which allows users of Orion Health HIE to view real-time patient information on their iPhones and iPads.
Ormed sells its Canadian business to a subsidiary of Constellation Software, saying it will now focus on selling it ERP, HR, and decision support products to the US healthcare market. Constellation has completed several acquisitions this month, including buying documentation and charge capture systems vendor Salar from Nuance. Constellation also owned 21 percent of Mediware, or about $40 million worth, when that company was acquired by Thoma Bravo last month.
A profile of NewYork-Presbyterian Hospital SVP/CIO Aurelia Boyer, RN, MBA describes the organization’s use of Caradigm Amalga to analyze quality measures in real time, which she says saved $1.5 million in discovering CHF treatment variations.
Medecision’s Aerial care management system earns NCQA disease management certification.
Government and Politics
ONC recognizes Ohio for coordinating its Regional Extension Center, HIE, and Beacon Community in supporting Meaningful Use and interoperability. More than 8,200 Ohio providers have met Meaningful Use requirements, receiving $368 million in federal payments.
In England, the chair of the Public Accounts Committee says paying trusts to implement CSC’s Lorenzo system are “bribes.” An earlier report from eHealth Insider says that CSC has offered $1.6 million each to the next 10 hospitals who sign up for Lorenzo, with funds coming from the Department of Health and CSC. CSC says the report contained factual errors, while Department of Health denies the suggestion that the incentives give CSC an advantage over competitors.
An article in a North Carolina newspaper illustrates why hospitals are snapping up medical practices. Simply by buying the practice, hospitals can bill up to double or more what the same physician in the same office would have been paid for performing the same service. Non-profit hospitals argue that they deserve to bill extra because of Medicare underpayment, a higher level of regulation, treatment of the uninsured, and a higher level of staffing. The article says North Carolina Attorney General Roy Cooper is considering using of antitrust laws to keep hospitals from raising healthcare costs by buying up their practice-based competitors. It cites an example of a patient’s echocardiogram, whose cost to her jumped from a $60 co-pay to a $952 bill even though the same technician performed the same test. In the Charlotte area, more than 90 percent of cardiologists are now hospital employees, spurred by a decline in their incomes of 30 to 40 percent in the past three years.
Weird News Andy says this baby was saved by scissors, but not like you’d think. UK doctors decide to save a baby born after 23 weeks of gestation (within the limit of legal abortion in almost all US states) because she weighed the minimum one pound to be considered viable. Only later did they realize that she had been weighed without removing a pair of scissors from the scales, with her actual weight being only 13 ounces. She’s been discharged after six months (after what must have been a monumental taxpayer expense) and is doing fine.
Several Marines pay a visit to eClinicalWorks’ Westboro, MA headquarters to collect donated toys for Toys for Tots.
CommVault will pay $5.9 million for land in Tinton Falls, NJ to build its new headquarters.
A Wolters Kluwer Health survey finds that 80 percent of consumers believe they would benefit from have more control of their healthcare, though only 19 percent have a PHR. Nineteen percent also say that the most important consideration when selecting a physician is the practice’s level of technology.
Surgical Information Systems showcased its AIMS solution at this week’s PostGraduate Assembly on Anesthesiology in New York City.
PSS World Medical will offer Wellcentive’s population health management and analytics platform to its customers.
GetWellNetwork integrates Stanley Healthcare’s RTLS with its interactive patient care solution to identify caregivers entering patient rooms.
Dx-Web will offer LDM Group’s PhysicianCare and ScriptGuide products to its network of EMR vendors, expanding the relationship between the companies.
The Center for Medicare and Medicaid Innovation awards the Mayo Clinic, Philips Research North American, and the US Critical Illness and Injury Trials Group over $16 million to improve critical care in the ICU.
Billian’s HealthDATA offers strategies for providers to reduce re-hospitalization rates in a blog post.
AirStrip Technologies will add secure messaging to its applications using Diversinet’s mobiSecure SDK.
RazorInsights will incorporate Health Language, Inc.’s software into its EHR system to support standard terminologies.
Clinithink publishes the seventh installment of its seven-part blog series entitled, "Clinical NLP in Plain English."
DrFirst is ranked by Black Book as the #1 vendor of standalone electronic prescribing systems.
Report from the Healthcare Privacy and Security Forum December 2-3, Boston, MA By MrVStream
If you are not serious about your patient information security and privacy issues, the Office of Civil Rights (OCR) is, and it will have both financial and legal consequences for the entity. Just check out the Case Examples and Resolution Agreements (more on OCR to follow.)
I had the very good two days attending the inaugural Security and Privacy Forum sponsored by Healthcare IT News and HIMSS in Boston last week. It was well attended with over 250 registrants and 15 corporate sponsors. It does remind me of the early days for HIMSS (I won’t tell you how many years ago that was). It was serious, interactive, and had relevant subjects.
Here are some of the highlights and noteworthy points.
The keynote was delivered by Tim Zoph, SVP of administration of Northwestern Memorial Healthcare. He shared the greatest impact of a lack of focus on patient security and privacy is the erosion of confidence from patients and consumer towards healthcare providers, with the reported 435 breaches that affected 500 or more individuals since September 22, 2009, now totaling more than 20 million impacted individuals. Tim offered hopes and guidance to healthcare leadership that through creating a culture of security, simplifying the technology environment, using a standards-based security model, being proactive, and most importantly applying the right governance structure that is multidisciplinary, we can avoid security as one of these blind spots outlined in How the Mighty Fall by Jim Collins.
Barbara Demster, chair of the HIMSS Patient Identity (PI) Integrity Work Group, outlined that PI Integrity has direct impacts to privacy and security in the areas of operations and finance. She offered a HIMSS white paper from the Patient Identity Integrity Toolkit. The current estimate is that records are duplicated in the eight to 12 percent range, with institutions experiencing 47 percent false negative and 51 percent false positive (more problematic). The financial impacts range from administrative, regulatory, and patient care-safety. Barbara also suggests that PI integrity processes need to include stakeholders across the organization. Barbara emphasized that commitment and explicit organizational guidelines towards data governance are imperative.
Lisa Gallagher (senior director of privacy and security for HIMSS) and Bob Krenek (senior director of Experian Data Breach Resolution) presented the summary results of the 2012 HIMSS Security Survey, released December 12. Summary: (a) security budgets hold steady at 3 percent of the IT budget; (b) those organizations not conducting formal risk assessments will not qualify for MU incentives; (c) organizations need to establish a robust patient information secure environment in order to be able to safely share data externally; and (d) physician practices are not as advanced as other healthcare organizations in many areas of data security.
Sharon Finney, corporate data security officer for Adventist Health System, shared that her approach in meeting the needs and prepare for an OCR audit is moving her department from internal audit functions to risk assessment, focus on the potential risk impact, quantifying the financial risk, and engaging other departments. She also urged understanding people and process and to focus on the connecting points between each steps. She said she expects MU audits to be performed on all the institutions received funding.
Edward Ricks, VP/CIO of Beaufort Memorial Hospital suggested that to prepare for an OCR audit is to simplify the process and use outside consultants for support.
Mobile access and BYOD in healthcare are still major issues for patient information security and privacy with no single strategy, especially in the areas of device-to-device communication of PHI and home or consumer data collection. Sample strategies: Kaiser (do not allow any BYOD), Partners (restrict to technology standards — iOS only), Children’s Hospital of Central California (provide a virtual desktop environment), and others using network security to limit information access. The general agreement is that leadership is required to create a culture of patient information security. There is plenty of work to be shared by all the functional roles, but the reality is, a low amount of resources devoted and focused on the efforts of patient information security and privacy from both the administration and the white coats.
Jennings Aske (CISO of Partners HealthCare) and Darren Lacey (CISO and director of IT compliance of Johns Hopkins University and Johns Hopkins Medicine) discussed the role of cloud computing. They suggested that it is necessary for the cloud supplier to sign a BAA, disclose underlying infrastructure, obtain third-party certification, and to demonstrate disclosure transparence. They did suggest that hybrid cloud services architecture is a good compromise.
Leon Rodriguez, director of the Office for Civil Rights (OCR), made these statements in an interview:
HHS OCR enforces the HIPAA Privacy and Security Rules as well as the HITECH Breach Notification Rule.
The final HIPAA Privacy and Security Rules are expected very soon.
The greatest challenge is the transformation of the agency from a regulatory body to an enforcement agency, where the scope is expected to be broader in nature.
The director position requires a balance of business needs and the need to comply with the regulations.
OCR expects from providers a well-documented procedure and we expect the entity to follow the process. The focused is on encryption, encryption, and encryption.
The awareness of management is still lacking, which makes it difficult for healthcare organizations to meet the regulations.
OCR has to work to help consumers to understand privacy violations.
OCR is starting to move from a reactive mode to proactive audits based on risk analysis.
OCR expects more monetary restitution in the future and to expand the agency using the proceeds of the fines. $4 million was collected in 2012, but that is expected to grow.
OCR most likely will offer technology guidance, but will focus on the process.
OCR is still trying to assess the level of resources necessary to complete the audit.
Healthcare entity leadership will separate the successful implementation of a security and privacy plan from the unsuccessful ones.
Do you hear the OCR coming down the chimney to your facility? Plan to attend the Forum next year. I think you will find it worthwhile, and it may get you on the official Good List.
From John: “Re: ONC. What happened to its announced intention to publish an EHR safety action and surveillance plan? It was announced in November 2011 and was supposed to be finished within 12 months.”
From California Dreamin’: “Re: MMRGlobal’s patent trolling lawsuits for patient portals. I hear ONC and the California Attorney General are interested in the company’s reason for e-mailing individual hospitals about its patents. The company seems to be going after hospitals rather than vendors for patent infringement.” The former is unverified, while the latter does seem to be the case as the company’s lawyers cast the net wide, apparently including just about every hospital as a potential patent violator.
From Former Allscripts Employee: “Re: HHC lawsuit. I know for a fact that Glen and many others at Allscripts (as well as many outside of the company) are convinced that Epic is fleecing its customers. They feel Epic’s costs – especially the undisclosed long-term costs of operation – are outrageous and are hurting healthcare. As a former employee who participated in many C-level conversations, I’m guessing that they hope to use the lawsuit to bring those costs to light through the discovery process. Moreover, Allscripts has in fact demonstrated the integration of its ambulatory and inpatient EHRs at least one live site. And I’m sure they feel HHC could benefit from connectivity to Allscripts systems currently in place at Columbia, NewYork-Presbyterian, Memorial Sloan-Kettering, North Shore Long Island, and other NYC-based health systems serving millions of local patients whose records would be helpful to HHC providers. So while I agree it’s a dumb PR move for Allscripts, it’s not necessarily a bad business decision.”
Most poll respondents don’t think FDA should create an Office of Wireless Health, which opens up another question: if you feel that way, why? Leave a comment with your thoughts. New poll to your right: how has the Allscripts lawsuit against HHC and Epic affected your opinion of the company? As always, click the Comment link on the poll once you’ve voted to explain your position.
Speaking of the Allscripts lawsuit, the company sent over this statement in response to Friday’s HIStalk write-up:
Allscripts filed the lawsuit because NYCHHC failed to even address, much less resolve, significant concerns that Allscripts’ raised in its agency-level protest concerning the propriety of HHC’s iCIS award decision. Documents produced by HHC indicate that the agency failed to follow the rules governing the competition and overlooked hundreds of millions of dollars in potential savings offered by Allscripts’ proposal. In these times, it is critical that public procurements be awarded through the conduct of fair competitions that objectively assess the merits of competing proposals and document a reasonable basis for the decision. From all available information, the HHC award to Epic is lacking in all of these respects. Allscripts’ product is currently being used by some of the most prestigious organizations in New York, we offered substantial cost savings over the life cycle of the project, and we committed to creating more than 100 new technology jobs in the City. Had proposals been evaluated properly, we believe that our offer was clearly the best value for the City. Our goal remains the same: We want transparency in the process… we want the bid process reopened so that the competing proposals can be reviewed fairly, consistently and side-by-side to ensure that the taxpayers of NYC obtain the best value Electronic Health Record solution.
HIStalk Practice joins HIStalk Connect in receiving a design facelift, although not an identical one because of the length and type of articles. HIStalk is next and it will look very much like HIStalk Practice, which I think is easier to read and less claustrophobic than this 2007-era layout you’re reading that has served nobly for all those years.
I made a new Spotify playlist with old and new cool stuff from The Cult, Superchunk, Guided By Voices, Grizzly Bear, and others. It’s a work in progress since I may add more as I keep listening.
QxMD releases its free medical literature app, which allows browsing through topic reviews, reading journals, searching PubMed, and sharing articles via social media.
ONC announces the release of the 2014 Edition Test Method for EHR Certification.
In England, a government spending watchdog considers a review of the Department of Health’s payout to CSC for terminating its sole provider status as NPfIT was being dismantled. The Department of Health has said its ongoing support payments to CSC are funding centralized support, which critics say gives CSC a competitive advantage. Cerner has already raised concerns.
Baylor Health Care System announces that it will merge with Scott & White Healthcare, creating the largest not-for-profit health system in Texas with 34,000 employees, 42 hospitals, 4,000 physicians, and $8 billion in annual revenue. They created Vision for Texas Care site to explain the rationale.
NextGen Healthcare over sent an explanation of Michael Lovett’s new role mentioned in Friday’s post: “Michael Lovett is the senior vice president and ambulatory division manager for NextGen Healthcare. This is a newly-created role and Michael is responsible for developing and implementing the division’s strategic plan and ensuring that this plan is aligned with the company’s strategic direction.”
Just in case you missed Inga’s Friday morning post, here are the Best in KLAS winners for 2012. Notable factoids from it: (a) it was not surprising that Epic was by far the highest-ranked product suite, but McKesson Paragon beat Cerner to come in at #2, while the usual other big-hospital contender Allscripts finished next to last at #8; (b) McKesson came in last in physician practice rankings, with Cerner, Vitera, and Allscripts rounding out positions 7 through 9 ahead of it; (c) in the all-important inpatient EMR category, nobody’s even close to Epic, while Allscripts and Meditech populate the bottom; (d) Siemens Soarian takes the #1 spot for community EMR, although Prognosis, Meditech C/S, and RazorInsights had similar scores but were excluded because of confidence levels or because that’s not their primary market; (e) Epic is easier to beat in departmental systems, where it lagged other vendors in ED, scheduling, and anesthesia. The top three vendors overall were Epic, Wolters Kluwer, and 3M, while the bottom three were Agfa, McKesson, and Allscripts.
HealthTrio files a patent infringement lawsuit against Aetna and its ActiveHealth Management and Medicity subsidiaries, claiming that its patient portal patents have been violated.
Healthland will make the FollowMyHealth Universal Record Solution from Jardogs available to customers of its patient engagement portal.
A jury returns a $140 million medical judgment against an Alabama hospital following the 2008 death of one of its patients by insulin overdose. The patient’s physician had dictated the results of his medication reconciliation, and since his original paper form was being scanned, the offshore-prepared transcription was used by a nurse as an order. The patient was given 80 units of Levemir insulin — 10 times the prescribed dose — and died. Testimony in the trial indicated that India-based transcription companies like the ones involved follow more lax standards. Precyse Solutions, the American company to which the hospital had contracted its transcription services, claimed that its Indian subcontractors follow American error standards, but deposed officials from those companies testified that they do not. The defendant’s attorney said the mistake should never have happened because the nurse should not have used the unreviewed transcription document to create an order. He also says hospital employees and physicians did not know that transcription work wasn’t being performed in-house, adding that the hospital’s executives did not know even the names of the Indian companies until the deposition. Those companies had previously settled with the plaintiff.
Conservative commentator Michelle Malkin calls HITECH a "big fat bust," saying it is not adequately supervised, it has created cronyism, and it has negative effects on job creation and privacy. There’s not a single original thought in the entire piece, as it was obviously just assembled from readily available Internet content. It claims that Epic "lobbied loudest for the mandates" as one of the dated "hard-drive dependent software firms." She also makes the classic but nearly unforgivable mistake of editorializing loudly about providers who are fraudulently receiving payments for using EMRs they already owned, apparently unaware that HITECH was written precisely to encourage that practice. Unlike Cash for Clunkers, EMR drivers get paid for driving their same old cars.
An article in Iowa newspaper says that the i-PHACTS system developed by the state’s Department of Public Health in 2010 to track available hospital beds is nearly useless for placing patients because it’s only updated daily. A medical student is creating his own version, but it has the same limitation — integration with hospital systems is complex and hospitals aren’t willing to manually update their information on unoccupied beds regularly.
A North Carolina business paper profiles Greensboro-based Intellect Resources, which it says has quadrupled sales in each of the last two years as it provided consulting and recruiting services for hospitals implementing electronic medical records.
Health Management Associates, the subject of a "60 Minutes" report claiming its hospitals admitted patients needlessly, says the program’s sources were disgruntled former employees, one of them a physician who used court-sealed information provided to him by the program to amend his lawsuit afterward. The doctor changed his 2010 lawsuit when he saw sealed details claiming that the company’s ED software was being used to increase admissions, adding that claim to his own already-filed suit. HMA says its ED doctors don’t make admission decisions and they’ve stopped using the software.
An armed visitor shoots a police officer and two employees of St. Vincent’s Hospital (AL) on a nursing floor at 4:00 a.m. Saturday. Their injuries are not life-threatening. The suspect was shot dead by a second police officer.
Medicare’s $77 million fraud detection system, widely panned after audits found it had prevented only around $8,000 in fraudulent claims, is now claimed by CMS to have saved $115 million, although the report does not indicate how many providers were suspended from Medicare as a result. The report also indicates that the actual savings was $32 million, with the higher total being claimed as the future value of fraud that would have happened otherwise.
