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July 5, 2011 News 13 Comments

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7-5-2011 5-37-48 PM

image Management consulting firm Beacon Partners will announce Wednesday that it has acquired Healthcare Innovative Solutions (HIS), which offers consulting services related to clinical system implementation and workflow redesign. The ten-year-old HIS gives Beacon additional Siemens capabilities, adds to its CPOE expertise, and boosts its revenue and headcount by 15%. I did an HIT Moment With interview with HIS CEO Daniela Mahoney RN a few weeks ago. Congratulations to HIS as the latest in a long list of HIStalk sponsors to be successfully acquired.

Reader Comments

image From NAFTA Doesn’t Work: “Re: Ontario. Healthcare informatics is at an all-time low here, with contracts based on who you know. I applied for a NAFTA-defined TN-Visa for professionals after being hired for a US contracting gig. No problem if you are a US citizen coming into Canada for EMR work, but if you try to go into the US, you are in for a chop-busting. Bring your degrees, transcripts, licensure, immunization records, and first-born child. An immigration officer berated me for being an RN and computer science graduate, saying ‘Seems like an odd combination, doesn’t it? Who would hire you anyway? Why are you trying to take jobs from Americans?’ Like it’s my fault your country can’t find enough people qualified to implement clinical systems based on the $19 billion ARRA commitment. Nothing like being stuck between a rock and a hard place.” We’re not very visitor-friendly here, that’s for sure, but that’s a 9/11 thing. We have a massive Homeland Security bureaucracy, along with a close-the-borders mentality that has caused quite a drain in technology expertise. I know from limited travels out of the country how unwelcome even US citizens are made to feel at immigration after short-term travel, so I can only imagine being a non-citizen trying to relocate here. I felt more welcome and respected in Russia than Newark.

image From Mr F: “Re: The PACS Designer’s WebGL blurb. Key point left out: Microsoft won’t be implementing it in IE because they think it is inherently insecure.”

image From Dakota Dan: “Re: Henry Ford Health System SVP/CIO Arthur Gross. No longer on their Web page.” His bio page has been removed, but that’s all I could turn up since I don’t have contacts there that I recall.

7-5-2011 7-54-30 PM

image From Collard Greens: “Re: KLAS. To consolidate their ambulatory EMR categories, also looking to consolidate/drop research for other ‘non-profitable’ research segments.” I contacted Adam Gale, president of KLAS, who says you are partly right. KLAS is planning to reconfigure their ambulatory EMR categories to better map how those solutions are actually sold to the market. Something like, let’s say, small practices (1-10 docs), medium (11-50), and large (51+). Adam says the other half of your statement isn’t true, though: market need rather than profitability drives the research segments KLAS covers and they’re planning to continue rating mostly the same categories ongoing. It almost seems the opposite to me: they keep adding interesting categories.

HIStalk Announcements and Requests

image Someone asked me at work today about the Stage 1 Meaningful Use rule for hospital clinical decision support. Since I had to look it up anyway to make sure I hadn’t forgotten something, here’s the summary. You have to implement at least one real-time alert and it can’t involve drug-drug interactions or drug-allergy contraindications. It must use information from the meds list, allergy list, demographics, or lab results. The rule must address something that’s of high clinical priority to the hospital and you have to be able to track compliance with the rule. If the rule is of the “don’t enter this order under any circumstances” variety, then the numerator could be calculated as: (number of times the rule fired minus the number of orders entered anyway) divided by the number of times the rule fired. Otherwise, you would need to electronically ask the provider if they changed their intentions based on the rule’s recommendation since you can’t assess compliance or rule effectiveness otherwise, unless you’re comfortable looking at overall ordering patterns for changes (and I wouldn’t be).

7-5-2011 7-24-53 PM

Thanks to new HIStalk Platinum Sponsor McKesson Paragon HIS. If you follow the industry, you know that Paragon is pretty hot stuff, named for five straight years as Best in KLAS in the Community HIS category. It’s certified, runs on a single database, is fully integrated (including clinical and financials), has low hardware costs, is intuitive and easy to use, and runs on pure Microsoft technologies (including SQL). Clinical modules include clinical assessment, CPOE, care plans, order management, meds, and results reporting. On the financial side, there’s patient management, AP/GL/MM/FA, payroll, resource scheduling, HIM, transcription, utilization review, and release of information.  Ancillary apps include pharmacy, OR, ED, rehab, radiology, lab, mobile phlebotomy, and micro. If you are a Meditech customer or prospect, McKesson would be happy to send you a white paper describing the benefits of Paragon for your consideration. I’ll throw in an observation that even though KLAS ranks it under the Community Hospitals category, I’ve heard from users first hand that it scales well to facilities up to at least 400 or 500 beds even though you don’t need a lot of IT people to run it, so don’t let that label scare you off. Thanks to the McKesson folks involved with Paragon HIS for their support of HIStalk.

