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January 30, 2014 News 6 Comments

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1-30-2014 8-32-06 PM

The Department of Defense opens bidding to replace all of its EHR systems, saying the new system will use off-the shelf technologies running on ONC-approved standards. The VA solicited bids Tuesday for the next step in its replacement of VistA. Evidence is scant that the two groups plan to work together to implement a single EHR systems as mandated by the President and Congress, with their only obvious common ground being a willingness to separately enrich the usual government contractors with massive taxpayer dollars.

Reader Comments

From Silversand: “Re: MU Stage 2 CQM measures. In meeting with our vendor, we were told they can’t submit them electronically yet because the standards changed in December and their software hasn’t been updated. I can’t find anything on a standards change. Is this true? Are other vendors running into the same issue? I would love to know what your readers think.” So would I (cue readers to chime in.)

From Ockham: “Re: vendor market share. KLAS estimates by bed size, i.e. ‘Meditech has 18 percent of hospitals over 200 beds.’ This is meaningless. It should be expressed as the number of beds in all hospitals using a system, which would be easy to calculate using information from HIMSS Analytics. Having a lot of beds means having a lot of clinician users, which pushes product development. Epic blasted into a leadership position is because having 400 hospitals that are large and larger trumps having 2,000 hospitals that are small (Meditech).” That’s true, as long as your product is suitable for large hospitals and you have the competence to sell it to them. Epic’s timing was perfect because soon those big, Epic-using hospitals will have bought all the smaller ones and replaced their incumbent systems, putting Epic in hospitals that couldn’t have afforded or supported it on their own. It’s like the political system – you’ll see all kinds of parties on the ballot, but only two of them get a significant number of votes.

HIStalk Announcements and Requests

inga_small A few HIStalk Practice highlights from the last week include: physicians prefer smartphones to tablets to perform most professional tasks. Practice Fusion offers free Google Chromebooks to new users. CMS reminds EPs of pending deadline to attest to MU for the 2013 Medicare EHR incentive program. In part three of our series, HIT vendor execs share details about technologies on their company’s roadmap for the next 12-18 months. Thanks for reading.

1-30-2014 6-59-18 PM

Welcome to new HIStalk Platinum Sponsor Optimum Healthcare IT. The Jacksonville Beach, FL-based full-service consulting firm provides expert consultants at competitive rates. Services include EHR deployment (all major vendors); integration services (interface development and integration engines); staff augmentation (program directors, project managers, application builders and testers, clinical experts, analysts, security experts, trainers); security and identity management; and regulatory guidance (Meaningful Use, ICD-10.) The company provides small-business flexibility with large-business stability, but without the high cost. Thanks to Optimum Healthcare IT for supporting HIStalk.

Upcoming Webinars

February 5 (Wednesday) 1:00 p.m. ET. Healthcare Transformation: What’s Good About US Healthcare? Sponsored by Health Catalyst. Presenter: John Haughom, MD, senior advisor, Health Catalyst. Dr. Haughom will provide a deeper look at the forces that have defined and shaped the current state of U.S. healthcare. Paradoxically, some of these same forces are also driving the inevitable need for change.

February 12 (Wednesday) 1:00 p.m. ET. Healthcare CO-OPs and Their Potential to Reduce Costs. Sponsored by Health Catalyst. Presenters: David Napoli, director of performance improvement and strategic analytics, Colorado HealthOP and Richard Schultz, VP of clinical care integration, Kentucky Health Cooperative. Consumer Operated and Oriented Plans (CO-OPs) were established by the Affordable Care Act as nonprofit health insurance companies designed to compete in the individual and small group markets. Their intended impact was to provide more insurance options for consumers to pay for healthcare.

February 13 (Thursday), 12 noon ET. Advancement in Clinician Efficiency Through Aware Computing. Sponsored by Aventura. In an age of information overload, a computing system that is aware of the user’s needs becomes increasingly critical. Instant-on roaming for virtual and mobile applications powered by awareness provides practical ways to unleash value from current HIT investments, advancing efforts to demonstrate meaningful use of EHRs and improve clinical efficiencies. The presenters will review implementation of Aventura’s solution at Orange Coast Memorial Medical Center.

Acquisitions, Funding, Business, and Stock

1-30-2014 5-46-59 PM

GNS Healthcare, a provider of big data analytics products and services, completes a $10 million Series B financing round led by Cambia Health Solutions.

1-30-2014 5-49-51 PM

VMware reports Q4 results: revenue up 20 percent, adjusted EPS $1.01 vs. $0.81., beating earnings estimates.

