From HIMSS 2/22/11

From Another CIO: “Re: VIP lines. My title is CIO, but it isn’t worth the ink to print it if all of our staff aren’t working together to accomplish everything that needs to get done.  To this end, I am literally embarrassed to hear about a ‘VIP Line’ at the HIMSS conference and wouldn’t be caught dead in one.” I’m sure HIMSS rationalizes its VIP treatment of CIOs by citing the vendor bucks chipped in to provide them with closed-session speakers, food, break rooms, and other perks. It also used to bug me that there was always an area where vendors could book time with HIMSS-pimped CIOs if they were willing to pay the CIOs cash for a ‘briefing’ (i.e., I’ll pay you to listen to my sales pitch). I suppose their other excuse is that it’s even worse than that at CHIME but  nobody’s complaining because non-CIOs aren’t invited there. Some hospitals have strict policies against executives accepting vendor gifts (“touch that vendor demo bagel and you’re fired”) but the rules doesn’t seem to extend off campus.

From All Hat No Cattle: “Re: Marc Overhage of Regenstrief. Resigning and going to Siemens. We received the announcement earlier this week and had an emergency medical informatics faculty meeting yesterday. Bill Tierney is taking much more of a leadership position initially and the search committee for the next leader of Regenstrief Medical Informatics has been formed.  He is fast tracking this search and we still hope that the next Chair of my department will also be a high level medical informatician.” Apparently verified, at least according to people who said they saw Marc wearing a Siemens badge at HIMSS.

From Florida Flash: “Re: Noteworthy Medical Systems. Continues cratering. Rick Mullins is now the former president and CEO. I guess the bright idea of getting rid of all the sales force, using a lead gen company, and then hiring salespeople back to work the leads didn’t work too well.” Unverified. Rick Mullins is still listed on the executive roster. I should have asked the folks in the CompuGROUP booth today when I was checking them out since they own the company.

From Digger: “Re: ONC. It was asked in the physician symposium what would happen if docs just sit on the EMR sideline until penalties kick in, and then either retire or stop seeing Medicare patients. ONC gave a politician’s non-answer.” It’s a fair question – there is a built-in assumption that doctors will voluntarily give up money rather than opting out of Medicare or hanging up their stethoscope. I overheard someone’s recommendation about shifting value of EMRs back toward the provider and away from the insurance companies: charge patients a $5 per visit surcharge and build a marketing plan around explaining to patients why that’s a good value. I also had another reaction: if doctors had any kind of pricing power, maybe the EMR burden would be lessened since they could charge more to cover their lost productivity. I still like the model of paying them to contribute their data for others to use, which would provide incentive for them to choose whatever product best meets their needs and implement it in a way that optimizes those contributions of patient information. If you were paid X dollars for a contributed H&P or other data set, Uncle wouldn’t need to be in the EMR bribes business.

From Zensocrates: “Re: Allscripts. Encouraging votes for Stephanie Reel is funny given JHM is negotiating with Epic to replace SunriseXA.” Unverified, but commonly known, I think.

From InfoNurse: “Re: HIMSS. Is that Elvis! No, that’s Neal Patterson! By golly, he’s coming to HIMSS11 on Wednesday. Just a walk-through after the lovers’ quarrel and breakup with HIMSS in San Diego. Must be coming to get the pie.” Cerner was a little shifty in mentioning a HIMSS booth number, but it was actually in the IHE section and not a real Cerner booth on the regular exhibit floor. Someone told me Cerner has a room in the convention center, though. I think I knew that vendors can book rooms out of the public eye to entertain right in the convention center. Speaking of The Pie, Neal did win again and I need to post the other HISsie winners, but I may do that when I get back home where I’ve got a more comfortable keyboard.

From Jay: “Re: AHDI/CDIA. CEO Peter Preziosi resigns.” They say they’ll miss him “sorely” and the announcement is gushy in general, so it sounds like it was his choice. The former Medical Transcription Industry Association just rechristened itself as the Clinical Documentation Industry Association.

From Mobile CMIO: “Re: Epic Canto. I have a working sample of the iPad app. Even though it is version 1.0, it is fast, great interface, and embedded dictation tool. I expect this to be quickly and enthusiastically adopted by our medical staff when we go live.” I mentioned Canto yesterday when I saw a poster for it on the outside wall of Epic’s booth.

