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February 6, 2014 News 6 Comments

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2-6-2014 8-50-45 PM

Athenahealth reports Q4 results: revenue up 48 percent, adjusted EPS $0.57 vs. $0.29, beating analyst expectations for both and sending ATHN shares up 19 percent in after hours trading Thursday. Above is the one-year performance of ATHN (blue) vs. the Nasdaq (red).

Reader Comments

2-6-2014 11-18-52 AM

From OnTheFringe: “Re: KLAS. Sponsoring a Best in KLAS TweetChat Friday. Oh my, I think I might have a few beers and fire up my Twitter account.”

2-6-2014 11-49-01 AM

inga_small From Faithful Sponsor: “Re: HIStalkapalooza attire. While I did not make the cut to attend HIStalkapalooza 2014, one of my executives did and I wanted to touch base to see what the theme was this year.” Let me start by saying that no one is sadder than Mr. H and me that we were not able to accommodate all our faithful readers and sponsors due to capacity limitations. The only HIStalker more sad than us is probably Dr. Jayne, who was unable to score an invite for her “+1,” a gentleman that Dr. Jayne assures me  is terrific, even if he did just cancel his HIStalk subscription over the perceived snub. Next year I am proposing we rent Soldier Field so we have plenty of room for anyone (though I suppose we might need to wear snow suits.) As for this year, we will once again be seeking contenders for the Inga Loves My Shoe contest, so please bring your A game. Overachievers who are able to pull off the whole package may be in the running for HIStalk King or Queen. If that’s not specific enough, here’s a good rule of thumb: leave the “just off the exhibit floor” company golf shirt in your hotel room and come adorned in something fun, flirty, and suitable for sipping Ingatinis. You’ll see some long gowns, a tux or two, plenty of cocktail dresses, and the occasional pair of blue jeans. It’s going to be fun.

From Gary: “Re: HIStalkapalooza. Rejected third year in a row. I have concluded that this is a hand picked, very political event, your own version of the Good Ole Boy network.” Every year I swear I’ll never do another HIStalkapalooza because of the endless complaining about who gets invited and the time and energy it takes to wade through hundreds of emails begging for (or demanding) invitations, insistence on bringing uninvited guests, or asking me to personally repeat event details that have already appeared several times in HIStalk. The event is a really nice, free party for maybe 1,000 people and neither the sponsor nor I get anything out of it except a ton of work, but somehow we end up being the bad guys when demand for invitations exceeds supply. The invitation process is clear and hasn’t changed since 2008: employees of non-profit providers (hospitals, practices, universities – hardly “political”) who request invitations come first. This year a huge number of providers signed up, leaving around 1,000 others without spots no matter how cool they are or how much I like them. It’s no different than a popular show or sporting event – not everybody is going to get a seat. Next thing you know scalpers will be lined up outside of the House of Blues.

Speaking of HIStalkapalooza, every year at least 40 percent of those invited don’t show up. This year I’m keeping a database of no-shows who don’t let me know in advance so that I can give someone else their spot – that will be the last HIStalkapalooza invitation they’ll get. A few invitees have already emailed to say their plans have changed and I really appreciate that.

From Reader: “Re: HIStalk. Thank you again for the wonderful service you offer our healthcare industry. So many of us wake up each morning to stay informed to the latest news via HIStalk. I am amazed at how well your content remains timely, fresh, and complete. We hope to see you at HIMSS, where we will release the next generation of our solution. Wishing you continued success in 2014.” Thanks. I don’t usually have enough time to watch demos at the HIMSS conference, but I will try to swing by at least briefly and anonymously.

From Silent: “Re: Epic. Going into the consulting business. This will greatly disrupt the current vendor marketplace.” Unverified.

From WildcatBelievers: “Re: The University of Arizona Health Network’s Diamond Children’s Hospital. Went live on Epic in November, recently put together this fantastic video with special guest band American Authors to celebrate the tremendous and impactful work they are doing to improve the lives of the children of Arizona.”

HIStalk Announcements and Requests

A few HIStalk Practice highlights from the last week include: Epic, eClinicalWorks, and Allscripts own 30 percent of the physician EMR market. Physician practices are far from ready for ICD-10. HHS finds that few health centers have the capacity to meet MU data sharing objectives. Reimbursements remained flat in 2013 for existing patient visits and declined for new patients. EHR alerts show promise in changing physician behavior when treating obese and overweight children. Dr. Gregg recommends taking time to step across the divide to reinvigorate your viewpoint. Culbert Healthcare’s Brad Boyd offers tips for optimizing clinical documentation. Thanks for reading.