1-30-2014 5-50-35 PM

CommVault releases Q3 results: revenue up 20 percent, adjusted EPS $0.54 vs. $0.39, beating estimates on both.

1-30-2014 5-51-15 PM

Quest Diagnostics announces Q4 results: revenue down one percent, adjusted EPS $1.03 vs. $1.01, beating estimates on both.

1-30-2014 6-57-56 PM

McKesson announces Q3 results: revenue up 10 percent, adjusted EPS $1.45 vs. $1.44, beating revenue expectations but missing expected earnings of $1.84. CEO John Hammergren said the results of Technology Solutions was disappointing (revenue up 6 percent, margins 8.55 percent) because the company had to  “take action in response to the anticipated timeline for Meaningful Use 3 and to size our organization in Horizon Clinicals appropriately” and took a $42 million restructuring charge to reduce headcount.

1-30-2014 9-07-20 PM

CPSI anounces Q4 results: revenue up 7 percent, EPS $0.90 vs. $0.83.


1-30-2014 5-52-06 PM

Texas Children’s Hospital selects OpenTempo’s scheduling and workforce management solution.

1-30-2014 5-53-53 PM

Valley Health (VA) selects Capsule Tech to integrate medical devices in operating rooms with Epic EMR.

1-30-2014 6-52-22 PM

Greater Regional Medical Center (IA) implements PeriGen’s PeriCALM fetal surveillance system.


1-30-2014 5-57-54 PM 1-30-2014 5-58-50 PM

Cumberland Consulting Group promotes Greg Varner and Mike Penich from principals to partners.

1-30-2014 5-59-52 PM

Community Health Network (IN) names Ron Thieme, PhD (AIT Laboratories) chief knowledge and information officer.

1-30-2014 6-00-48 PM 1-30-2014 6-01-34 PM

Population health management vendor Welltok hires Michelle Snyder (Epocrates) as chief marketing officer and Vance Allen (Pearson eCollege) as CTO.

1-30-2014 6-03-05 PM 1-30-2014 8-03-22 PM

Charles Denham, MD, accused by the Department of Justice of accepting $11.6 million in kickbacks from CareFusion to promote its skin disinfectant product at the National Quality Forum, resigns from the board of The Leapfrog Group. The DOJ has assessed a $41 million fine against CareFusion; Denham says the allegations are false. There’s a healthcare IT connection: when Dennis Quaid started limelighting  for patient safety after his newborn twins were overdosed with heparin at Cedars-Sinai (he had breezy good intentions, but minimal knowledge even for an actor), HIMSS put him on stage at the 2009 conference and inexplicably donated to his foundation. Dennis apparently found another shiny object and merged his foundation a year later with Texas Medical Institute of Technology, which was founded and run by Chuck Denham (who didn’t live in Texas, but instead in a $14 million oceanfront estate in Laguna Beach, CA.) Denham claimed that TMIT’s “national research test bed” involved 60 percent of US hospitals, although few people seemed to have heard of it. the other healthcare IT connection is that CareFusion sells Pyxis drug dispensing machines and Alaris smart IV pumps, just in case your hospital feels the urge to buy something from a company willing to bribe its way to the bedside.

1-30-2014 7-46-27 PM

Microsoft’s board is rumored to be preparing to name Satya Nadella, VP of the company’s cloud and enterprise group, as CEO as soon as Friday. The board is also discussing the possibility of replacing Bill Gates as their chairman with an unnamed candidate. Nadella would be the company’s third CEO following Gates and Steve Ballmer.


Announcements and Implementations

More than 800 hospitals and 6,000 medical groups are participating in the eHealth Exchange, a group of government and non-government organizations that agree to support interoperability standards to exchange information.

1-30-2014 6-05-42 PM

Scott & White Memorial Hospital (TX) goes live on Epic.

1-30-2014 9-03-23 PM

Greater Baltimore Medical Center (MD) goes live with the PatientRoute Systems patient flow solution.


1-30-2014 6-08-25 PM

Members of the governing board for the UK’s Croydon University Hospital raise concerns that the hospital’s new Cerner system has led to increased waiting times and has lost patient information. Despite Cerner’s assurances that the system issues have not harmed patients, at least one board member expressed doubts:

You say that no harm has occurred, but while we’ve had no direct incident so far, patient care has definitely suffered. You talk about increased waiting times and there’s a risk that harm may occur because of the difficulty in getting in touch with clinicians who actually know what is going on with the patient. I’m very concerned from a quality point of view that our main provider has a serious problem with its information systems.

1-30-2014 6-09-11 PM

CCHIT announces that it will no longer offer ONC testing and certification and will change its business model to become a certification consulting firm. CCHIT recommends that its customers work with ICSA Labs for future testing and certification services.

