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Morning Headlines 10/10/13

October 9, 2013 Headlines 1 Comment

ACO veterans share lessons from the trenches at MGMA

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

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

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

Advice to the Next National Coordinator

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

Shinseki wants a budget for the VA

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

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October 9, 2013 Headlines 1 Comment

News 10/9/13

October 8, 2013 News 5 Comments

Top News

10-8-2013 7-28-00 PM

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

Reader Comments

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

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

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

HIStalk Announcements and Requests

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

Acquisitions, Funding, Business, and Stock

10-8-2013 7-17-51 PM

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

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


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

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

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

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

10-8-2013 7-33-50 PM

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

In Brazil, Hospital Israelita Albert Einstein chooses Cerner Millennium.


10-8-2013 3-40-00 PM

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

10-8-2013 3-51-08 PM

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

10-8-2013 3-57-23 PM

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

10-8-2013 5-40-50 PM

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

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

Announcements and Implementations 

10-11-2013 7-14-30 PM

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

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

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

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

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

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

10-8-2013 4-49-11 PM

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

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

10-8-2013 5-32-04 PM

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

Athenahealth announces its readiness for Meaningful Use Stage 2.

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


10-8-2013 7-38-52 PM

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

10-8-2013 6-11-43 PM

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

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

10-8-2013 7-39-44 PM

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

Sponsor Updates

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 8, 2013 News 5 Comments

Monday Morning Update 10/7/13

October 5, 2013 News 2 Comments

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

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

10-5-2013 4-21-58 PM

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

10-5-2013 9-01-10 AM

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

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

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

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

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

10-5-2013 4-18-37 PM

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

10-5-2013 4-26-57 PM

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 5, 2013 News 2 Comments

News 10/4/13

October 3, 2013 News 6 Comments

Top News

10-3-2013 5-38-48 PM

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

Reader Comments

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

HIStalk Announcements and Requests

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

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

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

Acquisitions, Funding, Business, and Stock

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


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

10-3-2013 6-03-42 PM

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


10-3-2013 3-41-21 PM

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

10-3-2013 5-14-25 PM

MaineHealth names interim CIO Andy Crowder as CIO.

10-3-2013 5-30-19 PM

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

10-3-2013 5-33-17 PM

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

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

Announcements and Implementations

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

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

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

Government and Politics

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

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

Innovation and Research

10-3-2013 10-13-22 AM

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


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

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


10-3-2013 1-02-38 PM

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

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

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

Sponsor Updates

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

EPtalk by Dr. Jayne

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

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

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

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

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

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

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 3, 2013 News 6 Comments

News 10/2/13

October 1, 2013 News 16 Comments

Top News

10-1-2013 11-09-42 AM
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10-1-2013 4-21-38 PM

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

Reader Comments

10-1-2013 4-48-54 PM

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

10-1-2013 4-50-16 PM

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

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

HIStalk Announcements and Requests

10-1-2013 3-48-00 PM

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

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

Acquisitions, Funding, Business, and Stock

10-1-2013 4-51-58 PM

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

10-1-2013 4-53-21 PM


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

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

10-1-2013 4-54-54 PM

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


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

10-1-2013 4-56-00 PM

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



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

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

10-1-2013 3-00-40 PM

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

10-1-2013 1-51-22 PM

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

10-1-2013 10-28-26 AM

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

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

10-1-2013 1-53-10 PM

SRS names Peter Bennfors (Asset Control) CFO.

10-1-2013 4-04-17 PM

Infina Connect names Mark Hefner (Allscripts) as CEO.

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

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


Announcements and Implementations

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

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

10-1-2013 11-16-19 AM

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

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

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

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

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


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

10-1-2013 5-00-02 PM

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

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

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

10-1-2013 9-23-52 AM

10-1-2013 9-25-13 AM

10-1-2013 9-26-59 AM

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

10-1-2013 9-38-46 AM

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

10-1-2013 1-39-59 PM

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

10-1-2013 10-00-15 AM

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

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

Here’s an Intermountain video describing its Cerner selection.

Sponsor Updates

10-1-2013 4-06-10 PM

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


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

More news: HIStalk Practice, HIStalk Connect.


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October 1, 2013 News 16 Comments

Monday Morning Update 9/30/13

September 28, 2013 News 12 Comments

9-28-2013 3-13-26 PM

9-28-2013 3-15-26 PM

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

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

9-28-2013 5-27-33 PM

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

9-28-2013 5-28-13 PM

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

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

9-28-2013 1-19-31 PM

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

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

9-28-2013 4-04-13 PM

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

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

9-28-2013 5-21-11 PM

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

9-28-2013 5-29-36 PM

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

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

9-28-2013 4-31-58 PM

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

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

9-28-2013 2-38-08 PM

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

Sponsor Updates

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

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


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

More news: HIStalk Practice, HIStalk Connect.


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September 28, 2013 News 12 Comments

News 9/27/13

September 26, 2013 News 11 Comments

Top News

9-26-2013 11-24-53 AM

9-26-2013 8-02-35 PM

ONC Principal Deputy National Coordinator David Muntz will leave his post next month, according to an ONC email to staffers. Muntz, who joined ONC in January 2012 after six years as SVP/CIO of Baylor Health Care System, was considered by some as a potential successor to Farzad Mostashari, MD. Chief Medical Officer Jacob Reider, MD will serve as acting ONC director, while current Deputy National Coordinator for Operations Lisa Lewis will take over as acting principal deputy.

Reader Comments

9-26-2013 8-49-59 PM

From Frank: “Re: Consumer Reports list of patient medical gripes. Health IT can resolve many of these issues.” Actually, it’s the use of health IT that might solve some of these problems. I say that intentionally because doctors could fix most of these problems themselves without adding technology at all, and if they haven’t fixed them, turning themselves into technology users may not help.

From Jim: “Re: Jonathan Bush on CNBC. A classic quote on healthcare industry consolidation.” Per Bush, “The dinosaurs are mating as the ice cap is melting.”

From Horschack’s Laugh: “Re: RFI/RFP template for provided EDW/BI solution (build, buy, license options)?” I’ll allow readers to respond.

9-26-2013 9-26-52 PM

From Bo Knows: “Re: McKesson InSight in Orlando. So big it’s almost a mini-HIMSS.”

HIStalk Announcements and Requests

A few highlights from HIStalk Practice over the last week include: a chat with the CEOs of Vitera and Greenway about the impending shared ownership of their companies. A look at Practice Fusion and its plans to grow revenues and its customer base. CMS offers an online calculator to determine payment adjustments based on participation in Medicare’s e-prescribing, MU, and PQRS initiatives. A British Columbia newspaper provides insights into the province’s EMR adoption program. The American College of Physicians offers an online clinical decision support tool for internal medicine physicians. Jason Drusak, manger of consulting services at Culbert Healthcare Solutions, offers tips for preparing for Stage 2 MU. And, coming to HIStalk Practice this weekend: our annual list of must-see vendors at MGMA, all of which happen to be faithful HIStalk sponsors. Sign up for email updates so you don’t miss details on how to find these vendors and what they will be discussing at next month’s conference. Thanks for reading.

Acquisitions, Funding, Business, and Stock

9-26-2013 7-48-13 PM

Group purchasing organization Premier Inc. raises $760 million in its IPO. Shares rose 13.5 percent Thursday.

9-26-2013 7-51-27 PM

Shares of Compuware spinoff Covisint jumped 23 percent on their first day of trading Thursday.

9-26-2013 7-52-33 PM

Aventura completes a $4.3 million investment led by current investors.


9-26-2013 7-55-06 PM

F.W. Huston Medical Center (KS) will implement RazorInsights ONE-Health System Edition EHR and financials platform.

The VA extends a three-year, $8 million contract to Harris Corporation for a Correspondence Tracking Software system to improve communications between the VA and veterans.

Intermountain Healthcare (UT) selects Security Audit Manager from Iatric Systems to provide patient privacy auditing and incident risk management across its 22 hospitals and 195 clinics.

Orthopaedics & Sports Medicine Owensboro (KY/IN) selects SRS EHR for its 11 providers.

WellSpan Health chooses Perceptive Software’s vendor-neutral archive for enterprise clinical content management.


9-26-2013 8-18-07 PM

Shareable Ink appoints Dave Runck (Baxa Corporation) as CFO and announces the opening of an expanded office in Boston’s Innovation District.

9-26-2013 8-19-47 PM

Aventura appoints acting CEO John Gobron to president and CEO.

Announcements and Implementations

Cerner and Children’s National Medical Center (DC) invest several million dollars each to build an HIT center for pediatric technology innovation.

Henry County Health Center (IA) becomes the first healthcare facility to go live on the Iowa HIN.

Boston Children’s Hospital (MA)and IBM pioneer OPENPediatrics, a cloud-based learning platform for sharing best practices for the care of critically ill children.

9-26-2013 11-58-25 AM

Hillary Rodham Clinton will become the second Clinton in as many years to provide a keynote address at the HIMSS annual conference. President Bill Clinton drew such a large crowd last year that the overflow masses could only view the speech from a monitor outside the ballroom. Hillary may not attract the same numbers her husband did, but just in case, I hope HIMSS is securing a sufficiently large room to accommodate me and a few thousand of my fellow political junkies.

9-26-2013 8-30-55 PM

Fox Army Health Center (AL) goes live on Tricare Online and RelayHealth online portals.

9-26-2013 8-31-56 PM

The University of Mississippi Medical Center uses MediQuant’s DataArk active archive technology to migrate financial and patient records to a new information system.

9-26-2013 11-33-51 AM

Dossia rolls out Dossia Dashboard, a population health management system that works with the company’s personal health management platform with real-time data analytics and evidence-based health rules.

9-26-2013 9-15-47 PM

Specialty EMR vendor Modernizing Medicine will work with Miraca Life Sciences to develop an enhanced system for communicating diagnostic information between dermatologists and pathologists.

National eHealth Collaborative opens board member nominations.


9-26-2013 8-47-07 PM

Regions Hospital (MN) reduces the average amount of blood transfused by 14 percent after implementing a decision support tool with its EHR. The tool, which Regions developed with the American Red Cross, uses evidence-based clinical guidelines to determine the appropriate use of red blood cells.

Doctors in Colombia amputate a 66-year-old man’s fractured and gangrenous penis after he intentionally overdosed on Viagra to impress his new girlfriend. No word on whether she remains impressed.

Weird News Andy adds a Rodney Dangerfield quote to this story: “I was such as ugly baby that when the afterbirth came out, the doctor said, ‘Twins!’” New mothers are practicing umbilical non-severance, or lotus birth, in which the baby’s placenta is left attached until it falls off on its own days later.

Sponsor Updates

  • SCI Solutions announces details of its Client Innovation Summit next month in Braselton, GA.
  • EDCO releases a recorded Webinar, “Point of Care Medical Record Scanning.”
  • Intelligent Medical Objects releases new videos on ProblemIT and its mobile app.
  • Shaun Shakib, medical informaticist for Clinical Architecture, offers some considerations for organizations implementing and utilizing controlled clinical terminology.
  • HIStalk sponsors earning a spot on Healthcare’s Hottest recognition program for the industry’s fastest-growing companies measured by revenue growth include Allscripts, Beacon Partners, CTG Health Solutions, Cumberland Consulting Group, ESD, Impact Advisors, Imprivata, Intellect Resources, and The Advisory Board Company.
  • AirWatch announces comprehensive enterprise management support for iOS7.
  • Iatric Systems announces that its Meaningful Use Manager and all three Public Health Interfaces have been certified as modular EHRs.
  • Martin’s Point Health Care (ME) details how Forward Health Group’s PopulationManager is helping improve patient care.
  • Valence Health releases details of its November 12-13 thought leadership conference.
  • Chilmark Research selects Wellcentive as a best-of-breed vendor in its 2013 Clinical Analytics for Pop Health Market Trends Report.
  • Ping Identity CTO Patrick Harding joins the board of the Open Identity Exchange.
  • Seven disease management programs supported by TriZetto’s CareAdvantage Enterprise solution earn NCQA Disease Management Systems certification.
  • SuccessEHS hosts more than 475 attendees at its annual user conference this week in Birmingham, AL.
  • Care Team Connects offers an October 8 webinar highlighting the upcoming Medicaid expansion and what it means from a care management perspective.
  • EXTENSION will showcase its alarm safety and event response platform for nurses and other caregivers at the American Nurses Credentialing Center National Magnet Conference October 2-4.

EPtalk by Dr. Jayne

9-26-2013 7-44-23 PM

The recent announcement of the pending union of Greenway and Vitera has been hot news in the physicians’ lounge this week. One of my colleagues was even reading Inga’s interview with Tee Green and Matthew Hawkins while we were talking. Several of the providers at the table were Greenway customers and they are understandably concerned about where things are headed.

Once upon a time I was a user of Medical Manager and then of Intergy, both of which have been absorbed into the Vitera product line. Back in the day, the best part of Intergy was its use of the MEDCIN terminology as the framework for documentation. The process of building point-of-care templates was straightforward (although tedious) and it was fairly easy to document visits. Looking at Intergy now, it barely resembles its original self, which in the software life cycle is a good thing.

Since I’ve been around the EHR world a fairly long time compared to many of my primary care peers, I am sometimes asked to help a practice create an RFP document or to offer an opinion on their system selection process. Recently, I was asked to attend a demo of Greenway and to give my opinion, although my colleague wouldn’t divulge the identities of the other two competitors involved. I thought that was an interesting way to get an opinion without the pros and cons of the other products overshadowing what Greenway had to offer.

I had intended to write it up for HIStalk (after enough of a newsroom embargo to shield my identity) but didn’t want to appear as if I was just talking about a sponsor to talk about a sponsor. Now that Greenway is front page news, though, it seemed like the right time. As background, this was a web demo given by a seasoned Greenway rep and was targeted towards a solo physician in primary care.

He delivered the standard sales background, including number of specialties and clients live. Walgreens and their TakeCare business line was included, with it live in over 4,000 locations. I thought this was interesting given the prevalence of pharmacy-owned clinics in our area and thought that the potential interoperability on that might be kind of nice for the solo primary care doc I was with. He really sold the fact that PrimeSuite focused on the EHR and practice management infrastructure, positioning Greenway as a company that didn’t want to allow other business lines to distract from their core offering.

One surprise was that Greenway wasn’t keen on interfacing with an existing practice management system – it’s an all-or-nothing deal, which is generally a good idea. I’ve seen practices tank implementing a perfectly good EHR because they’ve slaved it to a dud of a practice management system using interfaces that led to dual data entry and a whole lot of headaches. In a lot of ways, refusing to interface would help a vendor choose its customers to some degree. I know several vendors who would benefit from being willing to walk away from practices who don’t understand the benefits of a unified system.

We continued on with the background including their high KLAS rankings over the last decade, which they attributed to word of mouth and happy customers. One of the reasons their customers are happy is their training approach. Their goal is to spell it out to customers as far as what it takes to be successful and how many training hours are needed – it sounded like they take a hard line with customers who don’t want to agree to the recommended amount of training. At the time, ongoing training was available with classes offered nearly every day. I’d have to check with actual clients to see if this is still the case, but it sounds better than what I’ve seen with other vendors, who let clients cheap out on training which leads to crises later.

The inclusion of upgrades in the monthly support fee is a benefit for the Meaningful Use crowd. Having been hit by one particular vendor for upgrade charges in the past, I know this can be a big deal. Greenway has been CCHIT certified a number of times and is offering a guarantee to ensure they maintain certification, otherwise they will compensate providers equal to the amount of lost stimulus funds. A pretty extensive list of happy clients was offered up without asking, including multiple sites within a 30-minute drive. That’s always a good thing to hear during a demo.

In addition to the flagship PrimeSUITE product, they have an interface engine, patient portal, mobile app, and clinical device integration, which I would expect from any vendor who plans to be a contender. Interoperability with Cerner and Epic was mentioned more than once. One offering stands out and that’s their clinical research module, PrimeRESEARCH. Not only does it have a system for managing clinical trials, it allows participating practices to network in hopes of increasing the number of eligible patients. I don’t think there are a lot of vendors offering that functionality, let alone the ability to track trial budgets, patient stipends, and sponsor funding, which it also apparently does. Monthly emails let the practice know if it has patients who would qualify for a trial. Having done outcomes research for a local medical school, this is a potential game changer for community physicians who want to participate in trials but hate the hassle.