Health management and analytics systems vendor Medecision will lay off 83 employees in Wayne, PA headquarters, according to WARN act documents filed with the state. The company says those affected work in software development, program management, and technical support.
Weird News Andy is tickled by this story, which he snickeringly subtitles, “Little Angel.” Doctors eventually figure out what’s causing the swollen jaw of a seven-month-old girl: a two-inch feather embedded in her cheek.
Here’s Vince’s holiday gift for you, “The 12 Days of Go-Live.”
AMDIS Lover provided this message from the AMDIS listserv taking a tongue-in-cheek view of the Informatics Board Certification exam that launches in 2013. He says not all readers will appreciate it, but it captures the essence of existence of CMIOs. The original came from Joe Boyce, MD, CIO/CMIO of Heartland Health (MO).
Communications. Combine the following medical, cultural, and technical TLAs and FLAs into a meaningful sentence. You may use one pronoun, one verb, two prepositional modifiers, and a gerund. Ex: IMHO, CMIO NCQA PCMH FAQs without LOINC, HL-7, or SNOMED FYIs were DOA and SOL. SNAFU.
PS: if you know all these, you do not need to complete the rest of the test.
SQL, LOS, CMS, PDQ, CDS, MSSP, MRSA, TIN, RAC
HTML5, CVA, TJC, CFO, FYI, CXO, EDW, HIE, AKA
CPOE, CTO, SOL, HIPAA, ACO, TIA, IMHO, GOMER
PERL, TWAIN, ACA, VTE, PHR, CAPTCHA, POS, POC
Patient management. Who will have the most useful problem list?
Five different hospitalists, NPs, and nurses using a combination of ICD9/10, SNOMED, and homegrown synonyms, with no one in charge
A 70-year-old GP using free text
Surgeon – two items for 84-year-old ICU patient
Neonatologist — 27 SNOMED items for a three-day-old
Training. Which of the following techniques works least badly?
Day-old pizza and handouts in the lunch room
Department meetings at 7 a.m. on a Monday
E-mails from people no one has heard of
At-elbow support by people who just heard about the project yesterday
Leadership. You have 15 hospitals over four states. Which model of leadership works best?
Central (disconnected, jet lagged, and intermittent)
Local (random, quirky, and adversarial)
Democratic (but only certain people can vote)
A CMIO with no direct reports, graded on “influence”
Fill in the correct phrase or words.
CFO is to Budget as Sphincter is to __________.
Twitter is to Communications as Static is to ____________.
Regulation is to Efficiency as Friction is to ____________.
ACO is to HMO as Deja vu is to ___________.
Order management. You are leading a CPOE installation and want to use the latest evidence-based guidelines. What is the right approach?
Call a meeting of department leads, take two years, then make them up yourself
Use third-party content, send to department leads, wait six months, then make them up yourself
Use your paper-based content and sneak in the latest content with the one guy who comes to your meetings (i.e., make them up yourself)
Support. You are stopped in the hall and asked to design a new system that will save this physician maybe 2 –3 clicks a week, but will take your team at least two months of design, development and testing, two more months of training the entire staff, along with disrupting everyone else’s workflow. What is your response?
Ask them to send you an e-mail describing the effort, knowing that they are “too busy” to get around to it
There is no other correct answer
Software selection. You have been asked to select a new EMR for your 200-bed hospital. What are the first steps you should take?
Change your bed number to 500 so Epic will talk to you
Watch the Cerner salespeople twitch when you ask one of them to demo the entire “standard implementation”
Read KLAS, develop detailed requirements, do reference visits, then cave in to the most powerful docs (that couldn’t be bothered to come to demos) because they heard that System X was hard to use
Go to HIMSS for wine and dine, then play spin-the-pocketbook and pray you get the “mature” implementation team promised by a sales guy you will never see again
Statistics. Which of the following principles are true?
Pareto principle – 20 percent of the producers will make 80 percent of the product, but they will not be paid like it
Death panel principle – 5 percent of the population consumes 50 percent of the costs, but you can’t do anything about it
Incentive principle — the other 80 percent (see Pareto) will spend more energy gaming the system than producing
Software development principle – 3 percent of the use cases will drive 80 percent of the timeline delays
Meetings. As CMIO, you are invited to a 2.5 hour mandatory budget meeting. What is your response?
Attend with iPhone and iPad charged and catch up on e-mail
Dial in while getting work done from your office, knowing that the CFO’s secretary will not be able to figure out the teleconference link
Attend, listen closely, and wait for the moment when a physician’s fiscal wisdom will be most appreciated
CMIOs do not get invited to budget meetings, and if they do, that is when you use the spam filter excuse.
Alerts. What is the most effective method of providing meaningful alerts to busy clinicians?
Goldilocks – community-based balanced approach that will still get you eaten by the bears, and the “ community” will be nowhere around
Overalerting — as determined by docs who just want to know when they are definitely going to kill someone
Underalerting — as determined by your legal representation
Individually tuned for relevancy, with actionable orders easily accessible within the order, highlighting only important info that you didn’t know and makes a difference in this unique patient (available in the next release)
Horror stories in the physician’s lounge
User interface. Which of the following is the most effective modality for communicating key clinical information?
A 24-inch LCD monitor with 5,347 elements in three-column view, vertical scrolling, and 23 colors
An iPhone with no information on the top screen, but multiple branching links which will eventually lead you to YouTube
An angry nurse that you have not returned pages to for over an hour
An intern whose pre-med major was theatre arts
13. Pa55Words. Which of the following is optimal policy?
Same password for all your applications “HckerPLsDoEmails2OK?”
Four factor – iris scan, voice profile, 10-character randomly generated password changed every three months, with RFID embedded chip, Comrade
Three strikes, you get pepper spray
Prefilled sticky notes attached when shipping monitors
Allscripts files suit against NYC Health & Hospitals along with Epic Systems over the $303 million contract HHC awarded to Epic in late September. The complaint says the award is “arbitrary, capricious, an abuse of discretion, and lacks a rational basis” because it claims Epic’s proposed cost is $535 million more than that of the Allscripts proposal. HHC says it will defend its decision and added, “Allscripts’ claim that it underbid Epic by more than half a billion dollars is absurd and strikes us as an ill-fated attempt to reassure investors and inflate its sagging stock price. Unfortunately, as our multi-year review has revealed, Allscripts lacks a truly integrated EMR solution and has repeatedly lost business to Epic and other vendors as a result.” MDRX shares closed Thursday at $10.80, down 2.44 percent and indeed sagging at less than half their February price.
From Bain Marie: “Re: Allscripts sore loser lawsuit against New York HHC. They had to deal with Hurricane Sandy and now will spend a fortune to defend themselves against Glen’s bizarre public accusation that its prospect would pay almost anything to avoid buying its product. Would you say this is the dumbest move in HIT history?” It’s certainly in the top handful, and probably the undisputed #1 in the “desperation” category (HBOC’s frenzy to mate with McKesson was even more desperate, but Allscripts wins on style points for suing a non-profit hospital.) I won’t editorialize further since Allscripts employees, shareholders, prospects, customers, and potential acquirers (if indeed any are still interested) are probably already amply embarrassed by this latest in a string of bad company decisions that always send competitors running gleefully to the scanner to make sure prospects get copies. That’s my opinion. If you work for a hospital, especially one with Allscripts connections, I’d like to hear yours. If you work for Allscripts, I’d be even more interested.
From Nasty Parts: “Re: Mike Lovett. Promoted to replace Scott Decker at NextGen.” Unverified. His LinkedIn profile shows a new job of SVP/QSI Division Leader – Ambulatory Division.
From Kaiser Surgeon: “Re: video by KP ambulatory surgery staff at Fremont Ambulatory Surgery Department. They are well known for high-volume cataract surgery on our Kaiser patients. They do seem to have an esprit de corps.” I’m always a sucker for hospital music videos like this one.
From Former Stanley Tool: “Re: Healthcare Informatics Associates. Stanley Healthcare Solutions is shutting it down.” Unverified, but searching LinkedIn finds at least one former employee who is freshly entering the job market.
HIStalk Announcements and Requests
If you have been busy holiday shopping and missed reading HIStalk Practice this week, here are some highlights. Two-thirds of EPs will apply or have applied for MU incentives. ONC says that more office-based physicians are using EHRs that have higher-level functionality to meet MU objectives. ED use declines when patients have access to after-hours service from their primary care provider. HHS offers tools to protect PHI on mobile devices. Physicians spend more time on health content-specific websites than any other health sites, though more are also visiting EHR portals. Epocrates releases a native app for iPads and iPad minis. Dr. Gregg pronounces the consumer the heir to throne of healthcare. I made the “nice” list again this year, but the only gift I need is a few more e-mail sign-ups on HIStalk Practice. Thanks for reading. (P.S. If you are a shoe distributor, own a wine shop, or are a male admirer who likes to give expensive jewelry, please disregard the “only gift I need” statement.)
Welcome to new HIStalk Platinum sponsor RazorInsights. I’m guessing the Kennesaw, GA-based company found HIStalk because I’ve run several non-anonymous hospital reader comments about the company’s ONE Enterprise HIS for rural, critical access, and community hospitals. It offers a single-database, certified, cloud-based hospital EHR. Every one of the company’s live hospital clients have earned Meaningful Use payments. Customers enjoy one database, one simple user interface, and capabilities that include a master patient registry, patient encounter management, nursing documentation, CPOE, and physician offline orders. It’s available in multiple editions that include clinicals only, clinicals plus financials, clinicals plus ambulatory, and the Enterprise Edition including all of those. Customers can go live in as little as 90 days, enjoying cost-effective training services and around-the-clock support. People always bemoan the lack of new companies and new, scratch-built technologies in the inpatient EHR business, so here’s one for you. The company’s management has plenty of industry experience, including folks with pharmacy and nursing degrees along with vendor experience. To learn more, sign up for a live product webinar on their site or check them out at the HIMSS conference in a few weeks. Thanks to RazorInsights for supporting HIStalk.
I always head over to YouTube when introducing a new company just to see what’s out there, so here’s an introductory video from RazorInsights. You’ll get a hint about the company’s name early in the video, although you might have to Google the reference like I did.
It’s an odd time of year to be swamped at the hospital and at HIStalk, but that’s the case. I work on HIStalk until at least 10 every night and I’m back in the same chair by 5 the next morning before I head out to work. I try to respond to requests quickly, but it often doesn’t happen, and re-sending the e-mail or expressing indignation doesn’t change my time constraints one bit. I usually catch up over the weekend, though.
Global Record Systems acquires the eCastEMR platform and service business from eCast Corporation.
Streamline Health Solutions reports Q3 results: revenue up 51 percent, EPS –$0.11 vs. $0.03.
LocalMed, a patient self-scheduling software company that won $3,500 in seed capital from the LSU Student Incubator, will establish its headquarters in Baton Rouge, LA and plans to hire 52 employees by 2016.
Sales Battle Mountain General Hospital (NV) selects ChartAccess EHR and FinancialAccess from Prognosis HIS .
HealthInfoNet, the HIE for Maine, signs a three-year agreement with Arcadia Solutions for its Analytics and Quality Data Warehouse platform for clinical data warehousing. Aracadia will also test the linkage of the HIE’s clinical data with claims data from the state’s All-Payer Claims Database.
The Brooklyn Hospital Center (NY) names Bill Moran (Dell) SVP and CIO.
Lisa Rawlins (Broward Health) joins SRG Technology as director of health care.
Norman Joseph Woodland, who co-invented the bar code as a graduate student in 1951, has died at 91.
Announcements and Implementations
Joslin Diabetes Center (MA) will use de-identified clinical data from Humedica for education and research activities.
Government and Politics
ONC launches a mobile device security initiative that provides white papers and articles to help providers understand how to protect patient information on mobile devices. The site is a product of HHS’s March 2012 Mobile Device Roundtable along with tips and information contributed during its 30-day comment period. Included is a video titled Worried About Using a Mobile Health Device for Work? Here’s What to Do!
AT&T unveils a prototype of Asthma Triggers, a wireless sensor that sends air quality data to mobile devices.
The Leapfrog Group, criticized by hospitals to which it assigned below-average patient safety grades last month, announces a partnership with Johns Hopkins Medicine to fine-tune its scoring methodology, also vowing that, “the Hospital Safety Score is here to stay.”
More than half of HIT professionals report a budget increase for information security, according to a HIMSS survey. Other key findings:
Most hospitals are conducting risk analyses, with 71 percent performing an analysis at least annually
One in five respondents say their organization experienced a security breach in the last year
More than half the organizations spend three percent or less of their IT budget on securing patient data
Two-thirds report that their organization conducted an audit of their IT security plan.
Paper medical records belonging to a recently raided and closed unlicensed pain management clinic in Florida are found in the dumpster of a nearby Dollar Store. Also found in the trash: used syringes and uncashed checks made out to a contracted pain doctor who was apparently being paid $1,500 per day to crank out oxycodone prescriptions.
Tampa General Hospital’s bond ratings agency calls out the hospital’s “compressed profitability” as being due to Epic implementation costs, lower inpatient utilization, and state Medicaid cuts.
Weird News Andy continues his armchair medical reviews with this article, in which Children’s Hospital of Philadelphia injects a disabled form of HIV into a six-year-old whose leukemia was expected to kill her within two days, hoping to stimulate her immune system enough to allow her to receive a bone marrow transplant. Six months after the infusion, the T-cells are still working and she’s in remission.
Mercy Regional Health Center (KS) expands its use of the Access Intelligent Forms Suite into its human resources department.
Vitera Healthcare announces the general release of Live Chat, which provides customers with immediate online access to Vitera customer support.
Surgical Information Systems enhances its perioperative information systems to provide interoperability with Siemens Soarian Clinicals.
Agilum Healthcare Intelligence publishes a white paper that includes strategies to help small and mid-sized hospitals overcome common obstacles to obtaining useful business intelligence.
Levi, Ray & Shoup sponsors this week’s Next Generation Healthcare Summit in San Antonio.
Emdeon discusses the benefits of utilizing check reader devices at the point of service in a newsletter article.
Adirondack Radiology Associates (NY) shares how it has increased coder productivity and reduced denials since implementing the Optum Computer-Assisted Coding solution.
API Healthcare’s Deborah Moore shares thoughts on the use of HIT to increase quality of care and patient satisfaction in a blog post.
Informatica offers predictions on where technology is heading in 2013.
Fourteen CareTech Solutions customers win a total of 20 eHealthcare Leadership Awards for their CareTech-designed websites.
RSource, a provider of receivables management recovery solutions, and Streamline Health Solutions will cross-market each other’s services within their client bases.
Winthrop Resources Corporation will offer equipment financing and advice to customers of MPC, an IT asset lifecycle management company.
The British Columbia Ministry of Health selects McKesson as the vendor of choice for its radiologist peer review initiative.
First Databank and JAC Pharmacy sponsor the Improving Patient Safety award at the NHS Isle of Wight Awards 2012.
NextGen Healthcare will offer Aviacode’s cloud-delivered medical coding services to its customers.
EPtalk by Dr. Jayne
Finally, a data breach that doesn’t involve a lost or stolen laptop. Dr. Travis tweeted about the breach at Carolinas HealthCare where an “unauthorized electronic intruder” (is there such a thing as an authorized intruder?) obtained access to a provider’s inbound and outgoing e-mails. Although there is no evidence that the information has been misused, impacted patients are being offered free credit monitoring services.
Should a hacker gain access to my work e-mail account, have fun reading all the incessant whining and complaining from physicians who hate EHR, the implementation process, the group’s compensation model, required CME, coding/compliance audits, and a host of other things. It just might scare you straight and make you never want to hack again.
Physician social networking site Doximity issues a call for fellows who will “gain insight into the power of entrepreneurship and technology in healthcare, engage with physician thought-leaders from across the country, and leave your mark on healthcare.” Applicants must be licensed physicians (MD or DO) and the time commitment is two hours per week. I can’t imagine it would be anywhere near as fun as writing for HIStalk, but if you’re looking for something interesting to do with your free time, it might be worth a shot. Applications are due December 31.
Inga has started getting invites for the HIMSS social scene, and as a good BFF should, she is sharing them with me. I’m definitely counting down to New Orleans (in fact, tried out some new shoes today that I hope will be both sassy and comfortable in the exhibit hall) and to seeing the HIStalk crew. I’m in the process of finding the perfect date for HIStalkapalooza. With any luck, he’ll be wearing a bow tie.
I asked last week for stories about the best (or worst) office holiday party ideas. Reader Rabbit takes the prize with his submission:
My wife’s practice is having their office party at a local brewery’s tap room, also known for great food. One of the doc’s hubby runs their hop farm, which also does farm-to-table stuff. Oh, wait:
It is on a Saturday at 10:30 a.m.
There is no drinking. The legal department says it can’t support drinking during any “sanctioned” event, even if off site and even if I pay for my own and don’t work for them.
It is a pot luck where the docs cook main courses. Which means this guy (pointing at myself) has to wake up and start cooking Cornish game hens or smoked brisket at 5 a.m. in order to have the meal ready. Even if I went the boring turkey route, I need to rise before the sun to cook on a Saturday. The rest of the staff don’t bring anything, but sit around and judge that the doctors (and their wonderful spouses) can’t cook.
It is still a "Christmas Party" and we are expected to dress “festive,” which means I must don gay apparel that supports a religion I don’t follow.
No kids. Good luck finding a 10 a.m. babysitter in a college town on a Saturday that is reliable and sober.
