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September 30, 2010 News 15 Comments

9-30-2010 8-33-42 PM

From Allscripts: “Re: the note from Clinical Wisdom on KLAS. We agree that there is a conflict of interest in having vendors pay large fees to the same company that is producing the ratings. We reached the same conclusion a few years ago and discontinued the practice. After our recent merger with Eclipsys, we inherited an existing Eclipsys contract that was in place with KLAS, so the information reported by the writer was technically correct. However, we have now canceled that contract and we do not currently pay KLAS anything. We realize that is counter-intuitive as we currently are and have consistently been highly rated across many product categories by KLAS, but ultimately we didn’t feel it was right to pay a firm that was also rating our products. Over the last two years, we have re-invested those dollars in a ‘Net Promoter Score’ process, which is widely considered across many industries to be the ‘gold standard’ for measuring customer loyalty. Using this rigorous, statistically valid methodology (developed by Satmetrix and Bain & Company), we get client feedback directly in a very methodical way and then act immediately on what we learn. The bottom line is that we agree with the Consumer Reports analogy from the writer – KLAS should provide a full accounting and disclose what they receive from every vendor. In that same light, we would encourage other vendors to disclose how much they are paying KLAS – complete transparency is critical when you’re talking about the core technology that providers use to make decisions vital to every American’s health.”

9-30-2010 8-37-00 PM

From Ben Cannoli: “Re: IOM’s study of HIT best practices. The IOM report is incredible even after a decade. I’m glad they are leading. HIMSS has been weak, negligent, and pathetic on this issue, but I don’t believe they can strong arm the IOM.” Inga mentions it below. The IOM gets an ONCHIT grant to look at how HIT affects patient safety. It will cover some industry hot buttons: surveillance and reporting of HIT-related patient safety issues, discussion of the possible roles of federal agencies like FDA or AHRQ, and impact of certification bodies and trade associations (HIMSS, you’d expect). I’d bet that Don Berwick made this happen. I don’t know how much they’ll get done for $1 million, but I’m interested to find out.

From Digital Bean Counter: “Re: real-time claims adjudication. Is it taking off yet? Any big players?” Little help, if you know.

9-30-2010 8-38-19 PM

From VaHooGirl: “Re: Martha Jefferson Hospital. No longer a rumor – they are merging with Sentara to become its 10th hospital.” Verified.

From TuTu True: “Re: Mrs. HIStalk. A source tells me that Inga is Mrs. HIStalk. Be honest – true or false?” False. And to answer the other occasional rumors: (a) yes, there really is an Inga – it’s not just me pretending to be her;  (b) yes, she really is a woman, and (c) yes, the Inga picture at the end of her posts really does look like her since I paid some offshore artist $15 to draw it from a photo.

From Luke O’Scyte: “Re: correction about the Canadian government spending $500 million on EMRs. Please replace ‘spending’ with ‘wasting.’ I’m highly skeptical of the value that will be generated from that half a billion dollars.”

From Portly Gentleman: “Re: Allscripts. A couple of executive suite offices are about to become vacant.” PG provided credible names and I’m sure his information is correct, but I feel funny about mentioning names of people leaving jobs. Watch for announcements early next week.

9-30-2010 8-40-19 PM

From MSFTGUY: “Re: McKesson Paragon. Just went live at 391-bed Lake Charles Memorial. Several big hospitals have gone live on Paragon this year. Maybe folks have a choice between a system that doesn’t work and is only 1/3 of an HIS (Cerner) and one that’s ridiculously irresponsible to purchase (Epic)?” I did some work at that hospital once. Nice folks. None of the systems you mentioned are for everybody, so it’s hard to criticize their choice, especially if it was a lot less expensive.

From Perineal Flowers: “Re: [name omitted] is one of two finalists to be CIO of Tenet.” I’m expunging the name since I’d sure hate to get someone fired if they don’t land the rumored new job after all, but I did manage to contact them. They humorously (or so I assume) told me the rumors also have them going to Allina, Duke, and Partners, all of which have open CIO jobs along with Tenet. I’m pretty good at reading between the lines, so I think there’s fire underneath that smoke. We’ll see from which direction soon, I’m betting.

Listening: The Tyde, obscure, Byrds-like LA jangle surf. 