Federal prosecutors charge former Allscripts director of internal audit Steven M. Dombrowski with insider trading, alleging that in 2012 he used a secret account in his wife’s name short MDRX shares ahead of a poor financial report, netting him $286,000.

1-30-2014 8-51-35 PM

The Wall Street Journal describes the analytics challenges of Memorial Hospital of Gulfport (MS), which can’t get much useful information from its separate inpatient and outpatient EHRs now, but hopes things will improve after a Cerner go-live in March followed by implementation of Health Catalyst analytics afterward. The hospital selected Allscripts EHR/PM in 2009.

In Israel, the health ministry launches a medical data sharing project for health fund clinics and hospitals.

1-30-2014 9-39-59 PM

Recently released documents from the antitrust lawsuit against St. Luke’s Medical Center (ID) reveal that its merger with Saltzer Medical Group could have raised pricing for outpatient visits by 60 percent and increased insurance rates by about 30 percent. Last week a federal judge ordered St. Luke’s to divest itself of Saltzer, saying the acquisition would give the health system an unfair bargaining position with insurance companies.

1-30-2014 6-12-56 PM

Epic is unseated for the first time since 2008 as the top overall vendor the 2013 “Best of KLAS” awards, with athenahealth leading the pack. Winners (with links to HIStalk sponsors) include

Athenahealth athenaCollector (practice management 1-10 physicians)
Athenahealth athenaCollector (practice management 11-75 physicians)
Athenahealth athenaCommunicator (patient portal)
CareTech Solutions (IT outsourcing, extensive)
CareTech Solutions (IT outsourcing, partial)
Cerner (application hosting)
Cerner CommunityWorks (community HIS)
Cornerstone Advisors (planning and assessment)
Cymetrix (extended business office)
Dolbey Fusion Speech (speech recognition)
Epic Care Everywhere (HIE)
Epic EpicCare (acute care EMR)
Epic EpicCare Ambulatory (ambulatory EMR 11-75 physicians)
Epic EpicCare Ambulatory (ambulatory EMR >75 physicians)
Epic OpTime (surgery management)
Epic Radiant (radiology)
Epic Resolute (patient accounting)
Epic Resolute/Prelude/Cadence (practice management >75 physicians)
Epic Willow (pharmacy)
Impact Advisors (clinical implementation principal)
J2 Interactive (technical services)
McKesson ERP Solutions (financial/ERP)
Merge Healthcare Cardio (cardiology)
Precyse (transcription services)
PwC (revenue cycle transformation)
QlikTech QlikView (analytics)
Quest Diagnostics ChartMaxx (document management)
Rays (teleradiology services)
Sagacious Consultants (clinical implementation supportive)
Sectra PACS (PACS)
Siemens Novius Lab (laboratory)
SRSsoft EHR (ambulatory EMR 1-10 physicians)
Thornberry NDoc (homecare)
Unibased USA RMS (enterprise scheduling)
Wellsoft EDIS (emergency department)
ZirMed (claims and clearinghouse)

Weird News Andy says this doctors has it. A New Zealand doctor spearfishing with friends is attacked by a shark, fights it off with a knife, stitches his leg wound on the beach, and heads to a bar for a beer. He goes to the hospital for more stitches only after bar employees notice him bleeding onto the floor.

1-30-2014 7-33-22 PM

WNA uses his less-cynical alter ego “Wonderful News Andy” in this story of medical dedication. A neurosurgeon working at an Alabama hospital is called to a cross-town hospital to perform emergency brain trauma surgery. His route is blocked by snow-related traffic, and as his cell phone signal fades, the second hospital’s neuro intensive care unit nurse hears him say, “I’m walking.” Which he did, covering six miles in a trek of several hours and then heading straight to the OR with the patient, who had a successful outcome.

