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Monday Morning Update 2/27/12

February 26, 2012 News 8 Comments
From MyEthicsKeepMePoor: “Re: HIMSS. How do you feel about folks interviewing with other companies at HIMSS while being paid for the trip by their current employer? Isn’t the hiring manager going to wonder about their ethics?” I don’t have a problem with that. The only cost to the current employer is the hour of time required, and I’d guess that most employees put in plenty of time. A lot of what happens at HIMSS is of questionable employer value if you try to account for every minute of time, but in the big picture, it’s worth it to most who attend, I assume. I would guess that quite a few folks make connections at HIMSS that result in an employer change and most conferences (including HIMSS) run a job fair for that purpose.

From Happy CEO: “Re: HIMSS. We had an incredible conference. Some of the really big names we met with said they knew what we have is special because they read about it on HIStalk. They said you are the most credible site in the industry and wonder how you can keep on top of what is here and what is coming. I’m proud of what my staff has accomplished, but I am conscious of how much your support is helping us. You are making a material difference.” I really appreciate that. I’ve enjoyed following the companies that I’ve profiled in my Innovator Showcase and your comment has inspired me to gear it up again. It’s unbiased since my impartial screening panel decides which companies are truly innovative, I interview a customer, and nobody gets paid anything. After the exposure, it’s up to the company to deliver, and this one obvious is doing so.

2-26-2012 3-21-21 PM

From Wade Wells: “Re: HIStalkapalooza. I was unable to attend due to a rollout, but I scored an invite for my CIO. Thanks a million! He had a ball and texted me to let me know how it was going. Wish I could have done the Booth Crawl as I would have loved to have checked out some of the sponsors’ products, but I did give a shopping list to the CIO. Thanks for giving me a glimpse of what I missed! Down Under is such a long way from Vegas.” Wade is from Australia.

From Sagacity: “Re: CMS Meaningful Use Stage 2 NPRM. Here’s a bookmarked version.”

2-26-2012 12-47-17 PM

From Frank Poggio: “Re: ONC Stage 2 fact sheet. Buried at the bottom is a real zinger. I may be wrong, but do they really want vendors to publish their prices? Wonder what kind of comments they’ll get from the big box boys?” Wow, that’s a surprise. An even bigger surprise would be if it actually becomes a requirement, especially since it seems unnecessary – a prospect should be able to get a price by simply asking the vendor (or if not, to move on quickly.)

From Lion Queen: “Re: HIMSS. What was the overriding impression this year?” I’ll invite readers to provide their conclusions since I’m not sure I have one. Mobile was a big deal, or at least HIMSS made it seem that way now that it has bought the mHealth Summit. Tools to support “bring your own device” policies were out in full force. Analytics had a presence, although maybe not as much as expected. HIE platforms are bigger than ever now that RHIOs are fading as private HIEs are growing. I didn’t feel much buzz at all from traditional inpatient systems. Defense contractors like Lockheed Martin had big booths, but I don’t take that to mean much. Conference attendance was announced as 37,032, 18% higher than last year.

2-26-2012 9-23-29 AM

Inga has posted new reader-sent HIStalkapalooza photos on our Facebook. I’ve watched the video ESD put together (great music, by the way) about 20 times and I’m in awe after noticing all kinds of details that I missed at the time: long-stem roses for the ladies, the cool tent cards on the tables, the A/V setup that allowed streaming the HISsies and logos of HIStalk’s sponsors throughout the venue, and of course great food and drink. Ross Martin MD was shockingly good as the white jumpsuited Elvis, who even penned a special tune (HIStalk Rock) for the occasion, sung to the tune of Jailhouse Rock. A sample:

Mr. Greg Wilson’s here to host the show,
Little Johnny Bush knows where the HISsies go,
We’ll have a fashion show and name the King and Queen,
You can wow the judges if you make a scene,
So let’s rock,
Everybody let’s rock,
Everybody here who loves HIStalk,
Start dancin’ to the HIStalk Rock.