With all that out of the way, we finally got into the product itself. Navigation was quick with the ability for users to configure it on the fly. It had everything I would expect in an ambulatory EHR as far as lab display, flowsheets, and tasking. Clinical alerts are generated based on criteria which can be customized from the base set they provide. There was an audible “ooh” from my colleague when he showed their clinical summary face sheet, which is user-customizable with drag-and-drop panes as well as the ability to hover over data elements for more information. Those of us who use products with these features every day tend to forget that a lot of systems out there don’t offer these niceties.

Visit note documentation was pretty standard, as was the ability to pull forward information from previous documents. I liked that abnormal physical exam findings displayed in red and italics. There seemed to be a lot of user-customizable features, but of course the proof is in the pudding when you actually get your hands on it rather than watching a demo. One feature that differs from some other vendors is the ability to keep multiple patients open at a time, which can be both a blessing and a curse. I have to admit I was taken by their document management (scanning) system. It has some nice features including fax integration and the ability to match incoming documents with outstanding orders, which is the holy grail for closed-loop order management.

A couple of months have passed and my colleague still hasn’t decided what she’s going to do. Thinking back on the demo as well as the company that Greenway will be keeping, it will be interesting to see what the future holds. I have several friends who work at Greenway, and for their sake, I hope it’s smooth sailing.

I’d love to hear from current customers on either the Greenway or Vitera products. What do you think the union will bring? Are there any product features you hope to jettison for something better? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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September 26, 2013 News 11 Comments

News 9/25/13

September 24, 2013 News 3 Comments

Top News

The FDA issues final guidance for mobile medical apps, saying it will exercise “enforcement discretion” (meaning it will not enforce requirements under the Federal Drug & Cosmetic Act) for the majority of health and wellness apps since they pose little risk for consumers. Examples of  low risk apps include those for self-managing a disease or condition and apps for the self-tracking of health information, exercise, or diet. Oversight focus will be on apps that present a greater risk to patients if they do not work as intended, such as those used as a medical device accessory (such as viewing a medical image on a smartphone) or as a mobile platform as a medical device (like an app that allows a smartphone to be used as an ECG to detect abnormal heart rhythms.)

Reader Comments

9-24-2013 10-50-48 PM

9-24-2013 10-51-55 PM

From The Fixer: “Combining Greenway and Vitera. I think the deal makes sense given that Greenway has more of a healthcare IT platform than Vitera does and Greenway is much more well run than Vitera. Over time, they will migrate all Vitera clients to Greenway’s platform and realize tremendous cost savings and synergies by leveraging Greenway’s infrastructure.” Perhaps they will head in that direction, but Matt Hawkins and Tee Green kept their plans pretty close to the vest when I talked with them Monday evening. Green noted that “maintaining multiple platforms probably isn’t going to be the long term strategy because that doesn’t create value for your customers and your team,” while Hawkins stressed that Vitera would continue to support, maintain, and update its various product platforms. Both declined to say who would lead the company going forward, but my money is on Hawkins taking the top spot.

From InsideOutsider: “Culture clash. Greenway has long had a reputation for its strong, family-oriented corporate culture. Kudos to Vitera for recognizing that and for trying to leverage Greenway’s better reputation and brand. Meanwhile, Greenway employees better hang on for the pending culture shock.”

From Upon Further Review: “Re: HIS Junkie’s statements about ONC systems. PopHealth is still an active project and has nothing to do with certification. Cypress had bugs, but it’s still being refined.”


HIStalk Announcements and Requests

9-24-2013 8-25-41 PM

Welcome to new HIStalk Gold Sponsor Summit Healthcare. The company offers application integration tools that include Summit Express Connect (the industry’s most powerful integration engine) and the Summit Scripting Toolkit that can automate any process (budget updates, point-of-care device integration, patient self registration.) The company has been a Meditech integration leader since 1999. Summit Provider Exchange allows patient information to be exchanged between hospitals and physician EMRs, while the Summit Downtime Reporting System gives users access to a patient data snapshot for managing  scheduled or unscheduled downtime. Thanks to Summit Healthcare for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

9-24-2013 10-11-21 PM

Practice Fusion raises $70 million in a series D round, bringing total funding to $134 million and valuing the company at an estimated $700 million.

9-24-2013 10-12-33 PM

PatientSafe Solutions closes an investment from EDBI, the investment arm of the Singapore Economic Development Board, bringing its total Series C funding to $27 million.

Mobile medication management solution provider MediSafe raises $1 million in funding, co-led by TriVentures and lool Ventures.

Online patient billing company Simplee raises $10 million in Series B funding, led by Heritage Group.

Inga interviewed the CEOs of Greenway and Vitera about their impending shared ownership on HIStalk Practice.


9-24-2013 10-15-55 PM

St. Joseph’s Hospital Health Center (NY) selects PeriGen’s PeriCALM Tracings fetal surveillance system.

University Health System (TX) licenses iSirona’s device connectivity solution for its 24 clinics, hospitals, and outpatient facilities.

South Jersey Family Medicine will replace its Alteer platform with e-MDs Solution Series EHR, PM, and patient portal solutions.

Michigan Spine Surgery Improvement Collaborative selects ArborMetrix’s registry solution to create a statewide database and reporting system for spinal surgeries.

Imaging Specialists of Charleston and Charleston Radiologists (SC) select Merge Healthcare’s Outpatient Radiology Suite and Honeycomb Archive platform.

The Houston City Council approves a $1.6 million contract with Oregon Community Health Information Network to implement an EHR for the city’s Department of Public Health and Human Services.



9-24-2013 9-02-35 AM

SyTrue hires Ketan Patel, MD (US Pain Management Corp.) as CMO.

9-24-2013 11-28-48 AM

Healthcare Data Solutions names David M. Thomas (IMS Health) to its board.

9-24-2013 11-35-20 AM

Transcription and coding solutions and services provider Amphion Medical Solutions appoints Subbu Ravi (Symphony Data Corporation) COO.

9-24-2013 10-30-10 PM

CORE Security names Eric Cowperthwaite (Providence Health & Services) as VP of advanced security and strategy.

Announcements and Implementations

9-24-2013 10-19-20 PM

The board of Greenville Hospital System (SC) approves a $97 million expense to implement Epic, replacing GE Healthcare and Siemens Soarian.

EClinicalWorks and Epic develop bidirectional interoperability between their EHRs.

Government and Politics

9-24-2013 2-46-58 PM

Seventeen GOP senators ask HHS Secretary Kathleen Sebelius for a one-year extension for Stage 2 MU to give providers extra time to meet the new requirements. The lawmakers agree that providers who are ready to attest to Stage 2 should be able to do so consistent with the current policy.


MyMedicalRecords files a complaint for patent infringement against Allscripts, alleging that its Jardogs FollowMyHealth technology violates MMR’s PHR patents.

9-24-2013 9-31-53 AM

A KLAS report finds that EHR replacement rates are up in the small practice (1-10 physician) market. Athenahealth, SRSsoft, and Practice Fusion are having the most success delivering quick and easy implementations of value-based products. Pediatrics-specific EHR PCC earned the top performance score among 27 vendors, while customers of McKesson, GE Healthcare, Allscripts, and Vitera expressed the highest levels of dissatisfaction based on unmet product expectations, poor upgrade releases, and inadequate relationships.

Senior hospital IT executives say that exchanging patient information in robust, meaningful ways and budget and staffing limitations are the biggest barriers for health information exchange between other hospitals, according to a HIMSS Analytics report.

John Lynn of EMR and HIPAA will interview Mandi Bishop of Adaptive Project Solutions Thursday from 1:00 to 1:30 on “Healthcare Big Data and Meaningful Use Challenges.” The Google+ Video Hangout will stream live, with the recording available afterward.

Zirmed earns  the highest customer satisfaction rating from large hospitals and academic medical centers in a Black Book research report on the RCM industry. Among small / rural and community hospitals, SSI Group scored highest, while Relay Health earned the highest marks from hospital systems, IDNs, CINs, chains, and ACOs.

Weird News Andy finds more weirdness: a man who had just used a university’s computer lab to Google symptoms of pain, tightness of chest, and sweating is found dead in his car in the parking lot.


Sponsor Updates

  • Elsevier launches SimChart for the Medical Office, a competency-based, simulated EHR that gives medical assisting students hands-on practice performing business and clinical skills.
  • Visage Imaging announces upgrades to Visage 7 Enterprise Imaging and Visage Ease.
  • VMware announces the GA of VMware vCloud Suite 5.5 and VMware vSphere with Operations Management 5.5. VMware also makes VMware Virtual SAN available for download and trial via a public beta program.
  • Oracle awards NTT DATA the 2013 Oracle Excellence Award for Specialized Partner of the Year – North America in Health and Life Sciences for demonstrating outstanding and innovative solutions based on Oracle products.
  • Intellect Resources President Tiffany Crenshaw talks about what’s behind the growth of her company after taking top honors in The Business Journal’s 2013 Fast 50 awards.
  • Craneware EVP of Revenue Integrity Operations Karen Bowden will lead a session on preparing for audits at next month’s 2013 CH100 Leadership and Strategy Conference in Greensboro, GA.
  • Orion Health offers scholarships and graduate recruitment programs through the University of Canterbury in New Zealand in an effort to attract talent and encourage more IT graduates.
  • Hayes Management Consulting offers two white papers to help organizations improve clinical optimization.
  • Nuance launches Clintegrity 360 | ICD-10 Education Services, an ICD-10 readiness program for physicians, coders, and clinical documentation specialists.
  • Capsule’s business development manager Elizabeth Skinner will discuss medical device integration at this week’s McKesson’s Insight365: 2013 Annual Conference in Orlando.
  • Caradigm introduces new versions of Caradigm Single Sign-On and Caradigm Context Management products, which feature tightened integration with virtual desktop technologies, simplified security compliance, and accelerated clinical workstation deployment.


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

More news: HIStalk Practice, HIStalk Connect.

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September 24, 2013 News 3 Comments

Monday Morning Update 9/23/13

September 21, 2013 News 9 Comments

9-21-2013 6-03-19 PM

From HIS Junkie: “Re: ONC. I find it absolutely depressing that the government has created a monster bureaucracy to test and certify healthcare software and spends over $70 million a year to do that,  yet these same people cannot release one piece of software that works right from the get-go. There is an article in the Wall Street Journal entitled ‘Pricing Glitch Afflicts Rollout of Online Health Exchanges.’ Another buggy system brought to you by Uncle Sam. If that was the only  glitch, I could look past it. But consider that over the last two years ONC has issued three software systems to support the vendor certification process and all have bombed more than once. They were – POP Health, Cypress, and the Transmission Transport Test tool. They eventually killed POP Health. All were needed to pass ONC certification. Each one created major delays and resubmits for vendors, not to mention the related wasted time and costs. Amazing that a federal agency that can’t get relatively simple software right the first time is telling vendors of mission critical complex software how to build theirs. I think we need to create another federal agency to certify ONC software before we let them move to Stage 3.”

9-21-2013 6-21-51 PM

From Vandy Watch: “Re: Vandy VPIMS lawsuit. I wonder if other facilities could be at risk? According to Acuitec’s website, ‘Acuitec’s flagship products are VPIMS, an integrated clinical solution for the perioperative continuum of care, and Vigilance, a customizable remote presence monitoring solution. Our strategic relationship with Vanderbilt Medical Center (VMC) enables us to ensure our products are thoroughly tested and clinically verified.’" I wouldn’t be too worried. The government hasn’t proven their rather broad claims against VUMC and even if they really did use VPIMS to intentionally overbill Medicare, that doesn’t mean anyone else would be forced to use VPIMS in the same way. It’s unlikely that fraud was baked into the product.

From The PACS Designer: “Re: Google Glass. The Yale football team got a chance to test Google Glass in a practice game and found the experience exciting from a quarterback perspective. The Internet link could present some interesting uses in healthcare for physicians seeking to inform others of their daily wants and needs.”

9-22-2013 5-49-14 AM

Poll respondents say the most valuable part of an electronic medical records system is clinical decision support. New poll to your right: when will vendor opportunities for population health and analytics really kick in?

Listening: new from The Sadies, Canadians who offer a compelling blend of American music styles like country, surf, and psychedelia. One of the members is Travis Good, no relation as far as I know to Travis Good, MD from HIStalk Connect.

9-21-2013 4-33-20 PM

Welcome to new HIStalk Gold Sponsor AirWatch, the leader in enterprise-grade mobility and security solutions. More than 8,000 customers across the world trust AirWatch to manage their most valuable assets: their mobile devices. The company’s highly scalable solution provides an integrated, real-time view of an entire fleet of corporate, employee-owned, and shared iPads, iPhones, Androids, Toughbooks, and more. With AirWatch, healthcare IT can automate the management and tracking of all mobile assets; reduce the cost and effort of device deployments; improve the technical support experience for device users; and enable and enforce IT security and compliance policies that secure the device and its data. Thanks to AirWatch for supporting HIStalk.

Here’s a YouTube video I found on AirWatch’s mobile device management.

9-21-2013 3-52-02 PM

The local paper covers the move from Healthland to Epic of Heart of 20-bed Heart of America Medical Center (ND).

9-21-2013 5-18-49 PM

I interviewed a patient about her use of the Good to Go recorded discharge instructions system from ExperiaHealth.

The HCI Group creates an integration and testing services division, naming Scott Hassler and Mark Jackson as VPs of integration services.  Both were previously with Information Technology Architects.

ABC for Health, a Madison, WI-based nonprofit healthcare advocacy law firm, receives a $1.2 million NIH grant to develop software that determines if a patient is eligible for government health programs.

Upcoming Webinars

9-21-2013 6-01-04 PM

Speaking of Webinars, I said when I started doing them that I wanted to showcase fresh ideas, giving a voice to folks who don’t usually do conference presentations. I’m really happy that several of those Webinars will be coming your way soon. I’m certain you will enjoy the topics and the presenters. Vendor-sponsored webinars make it possible to offer these non-commercial ones where everybody can use the Webinar platform I’m already paying for. If you have a great message that needs an audience, let me know.

9-21-2013 6-02-31 PM

FDA issues a rule requiring medical devices to bear manufacturer tracking codes. FDA will used the IDs to create a publicly searchable database. The likely next steps: (a) FDA, Joint Commission, Medicare, and insurance companies require logging the ID of each device implanted, and (b) vendors of systems used in the OR or elsewhere will be pressured to make recording and recalling this information easier.

Vince finishes up his HIS-tory of Cerner this week. Next up will be McKesson, which should be interesting.

Craig Richardville on the Future

Carolinas HealthCare SVP/CIO Craig Richardville followed up his September 13 interview on HIStalk with thoughts on the future.

As you look ahead over the next several years, one thing we can count on — it will be here and gone before you know it. The boost of HITECH has made technology more than an enabler as it has become a foundational element for all future endeavors. It is the common thread that not only provides the glue within service lines and organizations, but also connects the care, the care team ,and our patients across the continuum. 

The financing challenges of healthcare requires us to be more selective in our ideas, as only the best of the best will survive, and more innovative in how we deliver care and maintain the health of our consumer. As part of the Triple Aim, a main focus is on quality and high quality will become the norm to play in the game, and the other two elements — service and pricing — will become equally dominant as the industry continues its movement towards consumerism and choice. 

Healthcare will start to take on other characteristics of other consumer industries such as retail and banking. Online services will become the routine. Consumers will access a variety of comparative sources to make decisions, the same that we do today for other personal products and services, such as Consumer Reports, Angie’s List, Google Reviews, etc. Technology will be used to transform operations to be more efficient and provide access and engagement for the consumer, wherever and whenever it is required or requested. 

The care offered will continue to travel rapidly to the patient. Self-service tools will be a necessity. We will connect to patients via mobility, instant access, and migrate monitoring for fixed devices to smartphone apps and wearable devices. We will go to the patient, wherever they are and whenever they need us — the workplace, the home, across state boundaries, and while in motion. We will see competitive communities becoming connected and unifying for the benefit and health of the patient and of our populations.

