Giving a patient medications in the ER, having them pop positive on a test, and then withholding further medications because…
News 1/9/13
Top News
A RAND study finds that the cost-saving promise of healthcare IT it predicted in a vendor-subsidized 2005 study has not been reached because deployed systems are not connected and not easy to use. The study’s authors blame shortcomings in the design of IT systems and recommend improving interoperability between systems, providing better access to records for patients, and designing more intuitive systems. The original RAND study published in Health Affairs (above), partly paid for by Cerner, claimed that electronic medical records would save at least $81 billion per year, which the Congressional Budget Office said at the time was a ridiculously inflated number. Still, the study was cited repeatedly to justify government spending on EHR-related programs. Another RAND study predicted that HIEs would generate hundreds of billions of dollars per year in healthcare savings.
Reader Comments
From Homecare: “Re: interesting misstep. From a VC-backed home care tech vendor.” Family Care Medical Services (WI) files suit against medical equipment and home health billing service vendor Brightree, claiming that the billing company Brightree acquired made inadequate efforts to collect money owed to the business. Brightree, an investment of Battery Ventures, acquired home health and hospice software vendor CareAnywhere late last week.
From Big O: “Re: HL7. Announced in September they were going to open up their standards for free in Q1. Anyone know the specific data?” I inquired via HL7’s contact page. They didn’t respond. I found a bunch of free downloads on their site, but I don’t know what else they’ll be releasing.
From Mickie: “Re: CenTrak RTLS lawsuit. Attached.” AeroScout, owned by Stanley Black & Decker, claims Centrak violated its patent for a WLAN-based RFID asset tag and locating system.
From Brandywine: “Re: Octo Barnett, MD at Massachusetts General Hospital. He’s officially retired and is not giving interviews any more.” I’m sorry to hear that since I really wanted to interview him. He should write his biography since he’s one of the pioneers of healthcare IT, along with the recently deceased Homer Warner and a few other key players. Octo developed the MUMPS programming language in the 1960s with Meditech Chairman Neil Pappalardo, which more than 40 years later still runs the systems used to care for probably 90 percent of hospitalized patients in the US.
HIStalk Announcements and Requests
Mr. H and I have been talking HIStalkapalooza the last few days. I’m not sure he is quite ready to leak all the details, but here’s what I can share. The party, which will likely be the most fun event of HIMSS 2013, will be bigger than ever and include exotic shoes, excellent food and drink, entertaining music, a few contests, and even a bit of dancing. And of course the annual HISsies awards. You will want to keep your calendar open for the evening of Monday, March 4.
Acquisitions, Funding, Business, and Stock
Health Catalyst, known until recently as Healthcare Quality Catalyst, raises $33 million in Series B funding from Norwest Venture Partners, Sequoia Capital, and Sorenson Capital Partners. I interviewed co-founder Steve Barlow in 2011 and SVP Dale Sanders this past October.
Point-of-care technology vendor PatientSafe Solutions closes a $20 million Series C round led by the Merck Global Health Innovation Fund.
Private equity firm Riverside Partners invests in Stinger Medical, a provider of mobile clinical workstations and medical technologies.
Care Thread, a provider of secure mobile messaging and a recently named “App of the Month” by Nuance Healthcare, secures $250,000 in seed funding from Slater Technology Fund.
Lightbank, the venture fund launched by Groupon’s founders, leads a $1.4 million investment in fertility app vendor Ovuline. The startup’s next product is a pregnancy monitoring app.
Data analytics company Blue Health Intelligence acquires Intelimedix, a healthcare analytics firm specializing in employer group and payer reporting solutions.
Passport Health Communications acquires California-based Data Systems Group, a provider of revenue cycle software solutions.
Travis analyzes possible reasons that athenahealth acquired Epocrates on HIStalk Connect.
Sales
ICON selects Cerner’s Discovere Late Phase platform to support its pharma and device studies.
The Health Information Trust Alliance designates Booz Allen Hamilton a Common Security Framework Assessor, tasked with conducting information security audits of healthcare organizations.
The Liverpool Heart and Chest Hospital NHS Foundation Trust augments its Allscripts electronic patient record with Hyland Software’s OnBase solution for enterprise content management.
St. Anthony’s Medical Center (MO) selects Capsule Tech’s device connectivity technology for use in multiple areas to automate the flow of patient data into Epic.
Stellaris Health Network (NY) signs a multi-year agreement with MedAssets for strategic sourcing, BI, and process improvement consulting.
Delaware Health Information Network approves the AlliedHIE Company as a Direct messaging provider for the HIE’s enrolled practices, with messaging and interoperability technology provided by ICA’s CareAlign Direct Messaging and Exchange solutions.
