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Monday Morning Update 2/20/12

February 18, 2012 News 9 Comments
From Just One CIO: “Re: ICD-10 delay. Is it just for physicians or for any covered entity (including hospitals, in other words?)” I assume for everybody, but the fact that you’re asking the question may mean that I’m missing some nuance of the announcement. Readers, feel free to chime in.

2-17-2012 7-47-48 PM

From Zac Jiwa: “Re: HIMSS presentations. Long-time listener, first-time caller. I always enjoy your cynical commentary. Just in case you want to meet at HIMSS, I’m closing keynote at the HIE Symposium on Monday and then on the HIMSS State Leaders Panel on Tuesday morning.” I told Zac I’d pitch his presentations a little even though he didn’t ask. I know presenters always worry about being short on audience members. Zac is CTO of Louisiana Department of Health and Hospitals. He’s got more recommendations and connections than just about anybody I’ve ever seen on LinkedIn, so I’m sure he’s good. If your schedule allows, swing by and tell him you saw his picture in HIStalk.  

2-18-2012 8-24-25 AM

From Monty Hall Watcher: “Re: Northside Hospital, Atlanta. Corporate suits are roaming the halls, suggesting an acquisition. My bets are either HCA or Ardent, but perhaps NGHS or Emory.”

2-17-2012 8-43-33 PM

From Deborah Kohn: “Re: ICD-10. I’m one of those scheduled to speak on ICD-10 at HIMSS! However, my topic is more about understanding the plethora of HIT tools that can used not only for the next round of compliance dates, but even if ICD-10 gets bumped off the US landscape. So I don’t bore the audience with OS upgrade analogies, I was going to promenade in and flaunt my cute shoes. Now I have to think about how to inspire a session room of one or two souls since Mr. HIStalk predicts it will be seriously empty.” I’ll try to help out by pitching the cute shoes, which always gets the attention of a loyal core of readers.

Listening: new from Heartless Bastards, female-led bluesy roots rock from Austin, TX that can sound like everything from The Pretenders to a restrained, better voiced, and sultrier Janis Joplin. It’s basically all about Erika Wennestrom, who sings, plays, and writes with aplomb. I mentioned them in August, but I feel justified in doing it again since I’ll predict that the new album will make them stars. They actually play real music. I’m with Dave Grohl – learn to play an instrument, sing from the heart, and forget the computers.

Inga, Dr. Jayne, and I will be posting daily from HIMSS, so this is my attempt to clear out my inbox before then. Expect lengthy posts, lots of pictures, and quite a few reader comments for most of next week as we try to grasp and convey the enormity that is the HIMSS conference. If you want to help, we can use more eyes and ears since we can’t be everywhere at once.

My timely Time Capsule editorial this week from five years ago: Despite Your Resolutions, I Know What You’ll Be Doing at HIMSS. Example: “Thrust your chest out proudly, knowing that booth people will pretend to be impressed with your title, your employer, and your town, even though they are silently sniggering at all three and looking over your shoulder for a better prospect or an incognito competitor who might hire them.”

2-17-2012 8-46-09 PM

We rolled over the 5 millionth HIStalk visitor Friday morning at 6:54 a.m. Eastern time, which Inga and I both happened to see live by pure coincidence. A reader on an iPad from Boise, ID put us over the hump. There were almost 100 readers on at that odd time of day, from places like New York City; Atlanta; Washington DC; England; Ottawa; Pittsburgh; Madison; and Kirchheim, Germany. Thanks for contributing to that number, which I still can’t quite comprehend given that my view HIStalk is just an ever-hungry blank screen in my computer / exercise room.