Acquisitions, Funding, Business, and Stock

image Cerner shares hit an all-time high Tuesday (at least it looks like it as I’m eyeballing the share price graph), closing at $63.00 and pushing the company’s market cap to $10.6 billion.

Chicago area- based Resurrection Health Care and Provena Health will merge their twelve hospitals.


7-5-2011 10-00-13 AM

University Hospitals Case Medical Center (OH) will deploy athenaCollector for its 1,000 providers. Its MSO is already an athenaCollector client.

7-5-2011 4-13-02 PM

Presbyterian Intercommunity Hospital (CA) signs a services contract with Zotec Partners to manage its radiology department’s revenue cycle.


7-5-2011 5-22-54 PM

Blount Memorial Hospital (TN) names Clay Puckett CIO and assistant administrator. He was previously senior director of IS for Carolinas HealthCare System.

7-5-2011 7-09-27 PM

image Mathematician Robert Morris dies at 78, leaving a biography that should be made into a movie. He helped develop Unix, was a master cryptographer for the National Security Agency, led a 1991 cyberattack against Iraq before the first Gulf War, developed Unix security protocols in the 1970s that are used on Apple devices today, developed software that tracked enemy submarines and astronomical bodies, and warned Congress in 1983 that computer viruses were a risk but not likely to be created by children. He was proven wrong in that last assessment five years later when his own son’s worm program spread out of control and took down 6,000 Department of Defense computers (the lad is now an MIT computer science professor).

Announcements and Implementations

7-5-2011 10-02-18 AM

Legacy Salmon Creek Medical Center (WA) will go live on its $110 million Epic EMR by the end of September.

Government and Politics

CMS issues its proposed fiscal 2012 Medicare payment rules and suggests minor increases for most facilities and a whopping 29.5% decrease for physicians. Outpatient payments would increase 1.5%, ACS’s 0.9%, and dialysis facilities 1.8%.


Radiology site AuntMinnie runs an article on biometric ID,  mentioning palm vein scanning (PatientSecure), physician mobility (Imprivata), fingerprint ID (Digital Persona), and proximity biometrics (Proxense).


Here’s Vince’s latest, this time on minicomputers and complete with names you haven’t heard in quite some time, like Burroughs, DEC, and Four Phase.

image Epic ranks #1 in new HIT contracts for hospitals of greater than 200 beds. KLAS calls Epic’s track record of successful implementations “unmatched” despite lagging technology and a large price tag. Cerner was #2, with many of its new contracts involving new facilities for existing customers. The report finds hospital consolidation is increasing the interest in system integration.

image Johns Hopkins Hospital (MD) will eliminate 160 clerical positions by the end of the year as the hospitals switches to electronic medical records. The hospital will try to reassign the workers, who had been responsible for order transcription and creation and maintenance of paper charts. A reader sent a note last week saying Johns Hopkins was moving to Epic for its ambulatory clinics; Mr. H predicts the move to Epic will be system-wide.

7-5-2011 4-10-26 PM

USA Today profiles Banner Health’s (AZ) five year-old eICU network, which relies on remote critical care specialists to provide guidance to onsite providers. Banner has invested $11.3 million in equipment for the telehealth system and estimates that over the last four years, the program has helped prevent 600 deaths, reduced days in critical care by 26,000, and cut hospital stays by 100,000.

image AMA will draft model legislation for HIEs that will spell out who owns clinical information and who can view it. They seem concerned about insurance company ownership of HIE technology vendors (Aetna and UnitedHealth Group, which own directly or indirectly Medicity and Axolotl, respectively).

7-5-2011 6-43-04 PM

image Would you trust your HIPAA compliance education to this company?

image I thought of Dr. Jayne’s observations about the unhealthy lifestyle choices her patients often make when I read this article. A motorcyclist flips his Harley and dies of a head injury during an organized ride protesting mandatory helmet laws. Experts said the helmet he was illegally not wearing would have saved him. The event organizers, the state chapter of American Bikers Aimed Towards Education, announced that the rider “risked his all for freedom.”

Sponsor Updates

  • Aaron Kaufman, GM and VP of Kony Healthcare, will speak at World Health Congress (MA) July 28-29.
  • Clairvia leads the market segment in Staff/Nurse Scheduling according to KLAS 2011 Mid-Term Performance Review.
  • CareTech Solutions launches its Zero Worries campaign to promote the company’s hospital IT help desk services.


Mr. H, Inga, Dr. Jayne, Dr. Gregg.

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Currently there are "13 comments" on this Article:

  1. “Mr. H predicts the move to Epic will be system-wide.”