Historically competitive organizations will start to share data and collaborate to ensure that we are reducing duplication and providing all information necessary to treat the patient. We will not compete on data, but rather on how we use the data. Predictors and analytics will be a core competency and those who get their first, will have a small advantage as others will get there as well, and then we will need to quickly move to the next prospect. 

Expectations will continue to rise and new innovations discovered and the ability to be agile and collaborative will create a competitive advantage. Look to the use of data, ensuring privacy and security, development of new evidence, analytics, genomics and be prepared for the next unknown and seize the opportunity not to compete on transactional data, but predicting and engaging. 

There is not a day that goes by that new opportunities to optimize and advance arise, times will be challenging, and also very opportunistic. The best of times are ahead for all of us, especially our patients.


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

More news: HIStalk Practice, HIStalk Connect.


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September 21, 2013 News 9 Comments

News 9/20/13

September 19, 2013 News 12 Comments

Top News


The Greater Madison Convention & Visitors Bureau estimates the economic impact this week’s Epic user group meeting is $6.5 million, second only to the World Dairy Expo. Despite being behind the cow show, Judy Faulkner was apparently pleased to tell her 15,000 customers and employees that Epic now serves 51 percent of US patients and 2.4 percent of the world’s. She also reports that 86 percent of Epic implementation projects over the past two years have come in under budget.

Reader Comments

From Wild Duke: “Re: Caradigm. Did a major executive purge. Chief Medical Officer Brandon Savage and SVP of Product Management Mark Johnson both gone. COO Nigel Mason is heading back to GE. CTO Neal Singh is now running the show.” A Caradigm spokesperson responded to our inquiries by saying, “I can confirm that earlier this week Caradigm made some organizational changes within our product teams to drive greater alignment and focus on our healthcare analytics and population health solutions.” We’ll call it unverified since companies can’t comment on the status of individual employees.

9-19-2013 6-42-43 PM

FromPit Viper: “Re: VA. Under Secretary Petzel is resigning.” Unverified, but Pit Viper has been a good VA source previously. Robert Petzel, MD is Under Secretary for Health in the Department of Veterans Affairs.

9-19-2013 6-51-57 PM

From Would Like to Know:“Re: ICD-10. CMS is not requiring it for coding Liability Insurance, No-Fault, and Workers Comp until April 1, 2015. For vendors that rely on UB-04 billing data, this exception is causing some angst. We’ve heard hospitals will code in ICD-10 and then either crosswalk back to ICD-9 or code to ICD-9 for these insurers. Would you be able to survey hospitals about this? I love HIStalk and have promoted it inside my company, plus we are now a sponsor.” Thanks. I created a poll that will take hospital folks maybe 10 seconds to complete. I’ll share the results here in a few days.

9-19-2013 7-02-35 PM

From Movie Sign: “Re: open.epic. Epic’s big announcement to the world of modern startups looks like it was designed by an amateur. It doesn’t help accusations that legacy vendors are out of touch.” Nobody seems to know anything about open.epic other than what’s on the site, which indicates that it’s a connection from EpicCare to personal health devices. Folks attending UGM probably got more details.


HIStalk Announcements and Requests

9-19-2013 12-02-32 PM

inga_small Thanks to Jennifer Dennard (@SmyrnaGirl) of Billian’s HealthDATA for hosting Thursday’s #HITchicks tweetup, which happened to be the first TweetChat I’ve ever attended. The discussion covered women in the healthcare C-suite, mentoring, HIT week, and, my favorite: should women have to “harden” or “soften” themselves when in positions of leadership. I agreed with the consensus view that women (and men) must remain genuine and true to themselves. Nice job moderating, Jennifer!

9-19-2013 5-49-04 PM

inga_small I updated my iPhone 5 to iOS 7.0 last night (it took about an hour) and, so far, so good. I did have to delete about 2GB of videos to make room for the update, so beware if you are low on storage. I am excited about the new camera features, which include Instagram-like tools for enhancing photos and a faster shutter speed (which will be perfect for taking stealth photos of shoes at MGMA.) The iTunes Radio is also fun and should give Pandora a run for its money, especially since it’s ad free. I listened to a few tunes using the Bluetooth in my car, but then realized that too many tunes may be a quick way to eat up all the data included in my cell phone plan. Finally, the overall navigation is enhanced in several areas, resulting in fewer swipes to get where you are going.

9-19-2013 5-58-56 PM

Welcome to new HIStalk Platinum Sponsor Prominence Advisors. The company, founded by former Epic managers who hire Epic superstars, provides the country’s foremost healthcare organizations with Epic expertise, with over 90 percent of the company’s employees being Verona alumni. Prominence is a QlikView healthcare implementation partner, levering its knowledge of Epic’s data model to help organizations aggregate data from multiple systems to spot trends, predictively improve patient care, optimize revenue cycles, and monitor operational performance. High-profile projects require extraordinary, high-performing talent and Prominence has earned the reputation of deep domain expertise and exemplary character as it provides services in analytics, strategy, and execution. Thanks to Prominence Advisors for supporting HIStalk.

Bored? (a) sign up for email updates so you’ll be the first to know; (b) repeat for HIStalk Connect, where your signup gets you really cool HIT innovation news from Travis, Lt. Dan, and Kyle; (c) connect with us on Facebook, Twitter, and LinkedIn, including the HIStalk Fan Club that Reader Dann created a long time ago that now has 3,242 members, making my mom very proud even though she’s not sure why; (d) peruse and occasionally click the ads of the folks who keep me in keyboards and check them out in the Resource Center and Consulting RFI Blaster; (e) send me rumors, pictures, or whatever interesting stuff you have using the secure Rumor Report form that goes straight to my inbox along with any attachments you’ve included; (f) check out the Webinar Calendar and vow to learn something; and (g) accept my appreciation for your  support of HIStalk in whatever form that support takes (just reading it counts a lot.)

Upcoming conferences: Inga will be at MGMA in October, I’ll be at the mHealth Summit in December. That’s all we have on our dance cards for now.

HIStalk Webinars

9-19-2013 6-26-20 PM

Encore Health Resources will present “Full Speed Ahead: Creating Go-Live Success” on Tuesday, September 24, 2013, 1:00 – 1:45 p.m. Eastern, featuring William Sangster, MD. Dr. Bill will impart wisdom, I’ll say a few words that will be far less wise, and a lucky attendee will win a $50 Amazon gift card door prize. Register now.

Speaking of webinars, we’re doing quite a few of them and I could use a few more CIO-type reviewers. Here’s how it works: I’ll send you a link to the recorded rehearsal, you’ll spend 30 minutes or watching it and jotting down suggestions for improvement, and you’ll earn the same gift certificate as the Encore door prize winner. Let me know if you’re interested. Thanks to the folks who have been reviewing all along – your feedback is making the Webinars better and more enjoyable for everyone.

Acquisitions, Funding, Business, and Stock

9-19-2013 4-05-53 PM

Health tech business accelerator Healthbox selects its first Nashville class of seven companies, each of which will receive a $50,000 seed investment and four months of mentorship. Chosen were:

9-19-2013 8-45-00 PM

DreamIt Ventures launches DreamIT Health Baltimore, a partnership with The Johns Hopkins University and BioHealth Innovative, to accelerate the growth of early-stage HIT companies.

9-19-2013 6-21-15 PM

HIMSS acquires Health Story Project, which focuses on standards related to non-EHR clinical documentation such as transcription and electronic documents.


Skilled nursing and rehab operator Greystone Healthcare Management selects HealthMEDX as its HIT solution.

The New York Office of Mental Health awards health system integrator CGI a $48.7 contract to implement an EMR platform, including NTT DATA’s Optimum. Document Storage Systems will provide additional implementation services for the vxVistA EHR.

Vanderbilt University Medical Center (TN) will deploy MedAptus Technical Charge Capture solution to code and bill hospital-based procedures.

UC San Diego Health System (CA) selects Merge iConnect Access to image-enable its Epic EHR.

9-19-2013 9-00-19 PM

Self Regional Healthcare (SC) selects McKesson Paragon .

The New York City Health and Hospitals Corp. awards IBM an one-year, $10 million contract to build an analytics platform to improve patient care and operational efficiency.

9-19-2013 9-01-28 PM

The Torrance Memorial Medical Center (CA) selects Daylight IQ for disease-based clinical protocols.


9-19-2013 4-20-31 PM

Bronson Healthcare (MI) hires Paul Peabody (Palomar Health) as VP/CIO.

9-19-2013 4-31-22 PM

Emmi Solutions names Steve Martin (Merge Healthcare) as SVP of sales.

9-19-2013 7-31-25 PM

Ron Strachan (Community Health Network) is named CIO of McLaren Health Care.

9-19-2013 7-12-05 PM 9-19-2013 7-12-36 PM 9-19-2013 7-14-43 PM

Health Care DataWorks Co-founder Jason Buskirk is named CEO, Ivo Nelson becomes board chair, and John Gomez is engaged as a development consultant.


Announcements and Implementations

Fairfield Memorial Hospital (SC) goes live on Cerner.

9-19-2013 9-03-45 PM

Duke University Health System reports that it has installed Epic ahead of time and under budget throughout the entire system, including 223 outpatient facilities and Duke University Hospital. Epic says it was one of the company’s biggest single-day go-lives with 16,000 Duke employees trained. Competing Research Triangle health systems WakeMed and UNC are also implementing Epic.

Pacific Alliance Medical Center (CA) deploys electronic patient signature and e-forms solutions from Access.

Government and Politics

9-19-2013 7-32-34 AM

CMS publishes an online ICD-10 implementation guide to help practices, small hospitals, and payers navigate the ICD-10 transition.

9-19-2013 10-14-53 AM

ONC names GenieMD the winner of its Blue Button Co-Design Challenge for its app that helps users diagnose their symptoms, find providers, and learn more about medical conditions.

9-19-2013 10-45-36 AM

inga_small From an ONC post I missed last week: 54 percent of EPs have 2014 Edition EHR technology available to them from their primary 2011 EHR vendor; 45 percent of EHs/CAHs have 2014 Edition EHR technology available from their primary 2011 Edition vendor. An additional 13 percent of EPs and 19 percent of EHs/CAHs have a primary 2011 Edition EHR vendor that is on track toward providing a 2014 Edition solution. Translation: one out of three providers attested with EHRs that are potentially not on track with 2014 Edition technology. Another interesting nugget: 31 percent of the 861 ambulatory EHR vendors on the Certified HIT Product List and 49 percent of the 277 inpatient EHR vendors don’t have a single MU attestation. In other words, look for a sizable reduction in the number of vendors listed for 2014 Edition certification.

Here’s a new ONC video on interoperability.


The CMS Office of the Actuary projects that healthcare spending will increase at an annual rate of 5.8 percent from 2012 to 2022, or one percent faster than the GDP.

A former advisor to Australia’s billion-dollar eHealth system calls it “shambolic,” with incorrectly loaded data and doctors who don’t have the software to read it. The medical association pegs the odds of finding useful information for a given patient at 0.5 percent.

John over at EMR and EHR Videos has a Google Plus Hangout video featuring the always-fascinating Dr. Nick, aka Nick van Terheyden, MBBS, CMIO of Nuance Healthcare. You can also get on the update list and check the schedule of future events that are streamed live.

9-19-2013 6-55-36 PM

The Milwaukee newspaper runs an article about the growth in lucrative Epic consulting jobs, featuring a cool photo of Mark and Drew from Nordic, which has 350 employees and is adding 20 per month after bringing in $38 million in investor money in the past year. Frank Myeroff of Direct Consulting Associates is quoted in the article as saying the number of Epic consulting firms may approach 2,000. Also mentioned are Vonlay and BlueTree Network.

In Canada, Jewish General Hospital goes on diversion and elective imaging tests are postponed when its data center overheats, taking all of its servers down Thursday morning.

9-19-2013 7-25-27 PM

A report by Wells Fargo Securities says that CMS’s July attestation data suggests that the replacement EHR market will heat up in 2014 as practices drop productivity-sapping EHRs in favor of those products with a higher MU attestation rate. The report also says, “Replacement activity could
intensify further if CMS ever decided to audit providers who pocketed the Medicaid incentives instead of using them to fund actual EHR adoption. “

Weird News Andy, who as he says is “putting the ‘News’ in Weird News Andy for the past five minutes,” notes that Cleveland Clinic is shrinking. Employees were told this week that $330 million needs to be trimmed from the clinic’s 2014 budget and layoffs may be required.

9-19-2013 8-27-04 PM

At least it wasn’t healthcare: a BBC TV news anchor grabs a pack of copy paper instead of the intended iPad and bizarrely carries it around while reading the news. Anchors there hold the iPad to pretend they are technology-savvy journalists instead of talking heads reading off a screen, an illusion suffering mightily from this incident.

Sponsor Updates

  • The Colorado Technology Association names Ping Identity winner of its Technology Company of the Year award.
  • HCI Group posts an article titled “Credentialed Trainers – Secret Superstars of the Install.”
  • Lifepoint Informatics serves as a gold sponsor for next month’s G2 Lab Institute Conference in Arlington, VA.
  • Sunquest is attending ASCP in Chicago this week, exhibiting in Booth #219.
  • Direct Recruiters is named a Weatherhead 100 winner as one of the 100 fastest growing companies in Northeast Ohio.
  • Jeff Bell, director of IT security and risk services for CareTech Solutions, joins the HIMSS Privacy and Security Committee for a two-year term.
  • CCHIT certifies that Medseek Empower enterprise patient portal is compliant with the ONC 2014 Edition criteria and awards it certification as an EHR Module.
  • Merge Healthcare reports that radiologists use its certified EHR technology more than any other, according to HHS MU attestation data.
  • Drummond Group certifies that two SuccessEHS products, SuccessEHS 7.0 and MediaDent 9.0, are compliant with ONC 2014 Edition criteria.
  • CIC Advisory launches a Facebook page to provide an interactive forum on the operational and regulatory challenges facing HIT execs.
  • API Healthcare President and CEO JP Fingado participated in this week’s Healthcare Workforce Information Exchange demonstration.
  • Hospital Physician Partners (FL) reports on its experience using Ingenious Med’s business analytics platform.
  • Xerox researchers address the challenge of big data and what to do with social media analytics.
  • HCI Group details three areas a good credentialed trainer can impact during an EMR implementation.
  • Beacon Partners outlines six steps to minimize ICD-10’s negative impact on revenue cycle.
  • Nordic Consulting reports that its $38.3 million influx of capital from investment partners has allowed it to increase service offerings, bolster staff to over 300, and grow clients and partnerships to over 75.
  • Quantros hosts an Advisory Panel this week to discuss the commercial viability of data in an intermediary role and the value of bundled safety products.
  • Clients attending this week’s Verisk Health user conference prepared 2,000 food packs for Second Harvest Food Bank of Central Florida’s Hi-Five Kids Pack Program.
  • Vitera Intergy EHR is tested and certified as a complete EHR under the Drummond Group’s EHR ONC-ACB program and is an ONC 2014 Edition-approved solution.
  • Anita Archer, Hayes Management Consulting’s director of regulatory compliance, co-authors a HIMSS-published article entitled, “ICD-10 Documentation for State Medicaid Agencies (SMA) Health Conditions Categories.”

EPtalk by Dr. Jayne


Lt. Dan tweeted this morning about Google’s launch of Calico, a company that will focus on “the challenge of aging and associated diseases.” The venture will be led by Arthur Levinson, chairman and former CEO of Genentech. He’s also a director of drug giant Hoffman-La Roche and chairman of Apple.

My initial response to the announcement was that there are some significant conflicts of interest here. Others have had that thought as well, with Time posting a piece about it in the context of previous Google vs. Apple conflicts that received scrutiny from the Federal Trade Commission. My mind, however, was going more towards the conflict stemming from having a company like Google — which controls vast amounts of information about seemingly everything and everyone — cozying up with the pharmaceutical and genetic sphere.