There is also a three- hour-long White Elephant that ends the afternoon with us getting some sort of broken scented candle or a wine bottle sack/holder that looks like St. Nick.
Fa-la-la-la-la, la-la-la-la — my foot.
Oh, and I promise to take a picture of me standing in the corner seething wearing my favorite Santa sweater. Happy Holidays!
I must say I’m looking forward to the sweater pics. I definitely have some wardrobe that could hold its own in any holiday sweater contest.
WebMD Health Corp. will eliminate 250 jobs, or about 14 percent of the company’s workforce, in an attempt to reduce operating expenses by about $45 million. The company has suffered declining ad and sponsorship revenues and its stock price has fallen 63 percent since the start of 2012.
From Former MCK’er: “Re: Dave Souerwine, president of McKesson Provider Technologies. Gone and ‘pursuing other opportunities,’ according to an e-mail sent to employees Monday.” Several readers forwarded the internal e-mail from McKesson Technology Solutions EVP/Group President Pat Blake, to whom Dave’s former management team now reports. I confirmed Dave’s departure with a McKesson spokesperson: “After an intense period of execution and putting McKesson Provider Technologies on a positive strategic course, Dave decided to leave to reassess where he wants to spend the remaining time of his career. Dave played a key role in our Better Health 2020 strategy working with other presidents across our Technology Solutions businesses, and those efforts will continue as we focus on helping our customers prepare for the complexities of health reform.”
From Unbarred: “Re: Epic’s lawsuit against a consulting firm. It’s an intellectual property lawsuit in which Epic claims tortuous interference, breach of contract, trade secret misappropriation, and other related transgressions. They say the defendants inappropriately logged into the customer area of Epic’s website to access an ambulatory training video. Epic wants all of its material returned and removed from any website on which it was loaded, along with punitive and actual damages.”
From The PACS Designer: “Re: IT convergence. With all of the mobile devices and desktop workstations accessing data of all types in daily activities, it becomes more important for IT management to control the platform running everything viewed by users. Microsoft realizes the need and is addressing the challenge by incorporating Windows 7 and 8 in their .NET Framework software. As more vendors migrate to Windows 7 and/or 8, the pressure will build to move towards Microsoft’s .NET Framework solution to enhance IT convergence.”
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum sponsor Ormed of Austin, TX. The employee-owned company’s product line includes financial management (AP/GL, asset management); decision support (EIS, cost accounting, budgeting, dashboards); supply chain management; human capital (scheduling, HR, payroll, employee self-service); e-commerce transaction services; and accounts receivable. Ormed MIS decision support for healthcare includes Cyberquery information access, which delivers vital business intelligence information to authorized employees as graphs, reports, or spreadsheets. The fully integrated Ormed MIS software and Ormed X2 B2B portal help create efficiency, cost savings, and controls across the entire organization. The company has been working since 1989 to provide hospitals and other healthcare organizations with tools for timely and informed decision-making, cost-effective growth, and improved service and satisfaction levels, with over 5,700 software applications in use in the US and Canada (see the interactive user map, which lists its customers). Thanks to Ormed for supporting HIStalk.
Acquisitions, Funding, Business, and Stock
Sutherland Global Services will pay $184 million for the business process outsourcing unit of the India-based Apollo Hospitals Enterprise, which provides IT support services to more than 150 US healthcare organizations.
A Nuance Communications investor day presentation predicts a paradigm shift that will favor the company’s speech recognition and natural language processing products, observing that nearly every mobile device includes capabilities covered by a Nuance offering. Key product lines include the Dragon family, OEM versions of its speech recognition products increasingly being incorporated directly in computer hardware, voice-enabled televisions, and cloud-based speech recognition. Nuance’s healthcare division reports strong growth, aided by the HITECH act and relationships with EMR vendors such as Cerner and Epic.
Rothman Healthcare, which developed the Rothman Index for analyzing data points to identify hospitalized patients whose condition is worsening, renames itself PeraHealth and hires Stephanie Alexander (MedAssets) as CEO.
Kansas City-based Health Outcomes Sciences will relocate to Overland Park and expand from 13 to 37 employees in the next five years. The company, which is seeking incentives from Kansas state government for the move, offers the ePRISM clinical predictive modeling tool for improving outcomes. CEO Jim Wilson was previously president of Craneware and has worked for Cerner and Oacis.
The parent company of LifeCare Holdings, which operates 27 long-term acute care hospitals in 10 states, declares Chapter 11 bankruptcy to allow the company to be acquired by a group of its lenders.
LSU announces plans to form public-private partnerships for the operation of three of its hospitals, hoping the $12 million it will receive in advance lease payments will help it avoid the previously announced layoffs of hundreds of employees. The state announced similar privatization agreements for two additional hospitals in Houma and Lafayette as it dismantles its charity hospital system.
Duke University Health System (NC) will implement TeraMedica’s Evercore Smartstore and Univision modules for medical image management.
The University of Kentucky contracts with CSI Healthcare IT for project management and support services for current and future software applications.
Providence Health Care (BC) selects MModal Fluency for Transcription as the speech platform for all Lower Mainland Health Authorities hospitals and facilities.
North Oaks Health System (LA) selects iSirona’s device connectivity solution to integrate with Epic.
Cumberland Center for Healthcare Innovation (TN), a 29-practice ACO, will use clinical data analytics technology from Clinigence.
Sanford Health (ND) chooses Click Portal from Huron Consulting Group to manage HHS-mandated conflict of interest disclosure rules.
Sentara Healthcare (V) chooses Accalarad’s medical imaging solutions for its imaging centers and hospitals in Hampton Roads.
Clearwater Compliance hires Ashley Bampfield (Bampfield Communications) as director of marketing.
Cone Health (NC) promotes Steve Horsley to VP/CIO, replacing the retiring John Jenkins.
Ross Martin, MD, MHA (Deloitte Consulting) is named VP of corporate relations and business development of AMIA.
Jay Colfer (Prognosis Health Information Systems) joins Surgical Information Systems as sales EVP.
Phil Pead (Allscripts) is named president and CEO of application development tools vendor Progress Software. He was serving as executive chairman and interim CEO.
I interviewed Joseph Kvedar, MD of the Partners Center for Connected Health about his involvement with Wellocracy on HIStalk Connect.
Peter Cyffka (O’Melveny & Myers, House of Blues) is named CFO of Epic Systems.
The National eHealth Collaborative elects six officers including Janet Corrigan (National Quality Forum), Tom Fritz (Inland Northwest Health Services), Paul Uhrig (Surescripts), Bill Spooner (Sharp HealthCare), Michael Barr, MD (American College of Physicians), and Leslie Kelly Hall (Healthwise).
Announcements and Implementations
MaineHealth and Maine Medical Center go live on their $150 million Epic system, with which the organization hopes to qualify for $50 million in EHR incentives.
HIMSS names Mount Sinai Medical Center (NY) as the winner of the enterprise Davies Award. HIStalk sponsor Culbert Healthcare assisted Mount Sinai with the application process, including developing quality improvements measures and a return on investment model.
Community Health Solutions of America deploys Cognizant’s ClaimSphere HEDIS for compliance measurement and reporting.
Meridian Health (NJ) upgrades to ICA’s CareAlign Exchange platform, which includes Direct messaging, CCD repository, a patient identity manager and registry, HISP capabilities, and global opt-out for patients.
Oroville Hospital (CA), the first hospital to self-deploy the VA’s VistA, releases a self-developed, open source e-prescribing module under the name eRx VistA, which meets Stage 2 MU requirements.
University of Utah Health Care offers online access to its database of 40,000 patient satisfaction surveys, including comments about its 1,200 physicians.
Emmi Solutions announces EmmiPrevent, a population health management application that initiates interactive calls to patients to encourage then to take preventative action.
Government and Politics
National Coordinator Farzad Mostashari becomes a Blue Button user on behalf of his parents, finding that the straight download of claims data is hard to interpret even for a physician like himself. However, he finds that the iBlueButton app, which recently won an ONC programming challenge, does a nice job of reformatting the information into a usable list of problems, diagnoses, encounters, and treatments. In a suspiciously dramatic story, he reports that he downloaded the data Thanksgiving day, his father developed an emergent medical condition on Black Friday, and he was able to immediately share his freshly downloaded data with a specialist.
Innovation and Research
It happens every year right after the mHealth Summit concludes: an mHealth expert and advocate expresses frustration that the few clinical studies involving mHealth technologies usually fail to show any conclusive benefit, with most of the positive accounts coming from purely anecdotal reports. Or as NIH Director Francis Collins, MD, PhD said succinctly, "The plural of ‘anecdotes’ is not ‘data.’"
CardioMEMS, an Atlanta-based company that is developing wireless body monitors, wins the Intel Innovation Award.
An article in The Atlantic profiles a non-profit South Dakota "patient-less hospital" that provides long-distance critical care to rural hospitals in six states. Avera Health Network uses two-way video consulting to provide what it calls "hands in pockets doctoring," covering 60 percent of the ICU beds in South Dakota. They’re expanding to cover nursing homes and prison infirmaries. While the program reduces the cost of sending patients to major hospitals, it says its main benefit is to limit the decline of small, rural communities.
UCLA gastroenterologists test a program in which patients with inflammatory bowel disease are given free iPads to enter their information for remote monitoring by nurses. The software also provides education, a job coach function, mental health coaching, and even traffic reports for patient trips to the office. The UCLA Center for Inflammatory Bowel Diseases originally announced the program in September.
FDA is developing guidelines for how drug companies can promote their products using social media, but in the mean time, the manufacturers are finding new and unregulated ways to market their wares in potentially deceptive ways. Way back in 2010, the agency sent warning letter to Novartis for using a Facebook widget to market a leukemia drug by placing ads on the news feeds and profile pages of individual Facebook users.
Epic seeks to buy an additional 38 acres of land from a zoned subdivision southeast of its existing 811-acre property. The company presented conceptual plans to Verona, WI city officials that include proposals for a fourth and fifth campus. Some residents expressed concern that Epic’s never-ending construction projects are encroaching on nearby homes and creating noise and traffic throughout the area, but others expressed support for Epic’s plan to reserve part of the land for a park and said the company at least makes a better neighbor than closely spaced apartment buildings.
A KLAS report covering business intelligence finds that the most significant impact of BI solutions involves knowledge dissemination and end-user adoption.
India launches its first cloud-enabled eHealth Center for delivering primary care in remote regions. It provides remote medical consultations and sends SMS-based patient reminders.
Russian hackers hijack and encrypt the electronic patient files of a clinic in Australia, demanding $4,200 to restore the information. Experts say the clinic doesn’t have much choice but to pay up in this latest episode of so-called ransomware, but warn that paid-off hackers often hit the same victims again to demand more cash.
Greek hospitals are struggling in the country’s economic crisis, facing supply shortages and budgets cut by half. A neurologist says pay cuts have left him making $1,600 per month for a 100-hour workweek, while patients can’t get medication because the government can’t pay its pharmacy bills. Greek healthcare, critics say, is like the rest of the country’s economy in suffering from corruption and mismanagement.
Weird News Andy likes this “pacemaker for brains” story in which Johns Hopkins researchers implant a stimulation device in the brain of an Alzheimer’s patient in the hopes it will stop cognitive decline. Also from the infectious weirdness that is Andy: five Cedars-Sinai heart valve transplant patients contract staph infections when the gloves of their surgeon develop tiny tears, allowing bacteria from the wound on his hand to infect them. The hospital says the surgeon is no longer performing operations there.
Besler Consulting President Brian Sherin addresses the company’s growth over its 25 years in business in a newsletter article.
Emdeon reviews the top priorities of its channel partners.
William Bithoney, MD of Truven Health Analytics and Jeffrey Softcheck of Silver Cross Hospital address the future of healthcare and improving care quality and outcomes at this week’s IHI conference in Orlando.
StartUp Beat profiles PatientPay and its billing and collections technology.
NextGen launches its 8 Series EHR content, which includes embedded MU criteria and an optimized seven-tabbed clinical workflow.
The Orange County Registernames Kareo a “Top Workplace in Orange County.”
Prognosis will integrate its EHR platform with DrFirst’s e-prescribing solution.
From HITEsq: “Re: Epic. It appears they aren’t happy with some consultant, suing two individuals and three similar sounding entities (KS Information Technologies). They were granted a motion to seal the complaint to protect sensitive information. Maybe someone knows more.”
The government should get more proof that providers have met Meaningful Use requirements before sending them a check, according to 72 percent of poll respondents. New poll to your right: should FDA create an Office of Wireless Health as proposed by Rep. Michael Honda (D-CA)? I’ve generously included a “don’t know/don’t care” option for those anxious to participate despite indifference to the topic.
My latest Spotify playlist includes the usual mix of music I like, including Villagers, This Providence, Gov’t Mule, Faith No More, and going back decades, Mountain, Throwing Muses, and even the virtually unknown 60s Detroit band Frijid Pink. I spend a fair amount of time choosing what I think is worth listening to and then play the list several times to make sure it makes sense, not that I’m in need of extra work. Give it a listen if you’re stuck in a musical rut.
I never look at (and in fact am annoyed by) infographics, those trendy, huge, multi-font pictures that fool short attention span Internet skimmers into thinking they understand a complex topic, often created by someone who hopes their agenda will be accepted as truth instead of opinion because it’s easier to stare at dumbed-down pictures instead of using your brain to read something more challenging and informative. If you don’t feel that way, cruise over to ONC’s EHR infographic for consumers. At least theirs is footnoted.
The secretaries of Veterans Affairs and Defense say they will present a plan in January to speed up the VA-DoD EHR integration. The planned go-live date of 2017 may be moved up.
Manitoba’s eChart HIE will allow users to hide their information even though they can’t opt out of the service. It will contain prescription information, immunization histories, demographics, and lab results.
The Jewish Healthcare Foundation, the Pittsburgh Regional Health Initiative, and Health Careers Futures form the Pittsburgh-based QIT training center, funded by the foundation and the County tourism office. It will offer training to healthcare executives and workers on emerging technology. ONC Deputy Director Jason Kunzman is former CFO of the foundation. Also announced was the QIT Health Innovators Fellowship program for graduate students in the health professions, who will submit IT solutions for judging in a 10-week program.
Healthcare provider CIOs on the 2013 Computerworld Premier 100 IT Leaders list:
Horace Blackman, Department of Veterans Affairs
George Brenckle, UMass Memorial Health Care
Thomas Bres, Sparrow Health System
Sonya Christian, West Georgia Health
Chad Eckes, Cancer Treatment Centers of America
Randall Gaboriault, Christiana Care Health System
Theresa Meadows, Cook Children’s Health Care System
Mark Moroses, Continuum Health Partners Inc.
Stephanie Reel, Johns Hopkins Health System
Kathleen Scheirman, Kaiser Permanente
Thomas Smith, NorthShore University HealthSystem
A new KLAS report on revenue cycle performance finds that Meaningful Use, reduced payments, and ICD-10 fears are forcing providers to examine their revenue cycles more closely for efficiency and effectiveness, with many of them engaging outside assistance.
RSNA attendance was down 9 percent this year, with possible reasons being lack of technology breakthroughs and a new policy that required guest attendees to pay.
A technical school in the Philippines creates a telenurse training program, preparing nurses to offer their patient consultation services via smart phones. ClickMedix, an online health company is participating, offering the nurses access to its smart phone application, doctors, and medical library in return for a percentage of their billings. Experts say it’s time to create business models for nurses to become online health consultants. I tracked down ClickMedix, which turns out to be a US-based company (Rockville, MD) formed by faculty and students of MIT and Carnegie Mellon to address global healthcare challenges. The company’s mHealth platform offers modules for delivery of medical services, patient management, administration, and healthcare services purchasing.
Ergonomics researchers warn that the increased use of EMRs and other keyboard-based technologies for long periods of time raises the risk that providers will sustain repetitive stress injuries as happened when offices computerized in the 1980s. A small study found that more than a third of doctors reported RSI-related pain in their neck, shoulders, back, or wrists. In what could be an indirect measure of the uptake of EMRs, another small provider study found that more than 90 percent use a computer, averaging more than five hours a day.
An article in the Rochester paper describes the use of contracted scribes in the ED of Rochester General Hospital, which says its 60 ED scribes cost $1 million annually but save the health system $1.6 million per year. According to the associate ED chief, “When you come to see the doctor, you want to see the doctor. You want eye contact. You don’t want us standing at a computer screen. I care for people. I’ve never been trained to be a good typist or a data entry specialist.”
An Atlanta nephrologist serving as the medical director of a clinic owned by dialysis provider DaVita files a whistleblower lawsuit against the company under the False Claims Act after noticing that its computer systems showed large amounts of wasted drugs. His suit claims DaVita overcharged Medicare for up to $800 million over eight years by intentionally using oversized vials of medication and discarding the remainder, billing Medicare for unavoidable waste. The doctor was noticed by his fellow whistleblower, a nurse who says the company was pushing employees to increase their drug revenue. The company says CMS approved all of its practices.
Scheurer Hospital (MI) renovates its patient rooms to include technology improvements, placing a computer in each room to allow nurses to document at the bedside. They also added a new patient call system that alerts nurses on cell phones.
The former executive director of Syringa General Hospital Foundation (ID) is sentenced to six months in prison and is ordered to pay $115,000 in restitution after pleading guilty to using the hospital’s computer system to transfer money to her personal accounts.
Aetna will pay $120 million to settle lawsuits claiming that it used databases from UnitedHealth Group’s former Ingenix unit to intentionally underpay insurance claims for members using out-of-network medical services. UnitedHealth paid $350 million in 2009 to settle a similar lawsuit in New York, at which time Aetna also settled by agreeing to stop using the Ingenix database and paying $20 million to help create an independently developed replacement for it.
