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Monday Morning Update 10/10/11

October 7, 2011 News 6 Comments

10-7-2011 3-17-48 PM

From Spell Chequer: “Re: HIPAA. I thought you’d appreciate this full-page ad, from an e-guide on HIPAA compliance.” We’re reaping what we sow as a society. It’s considered uncool to correct anyone’s spelling or grammar these days, and thus sloppy mistakes are the rule. Text message writers and tweeters have dumbed down the language the point that it’s barely understandable. What could be more cluelessly arrogant than the implied message, “I’m too important to take the time to spell and write well, so I expect you to translate for me?” As foreign students work endless hours to master English to ensure their future success, ours spend their time butchering it. But even near-illiterates shouldn’t misspell an acronym, especially one in which they claim renowned expertise.

From Major Payne Diaz: “Re: 5010 upgrades. You still need to feed the clearinghouse 5010 data, so the practice management software needs to be updated with vendor code to enact the changes. Then the facility needs to make their modifications – install the new 5010 sub-forms, modify table values, modify the loop/segment data sent for a particular payor. None of these can be performed by the scrubber or clearinghouse. Consider just one – Pay to Provider (rather important, don’t you think?) How would the clearinghouse know this information unless the source system / scrubber values it appropriately? Since when did the clearinghouses get crystal balls?”

From McMessy: “Re: McKesson. Both employees you mentioned left after they got word that Horizon Clinicals is going maintenance-only.” I’ve seen no announcement about Horizon, so if you have, please send something my way to confirm. That rumor keeps floating around (like the one suggesting that MPT is going to be sold,) but it’s all smoke and no fire so far.

I was asked by a book publicist to consider writing about a new book called Your Medical Mind. I did, and it was a somewhat mixed review. It contains good if not occasionally obvious ideas about making medical decisions, but isn’t all that much fun to read, is a bit padded, doesn’t fully answer the question the subtitle asks, and either isn’t clear on its intended audience or fails to engage them on their level. I still like the concepts, though, even if I wouldn’t necessarily invest the time or money to buy the book. I’d like to see the authors (or someone else) turn it into a movement that would probably be more effective on a larger scale. It’s a good conversation-starter, at least.

My Time Capsule editorial this week from September 2006: Drug Rep Gifts Banned – What About IT Reps? A snip: “Having decision-making authority means vendor reps will try to soften you up like gangsters wooing supermodels — with flattery, rapt listening, and a shower of baubles.”

10-7-2011 2-59-48 PM

Most respondents to my poll said they follow their employer’s security policies all the time, but of course I didn’t really ask how stringent those policies are (especially those related to encryption of data on portable drives, accessing Web sites and online e-mail accounts from company devices, etc.) New poll to your right: what effect will ACO-type reimbursement models have on quality and cost?

St. Louis-based NextGen reseller KIG Healthcare Solutions is sold to another reseller, GBS Corporation of North Canton, OH.

10-8-2011 2-58-32 PM

A jury finds that Teva, Baxter, and McKesson must pay $20 million for selling the anesthetic Propofol in large vials that the plaintiffs say implied the vials could be used for multiple patients. Punitive damages of up to $600 million are being sought. The first two companies (not McKesson) were hit with a $500 million verdict previously in another case. Plaintiffs claimed the companies stopped making smaller vials of Propofol because the larger ones were more profitable; patients sued after contracting hepatitis from a Nevada colonoscopy clinic. The CDC said the infections came from the clinic’s use of Propofol vials for multiple patients, but the defense argued that the infection could have come from improperly sanitized instruments. The clinic’s former owner and some of his employees were indicted on criminal counts that included racketeering, insurance fraud, and patient neglect, but he was found incompetent to stand trial. Since McKesson is a distributor and not a manufacturer, you would expect their involvement to have been limited to filling the orders of its customers. Nearly 300 lawsuits have been filed against Teva, which says it will pay any damages levied against its distributors such as Baxter and McKesson.