The big acquisition announcement of the conference so far: Harris Corporation will buy identity management and integration vendor Carefx for $155 million. Obviously Harris wants more of the healthcare IT market than just its government and military business. The deal must have been struck awhile back since the Carefx booth had printed Harris information today that wasn’t an obvious last-minute add on.

Our other rumor was correct: TriZetto will acquire revenue cycle management vendor Gateway EDI.

One more acquisition: Scottish charge master vendor Craneware buys ClaimTrust for $20 million. The Tennessee company offers revenue cycle and auditing solutions, allowing Craneware to inflate its tagline to “automated revenue integrity solutions.” According to the ClaimTrust site, hospital revenue cycle consultant Joe Ferro and his programmer wife started the company in 1998. A nice exit for them.

HIMSS released its online survey results today. The Meaningful Use chase continues to draw a disproportionate share of hospital attention despite possibly more financially critical projects such as ICD-10 and preparing for healthcare reform.

We had a little lunch today for our sponsors, with Inga, Dr. Jayne, and me appearing in disguise for anonymity purposes (lab coats, surgical caps and masks, and reflector thingies). Thanks to Dr. Gregg for coordinating and Ed Marx for delivering a speech before we slipped in, did our thing, and headed out (I don’t know what he talked about, but I’m confident it was excellent). I can’t say we deliver an inspiring or polished performance for several reasons: (a) we have never appeared as ourselves in person and we were quite nervous about that, especially Inga, who Dr. Jayne and I thought sure was going to throw up on the sidewalk on the way in; (b) I had just met Dr. Jayne for the first time in the car (I like her – a little bit sassy and brash in a doctorly way); (c) we weren’t really sure what we should talk about; and (d) we’re writers, not talkers, so our oratorical skills are modest at best and Inga and Jayne declined to say anything at all once we got in the room (thanks a lot, gals). It was great to see everybody, though, and we really appreciate the support and the chance to say so in person. It would have been really cool to hang out for awhile, but we’re paranoid about anonymity since we’d rather not become unexpectedly unemployed. Inga wore the fab boots that I got her for Christmas and pics of those are going viral, she says. On the way in, some guy did a double take while checking our getup and asked if there was anything he should know. I told him we had the outbreak nearly under control.

Thanks to Dr. Gregg for choosing BB King’s for HIStalkapalooza way back in the fall and working up the menus and details. I liked the scale of the venue and the acoustics were good. Above is a red carpet picture from reader Rick. Below are some reader pictures – thanks for those.

If you’re at HIMSS, here’s my recommendation of a cheap, fun local place to eat that’s an easy walk up the street just past Pointe Orlando (one of my pals urged me to share it with you after I took him there even though he was paying and trying to steer me to high-end places). I’ve eaten at Miller’s Ale House probably 40 times over the years and it’s always good. The beer selection and prices are amazing, the waitresses are cute and fun, and you’d be hard pressed to find a better entrée than the $12.50 Bahamian dolphin baked in a foil pouch with garlic, wine, Tabasco, and vegetables. The blackened grouper sandwich is good, too. Start off with the excellent conch chowder and you’ll feel like a Florida native. I’d invite you to eat with me there except my doctor disguise wasn’t all that comfortable.

AT&T’s ForHealth division announces new products and pilots: a smart phone interface for its Healthcare Community Online portal, telepresence, and mHealth Manager.

Passport Health Communications announces a partnership with Bayfront Medical Center (FL) to beta test its precertification / prior authorization product, OrderRite.

I forgot to mention this the other day with all the HIMSS crush: athenahealth names former AMICAS CEO Stephen Kahane, MD, MS as president of the company’s Enterprise Services Group.

Merge Healthcare CEO Jeff Surges brings over some of his former Allscripts colleagues: Steve Brewer as EVP of solutions and Steve Martin as SVP of sales (please hold the arrow-through-the-head jokes since I’m sure he’s heard them many times).

McKesson announces its $1.5 million funding for six mobile health projects related to diabetes. The next grant cycle starts in April.

The folks behind the Extormity EHR and SEEDIE certification parodies come out of the closet: it’s NoMoreClipboard.com.

Allscripts announces its version of the Apps Store and demonstrates “native” integration between Sunrise and its Enterprise and Professional EHRs. I don’t know what “native” means when you have products developed by different companies whose only commonality is current ownership, but I’ll assume it just means you don’t need an integration engine or middleware. I heard a couple of times today that they’re doing a really good job, although whether it will be enough to fight the Epic juggernaut is anybody’s guess (actually, I’ll guess no since it’s late in the game, but kudos for going after them).