For quite some time, I’ve had concerns about so-called personalized medicine. Farzad Mostashari tweeted about this earlier this week, sharing why personalized medicine might be bad for all of us. The focus of the opinion piece is that when people increase focus on themselves and their personal choices, they tend to decrease focus on population-based health, such as global vaccination efforts and other public health initiatives. It also mentions pharmacogenetics, where drugs can be targeted for patients who have certain mutations present. It mentions the example of vemurafenib as a drug for metastatic melanoma, which can help 25 percent of patients live seven months longer.

This kind of data leads me to my chief concern with personalized medicine – is it cost effective, and who is going to pay for it? Vemurafenib costs $56,400 for a six-month supply. (Surprise, when I did my Google search to find out the cost, I discovered it is made by Genentech.) If it only works 25 percent of the time for patients with a specific mutation, and their lives are only extended seven months, should we be routinely recommending it? As a primary care physician who has cared for numerous terminal patients, I understand the appeal. If it helps a father live long enough to see his daughter married, or a mother long enough to see her son graduate from college, these are the Hallmark moments we all want to think of. But in our situation where the healthcare system is collapsing under its own weight and excess, I could really make the argument that spending $56,000 to help fight diabetes, obesity, or heart disease for many patients is a better investment of our increasingly scarce healthcare dollars.

One could argue that personalized medicine is for those who can afford it, but then we will have the counter argument about healthcare being a right and about treating everyone equally. Eventually we have to come to the realization that we can’t afford to provide these expensive treatments for everyone no matter how hard our heartstrings are tugged. As a family physician, I’m all for health promotion and disease prevention. I am not, however, in favor of extending life just because we can, and I think this venture has the potential to drive efforts in the wrong direction.

I recently saw an elderly patient in her mid-90s who has been blessed with extremely good health. She has taken care of herself all her life, watched her weight, didn’t drink alcohol, and didn’t smoke. Her only “vice” was wearing high heels every day, which has caused some orthopedic problems. As for medications, all she takes are pain relievers that she takes as needed for aches and pains. She is a remarkable lady. She has been widowed for more than 30 years, outliving most of her close friends and some of her family members. She doesn’t want to live forever.

When people think of halting the aging process, I think they expect it to be something like the movie “Cocoon,” where you have a bunch of sassy septugenarians frolicking around. How are we going to fund retirement for these folks? Will they understand that if they’re going to live to be 100 they need to work until they are at least 75 or 80 because the average person cannot save enough money to fund a 35- to 40-year retirement during a 45-year working life? We already have people who can’t save enough money for retirement period, let alone an extended one. The focus on instant gratification and the “me” generation can only skew that further as people spend their current income rather than saving it.

Anyone who has worked on a medical/surgical unit at a hospital has seen the people who are not as fortunate as my ultra-healthy patient. What about the people whose lives have been prolonged through multiple invasive treatments but who are debilitated and have a very low quality of life? Wouldn’t it make more sense to talk about palliative care for the obese smoker who has had four heart attacks, multiple cardiac catheterizations and a bypass, and can’t walk to the bathroom without being exhausted than to bankrupt his family by pursuing more invasive treatments?

I’m sure the argument here is that they want to come up with technologies to help that patient have a better quality of life, but I’m not sure I buy it. Looking at the players involved (Genentech, Roche, Google, and probably multiple intermingled board members from other companies) this feels more like a profit-driven venture than a humanitarian one. Like commercial space travel, it will be only for the ultra-wealthy and will potentially divert resources and attention from important work that could benefit all patients.

What do you think about Calico? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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September 19, 2013 News 12 Comments

News 9/18/13

September 17, 2013 News 8 Comments

Top News

9-17-2013 1-52-50 PM

Here’s a news item that Judy Faulkner probably won’t mention when addressing the Epic masses in Verona this week. She earns the #243 spot on the annual “Forbes 400 Ranking of the Richest Americans” with an estimated net worth of $2.3 billion. Terry Ragon of InterSystems, which sells the Caché database that runs Epic and other healthcare IT systems, also makes the list, tying Cerner’s Neal Patterson in the #352 position with a net worth of $1.5 billion.

Reader Comments

 9-17-2013 4-25-40 PM 9-17-2013 4-26-25 PM

9-17-2013 4-18-00 PM

inga_small From Spacey: “Re: Epic UGM. Over 15,000 people in attendance including 8,500 customers and 6,600 Epic employees. They now cover over 50 percent of US patients!” We reported in 2010 that attendance was 5,500 versus 3,800 in 2009. At the rate the Epic UGM is growing, it could surpass the HIMSS conference in a few years.

From GomiesGone: “Re: Nuance. Dropped the ball by failing to release Dragon Medical Network DM360 v2.0 as promised on September 16. Word is upper management is arguing over logistics.” Unverified.

9-17-2013 6-40-20 PM

From Curious: “Re: Epic. Looks like they’re no longer hiring project managers / installers for their US locations. Does anyone know why?”

From Reluctant Epic User: “Re: HIStalk. If you’re ever in my town and willing to blow your anonymity, I’d be thrilled to buy you a beer or two for the great work you do. People in my health system routinely think I’m a genius simply because of knowledge I have gained by reading your site faithfully for the last six years.” I appreciate both the nice comment and the six years of reading. I do like beer, so that just might sway me.

Acquisitions, Funding, Business, and Stock

9-17-2013 6-47-12 PM

In England, Emis, which provides physician practice systems, will buy hospital systems vendor Ascribe for $95 million.

9-17-2013 8-03-54 PM

A UK report says that CSC will pay $98 million to settle a class action suit in which shareholders claim the company knew its Lorenzo EMR, developed by iSoft, could never be implemented in the NHS’s NPfIT program long before a Department of Health breach of contract charge sent shares down sharply. Meanwhile, a watchdog’s report says costs continue to pile up for the failed NPfIT project because of ongoing liabilities and vendor termination fees, leading it to conclude that the project is “one of the worst and most expensive contracting fiascos in the history of the public sector” as updated cost estimates are revised upward to $15.5 billion vs. an estimated benefit of $6 billion.


Hunt Regional Healthcare (TX) will implement T-System PerformNext Care Continuity.

9-17-2013 8-04-45 PM

Tift Regional Medical Center (GA) will deploy RelayHealth’s RelayClinical platform for its HIE.

NYC Health and Hospitals Corporation selects Elsevier’s ClinicalKey to provide electronic medical reference and knowledge-based information to its clinicians.

9-17-2013 8-06-46 PM

CentraCare Health (MN) selects Strata Decision Technology’s StrataJazz for costing accounting, operating budgeting, capital planning, and rolling forecasting.


9-17-2013 3-34-05 PM 9-17-2013 3-34-52 PM

The Massachusetts Technology Leadership Council names athenahealth CEO Jonathan Bush CEO of the Year and Nuance Communications CTO Vlad Sejnoha CTO of the Year.

9-17-2013 3-36-23 PM

Voalte hires Kenda West (Johns Hopkins Medicine) as COO.

9-17-2013 3-37-34 PM

Amazing Charts names John Squire (Microsoft) president and COO.

9-17-2013 4-12-29 PM

Coastal Healthcare Consulting hires Gay Fright (Pivot Point Consulting) as EVP of business development.

9-17-2013 5-57-05 PM

Virtual Radiologic names Shannon Werb (Acuo Technologies) as CIO.

9-17-2013 6-43-18 PM

Bill Keyes (Allscripts ) is named SVP of sales of CoCENTRIX.

HIMSS recognizes Farzad Mostashari, MD, Congressman Tim Murphy, CMS Administrator Marilyn Tavenner, and Rhode Island State Representative Brian Patrick Kennedy with HIT Leadership Awards in recognition of their work to improve health with IT initiatives.  

9-17-2013 6-37-34 PM

WHITEC, the Wisconsin REC, provides a bow tie tribute to outgoing National Coordinator Farzad Mostashari, MD.

Announcements and Implementations

9-17-2013 8-09-56 PM

Mid Coast Hospital (ME) implements Gemalto’s Sealys MultiApp ID smart cards and LifeMed ID’s SecureReg solution to enable secure patient authentication.

Children’s Medical Center Dallas (TX) launches its TeleNICU, which will provide regional hospitals with access its neonatologists.

9-17-2013 8-08-33 PM

HIMSS awards the University of California-Davis Medical Center its 2013 Enterprise HIMSS Davies Award of Excellence.

HealtheLink connects three other New York state RHIOs to provide sharing for 5.4 million patient health records and links to 44 hospitals.

9-17-2013 4-02-57 PM

VitalWare introduces VitalCoder, a coding and compliance resource that includes real-time, automatic updates for organization-specific coding, regulatory, and financial data.

Nuance Communications announces an Epic-optimized version of its Dragon Medical 360 | Network Edition that contains 1,000 customized commands to enhance physician productivity in a Citrix environment.

PDR Network launches PDR+ for Patients, which incorporates drug  information into EHRs so that prescribers can discuss proper use with patients during the encounter.

Government and Politics

9-17-2013 10-34-08 AM

ONC releases online tools for providers and HIEs to educate patients about the electronic sharing of health information. 

9-17-2013 3-42-16 PM

ONC also publishes models for Notices of Privacy Practices for healthcare providers, which reflect the Omnibus Rule regulatory changes that go into effect September 23.

CMS commissions the National Academy of Sciences to study how best to add social and behavioral factors to EHRs without compromising privacy.

GAO identifies 12 potentially duplicate investments at three federal agencies that over the last five years have accounted for $321 million in IT spending, including $256 million for four HHS information security systems.

9-17-2013 3-44-37 PM

The House of Representatives is considering the TELEmedicine for MEDicare (TELE-MED) Act of 2013, which would allow Medicare providers to treat patients across state lines using telehealth technology without requiring them obtain medical licenses in multiple states.

Innovation and Research

9-17-2013 3-59-22 PM

A study published in The Journal of Maternal-Fetal & Neonatal Medicine finds that neonatal depression can best be predicted not only by common excessive uterine contractions, but also the concurrent presence of fetal heart rate deceleration. The study used tracing data from PeriGen’s PeriCALM system, which allows real-time detection of the condition.


PatientPoint releases PatientPoint Tracker, a patient engagement tool for tracking patients across the care continuum.

Caradigm releases Care Management, a population health management tool developed in partnership with Geisinger Health Plan.


9-17-2013 12-49-21 PM 

inga_small Canada becomes the thirteenth country to issue a patent to MMRGlobal’s MyMedicalRecords  subsidiary for its online medical records technology. In an MMR press release, the company notes it is negotiating an agreement with an investment fund specializing in financing the enforcement and licensing of global intellectual property rights which would “maximize MMR’s ability to exploit its global health IT patent portfolio.” “Exploit” sounds like an appropriate term to describe MMR’s apparent  modus operandi.

An Accenture survey finds that 40 percent of Americans would switch doctors to gain online access to their electronic medical records. That sounds like a suspiciously high number and no doubt it is – Accenture conducted the survey online.

9-17-2013 7-10-16 PM

CHIME President and CEO Russ Branzell pens a National Health IT Week piece called “HIT Capabilities – They Are Personally Important to Me.”

9-17-2013 4-29-24 PM

MU Stage 2 is accelerating EMR-specific patient portal adoption, though the trend is negatively impacting best-of-breed vendors that are not as well equipped as EMR offerings, according to a KLAS report on patient portals. Athenahealth, Epic, and Allscripts were the top-performing vendors.

9-17-2013 6-33-49 PM

A population health management report created for institutional investors by equity research firm JAAG Research concludes that the big PHM market opportunities are at least 10 years away; that lack of data standardization, timeliness, and completeness makes a “Big Data Mess;” and on the CommonWell Alliance “Maybe it’s just us, but all of this soft, ‘.org’ alliance, love-in, ‘we’re in this together for the good of the patients’ blather sounds more like a plan for each vendor to appear collegially engaged from a public policy perspective while keeping the government from forcing a solution on the market. Meanwhile, each ‘member’ works on its own, potentially more profitable solution, outside of the auspices of the happy ‘.org’ shell.” It concludes that “PHM will require a reengineering – almost a complete rebuild – of the healthcare payment and delivery process as we know it.” It’s an excellent report and a tremendously fun read.

I found the Epic UGM tweets and photos above using the cool page that Vonlay built to curate the event. Look carefully and you’ll see Judy in her Avatar outfit.

Weird News Andy titles this story as “Doctor Gives Patient the Finger.” A Florida doctor grows back a man’s amputated finger by using a pig’s bladder as a mold.

Sponsor Updates

  • CCHIT certifies that Wellsoft’s EDIS v.11 is compliant with the ONC 2014 Edition criteria and certifies it as an EHR Module.
  • NCQA awards Case Management Accreditation to Alere and OptumHealth.
  • Quantros hosts its first annual Pharmacy Quality and Safety Summit September 25-26 in Sarasota, FL.
  • Valence Health launches its Pathfinder Accelerator Grant program, which makes $1 million available to hospitals and health systems to apply towards Valence Health’s Pathfinder services for transitioning from volume-based to value-based care.
  • Vocera Communications CMO Bridget Duffy, MD will discuss improving the patient experience at two upcoming industry events.
  • 3M Health Information Systems will offer its suite of ICD-10 and CDI consulting services and software integrated with MedPartners HIM’s credentialed and clinical documentation improvement staffing resources.
  • Consulting magazine recognizes Aspen Advisors, Cumberland Consulting, and Impact Advisors on its list of “Best Small Firms to Work For 2013” and Deloitte Consulting on its list of  “Best Firms to Work for 2013.”
  • Frost & Sullivan presents Vitera Healthcare Solutions its 2013 North American Customer Value Enhancement Award for outstanding performance and success, which recognizes the company’s focus on implementing strategies to create customer value.
  • ReadyDock partners with IT provider Red River.
  • Managed Health Care Associates will launch MHAuthorizeRx, a solution powered by CoverMyMeds and designed to streamline the drug prior authorization process for pharmacies.


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

More news: HIStalk Practice, HIStalk Connect.


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September 17, 2013 News 8 Comments

Monday Morning Update 9/16/13

September 15, 2013 News 7 Comments

9-15-2013 7-37-58 AM

From Thinking UGMs: “Re: user group meetings. Our company is getting large enough to be considering holding our first user group meeting. Do you have ideas?” It’s a great question – quite a few companies are getting big enough to consider throwing a UGM. Let’s crowdsource the idea – take the survey I created and I’ll collect and publish all the ideas right here on HIStalk. What factors would help make a company’s first user group meeting successful?

9-15-2013 7-57-16 AM

From Neutron Jack: “Re: HealtheWay. It’s supposed to be the national backbone for clinical data traffic, but maybe it’s not ready for prime time production.” A reader forwarded an email detailing abysmal technical support from the public-private collaborative that supports the eHealth Exchange, formerly the ONC-run program known as Nationwide Health Information Network Exchange (NwHIN, although technically it should have been NwHINE).  A simple support ticket didn’t get a response for a week despite three requests and an email to the CEO.

9-15-2013 8-03-23 AM

From Keeping the News: “Re: MEA/NEA. Did you see the company that Lindy Benton runs has been acquired by Accel-KKR? MEA has grown with their esMD participation. This could take the company to the next level.” Lower middle market private equity firm Accel-KKR takes a majority position in EA Holdings, which owns National Electronic Attachment (NEA) and Medical Electronic Attachment (MEA). The companies offer a platform for the electronic exchange of medical and dental claims attachments.

From The PACS Designer: “Re: Big data. Recent comments on HIStalk about big data deserve a response. TPD never uses big data in early conversations with customers since it is so vague and can falsely represent giving data viewers valuable information about their practices. For big data to add the value proposition, you need to transform your data through vendor partnerships so the greatest gain in value can be achieved. Only when you impress intended users can the real value be realized for storage of big data.”

From Informatics Professor: “Re: HIPAA Omnibus webinar. Best information I have gotten on the topic. As always, HIStalk is the best source of info on anything related to HIT.” Thanks for those nice words, and thanks to Rebecca Fayed and Eric Banks of The Advisory Board Company for doing their presentation pro bono for HIStalk’s readers.