Sponsor Updates

  • HIStalk sponsors winning KLAS Category Leaders 2013 awards include Siemens (Soarian Clinicals), GE Healthcare (Centricity Perioperative Anesthesia), Merge Healthcare (cardiology hemodynamics), Elsevier (CPMRC), Wolters Kluwer (Sentri7, MediRegs Comply/Track), PatientKeeper (Physician Portal), 3M (360 Compass, Codefinder), Allscripts (EPSi), Phillips (IntelliSpace Portal), lifeIMAGE (image exchange), GetWellNetwork (interactive patient system), iSirona (DeviceConX), MedAptus (Pro Charge Capture), Passport (IntelliSource), TeleTracking (Capacity Management Suite), McKesson (EnterpriseRX Outpatient), Xerox (Midas+ Solutions, financial ERP implementation services), Fujifilm (Synapse RIS), Craneware (Bill Analyzer, Chargemaster Toolkit), Imprivata (One-Sign), API Healthcare (Staffing and Scheduling, Time and Attendance), VMware (vSphere), Emdeon (eligibility services), Encore (go-live support services), and Aspen Advisors (ICD-10 consulting).
  • McGraw-Hill Professional partners with RelayHealth to make the AccessMedicine online medical platform available to providers.
  • AirWatch adds a professional certification level to its Enterprise Mobility Certification Program.
  • Besler Consulting publishes a white paper focused on Medicare Transfer DRG underpayments.
  • AT&T sponsors a series of articles that explore how hospitals and health systems are addressing the care continuum in their strategic and operational plans.
  • ReadyDock founder and president David Engelhardt discusses when and how to clean and disinfect mobile devices in a blog post.
  • Extension Healthcare founder and CEO Todd Plesko explains the future of secure messaging app in a blog post.
  • Passport Health posts a white paper discussing the benefits of front-end patient financial patient triage.
  • A Virtelligence case study profiles Allina Hospitals and Clinics (MN), which implemented Epic with support from the company’s consultants.
  • SimplifyMD publishes proof statements highlighting various successes and stats as of the end of 2013.
  • QPID offers a case study highlighting Massachusetts General Hospital, which saw improvements in clinician productivity, higher throughput in the GI suite, and improved outcomes by avoidance of adverse events following the implementation of QPID’s automated record review.
  • Predixion will provide academic institutions with the free use of Predixion analytics software for students and teachers of data science.
  • NVoq highlights what’s new in its version V8.3.
  • Culbert Healthcare Solutions discusses the optimization of Epic work queues in a company post.
  • LifeIMAGE offers a series of customer testimonials highlighting their use of lifeIMAGE technology for image sharing.

EPtalk by Dr. Jayne

Mr. H published a rumor earlier this week about CCHIT leaving the EHR certification business. As many HIStalk rumors are, it was confirmed a few days later. CCHIT cites the complexity of testing and changing federal requirements as contributing factors. They plan to move into the consulting business.

This seems to be the big news of the week, which isn’t surprising considering we’re in the run-up to HIMSS. Major vendors aren’t going to be announcing much of anything, and instead will be saving any upcoming news for release at the big show.

I guess I’m also not surprised to see CCHIT exiting the testing business. Keeping track of the constantly changing testing criteria can’t be easy. I can barely keep track of the provider-based Meaningful Use requirements and the ongoing parade of CMS Frequently Asked Questions that cause ongoing re-interpretation of how we need to comply. If you haven’t seen the testing criteria, I’d recommend taking a look – they make some of the most complex projects I work on look like a cakewalk by comparison.

I know some of the people who participated on our ambulatory vendor’s certification testing team. The process sounds like it’s about the same level of fun as going through med school, trying to make sure you know everything, and then being an intern and having the worst call night ever – sleepless, stressed out, and having to deal with endless minutiae. I would imagine that being on the other side and having to deal with an ongoing parade of vendor teams who are similarly at their wits’ end may not be the most satisfying or stress-free job.

I’m not sure about the direction they’re taking. It seems like the consulting world is already saturated with Meaningful Use advisors, stakeholders, and other thought leaders. They plan to have a “series of summits and events to support that work,” but I’m not sure who will attend. Most of us in the trenches don’t have the budget to attend conferences and meetings we attended in the past and want to keep attending, let alone add other meetings to the docket.

The first CCHIT Summit will be held on Wednesday during the HIMSS conference. It will feature several former National Coordinators reviewing health IT during the last decade. It will be followed by an audience participation session to discuss what role health IT should play in the next decade. If they keep the CCHIT Summit events as part of existing conferences, they will definitely increase their chances for meaningful participation.

Along with the change in mission, CCHIT has restructured its board of trustees and will be replacing the CCHIT commissioners with stakeholder advisory groups. CCHIT was a leader in EHR certification and it will be sad to see them go, but I’d bet they’re not the only one that exits the business. At this point, there are fewer EHRs certified for MU2 than there were for MU1, and as more vendors abandon the Meaningful Use arms race, there won’t be as many products going through the process.

What do you think about CCHIT leaving the certification business? Leave a comment or email me.


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

More news: HIStalk Practice, HIStalk Connect.


