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Monday Morning Update 12/20/10

December 18, 2010 News 14 Comments

From The PACS Designer: “Re: ResMD from Calgary Scientific. ResMD has been mentioned on HIStalk Mobile several times as an up-and-coming mobile solution for referrers only, since FDA approval is still pending for radiology use of the iPhone. Now that ResMD image viewing software has been adapted for the iPhone, referrers can get very good image quality and navigation when viewing images of their patients.”

From Digital Bean Counter: “Re: Alere Health. The EVP/CIO was finally let go. It was a longstanding belief held by many that he was single-handedly responsible for the demise of Alere’s poorly implemented Pega-based clinical health management system.” Unverified – he’s still on their Web page. I couldn’t place the company name, so I Googled to find that it offers online wellness programs, a PHR, and a health portal.

Listening: reader-recommended and Minneapolis-based catchy power pop from Sing It Loud. Sounds kind of Gin Blossomy or Weezerish to me in places, although I could have done without their note-for-note cover of Get Down Tonight. I’ve listened to stuff from the two albums on Rhapsody and I kind of like it – it would make nice driving music. They’re recently defunct, apparently parting ways just three months after releasing a new album. The reader’s family member produced the album and used his Hammond B3 organ on it, which is always a plus.

It’s been a great weekend so far as I write this Saturday evening. I worked ten hours at the hospital Friday, came home and worked another eight hours on HIStalk stuff, including doing a cool interview that I’ll run Monday (although I took a break to escort Mrs. HIStalk to our favorite sexy Asian bistro for some fine pad kee mao), worked on the HIT course I teach, got up way before dawn and worked another several hours on HIStalk, ran eight sweaty miles on the gym’s treadmill while blasting Metallica and REM into my skull and trying to impress the lithe young females running effortlessly just as fast as me while reading their Kindles and chatting on the phone, had some private time with Mrs. HIStalk sitting in front of the fireplace (which might have been triggered by my fighting off leg cramps from my just-finished run since she may have thought that I was performing a mating ritual with all my spastic leg-flexing and prancing around that threatened to topple the Christmas tree), planned our upcoming out-of-the-country beach break, and am now settled in for a few more hours of HIStalk work with college football on. It doesn’t take much to make me happy, which is probably why I rarely think it sucks to be me even when it might.

12-18-2010 5-13-47 PM

Athenahealth warns that FY2011 earnings won’t meet expectations, expecting $0.68-$0.78 vs. expectations of $0.85. Shares dropped around 10% on the news, but started a move back up Friday. As the graph above shows, the last trade was at $40.99, vs. a 52-week high of $47.82.

A Huffington Post Investigative Fund article covers the IOM’s just-begun study of the safety of electronic medical records systems. An interesting quote from Peter Pronovost, one of the most influential patient safety experts in the country: “There is a need for the basic science of safety of HIT. There is still a lot of basic knowledge we don’t have.” During the IOM’s two-day meeting last week, Epic’s representative repeated the mantra of boss Carl Dvorak, urging that any recommendations not stifle innovation. Human-computer interface expert Ben Shneiderman said, “Until we have a more public data collection, we will not have quality.” IOM hasn’t posted the minutes from Wednesday’s meeting that I can find. I think the writing is on the wall: FDA’s going to get involved in clinical systems oversight, in the form of a vendor registry and voluntary surveillance program if I had to bet.

HIMSS and RSNA incorporate IHE USA. HIMSS VP Joyce Sensmeier will be its president.

12-18-2010 9-17-55 AM

Weird News Andy knows how to repurpose an old joke. Q: How do you get from the pancreas to the uvula? A: Practice, practice, practice. He’s referring to Google’s just-announced Body Browser.

We missed mentioning another sponsor KLAS win. GetWellNetwork was the category leader in Interactive Patient Systems, with a 100% “would buy again” score. It’s amazing to me how many HIStalk sponsors lead their markets, although not as amazing as how many have been successfully acquired in the past couple of years (I’m resisting the urge to claim that as a sponsor benefit).

