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September 4, 2012 News 9 Comments

Top News

9-4-2012 8-42-16 PM

HL7 will make its standards and other intellectual property available to all healthcare stakeholders at no charge by the first quarter of 2013. The company says it hopes to increase private and governmental use by eliminating licensing fees, thereby improving care and reducing costs.

Reader Comments

9-4-2012 8-46-11 PM

From Mandrake: “Re: NuPhysicia. I’m looking for information from healthcare systems that have worked with them, but I’m not having any success and I see they haven’t been mentioned on HIStalk even though they’ve been around for several years.” I couldn’t find anything either, but I snooped around and found that the company – which has offices in Houston, Brazil, and Malaysia – shares its Houston address with medical staffing company eCareGroup and is apparently the same operation even though they never actually say so (NuPhysicia also offers telemedicine services under the name InPlace Medical Solutions). NuPhysicia is selling a commercialized version of telemedicine software developed at UTMB, best known for its use in prisons, but also used in retail clinics and on oil drilling rigs.

HIStalk Announcements and Requests

9-4-2012 5-42-54 PM

Welcome to new HIStalk Platinum Sponsor Vonlay. Given their location in the epicenter of Madison, WI, you might cleverly guess that Vonlay is an Epic consulting firm and a successful one at that, with 30 clients in more than 20 states. It deploys some of the industry’s best EHR consultants individually or on teams, working at your site when you need them there or via Vonlay’s Remote Services program, which offers big savings to its customers. If your Epic go-live is impending or completed, Vonlay’s remote experts can help work down your open tickets, pitch in on applying upgrades and SUs, and help you phase out more expensive on-site consulting services. The company also provides application mentorship and management-level strategy consulting on how to design, build, and roll out EHR projects, including technical assistance with system builds, Cache programming, interfaces, Web services, and portals. You’ll be in their neighborhood if you’re going to next week’s Epic UGM, so keep an eye out for their folks. Thanks to Vonlay for supporting HIStalk.

Here’s a fun Vonlay video I found, Attack of the Issues List.

Acquisitions, Funding, Business, and Stock

9-4-2012 8-47-18 PM

Net Health Systems, which offers an EHR for wound care, acquires competitor Wound Care Strategies.

Data analytics startup Predilytics raises $6 million in its first round of VC funding.


Geisinger Health System (PA) selects TeleTracking’s RTLS technology to track mobile medical equipment at two of its six hospitals.

Saint Vincent Health System (PA) contracts with onFocus Healthcare for its enterprise performance management software.

St. Vincent Hospital (WI) will implement Merge Healthcare’s complete cardiology solution across its enterprise.

9-4-2012 8-48-16 PM

Rex Healthcare (NC) will use Passport’s eCare NEXT solution for eligibility checking, demographic verification, precertification, and estimation of patient payment.


9-4-2012 5-11-34 PM

Virtual Radiologic names John Way (UnitedHealth Group) CFO.

9-4-2012 5-37-59 PM

John Gomez of JGo Labs is interviewed at Apple’s WWDC.

Announcements and Implementations

9-4-2012 8-49-49 PM

South Lyon Medical Center (NV) will complete transition to CPSI’s clinical applications by the end of the year. 

Government and Politics

The VA says that over one million patients have registered to download their health information via Blue Button.

The FDA issues a warning letter to Merge Healthcare, saying the company isn’t manufacturing its blood pressure monitoring kiosks within FDA’s guidelines.


9-4-2012 6-12-49 PM

Picis, Epic, and GE own the largest share of the anesthesia information system market, according to KLAS. The survey found that customer satisfaction is highest when AIMS purchasing decisions are handled cooperatively between the hospital and OR/anesthesia department rather than either entity making the decision alone.

ZirMed will undertake a $5.1 million expansion project that is expected to create 85 jobs over the next two years at its Louisville, KY headquarters. The state is offering $2 million in incentives for up to 10 years.

9-4-2012 5-27-11 PM

Apple announces a September 12 event that is likely to include its announcement of the iPhone 5 (note the shadow in the picture. )

Scotland-based Craneware says demand for its hospital revenue products has returned to high levels after a slow first half caused by US hospitals focusing on EHRs.

The government of China will invest $63 billion in its healthcare system over the next seven years, with part of the money going toward creation of an electronic health information network.

Technology investor and Sun Microsystems co-founder Vinod Khosla says computers will eventually replace 80% of doctors because computers are cheaper, more accurate, and objective, while healthcare is “witchcraft … based on tradition.” He also says that it will take outsiders to fix healthcare rather than those working within it. He has a knack for throwing out outrageous sound bites that earn him exposure, such as saying that hybrid cars offer no environmental advantage – they just make their owners feel better about themselves.

Highly regarded UCSF physician Bob Wachter, MD (chief of medicine, invented the term “hospitalist,” author) says UCSF’s new Epic system generates an impressive-looking progress note from fragments of manually entered information, but the “monkeys and typewriters” approach not only violates the legendary teachings of SOAP note inventor Larry Weed MD (in the 1971 video above that everybody who designs physician documentation systems should study regularly), it’s not as useful as the old fashioned written note. However, he also offers a solution: ditch the use of Epic’s Smart Text and offer a “Big Picture” field where physicians are encouraged to tell the patient’s story as of that moment (although he wonders whether natural language processing will make that unnecessary at some point). Wachter describes the current state as:

Why did Epic and our UCSF IT gurus structure things this way? The primary virtue is that this charting-by-problem approach allows the patient to be followed longitudinally, since one can track problems such as “hypertension” or “ovarian cancer” over years, seeing how they have been managed and observing the response to therapy. It isn’t a bad conceit, and it probably makes tons of sense when described in a fishbone diagram on an informatics seminar whiteboard. But the effect I witnessed on patient care and education was less positive. When I was on clinical service in July and read the notes written by our interns and residents, I often had no idea whether the patient was getting better or worse, whether our plan was or was not working, whether we need to rethink our whole approach or stay the course. In other words, I couldn’t figure out what was going on with the patient.

