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March 11, 2014 News 6 Comments

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The HIT Policy Committee submits its Meaningful Use Workgroup’s Stage 3 recommendations.

Reader Comments


From Pointy Toes: “Re: CEHRT Hardship Exception Guidance. This is a joke. All you have to say to qualify for the Medicare hardship exemption to avoid the 2015 payment adjustment is say you  had ‘2014 Vendor Issues.’ Tavenner previously said some ‘narrow’ hardship exemptions would be granted. Sounds like anyone wanting an exemption can request it and presumably one will be granted one. Why not just push the deadline back for everyone instead of requiring providers to jump through an extra hoop?” CMS issued guidance Tuesday for EPs and hospitals worried about being hit with penalties, even going so far as to provide instructions to choose “2014 Vendor Issues” no matter what their actual issue. It is ridiculous – setting the bar high officially, then accepting a wink-wink rubber stamp excuse for anyone who can’t make it. Maybe someone should track the vendors whose non-compliant yet certified products forced their users to claim hardship.

From Canuck: “Re: rumore that UHN in Toronto is replacing QuadraMed EHR with Cerner. I believe instead it came down to Cerner and Epic and Epic won.” Unverified.

HIStalk Announcements and Requests


Welcome to new HIStalk Gold Sponsor SyTrue. The Chico, CA-based company offers a business and clinical intelligence platform that tells hospitals how their clinical objectives are being deployed; what physicians are doing; and who in the market is providing services at a given cost and outcome. It integrates and structures disparate EHR information for predictive and clinical analytics used for data analysis, electronic abstraction, outcomes analytics, operations, population management, clinical research, and patient engagement. Thanks to SyTrue for supporting HIStalk.


Here’s one final mug shot featuring Tammi’s office de-stresser, which must have traveled furthest from Orlando while still not leaving the continental US (the UFO on a stick in the background should give a strong hint of her location).


Thanks to the 355 folks who have completed my reader survey so far. That number provides respondents with good odds of being randomly drawn for one of three $50 Amazon gift cards, but represents only around 1 percent of HIStalk’s 30,000+ readers. Spend less than five minutes completing the survey and you’ll help me plan the next year of HIStalk and earn my appreciation besides.

I’m always looking for interesting people to interview. Know someone who would be stimulating, fun, and a straight shooter? Let me know.

Upcoming Webinars

March 19 (Wednesday), 1:00 p.m. ET. The Top Trends That Matter in 2014. Sponsored by Health Catalyst. Presenters: Bobbi Brown, VP and Paul Horstmeier, SVP, Health Catalyst. Fresh back from HIMSS14, learn about 26 trends that all healthcare executives ought to be tracking. Understand the impact of these trends, be able to summarize them to an executive audience, and learn how they will increase the need for healthcare data analytics.

Acquisitions, Funding, Business, and Stock

First-half results from Scotland-based Craneware: revenue up five percent, pre-tax profit up seven percent.

CompuGroup Medical acquires three European HIT providers: lab software provider vision4health Laufenberg & Co and office-based physician software vendors Imagine Editions and Imagine Assistance.

Quest Diagnostics completes its acquisition of Solstas Lab Partners Group and raises its full-year 2014 financial guidance.


Employer benefits platform provider Castlight Health raises the price range of its IPO to $13-15 per share, up from the $9-11 range it set just a week ago. The company, which lost $62 million on $13 million of revenue in 2013, would receive proceeds of $140 million, valuing it at $1.5 billion. The company’s founders are Todd Park (US CTO and co-founder of athenahealth); Bryan Roberts, PhD (chairman and co-founder of venture capital firm Venrock); and Giovanni Colella, MD (founder of RelayHealth).



The Royal Free London NHS Foundation Trust selects OpenText to manage its scanned legacy case notes.

The Community of Hope (DC) is implementing Forward Health Group’s PopulationManager and The Guideline Advantage.

The VA awards Leidos three contracts worth $16 million to support blood bank software and the MyHealtheVet program.


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TeleTracking Technologies names Diane Watson (Tilt, Inc.) COO and Joseph Tetzlaff (inVentiv Health) CTO.