India is moving to what it calls Telemedicine 2.0, going beyond videoconferencing to live streaming of data and images to mobile phones. A pilot project involves detection of retinopathy in premature babies, offsetting a shortage of specialists.

12-18-2010 8-36-53 AM

Thanks to new HIStalk Platinum Sponsor Vocera, providers of instant voice communication systems that enhance staff efficiency and improve patient flow for more than 650 hospitals and 450,000 daily users. It runs on voice-powered communication badges and smart phones, connecting healthcare workers to each other and to alarm and alert systems, and is exclusively endorsed by the American Hospital Association. The company just made some nice acquisitions that bring in products for managing patient hand-offs. The San Jose, CA company announced Q3 numbers that include a 39% year-over-year growth rate, 22 new customers, and 31 new employees. They not only now support HIStalk, they were an original Founding Sponsor of HIStalk Mobile. Thanks to Vocera for their support.

Jack Janoso, originally hired by Sharon Regional Health System (PA) as CIO, is named acting CEO after the incumbent is fired.

My e-mailed copy of December’s Microsoft HUG Connection (which I can’t find online) says that HIMSS is canning its Users Group Alliance Program and turning the Microsoft Health Users Group over to Microsoft. I could never figure out how HIMSS could justify running vendor-specific user groups in the first place, so I can’t say I’m crushed that they’ve flip-flopped. I don’t know what happens to their Cisco group, Community for Connected Health, the only other one. The same, I’d guess.

HIMSS Analytics names Marc Holland as VP of market research. He previously ran System Research Services, an HIT market research and competitive intelligence firm.

12-18-2010 8-44-41 AM

About half of provider readers say would be less likely to participate in an HIE if its technology was owned by an insurance company, with most of the other half saying that wouldn’t matter to them. New poll to your right: if some level of FDA oversight of clinical HIT is required, which options do you like? You can choose multiple items and click the Comments link to elaborate.

12-18-2010 5-59-15 PM

Nine employees of St. Joseph’s/Candler Health System (GA) are disciplined for uploading a cell phone photo taken of an x-ray of “a male patient’s pelvic region” to Facebook. The hospital says the information wasn’t identifiable, so the employees broke hospital policies but didn’t violate HIPAA. An investigation found that a radiology employee left their workstation logged in while doing a procedure in another room, allowing someone to access the image twice in that time. The hospital fired three employees, disciplined three, and suspended three without pay.

More WikiLeaks stuff, this time an embassy report on Cuban healthcare. It claims hospitals are infecting patients with Hepatitis C, providers administer chemo and radiation treatments without meds to treat symptoms and side effects, the government jails homosexuals with HIV/AIDS, one doctor works 14-hour days and then hitchhikes home because low salaries preclude buying a car, providers aren’t allowed to access the Internet or attend conferences, rich foreigners get first crack at the best medical facilities, and government officials seek their care from other countries. Most interesting: the government supposedly banned Michael Moore’s movie Sicko, which criticized the US health system and lauded Cuba’s, for fear that Cubans would immediately recognize the movie as bogus since they have no such access to the excellent care the movie claims (Moore made a statement saying the US government made that up to discredit him).

I like to cruise the Web sites of sponsors every couple of months just to see what’s new. Here’s what I found:

  • FormFast is offering a January 20 Webinar on lean healthcare strategies, featuring the well-known author of book on that topic.
  • I’ve been following the Facebook posts of Cumberland Consulting Group, which instead of being dry and infrequent corporate drivel, are regular, cute profiles of its people and their goings-on.
  • Lindsey Jarrell and Colin Konschak of DIVURGENT Healthcare Advisors have their book, Consumer Centric Healthcare: Opportunities and Challenges for Providers, published by ACHE. It’s available for $67.50.
  • “Local” consulting form North Highland opened a new office in Jacksonville, FL.
  • Orchestrate Healthcare and its partner Vangent won a $3.3 million contract to support a Meaningful Use HIE deployment for the Indian Health Service.
  • IntraNexus ran a case study of Oswego Hospital, which uses its Sapphire browser-based hospital information system that includes CPOE, results reporting, a clinical repository, barcoding, documentation, and other applications.
  • ZirMed released a free iPad app for its patient kiosk, which lets patients check in at doctors’ offices and send their information to its system. Future plans include real-time insurance verification and handling of co-pays.
  • Informatics Corporation of America won the attendee-chosen Best in Show from a field of 38 vendors at a November payer and provider summit.
  • Philips has started an Innovations in Radiology group on LinkedIn.
  • Stockell Healthcare Systems offers a webcast on its InsightCS revenue cycle system.
  • SCI Solutions has a good list of archived webinars, some created by hospitals, including How Can I Make My Customers LOVE Accessing My Hospital and Recipe for Success: How to Sweeten Physician and Patient Relationships.
  • Orion Health had several announcements last week: its Rhapsody integration engine was chosen my Genesis Health System, the company was chosen as the primary technical provider for Alaska’s HIE, it announced an enhanced release of Orion Health EHR, and it just released GA of Version 4.1 of its Rhapsody integration engine.
  • MedVentive’s founder and CMO Jonathan Niloff did a best practices Webinar called ACOs: Old Concept, New Name – Tales from the Field in late November. It’s available on their site through February.
  • maxIT Healthcare has tagline I hadn’t seen, “Meaningful Use Requires Meaningful Assistance”, highlighting its 400 clients and their 350-consultant average experience of 19 years.
  • Carefx will be at January’s eHealth Initiative Annual Conference in Washington and the 2011 Military Health System Conference the week after that.
  • MyHealth DIRECT is growing and has openings for several client services positions.
  • CynergisTek CEO Mac McMillan’s article (warning: PDF), Make Meaningful Sense of Meaningful Use: What to Do Right Now, is featured in the December issue of New Perspectives from the Association of Healthcare Internal Auditors.
  • Cyndi Cahill of Vitalize Consulting Solutions was elected to the CHIME Foundation’s board of trustees. The company was just named #4 on KLAS’s list of professional services providers, landing in the top ten for clinical implementation, staff augmentation, and technical services.
  • Mary Carr RN of iSirona just ran Part 3 of her series on steps to medical device integration success.
  • Sentry Data Systems demonstrated its drug tracking, 340B, and business intelligence solutions at the ASHP Midyear a couple of weeks ago.
  • MobileMD’s 4DX HIE scored (warning: PDF) 93.64 on its most recent KLAS report, with an all-green report card and all-green trending.
  • AdvancedMD is offering white papers for practices that include Medical Practice Optimization and A Prescription for e-Prescribing: How to Make It Work for Your Practice.
  • BridgeHead Software CEO Tony Cotterill was interviewed on the topic of protecting healthcare data, covering archiving, storage management, and data migration.
  • Culbert Healthcare Solutions is offering consultant positions.
  • Software Testing Solutions offers an analysis of how its solution can help Sunquest LIS users meet CAP requirements.
  • Holon exhibited at the ASHP Midyear this month, with one of its offerings being Virtual Central Order Entry Pharmacy, its Web-based solution to distribute order entry workloads using custom rules to allow pharmacists to manage physician orders from any location.
  • Virtelligence participated in the HIMSS Southern California meeting this month.
  • Renaissance Resource Associates has a number of open consulting positions (Epic, GE, and all major vendor systems).
  • EHRScope’s frequent blog postings cover industry news and product information.
  • Salar has posted a demo of TeamNotes, its clinical documentation system recently selected by PinnacleHealth (along with its charge capture system).
  • PatientKeeper offers a number of archived Webinars, including ones on physician adoption, CPOE, and physician portals.
  • We ran an interview with MedAptus CMO David Delaney, MD on the subject of revenue cycle management tools a couple of weeks ago.
  • NPC Creative Services highlights some of it public relations and press release work on its site. I believe Inga told me they were instrumental in steering a couple of new sponsors to HIStalk, which I appreciate.
  • Keane Optimum has earned Complete EHR certification.
  • An Intellect Resources blog entry covers how to choose your professional references.
  • Enterprise Software Deployment posts its holiday card online, complete with staff pictures (who doesn’t like looking at people pictures?)
  • Diligence Analytics offers its cost-effective, professionally conducted research and analysis services to HIT vendors.
  • A2M posted a list of of some of its big-name consulting clients.
  • MED3OOO just announced a strategic partnership with Emergency Reporting in which it integrated that company’s Web-based fire/EMS system with MED3OOO’s EMS billing and recovery services.
  • Daniela Mahoney RN, president and CEO of Healthcare Innovative Solutions, will present Co-Pilots to your CPOE Success – Clinical and IT Collaboration and other CPOE-related sessions at the Ohio Hospital Association CPOE meeting in Dublin on January 18. She will also present several sessions at the South Carolina Hospital Association’s STEEEP Summit the following week.
  • Anson Group posted its well-written review of last month’s mHealth Summit, comparing the rise in mHealth to that of Facebook.
  • Capsule is running a “Wish I Had Time To … “ story contest for nurses. The entry deadline is March 31 and the submissions will be published as an interactive storybook on their site. Winners will be chosen by Facebook Likes.