2-6-2014 9-43-34 PM

Welcome to new HIStalk Platinum Sponsor CitiusTech, a leading healthcare technology services and solutions provider with 1,400 professionals (including 500 certified in HL7) serving over 50 leading healthcare organizations. The company has grown 55 percent year-over-year for the past five years and has won awards for being a great place to work. Its BI-Clinical healthcare business intelligence and clinical decision support system has been deployed at over 1,200 provider locations, with pre-built clinical, financial, operational, and regulatory reporting apps and 600 pre-built KPIs. Services include software product engineering, professional services, QA and test automation, and technology consulting. Specific practice areas are Meaningful Use compliance, interoperability, BI, consumer health, care management, and cloud and mobile health.  The company serves all healthcare markets – vendors, hospitals, medical groups, medical device companies, HIEs, health plans, and pharma. Thanks to CitiusTech for supporting HIStalk.

Here’s an overview of CitiusTech.

HIMSS Conference Social Events

Aventura, Nordic Consulting, Avent, and IHS Consulting will host the Row 1800 block party from 4:00-6:00 p.m. on Tuesday, February 25. All will be serving food and drinks and Aventura will feature a magic show at booth 1831. All hated competitors are welcome.

Upcoming Webinars

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

2-6-2014 9-37-29 PM

Private equity firm Thoma Bravo acquires supply chain solutions vendor Global Health Exchange.

2-6-2014 1-27-57 PM

Praesidian Capital invests $8.3 million in Etransmedia Technology.

2-6-2014 1-29-56 PM

Alere announces Q4 results: adjusted revenue up two percent, ajusted EPS $0.68 vs. $0.55, beating estimates. Net product and services revenue from Alere’s health information solutions segment was flat.

2-6-2014 1-30-53 PM

Bottomline Technologies will pay $8 million for Rationalwave Analytics, an early-stage predictive analytics company.

From Cerner’s earnings call:

  • The company signed 25 contracts over $5 million in the quarter
  • President Zane Burke says half of the market will reconsider their EHR supplier in the next few years, most of them will choose Cerner or Epic, and Cerner’s win rate against Epic has doubled in the past three years.
  • Cerner says it replaced 18  ambulatory competitors in signature accounts.
  • It says it sold an HIE to a 600-bed Epic hospital because Epic was “was unable to effectively connect to other systems.”
  • The company says providers are consolidating and Cerner hospitals are buying smaller ones at quadruple the rate of Epic hospitals.


2-6-2014 1-31-50 PM

FirstHealth of the Carolinas selects Truven Health Unify for population health management.

2-6-2014 1-32-56 PM

Bozeman Deaconess Hospital (MT) will implement Merge Healthcare’s VNA and interoperability solutions.

Metro-North ACO (PR) selects eClinicalWorks Care Coordination Medical Record to advance its physician-led ACO objectives.

Adventist Health System selects HealthMEDX to automate Adventist Care Centers, its long-term care division.

2-6-2014 1-39-21 PM

Genesis Medical Center (IA)  will implement Wolter Kluwer Health’s ProVation Medical software for cardiology procedure documentation and coding.

Covenant Health Systems (MA) adopts MedeAnalytics’ analytics platform to manage population health for its employees.

Athens-Limestone Hospital (AL) selects Besler Consulting to assist in the identification of Medicare Transfer DRG underpayments.

Providence Health & Services and Swedish Health Services (WA) will implement care transition and utilization review solutions from Curaspan Health Group, as well as Xerox’s Midas+ Care Management platform.


2-6-2014 1-03-52 PM

Axiom EPM hires David Janotha (Loyola University of Chicago Medical Center) as VP of healthcare.

2-6-2014 8-59-17 PM 2-6-2014 9-01-32 PM

Parallon names Scott Armstrong (OptumInsight) SVP and Wendy Penfield (Intellect Resources) as AVP, both in revenue cycle consulting services.

2-6-2014 9-06-26 PM

Surgical supply chain software vendor Solstice Medical hires Todd Melioris as CEO.

Announcements and Implementations

2-6-2014 1-44-43 PM

Geisinger Health System (PA) deploys Courion’s identity and access management solutions.