Weird News Andy says he now knows how your mom always knew what you were thinking. Researchers find that a mother’s brain often hosts living cells from her children born decades earlier. WNA also digests new medical research as being an explanation for crazy cat ladies: a common cat parasite is found to have the ability to enter the human brain and to possibly cause behavioral changes.
More on CPSI in this week’s HIS-tory from Vince, putting it into current perspective by reviewing the MU success of its customers and how its practices parallel those of Meditech and Epic. Next up is NextGen’s inpatient division, so connect with Vince if you can help him out with background information.
Reuters reports that PE firms Thoma Bravo LLC, Thomas H. Lee Partners LP, and Francisco Partners have submitted revised takeover offers for Merge Healthcare and are awaiting a decision from the company.
From Nasty Parts: “Re: MedeAnalytics. Oracle backed out of a deal to buy the company, so they’re re-orging and putting a number of folks on the street.” Unverified.
From Spamalot: “Re: funny vendor spam. The ridiculous image and hilariously misspelled text caught my eye before I could hit the delete key.” Could it be that the company has decided to offend as many of the senses as possible, with your delayed “delete” validating their cunning premise of turning your head like a gruesome car wreck? Surely it was not a native English speaker who composed the pitch for business “coninuity” and referred to network security as a “new sexy term.” The company’s two addresses appear to be mail drops, and the Facebook link in the spam goes to a marketing person’s personal page that features family photos and cutesy kitty porn. I’ll hazard a guess that their incoming lines won’t be overwhelmed by clamoring prospects.
HIStalk Announcements and Requests
In case you have missed any HIStalk Practice posts in the last week, here are some highlights. Most physicians who e-prescribe believe it reduces prescription fraud and facilitates decision-making. Vermont’s eight FQHCs go live on five different EMRs. OIG finds that physicians who protest the denial of Medicare claims win their cases 61 percent of the time. Spring Medical Systems will offer its EHR clients an analytics solution from Clinigence. The AMA argues that pre-payment MU audits would be too burdensome for physicians. None of this news can be found on HIStalk, so if you are interested in the ambulatory HIT world, make sure to sign up for the HIStalk Practice e-mail updates. Thanks for reading.
I’m not really interested in two front teeth for Christmas since I don’t have a spot for them, but I could use some holly jolly reader gifts that cost nothing: (a) take 10 seconds max to sign up for spam-free e-mail updates from HIStalk, HIStalk Practice, and HIStalk Connect; (b) sleuth us out on Facebook, LinkedIn, Twitter and make the electronic connection; (c) support the companies that pay the bills by checking out their ads to your left, reviewing their offerings in the Resource Center, and sending out an effortless request for consulting information via the RFI Blaster; and (d) graduate from spectator to player by sending me news, rumors, and guest posts. I note that Dann’s HIStalk Fan Club on LinkedIn now has 2,881 members, all of whom get extra attention when requesting something because I’m reassured that they aren’t ashamed of reading HIStalk. A reminder: we’ve got the top headlines each weekday morning on HIStalk, courtesy of the newest crew member, Lt. Dan. You won’t get an e-mail blast to remind you since I figured that would be really annoying, so just head over to the main page and you’ll see what’s new before you head out for work (like I do).
Acquisitions, Funding, Business, and Stock
Toronto-based Constellation Software purchases 100 percent of the fully diluted shares of Salar from Transcend Services, a division of Nuance. Transcend purchased physician documentation and charge capture systems vendor Salar in July of 2011 for $11 million, followed by Nuance’s acquisition of Transcend for $300 million in March 2012. We ran an accurate reader rumor report of the then-unannounced sale on November 30.
EMR vendor Modernizing Medicine raises $12 million in Series B financing to expand into the orthopedic and ENT markets.
SAIC announces Q3 results: revenue up 3 percent, EPS $0.33 vs. –$0.28, missing on expectations of $0.35. The company said it signed over $100 million in contracts from its recent acquisitions, maxIT Healthcare and Vitalize Consulting Solutions. SAIC also announced that it will cut 700 jobs in advance of possible fiscal cliff federal spending cuts that would decrease defense spending. Shares that were at $20 in early 2010 closed Thursday at $11.26, valuing the company at just under $4 billion.
Presbyterian Healthcare Services (NM) signs a multi-year agreement with IT service provider T-Systems to manage the health system’s data center operations.
Martin’s Point Health Care (ME/NH) selects athenahealth to provide EHR, billing, PM, and care coordination services for its 90 providers.
Catholic Health Initiatives will partner with Encore Health Resources to create a suite of electronic healthcare intelligence solutions focused on quality, performance, and risk analytics.
Indiana University Health selects Healthcare Quality Catalyst’s data warehouse platform for reporting and analytics.
Mercy Medical Center (IA) will implement iSirona’s device connectivity software to automate the flow of patient data from more than 150 devices into Epic.
Abington Health System (PA) selects the Surgical Information Systems perioperative IT solution for its two hospitals.
WellSpan Health (PA) subscribes to the CapSite Database to improve its purchasing processes.
Maury Regional Health System (TN) selects Medseek’s patient portal solution.
Ophthalmic Consultants (MA) adopts the Professional Charge Capture solution from MedAptus.
Interoperability software provider Compressus names Joe Lavelle (Results First Consulting) as COO.
Clinithink hires Fiona Lodge, PhD (Microsoft) as director of technical operations and Nathan Skorick (Altos Solutions) as business development executive.
Huntzinger Management Group VP William Reed (above) joins the company’s board of directors, along with Richard Sorensen (US Health Holdings.)
Emdeon adds former Allscripts Chairman Philip Pead and former Harris Corp. CEO Howard Lance to its board.
Hospitalist Fred Chan, MD is named to the newly created position of CMIO for GBMC HealthCare System (MD).
Jardogs names Ken Mikesh (MyHealthDIRECT, above) as SVP of strategy and business development and Brenda Stewart (Merge Healthcare) as SVP of marketing.
Homer Warner, a cardiologist and medical informatics pioneer, died November 30. He started developing clinical software at University of Utah and Intermountain Healthcare in the mid-1950s and wrote Intermountain’s ground-breaking and still-used HELP system in the 1970s, one of the first electronic medical records and clinical decision support systems. He was chair of University of Utah’s Department of Medical Informatics, the first such program offered by a medical school. Intermountain opened the Homer Warner Center for Informatics Research at Intermountain Medical Center in 2011. He remained active, vital, and humorous until his death at age 90, as evidenced by this video interview conducted a few weeks ago.
Announcements and Implementations
Vitera closes its hardware support business unit through a partnership with DecisionOne, which will hire Vitera’s field technicians. Vitera notes that it has added more than 270 employees this year and anticipates filling another 200 positions.
The University of Texas at Austin launches the country’s first HIE laboratory, which is funded by ICA, Orion Health, eClinicalWorks, and e-MDs.
DrFirst announces Akario, a free secure clinical messaging system.
GE Healthcare launches its Centricity Business 5.1 RCM solution.
Allscripts releases Sunrise Financial Manager, a revenue cycle solution designed for accountable and value-based care payment models.
The HIEs of West Virginia and Alabama, both customers of Truven Health Analytics, earn federal recognition for reaching milestones for full query-based and directed information exchange.
MModal opens a medical transcription center in Mysore (India), where the company plans to create 100 jobs over the next two years.
Cisco Systems is providing video calls with Santa to patients at 31 children’s hospitals (including Children’s of Alabama in a photo from Tuesday, above) via its Santa Connection Program, which runs through December 21 .
Government and Politics
The IRS releases a final rule subjecting the sale of medical devices to a 2.3 percent tax beginning in 2013, which is expected raise $29 billion in tax revenue through 2022.
Innovation and Research
Independence Blue Cross, Penn Medicine, and DreamIt Ventures create Philadelphia-based DreamIt Health, yet another digital healthcare accelerator. It offers $50,000, a four-month boot camp, office space, mentoring, and a demo day. It gets 8 percent of the equity in return.
Athenahealth will buy the 29-acre, 11-building, 760,000 square foot Arsenal on the Charles complex in Watertown, MA from Harvard University for $169 million. The company was already leasing 330,000 of space in the complex for its headquarters.
A CapSite survey finds that one-third of US hospitals have adopted a vendor-neutral archive, while another 19 percent plan to do so.
Kaiser Permanente will open a new IT center in the Denver, Colorado area and will hire 500 IT employees by 2015.
A survey finds that 94 percent of healthcare organizations suffered at least one data breach in the last year. Other findings: (a) 69 percent don’t secure PHI-containing medical devices such as insulin pumps, and (b) almost all of them use cloud-based solutions and allow employees to use their own medical devices even though half of the organizations question the security of those technologies.
The CDC reports that 40 percent of office-based physicians now use an EHR with a basic level of functions, up from 34 percent a year ago.
At a dermatologist appointment this week, I noticed signs on the window urging patience, as the one-doc practice had just changed EMR systems. I asked the doctor and got an earful in return. He had already attested for Meaningful Use Stage 1, but was convinced by a salesperson to trash his EMR and move to GE Centricity. He said it’s the worst business decision he has ever made, not because Centricity is bad, but because he spent a lot of money, he’s being hit constantly with additional upgrade and maintenance fees, and to top it all off, he now realizes that he has no chance of collecting Stage 2 money because the bar is set too high for his practice. Not to mention that as a specialist, the EMR is not providing much patient value. He says he’s hoping to hold on for the 2-3 years it will take to get his practice back on its feet again, as the EMR is now his single largest expense. I can only describe his behavior as ashamed, followed by relieved as he realized from our discussion that he’s not the only one struggling to pay for something that he probably should never have bought in the first place. Needless to say, he’s not exactly thrilled with the HITECH program. It’s an eye-opener to realize that these little practices are cash-strapped businesses run by folks who may be excellent clinicians, but who are also marginal, accidental businesspeople just trying to keep the doors open and their employees paid. Derms are usually well paid and minimally stressed thanks to acne and Botox, so I can only imagine what it’s like for a primary care practice.
In Canada, Vancouver Coastal Health fires a long-time clerical employee for looking up the electronic records of five local media personalities out of curiosity.
Hello, Doc, Internet porn is free: a female employee of a doctor’s practice notices a red light glowing behind supplies in the restroom. She finds a video camera pointed at the toilet. The doctor finds his career potentially in that same toilet, as police executing a search warrant find the camera-controlling software on his computer. Maybe he should claim that the restroom doubles as a telemedicine station.
A privacy “weakest link” example. MC and Mel, a couple of morning zoo-type deejays from Australia sporting the worst fake British accents in history, call up the London hospital treating the Duchess of Cambridge for morning sickness, doing hilariously unskilled and giggling impersonations of Queen Elizabeth II, Prince Charles, and barking Corgi dogs. They get through to a nurse who provides a full update on the former Kate Middleton’s condition, learning that Kate “hasn’t had any retching with me.” The hospital is evaluating its privacy practices. UPDATE: in a not-so-funny ending to the story, the nurse who took the prank call has apparently committed suicide.
Billian sponsored the December 4 Health IT Leadership Summit at the Fox Theater in Atlanta, which attracted 600 attendees. Above are Ellen McDermott (University of West Georgia), Jennifer Dennard (Billian Inc.), David Hartnett (Metro Atlanta Chamber of Commerce), and Cynthia Porter (Porter Research).
AT&T adds a remote interactive patient monitoring solution from Ericsson to its ForHealth remote patient monitoring platform.
Mercy Regional Hospital (KS) implements a paperless employee time off request process using Access Evolution.
Healthcare Clinical Informatics offers ten tips for realizing the value of EHR.
Shareable Ink will exhibit at next month’s ASA Conference on Practice Management in Las Vegas.
Beacon Partners and its employees donate over $9,500 in support of the Red Cross’s Hurricane Sandy relief efforts.
ChartWise Medical Systems will integrate TruCode’s grouper, pricer, and editing Web Services into its ChartWise:CDI software.
Imprivata publishes a white paper highlighting best practices for realizing care team collaboration and productivity benefits using HIPAA-compliant texting.
CPU Medical Management Systems, a MED3OOO company, partners with RISARC Consulting to provide CPU customers an option for secure electronic document exchange.
EPtalk by Dr. Jayne
ONC holds its annual meeting on Wednesday, December 12 in Washington, DC and also accessible by webcast. It will include sessions on HIE and interoperability, patient engagement, and of course Meaningful Use.
A study in the December issue of Pediatricslists five key features needed for pediatric EHRs: well visit tracking, support of growth chart analysis, immunization tracking, immunization forecasting, and weight-based drug dosing. Although the article notes that “it’s nearly impossible to find an EHR that meets those standards,” I guess I’m lucky because my system supports all of these. One of my friends is looking to replace her system and I’m attending a demo with her over the holidays. We’ll have to see how that vendor stacks up.
Over on HIStalk practice, Inga mentioned a survey on e-prescribing. Although I’m optimistic about its potential, I’m skeptical about the ability of pharmacies to keep up. Case in point: e-prescribing of controlled substances. Although the DEA finally approved this and several vendors piloted it in a handful of states, there is still a lack of awareness. I happened to stop by the pharmacy at a local supermarket chain and ask if they’re ready to receive such scripts (because I’m more than ready to start transmitting them) and received a stern lecture from the pharmacist about how he’s been told it’s illegal to do so.
Weird news story of the week: A New Orleans ambulance crew finds their vehicle immobilized with a parking boot, applied while they were on the scene with a patient.
I previously mentioned Scanadu, the startup that hopes to make a Star Trek-style medical scanner a reality. The company unveiled its SCOUT product, which is headed to the FDA for approval as a home diagnostic device. If it really delivers what it says – five vital sign results in 10 seconds with 99 percent accuracy – I think they’re missing a major market. For physician practices where rooming patients quickly is essential, this would be a killer app.
One of my favorite Tweeps is @MeetingBoy. Since I shared my holiday party recipes, I’ll share his piece on Eight Reasons Why I’m Skipping the Office Christmas Party. I’ve never been to a real-life office Christmas party – we don’t have those in non-profit land. The closest we have is the holiday potluck. I’d love to live vicariously through HIStalk readers and of course promise to keep you anonymous. Bonus points for anyone who has received a corporate logo holiday gift worse than what I received one year: jumper cables.
Flu season has arrived early. If you haven’t received the vaccine, there’s still time. Whether you’re vaccinated or not, please keep covering those coughs, stay home when you’re sick, and keep washing those hands. And in case you wondered, paper towels spread fewer germs than drying your hands with a blower.
The Atlanta newspaper covers the case of an internist whose stolen identity was used to apply for a National Provider Identification number, then used to incorporate a fictitious Buckhead medical clinic using a UPS Store mail box as an address with “Olga Teplukhina” named as the clinic’s CEO. The paper then did its own investigation, finding 131 CMS-registered medical providers that used an Atlanta UPS Store as their practice location, resulting in OIG looking into at least two dozen of them. One UPS Store-based company was found to have billed Medicare for $1.2 million in fraudulent injections, but is still in business because companies that are barred from billing Medicare can still bill private insurance. Despite the fact that the newspaper created the list of 131 practices using minimal effort and desktop software, CMS says it doesn’t have the technology to recognize private mailboxes since they carry a regular street address. The article says CMS pays claims that it really should deny under existing regulations because it worries that legitimate provider mistakes would unduly delay payments. One doctor complained to CMS that his name was being used to bill Medicare fraudulently, but two years later, the phony provider still has an active NPI that uses the doctor’s name.
From Diminutive Avian: “Re: Epic. Most people don’t know that Epic has one final implementation check. Judy has to personally give the go-ahead. If she doesn’t like what she sees, she tells the customer she’s pulling out and gives them their money back. That’s another reason why the company has only successful implementations. Unlike publicly traded vendors, Epic is more than willing to walk away if the client is botching the install and ignoring Epic’s recommendations.” I’ve been told that at least two big academic medical centers are in precisely this predicament as we speak. From what I’ve heard, Judy gives the client two choices: (a) agree to let Epic send in a SWAT team to take over the project, or (b) find themselves another vendor.
From BubbaLove: “Re: Duke University. Heard they’re being sued by Deloitte for breach of contract due to mismanagement of the Epic implementation.” Unverified. Perhaps HITEsq or another attorney reader can scour the legal databases and report back. UPDATE: two well-placed sources and one even better second-hand source contacted me to say there’s no truth to this rumor. I’ve also had no volunteers tell me they’ve turned up any legal documents. I’m concluding that the reader’s report report, which they admitted was second hand, is inaccurate –the Duke and Deloitte working relationship hasn’t changed as the project continues.
From Current Epic Employee: “Re: Epic’s employee ages. In the November staff meeting it was announced that Epic’s #2 Carl Dvorak has worked for Epic for 25 years. He showed a slide saying that 42 percent of the current employees weren’t born then — i.e. are under 25 — and 78 percent are under 31.” People get nervous at the idea of fresh graduates telling major medical centers how to run their business, but it seems to work and it’s brilliant on Epic’s part. You take new graduates whose career prospects are negligible, plant them in Wisconsin where there aren’t many other jobs, and pay them more than they would make otherwise but less than everybody else pays their more senior HIT people. You train them in skills with minimal value elsewhere, like MUMPS programming, and give them job perks that make them feel like they’re working for Google. The young folks don’t complain much, they don’t bring in all the bad habits they learned working for less successful vendors, and by following the formula they almost always get the job done. That makes Epic almost infinitely scalable unless Midwestern universities stop graduating liberal arts majors with high GPAs. Nobody seems to mind except the experienced people who Epic won’t hire.