    No need to predict, it’s on their website, and I’m sure Mr. H will love that they refer to Epic as EPIC 🙂


    Why is Johns Hopkins Medicine implementing only the ambulatory EPIC system now?
    The roll-out of the EPIC system will require significant dedicated resources across the Johns Hopkins Medicine enterprise. Over the next few years, we have many exciting opportunities and initiatives that need extensive support from our employees and substantial financial resources. These include the opening of the new clinical buildings of The Johns Hopkins Hospital on the East Baltimore campus, the change in systems and clinical documentation to accommodate meaningful use, and the change in our diagnostic coding set to ICD10. Given these major changes on the horizon, a phased approach, starting with our outpatient ambulatory systems, allows us to insure success in all of these important projects and continue to focus on the financial planning for the next phase of EPIC to include inpatient and ancillary systems.

  2. NAFTA Does work: I loved the xenophobic display you put on. And it’s sad that Mr. H brought into it.

    I’m an American that graduated from a Canadian university with a medical degree with a BS in CS. What you described about Americans getting employment in Canada is patently untrue. I very much wanted to stay in Canada after graduation and work, but Canadian immigration abruptly told me that I had to go back to the States to find a job.

    I had degrees and experience not unlike yours. One of the officials even said that “would be in the best interests of Canada” but the offical felt otherwise. And last I checked, Canada still has a very strong nationalistic policy of employ, build and buy Canadian. Much more so than the States.

    For the record, our immigrant work policies are virtually identical to each other, so I’m sorry you feel slighted. I know the feeling. Please check…as I did.

    I’m sure a consummate HIT SME such as you would have no problem assisting the Canadian health system in its continued quest for interoperability.

  3. All these years and companies still can’t get HIPAA correct. But neither can providers.

    I went to an orthopedist in Texas last week. I was presented with a laminated “Notice of Privacy Practices” that didn’t include the required wording or tell me anything about what they do with my PHI.

    I was then presented with a piece of paper to sign. It stated I had received a copy of the NPP and that if I didn’t sign it the provider could refuse to provide treatment. I proceeded to ask for a copy of the NPP to take home and was told they don’t do that.

    The NPP wasn’t posted anywhere – another requirement.

    At least they didn’t ask me for a copy of my DL and SS Card – and claim it was for HIPAA (my gastroenterologist tried that one).

    FWIW – I spent 3 years as a HIPAA Privacy and Security Officer for a large IDN.

  4. Re: NAFTA.
    We have a “close the borders mentality…”? What country are you living in? Last I seen, anybody can walk across the southern border. Just aks Pablo!

    Re: Helmet laws and unhealthy lifestyle.
    I didnt realize that wearing or not wearing a helmet was a “lifestyle” choice. Seems more like a questionable decision. Motorcycle riding may be a “lifestyle”.
    Funny how elitism and politics are beginning to permeate this forum.

    As for me, I choose to wear a helmet, have loud pipes, smoke cigars, drink beer, eat burgers, and enjoy life in many other ways.

    Ms. Manners…enjoy your salad and hybrid.

  5. @El Jeffe – in Mr. H’s defense, I generally find his comments to be more libertarian than left wing, and definitely more in favor of small government and less bureaucracy . He is correct when he says that it is difficult to get a (white collar) job as a foreigner in America – it took my Canadian sister-in-law nearly a year to get her green card, and that was even with a valid marriage license.

    You’re kidding me, eh? is also correct – Canada does not freely give out their jobs to Americans whatsoever. Just ask my brother, a Yale graduate, who spent two years picking up odd jobs where he could when he lived in Toronto waiting for his wife (then girlfriend) to graduate from college.

    Our countries generally play well together, but neither one is going to be too keen on investing in workers who are not necessarily wholly committed to their new nations.

  6. What’s the best way to get dictated information into an EHR?

    Physicians are looking for ways to “data mine” their own patient EHR’s for information. . . Any thoughts on who’s the leader in this space?

  7. Oye John Galt,

    I’m a “foreigner” and I have had a white collar job for 25 years.

    I know many many other “foreigners” in white collar jobs.

    Getting a green card in a year seems reasonable to me, especially for the U.S. given the massive influx of …ehem…”foreigners” clogging immigration service.

    With regard to your comment on “our country’s investing in workers who are not wholly committed to their new nations” reeks of liberalistic idealism.

    When’s the last time you visited the campus of a major university in the U.S.? Didn’t thinks so.

    C’mon meng….get real…..Canucks….shees!

  8. I worked on a consulting assignment in Canada a while back… On my first flight into Toronto, I made the mistake of saying I was a consultant… which started a string of questions (mostly splitting the fine hairs of what “consultant” means).. and I was pulled out line.. and spent a half hour answering questions (yes, mostly economic related, like “so this is a job that has skills that are not available in Canada?”)… I didn’t know what to say… when I got to the client site, they all had a good laugh…” just tell them you’re in sales!” they goaded me… I took their advice, and no more issues… I was sweating in the airport on that first day, though…

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