News 9/30/11

Top News

VA CIO Roger Baker says his organization will allow smart phones and tablets on its network starting Monday, with the first batch of 1,000 users swapping out their laptops or BlackBerries for devices running an unnamed OS (Apple). He also says he’d like the VA to develop an enterprise-wide apps store, with some of those apps coming from its recently announced open source EHR project.

Reader Comments

From Matt Holt: “Re: unsubstantiated. C’mon Inga, be nice, or at least reasonable. Keanu’s comment that Health 2.0 was super disorganized? I hear everything from my team — including the three people who didn’t like my write-up of their bios — and I never heard about an argument breaking out about an ad. No one wrote mentioned the fact that we’re the only health conference with more than 120 LIVE demos, that we had two big time health plan CEOs talking directly about technology, that we put the ONC head on stage with seven patients, or that we had 1500 people come – more than 50% up on 2011? Guess next time I’ll have to ask the 20-30 people telling me that Health 2.0 is the best conference they go to that they should e-mail you instead.” Thanks, Matt, for filling in the missing details, although we just ran what an attendee (and sponsor, apparently) sent us. Maybe I am just bummed I couldn’t have been there myself to experience it. Next year.

From High-Heeled: “Re: Error messages. In my role of helping physicians survive and thrive with EHR adoption, some are generally frustrated by the error messages their applications throw up. This is a new error message one of our doctors sent to me and told me it didn’t bother her at all!” Please tell your physician that wine makes me more tolerant as well.

From Lou Reed: “Re: just good enough. Farzad Mostashari is urging the HIT Standards Committee to put out standards that are ‘good enough’ to get started on HIE. In my HIT experience, any link that is ‘just good enough’ handles the core data, but any data outside the norm (such as exceptions, outliers, etc.) gets trashed. Just look at what craziness the open text segments in HL7 cause. Providers will be spending thousands of man-hours trying to sort out this out as they trip over the myriad of exceptions that come up in health care cases. Although I am a firm believer in not letting the perfect be the enemy of the good, there are times when that approach does not fit. This is one. Would he take his child on a plane that is ‘just good enough’?”

From Sorbino: “Re: EHR. Check this KLAS report. Ever heard of PCC – Physician’s Computer Company?” I’ve heard of them, but I was never quite sure what they did (some kind of reseller, I figured). The PCC EHR, which is pediatrics specific, puts up monster KLAS scores. They’re pretty new on the report, though, and there’s often a honeymoon period before the scores start to slip as the company grows, expectations are raised, and an increasing number of users are surveyed. Still, it’s an impressive accomplishment. There’s something to be said for focusing on a particular market segment and excelling in it.

From Just Tennille: “Re: SRS user group meeting. I always feel that I’m among friends there and came home energized. “ I can see where the “energized” part came from – check out the Red Bull and coffee bean chocolates bar. All that’s missing is caffeine IV bags. The SRS developers, lined up for intros and appearing uncomfortable in their seldom-worn and/or borrowed suits, look like they would love to change into nerdwear, ravage the caffeine stash, and sling some code. That’s what you want in a developer, which is why the glad-handing and photogenic sales guys become physically uncomfortable in their presence. I’ve never had an energy drink, but I’ve noticed recently how expensive they are in bars and stores, probably making them even more profitable to their manufacturers than wine or liquor since they don’t have to pay high federal alcohol taxes (Red Bull’s founder is worth $3 billion). I bet they were a hit at the user group meeting.

From Meaningful User: “Re: NY Times on the UK’s HIT fiasco. Blumie toots a different horn now that he’s back using these poorly usable systems.” It’s a fun read, calling NPfIT “a slow-motion train wreck” and asking three experts on whether a similar disaster could befall HITECH, which costs even more than the hugely expensive NPfIT boondoggle. Former National Coordinator #1 David Brailer says the UK ran NPfIT as a giant procurement program, running all over clinicians in the process. Richard Alvarez of Canada Health Infoway says both the US and Canada are taking a different path than Britain in setting standards and outcomes, but not doing the actual implementation. Former National Coordinator #3 David Blumenthal echoed Brailer in saying it has to be a collaborative effort with clinician involvement. You docs who aren’t sold on even subsidized EMRs may have more power than you imagine, or at least Brailer thinks so: “The experience in Britain is a warning to us. The thing that brought them to their knees was the confrontation with doctors.”

From CDMer: “Re: stolen tapes. Another day, another breach.” SAIC says computer backup tapes were stolen from the car of one of its employees on September 14, potentially exposing the detailed health information of 4.9 million military beneficiaries who received care, lab tests, or prescriptions in San Antonio area facilities such as Brooke Army Medical Center.

