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Monday Morning Update 6/10/13

June 9, 2013 News 7 Comments

From CIO Reader: “Re: Webinars. I am thrilled you have put this type of process in place. I need to attend many of these Webinars to stay abreast of industry trends, yet many of them are sales pitches or poorly presented. Nothing is worse than having the presenter read slide after slide. A topic I’d like to see covered see is data governance, with real-life examples from hospitals that have developed a structure.” If you are a CIO who has implemented an effective data governance program, why not present your experience as an HIStalk Webinar? It’s just as gratifying as speaking at a conference without the logistical headaches and it makes a nice resume addition besides. Contact me if you are interested.

6-8-2013 6-51-05 AM

The vast majority of poll respondents, 82 percent, would avoid using a hospital whose clinicians are complaining publicly that its clinical systems are compromising patient safety. New poll to your right: should an EHR vendor be allowed to sell a patient’s de-identified data without their permission?

We’re doing an expansion of IT pay bands/job descriptions at my hospital, which caused me to recall how many times I’ve overseen that process at other hospitals I’ve worked in. The cycle involves: (a) deciding that IT has way too many job descriptions that don’t make sense and it would be better to collapse them into generic pay bands such as Analyst I/II/III; (b) everybody gets slotted with a lot of complaints, and the smart employees realize that the lower the band the better since their salary won’t decrease but they have more opportunity to move up; (c) the good IT people start leaving for greener pastures because there’s not much future upside if you’re already at the top of the grade with nowhere to go except into soul-sucking IT management, causing (d) HR and IT to agree that more job descriptions and pay flexibility would be just the ticket and it’s time to add a bunch of new job descriptions. This entire cycle gets repeated every 4-5 years, providing the illusion of effectiveness to IT and HR management.

6-8-2013 7-30-03 AM

Welcome to new HIStalk Gold Sponsor Alere Accountable Care Solutions. The company was formed in January 2013, made possible by Alere’s 2011 acquisition of Wellogic and integrating Alere’s offerings to help ACOs and provider groups improve outcomes and reduce costs. It offers interoperable HIE and EHR solutions developed with an emphasis on the physician-patient connection, physician usability, and innovation. Specific products include an HIE platform, EHR, PHR, connected biometric and diagnostic devices, decision support, real-time analytics, population analytics, wellness and health coaching, and evidence-based care management. Recently announced customers include Virtua, Triad HealthCare, and the MedVirginia HIE. Thanks to Alere Accountable Care Solutions for supporting HIStalk.

6-8-2013 7-46-25 AM

Supporting HIStalk at the Platinum level is Vital Images, part of Toshiba Medical Systems, which offers next-generation advanced visualization software that’s #1 ranked by KLAS and used by 5,000 customers in 83 countries. The software enables visualization and analysis by radiologists, cardiologists, and oncologists of 2D, 3D, and 4D images using CT and MR scan data. Its vendor-neutral Vitrea Enterprise Suite allows enterprise-wide sharing of images and functionality, providing consistent user interfaces and tools that that improve adoption and reduce support requests. The VitreaView universal viewer gives physicians fast access to DICOM and non-DICOM images from any archive via a zero-footprint browser or tablet, while VitreaAdvanced offers a wide range of best-in-class clinical applications such as stent planning, colon analysis, EP planning, and liver analysis. Check out their on-demand Webinar that explains how to image-enable the EMR using a universal viewer. Thanks to Vital Images for supporting my work.

6-8-2013 8-06-02 AM

Analysis of March-April MU attestation data by Wells Fargo Securities finds that Cerner has pulled slightly ahead of Epic in the percentage of clients achieving MU while McKesson has improved a lot. Meditech still leads the overall attestation count, while Epic is so far ahead in physician attestations that the analysis concludes, “… no vendor looks above average other than Epic.”

A newspaper editorial written by the manager of a North Carolina solo medical practice says the practice’s EMR implementation hurt its efficiency without improving patient safety. It also calls out state programs that chose the mothballed Allscripts MyWay as their foundation, the big financial losses experienced by Wake Forest Baptist Medical Center and Cone Health during their Epic implementations, and the failure of the state’s $484 million Medicaid system. She says that implementation of ICD-10 “would be the tsunami that derails our healthcare system.” Obviously she isn’t a fan of healthcare IT.

Here’s a video on the Blue Button Design Challenge from Health Datapalooza IV.

6-8-2013 8-28-13 AM

I take a mild blood pressure med that my doctor says I don’t really need but he likes me on it anyway. There was some screw-up with Express Scripts, so I decided to refill my 30-day supply at Walgreens. I thought I’d give their iPhone app a try and it was amazing. It located the pharmacy since it was nearest to me, then had me scan the prescription label’s barcode using the phone’s camera. A message said when it would be ready for pickup and I was done. You could literally request a refill in 10 seconds. The app also provides pill reminders, prescription transfer by taking a picture of another pharmacy’s label, loyalty card points tracking, the aisle layout of the store, and online shopping and weekly ads. I’m impressed. It makes “find our nearest hospital” apps seem pretty lame in comparison.

