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September 2, 2014 News 8 Comments

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Experts speculate that a known vulnerability of Apple’s FindMyPhone app allowed hackers to download nude photos of celebrities from their synced iCloud accounts using a brute force password attack program. Apple buries the optional two-factor authentication option in technical documentation and allows unlimited password guesses. The company has released an emergency patch. The healthcare connection: the timing for Apple couldn’t be worse as it prepares to announce new health-related apps next week. They’ve apparently known about the problem for a long time.

Reader Comments


From 123456: “Re: The Advisory Board. Announced a hiring freeze on Friday, but didn’t call it that.” The internal email says, “For the coming months, we will prioritize staffing needs based on member impact and growth, which also means in some cases deprioritizing currently open positions and not filling them this year.” ABCO has been on a hiring tear and will add another 400 employees by the end of the year (for a total of 1,100 new hires in 2014), so that seems like a smart decision and good news for existing employees. It’s like having a table in a restaurant that’s turning away walk-ups. It would be a far less upbeat story if they were laying off, shrinking headcount by attrition, or growing too quickly by bringing on poor hires.


From Unbelievable: “Re: QuadraMed. Announced another reorganization today. Customers have expressed disappointment with the services team and the lack of experienced resources, contracting directly with former employees to achieve Meaningful Use.” Unverified.


From CaptainSalty: “Re: Explorys. Apparently a large strategic player is deep in acquisition talks.” Unverified.


From Julia: “Re: 2014 CEHRT. A table on this page says the flexibility with MU2 reporting is for providers whose vendors have delayed 2014 Edition EHRT availability. But this chart implies you can choose Stage 1 criteria even though you’re using a 2014 CEHRT. Any insight?” I’ve lost interest in the Meaningful Use program, so I’ll let someone who follows it more closely answer. This latest round of tweaks exceeded my attention span permanently.

HIStalk Announcements and Requests


Citrix says they’ve fixed the GoToWebinar problem we had last week that locked some registered people out. We don’t trust their fix (in which they just rolled us back to the last good version), so we could use some help testing Wednesday (today) at noon Eastern. They say if we can get more than 32 people, we’ll be fine for our next live webinar on Thursday. To help us out:

  1. Register for our test webinar (just your name and email address is fine – GTW requires both).
  2. Jump on the webinar at noon ET Wednesday. You don’t even need to call in since we just need to see if we can get everybody logged on.
  3. Just hang out there until Lorre sees more than 32 people on and gives the OK to log off. She might tell stories or something while we wait.

The word I replace most often in reader-submitted articles: “utilize.” It’s no better than the shorter and less pretentious “use.” Here’s another oddity I see in nearly every interview: instead of saying, “We wanted to see how the market reacted,” I usually get, “We wanted to see how does the market react,” making me wonder whether or not to use a question mark after the oddly phrased semi-question.


September 4 (Thursday) 2:00 p.m. ET. MU2 Veterans Speak Out: Implementing Direct Secure Messaging for Success. Presented by DataMotion. Moderator: Mr. HIStalk. Panelists: Darby Buroker, executive director of health information exchange, Steward Health Care; Anne Lara, EdD, RN, CIO, Union Hospital of Cecil County, MD; Andy Nieto, health IT strategist, DataMotion; Mat Osmanski, senior application analyst, Steward Health Care; Bill Winn, PhD, Meaningful Use service line executive, Navin, Haffty & Associates. Panelists will discuss the strategy and tactics of meeting the transitions of care requirements for MU2, including assembling the team, implementing Direct Secure Messaging, getting providers on board, and reporting results.

September 11 (Thursday) 1:00 p.m.ET. Electronic Health Record Divorce Rates on the Rise — The Four Factors that Predict Long-term Success. Presented by The Breakaway Group, A Xerox Company. Presenters: Heather Haugen, PhD, CEO and managing director, The Breakaway Group, A Xerox Company; Bill Rieger, CIO, Flagler Hospital, St. Augustine, FL. Many users are considering divorcing their EHR as dissatisfaction increases. Many are spending 90 percent of their time and resources on the wedding  (the go-live) instead of the long-term commitment to new workflows, communication, education, and care outcomes (the marriage). Hear more about the findings of research published in “Beyond Implementation: A Prescription for Lasting EMR Adoption” about EHR adoption and success factors.  Registrants get a free electronic or paper copy of the book.

Acquisitions, Funding, Business, and Stock


Compuware will be acquired by private equity firm Thoma Bravo from $2.5 billion after years of pressure from activist hedge fund operator Elliott Management, whose $2.3 billion offer to buy the company was rejected in December 2012.



University of Toledo Physicians (OH) chooses athenaOne.


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News I missed from a few days ago: Rebecca Kaul, president of UPMC’s Technology Development Center and daughter of CEO Jeffrey Romoff, resigns three months after being given the chief innovation officer title. Her group developed several applications, including the ConvergenceMD tablet app, and invests in technology companies not owned by UPMC. VP and radiology informatics chief Rasu Shrestha, MD replaces her.


Forward Health Group names Laura Kreofsky (Seek LLC) director of client services.

Announcements and Implementations


The Department of Homeland Security goes live on eClinicalWorks at its 23 Immigration and Customs Enforcement detention facilities. Harris Corporation was the primary bidder.

The PACS Designer launches an Indiegogo campaign to fund development of his Solutions Whitebook that will cross reference ICD-10 codes to ICD-9.

Craneware launches Reference Plus to ease chargemaster maintenance and coding for critical access and independent community hospitals.


EDCO Health Information Solutions announces Version 3.5 of its Solarity medical record scanning and indexing software, which allows users to scan and send paper medical record components to HIM in as few as three clicks.


Spok announces Spok Mobile 4.0, the latest release of its secure messaging app that provides a user status indicator and free trial version.