10-7-2011 3-38-56 PM

Howard Hays, MD, MSPH, acting CIO of the Indian Health Service, testifies in a Senate hearing on that organization’s use of real-time videoconferencing, consultations, patient monitoring, and mobile health. They are providing services such as behavioral telehealth, home blood pressure monitoring for chronic disease management, tele-nutrition, and remote neurosurgical consultations from the University of New Mexico Regional Trauma center. Video of the hearing is here.

A Texas Tribune article covers practice groups in that state that are following new IT-enabled models. Examples: one practice performs all wellness exams in a single visit, answers patient e-mails 24×7, and logs diagnostic results immediately to their EMR. Another offers specialty storefronts, same-day appointments, and valet parking. Kelsey-Seybold Clinic in Houston has 373 physicians in 20 facilities, all with in-house lab and x-ray facilities, uses a single EMR (Epic), has offered an accountable care plan through Cigna for four years. They use the EMR to prevent duplicate tests or treatments and to provide best-practice alerts and preventive reminders. It’s a good reminder that a well-run practice can scale up without needing a hospital to buy it, although most practices are run as small businesses without a lot of business savvy (hint: if your business manager is the spouse of one of the doctors and the IT expert is one of their unemployed nephews, the chances are good that even notoriously inefficient hospitals could run it better).

Great Plains Health Alliance will use $5.2 million in federally guaranteed USDA loans to buy clinical software for 22 rural hospitals.

A Massachusetts state senator introduces legislation that would take away the power of the Massachusetts Historic Commission to restrict the use of land that isn’t listed in the state’s Register of Historic Places. That’s in response to Meditech’s announced plan to take its jobs elsewhere when the Commission insisted that a lengthy archaeological survey be performed before new offices could be built.

10-9-2011 12-13-58 PM

The widely decried “Coke and fries” program in Australia in which retail pharmacists would have received computerized reminders to push a particular company’s herbal remedies along with prescriptions has been shut down. The president of the pharmacy guild that came up with the idea is appalled that media coverage was negative. “The idea that community pharmacists would take part in commercial up-selling without regard to their professional standards is offensive to our profession and rejected by the guild.”

Hospital software vendor CPSI pays $102,000 to its employees after a Department of Labor compliance audit finds minor errors in some of its pay rules. CPSI was paying 1.5 times the hourly rate for overtime and a flat fee for being on call over the weekend. The issue involved employees who were already on overtime before the weekend started. The company thought (as did I) that on-call pay is discretionary and not subject to overtime regulations. Of its 1,000 employees, audits found 247 who were affected, with an average payout of $60. As CPSI CEO Boyd Douglas said, there would have been no discussion if CPSI simply shafted its employees like most companies and forced them to take call with no extra compensation.

10-9-2011 12-21-23 PM

Cleveland Clinic announces its Top 10 Medical Innovations for 2012, of which two involved healthcare IT: data analytics and mobile apps for physicians. Its just-ended Medical Innovation Summit was like a dream for right-winger capitalists rather than compassionate healthcare advocates, with keynotes by Dick Cheney, Jeff Immelt of GE, and the CEOs of drug and device companies looking for the next bottom line booster.

Oracle settles charges that it overcharged the federal government for software over a nine-year period by not offering Uncle Sam the same discounts that the company’s commercial customers receive. Oracle will pay $199.5 million under the False Claims Act, with the company’s former employee who filed the whistleblower lawsuit pocketing a cool $40 million. Oracle says it followed the rules, but the incidents are so old (1998 to 2006) that it can’t find reliable witnesses and would rather just move on.

Merge Healthcare chooses Dell as its preferred provider of cloud-based computing services, storage, and enterprise hardware. Meanwhile, Chicago Mayor Rahm Emanuel announces that Merge intends to grow its local workforce from 900 to 1,100 over the next two years and install 100 of its Vital Kisoks around the city.

