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April 24, 2012 News 10 Comments

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4-24-2012 6-30-08 PM

Cerner breaks ground on its $160 million Kansas City, KS campus, which will eventually house 4,000 employees. The first tower is projected to open mid-year 2013 and will serve 1,000 employees, including about 800 new hires.

Reader Comments

From THB: “Re: Accretive Health. Wanted to hire me with this exact thing under the guise of implementing an ACO-type process (do you want us to put the kidney stones back in?)” The State of Minnesota goes after Accretive Health for its actions on behalf of its hospital customers, including placing its employees in the ED to demand payment before services are rendered and for using information in hospital charts to try to collect overdue bills. I’m uncomfortable with the tone of the entire article, which seems to suggest that (a) hospitals should be passive in their efforts to convince patients to pay for services rendered, asking them nicely and infrequently if they wouldn’t mind setting their debts at some point if it’s not too much trouble; (b) it’s unethical to ask ED patients to make payments for previous visits before seeing them again, when in fact many of those patients show up for non-emergent conditions anyway and treat it more like a physician office visit; and (c) hospitals are being shady when they allow Accretive employees to work in its departments, even though full hospital departments like dietary and housekeeping are outsourced all the time.

Why isn’t the state upset about a national healthcare system based on ridiculously inflated charges that are favorably discounted to big insurance companies but not to patients without insurance, or with patients who incur healthcare services with no intention to pay for them even when they are financially able to do so? Hospitals and Accretive are doing exactly what you would expect given the goofy rules of the game – hospitals are often huge and hugely profitable non-profits (intentional oxymoron) with multi-million dollar executives who are wired to maximize the bottom line. The system was changed years ago to eliminate the charity and tax-supported models and instead requires hospitals to be run like a business. The shades of gray about which services are mandatory, who can and can’t afford to pay, and how aggressive the bill collectors are allowed to be just detracts from the central issue – hospitals are doing nothing illegal, just selectively distasteful to those who think healthcare isn’t a business when it clearly and intentionally is, rightly or wrongly.

4-24-2012 7-50-39 PM

From Banishing Bob: “Re: North Carolina hospitals. Subject of a scathing investigative series by the Raleigh newspaper.” The five part-series, called “Prognosis: Profits — Hospitals Prosper at Patient’s Expense” is an extension of the argument above – behavior that’s unsavory, but legal and, according to the hospitals named, necessary. North Carolina’s non-profit hospitals – which pay no income, property, or sales taxes — are banking annual profits of up to $500 million, erecting massively expensive Taj Mahospitals, paying their executives handsomely (25 in the state make over $1 million), strong-arming patients who can’t or won’t pay their bills, and sitting on multi-billion dollar reserves in a couple of cases. All in the name of sustainability and giving the locals the care they deserve, the executives say. Most of the 25 non-profit hospital executives in the million dollar club work for Novant or Carolinas HealthCare. Carolinas HealthCare paid its CEO $4.2 million, the COO $2.5 million, the CFO $1.8 million, and has EVPs making nearly $2 million. Novant’s chief clinical, medical, and administrative officers each made over $1.5 million and its general counsel was paid $1.2 million. On the IT side, Novant paid its CMIO $801K and its CIO $770K. I don’t know about Carolinas HealthCare since their federal 990 form isn’t readily available for whatever reason (I assume because they’d rather it not be). Excessive? You decide.

From Oblate Spheroid: “Re: Bill O’Connor. Gone from Zynx. What’s going on there?” Unverified. Bill’s LinkedIn profile says he’s still there. He is (or was, depending) the SVP of marketing, joining the company nine months ago.

4-24-2012 8-19-08 PM

From Beeper King: “Re: beepers. Because there is no guarantee of message delivery with cellular communications, pagers will be with us for a long time to come. How often have you received a cellular text message a day late? The cellular community will need to be pressured to make this change. However, given the small portion of their market that healthcare segment makes up, this probably isn’t likely to happen soon.” The beeper discussion is fascinating. Somehow every other industry makes do without beepers for their critical, real-time communications. The only time I felt secure in knowing whether my message was received (and opened) was in the old days of the two-way RIM pager, precursor to the BlackBerry. Even now, there’s no perfect system – secure, cheap, usable in all geographic areas, and with verifiable delivery.

