Giving a patient medications in the ER, having them pop positive on a test, and then withholding further medications because…
News 8/26/11
Top News
Cerner reveals plans for two stainless-steel and glass office towers for its new Kansas City, KS office complex. The exterior design of the buildings is based on a digitized image of human DNA. Construction of the 660,000-square-foot development, which will house 4,000 employees, is expected to be completed by mid-2015.
Reader Comments
From Beau Tocks: “Re: healthcare’s most influential. Not sure that is the real list of movers and shakers in healthcare, so maybe it says something that Mr. H is not on the list!! Did Judy have some airbrushing .. or go under the knife?” The 100 Most Influential list was developed based on votes from the publication’s readers. I’m sure HIStalk readers would have compiled a totally different list. BTW, Mr. H’s insights extend well beyond HIT — he, too commented that Judy’s new headshot looks a little Photoshopped.
From Dr. Nick Riviera: “Re: ExR. In a sales call yesterday, a physician said, ‘I do not want to buy an EMR. The federal government is only paying people that have an EHR. I am going to buy one of those.’” Scary, on many levels.
From EpicBlackEye: “Re: Carle Foundation Hospital. Heard their Epic consultants walked off the job before next week’s go-live.” Unverified. I e-mailed for confirmation, but didn’t get a response. I’m skeptical pending further information.
From MT Hammer: “Re: All Type medical transcription service, North Brunswick, NJ. Acquired by Medquist. Employees notified by e-mail.” Unverified, but also reported by several All Type employees on an MT discussion board.
From St. Eligius MD: “Re: half of physicians practicing with NPs and PAs. Hallelujah! The AMA must be gnashing their teeth. What wonderful news for a new dawn in medical care for the future – MDs actually working with extenders, rather than trying to keep them out of practice. The sun will have actually risen when NPs, PAs, and CNMs can actually open their own practice.”
From Alabaster: “Re: Medify. I know someone in their focus group, which was mostly clinicians with heavy healthcare advocacy experience. None of them found it intuitive, it covers few conditions, and its goals were unclear. I heard they mostly just scratched their heads.” It looked like they found some cool information and built a nice GUI around it without having a clear vision of who would use it and why. It’s like reading one of those slick HIT articles cleverly written by a reporter with no subject matter expertise, where you’re first impressed because it reads so smoothly and authoritatively, but then you realize only in hindsight that it didn’t really say anything useful.
From Porphyria: “Re: Medify. I searched for ‘autism,’ but the treatments suggested had nothing to do with the condition, suggesting several cancer drugs. Very confusing and inaccurate.”
From OhNoPerot: “Re: Dell Services. Another 200+ person layoff today, all in the legacy Perot teams. Healthcare team continues to take most of the hits as the legacy Dell leadership takes over all key roles.” Unverified.
HIStalk Announcements and Requests,
Are you current on all things ambulatory HIT? New this week on HIStalk Practice: Dr. Gregg applauds collaboration between EHR vendors and specialty societies. An EMR vendor promotes transparency with its Meaningful Use Tracking Board. Healthcare costs may rise as hospitals employ physicians. The AMA gives a thumbs-up to Bundled Payments. If you follow ambulatory HIT, make sure you remain in the know by signing up for e-mail updates on the site.
Also, have a look at HIStalk Mobile and sign up for those e-mail updates if you want, which is full of good mobile health news and analysis by Dr. Travis (example: he was the first I’ve heard mention a special deal given to drug companies by Facebook, where they’re allowed to selectively block objectionable postings to their walls).
Listening: reader-recommended Richard Ashcroft, his latest solo CD (he used to be in Verve). He’s apparently wildly full of himself and some of the reviews have been savage (mostly because it doesn’t sound like Verve), but I like it quite a bit. It’s got a nice orchestra-backed, pop-oriented hip-hop vibe, although it’s a bit repetitive and inconsistent. I probably like it better than Verve, which was known for big-sounding, trippy psychedelic lushness — you would instantly recognize their Bittersweet Symphony, although you probably thought it was U2 when it came out in 1997.
If you’re in need of JFK-like “ask what you can do for your HIStalk” ideas, here’s a few off the top of my head: (a) sign up for e-mail updates to your right so that you don’t miss anything and so Inga can brag on the number of folks like you who have done so (7,468, since I know you were about to ask); (b) connect with Inga, Dr. Jayne, and me on Facebook and LinkedIn, giving us a Like if you’re so inclined, and joining the HIStalk Fan Club on LinkedIn like our BFFs have done (1,792, since I know you were about to ask once again); (c) send me rumors, news, or other stuff by clicking the big green Rumor Report monstrosity to your right; (d) check out the sponsor ads to your left, which are becoming less animated day by day, and click on any that tickle your fancy; and (e) do some carefree navigating and searching of sponsor-land in the Resource Center. I get the whole passive reader concept, but a little interaction on your part goes a long way when I’m sitting here alone for very long evenings after work trying to be scintillating using the written word alone. Thanks for reading.