10-9-2011 12-39-46 PM

Last month’s arrest of the 17 year-old Matthew Scheidt posing as a physician assistant in a Florida hospital marks the third time he attempted to practice medicine at local hospitals. The earliest documented attempt was in 2007, when the then 13 year-old Scheidt masqueraded as a nurse; he also twice claimed to be a sheriff’s deputy. The Orange-Osceola State Attorney’s Office announced that Scheidt will be procescuted as an adult on two felony counts of impersonating a physician assistant and four felony counts of practicing without a license.

10-9-2011 12-46-57 PM

Nuance Communications discloses it has acquired Swype Inc. for $102.5 million. Swype is a provider of alternative keyboard input functions for mobile devices.

We were sent a fun resignation letter that made its way around. The author gave the OK to run it as long as his name and that of the company were removed (although he knows it won’t be hard to figure out which company he resigned from.) He was surprised that his vendor employer didn’t delete it off the e-mail server. Inga and I found him amusing in a Ricky Roma kind of way, so we’re trying to get him to write for us.

Let’s be honest. Resignation letters are usually brief, nice and boring. My goal is to make this none of those things. The only good ones are those accidentally sent out to the whole company where everyone tries to figure out why they got an e-mail about “Frank” who worked here for eight months as an IT consultant in Boise. Good ol’ Frank – he was solid from a technical standpoint, but not so solid at the TO: line of an e-mail.

I thought I might write this as a Top 10 list because that has never been done before … ever. I’m sorry, I have just been informed that I am only able to write this as a Top 7 list. If you want the full Top 10, you will need to wait for the next version – top10.1.1 or Service Pack 2.

And now, the thoughts of a man in a powder blue tuxedo.

10. Keep in touch. Keep in touch is the worst phrase ever. Let’s update that one: “Keep in touch on LinkedIn because I may need a recommendation soon.”

9. The Mothership. I am taking credit for giving the office this moniker, and it has now passed the test because I heard an “executive” use this phrase. I also like to put the word “executive” in quotes.

8. Casual attire. For those of you reading this outside of the Sanctuary walls (no, not that kind of sanctuary, that’s the name of our building), did you know that we can wear jeans every day? There are still some guidelines and I feel some of our IT friends need a little assistance. I have seen so many Canadian tuxedos in the last six months that I feel like I am backstage at a Rush concert.

7. Last season, our softball team was named the Crooked Numbers. It’s a softball term, I guess, but I also think it also describes the reason why we lost so many “executives” a few years ago.

6. Handing in your two-week notice. Other than my current haircut, this was my biggest mistake. I should have said that I am going to consult for all of our top competitors and am building an EHR in my garage so they would have kicked me out right away. Now I had to stay for two weeks to help “transition” someone into my “role” and “drag down morale” with my “shifty eyes” and “rugged good looks.”

5. (This item was not approved by legal, technical accounting, corporate, finance, and/or a gang of angry ninjas.)

4. I will miss many of you. Not all of you of course. But if I had to pick what I will miss most, it is you, free Diet Coke machine. Thank you for early morning wake-ups, late night keep-ups, and mid-day pick me ups. You are the epitome of ICARE.

I have worked here for nearly four years and there are some great people here. I thank them for everything.

Always up for a fried appetizer.

E-mail Mr. H.

Pediatric Office of the Future by Dr. Gregg

Tech Talk Theater–the “New Kid in Town”

Lots of folks are gearing up for (or just gearing down from) their pick of the onslaught of fall HIT and/or healthcare conferences. I know most of you HIStalk fans aren’t pediatric-oriented per se, but I’m guessing that most of you were, at one point or another, children. I’m further guessing that many, if not all, of you appreciate a little humor amidst your techno-serious daily chores.

With these guesses in mind, I asked Mr. H to share the following two video clips with you. They were 100% donated to the 100% non-profit, educationally-focused “Pediatric Office of the Future” (POF) exhibit which I am honored to direct at the upcoming American Academy of Pediatrics-National Conference & Exhibition, Oct. 15-18th, in Boston. These very fun clips were created specifically for our brand new “Tech Talk Theater” by the very good and amazingly-talented folks at Nuesoft. These were all done in house with family and friends, but you’ll swear they hired out!