I know many readers will be bugging out for the holidays this week. My wish for you is joy, peace, and unconditional love. Enjoy the break, then get right back here afterward because HIMSS will be just a few weeks away and it’s going to get crazy around here.

E-mail me.

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Currently there are "14 comments" on this Article:

  1. Mr. H,
    Regarding your great weekend, I am impressed how much you can squeeze into a day, including making time for Mrs. Histalk, which is very important!

    It is important to remember to get 7 to 8 hours of sleep per night. John Halamka brags about operating on just a few hours of sleep per night. Bottom line, I look forward to reading Mr. Histalk every morning for the reasons you have stated on your Linked-In page:
    “the occasional startlingly insightful editorial opinion, prediction, or summary. If you’re in healthcare IT and don’t read HIStalk, then your competitors will use their HIStalk-imparted wisdom to smite you and take food from your children’s mouths.”

    Therefore, if you begin to exhibit lemming-like behavior and utter the words, “In ONC I trust”, we will know you have are suffering from sleep deprivation.

  2. I read with interest your excellent highlights of your sponsors. There is reason to rejoice at their progress, except not one of the 42 you listed has issued information on safety.

    Personally, I was shocked to read of the Hopkins safety maven extraordinaire, Peter Pronovost, who stated there is a lot of basic knowledge we do not know about the safety of devices of HIT.

    I would take one issue with his descriptor “a lot”. The fact is that we know *nothing* of the adverse impact on safety except what has been reported by commenters here and at Health Care Renewal Blog. It is sad for the patients and the practice of medicine that for years, the vendors, with HIMSS and the LIEber run CCHIT leading the charade parade, kept such knowledge from public view.

    Happy and blessed holidays to you, Mrs. H, and Inga

  3. http://profiles.massmedboard.org/MA-Physician-Profile-View-Doctor.asp?ID=3685

    Sleuthing the court documents and those at the DOH of Mass brought me to this tidbit of information about the HIT czar, Dr. David Blumenthal. One point of interest is that the case settled the day before he officially took office. Another point of interest is that he had extensive experience with clinical EMR, his Harvard hospital and clinic being a trend setter with HIT and EMR. The logical interrogatory leads this reporter to ask about the role of the EMR in this case. Does any one know?

  4. Another article showing the experimental nature of health IT, this time from OHSU, certainly no underdog in the field:

    Unintended errors with EHR-based result management: a case series

    JAMIA 2010;17:104-107 doi:10.1197/jamia.M3294


    Test result management is an integral aspect of quality clinical care and a crucial part of the ambulatory medicine workflow. Correct and timely communication of results to a provider is the necessary first step in ambulatory result management and has been identified as a weakness in many paper-based systems. While electronic health records (EHRs) hold promise for improving the reliability of result management, the complexities involved make this a challenging task. Experience with test result management is reported, four new categories of result management errors identified are outlined, and solutions developed during a 2-year deployment of a commercial EHR are described. Recommendations for improving test result management with EHRs are then given.