Listening: Nick 13, shuffly old-school country swingabilly or something like that (I just made that up.) I’m not a country fan, but this is good, melodic, and sparsely produced. Their song In the Orchard 2011 is perfect. Live video here.

2-26-2012 1-34-02 PM

Now that HIMSS is over, it’s time for my annual reader survey. It would help me a great deal if you could spare a handful of minutes to answer the 14 questions. Just about every improvement I’ve made to HIStalk over the years has started off as a reader’s recommendation in the survey. Thanks for helping out.

2-26-2012 1-27-17 PM

Over 60% of respondents think that it was a mistake for HHS to delay its ICD-10 implementation date. New poll to your right: grade ONC’s performance with regard to Meaningful Use Stage 2.

Here’s the latest HIS-tory from Vince, covering the 1980s bedside device maker CliniCom.

A surgeon in India conducts a hip replacement procedure using an iPad to calculate and verify the position of the acetabular cup introducer, hoping to achieve a more accurate placement that can increase the useful life of the procedure by 100%.

Swisslog announces the first sale of its MedRover mobile medication dispensing cabinet.

I don’t think I’ve heard of Health IT Now!, a coalition advocating rapid adoption of patient-beneficial healthcare IT that counts among its members Aetna, Intel, Nortel, and quite a few other large corporations and member organizations. The organization issues a press release saying the proposed Meaningful Use Stage 2 doesn’t go far enough, unacceptably allows a delay in its implementation by an extra year, and doesn’t require referrals have to support electronic information exchange for two years.

This week’s Kaiser Permanente employee e-mail from Chairman and CEO George Halvorson was all about technology and mostly about HIMSS. He mentions that KP’s new smart phone app for patients got a million hits in its first month. He also mentions KP’s IT successes as announced at the HIMSS conference: 36 of the 66 EMRAM Stage 7 hospitals are Kaiser’s and KP won the organizational Davies (he says it’s like an HIT Oscar, except “bigger and shinier.”) Apparently KP’s HISsies win as the “Best Provider Use of Healthcare IT” was not sufficiently impressive to deserve a mention.

MedAssets announces Q4 numbers: revenue up 47%, EPS $0.07 vs. –$0.87. Non-GAAP EPS was $0.32 vs. $0.18. Shares were up 4% Friday on the news.

A reader passes along that if you’re interested in the Healthcare Experience Design conference in Boston March 25-27, you can save $100 on registration with promo code FRIEND. Jonathan Bush (athenahealth) and Todd Park (HHS) will be reunited as keynote speakers.

2-26-2012 3-24-22 PM

User-centered design consulting firm PointClear announces plans to open an office in the Atlanta area. The Huntsville, AL firm has 40 employees and expects to add at least 10 in Atlanta.

Odd: two prominent Montreal cardiologists are accused of taking bribes from patients in return for putting them at the front of the line for nationally funded healthcare services. A newspaper article claims that patients put $100 bills under their hospital pillows before being taken to the OR and others made off-the-books office payments of up to $10,000 in addition to what insurance would pay.

The Health IT Accelerator is launched in Cleveland, OH by BioEnterprise, founded by Cleveland Clinic, Case Western Reserve, and other local institutions. Company submissions are being accepted.

A guest article in London’s Daily Mail compares the author’s first-hand experience with Britain’s NHS and a stay at Cedars-Sinai. Conclusion: Cedars had a lot of computer gadgets (“computers on trolleys follow the nurses around like small dogs”) but waits were long, nurses were cold (“as if the price tag attached to medicine has desensitized them”) , and the costs were high. Advantage: NHS.

An employee of North Dakota’s worker compensation program says a claims supervisor violated state law when she ordered parts of a case manager’s patient notes deleted, removing information that would have supported the patient’s claim.

A Washington Post article finds that Medicare’s $77 million anti-fraud computer system, launched last summer and built by Northrop Grumman, prevented only one fraudulent payment by Christmas, saving taxpayers a grand total of $7,591. Medicare says looking at payment suspensions in a vacuum is an “unsophisticated view” of its activities and the actual benefits of the system exceed $20 million even though it can’t measure the actual recovery total. Sen. Tom Carper (D-DE) said, “I wondered, did they leave out some zeroes? … My point is there was off-the-shelf stuff they could have bought and applied … we ought to be seeing savings of $5 billion a month.”