A scrappy Austin-based non-profit investigative publication runs a pretty good story on the ongoing sale of de-identified hospital patient data by the Texas Department of State Health Services. Among their customers: GE and a company that runs background checks for border security. Deborah Peel MD was quoted as saying that a HIPAA loophole allows selling patient data to any entity that claims to be doing “research”, which isn’t defined. Now this is funny: the only parties that stay anonymous aren’t the patients, but rather the people who download the free data files covering 1999-2003. The article wanders all over the place and is predicated on your believing that de-identified data can be re-identified (which it definitely can to some reasonably high percentage, but some people refuse to believe that fact). If newspapers weren’t going broke, they should fund a re-creation of that experiment where patient data was re-identified by linking to common fields from other government-sold databases, such as driver’s license records.

9-30-2010 8-42-26 PM

Here’s another fun tidbit from the Austin article, even though I don’t believe its accuracy. The guy who wrote The Long Tail estimates that free EMR vendor Practice Fusion takes in $250 million per year from selling the de-identified patient data stored in its systems, dwarfing any possible revenue it could make by selling software. It cites a Practice Fusion job ad on Craigslist for a Data Sales Director, someone with experience creating “an aggressive data monetization strategy” who can pitch to “pharmaceutical companies, medical device companies, insurance carriers, government entities …” and “establish a fair market price for EHR data and negotiate effectively with buyers.” That position is still being advertised on Practice Fusion’s site, but the language has been dialed back a lot.

Cerner caves in to patent trolls Acacia Research (“research” meaning “writing threatening lawsuit letters to companies to see who will pay up”) and will pay that organization for the privilege of selling PACS, which Acacia’s often-waved patent claims they invented. Acacia’s strategy is smart: they threaten to sue, but offer a license for less money than it would cost to mount a legal defense. Most companies pay up and the threatened suits rarely go to court, although Epic mounted a swift legal counterstrike for being threatened. I never heard how that turned out, but it doesn’t matter – I still admire their willingness to fight for what’s right.

This is brilliantly funny: You may know Ross Martin, MD as the guy behind the HITECH Operetta and Meaningful Yoose Rap in his role as President of The American College of Medical Informatimusicology, although he has a less interesting but probably much more lucrative HIT consulting job. He writes a hilarious letter to the editor of The New York Times for not publishing a previous letter of his, threatening a class action suit by rejected would-be authors and signing it, “Yours in the quest for wealth creation through victimization, President, Literary Mediocrity Association.” They whittled his piece down to a paragraph, but they did run it. I think the HIStalk audience is more appropriate for his type of humor than that little New York paper.

WorkflowOne, which claims to be “the nation’s leading name in healthcare document management,” puts that leading name on a Chapter 11 bankruptcy filing. Premier just renewed its contract with the company, claiming that “no one is better prepared to help Premier members reduce costs and gain efficiencies across their entire print lifecycle than Workflow One.” Doh! Still, the company has big revenue and EBITDA, so I’m sure they’re not going anywhere. It seems odd that they even filed, frankly.

Lots of good jobs on the HIStalk Sponsor Jobs Page: Eclipsys Pharmacy Consultant, Natural (Software AG Product) Programmer Analysts, McKesson Workflow Clinician. On Healthcare IT Jobs: Product Manager, Lead Epic Analyst, Senior Clinical Systems Analyst, Solutions Marketing Specialist.

Sharp Healthcare chooses Aternity Frontline Performance Intelligence to monitor application user experience.

Vanderbilt launches its first preventive genetic screening program, testing all cardiac cath patients for clopidogrel metabolism problems and storing the results in their EMR so that a different blood thinner can be used if needed, avoiding expensive and dangerous blood clots. Several other drug-affecting genetic traits will be tested as well. Now that’s just cool.

Several national pharmacy organizations launch the Pharmacy e-Health Information Technology Collaborative, which will work to get pharmacist-needed functionality into EMRs.

CMIO interviews one of my favorite CIOs, Denni McColm, from 74-bed Citizens Memorial Healthcare in Bolivar, MO (the only one of very few HIMSS EMRAM Stage 7 hospitals, a standout on the list dominated by big, rich health systems). CMH has a bi-directional CCR interface with Google Health that Denni says will meet Meaningful Use requirements, saying interoperability doesn’t necessarily required an HIE. They’ll use Google Health to make sure patients who ask get a copy of their medical record within the MU-specified timeframe.