People
CHIME and HIMSS name University of Utah Health Care CIO James Turnbull its John E. Gall, Jr. CIO of the Year.
LifeBridge Health names Tressa Springmann (Greater Baltimore Medical Center) as CIO.
Blackford Middleton, MD, MPh, MSc (Partners HealthCare) will join Vanderbilt University as assistant vice chancellor, chief informatics officer, and professor of biomedical informatics.
O’Neil Britton, MD is appointed chief health information officer of Partners HealthCare, replacing David Blumenthal MD, who left earlier this year to head The Commonwealth Fund.
The South Florida REC promotes Amy Rosa from assistant director to interim director.
Vocera Communications names M. Bridget Duffy, MD (ExperiaHealth) CMO.
QuantiaMD names Daniel Malloy (IMS Health) SVP, promotes President Mike Coyne to CEO, and appoints CEO Eric Schultz to executive chairman.
Home monitoring systems vendor Healthsense names A.R. Weiler (Emdeon) as CEO.
Announcements and Implementations
North Arkansas Regional Medical Center becomes the first facility to implement the State Health Alliance for Records Exchange (SHARE), the statewide HIE for Arkansas.
CareCloud and the online physician platform QuantiaMD partner to survey QuantiaMD members on key practice trends.
Philips Healthcare introduces Lifeline GoSafe, a mobile personal emergency response system that includes fall detection capabilities, locating services, and two-way cellular voice communications.
Coding software vendor Trucode announces a cloud-based product that allows vendors to incorporate coder functionality into their systems. Customers include ChartWise, BayScribe, Dolbey, MModal, Precyse, and PlatoCode.
Florida Hospital Wesley Chapel (FL) completes the first phase of its nurse response system, which includes a Rauland-Borg nurse call system, Cisco wireless handsets, and Extension middleware.
Innovation and Research
The X PRIZE Foundation announces ambitious competition guidelines for the $10 million Qualcomm Tricorder X PRIZE, for which 255 teams have already registered. Along with monitoring vital signs and specific conditions, devices will need to address a core set of 12 conditions that include diabetes, atrial fibrillation, stroke, TB, and COPD.
Other
Hunting and fishing supplies retailer Cabela’s apologizes for a New Year’s Day computer glitch that added the Affordable Care Act’s 2.3 percent medical device tax to every purchase. The company says it has no idea how that happened.
In the UK, an NHS surgery practice blames human error on its creation of over 4,000 summary patient records without giving patients the chance to opt out.
Xerox files a protest with the West Virginia Department of Health and Human Services after the state awards a $248 million Medicaid claims processing system contract to Molina Medicaid Solutions. Xerox claims the state’s 2011 contract with Incumbent vendor Molina to upgrade the state’s existing system gave that company an unfair advantage.
An article on patent trolling identifies a maze of closely held companies that are sending out threatening letters to businesses, demanding license payments of $900 to $1,200 per employee for their patent that covers e-mailing scanned documents. The article says a study of startups found that 22 percent of them ignore patent trolling letters, 35 percent fight back at average court cost of $870,000, and 18 percent go out of business.
VistA guru Tom Munnecke observes that Secretary of Defense nominee Chuck Hagel was intimately involved with the MUMPS-based VistA system in its skunkworks early days as a VA deputy director, praising him for supporting the “Underground Railroad” despite the objections of VA brass who wanted to run a huge, centralized hospital information system instead.
Weird News Andy is stuffed with good news: the guy who invented the Segway is working on a gadget that will let people gorge themselves on food, then pump their own stomachs through a surgically installed abdominal valve. WNA says Dean Kamen obviously “has his finger on America’s thready pulse” since his inventions discourage walking and encourage gluttony.
Sponsor Updates
- The PriMed (CT) provider group and MED3OOO distributed coats, sleeping bags, and gift bags to the needy through the Bridgeport Rescue Mission’s Sleeping Bag Give-Away event right before Christmas.
- The local paper profiles Don Catino,who co-founded New Hampshire-based Digital Prospectors in 1999.
- McKesson Paragon is named Best in KLAS Community Hospital Information System for the seventh straight year.
- API Healthcare participates in the ACNL 2013 Annual Conference in San Diego February 10-13.
- AdvancedMD hosts a January 23 Webinar that provides a crash course on qualifying for Meaningful Use.
- T-System offers complimentary benchmark information that considers the timeliness and quality of ED care.
- Nuance Healthcare’s Jonathon Dreyer, director of mobile solutions, predicts that 2013 will be the “year of the mHealth user” with more widespread availability and adoption of mobile health technology.
- CSI Healthcare IT earns satisfaction scores 2.2 times higher than the industry average for staffing firms in an independent satisfaction survey, also earning a74 percent “would recommend’ score.