On the sponsor-only Job Board: Epic Implementation Project Manager, Epic and Cerner Consultants, Regional Sales Executive. On Healthcare IT Jobs, which is back online but a little behind on new job postings: NextGen Workflow Process Consultants, Senior Pharmacy Analyst, Manager IS Clinical Applications.
Acquisitions, Funding, Business, and Stock
Trend alert: the growing number of hospital-based physicians, along with stock market uncertainty, are fueling investments in practice management companies for hospital-based physicians.
RTLS vendor Awarepoint secures $27 million in a Series F financing round led by Kleiner Perkins Caulfield & Byers. The company will use the capital for growth and to drive adoption of its aware360Platform.
Canada-based aviation simulator company CAE acquires Sarasota, FL-based medical simulator technology vendor Medical Education Technologies Inc. (METI) for $130 million.
Sales
Ipswitch Hospital NHS Trust (UK) will deploy Microsoft’s Vergence single sign-on and context management solution to improve clinician access to systems.
People
Microsoft announces the appointment of Michael Robinson as GM of US Health & Life Sciences and Dennis Schmuland to the newly-created position of chief health strategy officer. Robinson previously served as GM, public sector for the Middle East and Africa. Schmuland is Microsoft’s former national director of Health Plan Industry Solutions.
Voalté hires Teresa Anderson as its chief nursing officer. She was previously an independent consultant for the American Nurses Credentialing Center.
Announcements and Implementations
HIMSS names two Davies Award winners in the public health category: the Florida Department of Health, Bureau of Epidemiology for its electronic surveillance system for early notification of community-based epidemics; and the NYC Department of Health and Mental Hygiene for its Primary Care Information project.
The Healthcare Business Solutions subsidiary of New Jersey Hospital Association partners with Artificial Medical Intelligence to offer its member hospitals the EMscribe’s Coding Assisting Coding product to facilitate the ICD-10 transition.
Medicomp announces the initial distribution of ICD-10 mappings and functionality in the new version of its MEDCIN Engine. It includes a new user interface to make it easier to use ICD-10 within EMRs, providing clinically contextual, problem-oriented views of incoming data using standard reference terminology.
QuadraMed announces a new version of its Quantim Facility Coding that will support both ICD-9 and ICD-10, allowing users to test ICD-10 transactions while coding live encounters in ICD-9.
WoundVision announces the launch of iNSIGHT, Web-based risk assessment software that supports prediction and prevention of pressure ulcers.
Crestwood Behavioral Health (CA) deploys the OpenDNS Enterprise intrusion-blocking system in its 23 locations.
Innovation and Research
Healthcare costs are lower when clinicians use an HIE to care for ED patients, thereby avoid ordering duplicate services due to lack of information, according to Humana.
Emory School of Medicine establishes a biomedical informatics department, led by Emory Healthcare CMIO Joel Saltz MD, PhD. He’s also a professor in Emory’s departments of pathology, biostatistics and informatics, and mathematic and computer science (his PhD is in computer science).
Other
GE Healthcare informs Milwaukee-area employees of its intention to cut 81 manufacturing jobs, primarily in assembly operations for GE’s diagnostic imaging business. Those affected likely include some who participated in the company’s annual Community Service Day this week by sprucing up 400 classrooms in area schools.
Kirby Partners is conducting a survey on hospital IT employee retention, with results to be presented at the CHIME CIO Fall Forum (and here first, they’ve promised, in return for my mentioning it). I looked it over and the questions are good. To take the survey, click the appropriate variant: CIO, manager/director with people management responsibilities, or staff member with no people management responsibilities. UPDATE: I changed the survey links because their setup is a bit goofy – the original links forwarded to a specific link that gave the “you already took this survey” message. Try again if you’re interested.
Despite an overall trend towards enterprise solutions, Dimensional Insight’s Diver Solution earned top markets in a KLAS report on business intelligence. Information Builders’ WebFOCUS, IBM Cognos 8 Business Intelligence, McKesson’s Horizon Business Insight, and SAP XI Data Analytics were also ranked.
The Texas prison system has saved almost $1 billion over the last 10 years by implementing a statewide EMR and leveraging telemedicine, according to a press release issued by its EMR vendor (BCA) that cites a Gartner study.