9-14-2013 3-25-24 PM 


9-14-2013 4-51-35 PM 9-14-2013 4-52-19 PM

Health Catalyst will present “Predictive Analytics: It’s the Intervention That Matters” on Tuesday, September 24 from 1:00 to 2:30 p.m. EDT. It’s a great topic: predictive analytics aren’t worth much if an organization doesn’t have the culture and process to intervene effectively to help the patient. Presenters will be Dale Sanders (SVP) and David Crockett, PhD (senior director of research and predictive analytics). Both are amply credentialed to speak on the topic — Dale’s been a CIO and data architect, while David is a PhD in biomedical informatics and pathology expert. I’ve signed up.

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

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9-15-2013 3-05-14 PM

I’ve had two recent needs met by one free (for personal use) software tool: TeamViewer. It’s really cool for remoting into someone’s PC to fix problems and also for transferring files from their PC to yours. I leave my desktop PC on all the time and Dropbox is good if you know in advance what files you might on other devices (like a laptop or phone), but TeamViewer allows navigating the entire hard drive in a password-protected session. It can also be used like GoToMeeting to run desktop sharing, as in online meetings and training.

9-15-2013 3-35-21 PM

Welcome to new HIStalk Platinum Sponsor MedData and its company MedDirect. The Brecksville, OH-based MedDirect provides reimbursement for outstanding patient balances while improving the patient experience. Utilizing proven patient segmentation and outreach strategies that educate, engage and communicate with patients in a way that drives results, MedDirect ensures that patients are treated with dignity and respect, exceeding patient expectations throughout every interaction. MedDirect services include innovative solutions for outstanding patient balances, patient satisfaction services, appointment scheduling and reminders, registration Point of Service payment portal, and patient billing. Thanks to MedDirect for supporting HIStalk.

Former Merge Healthcare CEO Jeff Surges will be named Monday as board chair of population health management systems vendor Strategic Health Services. Co-founder Tasso Coin will continue as a director.

9-15-2013 3-11-00 PM

GetWellNetwork will on Monday announce that Karen Drenkard, PhD, RN (American Nurses Credentialing Center) will join the company as chief clinical/nursing officer.

9-15-2013 3-18-39 PM

Medical provider database vendor Enclarity is acquired by LexisNexis Risk Solutions, joining previous acquisitions MEDai (analytics) and EDIWatch (fraud detection technology).

Texas Health Presbyterian Hospital Rockwall is implementing patient engagement technology from Emmi Solutions.

Thousands of Epic users are in Verona, WI this week for UGM. Madison-based Vonlay provides a user guide for attendees that includes useful tips, such as how to get to a local brewery using the hotel shuttles and where to rent bikes.

It’s only slightly HIT-related, but fun. Jeff Travis, a biomedical engineer who developed the database architecture of the Premise Patient Flow solution years ago, is now a filmmaker. Dragon Day, his first feature-length film, will premiere in theaters on November 1. It’s an ingenious plotline and looks like a fun watch if you like doomsday thrillers (and I do).

9-15-2013 4-24-50 PM

A Covisint-Porter Research study to be released Monday finds that provider executives are comfortable with the concept of cloud computing. Also: a third of respondents say their EHRs lack population health management capabilities and accountable care is on the radar or providers but isn’t a reality for them yet. The fact that jumped out at me is that most providers are still getting most of their inbound information by fax. Healthcare: the retirement home for 1980s technology.

The Congressional Budget Office says that replacing Medicare’s sustainable growth rate (SGR) reimbursement formula will cost $175 billion of your taxpayer dollars. CBO also found that very few Medicare demonstration projects actually reduced Medicare spending.

9-15-2013 5-33-46 PM

The local paper profiles Mary Carroll Ford, SVP/CIO of Lakeland Regional Medical Center (FL), although it manages to misspell her name in its headline.  

9-15-2013 5-29-23 PM

Allscripts CFO Rick Poulton, responding to a Chicago business paper’s dismissal of the company as a poor example for the city’s healthcare IT sector, says Allscripts is recovering from “a lot of self-inflicted wounds in 2011 and 2012” but concludes that, “We may not be as pretty as we could be, but we’re not a rehabilitation case.” Poulton blames the company’s problems on its 2010 merger with Eclipsys. He says Allscripts is still trying to integrate its hospital and ambulatory systems to compete with Epic’s “one patient, one record” architecture. Poulton has been with the company for less than a year.

9-15-2013 6-46-59 PM

The respective investment firms of former Allscripts CEO Glen Tullman and Chicago entrepreneur Brad Keywell form Zest Health, which will offer mobile apps that include Talk to Me (mobile phone access to clinicians), Schedule Me (booking medical appointments) Inform Me (patient education), and Track Me (a personal health record). Tullman’s company includes former Allscripts President Lee Shapiro. Zest Health’s CEO is Karen Ferrell, former CEO of Apollo Health Street.

9-15-2013 7-49-24 AM

Weird News Andy calls this Migration Malfunction. Patients of a Tacoma, WA non-profit breast center find that their electronic medical records contain information from other patients after a system conversion going back to September 2012.  A medical record number glitch caused problems, especially with scanned documents, in converting to the center’s radiology information system. The patient who complained to the state found that her 900-page chart contained 141 pages of information that wasn’t hers.

WNA also likes this item, which he clarifies isn’t about chastity belts, but rather security “breaches.” An employee of Minnesota’s new health insurance exchange releases the confidential information – including Social Security numbers – of 2,400 insurance agents by accidentally sending the file to an insurance broker’s office.

Vince’s HIS-tory of Cerner Part 5 covers HNA and acquisitions.


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

More news: HIStalk Practice, HIStalk Connect.


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September 15, 2013 News 7 Comments

News 9/13/13

September 12, 2013 News 7 Comments

Top News

9-12-2013 8-32-39 PM

A newly unsealed Medicare fraud lawsuit against Vanderbilt University Medical Center claims that its internally developed Vanderbilt Perioperative Information Management System (VPIMS) was used to bill services for physicians who were not physically present. Documents filed with the lawsuit, which claims the fraud spanned more than 10 years, include a Vanderbilt email telling surgeons to avoid documenting which rooms they were actually covering because “it only confuses and complicates the billing and documentation process.” The lawsuit concludes, “VIPIMS’ purported improvements in billing efficiency are, in fact, largely a function of Vanderbilt’s development of mandatory default software settings that require its physicians, in all instances, to document that they meet Medicare’s conditions for payment.” VUMC says its own investigation has uncovered no billing irregularities and vows to defend itself vigorously.

Reader Comments

9-12-2013 8-36-55 PM

inga_small From Bronwyn: “Re: Cerner Dynamic Documentation. Do you know of any hospitals currently using it who would be willing talk to a CIO about their experience?” Readers, send Inga a note if you can help.

9-12-2013 6-07-12 AM

9-12-2013 9-44-59 AM

inga_small From Reviewer: “HIPAA violation. If this isn’t the most egregious HIPAA violation ever, I don’t know what is!” A parent of a three-year-old patient posts a negative review on Yelp following a visit to a Phoenix plastic surgery clinic. The practice’s operations coordinator posts a reply that includes significant details about the patient and the office visit, as well as some harsh criticism of the mother and her parenting skills. Rebecca Fayed, associate general counsel and privacy officer at The Advisory Board Company, provided us her assessment:

I think that providers (or any covered entity or business associate for that matter) need to be particularly careful when posting anything online, whether it be on Yelp or other social media sites, that could be interpreted as a disclosure of protected health information. In this post,  HHS-OCR could view the response by the provider as a  disclosure of protected health information not permitted by the HIPAA Privacy Rule.

From Former Employee: “Re: Experian Healthcare, formerly Medical Present Value. Underwent its third round of layoffs this week, including its entire SME group and other client support staff. Sales are significantly down under Experian.” Unverified.

9-12-2013 6-13-00 PM

From small_data: “Re: misuse of the ‘Big Data’ buzzword. Simply storing data for archival purposes without intent of using that data for any kind of quantitative analysis is surely not ‘Big Data.’” The solution in question stores medical images. Everybody with a database now has “Big Data.” If they can export that information to Excel, they have enterprise analytics and business intelligence. If that worksheet can be emailed, they offer interoperability. If the worksheet can be stored on a Web server, it’s scalable and cloud-based. These are no longer technical terms with precise meanings; they have been hijacked by the sales and marketing people.

9-12-2013 8-07-06 PM

From Over It: “Re: Jody Albright, CIO, Overlake Hospital. Internal email says her position was eliminated and chief compliance officer will take on CIO duties. She had limited involvement with the Epic project and the go-live was a firestorm on several levels.” Unverified, but above is a purported internal email forwarded my way.

HIStalk Announcements and Requests

inga_small The latest news from HIStalk Practice includes: use of an EMR that includes automated growth monitoring helps doctors pick up on cases of possible growth disorders among kids.The AMA offers a toolkit (perhaps a little late) to help physicians prepare for upcoming HIPAA changes. HIT expenditures in physician offices jumped 28 percent from 2008 to 2012. Will cloud-based EHR/PMs really save practices from acquisition? Patients from Advocate Medical Group file a class-action lawsuit following the theft of unencrypted computers. Rhode Island primary care practices can earn up to $10,000 to connect to the state’s HIE. Culbert Healthcare Solutions VP Brad Boyd offers some advice for defining and measuring an EHR’s ROI. Thanks for reading!

9-12-2013 6-34-11 PM

Welcome to new HIStalk Platinum Sponsor EXTENSION. The Fort Wayne, IN company offers contextual alerting, secure messaging, and care team collaboration technologies, including specific solutions that address Joint Commission’s 2014 National Patient Safety Goal, “Improve the safety of clinical alarm systems.” First-generation systems just throw out a lot of alerts, but EXTENSION’s next-generation platform combines alarm safety software with a secure text messaging solution to optimize the workflow involved with clinical event response. The company’s HealthAlert solution solves the challenge of getting important clinical event notifications in the hands of clinicians, routing critical lab results, stat orders, staff assignment, patient monitoring, and patient nurse call requests. The system prioritizes the alerts, escalates based on defined rules, announces the event verbally to the recipient, and maintains an audit trail. It works with Android, Apple, Ascom, Cisco, Spectralink, and Vocera devices, including a mobile app that can run on a clinician’s own smartphone.  Thanks to EXTENSION for supporting HIStalk.

I found this short introductory YouTube video from EXTENSION called “The Power of the EHR-Extender.”

On the Jobs Board: Manager North America Professional Services West, Implementation Engineer (East Coast), Services Operations Manager.

HIStalk Webinar


Informatica will present “Best Practices for Delivering Better Quality Care and Reducing Preventable Patient Readmissions” on Thursday, September 26 from 1:00 – 1:45 p.m. Eastern.  Speakers are George Brenckle, PhD, SVP/CIO of UMass Memorial Health Care and Richard Cramer, chief healthcare strategist of Informatica (I interviewed him awhile back). Register here.

9-12-2013 8-28-25 PM

I recorded the HIPAA Omnibus webinar given by Rebecca Fayed and Eric Banks of The Advisory Board Company earlier this week and posted it to YouTube. The slides are here. Thanks to Rebecca and Eric, who stepped up when I asked for volunteers to run through the changes with HIStalk readers. We had a nice turnout, and in typical Advisory Board fashion, not a second was wasted due to inadequate preparation or lack of focus.

Acquisitions, Funding, Business, and Stock

Covisint will raise at least $64 million in its IPO by offering 6.4 million shares at an expected price of $9 to $11. The company generated $94 million in revenue for the 12 months that ended June 30.

Three partners of Morgenthaler Ventures create a new management company and the $175 million Canvas Venture Fund that will focus on early stage investments of $5 to $15 million in mobile, health IT, financial technology, and enterprise technology. The parent VC company invested in physician social network Doximity and free EMR vendor Practice Fusion.

9-12-2013 8-39-49 PM

The CSI Companies acquires Atlanta-based IT staffing firm Anteo Group.

9-12-2013 8-00-21 PM

Lincor Solutions moves its headquarters from Ireland to Nashville.


9-12-2013 8-41-38 PM

Estes Park Medical Center (CO) will implement HealthCare Anytime’s patient portal technology at its hospital and outpatient clinic.

The Valley Hospital (NJ) selects Merge Healthcare’s CTMS for Investigators to manage its clinical research operations.

UHS-Pruitt Corporation, a provider of post-acute care services, will implement healthcare analytics and population health solutions from Caradigm.

The 110-provider Prima CARE (MA/RI) selects Ingenious Med’s mobile revenue capture technology.

Washington Orthopaedics & Sports Medicine (DC/MD) selects SRS EHR for its 11 providers and three locations.


9-12-2013 3-34-37 PM

Wellcentive names Tom Zajac (Elsevier) CEO.

9-12-2013 10-14-16 AM

Health Catalyst appoints David K. Crockett, PhD (ARUP Laboratories) senior director of research and predictive analytics.

9-12-2013 5-17-06 PM

Robert Porr (Accenture)  joins Sandlot Solutions as EVP of sales and marketing.

9-12-2013 6-16-26 PM

Nancy Killefer (Department of the Treasury, IRS Oversight Board, McKinsey & Company) joins the board of The Advisory Board Company.

9-12-2013 6-31-43 PM

University of Missouri-Kansas City hires Mark Hoffman, PhD (Cerner) as director of bioinformatics core and associate professor to establish its Center for Health Insights informatics program.

9-12-2013 7-27-12 PM 9-12-2013 7-27-53 PM

Stanford Hospitals & Clinics (CA) promotes Pravene Nath, MD to CIO and Christopher Sharp, MD to CMIO.

MGMA-ACMPE names Garth Jordan (EDUCAUSE) COO.

Prime Healthcare Services (CA) will implement  Infor financials, supply chain and human capital management, clinical bridge, and analytics.

Announcements and Implementations

Quest Diagnostics joins LabCorp and almost all of Colorado’s large hospital laboratories in connecting to the Colorado RHIO.

The HIEs Michigan Health Connect and Michiana HIN will share health records between Michigan and Indiana providers.

The Patient-Centered Outcomes Research Institute board of governors issues 71 awards totaling more than $114 million to fund comparative clinical effectiveness research, including studies to improve the applicability of data collected through EHRs and social media sites and methods for engaging minority patients and caregivers in patient-centered health research.

9-12-2013 11-45-45 AM

Ivo Nelson’s Next Wave Health forms Smart Social Media, Inc., a software company that will develop a healthcare social media platform. Next Wave Health acquired the OneXPage social media platform from Digiapolis, Inc., founded by Minneapolis entrepreneur Eric Lopez, who will be CEO of Smart Social Media.

Gastroenterology EHR vendor gMed will use behavior-based prescription management messaging from LDM Group to improve medication adherence and highlight therapy options.

Government and Politics

ONC launches a patient matching initiative to seek common denominators and best practices being used by private healthcare systems and federal agencies.

Innovation and Research

The use of an electronic decision support tool linked to patients’ EMRs helped reduce deaths from pneumonia in EDs by up to 25 percent according to researchers from Intermountain Healthcare and the University of Utah.

9-12-2013 10-21-51 AM

inga_small An athenahealth analysis of EHR data from its user network reveals no signs of a national decline in childhood obesity over the last three years. Athenahealth obviously has a wealth of clinical data at its disposal and this type of analysis is interesting and arguably beneficial. However, are practices and patients aware of how athenahealth and other EMR companies may be using personal health information? More importantly, should they? To the latter question I say yes, and mechanisms should be in place to allow practices and patients to opt in or out.


AirStrip will develop and optimize its AirStrip ONE solution for Samsung tablets running Android and Windows 8.1 operating systems, as well as Samsung convertible and all-in-one desktop and laptop PCs with touch screens.

9-12-2013 8-43-40 PM

Lt. Dan covers the iPhone 5S announcement in his excellent HIStalk Connect analysis, “Apple Comes Up Big On The iPhone 5S Unveil: What it Means for Healthcare.”


The Tax Increment Financing Commission of Kansas City approves a $1.635 billion incentive for Cerner’s proposed plan to develop a 4.5 million square foot mixed-used campus.

VA psychiatrists and researchers are using natural language processing and query searches of doctors’ free-text notes to flag patients who present a clear risk of suicide.