2-17-2012 8-06-13 PM

Thanks and welcome to CTG Health Solutions, a new HIStalk Platinum Sponsor. They’re one of the largest providers of healthcare IT support in the country, helping hospitals of all kinds as well as physician organizations. Their delivery model offers deliverables-based pricing with adherence to quality standards, using a combination of on-site and off-site consulting, replicable processes, 24×7 support from their National Solution Centers, and a readily available pool of skilled resources that can be brought in as needed to assure speed to value. They provide services such as implementation builds, integration, application management, report writing, and testing. The company is ISO 9001 certified and uses the ITIL Framework for its work with advanced technologies. If your needs involve ambulatory EMR work, CTG has helped over 2,000 practices make the transition, all the way from vendor selection to benefits realization. The list goes on: strategic and operations consulting, information security, accountable care management, and compliance solutions. Thanks to CTG Health Solutions for supporting HIStalk. Or, if you’re going to HIMSS, you can stop by Booth # 2070 and thank them in person.

2-17-2012 9-21-14 PM

Santa Rosa Consulting is supporting HIStalk as a Platinum Sponsor, which I appreciate. The company is led by Rich Helppie, former founder and CEO of Superior Consultant (sold to ACS in 2005) and Tom Watford, former CFO/COO of First Consulting Group (sold to CSC in 2007.) These guys obviously have a track record in running well-regarded healthcare consultancies and have used that reputation to assemble a team of industry heavyweights (example: EVP Doug Hires, who has 25 years of healthcare experience, just wrote a timely piece on how providers can use the ICD-10 delay to their advantage.) Santa Rosa Consulting offers advisory and consulting services as well as help with implementation and integration of vendor systems (Epic, Cerner, Siemens, Meditech, Lawson, Oracle, NextGen, etc.) Areas of specialization include point-of care technology and workflow, patient safety and quality, and staffing and recruiting. You can’t be a good consulting company without excelling at managing consultants and I was impressed with their Core Values list (“We have fun and we get our work done. Common sense beats bureaucracy.”) If you’ve been in the industry for awhile, drop by their HIMSS booth (MP27, MP37) and you’ll probably see some familiar faces. Thanks to Santa Rosa Consulting for supporting HIStalk.

2-17-2012 10-30-26 PM

One more sponsor announcement. Thanks to long-time HIStalk supporter iSirona for upgrading their sponsorship to the Platinum level. The company can integrate medical devices to any EMR (Epic, Allscripts, Meditech, etc.) with their DeviceConX software, with the capability to connect to devices like ventilators that are not network-enabled. Their AlertManager manages device alerts, routing clinically descriptive messages to any nurse call system, smart phone, or e-mail address. Recent big announcements include being selected by Children’s Omaha, passing all interoperability testing at the IHE Connectathon, appointing a chief nursing officer, and of course being named Best in KLAS for 2011 in medical device integration (I’m pretty sure they’re sitting on a big client announcement for HIMSS or shortly afterward because I know people who know people at the hospital in question, so I’m watching for that.) Thanks to Founder/CEO Dave Dyell, President/Chief Sales Officer Peter Witonsky, and the rest of the folks at iSirona for their loyal support of HIStalk over several years and now taking it to the next level. They’re in Booth # 12414 at HIMSS and a stop on the Booth Crawl, so say howdy.


Speaking of the Booth Crawl, here’s one last reminder to download and print your form before you head out (feel free to print extra copies to recruit more players in the exhibit hall.) You’re eligible to play if  you work for a provider organization (hospital, practice, clinic, etc.) or a not-for-profit (university, association, etc.) It’s grown into a pretty big deal – I just Googled it and hits are everywhere. And why not? Playing gives you a really good chance of winning one of 55 iPads that sponsors have graciously donated, just for swinging by some booths. Our sponsors are amazing – when Inga and I threw it together on a whim at the last minute, I was doubtful we’d get the minimum of six or eight companies needed to make it worth doing, but we had 55 who jumped all over it, overwhelming us a bit with their desire to put iPads into the hands of readers. Thanks for playing on behalf of the Booth Crawl sponsors — we’re rooting for you to be one of the 55 winners.

I don’t know why I haven’t done this already, other than I’ve had no time to think it through and it’s probably really expensive. I should rent a tiny booth way off in a corner somewhere at HIMSS next year, staff it with perky attendees, and have them hand out sponsor-provided freebies, Booth Crawl forms, and anything else that would be fun for reader-attendees. Maybe just stick a couch there have friends of HIStalk hang out just to say hello. People keep asking if I’ll have a booth at HIMSS and I always think, “For what purpose?” but maybe just for fun, although I bet the logistics are daunting and I doubt HIMSS would encourage me.