ChartLogic earns EHR certification from Drummond Group.

iSoft convinces its bankers to reorganize the company’s debt. Shares are still at 13 cents. You would think those two events might attract takeover interest, but the company’s chair says conditions remain “challenging.”

A Chicago cardiologist will pay $20 million and spend five years in prison for defrauding Medicare and private insurance of $13 million, turned in by another doc who gets $3.5 million as the whistleblower. The cardiologist submitted 14,800 false claims that added up to more than 24 hours a day of work from 2002-2007, so he enjoyed a lavish lifestyle until the case finally ended. When the Feds raided his house, they found $6.7 million in uncashed insurance company checks.

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HERtalk by Inga

san diego grand hyatt

The Allscripts/Eclipsys crew sent over an invite to EUN 2010 Outcomes Through Innovation, which is the user meeting for Eclipsys clients. Wish I could go because it’s in one of my favorite cities, San Diego. The event is October 10-13 at the Manchester Grand Hyatt.

The board of governors of Good Samaritan Hospital (IN) approves the $400K purchase of McKesson’s PACMED and MedCarousel pharmacy packaging systems. At the same board meeting, the director of IS says the hospital is on target to earn nearly $7 million in ARRA incentives over the next six years.

St. Vincent’s Healthcare (FL) extends its seven-year partnership with TeleHealth Services. The health system will implement TeleHealth’s TV and interactive patient education solution at St. Vincent’s and St. Luke’s hospitals.

I noticed that Intellect Resources posted this article about the current shortage of IT professionals in the Nashville area. Middle Tennessee is home to a number of large HIT employers, including HCA, HealthSpring, Cogent Healthcare, and ICA. Several companies are working with on training initiatives at area colleges to help increase the pool of professionals with both healthcare and IT expertise.

Merge Healthcare adds two new perioperative solution clients: Exempla Saint Joseph Hospital (CO) and Kalispell Regional Medical Center / The Surgery Center of Northwest Healthcare (MT).


If you are headed to the American Academy of Pediatrics show this weekend in San Francisco, say howdy to HIStalk Practice’s Dr. Gregg Alexander. He’ll be directing the Pediatric Office of the Future exhibit, which will showcase technologies available for pediatricians. Dr. Alexander is pretty darned excited by the project, as evidenced by his  latest Intelligent Healthcare Integration post.

ONC awards the Institute of Medicine a $1 million contract for a year-long study of HIT’s effect on patient safety.

tiger institute

The Tiger Institute for Health Innovation celebrates its one-year anniversary and provides an update of its work to date. The Tiger Institute is a partnership between Cerner and the University of Missouri Health System to create new technologies. So far UMC has implemented bar-coded medication administration and is rolling out CPOE in a couple of months (not sure why that would be considered innovative) and is working on several prototype projects, including a mobile app that allows physicians to review clinical data and give orders via smart phones.

CIGNA and St. John’s Mercy Medical Group (MO) launch a 12-month accountable care organization pilot program. The pilot will target patients covered by a CIGNA health plan and receive care from one of St. John’s 165 primary care physicians. Physicians have the potential to earn bonuses for meeting quality improvement targets and lowering medical costs.

Mayo Clinic and five other health systems form the Mayo Clinic Center for Social Media, dedicated to the use of social media to promote health, improve healthcare, and fight disease. The Center will offer educational conferences and webinars and develop social platforms to share training and resources. The website www.socialmediahealthnetwork.org will launch October 25.


Baptist Health (FL) partners with Vitalz to provide provider-to-provider portal services between 13 Solantic Baptist urgent care centers and 40 Baptist primary care offices.

Texoma Medical Center (TX) implements Skytron’s RTLS to track and manage 200 hospital assets. When reading the press release, I was amused that either the hospital or vendor thought it was noteworthy to mention that Texoma is also using the RTLS technology to monitor vendor sales rep visits.

This week on HIStalk Practice: BlackBerry thumb, cell phone elbow, and Facebook depression; medical students say having an EHR is a very important factor in their decision what to practice; Phreesia and a few first impressions.