9-12-2013 1-29-05 PM

Crittenton Hospital (MI) will provide free electronic copies of medical records to the families of patients treated by Farid Fata, MD. Fata is the Michigan Hematology Oncology physician accused of deliberately misdiagnosing patients and improperly administering chemotherapy as part of a $35 million Medicare billing fraud scheme. The hospital provides records free only to medical doctors, but reversed its policy after the doctor’s patients staged a protest.

The New England Journal of Medicine gets banned from posting pictures on Facebook after running a medical image of a patient with scrotal calcinosis, which Facebook found pornographic. Facebook changed its mind shortly after.

Sponsor Updates

  • Aventura publishes an informative and entertaining HIT Survival Handbook.
  • Allscripts will add Inovalon’s quality improvement and risk score accuracy analytics  to its EHR platform.
  • Health leaders in Leeds, UK will evaluate whether outcomes can be improved by using Alere’s healthcare platform.
  • Medseek Empower 5.0 earns CCHIT certification as an EHR Module and is compliant with the ONC 2014 Edition criteria.
  • Campbell Clinic (TN) reports that its use of Emdat’s medical documentation solutions has improved documentation completion, workflow, and transcriptionist productivity.
  • Billian’s HealthDATA interviews Collin Searle, social media manager for Intermountain Healthcare (UT), about the health system’s social media strategy. 
  • Clinovations CEO Trenor Williams discusses the need for pharma companies to  use technology and think more strategically about communications with health providers and patients. 
  • Innovative Healthcare Solutions offers a white paper series that includes tips for a successful project outcome.
  • Hot jobs on the site of Henry Elliott & Company, which specializes in Caché and M/MUMPS technology positions, include Senior M/Caché P/A, Caché M/Mumps Web Developer, VistA Analyst, and .NET/Caché Developer.
  • Cleveland Clinic’s use of BI dashboards from Harris Healthcare has driven significant ROI and performance improvement, including a $10 million increase in net income.
  • Intelligent InSites announces details of InSites Build 2013, an RTLS learning event October 28-30 in Fargo, ND.
  • Sunquest Information Systems and the Association for Pathology Informatics will host a September 26 educational webinar on pathology informatics featuring Walter Henricks, MD of Cleveland Clinic.
  • Florida Hospital Celebration Health realizes increases in key HCAHPS categories since implementing GetWellNetwork’s Interactive Patient Care and Clinical Practice Design solutions.
  • UnitedHealth reports its use of InstaMed online payment option has resulted in over $3 million in payments since its late July rollout.
  • Trinitas Regional Medical Center (NJ) enhances staff safety with Versus Visibility Staff Assist RTLS technology.
  • Hayes Management Technology adds its go-live support and legacy support services to its website.
  • Divurgent and Medix will host a Retro Arcade Event during Epic UGM. Readers may RSVP here.

EPtalk by Dr. Jayne

Mr. H mentioned that PatientSafe Solutions has joined us as a Platinum Sponsor, but I wanted to offer my own shout out for its PatientTouch system. I first saw it at HIMSS13, and as Inga can attest, was really geeked out about it. I’d love to see it installed at my institution, so maybe I’ll “accidentally” leave their information on my boss’s printer.

I spent the earlier part of this week at the AMIA Clinical Informatics Board Review Course in Chicago. There were enough sassy young female physicians in attendance, so I feel fairly safe in admitting it while being able to still remain anonymous. I even saw some sassy shoes, so I felt like I was in good company.

Why a board review, and why now? This fall marks the first opportunity for physicians to actually seek board certification in the subspecialty of Clinical Informatics through the American Board of Preventive Medicine. There’s also a pathway through the American Board of Pathology – based on the number of pathologists in the class I don’t want to neglect to mention that because I know if they’re reading they’ll correct me – but the majority of informatics physicians I know are not pathologists.

As a new specialty, they’re offering a “practice pathway” for those of us who are not fellowship-trained to seek certification, through 2017. Candidates in this pathway have to demonstrate at least 25 percent practice in clinical informatics during three of the five years preceding application. In 2018 and later, candidates will have to have completed a minimum of 24 months in an ACGME-accredited Clinical Informatics fellowship program.

Many of us are not fellowship trained. Instead we’re homegrown informaticists who have been at this quite a while. We may have done some coursework in informatics or had intensive mentoring in order to reach our level of performance. In my case, the thought of trying to go back and do a formal training program on top of working the number of hours I do currently made my skin crawl, as did the idea of spending $40,000 or more on a degree that wouldn’t raise my income or the level of respect from my peers.

After a little cajoling from a colleague, I decided to aim for certification in the first round through the practice pathway. It’s a bit daunting because it’s a brand new exam. None of us really knows what to expect, and although the Board has published an “examination content outline,”  it’s pretty daunting since the level of detail they could be expecting could be all over the map. The application process was also daunting, as I had to track down former bosses who could best attest to the time I’ve spent in the field. I’ve had five bosses at three jobs in the last five years and only one is still working at the hospital where we were colleagues.

I’ve never taken a board review course before, so this seemed like a good time to try it given the breadth of the material. The class was a nice mix including average working CMIOs and high-powered names from major academic institutions. The VA and military were well represented, as were ambulatory organizations, payers, and vendors. I’m happy to report a Bowtie Index of 3.67 bpd (bowties per day) with one attendee having particularly fetching choices.

The group was pretty social and there were some key themes heard during the cocktail hour and various breaks. One is that there are quite a few institutions out there that still don’t value the contribution that a CMIO brings to the table. Many CMIOs are forced to try to do the job without the title or the appropriate level of authority. If you’re at one of those facilities who still question whether you need a CMIO, check that exam content outline to learn more about what we do and what we can bring to the table.

Another key theme is that there is never enough money to do the work that needs to be done. That goes right along with the theme that there are always more projects to be done than can be humanly accomplished. I also learned that many physician informaticists are very driven and devoted to the field – so much so that one physician sitting near me said his colleague’s inhuman level of work product clearly means that she’s a cyborg.

I’m unfortunately having to play catch up for the days out of the office, so you’ll have to wait until Monday’s Curbside Consult to hear about the rest of the course and some fun things I learned including some informatics jokes. I’ll leave you with this one in the interim:

A programmer is asked by his spouse to get some groceries. She asks, “Can you pick up a loaf of bread, and if they have eggs, get a dozen.” He returns home with 13 loaves of bread. She asks, “What happened?” His response: “They had eggs.”


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

More news: HIStalk Practice, HIStalk Connect.


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September 12, 2013 News 7 Comments

News 9/11/13

September 10, 2013 News 5 Comments

Top News

9-10-2013 9-30-03 PM

Healthcare learning and performance improvement systems vendor HealthStream acquires Baptist Leadership Group, a consulting practice owned by Baptist Health Care in Pensacola, FL, for $8.5 million. The company also announced that the health system will use its talent management software.

Reader Comments

inga_small From Warrior: “Re: telling clients about unethical sales tactics after quitting a vendor job. The answer to the question is an easy one. Take the severance package and agree to keep the pie-hole closed. Any unethical sales techniques will eventually reveal themselves. A couple of years ago I was a victim of senior management lies and deceit, to say nothing of what was being done to clients. I quit without calling customers or the competition regarding the egregious business practices. Three months after I resigned, several of the morally bankrupt executives were shown the door with very generous golden parachutes. Blood money – what goes around, comes around. My hands are clean!” My take: unless a former employer was doing something illegal as opposed to something unethical, keep the dirty secrets to yourself. If you were one of the “good guys,” your departure will make enough of a statement.

From More Cow Bells: “Re: Sutter EHR downtime. The spokesperson cited the uptime percentage as 99.4. It bothers me that the systems handling the clinical and financial information of our hospitals are estimated to be unavailable for more than 52 hours per year. I’m not sure any other industry that deals with public safety and well-being would tolerate being down an hour a week (air traffic control?) What about striving for the old standard of five nines?”

9-10-2013 9-37-46 PM

From Dirk Diggler: “Re: Sutter EHR downtime. You mentioned news articles whose come-on headlines don’t deliver anything but an advertiser click. Here’s one.” A HIMSS-owned publication lures readers in with the cutesy and eventually misleading headline above. The article it sits astride contains nothing but shallow information extracted from old press releases about Sutter’s Epic (actually Citrix) downtime. When you finally read down through an extra click to Page 2 (banking an extra click to impress advertisers), the healthcare IT expert cited is the hospital’s nursing union rep, who offered three suggestions: (a) train people on downtime procedures; (b) communicate well; and (c) get nurses involved in system design. You can decide whether the advice is more insulting to the healthcare IT experts targeted by the publication than the article itself. At least the headline didn’t start with a number (“Eight Reasons Apple is Really Cool”) or require clicking an idiotic slideshow of unrelated photos lifted from other sites. I don’t like getting fooled and I hate wasting time, so I stop reading sites that promise more useful information than they deliver.

9-10-2013 9-41-15 PM

From Not Intuit: “Re: Intuit Health. Fifty percent staff cuts today, including me. All seniors leaders except for the product development lead gone.” Unverified, but the source is not anonymous. The former Medfusion’s name is still Intuit Health temporarily, but it’s a private company again after being bought back by founder Steve Malik a couple of weeks ago. My August 27 interview with him is here.

HIStalk Announcements and Requests

9-10-2013 7-15-53 PM 

Welcome to new HIStalk Platinum Sponsor PatientSafe Solutions. The San Diego-based company offers smart point-of-care mobile solutions for the future of accountable care, delivering measurable safety and quality improvements that fit into care team workflows. The company’s flagship PatientTouch system, with 70 implementations, offers iPhone-powered software solutions to eliminate harm, reduce waste, and improve productivity. New York-Presbyterian Hospital chose PatientTouch a few months ago and Parkview Medical Center (CO) recently extended its use and integrated it with Meditech 6.0. Thanks to PatientSafe Solutions for supporting HIStalk.

I found this YouTube video on PatientSafe’s PatientTouch.

Upcoming HIStalk Webinars:

The Transition to ICD-10: Building the Bridge as You Walk on It (Thursday, September 12, 2:00 Eastern)
Using Infrastructure and Application Monitoring to Assure an Optimal User Experience  (Thursday, September 19, 1:00 Eastern)

Acquisitions, Funding, Business, and Stock

Disclosure management services company MRO Corp. acquires the assets of MTT Enterprises, a release-of-information service provider.

9-10-2013 5-43-06 PM

Santa Rosa Consulting completes its acquisition of IT security company EGIS Systems and renames it Fortified Health Solutions.

ZappRx, a developer of a mobile e-prescribing platform, raises $1 million in seed funding lead by Atlas Venture and Life Sciences Angel Network. 

9-11-2013 6-05-10 AM

Scotland-based Craneware says its revenue and EPS were up for the year despite not hitting its target of 1-2 big-hospital sales that can be worth up to $20 million each.

A Forbes editorial urges Nuance to put Carl Icahn on its board instead of fighting him off with a poison pill provision. Reasons: (a) financial results and management guidance have been poor; (b) Nuance shareholders should want Icahn involved given his past performance; (c) it can’t hurt; (d) Nuance doesn’t seem to have a strategy other than acquiring other companies; (e) CEO Paul Ricci is overpaid, having made $78 million in the past three years; and (f) the company should break up into separate business to make its Siri-type voice offerings more attractive, or as the article says, “If I’m Apple, I don’t want a medical transcription company with a bunch of transcription workers in India, but I’d be very interested in just the mobile speech piece.”


9-10-2013 9-44-03 PM

Sentara Williamsburg Regional Medical Center (VA) selects Versus Advantages Asset Tracking and Fleet Management.

Kmart will offer LDM Group’s PharmacistCare and CarePoints messaging solutions to pharmacists and patients to improve medication adherence.


9-10-2013 5-44-58 PM

Healthcare consulting firm Decision Resources Groups hires Courtney Morris (Truven Health Analytics) as EVP of solutions.

9-10-2013 9-21-01 AM

Geeta Nayyar, MD (AT&T) is named CMIO of PatientPoint.

9-10-2013 5-47-56 PM

Clarity Health Services names Karlynn Billings (McKesson Specialty Health) VP of business development.

Announcements and Implementations

9-10-2013 9-46-14 PM

Children’s Hospital Colorado will extend its use of T-System’s ED facility coding solution to two new locations that will open in 2014.

A total of 101 Ohio hospitals are participating in the Medicity-powered CliniSync HIE.

JIT Healthcare Marketing launches to offer ad-hoc marketing, PR, and design services with a simplified payment process.

Mediware will invest $2.8 million on enhancements to its rehabilitation and respiratory care electronic documentation solutions.

Memorial Health Hermann Health System (TX) takes almost 600 providers live on eClinicalWorks EHR and adds an additional 200 user licenses.

Infor announces GA of Infor Implementation Accelerator for Healthcare for the management of financials, human capital, and supply chain processes. Infor also releases Infor EMS Integrated Healthcare suite, which provides a real-time exchange of data between EMS and hospitals.

9-10-2013 7-00-01 PM

ImageTrend releases Version 3 of its patient registry system.

Liaison Healthcare announces the launch of EMR-Link, which allows clinicians to view lab and rad results reported through its hub on any smartphone.

Corepoint Health adds Direct Project protocol support to the latest version of its integration engine, giving customers a simpler way to exchange information with external organizations.

ICA announces its SmartAlerts service, which identifies high-risk patients in real time to reduce readmissions.

Government and Politics

9-10-2013 6-10-06 PM 9-10-2013 6-10-40 PM 9-10-2013 6-11-08 PM
9-10-2013 6-11-43 PM 9-10-2013 6-12-12 PM 9-10-2013 6-12-41 PM

The Meaningful Use Workgroup of ONC’s Health IT Policy Committee plans functionality goals for MU Stage 3.

ONC releases “Certification Guidance for EHR Technology Developers Serving Health Care Providers Ineligible for Medicare and Medicaid EHR Incentive Payments,” designed to help developers of EHRs for providers who don’t usually fall under HITECH (mental and behavioral health, non-acute care settings) design systems that are interoperable with HITECH-influenced EHRs.

Innovation and Research

A study published in JAMA finds that implementation of EHRs  Kaiser Permanente Northern California in 2004-2009 was associated with a slight but statistically significant reduction in ED visits (519 vs. 490 visits per 1,000 patients) and hospitalizations (251 vs. 239 per 1,000 patients) for diabetic patients. Office visit rates exhibited no association.  Another JAMA published study finds that EHR-powered small practices produced slightly better outcomes working under a pay-for-performance program.

9-10-2013 7-38-37 PM

Mike Wasser creates the very cool BloomAPI v 0.1.0, a free self-hostable API that queries the automatically updated latest version of the National Provider Identifier database. It also supports simple and complex online queries. You’ll be interested if you want to look up doctors in real time by name, ZIP Code, address, or NPI.

9-10-2013 7-58-14 PM

Brian Norris (@Geek_Nurse) follows up his Tableau-powered MU attestation slicer and dicer with one on data breaches. He seems to enjoy tearing into large, publicly available data sets to provide new insights and the results are cool, so he might accept suggestions (that’s where the breach idea came from).

9-10-2013 8-03-10 PM

A keyword-based search of online help wanted ads finds that healthcare IT-related job postings have increased by 86 percent since HITECH passed.

Southern Polytechnic State University in Atlanta will host the CDC Health Game Jam September 20-22, challenging entrants to quickly produce games that address CDC’s health priorities, such as disease prevention and healthy lifestyles.


The European Patent Office will grant PeriGen a patent that covers specialized techniques for displaying patient data to help OBs recognize trends and deviations from normal conditions.

Streamline Health Solutions releases its dual coding enhancement for the eCAC and eAbstract applications that allows users to assign ICD-9 and ICD-10 codes simultaneously.


A HIMSS Analytics survey on clinical and business intelligence finds that only 9 percent of respondents plan to buy a dedicated solution that integrates with their EHR, but among those who do, Truven, Elsevier, and Cognos, all of which significantly trail buying whatever their EHR vendor offers.  

9-10-2013 8-16-10 PM

A debt collection agency that previously worked for the University of Chicago Physicians Group announces that an incorrect security setting on its Web server opened up information about 1,344 still-active claims to anyone who happened to find it. The problem was reported by a debtor who noticed that they could see the information of other debtors.