From Suggestion Box: “Re: interviews. You should interview health system CEOs about IT-related topics such as Meaningful Use and ACOs.” I really like that idea. If anyone can hook me up, I’m happy to do it. I’ve tried George Halvorson of Kaiser a couple of times with no luck, but just about any big-hospital CEO would be fun.

From The PACS Designer: “Re: cloud collaboration. An application that has been adopted for collaboration by over 120,000 businesses is Box. Box offers secure, scalable content-sharing that both users and IT love. The app pioneers a new level of content management security, with role-based access controls, 99.9% uptime guarantee, and data encryption using 256-bit SSL." A one-user, 5 GB personal account is free, although so is the long-delayed, just-announced Google Drive.

From Frank Poggio: “Re: Medicare payments. CMS proposes a payment update for acute-care hospitals that it projects will increase operating payments by about 0.9% in 2013. Well, let’s see — that would mean if you did not meet Stage 1 MU, that would be a penalty of 0.3%. In a 250-bed facility, that would be maybe a $100k loss. Is it worth slamming in an EMR? I doubt it. Oh, by the way the docs got 0%, so one-third of zero equals zero penalty.”

4-24-2012 6-50-38 PM

From Daniel Barchi: “Re: Yale New Haven Health System. Greenwich Hospital went live big bang on Epic for all financial and clinical applications this past Saturday. Greenwich is the first of the three hospitals to go-live and it joins 36 physician practices from Yale Medical Group, Northeast Medical Group, and private community physicians who have been live on Epic since October. I could not be more proud of our local Epic team and the staff and leadership of Greenwich Hospital. We have also been really well supported by a talented team from Epic. I have been through many go-lives and the preparation and hard work of all of these teams made this about as smooth as a hospital go-live can go. The attached picture shows Greenwich Hospital President and CEO Frank Corvino throwing the switch at a go-live ceremony the first day.” Thanks for the report. Daniel is CIO of the Yale health system and the medical school.

HIStalk Announcements and Requests

4-24-2012 6-55-05 PM

Welcome to new HIStalk and HIStalk Practice Platinum Sponsor simplifyMD. The Atlanta-based company offers The Digital Chart Room, which includes medical-grade document management, auto-indexing of scanned documents, a template generator, the Productivity Pilot task organizer, and a personal health record. It eliminates the limitations of paper-based charts (one-person access, lost files, high labor costs), avoids the risks of EMR implementation (physician workflow interruption, expense, lack of ROI), and allows practices to increase their volume to offset higher costs and reduced payment. The company’s talking points are fast and friendly customer support, affordability, easy implementation, and elimination of customer exposure to technical obsolescence. Customers choose between a fully hosted cloud-based solution or a local cloud (a local server that allows uninterrupted operation if Internet access is lost, but with access from anywhere). It’s one monthly price ($395) for everything and the customer can just stop using it with no additional charges if they find that it doesn’t pay for itself. Check out their ROI calculator here. Thanks to simplifyMD for supporting HIStalk and HIStalk Practice.

Acquisitions, Funding, Business, and Stock

4-24-2012 6-15-50 PM

Streamline Health reports Q4 results: revenue $4.5 million vs. $4.9 million, EPS $0.00 vs. -$0.19.

4-24-2012 6-16-33 PM

Standard Register announces Q1 revenue of $157.6 million, which includes $57 million from its iMedConsent (dba Dialog Medical) division and other HIT solutions. The company notes that sales of clinical documents and administrative forms fell 12% from the previous year due to customers implementing EMRs.

4-24-2012 6-17-21 PM

Healthways acquires Ascentia Health Care Solutions, a provider of population health management technology to support physician-directed population health initiatives.