From UKnowMe: “Re: IBM. Seems like several high-ranking healthcare people are getting very connected on LinkedIn lately. A sign of change to come?” I don’t know, but I think your observation has business merit for LinkedIn. They could sell the names of companies that have a large percentage of current employees updating their profiles (preparing to bail) or companies newly added to a lot of profiles (on a hiring binge).
From HC IT Advisor: “Re: AeroScout, recently acquired by Stanley Black and Decker. Has issued a cease and desist order to Centrak and will be filing a patent infringement suit. Apparently Centrak is using the patented CCA capability in their new WiFi tags.” Unverified. Calling HITEsq again, either that or I need to sign up for one of the lawsuit databases like PACER so I can look these up myself.
Acquisitions, Funding, Business, and Stock
Health analytics and research company Decision Resources Group acquires the UK-based Abacus, a health economics consulting firm.
Talent management software provider HealthcareSource acquires NetLearning, which makes learning management software for the healthcare industry.
Nuance acquires Accentus, an Ontario-based transcription, documenting imaging, and remote coding technology vendor.
An article in the San Antonio newspaper questions whether Gene Powell, chairman of the University of Texas Board of Regents and co-founder of AirStrip Technologies, should have disclosed that Vanguard Health Systems, which the board chose to launch a new $350 million children’s hospital in San Antonio, had a pending business deal with AirStrip at the time. Powell did not vote on the issue, did not recommend Vanguard, and was not legally required to make any disclosure since he owns no Vanguard stock and is not a Vanguard employee, so perhaps it was a slow news day.
The former Big Five accounting firm Arthur Andersen, driven out of business in 2002 for its role as Enron’s auditor, is ordered to pay an additional and final $9.5 million for its similar auditing involvement in the 1999 merger of McKesson and HBOC. Andersen agreed to pay $73 million to settle McKesson HBOC-related class action claims in 2006, with the possibility of contingent payment claims.
Children’s Hospital of Central California will implement athenaClinicals, athenaCollector, and athenaCommunicator across its 127-provider system.
Marietta Memorial Hospital (OH) extends its IT services contract with CareTech Solutions for an additional three years.
Twenty-one VA medical centers will implement GetWellNetwork’s interactive patient care solution, including the new Interactive Patient Whiteboard.
Memorial Health System (IL) purchases the Omni-Patient enterprise master data application and the WebFOCUS BI platform from Information Builders.
MemorialCare Health System (CA) renews and expands its relationship with MedAssets to include GPO services for supplies and purchased services and MedAssets Capital and Construction solutions.
Huntsman Cancer Institute at the University of Utah selects Wolters Kluwer Health’s ProVation MultiCaregiver EHR.
Contract resource organization NCGS selects Merge’s eClinical OS and clinical trial management solution.
Consulting firm AmpliPHY will provide Wellcentive’s data analytics platform to primary care practices.
Managed care company Amerigroup Corporation chooses McKesson Clear Coverage for point-of-care utilization management, coverage determination, and network compliance.
Michigan Health Information Network Shared Services signs with HIPAAT International for technology that allows patients to control the sharing of their PHI and allow them to view an audit log of who has viewed it.
Qualis Health hires David Chamberlain (Cardiac Science and Criticare Systems) as CIO.
Saint Francis Hospital and Medical Center (CT) names Sudeep Bansal, MD as the organization’s first CMIO.
Todd Johnson, former president and CEO of Salar and SVP of Transcend Services/Nuance after Salar’s acquisition, is named CEO of HealthLoop.
Michael Waldrum, whose roles at the UAB Health System included a five-year stint as CIO through 2004, is named CEO of University of Arizona Health Network.
Charlie Baxter, AVP of Iatric Systems and former Army captain, died Friday at 48. The guest book is here.
Announcements and Implementations
Allscripts EHR customer Primary Physician Partners (CO) becomes the first practice to connects to the CORHIO.
The Indiana HIE says that more than 750 physicians and 174 practice sites have agreed to publicly post their clinical quality measure scores on the Quality Health First Program’s public reporting website.
Imprivata announces that more than 250 healthcare organizations enrolled in its Cortext HIPAA-compliant, pager-replacing text messaging solution its first 60 days of release. Pricing ranges from free (unlimited users, unlimited messaging, unlimited photo messages, standard support, 30 days’ archiving) to $5 per user per month (upgraded support and archiving).
Elsevier integrates its ExitCare library of discharge instructions and patient education with Meditech’s EHR.
ICSA Labs and IHE USA unveil a certification program to test and certify the security and interoperability of HIT, with three tiers of certification: conformance to IHE profiles, demonstrated interoperability among disparate systems, and validated implementations of deployed certified technologies. Participants in January’s 2013 NA Connectathon in Chicago can register for testing at the event.
Montrue Technologies releases a free version of its Sparrow EDIS iPad-based emergency department information system. I interviewed Co-Founder and CEO Brian Phelps, MD earlier this year.
Government and Politics
Recovery auditors collected $2.2 billion in overpayments in fiscal year 2012 and gave providers $109 million in underpayments. Net 2012 corrections were $2.4 billion, compared to 2011’s $939 million.
Congressman Mike Honda (D-CA) introduces the Healthcare Innovation and Marketplace Technologies Act to foster more healthcare innovation through the development of marketplace incentives, challenge grants, and increased workforce retraining. The bill would also establish an Office of Wireless Health at the FDA.
Innovation and Research
A Microsoft Research documentary shows the organization’s work in using technology to fight tuberculosis in India, including development of a biometric monitoring system to make sure patients keep their healthcare appointments and systems that trigger an SMS message to a manager when a patient misses scheduled medication doses. Treatment is effective and straightforward, but requires more than 40 clinic visits in six months. Non-compliance causes TB spread, drug resistance, and nearly 1,000 deaths per day in India.
UCLA engineering school researchers create BigFoot, a software package that allows people with chronic foot problems to track their conditions using a PC and flatbed scanner.
Streamline Health, which acquired Atlanta-based Interpoint Partners a year ago, will move its corporate headquarters from Cincinnati to Atlanta. The company will continue to operate the Cincinnati and New York City offices.
Cerner analyst Staci Klinginsmith is crowned Miss Kansas USA.
University of Virginia Medical Center warns patients that a mobile device used by on-call IV pharmacists in its home health agency is missing and contains patient information, including diagnoses, medications, and Social Security numbers used as health insurance ID numbers.
HIMSS, responding to OIG’s recommendation that the bar for Meaningful Use payments should be raised via pre-payment reviews, improved EHR MU reporting, and improved EHR reporting certification, supports CMS developing guidelines that will help providers prepare and retain audit-related documentation. In other words, like CMS, HIMSS isn’t a fan of pre-payment reviews.
I’ve spent a considerable amount of money and energy on programming workarounds required to make HIStalk work on the incredibly buggy and standards-breaking Internet Explorer, but I’ve noticed its gradual improvement. I’m encouraged that Microsoft gets the lack of browser love it receives and can even poke fun at itself with a fun “it sucks less” video (above) and a new site, www.browseryoulovetohate.com. I’m checking it out in Firefox, of course, since I’m not that forgiving of IE’s past transgressions, but I may download the IE10 beta just to see what all the fuss is about.
A new JAMA article finds that the average dentist now out-earns the average physician, with pharmacists not too far behind.
Lyle Berkowitz, MD (Northwestern University) and Chris McCarthy, MPH, MBA (Kaiser Permanente Innovation Consultancy) are editors of the newly published Innovation with Information Technologies in Healthcare. DrLyle says it tells the stories of 20 organizations who are HIT innovators in improving care quality and value, with details that he describes as “a big cookbook of recipes on how to innovate with HIT” divided into sections covering electronic medical records, telehealth, and advanced technology. I took a quick skim over a couple of the sample chapters he sent over and it’s meaty, without the usual fluff that makes some HIT books seem like a handful of good ideas and thoughts that were shamelessly padded to justify an author credit and a higher selling price. The book is $74.14 on Amazon and you can use the Look Inside! option to try before you buy.
A Colorado Public Radio article covers EMR adoption, showcasing a five-physician practice that expected its new EMR to increase patient capacity by 25% and get its bills out more quickly. That turned out to be wishful thinking on the salesperson’s part. They never got back up to more than 80 percent of their pre-EMR workload, they found that their Medicare patient volume was too low to qualify for incentive payments, one doctor quit over frustration with the EMR, and the remaining four partners were on the hook for the $200,000 they had borrowed to buy it. The end result: they had to sell their practice.
Use of mobile technology to view patient information and to access non-protected health information is on the rise, according to a HIMSS mobile technology survey. Key uses include collection of data at the bedside, bar code reading, monitoring data from medical devices, and capturing visual representation of patient data. Funding and security concerns are the top barriers to mobile technology adoption.
Athenahealth’s Jonathan Bush channels Dr. Mostashari on Fox Business wearing a holiday-red bowtie and pitching healthcare technology.
A local paper shares the story of a clerical supervisor in a British Columbia hospital who was conducting training on the Vocera communication system when the device issued a Code Orange, warning of an impending flood. Clinical staff moved patients to safety just before a wall collapsed in a flood of water, while the supervisor scrambled to save paper charts and the hospital’s stockpile of 75 Vocera badges.
Weird News Andy is really fired up about use of the Liverpool Care Pathway for palliative care in the UK. An audit of records from 178 NHS hospitals finds that nearly half of the dying patients who had life-saving treatment (drugs, fluids, food) withdrawn via the protocol weren’t told that fact, 22 percent had no documented evidence that their care and comfort was maintained, and a third of the families didn’t receive literature explaining the process. A proposal is on the table to require consulting with the patient or family before initiating the pathway, which leads to patient death in an average of 29 hours.
WNA could contribute only a “sheesh” to this article, which finds that Dallas mothers and daughters are bonding over cosmetic surgery procedures, often motivated by reality TV shows that make that practice seem normal.
A former Microsoft manager takes advantage of newly legalized marijuana in Washington by opening a “premium marijuana” retail business, expressing his desire to position his brand of weed like fine brandy or cigars to high-income baby boomers. He says, “Think of us as the Neiman Marcus of marijuana … the buzz is in the air.” He says he came up with the plan while high and will name the business after his marijuana-farming great-grandfather.
In Brazil, an apparently computer-savvy thief robs an ATM by replacing its USB security camera with a Plug and Play keyboard and a USB stick, then restarts the machine and keys commands to withdraw all its cash. He was caught. The article mentions the recent discovery of several ATMs at Inova Fairfax Hospital (VA) that were rigged with “ATM skimmers” that fit over the card slot, capturing the card’s number and in some cases using video recording to capture the user’s PIN.
Aspen Advisors hosted 62 associates at its annual retreat in Fort Lauderdale, which included a run fun that raised $1,000 for the University of Miami Health System.
Besler Consulting representatives will present at upcoming New Jersey and Metropolitan Philadelphia HFMA seminars.
Santa Rosa Consulting announces E2E Activation Support, a service line that will provide elbow-to-elbow EMR go-live support.
The Black Book Rankings names DrFirst the top vendor for e-prescribing and recognizes Emdeon for outstanding developments in clinical exchange solutions. Other HIStalk sponsors earning honors include Allscripts, e-MDs, Vitera, Aprima, SRS, Quest MedPlus Care 360, and McKesson.
A local paper profiles eClinicalWorks CEO Girish Kumar Navani and the success of his company.
AT&T names its top five healthcare trends for 2013, which emphasize growth in mobile apps and telehealth.
Sacred Heart Health Systems (FL/AL) shares how Iatric Systems’ Security Audit Manager has aided privacy compliance by capturing audit log data from its Siemens, McKesson, and Picis systems.
Three Informatica customers win Ventana Research Leadership Awards, including HMS Holdings (IT Leadership Award for Analytics and Overall IT Leader); Moffitt Cancer Center (Business Technology Award for Big Data); and Ochsner Health System (IT Leadership Award for Information Management.) Informatica’s PowerCenter Big Data Edition also won the Ventana Research Technology Innovation Award.
Mark Van Kooy, Myra Aubuchon, and Dawn Mitchell of Aspen Advisors present a December 5 Webinar on addressing EMR value with a hospital board.
3M Health Information Systems offers a Webcast featuring 3M CMIO Sandeep Wadhwa’s presentation on improving ACO efficiency and outcomes.
Cumberland Consulting promotes Charles Taylor to principal and Jose Gonzalez to executive consultant.
The Advisory Board Company’s Southwind program recognizes Dignity Health (CA), Adirondack Region Medical Home Pilot (NY), and Lancaster General Health (PA) for successful physician partnerships.
Covisint releases a white paper that outlines the evolution, growth, and future of HIEs.
Beacon Partners employees assemble 108 care packages for troops during the company’s annual meeting.
Wellcentive’s VP of Product Strategy Mason Beard discusses interface strategies for population health management in a blog post.
From NoNamesPls: “Re: MD Anderson. They will replace not only their in-house developed EMR, but also commercial systems for pharmacy, lab, RIS/PACS, and ADT/Scheduling. Epic and Cerner are the frontrunners.” Another reader forwarded me the internal e-mail from the deputy CIO and the CMIO, which says MDACC spends $20-$30 million per year on its homegrown ClinicStation but still can’t keep up with federal regulations. The RFP goes out in January. It’s interesting that the e-mail suggests that they’re happy with the patient benefits of their existing system, but will spend hundreds of millions of dollars to replace it for non-patient reasons. Somehow you have to wonder if that’s really a good thing.
From Upon Further Review: “Re: three hospitals of Dignity Health (formerly CHW). Scrapping their Meditech 6.0 and Medhost implementation that was supposed to start going live last week and moving to Cerner. Go-live required by January 1, 2014.” Above is part of Friday’s letter sent to employees by Chuck Cova, president and CEO of Marian Regional Medical Center, which says, “We are not confident in the Medhost and Meditech system’s meaningful use and ability to perform at a high level for optimal use.” It went down to the wire: Medhost was to supposed to be brought live starting November 26, but the project was delayed on November 13 and then killed on November 30.
DZA MD replied to my Time Capsule editorial from 2008 in which I suggested that patient encounters be recorded on video now that multimedia storage is cheap (security cameras are running everywhere, after all, and your encounters with Las Vegas card dealers are recorded in multi-angle splendor). Here’s what DZA MD had to say:
Imagine how well behaved everyone would suddenly be! Patients and caregivers. Both are in need of civility IMHO.
Though certainly not the first, I proposed this solution to patient care documentation to interested academics at my institution round the millennium. It was not taken seriously and was viscerally scary in a dot.gov sort of way, but the time has arrived. Some consequences (positive):
Documentation. Real-time video and audio. Obvious. Supplement with dictated or keyed notes into the EMR, capturing decision-making and care coordination / consults. Even online research pertinent to the visit (can sarcoidosis cause GI symptoms?) could be incorporated into the record (browser history), supporting decision making and due diligence. These AVI files are completely portable without need for interface language.
Billing. How about simply paying an hourly rate for time spent, like lawyers? Time stamps on audio and video, post-visit data entry and online patient care research would serve as indisputable evidence of billable time.
Legal. ‘Nuff said. Patients who opt in to AV documentation assent to legal arbitration. And benefit from reduced insurance costs associated with this documentation product. Patients who opt out must use the traditional tort pathway, but are exposed to the added expense of that course of action.
Patient education and self care. An electronic copy (edited or not) of the visit can be provided to the patient. Presumably the interaction involves patient education elements from the clinician.
QA. NLP can sort through audio files for key words related to quality metrics. AV files can be used for clinician feedback for both physical exam skills as well as interpersonal behavioral skills.
Cost. Memory is cheap. AVI files are portable, searchable, and easily indexed and archived. Insurers could develop pilot programs using this technology to study cost impacts in preparation for wide release if promising.
I hand-picked this week’s Spotify playlist with music sharing only one attribute: I like everything I included. On it: Pond, RPWL, The Killers, Band of Horses, Marina and the Diamonds, Turtle Giant, and a searing live version of “Little Wing” from Clapton/Winwood. Here’s a trivia throw-down: what movie (one of my favorites) opens with Tune #13 as buses drive by in the night? If you want to play along at home, I also created this empty playlist to which you can add your song du jour — I’ll listen to them and choose some for next week’s playlist (it’s like a clinical inbox for music referrals).
Welcome to new HIStalk Platinum Sponsor Fujifilm, which offers the Synapse product line (RIS, PACS, 3D suite, virtualization, managed services, and teleradiology RIS). The Web-based Synapse radiology management solution provides hospitals and outpatient imaging facilities such capabilities as integrated dictation, a referring physician portal, electronic dashboards, mammography reporting, peer review that meets ACR guidelines, and critical result notification, all included at no extra cost. Users can craft their own workflows via built-in tools for instant messaging, automated e-mail notification, and digital forms creation. They can also use drawable consent forms, inventory tracking, and real-time eligibility checking. The RIS integrates with every PACS on the market, including of course Synapse PACS. It even includes teleradiology capabilities. You can choose Synapse RIS as a turnkey system that includes software, hardware, hosting, system management, upgrades, and optional disaster recovery services and off-site archiving. Customers pay by exam volume rather than per user or per site, which makes it affordable for facilities ranging from small imaging centers to multi-facility enterprises. Thanks to Fujifilm for supporting HIStalk.
Here’s an overview of Fujifilm’s Synapse RIS that I found on YouTube.
Thanks to the following sponsors, new and renewing, that have recently supported HIStalk, HIStalk Connect, and HIStalk Practice. Click a logo for more information.