E-mail Mr. H.

Additional Booth Crawl Winners

HIStalk’s sponsors are the best. After I named the Booth Crawl winners, several companies got in touch and said, “We would really like to give an iPad to some of your readers. Can we do a draw of those who didn’t get all the answers right?” Congratulations to these additional iPad winners, courtesy of the sponsors who appreciate your imperfect but honest effort.

2-26-2012 8-51-26 AM

John Harte, Server and Development Manager
Self Regional Healthcare
Prize provided by The Advisory Board Company

2-26-2012 8-52-20 AM

Jason Blunk, Project Manager
Reid Hospital & Health Care Services
Prize provided by MedPlus, A Quest Diagnostics Company

2-26-2012 8-53-29 AM

Justin Graham, CMIO
NorthBay Healthcare
Prize provided by Medicomp Systems

2-26-2012 8-55-07 AM

Mark Schmidt, CIO
SISU Medical Systems
Prize provided by Sunquest

2-26-2012 8-56-18 AM

Kathy Wheatley, Clinical Solutions Director
HCA Healthcare
Prize provided by T-System

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Currently there are "8 comments" on this Article:

  1. HIEs were a bit overdone. What was more dramatic was the amount of sr. leadership there from payers especially UHG (head of Optum and a few sr. people from UHG insurance side) and Aetna. Funny to hear Bertolini describe Aetna as a technology company in his keynote when on the last 2 quarterly calls when sr. leadership at Aetna has said the exact opposite. Different strokes for different folks (crowds). Even some of the payer-oriented sessions were quite crowded with a large turnout of sr. leadership (VP and above) from varied payers. Surprised me.

    Ditto too with expanded telecom presence led by AT&T and Verizon who are both intent in really making legit inroads into this space in several capacities beyond their traditional offerings.

    As for analytics with the exception of particular predictive analytic methodologies proprietary to healthcare and some of the clinical surveillance stuff inside the hospital, everyone seems to be turning to the BI vendors for to utilize their traditional experience on BI-related issues (e.g., ETL, etc). The big acute EMR vendors have pretty much given up in the interim realizing this isn’t a core competency. They are all turning to BI vendors including Epic/Cerner/Siemens going with SAP Business Objects as their OEM partner. Some exceptions but partnering with BI vendors to power their solutions is going to be the way EMR/HIE vendors go for at least the next 3 years and probably 5 years.

    Did see a few really cool data visualization tools though. Seems like everyone is looking for good 3rd party graphic designers or solutions who can make data more visually appealing in their application beyond the basic set of charts/graphs in Excel. Hard commodity to come by right now with the tech boom and developers coming at a high price tag.

    Single most overhyped thing was the application stores that various vendors are trying to push out. Several vendors made key announcements around this at the conference. So vendors have a platform that developers and their clients can theoretically develop on because they released SDKs? Big deal.

    Maybe I am wrong and hospital IT depts create a critical mass of cool custom apps and they do get enough developers to actually develop stuff on it but that hasn’t been the case with a single vendor yet that has had an app store. Everybody seems to have Apple fever.

    The other overhyped trend is the patient as consumer. It felt like I was at a HSA presentation circa 2004 or 2005. Exact same problems that plagued HSAs then after the passage of MMA in 2003 plague them today almost a decade later. It applies to a segment of the insurance market for individuals who typically have at least a college education, at least a middle class income that is above say 50k or 60k a year, and don’t have multiple commodities. That leaves out whole and large segments of people who use the healthcare system.

    There are some really cool trends around finance going on including bundling that are going to wallop hospitals hard that are caught sleeping over the next 2-3 years but generally what I have seen is that employers are just fed up with cost increases. With a foreseeable weak labor market and almost no union membership in the private sector, private sector employees are just going to have to grin and bare the 50%+ cost pass-throughs their employers have subjected them the past 3 years for the next several.