Michael Hart is promoted to VP of IT applications at Arkansas Children’s Hospital.


Craig Joseph, MD (Agnesian HealthCare) is named ICD-10 and EHR physician advisor at Texas Children’s Hospital (TX).

Announcements and Implementations

Cox Health (MO) deploys Phytel’s population health and patient engagement platform.

McKesson announces QICS for Cardiology, a CVIS-based workflow and critical results communications platform. OSF Healthcare (IL) is piloting.

QuadraMed announces GA of its QCPR 6.0 enterprise EHR, which includes bar code medication administration, a comprehensive problem list, a Web-based patient portal, the ability to create a CCD, and Canada-specific architecture requirements.


In Canada, Bluewater Health will roll out patient flow software from Oculys.


University of Colorado Physicians goes live on the DocASAP self-scheduling system.

Government and Politics

Office of Civil Rights fines the public health department of Skagit County, WA $215,000 for HIPAA violations involving information on 1,581 people exposed in its public web server, the first time a HIPAA fine has been levied against a local government.


The White House launches #GeeksGetCovered, encouraging technology entrepreneurs who can now buy their own non-employer health insurance because of the Affordable Care Act to start their own businesses.

President Obama riffs hilariously with comedian Zach Galifianakis, appearing on “Between Two Ferns” to plug Healthcare.gov (“I wouldn’t be with you here today if I didn’t have something to plug … Healthcare.gov works great now.”)


The phrase “healthcare exchange” always seems to be preceded by “troubled,” so add Maryland’s $200 million version to the list.  Like other states, it decided to create its own site, hired a contractor that it later said underperformed, missed its go-live date, and had to create a backup plan to accommodate people who wanted to enroll but couldn’t. HHS announces that it will investigate.

Hillary Clinton’s financial disclosure forms for 2012 reveal that her husband Bill took a $225,000 speaking fee from the struggling, non-profit Washington Hospital Center as it was laying off employees. The hospital also brought in George W. Bush to speak, but since his wife isn’t running for office, his fee remains confidential. Bill made a bunch of money in 2012 for addressing money-losing non-profits. Somewhere in those records is the payment he received from HIMSS if anyone knows how to locate them. I’d bet $400K.

Innovation and Research


A NIST report says that inadequate workflow integration forces users of ambulatory EHRs to develop system workarounds, suggesting that EHR vendors develop these capabilities:

  • At-a-glance physician views of patient schedules
  • Task reminders from previous patient visits
  • Redacting and summarizing lab results
  • Draft creation of patients orders in advance
  • Conversion of working diagnoses to formal diagnoses
  • Skip or defer tasks when workload requires
  • Role-based views of progress notes
  • Visually differentiate copied-and-pasted progress note text from newly entered documentation
  • Manage referral and consultation messages with specialists
  • Track scheduled consults and lab results review


The Charlotte, NC newspaper says that Carolinas HealthCare System will use innovative (unnamed) software and the information collected by its multiple EMR systems to identify ED patients who are likely to be readmitted, allowing team-based intervention and remote management. The system’s chief medical officer weighs in on hospitals that don’t use electronic medical records: “You don’t know how bad it is until you actually go back. It was like a time warp. The care is unsafe, it’s uncoordinated. It’s a nightmare…The system was absolutely stupid, and frightening.” I interviewed SVP/CIO Craig Richardville in September 2013. It might be time for a follow-up to talk about analytics.



Wellocracy provides a well done comparison chart of wearable activity trackers.



A column by InfoWorld’s executor editor says a disconnect exists between complex government EHR requirements and the stubbornness of the healthcare industry to embrace them, summarizing, “We have a mess of proprietary EHR systems with highly customized processes, a set of HIEs that use different standards and protocols to connect them, and a mandate to provide human-readable data from these disparate systems. What could possibly go right?”

In England, University Hospital of North Staffordshire plans to conduct video consultations via Skype, saying the service will reduce outpatient appointments by 35 percent.