From Dolphins Fan: “Re: loss of Minnesota PHI. When something like this happens, everyone always points out that it was against company policy. Every healthcare company on the face of the earth has a PHI policy and most have an encryption policy. Unfortunately, for many companies the goal is to put a policy in place to make people happy, but then they fail to enforce it. Execution of a policy, versus simply having a policy, is where you really see how important PHI protection is to a company.”

HIStalk Announcements and Requests

In case you have been too busy following season-ending baseball drama, tracking the latest presidential polls, or watching Dancing with the Stars, here are a few highlights from HIStalk Practice over the last week: Dr. Gregg mulls over Abe Lincoln and HIT innovation. Electronic medical reminders improve care in elderly patients. Younger docs are not necessarily better at EHR than their older peers. MED3OOO serves up education, networking, and fun at its annual user conference. eClinicalWorks sells swag for charity at their national user conference this weekend in Phoenix.  If you have not been a HIStalk Practice regular in the past, I have good news: we are still accepting new subscribers. Thanks for reading.

Welcome to Executive Search Recruiting, supporting HIStalk as a Platinum Sponsor. The Cornelius, NC-based ESR is a boutique search firm (no, they don’t find boutiques, they recruit executives and sales talent) that works with providers, payers, vendors, and consulting forms to bring on partners, principals, directors, sales executives, and consultants, to name a few of the positions they can help with. They’ve worked with companies ranging from startups to Fortune 500 companies, so there’s a 100% chance that they’ve helped an organization similarly sized to yours, offering customized fee structures that include flat fee per hire, retained searches, contract work, and an interesting (low) hourly fee share for billable consultants. The company’s employees average 15 years’ of healthcare experience in executive search, so they know where to find the really good people (hire a bad one on your own and the value proposition becomes clearer.) On the other side of the jobs table, if you’re a high performer looking for an opportunity, check out their current openings and get in touch with Don Calhoun. Thanks to Executive Search Recruiting for supporting HIStalk.

Everybody likes big and/or round numbers, so here are some for HIStalk. E-mail subscribers: 7,546. Likes on Facebook: 1,595. Mr. H connections on LinkedIn: 920. Dann’s Fan Club members on LinkedIn: 1,857. Number of unique readers: 21,350. Number of visits since 2003: 4.56 million. You will make the small round number (zero) of HIStalk full-time employees happy by increasing those numbers where you can. Thanks.

On the Jobs Board: Implementation Project Manager, Epic and Cerner Resources, Director – Product Demonstration Specialists. On Healthcare IT Jobs: HL7 Interface Analyst, Director, Clinical Applications, IT Technical / Product Support Specialist, Epic Consultant Manager.

If you were toiling away in HIT prior to 1980 and want to reconnect with old pals at HIMSS, sign up so Vince can e-mail you details about a little get-together at the HIMSS conference. One reader is hoping for Neil Pappalardo or Octo Barnett from Meditech to attend, but even if they don’t, quite a few interesting folks have already said they’re planning to be there.

Acquisitions, Funding, Business, and Stock

Greenway Medical announces that it is acquiring certain technology assets of CySolutions, a provider of clinical management and EHR solutions for FQHCs and community health centers. Greenway did not disclose the purchase price or the exact technologies it’s buying, but does indicate that CySolutions CEO Bill Young and other development staff members will join the company.

Prognosis Health Information Systems completes its acquisition of Creative Healthcare Systems, a provider of financial management and patient accounting systems.

Sales

Jeff Davis Hospital (GA), a 25-bed Critical Access Hospital, selects Healthland’s Centriq EHR.

Meadowlands Hospital and Medical Center (NJ) chooses PatientPoint’s patient engagement platform for care coordination and revenue cycle management.

Allegiance Health (MI) signs a three-year contract with TrustHCS for its ICD-10 education services and DNFB Assurance program.

Atlantic General Hospital (MD) contracts for Sunrise Clinical Manager from Allscripts. The hospital already uses Allscripts on the ambulatory side.

Blue Cross Blue Shield of North Carolina will spend $15 million to subsidize the implementation of the Allscripts MyWay EHR for 750 North Carolina physicians, with 85% of the cost covered for eligible independent practices and 100% for free clinics, including training and support. BCBSNC will work with the NC Area Health Education Centers to help practices achieve Patient Centered Medical Home status and will also help providers connect to the North Carolina HIE. Allscripts will contribute an additional $8 million to the project.