    The recommendations were numerous, and the human resources needed to improve IT-based test result management were not at all specified. Those resources are likely to be considerable, over and above the tens or hundreds of millions for the IT, and nobody knows if those resources would equal those needed to better manage paper.

    Experimentation without patient consent indeed.

  5. MIMD – Where I think you fail to realize when it comes to EHR/EMRs is that there are about 400 million ways of installing them. The reason is that most organizations are doing something completely different from each other in the way they deliver care (i.e. what’s their workflow?). The organization can either try to put IT into a space where the paper-based workflow resided before, OR they can reinvent the process to better take advantage of the new system. It also doesn’t help when the organization tries to put together a disparate lab system combined with disparate pharmacy, MAR, and total EMR system. You are going to have a very hard time getting everything to talk effectively. I just don’t understand where the apprehension lies…

  6. PezMan Says:

    I just don’t understand where the apprehension lies…

    It lies in rushed national efforts to implement the systems that have 400 million different ways of installing them, plus hundreds of different ways of designing them in the first place, where poor install or poor design —> injury and death on unconsenting patients.

  7. MIMD – But how is that any different that a hospital experimenting with a new paper workflow process is any more dangerous than one with an IT process? The point of the matter is that the paper process has killed people due to massive inefficiencies and delays in getting and more importantly SHARING information with needed people.

  8. The point of the matter is that the paper process has killed people due to massive inefficiencies and delays in getting and more importantly SHARING information with needed people.</i.

    1. Most medical errors have nothing to do with documentation. See this link.

    2. Yet another new article (Unintended errors with EHR-based result management: a case series, JAMIA 2010;17:104-107 doi:10.1197/jamia.M3294, link) shows health IT creating new errors, of potential fatal nature, at one of the finest centers for health IT (OHSU).

    Remediation’s suggested, but the level of human resources needed for that remediation are unknown, and would need to be added to the $100’s of millions of dollars per medical center and hundreds of thousands of dollars per private doctor now currently being spent, or planned to be spent.

    That money would buy a tremendous number of paper-handling resources and document imaging systems (to make the info immediately available).

    So who’s inefficient?

  9. The ship has already sailed with regard to whether or not healthcare providers will receive incentives (or penalties) for implementing and using certified EHR systems (or not).

    The systems on the market, even “certified” ones, were not designed using the human factors approaches that have proven critical in improving the chances of safe and effective use in many other areas / industries.

    Fine. The systems are what they are. And the train ain’t gonna stop to make the ground-up changes that many of the most mature systems on the market would need to make them truly usable.

    What is important moving forward, though, is to have mechanisms in place both to collect data to identify and record crucial details around system-caused/contributed errors (and near misses) in a structured way…and the oversight systems and processes to take action to address them in real ways.

    It is truly baffling (and sad…and scary) that no one in government, the EHR industry or healthcare providers has put in place the systems and processes to adequately measure, learn and improve from our experience in transformation/disruption of the entire healthcare industry.

  10. Sorry about the dropped end-italics in #11.

    Mr Histalk: can you offer a “preview comment” feature?

    But how is that any different that a hospital experimenting with a new paper workflow process is any more dangerous than one with an IT process?

    Paper requires only a pen, not an instruction manual, login/logout, popup alerts and reminders, bugs, freezes, crashes, slow data retrieval times, cognitive overload from navigation and clickorrhea and screens festooned with widgets … need I go on?

  11. Paper requires only a pen, not an instruction manual, login/logout, popup alerts and reminders, bugs, freezes, crashes, slow data retrieval times, cognitive overload from navigation and clickorrhea and screens festooned with widgets

    Login/logout? Seriously?

    Popup alerts and reminders can be shut off. Of course, that could be a problem if the alert you shut off would have prevented you from killing someone.

    The slow data retrieval is almost certainly still faster than searching for paper records.

    I can’t help you with the cognitive overload, although I would expect a doctor to have a pretty high cognitive capacity.

    Pro-HIT, indeed…

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