9-4-2012 8-01-15 PM

Small software vendor QueueVision says the Tampa VA hospital is refusing to pay for its medication tracking software despite using it since 2006. The company says the purchase was approved by the hospital’s pharmacy administration, but the VA won’t cough up the $214K it owes. Says a partner in the company, “We were suckers. They took us. I figured the veterans were so happy, the staff was so happy, everybody loved it. So we thought they would pay. We never fathomed that they would lie to us.”

In England, small blood-tracking systems vendor MSoft eSolutions is expanding after winning eight of eight RFPs last year. Its Bloodhound system provides positive ID of employees and patients throughout the blood transfusion process.

I liked this Facebook article by disgraced investor / interesting author Henry Blodget, in which he says publicly traded companies destroy their own value by trying to appease impatient investors and venture capitalists. He explains why nobody should be surprised at the fall in Facebook’s share price (May IPO price $38, Tuesday’s closing price $17.73) given the clear message that CEO Mark Zuckerberg has sent all along that he’s focusing on the customer experience and long-term value as Amazon has always done rather than next quarter’s share price. A snip of Blodget’s paraphrasing of a section of Zuckerberg’s pre-IPO shareholder letter:

Let me remind you that I own 57% of the voting stock of Facebook, which means I have complete control over it. I organized the company this way many years ago, with the very deliberate intention of maintaining complete control over it. I did this so I wouldn’t get overruled and canned by venture capitalists, a fate that unfortunately befalls many entrepreneurs. I also did it so in the event that we ever had to go public—which we unfortunately have to do now—I would never have to pay attention to whiny short-term public shareholders. Those whiny short-term public shareholders have destroyed many great companies by making management obsess about absurd near-term financial targets … Maximizing near-term profits" often means under-investing in future innovation, customers, and employees. And although it sometimes temporarily boosts stock prices, it often guts companies and clobbers their value over the long haul.

The Florida teenager accused of impersonating a PA and practicing medicine without a license is found guilty by a Florida jury and could go to prison for up to 10 years.

Sponsor Updates

9-4-2012 8-53-18 PM

  • Aetna will offer eviti’s oncology decision support tool on its Medicity iNexx platform.
  • The Surgical Information Systems anesthesia information management system earns the highest client satisfaction scores in KLAS’s anesthesia specialty report.
  • MED3OOO CMO Paul McLeod, MD discusses the challenges of controlling ER visits in a blog post.


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

More news: HIStalk Practice, HIStalk Mobile.

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Currently there are "9 comments" on this Article:

  1. As a former NDC Health and McKesson empoyee, Mark Z just moved up up 10 rungs on my ladder of of respect. What a world it would be if more CEOs had this kind of candor.

  2. Larry Weed’s Emory grand rounds is inspirational, but also fuels my frustration when I look at how our problem-based tools are lying fallow in our electronic systems.

    Epic (and every other EMR I have seen) has good tools to document the problem-based approach. There is nothing in any EMR that “makes” the user create a nonsensical note. I have found that few physicians at any level of training “get” the problem-based approach, even after an in-person demonstration of how it makes notes shorter, more understandable, and more comprehensive simultaneously.

    We’ve had users exceed the generous character limit of our system (a note can be well over 200 pages long before it hits the limit) because of the linking of copious lab and radiology results into the note. They can’t understand why the system is so inadequate for their needs. This phenomenon alone shows how far away we are from grasping the idea of concise, comprehensive, problem-based documentation.

  3. I can see why Vinod Khosla is criticized, he’s on to something and the ‘old guard’ is threatened.

    Having those charged w improving healthcare today is like leaving the fox in charge of the hen house.

  4. RE: “HL7 will make its standards…available …at no charge… The company says it hopes to increase…use, thereby improving care and reducing costs.”

    What have been their goals up until this time?

    HL7 ranks up there near the top of most annoying license fees, right after NUBC and their ridiculous annual fees for the UB-04 specs.

  5. RE: Vinod Khosla’s comments

    Those currently profiting from a system will keep lobbying the government hard to keep in place regulations and funding structures which prevent true change and increase in value for the end customer. We continue to see a similar lack of interest in fundamental structural change from other industries such as financial services, agriculture and education.

  6. Re: Bob Wachter

    I couldn’t figure out what was going on with the patient.

    I can tell readers that med mal attorney groups to whom I present on health IT risks, lack of regulation, etc. also say precsiely the same thing about the charts they receive in Discovery. I could probably make a living as an EHR-to-coherent narrative translator alone.

    Perhaps the vendors have an ulterior motive in making EHR output cryptic…

  7. Re: Khosla vs Weed. Weed’s excellent video (88 keys on a piano, 1,000,000 symphonies) displays why it will be a long time before a digital deterministic computer excels at the analog world of disease diagnosis and treatment. Khosla is just one more in a long line of smart guys who underestimate the problem.

  8. Well, if Wachter can not figure out what was going on with the patient, how do they expect us mortal nurse and doctors to know. The devices have a way of keeping all care and the thoughts about it shallow, on the surface. My friends in nursing no longer know the neames or spelling of drugs because their minds are contained by the devices.

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