St. Luke’s University Hospital Network (PA) implements Get Real Health’s InstantPHR patient portal, which will be connected to Caradigm’s HIE platform.

HIMSS announces a Latin American version of its annual conference that will be held September 18-19 in Sao Paolo, Brazil.

Government and Politics

The Army and Air Force contract with a division of Goodwill Industries to scan and transmit to the VA the service treatment records of veterans discharged this year.

2-6-2014 8-43-51 PM

The DoD and VA collaborate to develop a way for the VA to review the scanned images of the DoD electronic medical records of disability claimants.

2-6-2014 10-16-45 PM

Farzad Mostashari tweets out a section of the proposed SGR bill that would roll Meaningful Use and PQRS incentives into a new value-based payment system that would start in 2017.  Additional language would require EHRs to be interoperable.

The former CFO of Shelby Regional Medical Center (TX) is indicted for Medicare fraud, charged with falsely attesting that the hospital met Meaningful Use requirements for 2012. The hospital was mostly paper-based, but ordered its software vendor (eCareSoft) and employees to manually enter information into the EHR months after discharge to earn $786,000 in incentive payments. The hospital was part of a now-defunct for-profit chain that collected $18 million in Meaningful Use payments before being dismantled after reports of serious patient care issues.

The governor of Massachusetts apologizes for the state’s dysfunctional insurance exchange website as a non-profit research firm finds the site loaded with “technical infrastructure and data stability problems.” The governor says that contractor CGI, which was also responsible for Healthcare.gov, was  not reliable and relieved CGI overseer University of Massachusetts Medical Center of further responsibilities.


New York officials report that the state’s online database for drug prescriptions has reduced doctor shopping by 75 percent since its August 2013 implementation.

The World Health Organization postpones the rollout of ICD-11 until 2017, two years later than planned.

Sponsor Updates

  • AirWatch opens an Australian headquarters in Melbourne.
  • Allscripts announces the general availability of Sunrise Version 14.1.
  • Jed Shay, MD shares how his use of AdvancedMD’s EHR and PM services have contributed to improved cash flow, productivity, and patient tracking.
  • T-System files a patent application for an ICD-10 feedback feature that helps clinicians document for ICD-10 without an interruption in workflow.
  • Huron Healthcare will integrate predictive analytic technologies from Connance into its revenue cycle solutions.
  • Russell Green, VP of research operations and engagement manager for Porter Research, discusses the mixed messaging of HIEs in a blog post.
  • Kelsey Creveling from Sagacious Consultants clarifies changes in the Safe Harbor regulation in a blog post.
  • MyCatalyst will use Liaison Healthcare’s Data Management platform for its myCatalyst Provider Portal and Population Health Reportal solutions.

EPtalk by Dr. Jayne


The pre-HIMSS mail bonanza has started. It seems a little earlier than last year. Today’s winner is GCX Mounting Solutions, whose “scratch and win” card fell victim to the Postal Service’s automated mail handling machines. A fair number of mailings arrive mangled every year. I wonder if the marketing and promotional companies ever consider doing a test mailing to make sure their items will arrive as intended?

Several vendors have shared invitations to their client appreciation parties and I’m looking forward to writing them up. I haven’t heard from very many EHR vendors, so either they don’t want sassy women in fabulous shoes to attend or they’re just behind. Inga will be sharing invitations from those vendors willing to open their events to HIStalk readers. I appreciate their willingness to let everyone share in the fun. After slogging through 500,000 square feet of exhibit space and 1,200 exhibitors, the opportunity to unwind and partake of a cocktail is more than welcome.

Something I’ll be on the lookout for in the exhibit hall: devices that use the new Corning antimicrobial Gorilla Glass. When I think about all the devices I come into contact with each day in the hospital compared to the variable handwashing behavior of some of my colleagues, it seems like a good idea. I see more people wiping down equipment at the gym than I see on the wards and that’s not a good thing. I haven’t seen any evidence-based reports on how well it works, so if you have any inside scoop, let me know.

The World Health Organization is postponing the rollout of ICD-11. Originally slated for 2015, it will be delayed until 2017. Hopefully this will quiet those voices advocating that we skip ICD-9 and go straight to ICD-11. ICD-10 was approved in May 1990 and first came into use in 1994, so based on the historical timeline, the United States should be ready for ICD-11 in 2038. Thank goodness I’ll be retired by then.