The vast majority of survey respondents believe that transcription is a commodity service differentiated primarily on price. New poll to your right: should the government require more upfront proof of attaining Meaningful Use before before sending payments?
Few people buy traditional software (i.e. PC programs in a box instead of apps in a Web store) these days, and those who do are rarely delighted. I’m happy to report an exception. I bought the just-released Dragon Naturally Speaking 12 and it’s amazing. The accuracy approaches 100 percent and it’s quite fast. I bought the premium version from Amazon for $126, which also includes the ability to transcribe pre-recorded dictation, sort of like Nuance’s eScription server-based speech recognition (the Home Version is only $50). You can speak at least three times faster than you can type, not to mention saving your wrists. I’ve used previous versions as well as the Windows 7 speech recognition and Siri and there’s no comparison. (Disclosure: Nuance is a sponsor and has offered me free copies several times, but I paid out of my own pocket so I wouldn’t feel bad about saying I hated DNS if that was the case). DNS 12 is one of the most amazing things I’ve ever seen run on a PC, although as critics always point out, you can’t use it with an EMR since that requires the more expensive medical version. But if you want to feel like Bill Shatner sprawling back in a chair on the Enterprise bridge and barking out orders for the computer to obey, you need it. It must be a miracle for people with handicaps who can’t use computers in traditional ways.
Scanadu, the 20-employee company whose tagline is “Sending your Smartphone to Med School,” announces that it will release three consumer tools by the end of 2013. The $150 Scanadu Scout is held to the temple and in less than 10 seconds, checks pulse, heart activity, temperature, and pulse oximetry and sends the results via Bluetooth to its smartphone app. Project ScanaFlo is a disposable cartridge that turns a smartphone into a urine analysis reader (pregnancy complications, gestational diabetes, kidney failure, or UTI). Project ScanaFlu is a saliva tester that detects cold symptoms by checking for strep, influenza, adenovirus,and RSV. Scanadu is best known for working on a tricorder-like health assessment device and these modules are the first components of it. Above is a Friday interview with the co-founder and CEO, who seems to be at a loss of how to explain medical principles to the sing-songy twenty-something interviewer who nods intently while saying “sort of “ and “you know” a lot while clearly not understanding most of what he’s saying.
It appears that Blackstone Group has become the frontrunner to acquire Allscripts, although the company is rumored to be holding out for more money than Blackstone thinks it’s worth. Shares dropped 11 percent Friday, having lost most of the gains that occurred after rumors of the company’s sale slipped out in late September. The other bidders were claimed to be Carlyle Group LP and TPG Capital Management LP. I don’t understand SEC rules, but this business of running newspaper stories quoting insiders about who’s making offers and at what price sure seems to open the door for cheating, like intentionally leaking out news that will move the share price up or down in a way that will benefit the leaker.
CareFusion announces that Children’s Hospitals and Clinics of Minnesota has gone live on wireless connectivity between its Alaris smart IV pumps and Cerner Millennium.
Health Management Associates warns investors that a “60 Minutes” report is expected to claim that the for-profit hospital operator’s contracted ED doctors were pressured to admit patients who didn’t need to be hospitalized. Both HMA and Community Health Systems have disclosed in SEC filings that several government agencies are following up on whistle-blower allegations by requesting admissions information. HMA says it thinks authorities want to know how more about its vendor-provided ED software and whether it was programmed to admit patients unnecessarily. Tenet Healthcare had accused competitor CHS in early 2011 of using ProMed Clinical Systems software to boost its admissions in a lawsuit, but a judge dismissed the claim. HMA is also a user of ProMed’s Web-based vEDIS software, which is ONC-ATCB certified. I seriously doubt that ProMed makes admission decisions that the ED docs can’t override, so if there’s a smoking gun, I’d expect to find it in internal e-mails, meeting minutes, or in interviews conducted with the actual ED docs.
Kansas Health Information Network becomes the first HIE to connect directly to the CDC’s BioSense outbreak tracker, allowing hospitals to quickly share information about threats and report them to CDC to investigate possible outbreaks.
Advanced Data Processing announces that it has fired an employee who admitted stealing data from an ambulance billing system it runs and selling it to a criminal group suspected of using the information to file fraudulent tax returns to collect refunds. The information came from Cape Fear Valley Hospital Health System (NC). The same scam has led to the arrest of three people in Florida, at least one of them an employee of Florida Hospital Tampa, who used hospital patient billing information to collect $1.5 million in IRS tax refunds.
Why can’t American healthcare strikers be this much fun? Public health workers in Spain protest government spending cuts and healthcare privatization by performing a flash mob dance outside La Paz Hospital in Madrid.
GE CEO Jeff Immelt says, “The next holy grail is about decision support and analytics.”
A rare Weird News Andy weekend update: in France, a man is awarded $250,000 in his lawsuit against GSK, maker of the Parkinson’s drug that he claims caused him to become addicted to gay sex and gambling. The suggestion that gay sex is a shameful addiction that requires compensation is kind of insulting, but apparently the jury bought it.
Bizarre: a pharmacist pleads guilty to planting mercury in areas of Albany Medical Center Hospital (NY) in the hopes that the ensuing panic would drive patients away. Police searching the home of the man, who was upset that the had hospital billed him for treatment, found child pornography, Nazi memorabilia, and a stockpile of guns and ammunition.
Also bizarre: a Washington veterinarian and aspiring EMT is charged with animal abuse after former employees claim he punched and choked animals under his care. He had already admitted to stealing and using drugs from his practice. The owner of one animal that was allegedly mistreated summarized, “Well, I wouldn’t want him to be my first responder. Golly.” The doctor’s Facebook blames disgruntled former employees and lawyers trying to change the state’s veterinary malpractice laws, which limit plaintiffs to recovering the “market value” of their animal with no pain and suffering award available for the lawyers to skim their 33 percent of.
Vince covers the fascinating HIS-tory of CPSI this time around, getting some help from Troy Rosser, SVP of sales there.
The Office of the Inspector General finds that CMS has not implemented adequate safeguards to verify the accuracy self-reported EP and hospital data for the MU program. It also says that the audits CMS plans to conduct after the fact may not work, either. OIG recommends that CMS randomly select providers to provide supporting documentation for pre-payment; issue guidance detailing the types of documentation that providers should maintain to support compliance; and require certified EHRs to produce reports verifying the achievement of MU measures. Medicare hasn’t audited any of the $3.6 billion it’s paid out so far. Acting CMS administrator Marilyn Tavenner doesn’t like the idea of pre-payment review, saying it could “significantly delay payments to providers” and “impose an increased upfront burden on providers.”
From Uncorked: “Re: MyWay switch. I’ve learned the upgrade that Allscripts is offering its customers from MyWay to Pro does not include a detailed conversion of financial data, meaning users have to work the old balances in MyWay. Sounds painful.” The details on the MyWay to Pro upgrade are on the client-only section of the Allscripts Web site, so I can’t verify. However, since detailed conversion of financial data between disparate systems can be quite complicated and time consuming, maybe the balance forward option is actually the lesser of two pains.
From NoNamesPls: “Re: MD Anderson. To release an EMR RFP in January.” Unverified.
From Lucille Carmichael: “Re: Nuance. Planning to spin off Salar, which it acquired with its Transcend acquisition, possibly as early as Friday.” Unverified.
HIStalk Announcements and Requests
If your week has been anything like mine, you are still recovering from all your thankfulness last week. In case you missed any HIStalk Practice news, here are some highlights. ONC says the percentage of physicians e-prescribing on the Surescripts network through an EHR has jumped from seven percent in 2008 to 48 percent as of June 2012. Almost 10 percent of US residents now receive their healthcare through an ACO. The highest-rated EMRs in an AAFP-member survey are Praxis, Medent, Healthconnect, Amazing Charts, and SOAPware. Pediatricians lag other specialties in EHR adoption. Practice Wise’s Julie McGovern offers key points for selecting an EMR vendor. Dr. Gregg muses about corporate chaos and HIT. Thanks for reading.
The mobile interactive health advice platform HealthTap acquires the health business of Avvo, including its directory and network of providers.
Ginger.io, which analyzes sensor and patient-entered smartphone data to for the equivalent of a “check engine light” for patient populations, raises $6.5 million. The investor is Khosla Ventures, whose founding partner Vinod Khosla famously predicted several weeks ago that machines will replace 80 percent of doctors (some of his other investments include iPhone attachments for heart monitoring and diagnosing ear infections). Ginger.io is based on research conducted at the MIT Media Lab. The company acquired another startup, Pipette, earlier this year for its technology that claims to reduce hospital readmissions by reviewing patient-reported outcomes. Travis reported the acquisition on HIStalk Connect back in March, where he concluded,
Ginger is a company we are going to hear a lot more about in the coming years. They have a clear focus on learning about patient behavior and proactively trying to address potentially costly events. The main question will be how much money can Ginger make quickly from pharma research or how much money can it raise to sustain itself until the healthcare industry is ready to pay for services like this. Either way, this acquisition is good for mobile health startups and Rock Health.
Stormont-Vale Healthcare (KS) selects Hyland Software’s OnBase enterprise content management solution for integration with its Epic ambulatory EMR.
Yale-New Haven Hospital contracts with Mediware for its Transtem software for tracking the use of stem cell products in providing patient care.
OnFocus Healthcare adds 75 hospital clients of its OnFocus | epm software during the company’s fourth quarter.
Pomona Valley Hospital Medical Center (CA) selects Dell and Siemens Healthcare to provide diagnostic image archiving and sharing services.
BJC Healthcare (MO) expands its use of the Surgical Information Systems perioperative information system to Saint Louise Children’s Hospital and Barnes-Jewish West County Hospital.
Santa Clara Valley Health and Hospital (CA) awards CSI Healthcare a contract to support its Epic initiatives.
Beaufort Memorial Hospital selects the Medseek Empowered solution to expand its patient engagement initiatives.
St. Joseph Health System (TX) chooses GroupOne Health Source for EHR medical billing services.
Ophthalmic Consultants of Boston (MA) deploys MedAptus for professional charge capture in its office and ambulatory surgical center locations.
SPI Healthcare appoints Ken Christensen (Health PCP) SVP of operations.
CareTech Solutions names Robert M. Johnson (Palace Sports & Entertainment) CFO.
Joseph Kvedar, MD, director of the Center for Connected Health of Partners HealthCare, signs on as a principal with Wellocracy, but will continue in his role at CCH. The new company will focus on personal activity trackers and motivation tools that integrate healthy activities into busy lifestyles, initially producing books. He’ll be joined by a self-help author, a personal trainer turned physician, and a media relations expert.
Bill Bria, MD (Shriners Hospital for Children) is named chief medical officer of business intelligence software vendor Dataskill.
Peter Henderson (PatientKeeper) joins social networking-based employee wellness vendor ShapeUp as COO.
Announcements and Implementations
Washington DC Mayor Vincent Gray announces the go-live of Direct Secure Messaging in the district using Orion Health’s technology platform.
RelayHealth announces that it will provide an open, vendor- and payer-neutral platform for patient identity management, patient consent management, and other technology services to enable a longitudinal patient record. The technology will allow providers to embed a cross-entity MPI into their native systems and enable patient identification across multiple systems.
Jennie Stuart Medical Center (KY) goes live on Ingenious Med’s Impower charge capture solution.
The Kansas HIN and ICA share patient data with the CDC’s Biosense public health tracking system.
Government and Politics
An opinion piece in The Wall Street Journal written by former US Senator George LeMiuex (R-FL) says the government is doing little to stop the estimated $100 billion per year that Medicare loses to waste, fraud, and abuse. He had proposed a credit card-like fraud prevention system that would stop questionable claims before they’re paid, but that’s the $77 million system developed by Northrop Grumman and Verizon that had stopped less than $8,000 in questionable payments in its first eight months. He concludes that the problem is “bureaucrats hiding in their own ineptitude.”
CMS has paid more than 150,000 EPs and 3,238 hospitals $8.4 billion in MU incentives through the end of October.
CMS extends the Medicare MU attestation deadline for New York and New Jersey hospitals affected by Hurricane Sandy. Eligible hospitals must submit to CMS and extension application to extend the attestation deadline from November 30, 2012 to the spring of 2013.
HHS issues a guide for de-identifying patient data to meet HIPAA privacy rule requirements.
British troops in Afghanistan are using a portable 3D camera to assess battlefield injuries and send images around the world for second opinions.
Surgical Theater LLC sells its first 3D imaging surgical rehearsal platform. It generates statistical models from an individual patient’s scanned images, providing life-like feedback using flight simulator technology that allows the surgeon to practice the procedure hands on. The first customer is University Hospitals Case Medical Center (OH), which isn’t surprising since its co-originator is the chair of the hospital’s neurosurgery department and the product bears his name. FDA approval is pending. The co-founders are former members of the Israeli Air Force, with my reason for calling out that fact becoming more clear as you read further down the page.
The California Department of Public Health fines Prime Healthcare Services $95,000 after determining that Shasta Medical Center violated patient confidentiality when it shared a woman’s medical information with journalists and sent an e-mail about her treatment to several hundred hospital employees. The disclosures were made when the hospital was seeking to respond to a news story featuring the woman and the hospital’s alleged overbilling of Medicare.
Philips moves from last place to first place in KLAS’s review of the MRI market.
A survey finds that promoting EHRs and mobile health are a low priority for voters compared to other healthcare issues. When asked where federal healthcare spending should be cut, 50 percent of voters said payments to providers should be reduced, while 42 percent said the government should spend less on healthcare IT.
Leapfrog Group’s second round of hospital safety ratings show significant swings in the months since the original report after it changes its methodology and uses newer data, with 103 hospitals moving from a C to and A, two changing from A to D, and an overall 8 percent moving at least two grades. Ronald Reagan UCLA Medical Center earned an F grade along with 24 other hospitals, while Cleveland Clinic took home a D. Predictably, the high-profile hospitals with the bad grades denounced the methodology when stung by local press coverage of their embarrassing results, claiming they’ve improved vastly in the 1-3 years since the information was collected.
The Bureau of Labor Statistics predicts that IT positions in healthcare and social assistance will account for about 28 percent of all new jobs by 2020.
A New Zealand sleep expert blames mobile devices for a 50 percent jump in sleeping pill consumption by young people, saying, “People go to bed with their iPhones and iPads and expect to be able to then go straight to sleep, but realistically, you can’t do that. You really need to put these devices down about an hour before you go to bed.”
I was interested in the answer Kobi Margolin gave to my interview question about why Israel produces so many healthcare IT companies that sell products to the US. He suggested reading Start-Up Nation, which describes the business climate there. I plan to do so, but from the Amazon reader comments, some of the reasons that the country is so successful despite being constantly at war, surrounded by enemies, and devoid of natural resources are: (a) mandatory military service that encourages innovation and forges early social networks; (b) Jewish tradition; (c) open immigration that encourages brilliant innovators to come there; (d) a tradition of young people traveling all over the world due to the small size of the country; (e) government policies and culture that supports entrepreneurism and the questioning of authority; (f) a flat hierarchical society; (g) acceptance of failure in the quest for success; (h) early maturity and lack of belief that people shouldn’t start businesses without a lot of experience, emphasizing instead agile, problem-solving generalists; (i) mashing up technology with other disciplines in fresh ways; and (j) great universities. In other words, pretty much exactly opposite what we have in the US except for the great universities part. If you’ve read the book, feel free to chime in.
An article in The Wall Street Journal raises the question of the ownership of data created by implanted medical devices like defibrillators. It’s your body, but only the device manufacturer (and possibly your doctor, if you see one regularly) can see what it’s emitting. A Medtronic spokesperson says, “Our customers are physicians and hospitals” and says demand is low and patients couldn’t make sense of their data anyway, but then admits that the company is thinking about selling its patient data to health systems and insurance companies. Another senior Medtronic executive calls the information it collects “the currency of the future.” The company has created a data unit specifically charged with creating a business around selling patient data, working the loophole that only providers are covered by the 17-year-old HIPAA regulations, not device manufacturers. One patient paid $2,000 to take a technician’s class for reading the reports, but still has to pay his cardiologist for a visit to get the data.
Remedy Health Media launches a service that will send electronic newsletters to patients with specific conditions under the name of their doctor, who pays the company for use of its patient data management system. The company says health reform gave them the opportunity, while advertising drug companies give them their profit. It’s a double-opt in service due to comply with spam laws, meaning patients need to sign up and then click a link on a welcome e-mail indicating their interest to receive further e-mails. Some of the company’s brands include HealthCentral, The Body, RemedyMD, and My Refill.
Attendees of an auction at a bankrupt and closed Pennsylvania hospital claim to have seen unattended medical and employee records and computers up for bid that were displaying patient information. The bankruptcy trustee claims the medical records were in roped-off areas and the computers had been wiped clean, but a bidder says that’s not the case.
An excellent article in the Toronto newspaper questions whether e-health will ever deliver a return on investment in Canada. It calls out the massive spending on eHealth infrastructure, implying that it’s a desperate shot at addressing the question, “Could the elderly bankrupt Canada?” but points out that for all the investment, Canada is still well behind most of the industrial world, with 80 percent of its physicians still using “a fax machine running full blast against a ceiling-high backdrop of manila files.” It says that Canada’s efforts are looking a lot like those of the UK, where ambitious and expensive programs tanked with little to show for it other than billions of taxpayer pounds transferred to consultants and contractors. A former deputy health minister had an interesting thought: instead of buying EHRs for everybody, which he says will cost more than the healthcare services they consume, he suggests providing them only for seniors and people with chronic disease since 1 percent of Ontario patients have been found to consume 50 percent of hospital and nursing home costs.