Hospital bond ratings may suffer from the costs and problems introduced by an Epic implementation, but the bonds of Dane County, WI (home of Epic) enjoy a AA+ rating from Fitch because of Epic’s employee growth.

Speaking of Fitch bond ratings, Mary Washington Healthcare (VA) gets a low rating and downgrade after a $28 million profitability hit in FY2012 due to a billing systems conversion and another $2 million drain due to CPOE implementation, causing the hospital to write off $25 million. I believe both systems are Siemens Soarian.

Weird News Andy wonders what the funniest or most interesting things providers have experienced from their patients as in this story, where a man coming out from surgical anesthesia notices a woman next to his bed and says, “Man, you are eye candy. Whoa. You may be the prettiest woman I’ve ever seen. Are you a model?” When reminded that the eye candy in question was in fact his wife of six years, he exclaimed, “"Oh my God, I hit the jackpot.”

Sponsor Updates

  • Capario announces it is ready to begin ICD-10 testing and offers customers an online ICD-10 submitter testing tool at no charge.
  • Aprima Medical integrates NoteSwift into its EHR system.
  • A Forbes article on the use of IT to advance the delivery of healthcare highlights QPID Health, which it calls a “promising startup software development firm.”
  • Convergent Revenue Cycle Management will offer RCM solutions to Siemens customers.
  • HIMSS Analytics reports that Imprivata OneSign is the most widely selected SSO solution among hospitals using EpicCare.
  • ZirMed will offer tools to help providers transition to ICD-10.
  • ATT offers a white paper discussing how providers can use a collaborative care approach to earn incentives and prepare for accountable care.
  • Sumit K. Nagpal, president and CEO of Alere Accountable Care Solutions, shares his thoughts on how the use of technology can improve patient outcomes.
  • Etransmedia CEO Vikram Agrawal discusses the lack of access to qualified programmers.
  • Greenway Medical adopts the EHR Developer Code of Conduct issued by the HIMSS EHR Association.
  • Divurgent posts tips for go-live personnel on how to make the most of relationships with recruiters.
  • HIStalk sponsors listed on the 2013 InformationWeek Top 500 include: ATT, CommVault, Emdeon, Informatica, InterSystems, McKesson, MModal, NTT Data,  TriZetto and Xerox.
  • The CSI Companies acquires IT staffing firm Anteo Group.
  • The GE Foundation awards The Guideline Advantage an $880,000 grant to provide 12 FQHCs with quality improvement technology from Forward Health.
  • Billian’s HealthDATA hosts an #HITchicks tweet chat September 19 to discuss four gender-related HIT topics.
  • Nuance partners with Hyland Software to enable eCopy ShareScan to scan directly into Hyland’s OnBase EMC system.
  • Benson Area Medical Center (NC) reports that it has reduced IT costs and improved security of patient data by utilizing the e-MDs EHR software within the ClearDATA HealthDATA cloud platform.


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

More news: HIStalk Practice, HIStalk Connect.


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September 10, 2013 News 5 Comments

Monday Morning Update 9/9/13

September 7, 2013 News 6 Comments

9-7-2013 5-53-44 PM

From The PACS Designer: “Re: Apple’s fingerprint reader. With Apple possibly launching several products next week, TPD thought it would be good to give you a glimpse of what’s coming next. The fingerprint reader, if introduced, brings an interesting security solution for healthcare in that lost devices will be unusable as long as the security lock remains active.” Above is a leaked photo of a new iPhone start button with what appears to be a built-in fingerprint reader, from Sonny Dickson.

From IT Guy Turned Patient: “Re: Apple and healthcare. Interesting perspective. I could still argue persuasively for the Windows model. but what I know about the healthcare system could be inscribed on the top of a pin and still leave room there for me to ice skate. From my perspective as a recent user of healthcare, what seems to be the driving factor is simply referrals. I go to a primary healthcare provider who by most standards would be considered way better than average. I am listened to regarding symptoms, then referred to a specialist to whom I give the same answers to regarding symptoms, I am tested, receive boilerplate textbook treatment, and ushered out the door as I hear a receptionist behind me say, ‘Next.’ Meanwhile, five months later, nothing has changed. I am in exactly the same boat as I was pre-visit to either facility except about $1.800 lighter. I’ve never been called to be asked, “How are you? How did we do?” There’s no warranty. No one really seems to care once you’re out the door, which is interesting since the industry that I work in routinely makes that call. Why do people not howl at the moon over piss-poor healthcare the way they do over even mediocre or worse car care or home remodeling? I don’t know what it would take. I don’t know whether the Apple model or the PC model would work better, but from my point of view the entire experience seems so institutionalized and insulated from capitalism and the rest of the world. Something needs to change, but getting government more involved rather than less won’t accomplish that. One thing I know for certain is that we live in the United States of Unintended Consequences.” I’ll say again as I always do — you get what you pay for. More precisely, you get what insurance companies and the government pay for, and that’s patient and procedure volume. Unfortunately for now, nobody’s paid very much to care about how you like it.

From Caveat Emptor: “Re: ethics. Is a sales employee who feels their former employer engaged in unethical sales practices obligated to inform customers instead of accepting a generous severance package that prevents disclosure of those practices” I’ll open it up to readers for comments, but my answer is no. It’s not appropriate (much less an obligation) for a company’s former employee to start calling customers making accusations about company ethics. If the sales practices were all that bad, customers will find out and make their own complaints (possibly legal ones) that would carry more weight than those of someone who didn’t speak up while drawing a paycheck from that company, but suddenly feels moved to do so after quitting. I don’t have specifics about the practices mentioned here, but I’ll ask readers to weigh in anonymously on that issue as well – what are some really abhorrent sales techniques you’ve seen used?

9-7-2013 5-06-26 PM

Half of poll respondents attend the HIMSS conference because they want to see other attendees, while only 15 percent are primarily drawn there by the educational sessions (which is probably a good thing based on my perception of the slide in quality of the education track). New poll to your right: which of John Halamka’s five CIO challenges will be most important?

George Giorgianni, who has worked for HBOC, SIS, DocusSys, and Unibased in his 35 years in healthcare IT, will retire on October 4.

9-7-2013 5-49-21 PM

Cornerstone Advisors names John McGuinness, MD (Meditech) to the newly created position of CMIO.

Baylor Health Care System wins a local technology trade association’s innovation work for its development of add-on modules for Allscripts Sunrise Clinical Manager, including a physician documentation tool.

9-7-2013 6-01-37 PM

Jimmy Weeks posted on Twitter this photo of the Bridgeport Hospital appointment conversion team beginning the move to Epic. They’re part of Yale New Haven Health.

9-7-2013 6-17-52 PM

A business site says that Aetna once offered to buy physician appointment scheduling app vendor ZocDoc for $300 million, but the founders turned the deal down, probably wisely since the company is valued at a lot more than that now.

Vince’s HIS-tory Part 4 on Cerner looks at the company in its early LIS-centric days in the form of a customer’s system search.


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

More news: HIStalk Practice, HIStalk Connect.

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September 7, 2013 News 6 Comments

News 9/6/13

September 5, 2013 News 8 Comments

Top News

The HIT Policy Committee approves multiple recommendations presented by the FDA Safety and Innovation Act (FDASIA) Workgroup, including:

  • HIT should not be subject to FDA premarket requirements except when it constitutes medical device accessories or involves certain forms of high-risk CDS, such as computer-aided diagnostics. EHRs, decision support algorithms, and HIE software may be subject to regulation.
  • Vendors should be required to list products that are considered to represent potential risk.
  • Post-market surveillance of HIT should include reporting from users and vendors and also include post-implementation testing.

The committee also called for adoption of existing standards and creating new standards to address specific areas, including HIE. The recommendations now go to the FDA, ONC, and FCC, which are expected to release a proposal for public comment early next year.

Reader Comments

inga_small From Dr. Loredana: “Re: male vs. female physician compensation. A study found that women docs spend more time with patients. Therefore, they see fewer patients and thus make less money. Physicians’ time should be valued and addressed just like any other resource in healthcare. It is finite and scarce and we only have 24 hours in the day like anybody else.” A quick Google search uncovered a number of studies indicating that female physicians spend an average of 10 to 50 percent more time with patients than their male counterparts. Now I am curious if there are any studies tying outcomes with time spent per patient encounter.

From Tallman Letters: “Re: consulting firms and vendors. I’m turning to you, our most trusted source! Which healthcare consulting firms or vendors are most qualified to (a) provide technical consulting to providers about what technical architecture they should use; (b) build a healthcare data model; and (c) implement the tech architecture for full EDW/BI? Keep up the great and amusing work you do for us all!” I’m turn to my most trusted source – readers. Please leave a comment with your thoughts for TL.

HIStalk Announcements and Requests

9-4-2013 3-58-01 PM

inga_small Some of this week’s highlights from HIStalk Practice include: athenahealth reveals development plans for its recently purchased Arsenal complex, including walking and biking paths, an incubator for HIT startups, and a beer garden. Minnesota State Fair visitors are given coupons for free healthcare e-visits. More than half of all medical students use tablets as part of their medical training. The IT administrator at an orthopedic practice accesses a physician’s electronic signature to forge prescriptions. Dr. Gregg discusses the darker side of vendor-provider relationships, including Practice Fusion’s opt-out policy for sending patients emails that appear to come from providers (I also share my view.) Thanks for reading.

On the Jobs Board: Healthcare Customer Advocate, Clinical Applications Consultant, Project Manager.

Acquisitions, Funding, Business, and Stock

9-5-2013 9-24-25 PM

Agilum Healthcare raises $1.43 million in a debt offering.

9-5-2013 3-31-37 PM

Teladoc acquires fellow telemedicine services provider Consult A Doctor for an undisclosed amount.

9-5-2013 9-08-42 PM

SAIC announces Q2 results: revenue down 12 percent, EPS $0.13 vs. $0.32, missing expectations and cutting its 2014 outlook. Its health an engineering segment did better, but only because of the recently acquired maxIT Healthcare. SAIC plans to split itself into two companies, with its national security, health, and engineering operations to be moved to a new company called Leidos, with headquarters in Reston, VA. Healthcare is the smallest of the three operations with 6,000 employees.


Tenet’s Saint Louis University Hospital selects iSirona’s device connectivity solution.

9-5-2013 9-26-24 PM

Pekin Hospital (IL) selects Interbit Data’s NetSafe business continuance and downtime protection software.

The VA awards AMC Health a five-year, $28.8 million contract to provide telehealth solutions and services.

9-5-2013 9-27-12 PM

Mt. Washington Pediatric Hospital (MD) contracts with HealthCare Anytime for its Enterprise Patient Portal Suite.

Community Medical Centers (CA) selects Infor Cloverleaf.



9-5-2013 7-56-11 AM

Cerner promotes Zane Burke from EVP of the company’s client organization to president. Neal Patterson, who covered the president role since former President Trace Devanny left in 2010, will retain the titles of chairman and CEO. Cerner says that Burke’s promotion does not represent a formal succession plan announcement.

9-5-2013 8-46-58 AM

HIT consulting firm Meditology Services names Michael Flynt (Workday) VP of sales.

9-5-2013 8-59-17 AM

Patient engagement portal provide Omedix appoints Shay Pausa (ChiKiiTV/Magnet) CEO.

9-5-2013 10-59-02 AM

Caradigm appoints Joel Ratnasothy, MD (Fujitsu) as medical director for Europe, the Middle East, and Africa.

9-5-2013 3-45-29 PM

Anil Chakravarthy (Symantec) joins Informatica as EVP/chief product officer.

9-5-2013 8-29-06 PM

Diane Cecchettini, RN, president and CEO of MultiCare Health System (WA), announces her retirement next year. She served as a flight nurse in Vietnam, was a troop commander in Desert Storm, was president of the Washington State Hospital Association from 2005 to 2007, and won several IT awards.

Marc Donovan (World Wide Technologies) joins Nexus as sales director for the company’s connected healthcare practice.

Announcements and Implementations

9-5-2013 9-28-06 PM

Virginia Hospital Center will invest five to $10 million to consolidate its 100-plus employed physicians into one multi-specialty group and migrate the currently separate practices to eClinicalWorks.

Cerner will integrate Elsevier’s CPM CarePoints and InOrder evidence-based content solutions into its PowerChart EHR.

Artemis Health Group will add Health Language’s clinical language management tools from Wolters Kluwer Health into the Artemis OB/GYN EHR, PM, and patient engagement solutions.

Carolinas HealthCare System will use aggregated claims and clinical data from Verisk Health to analyze and manage population health.

9-5-2013 9-28-52 PM

Castle Medical Center and Hawaii Pacific Healthcare will join Health eNet, Hawaii’s statewide HIE.

9-5-2013 4-01-35 PM

A new KLAS report on enterprise patient access finds that best-of-breed solutions are common, with the most important functions to users being calculation of estimated patient responsibility, eligibility verification, and preauthorization.

HealthTech’s YourCareCommunity.Com v1 earns ONC-ACB certification as a modular EHR.

9-5-2013 9-32-40 PM

Intelligent InSites adds integration with HyGreen’s hand hygiene monitoring system to warn workers who haven’t washed their hands.

The UHC alliance announces plans for an automated program that will extract clinical and administrative information from the IT systems of its members and transfer it to UHC for benchmarking. NYU Langone Medical Center and Cleveland Clinic will be the first adopters, with the system expected to be available to all UHC members by the end of 2013.

NextGen Healthcare client Willamette Valley Providers Health Authority (OR) deploys a clinical decision support tool developed by the Clinical Decision Support Consortium that takes a request for CDS from NextGen Ambulatory EHR, delivers it to an enterprise clinical rules service at Partners HealthCare for analysis, and immediately returns recommendations within the NextGen application. The “cool” factor here: community-based physicians can access CDS data from a large academic medical center across the county and retrieve recommendations at the point of care. The Consortium aims to establish nationwide consistencies for CDS recommendations and is comprised of members from provider organizations and EHR vendors, including Partners and NextGen.

Government and Politics

9-5-2013 4-11-39 PM

Brian Norris of Social Health Insights LLC  created a cool visualization page for Meaningful Use attestation data using tools from Tableau Software.

Innovation and Research

GE, Under Armour, and the National Football League launch the GE NFL Health Health Challenge, which will award prizes of up to $10 million for concussion-related solutions that can include technologies to detect and measure brain injury.

9-5-2013 9-30-51 PM

Palomar Health expands its Google Glass incubator Glassomics to include smart watch technology in healthcare. For some background on the smart watch market, see Lt. Dan’s post on HIStalk Connect, “A Primer on the Up-and-Coming Smartwatch Market and What It Means for Healthcare.”

A Mayo Clinic study finds that data from the Fitbit activity tracker can help predict the mobility of post-op patients and help clinicians customize their care plans.

Research by the Pennsylvania Patient Safety Authority finds that EHR default values cause quite a few errors in drug doses and times, although nearly none of the errors caused patient harm.


John Halamka’s five biggest CIO challenges for the next few months:

  1. IT requirements driven by mergers and acquisitions
  2. Regulatory uncertainty related to ICD-10, HIPAA Omnibus, and Meaningful Use Stage 2
  3. Meaningful Use Stage 2 requirements, particularly at shops like BIDMC that build their own applications
  4. The ability of provider organizations to keep the doors open while trying to meet all the regulatory requirements as revenue declines and risk-based reimbursement increases
  5. Leading in real time

9-5-2013 11-16-06 AM

inga_small I am ashamed to admit that I found this story just a teeny bit amusing, though so pathetically wrong. A patient files a civil lawsuit against Torrance Memorial Medical Center (CA) after discovering that an anesthesiologist had decorated her face with stickers while she was unconscious during surgery. A nurse’s aide snapped a photo of the patient, who was freshly adorned with a black mustache and teardrops. The anesthesiologist and other involved employees were disciplined but not fired.

9-5-2013 8-45-00 PM

Three UK doctors face a loss of their medical licenses after allegations that they copied material from a book to create an iPhone app that helps evaluate clinical evidence. One of them faces an additional charge of posting a positive review of the app on the App Store without disclosing that he has a financial interest in it.