Several readers emailed about this week’s Curbside Consult on wearable tech. One mentioned the lack of interest in a mobile healthcare enterprise device. Manufacturers are focused on selling directly to the masses, but it would seem like there is a place for enterprise devices in the Accountable Care or HMO spaces. Another lamented the lack of integration among devices — “I feel like a nurse with 50 devices being a kangaroo.”

When I was in residency, we used to refer to the group of pagers that you had to wear when you were on call as the Batman Utility Belt. There was the on-call pager, the code team pager, and your personal pager. You also had to carry the elevator keys (because who wants to run up 17 floors when a patient needs CPR?) Throw on a bulky cell phone, and if you were extra lucky, the labor and delivery pager, and you were ready to go. I almost forgot – some also had a Palm Pilot, although I was partial to the Pocket PC.

We’ve certainly come a long way. Some of us are down to one device if we work in a BYOD environment. I’m still toting a corporate phone and a personal phone, but it certainly could be worse. Have you been able to shed the utility belt? 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. ATHN – I’m not sure I get it…

    Did they really make 2.6 Million dollars (enough to pay off Mr. Evil 2 times over) which is 1/6th of what they made last year?

    I’m not a financial expert nor an investment genius. Can someone who understands financials, financing and the public market comment?


    For the year ended December 31, 2013, GAAP Net Income was $2.6 million, or $0.07 per diluted share, compared to $18.7 million, or $0.50 per diluted share, for the year ended December 31, 2012.

    For the year ended December 31, 2013, Non-GAAP Adjusted Net Income was $44.3 million, or $1.16 per diluted share, compared to $37.2 million, or $1.00 per diluted share, for the year ended December 31, 2012.

    Our full year non-GAAP effective tax rate of 37% was lower than we anticipated primarily due to better than expected research and development tax credits. This lower non-GAAP effective tax rate increased our Non-GAAP Adjusted Net Income per Diluted Share for the year ended December 31, 2013, by approximately $0.08.

    As of December 31, 2013, we had cash and cash equivalents of $65.0 million and outstanding indebtedness of $223.8 million.

  2. To Gary – I don’t think Histalkapaloza is rigged for invites. I got one last year and attended, and while I am an avid reader – I am not a celebrity invite by any means. It was a very nice event and I appreciated the experience.
    I find it really surprising that 40% would not attend without notice… It’s easy enough to drop a quick email or send a tweet.

  3. Re: Epic. Going into the consulting business.

    I predict this will be good for their customers. Organizations willl now be able to contract directly with Epic for specific resource requirements. While Epic, like other vendors, is not perfect, they set the standard very high for their staff.

    I hope it is not used as an opportunity for Epic to capture the lions share of the consulting market by ‘banning’ competing firms.

  4. Epic is already been in the consulting business. They have an Implementation Services team (IS) comprised of full time staff who are not developers and who shepherd along the implementation process at clients. So if by “consulting”, you mean they are venturing into more PM roles, it appears they are already there. Can someone please clarify “silent”s comments – it just seems like old news (as is 4 years old +) to me?

  5. To Silent and Clarify and ConsultingForEpic:

    Epic is not in the business of consulting.

    It would be a conflict of interest for them.

    Epic Staff site visits:

    these can be broken out into Immersion trips, R&D trips and Technical Services trips

    1. Implementation Immersion/Immersion trips cost:
    Expenses incurred by learners are usually covered by Epic. Occasionally, when the learners will be active participants in the implementation sessions, Epic will
    bill for learner expenses. Your Epic implementation coordinator will contact you if this is the case.

    Your assigned Epic implementation team will bill their time and expenses normally.

    2. R&D trips cost:

    R&D immersion expenses are covered by Epic.

    3. Technical Services trips cost:

    Depending on the circumstances of the trip, a TS onsite visit might be billable.

    Before everyone gets up in arms and calls foul, there are subtleties to this

    they may include:

    Charges for Epic programming, systems assistance, interfaces, technical services, change orders

  6. Re: Gary: “Re: HIStalkapalooza. Rejected third year in a row

    I went back and checked the HIStalkapalooza invitee lists for the past two years and Gary was invited to both. This year he was not. Whether it was the fault of his employer’s spam filter or his oversight you can hardly blame Mr. H for not selecting someone who was invited the prior two years but didn’t show up when there were more requests for invitation than he could accommodate. Sorry, Gary, you were hand picked to be one of the Boys and we gave you the secret handshake, but after two years, your invitation expired.

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