St. Francis Hospital (CT) executes a three-year agreement with MED3OOO to provide RCM services for its 200 employed physicians.

People

Ryan A. Secan, MD, the former medical director of hospitalist programs at Lowell General Hospital Medical Group and Anna Jaques Hospital, joins MedAptus as chief medical officer.

T-System promotes Erin Estes from director of implementation services to VP and GM of performance solutions.

Announcements and Implementations

Cerner announces the Cerner Reference Lab Network, which requires one standard connection to communicate with all reference labs on the network.

Community Medical Centers (CA) goes live this week on Epic.

CareTech Solutions earns HDI Support Center Certification for its Service Desk IT help desk offering, which it says is the only hospital-specific help desk in the country. The company also just invested $1.5 million to reconfigure and remodel the operation. The press release casually mentions that it’s an “on-shore medical help desk,” meaning that when you call, you’re talking to someone in Troy, Michigan, United States of America.

Scottish charge master vendor Craneware announces financial tools designed for Critical Access Hospitals.

Government and Politics

HHS launches the Comprehensive Primary Care initiative, which will pay primary care practices $20 per beneficiary per month for providing better-coordinated care for Medicare patients. The program calls for participation from private and state insurance providers, requires providers to meet certain quality measures, and will eventually include a shared savings component for participants.

iSoft will provide its Enterprise Management hospital information system to create the Brunei Healthcare Information System, a government project with a goal of creating a single electronic record for every patient in Brunei.

Fujitsu prepares to sue the UK Department of Health for $1.1 billion, saying it’s owed that amount after pulling out of NPfIT in 2008.

Innovation and Research

A hospital in England explains its green IT efforts, which include moving to virtualized servers, replacing desktops with thin client devices, and implementing the NightWatchman power management solution that powers down idle PCs in non-critical areas.

Other

An Atlanta medical practice’s IT specialist pleads guilty in federal court to intentionally accessing the protected computer of a competing perinatal medical practice. Using his home computer, Eric McNeal accessed the system of a former employer, downloaded patient data, then deleted all the patient information from the practice’s computer. He used the patient data to run a direct mail marketing campaign to benefit his new employer. He faces up to five years in prison and a fine of up to $250,000.

Weird News Andy elects not to steal second base in declaring, “I’m not touching this one.” A woman undergoing a swap-out of her breast implants wakes up after surgery to find herself with symmastia, also known as  “uniboob.” She said, “It looked like I had one big breast instead of two,” but the uniboob has since been successfully re-cleaved by another surgeon and the inevitable lawsuit has been settled.

National eHealth Collaborative seeks nominations for its board.

Consumers in Australia complain about the pharmacy association’s plan to push a particular manufacturer’s nutritional supplements when patients pick up their prescriptions. The association’s computer system will remind the pharmacist to tell the patient that the supplements can help mitigate side effects of the prescribed drug. The association’s president is particularly proud of the computer reminders, calling them a “world first for IT-enabled, software-promoted pharmacy sector messages to facilitate targeted recommendations to patients.” The manufacturer’s CEO raised the most ire when she characterized the sales program as a “Coke and fries” upselling opportunity that will boost pharmacy profits. The president of the Australian Medical Association was unimpressed: “I think the evidence for Coke and fries is about the same as the evidence for these products.”

A Denver-area agency ICU nurse is charged with identity theft and theft of medical records after Centura Health discovers he had accessed patient records inappropriately. The complaint against him says he used patient information to sign up for credit cards. His nursing license from another state had already been suspended in connection with a prescription fraud investigation.

A St. Louis-based physician and geriatrician urges the US to emulate the healthcare system of France (#1 in the world vs. the US at #37) and its smart card system. which is really just a microchip ID card that contains no medical information and is required for every citizen over 16 years of age:

The most magnificent component of the French medical system is the "Carte Vitale." This looks like a credit card and is given to the physician by the patient. It is inserted into a computer allowing the physician to review the patient’s basic medical history and is also used for billing the patients visit to the government. The patient thus controls his or her own health records, maintaining privacy.

A family practice physician in Canada, talking to a reporter about the loss of a PHI-containing memory stick from a local hospital, says patients of his own practice are not at risk. “My system is hard copy — paper, and it’s worked for me and many doctors in the city who still use it. It’s awfully hard to lose an entire filing cabinet.”

Thomas Manning, the retiring head of Commonwealth Medicine (a consulting division of the University of Massachusetts Medical School,) will become the state’s highest paid retiree with an annual pension of $347,000 when he retires next year. The organization is under investigation for receiving no-bid Medicaid contracts from the state that cost $138 million per year, but says that’s not related to Manning’s retirement.