4-24-2012 6-18-03 PM

HealthStream announces Q1 numbers: revenue up 28%, EPS $0.05 vs. $0.07, beating revenue estimates but missing consensus earnings estimates of $0.06. Shares made Nasdaq’s biggest percentage losers list for the day, down 10%.

4-24-2012 6-41-41 PM

Apple beats all Q2 expectations with revenue up 59% and EPS $12.30 vs. $6.40. The company sold 35 million iPhones that accounted for 58% of its revenue. It sold 11.8 million iPads, more than double the year-ago number even though the newest model was available for only the last month of the quarter. Mac sales were up 7% to four million, while iPod sold 15% less than the year-ago figure.


DR Systems announces seven new PACS contracts totaling more than $3.7 million.

The 90-physician Allied Pediatrics (NY) selects Isabel Healthcare’s diagnosis decision support technology, which will be integrated with Allied’s GE Centricity EMR.

The VA extends its contract with Authentidate for home telehealth devices and services for at least one more year with three one-year extension options. 

4-24-2012 6-43-09 PM

Indian River Medical Center (FL) selects RelayHealth to provide HIE and PRN technologies.

The Saskatchewan Surgical Initiative announces that it will expand the implementation of Surgical Information System technologies into new hospitals.

4-24-2012 6-44-35 PM

Duke University Health System will implement iSirona’s device connectivity solution.

Cuyuna Regional Medical Center (MN) chooses PatientKeeper’s clinical applications to create a virtual EMR from the hospital’s Meditech inpatient and Allscripts outpatient systems.


4-24-2012 6-27-11 PM

Poudre Valley Medical Group CEO Russell Branzell joins GetWellNetwork’s board of directors. He was formerly CIO of Poudre Valley Health Systems and the president and CEO of that organization’s for-profit IT company.

4-24-2012 6-27-54 PM

Communications consulting firm WCG hires Rob Cronin, the former head of corporate communications for SureScripts, as practice leader of healthcare technology and transformation.

4-24-2012 8-30-48 PM

AMIA President and CEO Kevin Fickenscher MD is named chairman of the newly created healthcare advisory board of Intelligent InSites.

4-24-2012 8-25-50 PM

Lt. Col. Danny J. Morton (on the right above) is named as the Army’s MC4 battlefield EMR product manager, replacing Lt. Col. William E. Geesey in a ceremony at Fort Detrick, MD.

Announcements and Implementations

Open source provider Medsphere Systems joins the Open Source Electronic Health Record Agent community, which focuses on establishing a code repository for the VA’s VistA EHR.

4-24-2012 9-37-52 PM

Mount Sinai Medical Center (NY) implements Perminova EP to manage the scheduling, workflow, documentation, and billing processes for cardiac electrophysiology procedures.

Phreesia adds an electronic version of the M-CHAT autism screening tool for toddlers to its patient check-in system.

The Health Information Trust Alliance (HITRUST) establishes the Cybersecurity Incident Response and Coordination Center to provide alerts and information-sharing related to healthcare cybersecurity threats.

EHR Doctors announces that its CCD Generator is being used by Ministry Health Care to create an ONC-ATCB certified Continuity of Care Document from its multiple EHR systems.

TigerText announces a new version of its secure text messaging application, with University of Louisville as its first higher education customer.

In Canada, doctors at Ottawa’s Queensway Carleton Hospital say they like what they’re seeing in the pilot project for a discharge information system developed by TELUS Health. PCPs automatically get electronic copies of the records of their patients who are seen in the hospital’s ED, replacing the paper records that took two weeks to deliver.


inga_small I don’t watch much TV (American Idol excluded) but I was glad to see that Epic employee Rachel Brown is still a contender in The Amazing Race. Rachel and her Army helicopter husband Dave are one of four remaining couples in the running to win a $1 million grand prize. If the Browns win, I am sure that Judy will be happy to offer investment advice.