6-9-2013 11-42-13 AM

Perhaps ONC will learn the how hard it is to design usable software by introducing its “Health IT State Summaries” widget. States are arbitrarily divided into geographic regions that each have their own dropdown with resulting wasted space, words are misspelled (“state’s,” “South Caronlina”), and it’s an awfully big widget to embed on a website.

6-9-2013 1-09-46 PM

Researchers at the Parkland Center for Clinical Innovation, part of Parkland Memorial Hospital (TX), get a write-up in the Dallas paper for their work in developing a model called PIECES that analyzes EMR data to flag patients at risk for cardiac arrest. A randomized controlled study of the software’s effectiveness will start later in the summer. The Center has 35 employees and a $6.7 million annual budget. PIECES use information that includes monitoring data, lab results, MEWS, unit assignment, and orders to predict clinical deterioration 16 hours in advance on average. The original article in BMC Medical Informatics and Decision Making, published in February 2013, is here.

6-9-2013 12-19-37 PM

Hello Doctor introduces an iPad app that allows patients with complex medical conditions to organize their medical records for conversations with their physicians. 

New York City’s 911 operators are forced to use handwritten notes delivered by runners when the city’s new $88 million emergency dispatch system goes down for several minutes on at least three occasions.

A patient at the Bronx (NY) VA hospital dies when a gamma camera collapses on him during a radiology procedure.

Sue Fischer, a nurse who works in the Cerner practice of Encore Health Resources, recently saved the life of a man who had gone down in cardiac arrest in a Phoenix airport jetway by giving him CPR.

6-8-2013 7-21-05 AM

John Alexander (Optimum Healthcare IT) joins ESD as Epic practice director.

6-8-2013 8-01-31 AM

Glenn Cole (The Ghafari Companies) joins Nordic Consulting as CFO.

An Ohio medical practice’s letter to the editor of the local newspaper requests the understanding of patients as it transitions to an EMR, saying, “For the most part we are not computer savvy so this has been a real challenge. While we struggle with this change we are just not able to see the number of patients we had previously.”

Vince Ciotti has been a longstanding critic of what he sees as Epic’s cult of Kool-Aid drinkers, so did a personal audience with Judy Faulkner change his tune? Find out in this week’s HIS-tory.

Sponsor Updates

  • HCA will present its experience implementing identity and access management solutions in a Monday, June 17 Webinar sponsored by Caradigm.


Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis.

More news: HIStalk Practice, HIStalk Connect.


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Currently there are "7 comments" on this Article:

  1. ONC’s widget also misspelled “Louisianna” and “Minnessota,” excluded Utah and Wyoming and listed the District of Columbia as a state! Maybe a geography course would help.

  2. RE: HIS – Tory


    For the story on Epic, to be balanced please provide some of the answers to the harder questions that we have all been asking of Epic, for example on the non-complete for employees and staff of hospitals, recent significant implementation cost over runs etc.

    The opening looks like a PR story sponsored by Judy and Epic.

  3. Problems w/ ONC widgets.- hard to believe?

    ONC’s track record on software development is not the greatest. Remember in Stage 1 they created a tool called POP Health to allow vendors going thru certification a way to test their Quality Measures calculations. Several of my clients tried it and guess what …they never could get the interfaces to work! Can you imagine that? POP health was killed not long after its birth and totally replaced with Cypress written by an outside contractor.

    More recently in testing under Stage 2 clients have had all sorts of problems with a tool to test the Data Portability (170.314(b)(7) criteria.

    The real irony is that a vendor undergoing certification testing must have their software perform in a stable & reliable manner. The ATLs clearly state in their contracts that if you hit too many ‘Oops’ incidences that can flunk you immediately.

    With that rule I doubt ONC could pass their own tests…

  4. @ Vince,

    Agree with the above poster; this is the only time your HIStory series reeks of marekting…dont sellout bro!!!

  5. How do you suppose #BigData would use the information provided by “Big Datty”?

    This is merely another case of GIGO that will confound the bean counters and data crunchers.

    The problem is widespread but no one seems to care.

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  1. I share your concerns about a lot of similar projects, but I think this one's an outcomes comparison thing, not…

  2. "Ascension Via Christi sent several ICU nurses home after they raised concerns about inadequate staffing." Nice. That'll show em.

  3. Thank you for sharing the full HIStory file. What a great tribute to Mr. Ciotti. “Those who cannot remember the…

  4. "Epic will roll out a “patients like this one” type tool to its users in Indiana this summer. It will…

  5. I don't see Cerner winning employee satisfaction surveys. I can't see VHA pivoting to Epic. It's going to be some…

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