Weird News Andy wonders if this is where we’re headed. In England, sick babies are being put on “death pathways,” with the rather lurid newspaper article quoting one doctor who admitted that he took part in “starving and dehydrating ten babies to death in the neonatal unit of one hospital alone.” A hospital nurse calls it “euthanasia by the back door.” An investigation will determine whether hospitals earned bonuses for hitting death pathway targets.
Nuance gives the $73 (at Walmart) Philips Digital Voice Tracer dictation recorder its highest rating for recording and voice recognition accuracy with Dragon Naturally Speaking.
3M announces details of its 2013 Client Experience Summit, set for April 2-4 in Tysons Corner, VA.
Liaison Healthcare announces that four out of five global pharmaceutical companies use its integration and data management services.
The Orlando paper spotlights Kony Solutions and its “cutting edge” app development.
Levi, Ray & Shoup publishes a case study highlighting the benefits that Memorial Hermann Healthcare (TX) realized simplifying output management.
SuccessEHS integrates the Midmark IQvitals device with its EHR.
BridgeHead Software releases a white paper highlighting the crucial concerns of image availability.
Besler Consulting offers a free comprehensive summary of the Hospital Outpatient Prospective Payment System final rule.
API Healthcare offers five tips for payroll success in hospital mergers and acquisitions.
Informatica introduces a global messaging routing capability for the Informatica Ultra Messaging environment.
The Tampa Bay Technology Forum honors MedHOK with the 2012 Emerging Technology Company of the Year Award.
Ingenious Med releases software upgrades for its Web and mobile solutions that include a Virtual Superbill to improve charge capture.
Health Language Inc. releases new terminology mapping to support providers and EHR vendors meeting Stage 2 MU requirements for SNOMED-encoded problem lists.
iSirona releases Software Makes Sense, a five-part video series detailing the specific configurations and their advantages used by iSirona’s hospital customers to sync medical devices and EHRs
EPtalk by Dr. Jayne
Friday is the last day for HIMSS 2013 Interoperability Showcase submissions. Demonstrations must include health information exchange between at least three healthcare organizations.
Friday is also the last day for Eligible Hospitals and Critical Access Hospitals to register and attest for incentive payments in fiscal year 2012. CMS has a tutorial on YouTube which, strangely, enough seems to have been filmed in front of a green screen that wasn’t replaced by graphics, rendering it nauseatingly distracting.
Finally, a data breach that doesn’t involve a lost laptop or stolen hard drive. A resident physician terminated from the University of Arkansas for Medical Sciences kept patient lists and notes after being terminated in 2010. The resident began to produce the records during a lawsuit against the residency program, leading to a court order to prevent further release.
Discussions at RSNA reveal mixed opinions about releasing radiology results directly to patients. I think many providers would prefer to release only annotated results to patients – those results to which the ordering physician has added comments that explain the clinical significance of the radiologist’s interpretation. There are a lot of vague terms used by some radiologists (clinical correlation recommended, questionable presence of something, etc.) and that leads to fear of patients misunderstanding, which leads to fear of being transparent with results. If health systems are going to release without annotation, maybe they should require radiologists to document results at the 5th grade reading level: “Your chest x-ray looks like the chest x-ray of every other person who lives in your part of the country. I don’t see anything that doesn’t belong there.”
For those whose providers have embraced transparency and are offering patient portals and other engagement platforms, the Family Caregivers Video Challenge offers a chance to tell how health information technology or eHealth tools have helped manage a loved one’s care. Video submissions are due by December 10 and prizes worth $8,350 are at stake.
My hospital has been lucky that this hasn’t happened to us (yet). A NYU staffer inadvertently sends an e-mail that allows a student to accidentally “Reply All” to nearly 40,000 of his classmates. Thousands of students jump on the bandwagon, creating what some termed the “replyallcalpyse.” It’s only a matter of time before it happens here.
OIG includes “integrity and security of health information systems and data” as one of the top management challenges faced by HHS for 2013.
From Image Is Everything: “Re: RSNA. As a vendor, some of us had to go to Chicago the Monday before Thanksgiving and work through the weekend. The trick was to take your spouse, since the Magnificent Mile had beautiful displays, shopping, tourists from around the world, and lots of nice people. The problem was Thanksgiving dinner – think the Chinese restaurant in ‘A Christmas Story.’” I accompanied Mrs. HIStalk to a Chicago conference a few weeks ago, the first time I’d been there since the wintry HIMSS conference of 2009. We had a pretty good time this trip – stayed at the Hyatt on the river, ate at semi-touristy places (XOCO, the Walnut Room, South Water Kitchen, and the Metropolitan Club in Willis Tower), bought Frango Mints, and tried to stay warm since the temperature dropped from the mid-70s the first day to the 40s the rest of the week, ruling out the architecture boat tour. I wouldn’t say Chicago is my favorite city (I think Seattle and San Diego probably top my list), but I at least liked it better than when snow and fellow HIMSS attendees were swirling around me.
From The PACS Designer: “Re: 3D printing. TPD has posted about 3D software solutions in the past, and now you’ll become aware of a retail 3D printer called MakerBot. This company reminds TPD of when Xerox was first to introduce a new way of high quality printing decades ago. MakerBot just opened the first 3D Photo Booth in NYC, its home base, and I’m sure when the photos are viewed, word will spread across the country quickly. Healthcare could benefit by employing this 3D solution to view images of the anatomy, especially the heart, by practitioners and patients undergoing treatment.”
From Keystone: “Re: EMR. I’m involved with five practices being implemented and all are complaining that their efficiency is going backwards because of extra keyboarding. Do you think this is due to added documentation that they should have been doing all along, poor system design, or both? These are mostly primary care physicians and they are definitely seeing fewer patients per session. Also, do you know of bolt-on products to support dictation or other simpler input tools?” Readers, I’m sure Keystone would welcome your comments, which you can add at the end of this post.
From Cloud Dancer: “Re: PACS. Your blog is incredible! Was wondering about your coverage of cloud imaging solutions like Merge as well as other trends in PACS going cloud.” One thing I excel at is recognizing my innumerable limitations, among them being paucity of in-depth knowledge about imaging and lack of time to learn since I’m a full-time hospital employee. I could use an expert contributor if anyone is interested in taking HIStalk a bit deeper into that area. The other areas that people seem to want more coverage about include HIT-impacting federal policy activity, patient-centered technologies, and startups and other innovation. You might think it would be easy to find and engage experts to contribute to HIStalk, but it’s not – they’re either too busy or not all that interested in writing regularly since it’s harder than it looks.
HIStalk Announcements and Requests
I am back from my Thanksgiving break, which included a bit of holiday shopping. I was remarkably restrained in my purchasing, though I did note quite a few items for my letter to Santa. Topping the list: Christmas tree ornaments for the shoe lover.
Thanks for the nice comments folks have sent about the redesign of HIStalk Connect (the artist formerly known as HIStalk Mobile). Next up: a revamp of HIStalk Practice and HIStalk, which will have a different look that’s more appropriate to longer posts. I haven’t changed the appearance of the sites since 2007, so hopefully nobody will be too jarred by the change (me included).
Just in case you have any doubts about the financial literacy of the average American, check out the lines of people waiting to buy tickets for the $500 million Powerball lottery. These are the folks who couldn’t be bothered to play when the prize was only a couple of hundred million. Does that make sense? Do you suppose a lot of statisticians are plunking down their cash given the impossible odds of getting it back? Maybe the feds should run a lottery to help pay down the smothering national debt – it’s like a tax that nobody complains about.
Welcome to new HIStalk Platinum Sponsor Innovative Healthcare Solutions. The 12-year-old Punta Gorda, FL-based company offers clinical and revenue cycle implementation services, with a focus on Epic and McKesson (ambulatory and inpatient EMR, STAR, Pathways, and Horizon, including upgrades and optimization.) They’ve been a Best in KLAS winner for the past two years in the Clinical Implementation – Supportive Work category. They also do assessment, optimization, testing, and strategic planning. Their approach is proven and cost effective, with the recognition that healthcare organizations are required to focus on both financial and clinical excellence for success. The principals have lot of industry experience – Robin Bayne was at McKesson for many years and Pat Stewart has been in healthcare for more than 30 years. Thanks to Innovative Healthcare Solutions for supporting HIStalk.
Acquisitions, Funding, Business, and Stock
Healthrageous announces that Partners HealthCare participated in its recent $6.5 million round of Series B financing.
Hello Health, which offers an EHR platform that’s paid for by patients ($5 per month, according to its site) instead of doctors, secures $11.5 million in financing.
VisionMine launches a service and Web portal that will match small startups with big companies trying to solve specific technology problems. The company will grade startups for the review of the large companies and will coordinate introductions when there’s mutual interest.
Merge Healthcare files a lawsuit against orthopedics PACS vendor Medstrat, claiming the company’s false claims and unfair business practice have cost Merge tens of millions of dollars in revenue. The suit claims that Medstrat sent e-mails and advertisements to Merge customers implying that the company’s announced plan to seek strategic alternatives was an indication of instability, tagging one e-mail with the phrase, “Why go through more pain? Converting is simple.” MRGE shares closed Tuesday at $3.31, down more than 50 percent since February.
Valley Medical Group (MA) contracts with eRAD for its PACS and speech recognition solution.
Intermountain Healthcare (UT) signs an $11.7 million, multi-year contract for Siemens Image Sharing and Archiving.
Adventist Health System will expand its use of Cerner’s P2Sentinel solution for auditing clinician access to patient data.
Virtua (NJ) implements the Vergence and proVision identity and access management solutions from Caradigm.
Cadence Health (IL) names Dan Kinsella (Optum Insight) CIO and EVP, replacing the recently retired Dave Printz.
Orion Health names Tracey Sharma (Baxter) sales director, Sergei Maxunov (Bell Canada) senior solutions consultant, and Health Linkletter (EMIS) project manager of its Canadian eHealth team.
Announcements and Implementations
HIMSS honors the family practice of Jeremy Bradley, MD (KY) as a winner of the 2012 Ambulatory HIMSS Davis Award of Excellence.
Cerner and telecommunications information company Global Capacity partner to deploy Cerner Skybox Connect, a high availability private network for the healthcare industry.
Children’s of Alabama implements Accelarad’s medical image sharing network to enhance care coordination with referring facilities.
Jefferson Radiology (CT) deploys Repair, a remote MPI management service from Just Associates.
NextGen Healthcare and Microsoft launch NextGen MedicineCabinet, a free app for the Windows 8 platform for the management of personal medication records.
Nuance Healthcare announces Assure for Powerscribe 360 | Reporting, which uses clinical language understanding to QA radiology reports before they’re signed.
Medsphere marks its tenth anniversary by noting that more than 70 percent of its OpenVista customers have achieved Meaningful Use Stage 1 so far.
Wellcentive announces that its Advance Outcomes Manager population health management and analytics solution has earned NCQA certification.
GetWellNetwork and Sharp HealthCare (CA) develop and launch what they say is the first in-room collaborative patient whiteboard. It identifies care team members, tracks visits and family questions, provides a daily schedule and plan, and allows patients to communicate with their family members.
University of West Georgia in Carrollton, GA, whose graduates make up a third of Greenway’s employees, names its new sports stadium building “Athletic Operations Building, sponsored by Greenway, Inc.” and adds the company’s logo to the building.
Cerner lists all of its customers that have successfully attested for Meaningful Use Stage 1.
Chicago-based Valence Health, which offers population management and reimbursement risk management tools and services to providers, announces that its 2012 revenue will increase by 75 percent to over $30 million compared to 2011. The announcement mentions new hires Eric Mollman (Staywell Health Management) as CFO, Kevin Weinstein (ZirMed) as chief marketing officer, and Prasanna Dhungel as VP of product development.
The Panama City, FL paper writes up the expansion of local business iSirona,which also announces that Mercy Medical Center (IA) has contracted for its medical device integration in the OR.
Government and Politics
CMS awards a 10-year, $15 billion contract to eight vendors to compete to build various aspects of a virtual data center for the agency’s IT infrastructure, including claims processing and hosting services for a national data warehouse application.
CMS picks the Kansas City Improvement Consortium, the Health Improvement Collaborative of Greater Cincinnati, and the Oregon Health Care Quality Corporation to be the first organizations to participate in a Medicare claims sharing initiative to assess provider performance.
November 30 is the last day for eligible hospitals and critical access hospitals to register and attest for an EHR incentive payment in fiscal year 2012.
Tennessee’s Medicaid program requests $9 million to replace its obsolete IT system with the VA’s VistA.
The Madison, WI paper looks at the growth of Epic and its impact on the region. Epic left Madison several years ago for Verona, which has seen huge jumps in property values, but Madison has also benefited by increased demand for rental property and more employment opportunities. Madison city officials say Epic visitors are driving revenue to the hospitality industry, resulting in a 30 percent increase in city room tax receipts from 2010 to 2012.
A new KLAS report concludes that the top global radiology PACS vendors vendors are those offering meaningful and timely upgrades with expanded usability. Infinitt and Intelerad rated highly as innovators, along with DR Systems, McKesson, Novarad, and Sectra.
A Weird News Andy literature review notes that two new studies conclude that “flu vaccine is a heart vaccine” since people in the study who got a flu shot experienced 50 percent fewer cardiac events and 40 percent lower heart-related mortality. I’d need to review the original research to feel good about that conclusion, about which I’m skeptical otherwise.
Also from WNA: in the UK, ministers are warned that a plan to implement “virtual clinics” powered by Skype will save billions of pounds immediately, but could leave less technology-savvy patients behind. The Health Minister expects video visits to reduce unnecessary hospital stays, saying that a third of patients can be managed without a face-to-face appointment, leaving more capacity for those who need to be seen in person.
WNA also notes this nugget: the Cincinnati-based TriHealth health system fires the 150 of its 10,800 employees who did not get a mandatory and free flu shot.
I’ve mentioned Italian brain cancer patient (and artist, engineer, and TED fellow, as it turns out) Salvatore Iaconesi several times for his “My Open Source Cure” appeal for treating his condition, much of which involves the struggle to share his records electronically with experts around the world who volunteered to help. CNN ran his story on its main page Tuesday morning. You should watch his newly published TEDx talk above on the challenges created by the medical establishment and his views on wellness and cures (the human being, not the “patient”). I don’t agree with everything he says, but he will definitely make you think, especially if you’ve been a patient with a serious condition. He is exchanging information with 15,000 people and 60 doctors and reviewing 50,000 strategies sent to him with the help of 200 volunteers.
MMRGlobal is awarded a fifth EMR-related patent, proudly proclaiming that despite having supposedly harassed companies into signing $30 million worth of license agreements for its newly-issued patents, the company is not a patent troll since the patented technology is part of products it sells itself. Or tries to, anyway – according to this month’s quarterly filings, the company’s total quarterly revenue was $346,000 with a net loss of $1.5 million, with current liabilities exceeding current assets by $8 million and only $42,000 cash in the bank as it seeks additional financing from its founder and anybody else willing to loan it money. OTC-listed shares are at $0.0147, valuing the whole enterprise at $7 million and obviously reflecting serious market doubt about the company’s banking the $30 million it claims to be owed for its newly created intellectual property portfolio.
Cleveland Medical Mart announces that it has signed Cleveland Clinic and GE Healthcare as tenants. HIMSS, which had signed on with a similar project in Nashville that went bust, has toured the facility, which is three-quarters complete and scheduled for a September 2013 opening.
The local paper in Edmonton, Alberta gets its hands on the expense records of the former CIO of the Capital Health region, whose boss there was found to have been reimbursed $350,000 for questionable expenses that included opera tickets and a butler. Donna Strating, who like her boss was billing $2,700 per day as a consultant, was reimbursed for large restaurant tabs, movie tickets, and snacks.
Employees of Digital Prospectors supply 30 Thanksgiving meals to the New Hampshire non-profit Families in Transition.
MModal releases software updates to its Fluency for Imaging Reporting technology platform to support report creation and clinical documentation workflow.
Merge Healthcare makes its iConnect Enterprise Clinical platform available through EMC Select.
The GPO Yankee Alliance offers its healthcare members connectivity solutions from Lifepoint Informatics.
Frost & Sullivan honors Acuo Technologies with its 2012 Market Share Leadership Award in Imaging Informatics.
From Non Sequitur: “Re: UNC. I told you I would submit the official Epic announcement when it was released. Since you have already mentioned this, it’s not really newsworthy.” Au contraire – it’s nice to get official verification, which apparently came from UNC Health Care System (NC) on November 19 with its Epic announcement. Cerner and Siemens were the also-rans. Assembly of the implementation team will start early in 2013, with 80-120 folks tapped to begin the rollout of Epic to UNC Hospitals, Rex Healthcare, Chatham Hospital, the UNC Physicians Network, and UNC Physicians & Associates.
From Max Headroom: “Re: CES Unveiled. The consumer electronics show had a lot of Fitbit-type companies, but the coolest and most Thanksgiving relevant was the HAPIfork from a Hong Kong company. The USB-connected fork tracks how many bites you eat over what time, with the premise that eating more slowly has more positive effects on metabolism. It even has a reminder to eat more slowly, so people can get alert fatigue from eating.” That sounds somewhere between creepy and pretty smart, at least if you believe that eating slower means eating less and if you don’t eat a lot of fork-free sandwiches or soup. The fork records everything without being USB connected, then uploads to an online dashboard and to Facebook if you want (I guess that would be social net-forking).