9-5-2013 8-53-09 PM

A Forbes article wonders if Cleveland Clinic can save its home city with its $6.2 billion in revenue, $300 million in operating income, $10.5 billion in assets, 42,000 employees, its own 141-trooper division of the state police, and now its plans to spin off for-profit companies and jump start the local economy with the Global Center for Health Innovation, scheduled to open next month with HIMSS as its largest tenant. Cleveland’s population has dropped 10 percent in the last decade and median income fell 60 percent, with its only economic bright spot being healthcare.

9-5-2013 9-16-03 PM

Anybody see a HIPAA problem with this pre-med student’s Google Docs-based patient tracking solution?

9-5-2013 9-36-49 PM

Cardiologist Eric Topol, MD, who is also editor-in-chief of Medscape as of February 2013, interviews Farzad Mostashari, MD. It’s good. Some snippets and factoids:

  • Mostashari came to the US from Iran at 14, then went to Harvard and Yale.
  • “Ninety percent, probably, of what happens in healthcare today has no basis in evidence. At the very least, I think what we owe ourselves and our patients, what we really want to do is: If we have variation, if we make a decision that is not based on the general guideline, it should be studied so that we learn something from that variation.”
  • “The dream is that with every encounter, you know everything about the patient. You know everything about any medical knowledge that has ever been generated and you know everything about what is happening right now in the community where we are. Because the treatment for a sore throat is going to be different in January with the flu epidemic than it is going to be in September when asthma is peaking. So you have to bring in the 10 to the 6th power, the 10 to the 3rd power, and the 10 to the zero in that encounter. Whatever you do generates and goes back to teaching everybody else what is going on in the community, what is going on in medicine, and contributes to this patient’s knowledge. Right now my visit doesn’t even contribute to my next visit.”
  • On $37 billion in HITECH incentives: “I think doctors would say that they earn it. No one gives out anything.”
  • Mostashari and US CTO Todd Park roomed together when they moved to Washington, DC four years ago in July, sharing a small apartment with no air conditioning.
  • On the jokes that ONC stands for “Office of No Christmas” because of the push to get the work done. “That is what it felt like — that there is this incredible urgency. You have a day, a week, a month, and pretty soon the opportunity to make a difference is gone.”
  • “Meaningful Use, it is a tool. Take that certification, take that decision support, take that quality measurement. Don’t have quality measurement done to you or say, ‘I am going to be paid and judged based on quality. I can’t control that.’ What you can do is make it meaningful; take the tools and make them meaningful. Help your staff make the tools meaningful.”
  • “We are going to solve this path that we have been on towards unsustainable cost growth. One out of every $5 spent in this country is being spent on healthcare. It is just amazing, and it is not sustainable. It is not sustainable for people, for families, for businesses, for state governments, for federal governments. It is not sustainable for anybody. We are going to solve that. I think we are going to solve it not by cutting people back, not by saying ‘You can’t get that,’ but by delivering better care. I really believe that.”

9-5-2013 4-28-10 PM

Weird News Andy thinks it’s cool that a University of Michigan 3D-printed lung splint saved a child’s life. The surgeon says he hand-carves such devices when necessary, but he can’t match the accuracy or speed of the computer.


Sponsor Updates

  • Forrester Research names Ping Identity a leader in its identity and access management report.
  • EDCO creates  a video explaining its point-of-care medical records scanning process.
  • Truven Health Analytics releases ActionOI Practice Insights, which allows hospitals and practices to compare productivity, costs, and utilization.
  • ZirMed partners with EHR Integration Services to provide Allscripts PM and GE Centricity Group Management customers integration with ZirMed’s RCM, clinical communications, and analytics solutions.
  • Kareo tops Black Book’s list of Top 20 Seamless Software Vendors for EHR, Practice Management, and RCM.
  • NYC REACH, the REC for New York City, assigns Aprima the Medical Meaningful Use Champion status in its vendor recognition program.
  • Medseek reports that 10 healthcare organizations are using its Empower enterprise patient portal and another 11 will go live in the next six months.
  • Paul Taylor, MD, CMIO of Wellcentive, outlines the performance and improvement part of the Health Care Network Maturity Model.
  • Vitera hosts a September 25 webinar on preparing for the PCMH transformation.
  • An SiS blog post lists the “Top 6 Things Anesthesia Providers Should Know When Evaluating AIMS.”
  • GetWellNetwork shares data from its healthcare system customers that demonstrate the relationship between patient engagement and improvements in patient satisfaction, quality and safety, and finance and operations.

EPtalk by Dr. Jayne

I wrote last week about a Wall Street Journal Health Blog piece. It referenced a survey about what motivates doctors as they make care decisions. More than half felt physicians want to do what’s best for the patient, where the choices of “fear of lawsuit” and “business / financial considerations” each received 21 percent of the response.

Since I covered fear of lawsuits already, let’s talk a little bit more about financial considerations. It’s easy to see a response of “business / financial considerations” and assume that means “what’s in the provider’s best financial interest.” I don’t think the vast majority of clinicians think that way. If we were constructing this survey, we’d have more granular choices. One of the main things I think about (after discussing the clinical appropriateness of a proposed procedure, treatment, or test) is whether there is a way to pay for the test. It was bad enough when all I had to worry about was whether the patient had insurance that would cover it, but today it’s so much more complicated. It doesn’t do any good to recommend a treatment if there is no way the patient can receive it due to financial constraints.

First, we have to think about whether the patient even has insurance coverage or not. If they do, is this symptom or condition related to anything pre-existing that may or may not be covered? If not, do I need to contact the payer for an authorization? How difficult is it to obtain the authorization? Are there tests, documents, or examples of trials of therapies that have to be provided for a medical review board to determine coverage? Does the payer have arcane rules that have been grandfathered into the plan regardless of recent legislation to ensure services are covered?

Should the authorization be obtained, are there limits on where I can send the patient? Does the patient have geographic or transportation issues that would make it more feasible (economically or otherwise) to do it at one facility over another? Does the patient have religious preferences that are in conflict with the mission of the preferred facility? Do I have to write a letter to explain the distress it would cause if allowances can’t be made for a non-preferred facility?

The next consideration is that even though the patient may have insurance and the procedure may be authorized, the out of pocket cost for the patient may be more than he or she can bear. Those under high-deductible plans are electing to defer care to the end of the year in hopes that they will meet their deductibles by then. If it’s a preventive service, we may have the opposite time shift: some plans have yearly aggregate limits on preventive services, so if they’ve already met the limit for the year, they may elect to push it to the next calendar year. Regardless of the kind of coverage, we have to know whether the patient can afford the patient portion of the cost, whether it’s a deductible, co-pay, co-insurance, or something else.

Let’s say the patient does not have insurance coverage. We have to think through whether the patient qualifies for any public assistance programs and if so, how long it would take to become enrolled vs. how acute the need for the test / treatment / procedure might be. If they don’t qualify for public assistance, are there any grant programs? Are there public health resources? Is there a hospital or imaging center doing a free outreach program? If not, do I have any colleagues in my hip pocket who would be willing to perform the procedure with a payment plan or under other medical hardship arrangements? Does the facility make allowances for self-pay patients and do they allow them to negotiate price? If so, what is a reasonable price? Where can the patient get more information?

Once we get through figuring out if we can proceed and how we’re going to pay for it, can the patient afford to take off work to have surgery, complete treatment, etc.? Is he or she covered by the Family and Medical Leave Act? Does he or she have to wait until they are eligible for coverage? Is there a short-term disability policy in place, and if not, does the patient have enough vacation time or other resources to be able to be off work? Or does he or she have to take the time off unpaid? Are there other family dynamics or barriers to care, such as who will take care of small children while the patient is in treatment? (Remember assessing barriers to care is part of being a patient-centered medical home and participating in pay-for-performance and accountable care initiatives. Believe it or not, worrying about the patient’s childcare arrangements has become our problem.)

If you’re not a provider, are you exhausted just reading this? I know I am. The absolute last thing to cross my mind in these situations is whether my practice will make any money ordering the intervention. Looking at the costs in the office for clerks, paper pushing and administrative shenanigans, multiple phone calls, faxes, the patient’s time, and my time to work through all of this, we’ve already lost money before the order even leaves the EHR. When you think about it this way, I’m surprised that business and financial considerations didn’t rank higher in the survey because it seems they’ve become part of nearly every clinical decision we make.

Maybe elements like this roll up under the attempt to do the right thing for the patient. Or maybe the average person taking the survey didn’t think about all these different factors. This wasn’t really a scientific survey, but I bet if you wanted to create one, the qualitative researchers would have a field day. I’d enjoy seeing the comparison between a survey of the general population vs. a survey of healthcare providers.

What do you think motivates doctors as they make care decisions? Email me.


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

More news: HIStalk Practice, HIStalk Connect.


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September 5, 2013 News 8 Comments

News 9/4/13

September 3, 2013 News 3 Comments

Top News

9-3-2013 4-32-16 PM

A new Robert Wood Johnson Foundation project called “Flip the Clinic” looks for ways to redefine the patient-provider encounter, including examples such as OpenNotes, Blue Button, and the Project ECHO telemedicine program. The program, bring run with a social innovation consulting company and a design firm, will launch a toolkit in early 2014.

Acquisitions, Funding, Business, and Stock

9-3-2013 3-30-06 PM

Quantia, the developer of physician social networking and learning platform QuantiaMD, raises $10 million in Series B financing, led by Safeguard Scientifics and Fuse Capital.

A Crain’s Chicago Business column ponders “Why is Chicago so bad in health care IT?” saying that at Merge Healthcare and Allscripts, “sales are shrinking and losses are rising at both companies; each has endured upheaval in the executive suite.” It concludes that both companies need to turn around before the HITECH well runs dry and laments that local healthcare IT startups “don’t have have better role models.”


9-3-2013 3-32-31 PM

Jamaica Hospital Medical Center (NY), Catholic Health, INTEGRIS Health, (OK) and about 40 additional provider organizations select Nuance Clintegrity 360’s computer-assisted coding platform.

Long-term care provider Nexion Health selects the Daylight IQ clinical outcomes management system.


9-3-2013 3-57-06 PM

Kristi Syling (Vanguard Health Systems) joins PerfectServe as compliance officer.

Announcements and Implementations

9-3-2013 11-22-40 AM

Novant Health Presbyterian Medical Center (NC) will deploy Epic October 5, the first of the health system’s 14 medical centers to go live. Novant’s 1,205 providers are already using Epic across 316 clinics as part of the organization’s $600 million EHR initiative.

The New Zealand Ministry of Health implements the Health Identity Programme, a standardized interoperable platform built on IBM’s Infosphere Master Data Management to identify patients and providers across the country’s health sector.

9-3-2013 9-23-35 AM

inga_small HIMSS names eClinicalWorks customer White River Family Practice (VT), winner of the 2013 Ambulatory HIMSS Davies Award of Excellence for its success in improving quality of care and patient safety while achieving a demonstrated ROI. In its award application, the practice hits on a point too often overlooked by providers unwilling to dedicate the time and money required for EMR success:

“Return on investment is critically dependent on how quickly the practice returns to typical patient-visit volume. To that end, investing time and resources to learn the chosen EHR system up front will expedite the office’s return to pre-EHR patient volumes, obviating the need to spend late nights trying to catch up.”

9-3-2013 3-34-53 PM

Cheyenne Regional Medical Center (WY) will pay about $50,000 a year to participate in the state’s MyWy Health information exchange, which is currently funded with a $4.9 million HHS grant and $260,000 from non-governmental sources.

Allscripts announces GA of Professional EHR 13.0.

9-3-2013 7-47-12 PM

Microsoft shows off sports-related applications that use its products, including the National Football League’s eClinicalWorks EMR and the X2 sideline concussion diagnosis system.

Truven Health Analytics announces that Micromedex NeoFax and Pediatrics now support HL7 integration with EHRs for clinical decision support and CPOE.

Merge Healthcare’s iConnect Enterprise Archive is named the leading vendor-neutral archive solution in the US and the world, accounting for 32.6 percent of all studies stored in a VNA in the US and 22.7 percent worldwide.

Government and Politics

9-3-2013 3-45-11 PM

The HIT Policy Committee will meet Wednesday from 9:30 a.m. until 3:15 p.m. in Washington, DC (with live streaming) to review the FDASIA Workgroup’s recommendations and to hear from the Meaningful Use Workgroup on progress toward Stage 3.

England’s Department of Health announces $375 million in funding for information technology for hospitals, surgeries, and EDs, raising the total money placed in the Technology Fund at more than $1.5 billion.


9-3-2013 10-02-45 AM

Nine out of 10 hospitals report they experienced RAC activity in the first half of the year, according to an AHA survey of 12,000 hospitals. Requests from Medicare for medical records are up 47 percent since the fourth quarter of 2012 and complex audit denials by Medicare RACs rose 58 percent in the second quarter of 2013.

9-3-2013 3-40-55 PM

A Missouri orthodontics practice notifies 10,000 patients that their information was stored on unencrypted computers that were stolen from the practice in July.

The CIO of the Marine Corps says, without referencing the source, that 25 percent of surgery liability lawsuits are related to software.

9-3-2013 10-34-23 AM 

inga_small Sign of the times? Mayo Clinic Health System announces the closing of its Blooming Prairie, MN (population 2,000) facility after the resignation of the practice’s sole provider. Mayo says the closing is temporary and encourages patients to travel 15-20 miles to other locations.

Bradford Regional Medical Center (PA) opens the country’s first inpatient treatment program for Internet addiction, which will cost $14,000 for a 10-day stay that insurance won’t pay for.

9-3-2013 12-11-40 PM

inga_small I’ve noticed several eye-catching headlines this week highlighting the continued inequities in compensation between male and female physicians. Research published in JAMA finds that the gender pay gap among healthcare workers has grown over the last decade, with male physicians earning about $56,000 (or 25 percent) more than their female peers. Researchers note that a physician’s specialty or practice type may account for some of the difference, but say more research is required to understand if specialty and practice choices are due not only to the preferences of female physicians but also unequal opportunities to enter high-paying specialties. The Gloria Steinem in me would love to hear readers’ theories for the compensation gap.

MMRGlobal not only terminates its patent infringement settlement with WebMD and refiles its original lawsuit, it also adds an additional complaint related to its newly issue patent entitled “Method for Providing a User with a Service for Accessing and Collecting Prescriptions.”

9-3-2013 4-22-51 PM

A startup called Handshake lets Internet users broker the sale of their personal data to interest companies, disintermediating market research firms and companies like Google and Facebook that grab it for their own bottom lines and instead allowing the user to negotiate their own deals. The site estimates that individuals could earn up to nearly $8,000 per year. Imagine the possibilities with health-related data.

A report by the Federation of Indian Chambers of Commerce urges the Indian government to restrict the importation of medical technology and instead encourage local innovation that will allow making services more affordable for all.

Sponsor Updates

  • Etransmedia highlights a video describing how its Direct Care Coordinator software helped doctors at the Albany Med Faculty Physician Group communicate with other physicians.
  • NextGen Healthcare releases an updated version of its Patient Portal, which incorporates Spanish and two dialects of Chinese.
  • Beacon Partners hosts a September 13 webinar on using data analytics to improve population health management.
  • CommVault reports earning a 96 percent customer satisfaction rating its support services survey.
  • Xerox has processed and disbursed more than $1.7 billion in federal payments to providers for MU incentives through its State Level Registry tool.
  • Jon Hamdorf, healthcare solution manager for Perceptive Technologies, participates in a panel discussion on the challenges of health information exchange at this month’s Health IT Summit in NYC.
  • A Billian’s HealthDATA report lists 112 US hospitals that demonstrate positive net patient margins and 30-day readmission and mortality rates above the national average for heart attack, heart failure, and pneumonia, according to CMS.
  • Divurgent co-authors a white paper with Bon Secours Kentucky Health System that provides both a client’s and vendor’s perspective on implementing an EMR.
  • Wellcentive SVP Mason Beard and CMIO Paul Taylor, MD host a September 17 webinar on implementing an effective population health management and data analytics program.
  • Ryan Uteg and Lyndon Neumann of Impact Advisors discuss EHR roadmap evaluation at a September 18 CHIME College Live Session.


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

More news: HIStalk Practice, HIStalk Connect.


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September 3, 2013 News 3 Comments

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