2-18-2012 8-44-00 AM

Oopsie: the HealthIT.gov folks might want to add HIMSS to the old spellchecker. Given no announcement on Meaningful Use Stage 2, I’m wondering if HHS will put out a press release Monday or Tuesday, then let Farzad Mostashari spell it out in his Thursday morning keynote? That’s strictly conjecture on my part, but I still get the feeling it’s imminent and ONC’s getting pretty good at public relations, so I have to think something will happen next week. I’m not a fan of the idea since everybody’s going to be too swamped at HIMSS to sequester themselves for in-depth analysis of complex Notice of Proposed Rulemaking documents. The week after would be much better for all involved if you ask me.

Kudos to HIMSS for calling out the feds for their bizarre decision to delay implementation of ICD-10. HIMSS rarely takes a stand on issues unless they threaten the bottom line of their Diamond Members (although some of those do offer ICD-10 services, I suppose) so this is a surprise. HIMSS says most of the industry is ready, and given the more than 1.5 years that remain until the original implementation date, there’s no reason to extend the date now (or for those reading between the HHS lines, just canning the ICD-10 idea entirely since they didn’t give a new date or explain why the delay needed to be implemented so early.) HIMSS says it’s going to be expensive for providers to maintain two systems and to bring the consultants back for a refresher round later, not to mention that ICD-10 is built into Meaningful Use and has the potential to improve care, payment, evidence-based medicine, and quality monitoring. I wouldn’t hold my breath that HHS will change its mind since they’re going to look stupid either way, so I think whatever hidden agenda made them extend it in the first place (campaign dollars and re-election support, I’d bet) will prevail over common sense.

In the meantime, the AMA is positively beaming over the decision, which came just four weeks after they wrote the Speaker of the House to get him to put the ICD-10 brakes on. They look forward to having a “productive dialogue,” obviously feeling empowered to influence federal policy directly. I do give them credit for using the word “hassles” in the announcement attributed to AMA President Peter Carmel, MD, who doesn’t look like the kind of guy who would actually say that. Medicine has been very good to him: he’s a pediatric neurosurgeon, his wife is a neuroradiologist, his son and daughter-in-law are doctors, and his other two kids run his asset management company.

2-17-2012 8-24-12 PM 2-17-2012 8-26-22 PM

Vitera Healthcare Solutions names Lara Stout as VP of professional services. She was previously with McKesson. The company also appoints Mark Janiszewski, also previously with McKesson, as SVP of product management.

GE Healthcare responds to a recent comment from MJOG regarding the retirement of Centricity Advance, in which he mentioned a price of $1,500 per month. I appreciate their taking time to clarify.

GE recognizes the inconvenience to these small practices that relied upon Advance, which is why GE guarantees a competitive price of $650 per provider per month for the first two years of the agreement. True, after that period, pricing is set at the discretion of the VARs but we’ve spoken with them all and have consensus that MJOG’s cited $1500 is remarkably high and well above what the going rate would settle at.

2-17-2012 8-33-04 PM

Former US CTO Aneesh Chopra rejoins his previous employer, The Advisory Board Company, as senior advisor for healthcare technology strategy. He will consult with member hospitals and contribute to the company’s strategic initiatives.

HCA will expand its use of technology from AirStrip and has taken a financial position in the company. Most HCA hospitals have been using AirStrip OB since 2007 and the hospital company will broaden its rollout of AirStrip CARDIOLOGY.

It’s a funny coincidence that we just mentioned some history of the HIMSS conference the other day (courtesy of History Buffy) and now Vince is taking a HIS-torical look back at the good old days when you could’ve fit the entire conference in a Starbucks. For some reason, I’m totally drawn to the beach photo even though I don’t know any of the people in it – something about the lighting or the composition is compelling.