Welcome to new HIStalk Platinum Sponsor Acuo Technologies of Bloomington, MN. The company offers Universal Clinical Platform (a vendor-neutral archive) and clinical data migration solutions that let customers liberate their clinical content from departmental silos (including enterprise medical images). The result: putting patient information where it’s needed, with customers executing their own clinical strategies instead of meekly following those dictated by their technology vendors. It often makes sense to pursue a selective best-of-breed strategy for wound care, pathology, and neurosurgery, and Acuo’s technologies allow making data from those systems liquid while ensuring vendor independence and multi-site support. The benefits include lower TCO, built-in business continuity and recoverability, better network utilization, implementation of IHE-profile standards and vendor neutrality, and the ability to monitor system health via a single dashboard. Not to mention that the client owns both the data and the archive. The DoD chose Universal Clinical Platform a few weeks back to consolidate images from 62 Army and Navy PACS sites located around the world – UCP works with every major radiology and cardiology PACS. The company just released a white paper that describes how three of its hospital customers weathered Hurricane Sandy, along with an overview of the business continuity possibilities offered by UCP. If you’re at RSNA this week, drop by booth #7146 and tell the Acuo folks that you saw them mentioned in HIStalk. Thanks to Acuo Technologies for supporting my work.
From my usual YouTube cruise, here’s a video featuring customers talking about their Acuo implementation.
HIMSS and vendor user group conferences are those national meetings most commonly attended by poll respondents, with the other events lagging far behind them. New poll to your right, following up on a Dr. Jayne question: is transcription a commodity service that’s differentiated mostly on price? Feel free to click the poll’s Comments link after you’ve voted to editorialize your position.
I’ve been revamping HIStalk Mobile over the last several days. The site has a new look and a gradually changing name – HIStalk Connect. Travis is posting from the physician and entrepreneur perspective while Lt. Dan is handling the daily news posts. If your interests include startups, cool technologies, consumer health IT, and telehealth, you might consider becoming a regular contributor, a guest author, an interview subject, or a news tipster. I’ll have some new sponsors to announce shortly.
The First Minister of Wales opens Clinithink’s research and development center in Bridgend, emphasizing the government’s commitment to stimulate economic growth by supporting technology companies. That’s Rt. Hon. Carwyn Jones SM on the left, Clinithink CEO Chris Tackaberry on the right (he wrote a Readers Write article a week ago). The company offers the CLiX clinical language indexing engine for ICD and SNOMED that turns medical notes into coded data.
I create an eclectic music playlist every week in the hopes that folks who’ve been stuck in a musical rut going back to their college days (or since computers took over most musically related chores) will find something fresh to listen to. The one for this week includes a mix of genres and vintages: Soundgarden, Auf Der Maur, Zip Tang, Morrissey, Lana del Rey, and some cool surf tunes. Some of the tracks were recommended by readers. Let me know if anything speaks to you.
I was thinking about HP’s accusation that its recent acquisition target Autonomy had fraudulently misstated earnings, forcing it to write down $9 billion as announced last week. I’m beginning to be skeptical that Autonomy was the lone gunman. HP has been a train wreck in every conceivable way, so it seems suspicious that the company chose the day of a bad quarterly report to trot out excuses from an acquisition that closed a year ago. Peering deeper into the numbers, HP says the magnitude of the alleged accounting fraud was a few hundred million dollars, which caused it to pay $5 billion too much. That would seem to imply that the other $4 billion that was written down was because HP vastly overpaid (which was why companies better than HP had already passed on the deal). All of this happened before Meg Whitman took over as CEO (she was hired September 22, 2011), but the (literal) bottom line is that the company peed away $9 billion, with the only question being which aspect of HP’s due diligence stupidity (valuation or forensics) was at fault. It would appear that HP’s bragging rights for hiring (and most puzzlingly, retaining) the least-competent board of directors in the country remains unthreatened.
An NIH-funded project to match DNA samples from 100,000 volunteer Kaiser Permanente patients with their electronic medical record information is creating a “playground of incredibly rich data” that is already turning up medical discoveries. Researchers have discovered genetic variations that seem to influence the effectiveness of statin drugs. They’ve also found something that sounds like a like a palm reader’s life line – a specific genetic component whose physical length seems to correlate with lifespan.
Accretive Health writes $4,000 checks to 90 Minnesota patients who complained that the company harassed them with abusive medical collection practices.
A UK doctor blames the death of one of his patients on the practice’s EMR, saying he failed to notice that the patient had stopped taking proton pump inhibitors and died of a stomach ulcer as a result. The doctor says of the since-replaced system, “In a highly-charged meeting with a patient, when you’re discussing very important matters, I failed to notice the absence of a D on the computer screen. The systems fail to flag up under-use in an adequate way. It’s a hazardous system.”
Also in the UK, a patient dies after an erroneously programmed IV syringe pump delivers a 24-hour narcotic dose over just 12 hours. The nurse who set the pump admits that she isn’t sure that she understood the pump instructions another nurse gave her.
UC Davis Children’s Hospital (CA) tries its hand at crowdfunding, seeking donations for the purchase of specific items that range from $30 toys to a $12 million NICU wing. A “medical computer suite” costs $2,210 just in case you’re up for providing a stocking stuffer.
Decision support tools from Dallas-based cardiology software vendor Emerge Clinical Decision Solutions are chosen by the HeartPlace cardiology practice for use in 31 clinics and 25 hospitals. Software algorithms review patient symptoms and histories, with the company claiming that identification of some cardiac conditions is increased by 300 percent.
I noticed a drug study authored by a pharmacist from Cerner Research. That reminded me that Cerner mines and sells the patient information stored by its hosted EMR clients.
I’m annually amazed that RSNA convinces 60,000 people to leave their families Thanksgiving weekend to head off to chilly Chicago. If you are there, enjoy the conference.
The Milwaukee business paper takes a field trip to Children’s Hospital of Wisconsin to check out its $129 million Epic implementation. At 263 beds, that’s a truly Epic cost of almost half a million dollars per bed.
As more Americans get fatter, so does their mental picture of what ideal weight should be. Sixty percent of people think their weight is about right despite CDC statistics showing that 69 percent of Americans are overweight. I theorize that foreign travel will suffer as junk food eating and expandable pants wearing Americans realize that they stand out like lumbering giants when immersed into a culture of svelte locals in Asia, Scandinavia, and almost everywhere else. I blame vanity sizing, where clothing manufactures make everything several sizes bigger than the label says so customers can pretend their mirrors are defective. Not appropriate post-Thanksgiving talk, I know.
Strange: an air conditioning technician files a $1 million negligence suit against Kingwood Medical Center (TX) after stinging bees cause him to plunge through the hospital’s skylight.
The re-domesticated Vince picks up where he left off with the HIS-tory of CPSI, founded by Denny and Kenny (one of them really was a rocket scientist). Vince thrives on memory-refreshing reader e-mails, so if you have interesting nuggets or current contacts from the sepia-toned HIT of yesteryear, he would enjoy hearing from you.
Nuance reports Q4 results: revenue up 28 percent, adjusted EPS $0.51 vs. $0.42, beating expectations of $0.48. In the earnings call, Chairman and CEO Paul Ricci said the company’s healthcare business will generate more than $1 billion in 2013, making the company one of the largest HIT vendors. He also said that the recent Quantim and JATA acquisitions will contribute $90-100 million in annual revenue.
From Samantha Taggart: “Re: giving thanks. I am very grateful and thankful to all of you for doing what you’ve done for this (our/my/your) industry. Healthcare is a precious thing and I can’t imagine what HIT would be like today if you all hadn’t somehow provided the transparency and insight into what’s really going on in this industry. We ALL thank you so very much. Enjoy your holidays and feel very good about what you do.” On behalf of Mr. H, Dr. Jayne, Dr. Travis, Dr. Gregg, Donna, and Lt. Dan, a big thank you for the kind words. I will save this note for those days I find myself thinking I can’t possibly read one more thing about healthcare and technology. I am thankful that I lucked into the greatest job ever in HIT, that I work with such fun and smart people, and that people continue to read and support HIStalk week after week. Best wishes to all for a great holiday. I’m off for the rest of the week off to spend time with family and friends, eat too much food, watch some football, and perhaps buy a couple of pairs of new shoes.
From MDRX Scrooged: “Re: Allscripts. Everyone is expecting huge cost cutting if Allscripts is sold to a private equity firm, but what may not be expected is that the cost cutting will start in the next couple of weeks. Between 70 and 130 employees will be let go, mostly from services and engineering. Happy holidays to us!” Unverified. I’ve received a few rumors on where the possible acquisition stands, pretty much split between: (a) talks are at an impasse because the PE people won’t pay above $15 per share and the board won’t accept that offer with shares trading at $12.35, and (b) a deal has already been finalized but not yet announced. In other words, I don’t know any more than you do.
From Force Majeure: “Re: Allscripts. A practice that requested termination of its MyWay agreement was turned down even though its contract says Allscripts will comply with any CMS requirements to meet MU and any other standards, with the explanation that the practice was offered a free upgrade to Professional. What about costs for infrastructure, equipment, and possible lost productivity? The contract didn’t say they company will meet the requirements by making the customer switch products. They’re going to be flooded with these requests.” Unverified, but FM provided a copy of the purported e-mail above, where the company takes the position that moving a customer to a completely different product than the one they bought is contractually acceptable since it’s a free switch to a more expensive product. I think I’d probably side with the company legally, although as a customer I’d still be ticked that I have to spend money and energy because of the company’s business decision. Obviously your options as a customer are limited if you recently signed up for the five-year lease – you’re going Professional unless you’re willing to lose a lot of money (either by not collecting Meaningful Use money or in paying off your lease while buying a competitor’s product). I assume the leases work like they do for a consumer transaction – a third-party financing company buys the contract at a discount and handles the payment collection, meaning it’s not up to Allscripts to let customers out of their lease agreements. Leasing terms might make an interesting topic for Bill O’Toole in a future HITlaw column given this example.
From Nasty Parts: “Re: [company name omitted]. They were apparently shocked to see former employees working for competitors at MGMA and offered a bounty to current employees to identify them so they can be send cease and desist letters.” Unverified. I’m sure someone must have proof if this claim is accurate, so I’ll fill in the blank if someone will provide that proof.
HIStalk Announcements and Requests
I will most likely not do news this Friday unless I get bored since I doubt anyone would read anyway. Enjoy your holiday. I’ll be back at the keyboard Saturday as usual putting together the Monday Morning Update.
Acquisitions, Funding, Business, and Stock
Medical education firm Pri-Med, a division of Diversified Business Communications, acquires EHR provider Amazing Charts.
Shades of McKesson-HBOC: shares of the perpetually bumbling HP drop 12 percent Tuesday after the company announces that it will take an $8.8 billion write-down on its 2011 acquisition of British software vendor Autonomy. HP says Autonomy had cooked its pre-acquisition books by counting low-margin hardware sales as software income and claiming that resellers were customers. Details have been shared with US and British regulators to pursue criminal and civil charges. If HP is right, nice work by Deloitte, to whom it paid big money for pre-acquisition due diligence. The previously fired CEO of Autonomy denies everything, defers to Deloitte’s audits, and says HP destroyed the company’s value by raising prices and lowering sales commissions, adding that, “The difficulty was that the company [HP] needed a strategy, and I still couldn’t tell you what that is.” HP’s now-irrelevant Q4 numbers: revenue down 5 percent, adjusted EPS $1.16 vs. $1.17 but more dramatically –$3.49 vs. $0.12 including the write-down. The ugly five-year chart above plots HP shares (blue) against the Nasdaq index, indicating that you’d probably have been better off burning dollar bills to keep warm. Oracle was smarter: they passed when Autonomy made a “please buy us” pitch – see the hilarious Another Whopper from Autonomy CEO Mike Lynch post from September 2011 on Oracle’s site, placed there after Lynch denied trying to convince Oracle to buy his company. The always-feisty Oracle, in response to his denials, posted the PowerPoint slides Lynch used in the meeting, which seemed to jog his memory of the conversation.
The National Football League signs a 10-year contract worth $7-$10 million with eClinicalWorks to implement an EHR that can help the league research and treat player head injuries.
DoD awards Acuo Technologies a nine-year, $40 million contract for its vendor neutral archive solution.
Huntington Memorial Hospital (CA) selects the Merge PACS iConnect Enterprise Clinical Platform for its hospital inpatient EHR and its Huntington Health eConnect HIE.
Sharp HealthCare selects 3M’s 360 Encompass System for medical records coding, clinical documentation improvement, and performance monitoring across its four hospitals and affiliated medical groups.
Aurora Health Care (IL, WI) will deploy Humedica’s MinedShare analytics platform to support its ACO initiatives, improve coding accuracy, and develop ambulatory physician scorecards.
CareCloud hires Ralph Catalano (athenahealth) as VP of operations.
Health monitoring company Medivo appoints David B. Nash, MD (Jefferson School of Population Health) to its medical advisory board.
Announcements and Implementations
White Plume Technologies releases its AccelaMOBILEmobile charge capture product app.
McKesson will give $1 million in free Practice Choice EMR licenses to 100 small-practice physicians who practice in primary care, internal medicine, gynecology, or pediatrics and who have a history of providing unreimbursed care to low-income patients.
MedCentral Health System (OH) expands its system-wide use of the Surgical Information Systems solution to include anesthesia automation, perioperative analytics, patient tracking, and integrated tissue tracking.
NextGen Healthcare releases its 8 Series EHR content, which includes a new user interface, standardized framework for templates, and streamlined navigation.
Children’s Hospital Association goes live a contract with Baltimore-based mdlogix to provide an informatics platform that will support its Hospital Survey of Patient Safety tool.
Government and Politics
The GAO finds that CMS is behind schedule on the implementation of its Fraud Prevention System for analyzing Medicare claims data for fraudulent behavior.
CMS releases Meaningful Use Stage 2 spec sheets for EPs and hospitals.
The Tampa paper covers the power struggle between dueling startup HIEs, the state-run one and a local, for-profit HIE that has the Hillsborough Medical Association as a member. The article suggests that the organizations are fighting for the potential profits involved with selling HIE-collected de-identified patient data. The local HIE says the state HIE is not seeking physician input, noting that the average hospital doesn’t see most of the patient population and also generates only 10 percent of patient health records.
Innovation and Research
The Consulate General of Canada in Philadelphia will launch a healthcare IT accelerator in early 2013, hoping to increase growth opportunities for Canada-based companies as similar efforts have done for companies in Israel. The 4th Annual Canada-US eHealth Innovation Summit will be held November 28 in Philadelphia, featuring presentations from Canadian companies Caristix, EDO Mobile Health, Evinance, Input Health, HandyMetrics Corporation, Mensante Corporation, Memotext, NexJ Systems, Nightingale Informatix Corporation, Orpyx Medical Technologies, TelASK Technologies, and VitalSignals Enterprises.
A JAMA-published study finds that patients using a patient portal had a higher number of office visits and telephone encounters than non-users. The study, which reviewed the use of MyHealthManager by patients of Kaiser Permanente Colorado, concludes that just putting up a portal doesn’t reduce demand for clinical services, and in fact may have the opposite effect.
ADP-AdvancedMD introduces a charge capture app for EHR for use on the iPad and iPad mini.
Nurses at Phoenix Children’s Hospital create the Journey Board discharge teaching app, funded by a $5,000 donation from former hospital patients. It’s available free for Android and iOS.
Massachusetts General Hospital Emergency Medicine Network launches EDMaps.org, a national ED locator for travelers, and a new version of its EMNet findER app.
Key findings from the eHealth Initiative’s 2012 Report on HIE:
Support for ACOs and PCMHs is on the rise
Federal funding still supports many HIEs, raising concerns about their long-term viability
HIEs worry about competition from other HIEs and from HIT vendors offering exchange capabilities
Other challenges for HIEs include privacy, technical barriers, and addressing government policy and mandates
Support for Direct is growing, particularly to facilitate transitions of care and the exchange of lab results.
The National eHealth Collaborative publishes a five-tier framework of strengthening patient engagement strategies that includes steps entitled Inform Me, Engage Me, Empower Me, Partner With Me, and Support My Community.
An Imprivata roundtable on the healthcare impact of technology and mobility featured Boston-area healthcare IT executives, with their discussion summarized in the eight-minute video excerpt above.
Weird News Andy says “This doc was da bomb.” A 60-year-old doctor and Occupy Wall Street protester who was fired by his hospital employer in 2007 for suspected stalking of a nurse is arrested when police find assault rifles and large quantities of bomb-making chemicals in his basement.
MedAssets CEO John Bardis wins a Community Leadership Award for driving and supporting the volunteer activities of his employees.
Greer Contreras, T-System’s VP of revenue cycle coding, discusses revenue integrity and the need for organizations to have a holistic view of their revenue cycle processes in a guest article.
Compressus integrates MModal’s speech understanding solution into its MEDxConnect suite.
Vitera Healthcare introduces Hands-On Lab for virtual product training.
Shareable Ink is spotlighted for assisting The Center for Orthopedics (OH) capture MU data.
Zirmed releases a white paper on the use of technology to manage rising levels of patient responsibility.
PeriGen posts its November and December Webinar schedule.
David Caldwell, EVP of Certify Data Systems, discusses opportunities offered by HIEs that can enhance revenue and improve patient care in a guest article.
Besler Consulting’s CTO Joe Hoffman reviews challenges in complying with the CMS exclusion list during a November 28 Webinar.
Dell ships its PowerVault DL2300 appliance with CommVault Simpana 9 software for enterprise-wide data protection.
SCI Solutions recognizes Mountain States Health Alliance (TN) with its Most Innovative Use award for best adoption and implementation of its self-scheduling tool.
Levi, Ray & Shoup releases an enhanced version of its Enterprise Output Management software that includes mobile access and support for Windows 8.