Cedars-Sinai picks Encore Health Resources to help with the next stages of  its EHR implementation.

Keane Healthcare Solutions Division announces a mobile client for its Optimum system.

Ross Martin provides this picture of the next challenge for IBM’s Watson, accompanying his funny writeup. “They also believe there is a place for synthetic vocals in pop music today. Andy Aaron, who lead’s Watson’s speech team, says, ‘We’ve hired will.i.am as a consultant to figure out how he makes his voice do that cool, computery voice thing and mimic that.’ Apparently, IBMers have not discovered Anteres Auto-Tune.”

GetWellNetwork announces GA of GetWell@Home, which allows discharged patients to use care plans, teaching tools, and personal health information created for them in the hospital.

From an athenahealth-Sermo survey of physicians about EMRs: three-fourths say they’re good for patient care and two-thirds say they’re worth the money, but 60% say EMRs slow them down. Still, 95% of those docs surveyed will seek Meaningful Use money. Other concerns involve the future of small practices, the impact on patient care of the Affordable Care Act, and the quality of medicine in general down the road.

Drummond Group announces its certification program for hospital EHRs that cover multiple or self-developed applications. The whole “complete EHR” Meaningful Use issue came up in the X.0 session I attended today, where vendors either don’t seek modular certification or decline to sell their offerings piecemeal, making it unclear whether a provider using or owning only specific modules can still claim to be using a certified EHR. ONC really needs to clarify this since it’s a mess and integrated systems vendors have little incentive to clean it up.

Palomar Pomerado Health announces Medical Information Anytime Anywhere (I’ll give them one-time dispensation for making Anytime one word when it should be two). Vendors already offer their own iPhone and iPad apps, but the hospital’s product works can assemble a single view of information from multiple systems (vendors don’t offer that, of course). Cisco covered half of the $250K cost of developing the prototype, but it will take lots more cash to turn it into a stable, off-the-shelf product (which is the hurdle that 95% of hospital-developed apps can’t clear).

Voalté hires former Ritz Carlton quality director Gigi Gray as user experience manager.