Sponsor Updates

  • Fred Castillo, VP of healthcare mobility sales for AT&T and Eleanor Chye, executive director healthcare mobility product management at AT&T will participate in separate panel discussions at the CTIA Everywhere Healthcare event next week in San Francisco.
  • Methodist Hospital of Southern California goes live with API Healthcare’s Human Resources and Payroll solution.
  • Sharp Memorial Hospital (CA) selects GetWellNetwork’s bedside education/entertainment system. GetWellNetwork’s patient education and communications tools will be interfaced with Sharp’s Cerner EMR system.
  • Susquehanna Health (PA) plans will add the perioperative information management system of Surgical Information Systems to its three-hospital system. Susquehanna will integrate the SIS solution with its existing Siemens Soarian applications.
  • Albemarle Hospital (NC) selects the Access Intelligent Forms Suite to bar-code patient forms for auto-indexing via a document management system into its Meditech EHR.
  • Ingenix CareTracker earns CCHIT Certified 2011 Ambulatory EHR certification.
  • Zac Fritz joins My Health Direct as SVP of sales and marketing.


Here at HIStalk, we love well-intentioned works of charity. Thus, I applaud Cincinnati Bengals wide-receiver Chad Ochocinco for promoting contributions to Feed The Children. Ochocinco has his own personalized “OChocinos” cereal and includes a Feed the Children phone number on the box. At HIStalk, we’re also about getting the little details right, so bummer that Ochocinco didn’t get Mr. H to proof the cereal box. Perhaps he could have caught a certain typo before the box it hit the production line. Mr. H likes the occasional smut reference, so I’ll mention that the Feed the Children phone number listed was actually a phone sex hotline. Oops.


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Currently there are "15 comments" on this Article:

  1. House of Pain says:

    CHW will have 31 of 42 hospitals migrating or live to Mediech 6.0 by next year.

    So 10 years later, Cerner wont get to finish that install to validate their typically hyped ROI.

  2. The IOM program regarding the safety breaches and adverse events caused by HIT is 10 years late. It is a no brainer that the FDA should have been vetting and providing surveillance HIT for safety and efficacy from the get go. Since Dr. Blumenthal depreciates all reports of adverse events as anecdotes, will he do the same to those HIT catastrophes reported to the IOM?

  3. I had to laugh at Allscripts admitting that they had seen the light and that they realized that paying KLAS large amounts of money was a bad (conflict of interest/counter intuitive) thing to do. Naturally, they’ve stopped Eclpsys from continuing their payoff (I mean contract) with KLAS also. Wow – does that grant them amnesty by admitting they’ve paid large sums of money in the past; but, because they now know it was wrong and are confessing it, makes it okay? Remember that the only thief that is sorry is the one who got caught.

    The sad thing is, it’s not just Allscripts – it’s widespread in the industry. Wonder who will confess next, that they too, paid KLAS large amounts of money, and assume that having confessed their “sin” that they should be forgiven and potential buyers should overlook that fact.

    But wait, you have to toss KLAS into this farce as well. THEY were the ones taking the money. Maybe KLAS will join the 12 step program and admit that they were bad boys/girls too; but, have seen the light.

    Allscripts NPI score…don’t even go there.

    Secrets and Lies.

  4. Ironically KLAS posted their newest metric today which is all about transparency.

    Per the KLAS website: “KLAS will be introducing a new metric as part of our research, a vendor disclosure level. You’ll know who provides complete client lists for us to confidentially interview. You’ll know who tells us to take a hike when we ask to talk with clients. We measure them either way, but now we’ll shed more light on the personalities of these companies you are looking to partner with. Most of our research comes outside of any lists that a vendor may or may not provide, but it certainly sends a message when a vendor is willing to be open and honest about where they stand. In this time of intense focus on healthcare IT, is your vendor one of those few that is crawling back into its shell hoping to keep those corners dark, or are they shining a light on every possible area looking to improve and solve the significant issues that healthcare faces?”

    I can’t see vendors rushing to hand over their client lists. Not because they have something to hide, but because many of their contracts include confidentiality statements.

    And, if a vendor does happen to hand over their list, does it mean that the surveys their clients submit get processed prior to those of a vendor in the same space that does not?

    Perhaps it is time for KLAS to revisit their current business model, or maybe Consumer Reports should venture into the Healthcare software space.

  5. The experiment about matching health records has already been done by Latonya Sweeney and now more recent work by Brad Malin’s team at Vanderbilt. Check out their latest studies about voter roles and now GWAS studies. Very helpful as we think about data reuse:

    Benitez K, Malin B. Evaluating re-identification risks with respect to the HIPAA privacy rule. J Am Med Inform Assoc. 2010 Mar-Apr;17(2):169-77.