The Gainesville, FL newspaper profiles Shadow Health, whose founder licensed avatar technology from the University of Florida to create nursing school education tools that students buy for $89.

A study finds that incorrectly flagging patients as being allergic to penicillin increases overall inpatient days by 10 percent and increases resistance to broad-spectrum antibiotics. Up to 95 percent of patients who say they are allergic to penicillin really aren’t.


New York-Presbyterian Hospital will host a hospital hackathon this weekend in which teams will design apps for its portal that improve patient access to care. The hospital is offering $85,000 in prizes and has filled all of its slots with 120 participants. Dr. Oz provides the video introduction.

Sponsor Updates

  • Kinetic Data names CareTech Solutions “Innovator of the Year” for realizing $4.7 million in cost savings by implementing Kinetic Request.
  • Premier enhances its OperationsAdvisor labor management solution to give healthcare organizations the ability to analyze labor efficiency across multiple care settings.
  • Ryan Uteg, senior advisor for Impact Advisors, is named to Consulting Magazine’s “35 Under 35.”
  • Allscripts Sunrise is selected by Black Book as top inpatient EHR.
  • Iatric Systems will deploy integration in the EDIS and vital sign monitors as Southeast Alabama Medical Center (AL) upgrades its McKesson Paragon HIS.
  • MedAssets’ National Sourcing Collaborative cumulatively saves providers $135 million over the last three years.
  • Wolters Kluwer Health launches Bates’ Visual Guide demonstrating evidence-based physical exam techniques.
  • Santa Rosa Consulting’s Fred L. Brown is inducted into Modern Healthcare’s “Health Care Hall of Fame 2014.”
  • Kareo announces that its ICD-10 Success Checklist is available on a write-on poster.
  • NextGen Healthcare’s CMO Sarah Corley is elected to serve on the EHR Association Executive Committee.
  • Medical Economics spotlights e-MDs customer John Bender, MD of Miramont Family Medicine (CO) for expanding his practice while 30 percent of local practices have sold or closed.
  • Health Catalyst publishes a free white paper with a candid 12-point review of population health management software vendors.


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. During Tuesday’s HIT Policy Committee Meeting, Judy Faulkner said that Stage 2 cost Epic 350 person years of effort to develop. She said it’s about $50 million. An impressive number that shows that Meaningful Use and Certification have become a tangled web of functions that are useless to many hospitals.

  2. Re: CEHRT Hardship Exception Guidance
    Amy thoughts on what this means for incentive payments? Do EP’s pick up in 2015 with the payment they would have received in 2014 – or do they decrease to what they would have been scheduled to collect in 2015?

  3. Allscripts beats Epic, impressive. Allscripts dbMotion was ranked the #1 HIE by Black Book too. How does Black Book differ from KLAS?

    Thank you

  4. @professional user: CMS has previously said that any provider who claims a hardship exemption will still be considered to have participated fully in that payment year. As a result you’d lose out on the incentive dollars for the year you claim an exemption and the next years incentives would be stepped down accordingly. You do avoid the future penalties though.

  5. A couple of observations on the Stage 3 MU recommendations.

    1) Now in demographics they want sexual orientation, preferred method of communication, occupation and industry codes. Here we are in Stage 3 after four years of a wild and crazy process and we still are not required capture patient name, address, SSN, insurance, or other basic info. Did you know a vendor could pass the ONC test and never show a patient name?

    2) Under Patient Amendments the Staples Easy button is now required! It states: “Provide patients with an easy way to request an amendment to their record online”. With no description of ‘easy’ it must be the Staples button!

    Re: MU penalty exceptions and the ‘Vendor Issues” excuse.

    Vendors better watch out on this one. If a client uses this excuse I would expect ONC via the AA (ANSI) to look into pulling the vendors certification. Remember under the final rules the AA must address provider complaints about systems not functioning according to the Certification requirements. When a provider complains about a vendor failure then the AA must issue a public notice that the product is under investigation (much like the FDA does with drugs). The reality is if the AA were to issue a notice of review due to provider complaint, your sales for the next six months will probably dry up. OUCH!

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