Exhibit Hall and Session Notes

• CCT, which offers training contracting services with emphasis on clinical systems, is holding mock training classes on the hour in booth # 5769.
• NCR announces new versions of its portal and kiosk products.
• The X.0 people seemed crestfallen that their beloved Twitter feed was down, forcing people to actually ask their questions instead of Tweeting them.
• Someone’s session talked about cost savings from IT, leading me to ask myself this: cost savings to whom? If you cut costs, you’ll just increase insurance company profits in most cases. They don’t often reduce rates even when their costs goes down. And second, hospitals are so inefficient that they never reduce rates when their costs go down, either. Even if technology allows cost savings, who gets the money?
• In a session on mHealth, one thing was clear: much of the variation in cost and outcomes is because patients are non-compliant. I was thinking that perhaps that’s why our outcomes and costs are so bad compared to those of other countries – our people are fatter, less motivated, more likely to be stressed in their quest for consumer bliss, and often unwilling to make even modest effort to improve their own health. That’s not something that providers can influence very much.
• I checked out a couple of products in the New/Emerging Technology part of the exhibit hall. Oddly enough, people from these startups seemed mostly uninterested in connecting with people looking at their offerings and neither of them offered me a demo despite not having much else to demand their attention. Expert-24 had Virtual Expert, a decision tree generator that looked a good deal like Visio and can supposedly be used by non-programmers to build simple applications that collect information or step through decision support steps. Canadian vendor MedConnex had a simple EMR. I would have had more to share if they had shown more interest.
• I said yesterday that ESD was the most creative vendor given their tiny space, and that’s not even counting the ultra-cool sign I saw in their booth today that I missed then. It said, “Big brother is not watching you,” explaining that you could visit them without being tracked because they opted out of the idiotic HIMSS vendor technology to track attendees with RFID like stray cattle in the exhibit hall. Kudos to them.
• Clairvia didn’t offer a demo of their scheduling and acuity apps despite broad hints from me that I was interested and a conversation of several minutes in which I asked about it, but I can say it looked very cool on the screen I saw.
• I will say that in general, booth people seemed out of energy today. Many of them were fiddling with their phones, talking to each other instead of paying attention to passers-by, or just sitting and staring at the floor. Maybe vendors should send in a fresh team on Tuesdays since many of them were letting prospects walk away without getting any recognition. I keep thinking about the cost of buying a booth just to give reps a place to sit, chat with each other, or talk on the telephone.
• I got a nice pitch from Healthcare Innovative Solutions, which provides consulting services specific to CPOE and EHR. They have a a good story.
• A company called ESET was giving out personal one-year licenses for the company’s antivirus product. I’ve never heard of them, but they say they’re replacing McAfee and the big boys pretty often because their product is more lightweight and doesn’t download huge updates, with their average update being only 18K in size. I’m going to install the license they gave me on my PC at home. I wish I could replace the one at work since when it cranks up once a day, it sucks the life out of my laptop for a couple of hours, not good news when there’s a technical or clinical emergency to deal with.
• Blue Cat Networks had a couple of girls in sequiny, skin-tight costumes that could have passed for spray paint. Just saying. Like many of the pretty females working booths, they were a bit cold, which I guess is the result of being leered at all day.
• Prognosis also didn’t offer a demo or pay much attention despite my broad hints of interest, but the product looked good on the screen shots.
• The folks at C3 Partners explained their Meaningful Use Monitor, a tracking tool to document MU status, ready to submit (after Stage 1, which does not require anything more than attestation, apparently).
• Google had a crappy little booth with – no lie – black and white photocopied sheets about Google Health that had been cut in half. They had a total of four PCs for demoing, which was three more than they needed at that point in time.
• Stoltenberg Consulting was offering free chair massages, which I could definitely have used if they had picked up on my obvious interest (clearly I get miffed when I’m ignored, but at least unlike the average attendee, I can call them out publicly on behalf of all of us).
• MediQuant had an excellent magician with some fun product pitch mixed into his patter. Definitely worth checking out. The guy will read your nametag clear across the aisle and call you by name to get you drawn into his tricks. You won’t mind.
• SSI was the company from Inga’s picture that had females wearing evening gowns.
• Someone asked me what I thought the big theme is this year. I don’t think there is one. iPads are cool, but not all that different, ICD-10 and tools to migrate to it are obviously on everybody’s radar. Other than that, nothing would distinguish this year’s conference from the last two or three. Everybody’s talking innovation, but I don’t see much if it out on the show floor. You tell me – what’s the coolest thing you’ve seen?

I have no further HIStalk responsibilities and I’m not leaving until Thursday morning, so let me know if you’ve seen something I should check out.

E-mail me.

HERtalk by Inga

Yes folks, that is my brand new iPad. I was one of Medicomp’s lucky winners. And yes, Medicomp was our amazing HIStalkapalooza sponsor and they also made me the proud owner of a cool toy. Regardless, their new Quippe is a serious game changer. I looked at the technology that is embedded into MED3OOO’s Integreat product and was amazed. Today I saw Medicomp demonstrate it further and I am convinced that every EMR vendor needs to check out this technology. I haven’t seen any product with anything similar and I am convinced that it’s the way of the future. I realize that I am such raving without giving details, but I will have to go back to that another time.

So this is going to be a totally rambling post, so hold on for the ride.

HIStalkapalooza: OMG I had an amazingly fun time. I must ask Mr. H who the red carpet gals were, but they were gorgeous and hysterically funny. Check out the YouTube video and see for yourself. Many folks came dressed to the nines, including our Inga Loves My Shoes winners and all the finalists for HIStalk King and Queen. If you were a winner, send me a note so I can mention your name. Our judges Lindsey and Greg were the most adorable and funny things. If Lindsey hadn’t been a judge, her pink stilettos would have surely won.

Ingatinis: I had one in the SIS booth yesterday as well as one at BB King’s. The original won over the newbie, though that didn’t stop me from drinking them at BB King’s.

Mr. H, Dr. Jayne, and I treated our sponsors to lunch today. We made a brief appearance and Mr. H said a few words. I rarely get anxious or nervous, but I was a wreck this morning. Thanks to the 100 or so that showed up and showed us the love. One of the sponsors told me that his table included someone from eClinicalWorks, Allscripts, Greenway, and e-MDs, and the NextGen guy came over to say howdy. How often do guys like that break bread together? I wish I could have heard what was being said.

HIMSS isn’t over yet, but already the conference has hit a record number. 30,947 so far, compared to an estimated 27,800 last year in Atlanta.