Sponsor Updates

• Imprivata reports that the healthcare sector is the leading adopter of desktop virtualization technology, according to a recent cross-industry survey of 477 IT decision makers.
• Wolters Kluwer Health announces that Children’s Healthcare of Atlanta (GA) has selected its ProVation MD software for its GI departments.
• Surgical Information Systems (SIS) becomes an Industry Supporter of the American Society of Anesthesiologists (ASA).
• TeleTracking Technologies announces a free webinar series addressing patient throughput, overcrowding, RTLS asset management, performance improvement, and inter-hospital transfers.
• The executive director of medical operations for Pocono Raceway (PA) discusses how emergency responders are using technology from T-System and Shareable Ink.
• MobileMD introduces its 4DX Connected Health Record, an EHR application for small and family physicians that should be ONC-ATCB 2012 certified in Q4.
• Capsule announces record growth, including the addition of over 90 facilities over the last six months.
• iMDSoft adds Metropolitan Medical Services as a reseller of its MetaVision Suite.
• Billian Publishing launches HITR.com, a HIT benchmarking and social networking community for providers and vendors. The free tool includes customer satisfaction scores for nearly 40 IT systems and 300 vendors.
• CapSite releases a study of the RIS market and finds that 22% of hospitals have plans to buy a new RIS. Sixty-one percent of installed RIS systems are at least five years old.
• HIT consulting firm Care Communications collaborates with Elsevier/MC Strategies to incorporate Elsevier’s ICD-10 transition tools into its ICD-10 readiness and implementation offerings.
• Frost & Sullivan awards Awarepoint its RFID and RTLS Healthcare Competitive Strategy Leadership award.
• For the twelfth consecutive year, CMS extends its use of McKesson’s InterQual Criteria for decision management.

EPtalk by Dr. Jayne

Web sites like Groupon offer discounts on a variety of products and services. A recent article notes that such discounts may be illegal where health care services are concerned. Because part of a patient’s payment is kept by the site, it could be interpreted as violating anti-kickback laws. The American Medical Association hasn’t taken a stand, but two medical boards in Oregon (dental and chiropractic) have banned the practice.

The National Labor Relations Board affirms the right of a physician to terminate an employee for bad-mouthing the practice via social media. However, if multiple employees are collectively complaining regarding legitimate issues, employees may be protected. Timing, audience, and composition are key determinants of whether the speech is protected or not. Better dust off those policies and procedures and make sure social media use is addressed at your practice or hospital.

US District Judge Marcia Cooke has blocked enforcement of a Florida law that restricts physician questions about patient ownership of firearms. For those of you customizing EHR content and intake forms to remove these questions, you’re off the hook.

Accenture is chosen to head efforts to build a national Personal Health Record system in Australia. Orion Health and Oracle are also on the team. The system will include both patient and provider portals.

I maintain admitting privileges at a community hospital that is just now preparing to implement CPOE. I received a hilarious memo from them this week which contained so much worthless consultant-speak that I could have won a round of “Buzzword Bingo” without missing a beat. My favorite part was the discussion of a “cross-functional team dedicated to surveying spaces throughout the facility for process utilization.” I think this is fancy-talk for, “We have to figure out where we’re going to stick all these blasted workstations.” Broom closets, beware!

Sixteen organizations (including vendors, consultants, and advocacy groups) come together to form the Accountable Care Community of Practice. In their own words: “The overriding goal of the CoP is to help enable rapid, effective and efficient adoption and use of Health Information Technology (HIT) by providers implementing new care models in support of accountable care.” In addition to Webinars, they will hold regional forums in Minneapolis, Boston, New York, San Francisco, Seattle, and Austin.

PEPID announces the delivery of the National Drug Code (NDC) database to health IT systems. I’m not a fan of using NDC information for drugs, as it introduces a certain “clutter factor” depending on how vendors utilize it. Although highly specific, NDC codes for a given dose of a particular drug differ based on what kind of packaging holds the drug. As a front-line clinician, I personally don’t care if the pharmacy has 500-tablet stock bottles or 100-capsule stock bottles or which manufacturer it comes from. And don’t forget that generic drugs can have dozens of different NDC codes for the same medication.

I thought of Inga when I came across this business mentioned on a friend’s Facebook page. If it was in my home town, they would definitely get my business. It would also be an excellent name for a woman-owned software consulting firm. Now why didn’t I think of that? I could have probably expensed a number of sassy shoes as a business / advertising expense.

Contacts

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