A KLAS report says almost half of inpatient providers plan to purchase a computer-assisted coding solution within the next two years, according to KLAS, mostly because of ICD-10. The most recognized vendors are 3M, OptumInsight, and Dolbey.

4-24-2012 8-05-20 PM

Epic beats IBM in the StarCraft II Championship, earning $5,000 for its charity of choice, Doctors Without Borders. The motto of the 12-0 team, captained by JDUB, is “Need Medical Attention?”

A New Zealand doctor is reprimanded for failing to tell a patient about an abnormal blood test result. The doctor said he hit the wrong key on the keyboard, but a public health commission said he should have used other software to remind him about the result.

Sponsor Updates

4-24-2012 7-57-37 PM

  • GetWellNetwork customer Celebration Health and its CEO, Monica Reed MD, will host all 350+ attendees on its campus to kick off GetWellNetwork’s user group meeting in Orlando next week.
  • CynergisTek partners with the law firm of Davis Wright Tremaine to create the HIPAA Audit Readiness and Response Solution Portfolio for OCR audit compliance.
  • NextGate announces the release of MatchMetrix v8 and NextGate Registries for Healthcare for accurate identity matching and health information exchange.
  • Cuyuna Regional Medical Center (MN) selects PatientKeeper technology to aggregate data from the MEDITECH system used by the hospital and the  ambulatory care offices’ Allscripts system.
  • Meritas Health Corporation (MO) selects eClinicalWorks EMR for its 72 employed physicians.
  • Lakeside Orthopedics (NE) chooses the SRS EHR for its five physicians.
  • eClinicalWorks opens a Chicago office to provide a central US presence. The city will host eCW’s user group meeting April 28-29.


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

More news: HIStalk Practice, HIStalk Mobile.

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Currently there are "10 comments" on this Article:

  1. You do know that the Accretive thing was supposed to have been triggered by an associate having a laptop with PHI on it stolen from a rental car – right?

  2. Accretive Health employees (or at least one employee) were also responsible for HIPAA violations involving data for thousands of patients at several of their hospital clients in Minnesota. While some of what you say is probably true, I don’t get the feeling that the interactions between these hospitals and Accretive were all completely on the up and up.

  3. Not sure why Epic’s video game team merits a mention here, aside from the comedy of looking at that team picture. Also not interested in the Yale CIO tooting his own horn about his go-live. Might be more interesting to get Yale’s CFO to do an interview about the cost and financial impact of the EMR on hospital operations. Rather than hospital CEOs, I’d rather hear from CFOs in general about what they think of the financial impact of their EMRs.

  4. The New & Observer article, ran in both the Charlotte and Raleigh market.

    As a CIO at a not-for profit health system and having worked on the publicly traded vendor side. I know that the waste in healthcare does not lie on the provider side.

  5. I would just say that there’s enough blame to go around when it comes to waste in the healthcare system. To say it’s not on the provider side is just ludicrous. The margins that some non-profits are making are really high. It’s everywhere, but no one wants to claim their part.

  6. “Why isn’t [everyone] upset about a national healthcare system based on ridiculously inflated charges that are favorably discounted to big insurance companies but not to patients without insurance, or with patients who incur healthcare services with no intention to pay for them even when they are financially able to do so?”

    Best quote I’ve seen in writing in a long time. I shake my head every time I see a gross charge say an office visit at $185 discounted to $35 and paid at $25 I wonder how a provider could survive on that, and then immediately think of the poor individual with no insurance that has to pay the $185 in full. Isn’t it ironic…

  7. When you interview a hospital system CEO please ask about the indecency of charging more to uninsured patients.

  8. Meaningful use penalties for physicians are absolute reductions in Medicare reimbursements, not fractions of rate increases like they are for hospitals.

  9. HIS Consultant is right…my mistake. But consider this…for over four years ProPAC has recommended cuts of up to 30% for docs, but each time congress has delayed it, allowing zero change. So I do not think ONC will be able to get a 1% reduct in fees, in fact there are several ‘hardship’ exemptions written into the regs.

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