There are over 1,000 exhibitors, which means it is virtually impossible to check them all out. However, I asked my new BFF Dr. Jayne to join me for a peek at a few EMRs. For whatever reason, we had difficulty getting anyone to show us stuff, usually because people were too busy. We tried to look at Azzly, which I had seen in MGMA in October. It’s brand new and is having its first practice go-live in a couple months. It is cloud-based, so our demo was over the Internet. Apparently the Internet connection was horrible and thus it was impossible to get a feel for the product. Azzly does not offer a local version as a compliment to its hosted version. It’s a little scary to think of all the potential problems of having an Internet-based only product, though everyone is going that direction.

Another vendor said he had to pay $1,500 a day for high-speed Internet access in the booth. I think I heard him right. Could that number be correct?

Dr. Jayne and I also tried to check out Practice Fusion. Apparently they had similar Internet issues and were only providing demos on one small screen. The cute young guy working the booth told me that only about four of their clients go for the ad-free version of their product. When I interviewed Practice Fusion CEO Ryan Howard a couple of months ago, he wouldn’t share that number, by the way.

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Software AG is raffling a hot-looking Fender electric guitar. I gave it a test drive and totally impressed the booth staff.

I did a quick walk through the Interoperability section. There was apparently a speaker at the little theater in there and the crowd was  20 people deep. If you look really hard, you can see a speck that looks like David Blumenthal.

Speaking of Blumenthal, am I the only person who has noticed that SRSsoft’s Evan Steele could be Blumenthal’s better-looking brother?

Second best “trinket” after the iPad: a stainless steel coffee traveler cup from MedAssurant.

Cute fedora hats at FormFast, I think. They are apparently giving them away. I am not sure what it all means, but they also have a pseudo-juggle thing going on in their booth with lots of foliage adornment.

So much more to say, but I scored an invite to one of the big parties, and well, what’s a girl to do?

E-mail Inga.

EPtalk by Dr. Jayne

The highlight of today was stopping by the HIStalk sponsor lunch with Mr. H and Inga.  I felt like a rock star arriving in the HIStalk limo, but the looks on the faces of other patrons at Pointe Orlando at seeing the three of us in our white coats and surgical caps was priceless. We appreciate your sponsorship and thanks to all of you for welcoming me as the newest member of the HIStalk family.

The best thing I saw in the exhibit hall today was Medicomp’s Quippe offering, which they were demoing on the iPad.  Using the MEDCIN Engine as its backbone, it allows for creation of dynamic templates for documenting patient care, allowing physicians to customize while still mapping to recognized findings behind the scenes so that it all works for coding, compliance, and interoperability. You can see it at work also at the MED3000 booth as they have integrated it into their product.  As many vendors move to map to SNOMED and other standards, this approach is one that should be given serious thought.

And as more and more physicians express a desire to have templates that build the note on the screen, this type of functionality should be easier and easier to integrate into existing products.  Of course, some docs still aren’t going to like it, and there will be the ever-present debate over whether findings should be documented in clinical terms vs. patient terms.

I’d be interested to see what physician readers think about this idea – knowing that patients are going to have more and more direct access to their charts, are you changing the way you document? This is a fundamental issue that all of us are grappling with. How are you handling it?  Since Medicomp also gave iPads loaded with Quippe to the physicians attending HIStalkapalooza, let us know how you like it after you have a chance to try it. Drop me a note and I’ll write it up.

Thumbs down to the food court today, when the machines ran out of Diet Pepsi.  Sounds like quite a few of us are trying to avoid the extra sugar that comes with the caffeine that keeps us going.  Even for those who choose the full-sugar versions, at least we’re burning some calories with the trek through the convention center.

I’m still tuckered out from HIStalkapalooza. It was nice to see so many “real” physicians in attendance and I enjoyed talking with some of you. I also enjoyed talking with those of you who are suits – it was nice to share war stories and make some new connections. 

The awards ceremony was priceless and this being my first HIStalk party, I’m glad my expectations were exceeded. Looking forward to many more to come!

Tonight I swung by the Compuware bash at Cuba Libre with my wingman. Great atmosphere (a little heavy on the cigars, though) and reasonably good Mojitos. Enjoyed the heavy dance beat and the excellent people-watching as the night wore on.

Tomorrow’s my last day at HIMSS11, so if there’s something you think should be on my "must see" list, e-mail me.

E-mail Dr. Jayne.