Minnesota Health Information Exchange (MN HIE) quietly shuts down, merging its operations into a Duluth-based Community Health Information Collaborative (CHIC). CHIC’s president and CEO says their work overlapped and there wasn’t enough grant money to go around. MN HIE focused on EDs, with some big-name players that included Allina, BCBS, HealthPartners, and the state’s Department of Human Services. The splashy 2007 announcement of the formation of MN HIE, in which the governor said it would be one of the largest in the country, is here.
An Indiana prosecutor will ask the Office for Civil Rights to investigate the apparently intentionally circulated medical records of a city judge (and election candidate) following his stay at IU Health Ball Memorial Hospital.
Fellow shoe enthusiasts: a friend of mine wore these beauties to a party we attended last weekend. Sadly, I was unsuccessful at stealing them. They come from Turkey, so if you happen to be traveling that way, let me know.
Sponsor Updates
- Companies earning a spot on Inc.’s Top 500/5000 include Advanced MD, Concerro, Culbert Healthcare Solutions, Cumberland Consulting Group, e-MDs, EnovateIT, Enterprise Software Development (ESD), GetWellNetwork, Greenway Medical, H/P Technologies, Hayes Management Consulting, Healthcare Innovative Solutions (now part of Beacon Partners, which also was just named to the Top 100 Best Places to Work in Healthcare list), Iatric Systems, MED3OOO, MEDSEEK, TeleTracking Technologies, Vitalize Consulting Solutions, and ZirMed.
- iSirona releases a white paper illustrating how device integration improves EMR data.
- MD-IT announces a series of webinars for channel partners and transcription associates.
- ICA Informatics releases two new white papers entitled HIE Strategies Discussed at HLNY ACHE and HIEM Expands Use of CareAlign HIE Platform.
- Practice Fusion’s Research Division releases data indicating that one out of three children are now overweight or obese.
- ZirMed partners with Waiting Room Solutions to offer an insurance eligibility and claims solutions for physician offices.
- SCI Solutions will participate in healthcare access management meetings in Maryland, North Carolina, and Arizona in September.
- MEDecision achieves NCQA HEDIS recertification.
- A Billian’s HealthDATA blog entry discusses the benefits of data in healthcare.
- Nuance offers a webinar entitled Spotlight on Innovation: eScription V10 on September 14.
- Grays Harbor Community Hospital expands its use of Access Intelligent Forms Suite after a successful pilot.
- Aspen Advisors announces successful implementation of CPOE at Virtua (NJ).
- Samaritan Medical Center (NY) selects ProVation Order Sets.
- Frank L. Urbano, MD joins the care coordination and compliance practice of BESLER Consulting.
- Lahey Clinic (MA) selects computer-assisted coding technology from 3M Health Information System.
EPtalk by Dr. Jayne
I’m surprised it hasn’t happened before now — the marketing people have apparently found my e-mail address. Today was apparently Send Jayne a Press Release Day. Leading the pack in the “why bother” division was the American Medical Association with an absolutely banal statement about its stance on bundled payment initiatives at CMS. Blah, blah, blah. The AMA is increasingly seen as irrelevant, and if they hope to counter that sentiment, they really should step it up.
As usually I’m a bit behind in my e-mail, so I was going through it during an extremely boring Grand Rounds presentation. Direct-to-physician marketing group Physicians Interactive wanted my opinion about something. Usually I ignore those messages, but this one invited me to participate in an 8-10 minute market research study about my “use of ePrescribing and Electronic Medical Records.”
With the promise that my opinions would “assist in understanding the potential for reaching Health Care Professions through ePrescribing/EMRs” as well as “help to evaluate the value of integration of clinical reference materials at the point of ePrescribing” I decided to give it a whirl. Unfortunately, the survey was closed by the time I responded. Maybe that’s an incentive to keep up with my e-mail. I’d love to see how companies are thinking about marketing through EHRs. Just what we need – more distractions that are incorporated into our workflows for secondary gain.
In follow up on an item I mentioned earlier this month, the South Carolina man who was denied Medicaid coverage for his breast cancer treatments has been granted coverage by the state Department of Health and Human Services. Director Tony Keck states, “If the federal lawyers choose to deny those claims based on a discriminatory policy, that is their choice and our department will appeal the decision.” I’m no Constitutional lawyer, but score one for states’ rights and general human dignity.
This week is National 5010 Testing Week. Are you ready? From talking to my colleagues, it seems there are quite a few practices out there that aren’t even on compliant software yet.