  2. Well then but, the genomics revolution was big at the HIMSS, my golly gosh. This guy Topol was pushing this and other well then how do you say, gizmos.

    Well, you know then but, very very little bits on safety that leaved me disappointed.

    And my golly gosh, you write about the woman from UK who found little attentions in her care at Cedars Sinai with all of its computers EHRs and CPOEs taking up all of the nurses’ times.

    Well you know then but, I thought Cedars had deinstallationed their CPOE years ago. My golly gosh, it must have made mistake to reinstall according to this patient who suffered from neglects by the nurses who liked working with computers pupy dog more than with patient.

    Well then but, I always wishes to thank you for coverage of HIMSS. But how educational was it really??

  3. The Epic article is from 2008. Their numbers are much larger now.

    [From Mr. H] Thanks for catching that date! Somehow the article popped up as a news alert in my inbox. I’ve removed the reference. Too bad they can’t get a current version of it because it was pretty interesting.

  4. I love seeing all those smiling faces from HIMSS, but,
    an HIT Acclerator in Cleveland? Hmmm.

    Considering the absence of any data showing improved overall outcomes or costs from EHRs and CPOE, it seems to me they need an air brake and red flashing warning lights.

    BTW, do patients’ physiology and natural history of disease accelerate when care is directed by EMRs, CPOEs, and CDSs?

  5. As I was leaving one of the Stage 2 presentations, I had a hallway conversation with a CIO. She will certify for Stage 1 incentive payments next year when her budget allows her to buy 2 modules that she has no need for and will never use. Because the system was certified as a “Complete EHR”, she must buy all the modules that were certified together in order to qualify for MU.
    Additionally, she may have to discontinue use of a specialty system that provides better efficiency and patient support until MU requirements become friendly to best-of-breed systems. Stage 2 exclusions still don’t cover the case where you need a core system to cover things like CPOE and meds administration, but want the benefits of a specialty system to handle certain departments. Having to buy the Complete EHR is an unneeded cost.

  6. Re: Frank Poggio’s comment on “Comment is sought on the concept of price transparency related to the price associated with a certified Complete EHR or certified EHR Module. We request feedback from the public on whether we should require EHR technology developers to disclose the full cost of a certified Complete EHR or certified EHR Module.”

    He’s right, sort of. At this point, it looks like they’re just seeking feedback.

  7. RustBelt –
    Can’t wait to read the ‘feedback’…
    In my 35 plus yrs in this healthcare world one thing I learned is: On Monday the feds ask you to publish your prices, on Tuesday they tell you what your prices s/b!

  8. To MyEthicsKeepMePoor with respect of employee morals with respect to traveling on the employers dime and seeking employment elsewhere;

    The bottom line is that you must network wherever and whenever you can. For IT people that work countless hours both on-call and off, carry pagers and smartphones to be ready 24×7, the line between what time is an employers time and what belongs to the employee is fuzzy at best. If you’re in hospital IT I’ll wager you a dollar that if you were to count up your salary and divide it by the hours you ACTUALLY work, you’re roughly at fast-food levels.

    If one feels they are not fairly compensated or are working in a job that for whatever reasons both personal and professional are not a good fit, be thankful the person chooses to leave and try to be happy. I applaud the actions of anyone in this job climate who are actually trying to better their position.

    I’ll bottom line it for you. It’s Corporate HR and their Excel tables vs. The Little Guy. Anyone who believes in deep corporate loyalty either owns the company, has a controlling stock share or is, unfortunately, deluded. God help them.

    It reminds me of an old African saying:

    “Every morning in Africa, a gazelle wakes up. It knows it must run faster than the fastest lion or it will be killed. Every morning a lion wakes up. It knows it must outrun the slowest gazelle or it will starve to death. It doesn’t matter whether you are a lion or a gazelle. When the sun comes up, you better start running.”

    HIMSS is big and lots of running is involved there.

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