The Allscripts earnings call transcript is here. They tout Sunrise’s ability to connect with affiliated physicians and its “open platform,” talk about the contract with SA Health in South Australia, and talk about EMR demand, which they say won’t peak any time soon (“we’re in the third inning”) but will shift to smaller practices.

2-17-2012 10-50-57 PM

Slightly more respondents think that big IT shops will improve patient outcomes of little hospitals they take over than believe they will make things worse. New poll to your right: was delaying ICD-10 a good thing or a bad thing overall? 

CSC, stung by huge financial losses and investor lawsuits from its participation in the UK’s failed NPfIT, will lay off up to 500 employees who are assigned to its NHS projects.

Dr. Jayne mentioned some of the good and bad pieces of HIMSS-related bulk mail she has received. I toss all of mine without opening, but Friday I got a giant cardboard tube that weighed nothing and had no return address, a sure sign of some kind of HIMSS promotion gone mad that I knew I’d want to criticize. After finally getting it open, inside was one skinny detailed-crammed poster from Lumeris, if I’m remembering correctly (obviously their attempt to make an impression failed). Mrs. HIStalk was appalled at the cost, the inconvenience to the post office, and having to stuff it in a trashcan. Here’s what I would do if I were HIMSS as an alternative to all the tree-slaying that happens every year (I’m stealing the idea from the cruise lines, which do something like this now):

  1. Automatically set up a Conference Personalizer membership-type site for every registered attendee, where you can log on with your conference confirmation number.
  2. Allow vendors to target their announcements and invitations to be sent to the individual member’s site. Like e-mail, the attendee can simply delete them to make them go away.
  3. Provide the capability for events to be accepted and turned into a printable / downloadable conference calendar, also RSVP’ing automatically to the sponsor of the events.
  4. Allow attendees to connect with each other to whatever degree they choose in a LinkedIn-type closed message model.

Sponsor Updates

  • First Databank will announce Monday the release a new alert management solution, FDB AlertSpace, that addresses alert fatigue. It allows users to customize CPOE alerts, the great majority of which are overridden during order entry, and to share common alert settings with other facilities. They will be demonstrating it at the HIMSS conference.
  • Healthcare Clinical Informatics is offering a free Webinar, Making Molehills out of Mountains: EMR Optimization and Clinical Adoption, on Wednesday, March 7.

2-18-2012 8-41-40 AM

Las Vegas weather: very pleasant and sunny all week after a slightly cooler Sunday and Monday, with highs in the 60s to low 70s, lows in the mid 40s. If you are headed out, safe travels. If not, we’ll tell you what’s happening there.

E-mail Mr. H.

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Currently there are "9 comments" on this Article:

  1. ONC and CMS could have easily met their dates to have MU Stage 2 out by now. If attendees had at least a week to digest MUs2, HIMSS would have been a great place for people to connect, ask knowledgable questions and interact with ONC in a meaningful way at their plethora of town hall meetings.

    Instead, only ONC knows what will be in MUs2 – they will have their talking points prepared. Of that you can be certain. Everyone else won’t have a clue what to even ask.

    ONC should be embarrassed – their lack of transparency and their desire to treat HIMSS as a press event show disrespect to the entire industry. As does CMS in announcing ICD10 without even so much as a plan. I do feel for the vendors and the attendees (yes many attendees were coming to HIMSS to better understand ICD10) who have invested millions in HIMSS this year to deal with it.

    What an embarrassing week for ONC, for CMS and for our industry. And for taxpayers, we should request a refund. HIMSS is a wildly expensive place to go just for an ONC press conference.

    When they get around to working on the budget, I seriously hope they cut ONC’s in a dramatic fashion. Let the stimulus money accrue to the hospitals and doctors for doing EHRs as intended and get rid of all the rest of this made up noise.

    Time to write your congressional representative!

  2. Dear “ONC Arrongance”
    Your outrage at ONC and CMS seems unfair. Why shouldn’t ONC and HHS use the HIMSS meeting for it’s press release? HIMSS is the legitimate marketing organization of our Health IT industry. We pay very good money in dues and exhibit costs. ONC and HHS are the designated marketing agents of HIMSS. We all seek the same thing: to stimulate and require purchase of our Heath IT products. That’s why our David Brailer set up the ONC (before returning to venture capitalism). Your attack on our industry and the regulations to require our products and services may undermine sales.