Government and Politics

The new US Digital Services posts its Playbook with 13 key plays and associated checklists and key questions for each :

  1. Understand what people need.
  2. Address the whole experience, from start to finish.
  3. Make it simple and intuitive.
  4. Build the service using agile and iterative practices.
  5. Structure budgets and contracts to support delivery.
  6. Assign one leader and hold that person accountable.
  7. Bring in experienced teams.
  8. Choose a modern technology stack.
  9. Deploy in a flexible hosting environment.
  10. Automate testing and deployments.
  11. Manage security and privacy through reusable processes.
  12. Use data to drive decisions.
  13. Default to open.


A Wired article on how to make programming code “beautiful” explains at great length what seems like a fairly obvious method to avoid deadlocked rows, storing multiple versions, and tracking status changes: store the original row when added, then never update it directly, instead recording transactions that are performed on it such as “invoice status changed” and “line item added.” Sounds good except for the overhead required to look at the current state of the row, which would require replaying all the individual transactions created against it. Nobody likes seeing a “record lock” error, but they also don’t like waiting to see the information they requested.



Chicago-area Northwestern Memorial HealthCare and Cadence Health merge to form a four-hospital, 19,500-employee, $3 billion organization.

A before-and-after study of 30 hospital-associated medical practices finds that EHR implementation in 2007-2009 was associated with increased revenue, but with fewer patients seen. It concludes that while productivity slipped with EHR usage, increased orders for ancillary procedures (not upcoding) increased revenue, leading the authors to speculate that doctors possibly “were taking better care of fewer patients.”


In England, the influential doctor who serves as Chief Inspector of General Practice says that hospitals and practices put patients lives at risk by not sharing electronic medical records. He says the “wall between hospitals and GPs” forces consultants to write letters describing recommended treatments instead of entering them into a shared medical record and prevents hospitals from seeing office-based lab test results. He also advocates giving patients access to their own records.

The Toledo newspaper reports that many area private practice doctors are signing up to become hospital employees, with one cardiology group reporting that cardiologists went from 85 percent in independent practice to 85 percent employed in just 18 months. It quotes a family practitioner who listed access to Epic as one of the reasons he went to work for a hospital, explaining, “A doctor in practice will never have Epic. They don’t sell that to small groups — it’s too expensive.”

Sponsor Updates

  • iHT2 releases a research report titled “Answers to Healthcare Leaders’ Cloud Questions.”


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

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Currently there are "8 comments" on this Article:

  1. To Julia, Re: 2014 CEHRT

    Let’s say a provider was not able to get access to a 2014 CEHRT until September 2014. The provider is Stage 2 eligible but doesn’t have enough time between September and October 1 to train staff and educate patients on the new workflows required to meet Stage 2 (patient messaging, etc.). Under the new flexibility rule, that provider could choose to complete Stage 1 for the last quarter of 2014 to meet 2014 reporting criteria, which would be somewhat easier than meeting all of the Stage 2 requirements which have new measures and higher thresholds. Important to note, however, that the provider in this scenario would still be required to complete a full calendar year reporting period meeting Stage 2 criteria in 2015. If that seems like an illogical jump in requirements from one year to the next, you’re in the same boat as many hospital execs.

  2. Anyone betting that we’ll see a eCW / Harris press release congratulating themselves on achieving Meaningful Use for their 1000+ EPs in 90 days?

  3. Re: Toledo newspaper report

    As I browse our provider directory, we have now just two cardiology practices in town – each one associated with the two competing hospitals. I don’t believe the docs are directly employed, but they live in our building, use our systems, etc. – so what is the difference, really. Before Epic they were “kind of” independent though aligned, and after Epic they both went in deep with each hospital. I agree that independent practices will need to get on board with the primary EHR in town – though think that Epic is not out of reach with the ability for hospitals to “resell.”

  4. I think comatose was a perfect descriptor for the current state of the MU program.
    The sad thing is that CMS had an opportunity to improve things by making 2015 more flexible.

    Instead we got:
    1. Relief/flexibility in 2014, which ends in 27 days, so many folks have already figured this one out if they ever were going to.
    2. Pushed Stage 3 from 2016 to 2017, which virtually no one cares about today.
    3. No change for the year-long reporting period that begins in 2015, which starts in 27 days and was the primary stressor for most community hospitals.

    #3 was completely ignored, despite > 1000 public comments urging CMS to address this. As someone on the ground level with several community hospitals desperately trying to be ready for 2015, and realizing they aren’t going to make it, it is just crazy that this was ignored.

  5. re: Wired article on “append-only” databases. Very interesting – welcome to MEDITECH 6.x. The database described there is very similar to the M-AT (MEDITECH Advanced Technology) database. No direct updates to the record, just new records/transactions added. Data integrity is better. Audit trails are a natural byproduct. However, database performance due to the ever-growing record is an obvious issue as the article pointed out.

  6. No one from Quadramed (or more importantly the parent company ) asks me or my staff to comment on the performance of its business units. The previous reorganization proved only to make all of us feel more isolated, less supported and more committed to identifying an alternative supplier. The current reorganization removes ANY reluctance we had to the painstaking process of changing vendors. Many of the QCPR users I have known have already moved to another vendor, and all of the current users I know are embarrassed by the level of service and support they are expected to accept. What happened to the product/company that many of us were proud to choose as our preferred vendor many years ago? Unfortunately, that pride of ownership does not exist at the executive levels of Quadramed, or Harris/Constellation. If it did, so much would be different, and they would not have appointed the senior personnel now in place.

  7. Many of my colleagues including myself see these reorganizations being used to indicate progress and growth, when in reality we are losing customers and have no new sales. The offices are ghost towns. Most of the knowledgeable employees have left and the rest of us are actively looking. It is a real mess

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