Hofstra North Shore-Long Island Jewish School of Medicine began classes this month. As a brand new medical school, faculty are putting some interesting spins on how physicians are trained. One of these initiatives includes training incoming students as Emergency Medical Technicians. The goal is not only to teach students valuable skills, but to reinforce the team care concept of medicine.
The school is holding off on its traditional “white coat ceremony” (where students are presented with the white trainee’s coat and often take the Hippocratic Oath) until after the students take the New York state EMT exam. I’ll be looking forward to seeing how these students progress and how a new medical school incorporates healthcare IT in training. If you’re on faculty or involved in this program, I’d love to hear from you.
Contacts
Mr. H, Inga, Dr. Jayne, Dr. Gregg.
“Re: Carle Foundation Hospital. Heard their Epic consultants walked off the job before next week’s go-live.” Unverified. I e-mailed for confirmation, but didn’t get a response. I’m skeptical pending further information.
Should this be true, it should not be labeled “EpicBlackEye”, it should probably be labeled “CarleFoundationBlackEye”. This is not a verified event, and the details would be interesting, but I would place my money on organizational issues and not an Epic Failure. Leadership and team building are investments, just ask the CEO of this hospital when or if the root of the issue is revealed. When you treat consultants like consultants and not like members of the team, there will be issues. Not saying this is the case, but as someone who just signed a large contract with an EMR vendor, I am very sensitive to this issue.
“Kirby Partners is conducting a survey on hospital IT employee retention, with results to be presented at the CHIME CIO Fall Forum (and here first, they’ve promised, in return for my mentioning it). I looked it over and the questions are good. To take the survey, click the appropriate variant”
I clicked on the appropriate variant and it said that I had already taken the survey. Not.
[From Mr. HIStalk] I changed the links. I had used the URL that displayed when I clicked the links they sent, but it’s some kind of weird LinkedIn auto-forward that creates a specific link on the fly to avoid multiple responses. It seems to work OK now.
Re GE
Why is Jeffrey Immelt Obamas job czar?
Especially after yukking it up w BHO over shovels… Then closing a factory in WI and shipping jobs to China.
Hey Judy! Keep kicking his teeth in out there
RE: BCA EMR supporting Texas Prison system. I am familiar with that operation and agree that it is a model of how to provide quality care to inmates while holding down costs.
TX is successful because of several reasons – a very competent team led by Mickey Bourdeau, their use of advanced tools (you should see their Telemed process) and TX laws and regulations that make it easier and quicker (and even possible) to make the decisions needed to achieve this success.
I studied the CA process about 3-4 years ago when they put out an RFP to start to automate their healthcare. That system is a disaster – just like most things CA gov’t does (IMHO) – and is buried under regulations, special interests that conflict between the unions (a lengthy list of unions – guard, electrician, craft, etc), plus the political structure and the gang issues and “rights” lawyers that will totally prevent any meaningful changes in their prison situation. Even the “fix was in” for vendor selection prior to the (never awarded) award. And that RFP was not even for an EMR, since the consultants admitted that was an impossibility.
It is so bad that their system has been under federal receivership for years and STILL can’t seem to be fixed. TX went under similar receivership more than a decade ago and look what they’ve accomplished with the right leadership, policies and laws.
I can list all of the steps CA needs to take to fix this – it isn’t difficult and could be fixed for the cost of one year’s waste – but politically and special interest-wise, it will never happen.
Interesting summary from KLAS about BI vendors but wonder why it doesn’t really correspond to Gartner’s Magic Quadrant for BI. I suspect that the key attributes for the KLAS ratings are really dependent on the data staging/marts in the underlying database which probably explains why Dimensional Insight scores highly with KLAS but non-existent with Gartner. Also, I find it interesting that KLAS rated IBM Cognos version 8 and not 10. I agree that there’s a trend toward enterprise BI standardization with large healthcare organizations, but if you delve in deeply, you really find adoption and use very compartmentalized to a specific industry segment — standardization is great but business users will usually find away around IT driven standardization initiatives if needs are not being met. Epic Clarity is a great example of this. They push reporting certification on virtually every application with Business Objects as the standard, but at the end of the day, many organizations are pulling data from Clarity into another SQL database for some other flavor of BI. Why? The business users have unmet needs and there’s another BI tool or niche vendor that fills this gap.
Interesting that Cerner continues to develop real estate since they have once again dropped their stance of “employees must live in Kansas City”.