- Vocera releases updates to its software platform that enhance nurse workflow and provide improved analytics and reporting.
- Medseek looks at patient engagement, MU, and meeting patient expectations with technology in a January 16 Webinar.
- Billian’s HealthDATA releases a white paper that focuses on the top innovations in HIT.
- Imprivata names Johns Hopkins Medicine the winner of its 2012 Healthcare Innovator of the Year Award for an exceptional implementation of OneSign.
Contacts
Mr. H, Inga, Dr. Jayne, Dr. Gregg.
More news: HIStalk Practice, HIStalk Connect.
http://www.hl7.org/documentcenter/public_temp_23F6BE20-1C23-BA17-0C1B33A6AB6C8701/pressreleases/HL7_PRESS_20120904.pdf
Re: The RAND study and the less-than-stellar ROI of EMRs.
Of course this will sound like a broken record from a broken record player, but… the ROI from EMRs comes from the the appropriate implementation and utilization of analytics to improve the quality of care and reduce the cost of care. EMRs are a means to an ends… they are not the end goal. In that context, I wish HITECH would have encouraged the adoption of analytic platforms and process improvement training for healthcare– e.g., commercialize the Advanced Training Program led by Brent James at Intermountain. Organizations would have purchased EMRs as a consequence, but not stopped there. Data analysis and process improvement are the end goal.
Sign me up for one of those Gluttony Valves. 🙂
I am shocked, literally shocked, at the results of the new RAND study.
How does RAND reconcile the differences between this and the Cerner funded study by Hillestad et al?
Well. the good commenter Dale Sanders offers up another #Bigdata excuse as to why we should continue to pour money into the HIT sink hole. The jusification of using analytics from HIT when there are boatloads of GIGO and QIGO is fundamentally flawed. Look, the vendors bought results that had RAND’s name on them, to legitamize them. Well, you knopw then but, how do they say, what a sham!!
Trying to compare and reconcile the two RAND studies is a bit silly as well as trying to say there is some causality between a study partially supported by a vendors and one that is not.
Without a thorough evaluation of methodology, metrics used etc. and differences thereof between these two studies, nothing but hot air.
And Dale rightly points out at least one thing, EHRs are but a means to an end. It is not the deployment of the EHR itself that matters, it is how it is used and how the data it collects is used to improve operational performance.
This all harkens back to MIT economist Robert Solow’s comment from 1987 which led to the common term of the productivity paradox, which I saw first hand in the mfg sector. Lesson learned: Give it time, the future “ROI” will be forthcoming, just not in tomorrow’s forecast figures nor in any near term RAND study.
The ROI from EMRs will never be realized because first, there is no longitudinal patient view available to most caregivers – they only have data from their EMR silo, and HIEs have not proven to be the large answer due to a myriad of issues, including funding them. Second and most important, there are no care alerts/gaps in care noted for the provider at the time of service (and just piping data from an HIE without analytics to provide those care gaps is not effective). Performing these would not only improve heath by ensuring the patient is up to date on their chronic treatments/tests, but it provides revenue opportunities for the provider, thus an additional incentive to act. A byproduct of this then is the ability to easily measure quality and outcomes by physician. Companies like MDdatacor where I work and our competitiors already provide this type of connectivity and we’ve seen this as a major step forward in decreasing costs while improving care and health levels.
Re Dean Kamen’s pump technology:
– Current development (as described) could cross over into an unexpected industry… One possible ad campaign: Nike GutPump: Eat. Pump. Repeat.
– Wouldn’t it be safer (certainly less disgusting) to invent a neurofeedback solution that fakes out diners into thinking they are actually gorging themselves a la Jack Black in “Shallow Hal”?
I agree with Dale that EMR’s are a means to the ends…….the pot of HIT gold at the end of the rainbow is in the analytics. If my health record is compared with other people who share similar characteristics in areas such as age, weight, diet, exercise, where I reside, past health issues, past and current profession/workplace, etc, we all know certain common anamolies will emerge. Predictability of future health concerns can more accurately hypothesized; course-corrections in life-style, diet, exercise, etc. can be more rapidly prescribed….the list goes on. Data analysis and process improevement are indeed where focus need be applied in order to achieve effective EMR utilization.
Re: RAND study. John hits the nail on the head when he mentions the productivity paradox. That led me to an excellent article in the NEJM that addresses the implications for healthcare: http://www.nejm.org/doi/full/10.1056/NEJMp1204980
Re:looking deeper
The problems with EMRs far exceed a productivity paradox. There may also be a safety paradox and a cognitive paradox, but, no one has wanted to know since the money continues to flow due to government mandates.