  3. Well then but, all this talk about ICD-10 delay has been very good for the doctors and users of the technological systems. My golly gosh, what is good for the vendors is not always good for the doctors and patients.

    And, well you know then but, what CMS does and what HHS does and what ONC does has been generally to help promotion of the devices from the HIMSS members; so maybe they know something importance which is why they halted ICD-10.

    And besides, you know then but, I do not fathom that people spend all that money to do HIMSS just to hear of the boredom of ICD-10. As Mr. Cabbage says above, HIMSS is a legitimate marketing group so most should come not for the ICD-10, but to learns of the wonderfully transformational HIT products coming doen the pike. Oh my golly goah, I can not wait. I will wink at you, Inga.

    ONC is doing the best it is capable of doing as is Sebelius and CMS Tavenner.

    I feels bad for Ms. Kohn who has studied ICD-10 tools to present; and now has maybe no audience. Howevers, but you know, she should still get audience by twittering that she will discuss the wild and crazy diagnoses availaable on the iCD-10 and for good measures, use that time to speak on the safety and benefits, if any, proven of these new HIT tools.

    Thank you for all you do, Jayne, Inga, and Mr. Histalk.

  4. I’m an unabashed, long time fan of my Associate Debby Kohn, great shoes or no. Not only a fabulous dresser, but a career long EHR champion and HIT expert, and superb speaker. A rare combination of straight shooter and class act.

  5. Of course ICD-10 delay applies to hospitals and physicians and all other providers… who diagnoses a patient in the hospital? A physician. No one is expecting a physician to use ICD-9 in their office and ICD-10 in the hospital, as if those lines are that distinct anymore these days.

  6. It never ceases to amaze me that key sections (HHS, CMS, ONC) of the US Government are partnering with an industry trade group, HIMSS. to promotes its devices.

    I agree with Babbage.

    This is like the US Government sending its leaders to speak on behalf of tobacco at the now defunct Tobacco Institute’s annual “scientific” sessions.

    Their remains a gap in what the HIMSS promotes for its vendors’ devices and what they actually do.

    I can not think of much that the US Government has ever done in which it gave $ billions from the taxpayers to an industry while ignoring the precepts and realities of safety, efficacy, and usability.

    How many sessions at HIMSS are there on the hours of down time, adverse events and deaths from its products? Just wondering.

  7. ICD-10…patient/healthcare friendly or just the new metric system?

    ANSI 5010 was more of a bang than a wimper for those of us in the trenches – and CFO/CEO/CIO’s who are responsible for the bottom line (dollar) of funding patient care are still feeling the reverb. Even though they don’t fully understand it.

    Does anyone think the industry can accomodate the massive changes needed for ICD-10 without an impact on patient care?

    Does anyone remember how the NPI was supposed to be the panacea of provider reimbursement simplification?


  8. Two points.

    1. Having been involved in MeDRA migrations and updates at a major pharma, and seeing the levels of computational linguistics/ontological expertise required (e.g, PhD level), and that evne the highest-caliber personnel with that expertise found the process exceedingly difficult, … hospitals stand a snowball’s chance in hell of getting the ICD-10 migration right in any reasonable timeframe.

    2. I wonder if HIMSS is sponsoring any talks on the meaning of health IT certification regarding health IT safety, efficacy, indemnification from liability, etc. I recently wrote this on that issue:

    Hospitals and Doctors Use Health IT at Their Own Risk – Even if “Certified”

    I think users, especially users coerced into 2012-style HIT usage by their hospitals, need to be aware of this.

    — SS

  9. #7 ToxicShock

    Which field is less evidence-based?

    1) Medicine
    2) Health IT

    I find it ironic that those in a non-evidence-oriented field such as health IT tell medical professionals these tools will help the latter practice evidence-based medicine.

    We need evidence-based computing as an antecedent to EBM.

    — SS

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