    Loukides G, Gkoulalas-Divanis A, Malin B. Anonymization of electronic medical records for validating genome-wide association studies.
    Proc Natl Acad Sci U S A. 2010 Apr 27;107(17):7898-903. Epub 2010 Apr 12.

  6. The datamining capabilities are certainly reality, as I wrote about a couple of weeks ago when I read some of PF’s fine print. How much that info can be reidentified is debateable, but the fact is that many in the field see selling deidentified data as a hot side market. If the clinician and the patients are OK with that, then there’s not a huge issue: but I think people should know it’s happening.

    Thanks for the tip about ChartLogic’s certification: it appears the race to certify first is now won. But since HITECH is more a marathanon than spring, the real competition will be to see who’s certified products yield stimulus checks (even though we know that will depend as much on the clinicians’ use as the product itself).

  7. Chicago Cardiologist follow-up – I looked the doctor up on Vitals and got interesting results. He got an overall 2.5 out of 5 and the major complaints where “long wait times”, “inappropriate diagnosis” and “doesn’t spend enough time with patients”. It seems working more than 24 hours a day affects quality and customer satisfaction.

  8. KLAS allows me to voice my opinion about the vendors that i currently use at my hospital. The reports that i’ve been given access to appear to be accurate. I don’t just rely on those reports but i talk to peers in other organizations and 99% of the time KLAS rankings are dead on with the feedback i get.

    Sunquest and Allscripts are the most vocal about KLAS not being fair and accurate. They are just cry babies because they’ve seen their once stellar products go down over the past 5 years.

  9. The IOM study on patient safety is the result of a recommendation made by the HIT Policy Committee. It has nothing to do with Don Berwick or CMS.

    David Blumenthal is correct when he says that information about adverse events is anecdotal. The pupose of the IOM study is to carefully analyze those events and provide information that might be actionable.

  10. Allscripts “re-invested those dollars in a ‘Net Promoter Score’ process.” What exactly does that mean? You’re paying them instead? Do businesses that appear in Consumer Reports need to invest dollars in that process?

  11. From that link above, CCHIT was approved as a certifying body on 8/30, then 20 days later opened its testing process. After only 10 days of certifying, they’ve approved 33 products already? I’m all for lightning speed, but have to really wonder how rigorous this certification process is for vendors.

    I hope Drummond puts a little more effort into it. I suspect they will, as they have a much more comprehensive software certification business than CCHIT. Across health IT, we tend to settle for lower standards and less rigor than the IT community at large (e.g., KLAS), which is a shame.

  12. Perhaps the Net Promoter program will enable Allscripts to reallocate KLAS $$ to Misys practices that are being given emr/pm in an effort to retain the base – which isn’t working in many cases. If I were a decent size Misys group, I would refuse to pay a dime if Allscripts forced me to migrate to a new solution. At some point, this has to affect the bottom line.

  13. Real-time claims adjudication is definitely possible with multiple vendors out there. The issue with real-time claims adjudication is not the software, but more the workflow within an organization.

    The two main hurdles are getting the providers to close out their encounters so the appropriate charges can be dropped and then the claim edits from the billing departments. You can’t file charges if the doc is not done with the encounter. Once the doc does that, then the billing office has a bunch of edits before the claim is ready.

    Once you get through those hurdles, claim submission via the 837 to payors with immediate response from the payor is definitely possible. Good systems will immediately send the 835 back from the payor and automatic payment posting with the 835.

    The technology is there. It’s just getting the different organizations on the same page with the workflow. People really struggle with that and I’m not sure why. I often wonder if the payor likes the delay because they can hold on to their money longer. They certainly have a conflict of interest.

  14. So does Allscripts dare to disclose their Net Promoter Score? Last Misys user group (pre-merger), they announced that it had improved from a -10 to a 0 (out of a possible range from -100 to +100). They were very proud, indeed.

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  1. Upvote for Living Colour. And I had lost track of them too, after their initial breakout success. "Cult of Personality"…

  2. The part that Gurley totally missed, and I as many others lived thru it, was that in the early 2000's…

  3. Does use of the "cloud" infrastructure mean that Oracle's newly transformative platform will be vaporware like many of Cerner's previously…

  4. To Code Spewer (above): 100% agree re CASE tool hype/hope, and long known - sadly ignored by IT - reality…

  5. Four points - 1. Is an "Epic" possible in today's regulatory world? 2. How many EHRs were there in 2009?…

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