I can 99.9% guarantee these short “sizzle reels” will bring a smile to your day! (The 0.1% accounts for those incorrigible curmudgeons out there or those who watch just after walking out of a hospital finance meeting.)

Please disregard the blatant “self”-promotion for the greatly expanded POF with our new focus upon all 3 offices where docs work: outpatient, inpatient, and mobile. Disregard, too: our 500% growth; our 31 fantastic sponsors; our brand new “Hospital of the Future” booth; that we’re helping a local free clinic; that we’re giving away low cal ice cream; that we’ve got robots, telemedicine, patient engagement & education tools, cool hospital tech, diagnostic wizardry, etc.; or that we’ve got our new Tech Talk Theater running 28 little 15-minute talks throughout the show with a diversity of speakers on “news, views, & current events from the world of pediatric healthcare technology.”

Did I hear someone say “Emmy”? We’re Tweeting about it at @PedsOfficeFutur.

gregg alexander

E-mail Dr. Gregg.

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Currently there are "6 comments" on this Article:

  1. Tech Talk Theater had me laughing… especially the part where it claimed it would leave me breathless and the woman in the audience was pulling on the oxygen mask. Love it! (And I wish I could figure out how to make the noise the kid in the red shirt was making with that hand-slap deal on the “new kid in town” reel. If you can teach me, let me know.)

    Just goes to show that pediatricians do know how to have a good time, even when they’re not wearing bow-ties.


  2. You don’t need to feed the clearinghouses 5010 data for them to pass 5010s to payers in the overwhelming majority of cases. Yes, there are a few new data fields but many PMs already track this fairly normal data (it’s not like 5010s are asking for anything funny) and for most claims, it’s not necessary anyway (i.e., the data is hardwired).

    Otherwise, why would all the clearinghouses be bragging about upcoding the 4010s to 5010s for you?

    Let’s put it this way: there are clearinghouses still taking NSF formatted claims (when did that die? 8 years ago?) and some, still, taking PRINT files.

    I say that these $50-20K upgrade charges for small medical practices to be “5010 compliant” when they submit all their claims through, say, Emdeon, are outrageous.

  3. In regards to what Spell Chequer said about the “dumbing down of our language” due to “tweeters and texters”
    Is that really what is going on? It’s no surprise to anyone that our country is “dumbing down”… let’s face it… we’re lagging behind most industrialized countries regarding educating our youth. We’re no longer at the top of the list, but what does that have to do with our new language trend?
    Language has been evolving since we started to communicate verbally. If you read something our forefathers wrote you will notice immediately that our spelling of various words, their meaning and use have changed over the years.
    In the age of 140 characters or less, where time is of the essence and we’re communicating to a hoard of people through technology instead of face to face encounters, the necessity to shorten our words has been inevitable. It is just a new form of shorthand. Terms like: LOL, OMG, BRB have been around for over 15 years. Our technology has been increasing at an astronomical rate and with it our form of communication, need for new words (no one knew what a “tweet” was 10 years ago unless it was associated with a bird) and new acronyms. Particularly in Healthcare IT (HCIT) where acronyms abound.
    It isn’t that the changes in our language are an indication that we’re getting “dumber”, we’re just evolving. Obviously one has not much to do with the other. If a teen doesn’t know whether to use it’s or its… or whether vs. weather or accept vs. except, that is a failing of our educational system, but if we, as a society don’t keep up with technology and the changes in our mode of communication, that is a failing on a different level all together.

  4. Whatever happened to the policy of No Animated GIFs of your sponsors? It’s still a Vegas light show in the left side of my screen…

    [From Inga] We are hanging on to Vegas through the end of the year, giving our sponsors have plenty of time to create new ads. Many have already made the switched and we are receiving replacement ads weekly.

  5. Spell Chequer: Do you think the author realized that neither “dumbed” nor “cluelessly” are in Merriam-Webster’s Dictionary?

    Wait, does this observation make me uncool or cool?

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