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Currently there are "6 comments" on this Article:

  1. Re: WNA uses his less-cynical alter ego “Wonderful News Andy” in this story of medical dedication. A neurosurgeon working at an Alabama hospital is called to a cross-town hospital to perform emergency brain trauma surgery. His route is blocked by snow-related traffic, and as his cell phone signal fades, the second hospital’s neuro intensive care unit nurse hears him say, “I’m walking.” Which he did, covering six miles in a trek of several hours and then heading straight to the OR with the patient, who had a successful outcome.

    I heard about this wonderful doctor interviewed on CNN. WNA neglected to mention that he apparently was wearing his scrubs and slip on clogs, under his jacket for his 6 mile, 2 hour trek. He doesn’t consider himself a hero, but sounds to me like he saved a life! Thanks for sharing this.

  2. As a former CCHIT employee, I will be sad to see them go. However, I think it’s the right decision. They’ve accomplished their mission – certification and adherence to standards are now a government mandate (even if it has been watered down). Years ago when they first started nobody was even thinking about certification and most vendor employees could barely name three healthcare standards much less know how to incorporate them into their products. CCHIT managed to get vendors, hospital leaders and standard organizations sitting at the same table discussing how best to nudge the industry forward. I don’t know anyone other than CCHIT that has been able to get Epic, GE, Eclipsys and other vendors to sit down with clinicians and talk about how best to incoporate a minimum set of standards, security, interoperability and clinical functionality into their products. For many years before Meaningful Use, CCHIT was helping to set development expectations for most of the major vendors.

  3. As a former cchit committee member way-back-when, I will suggest that the reason those big vendors agreed to sit down is that they realized that certification would become an excellent way to squeze out many of the small and medium sized vendors (this is particularly true in the ambulatory market). By raising the cost of doing business for everyone, those vendors have effectively started eliminating competition.

    Th hospitals and health systems are worse and are even less altruistic than the vendors.

    The irony is that CCHIT is being affected in the same way their certification efforts have affected vendors. Too much effort for too little return. The proof has been in very HIStalk release for the last few weeks and the next year.

  4. ” Re: MU Stage 2 CQM measures. In meeting with our vendor, we were told they can’t submit them electronically yet because the standards changed in December and their software hasn’t been updated. I can’t find anything on a standards change. Is this true? Are other vendors running into the same issue? I would love to know what your readers think”

    Encore’s MU and eMeasure experts respond:

    They may be confusing the QRDA level 1 vs Level 3 issue.

    The only way to submit electronically is via patient level data at QRDA level 1 through your vendor. Level 3 aggregate is “not feasible” per CMS’s comments in the IPPS rule this summer, which probably means they weren’t ready to accept and process that format

    So you can continue to report aggregate numbers manually typing in the MU portal and NOT report electronically this year.

  5. “CareFusion sells Pyxis drug dispensing machines and Alaris smart IV pumps, just in case your hospital feels the urge to buy something from a company willing to bribe its way to the bedside.”

    Whoa there, pardner. No need to throw the baby out with the bath water.

    Of all the places where I’ve worked, CFN was far and away the most obsessed with making sure employees knew they weren’t supposed to do any favors for physicians. For each expense we submitted for reimbursement — down to a $10 lunch — we had to certify that the money did not go to a physician precisely in order to avoid a case like this.

    True that CFN sells the Pyxis and Alaris products in addition to the skin disinfectant at the center of this DOJ investigation, but these are run as completely separate businesses by different presidents. They only meet at the CEO level, and Kieran doesn’t deal this way.

    If there was a bad actor deep inside the ChloraPrep business, that person will be dealt with both internally and by the authorities. A $41 million fine is enough of a tax on Pyxis and Alaris, who together are responsible for nearly all of the company’s profits. The people in those businesses make great products and don’t need you to call for a boycott because someone elsewhere in the company screwed up.

  6. ” Re: MU Stage 2 CQM measures. In meeting with our vendor, we were told they can’t submit them electronically yet because the standards changed in December and their software hasn’t been updated. I can’t find anything on a standards change. Is this true? Are other vendors running into the same issue? I would love to know what your readers think”

    Quality Data Model
    In case you missed it, we released a new version of the Quality Data Model (QDM) in December. The QDM was put together by the Centers for Medicare & Medicaid Services (CMS) and ONC and describes clinical concepts in a standardized format to enable electronic quality performance measurement. The model is the backbone for representing criteria used in clinical quality measures. The QDM is currently being harmonized with other relevant quality improvement and CDS standards. We are going to discuss plans for updating versions of the electronic specifications for clinical quality measures (CQMs) and continuation of the QDM user group during a public webinar on Feb. 6, 2014 (11am-12:30pm, EST). For more information on the QDM and QDM User Group, please visit http://www.healthit.gov/quality-data-model or contact qdm@mitre.org.

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