Went to hear Nils Lofgren last night at a small venue here in Tucson and was blown away. I’m a long-time fan since Grin days and of course love his work with Springsteen. But he, along with one accompaninist on key board and guitar, played mostly accoustic with some harp, and rocked the roof off. His guitar work is simply amazing. Check out his live versions of “Girl in Motion” and “Keith, Don’t Go”, and I’ll bet you’ll be seeking out more of his early work. He’s coming out with a new album later this fall that I’ll buy based on the few samples he played last night.
Mr H.,
I am Co-Founder and CEO of Medify. Thank you for taking the time to look at and write about our website on August 24. As a young endeavor, all feedback is helpful. I look forward to your continued input as we evolve.
I wanted to respond to some of the items in your post.
As I broad response I can tell you that all of us at Medify are committed to building the best place online for people who are managing important health situations to discover what works for people like them, and to get help from those they most trust. When my daughter was diagnosed with a serious condition two years ago I found the unpersonalized information offered by major health sites to be too high-level and often irrelevant. I really needed to discover the experiences of other patients like her. I eventually found them by painstakingly digging through research and manually cobbling together relevant findings. It’s resulted in better care for her because my wife and have more informed and productive conversations with her doctors. At Medify, we’re simply hoping to make that process smoother.
You’re correct that our search engine can and will get better. That’s part of the process of being in beta with a new technology. Thanks for the catch on congestive heart failure. We actually do cover that condition on Medify under the search “Heart Failure” (53 million patients across 25,000 studies). We’re working on better mapping of terms.
Similarly, we’re continually improving the “consumerfication” of the content on our site. While treatments like Clindamycin are still a bit technical, others, like silver sulfadiazine (listed right before Clindamycin for cellulitis) is described as “a topical sulfonamide/silver antibacterial used as a topical burn cream on burns, including chemical burns. It prevents the growth of a wide array of bacteria, as well as yeast, on the damaged skin.” Over time more and more definitions on the site will look like this…and then we’ll make them better.
Finally, your search for cellulitis treatments intrigued me. The fact that obscure things like “debridement via maggot therapy” are studied by medical professionals and can be compared side-by-side with more common and other alternative treatments demonstrates the richness of the landscape of options that patients face. When you’re facing and important health situation, and you need to build knowledge beyond the clinic visit, understanding this landscape and the relativity among options is incredibly important. This is where Medify can help people.
(FWIW, the study I found on maggot therapy said it, along with “electromagnetic therapy, therapeutic ultrasound or growth factors” didn’t typically work as well as “hand washing, wound cleansing, antibiotic treatment, and debridement through other means” for cellulitis treatment.) https://www.medify.com/insights/article/15103479
Thank You,
Derek Streat, CEO, Medify
To Porphyria…
I am Co-founder and CEO of Medify, and I want to make sure you get the information you seek.
In your comment re: Medify and your search for autism, you mentioned you only found anti-cancer treatments. Actually, a search for autism on Medify yields hundreds of treatments, primarily anti-depressants and mood stabilizers, as well as music, language, and many other non-pharmaceutical therapies. In fact, I couldn’t find any anti-cancer treatments, although I wouldn’t be surprised if some of those were studied in the context of autistic kids as well.
To get these results simply type in “autism” into the search box, and then select the orange “compare” button next to the first five treatment options listed.
Please let me know if I can be helpful in any other way.
Derek Streat, CEO, Medify
A significant study came out of the Journal of the American Medical Informatics Association recently, “Factors contributing to an increase in duplicate medication order errors after CPOE implementation”, and I’m wondering if anyone’s reviewed the full report. It evaluated the incidence of duplicate medication orders before and after CPOE with clinical decision support implementation, and found that duplicate medication ordering errors increased after CPOE implementation. Some of these were apparently very serious – the study indicates that factors included confusing alerts and a high rate of false-positive alerts, and CDS algorithms missing true duplicates. The study mentions that it was performed in two intensive care units and was an EpicCare Inpatient Clinical System.
Has anyone else thoroughly reviewed this study? And how does this compare to other products? I’ve seen snippets out there, but I think the paid report in its entirety is important, and I don’t think I’ve seen anyone cover it in more detail.
[From Mr. H] I reviewed the full article in some detail:
http://histalk2.com/2011/08/23/news-82411/
Nick,
Not sure which part is scary but technically speaking, with Stage 2 MU, the MD is correct. Many define EMR as designed for single entity and an EHR as “interoperable”, able to share data across entities. State 1 MU removed interoperability requirements, one reason why we have about 1000 certified vendors.
How many currently certified “EMRs” will never qualify for Stage 2 “EHR” status, leaving docs who acquired them in the lurch? A well known enterprise vendor leads with this sales pitch in selling against smaller, less expensive ambulatory solutions which the MD likely heard.