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October 7, 2014 News 14 Comments

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CMS will reopen the submission period for EHR hardship exceptions through November 30, 2014. Valid circumstances are vendor delays in providing 2014 Edition CEHRT and the inability to attest via the 2014 CEHRT Flexibility Rule. They didn’t give a reason, but it’s probably because their attestation system wasn’t working and providers were going to be penalized for another CMS technology screw-up.

Reader Comments

From Zephyr: “Re: Ebola. Epic is hosting a conference call Wednesday to allow users to share strategies for screening, notification, and management of communicable diseases.” Unverified, but I think all ED system vendors should consider doing this. Epic has a vested interest since it was called out (correctly or not, depending on which hospital press release you believe) by Texas Health Resources, which owns the hospital that discharged an Ebola patient from its ED due to poor communication of his stated recent visit to Liberia.

From Doppelganger: “Re: MU. We are an EH trying to attest since July for Stage 1 Year 2 for the period April-June 2014. We first attested under Medicaid for 2012, then Medicaid and Medicare in 2013. There’s a bug in the CMS website – they think we’re in our third year of attestation, so we must be on Stage 2. I’ve heard this is happening to everyone who attested under Medicaid for 2012 only. CMS said the bug would be fixed on October 1. It still isn’t and my CFO wants his ‘free’ money!” CMS seems to be struggling with its websites these days, so I’m sure others are having the same problem.


October 21 (Tuesday) 1:00 p.m. ET. Electronic Prescribing Of Controlled Substance Is Here, What Should You Do? Sponsored by Imprivata. Presenters: William T. “Bill” Winsley, MS, RPh, former executive director, Ohio State Board of Pharmacy; Sean Kelly, MD, physician, Beth Israel Deaconess Medical Center;  David Ting, founder and CEO, Imprivata. Providers are challenged to use EPCS to raise e-prescribing rates for MU, improve physician productivity, reduce fraud and errors, and meet New York’s March 2015 e-prescribing mandate. Hydrocodone painkillers such as Vicodin have moved to Schedule II, with the higher CS prescribing volume adding another reason to implement e-prescribing. This webinar will describe why organizations should roll out EPCS, presented from the perspectives of pharmacy, compliance, physicians, and technology.

Acquisitions, Funding, Business, and Stock


Cognizant, which bought TriZetto two weeks ago for $2.7 billion, acquires healthcare digital marketing company Cadient Group.  

Rock Health runs an interesting interview with a Goldman Sachs healthcare IT guy on doing IPOs. A good quote: “Being public—not just going public—can put you in a very powerful position as you continue to build your toolset and maximize its importance in the world. But the process is time intensive and distracting, so always be objective and sober about it. Maintain control and don’t let the euphoria and momentum of the IPO process carry you away such that you later wish you had spent time continuing to innovate and build the business rather than focusing on the IPO.”


Hewlett-Packard will split into separate companies, one (Hewlett-Packard Enterprise) focusing on enterprise hardware and services and the other (HP) on PCs and printers. 


Medical supply manufacturer Becton Dickinson will acquire CareFusion for $12 billion in cash and stock. CareFusion’s health IT-related product lines include Alaris (smart IV pumps), MedMined (infection surveillance), and Pyxis (medication and supply dispensing). The company was a 2009 Cardinal Health spinoff. The Department of Justice fined CareFusion $40 million earlier this year for paying high-profile patient safety advocate Charles Denham, MD nearly $12 million to recommend the company’s skin prep cleanser via the National Quality Forum.


Alteryx, which offers software that allows minimally technical users to create workflow-driven applications from data sources, raises $60 million in a Series B round. The company, which partners with Tableau and QlikView, offers a 14-day free trial download.


United Physicians (MI) will roll out Wellcentive’s population health and risk management solutions to cover all its patients.

Community Health Centers of Arkansas will implement eClinicalWorks Care Coordination Medical Records across 10 practices and 58 locations.


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GE Healthcare President and CEO John Dineen resigns effective immediately to “look at new leadership opportunities outside GE.” He will be replaced by SVP of business development John Flannery.


Sheryl Bushman, MD (NYU Langone Medical Center) joins Optimum Healthcare IT as CMIO.


Sean McDonald, who founded the Pittsburgh-based hospital pharmacy robotics vendor Automated Healthcare and sold it to McKesson in 1996, leaves his CEO job at Precision Therapeutics.


Jim Cato, EdD, RN, MSN, CRNA (Christus Spohn Health System) joins GetWellNetwork as SVP of clinical integration and operations.

Announcements and Implementations


XIFIN will use SyTrue’s terminology as a service to improve pathology services billing and to ease the conversion to ICD-10.


A local newspaper article by Lee Memorial Health System (FL) CIO Mike Smith describes its go-live with Epic MyChart.


Caradigm releases a population health applications bundle that includes its Intelligence Platform plus modules for patient knowledge aggregation, risk management, quality improvement, and care management. 


Surescripts integrates its CompleteEPA medication prior authorization system with Epic.

T-System releases system-agnostic Ebola patient screening tools that are free to all providers.


Premier adds real-time predictive analytics from Predixion Software to its PremierConnect data management and decision-making platform.

Merge Healthcare adds electronic referral and order management to its iConnect image sharing network.

Government and Politics

Medicare will change its five-star rating system for nursing homes after news organizations questioned the validity of self-reported data. Among the changes will be mandatory quarterly electronic submission of payroll data to verify staffing levels and an auditing program to validate quality measures ratings.

The VA, following up on its investigation of long wait times, fires three health system directors and its chief procurement officer. One of the fired directors announced his retirement four days before his termination was made public, which the chairman of the House Veterans’ Affairs Committee called, “semantic sleights of hand.” The procurement officer was fired for inappropriately influencing a contract award and then trying to block the resulting investigation.


Massachusetts Governor Deval Patrick says the state’s health insurance exchange has been fixed for $26 million and a total cost of $254 million, far les than the $600 million total that a think tank had estimated last month.  


A Texas Senate committee is holding hearings into how Ebola patient Thomas Duncan ended up at Texas Health Presbyterian Hospital and why the hospital’s ED discharged him even though he was feverish and told the nurse just came back from liberia.  

Innovation and Research


Orlando Portale, president of Health Innovation Partners, mocks up an Ebola early warning app for hospital EDs that would connect to the system in which the US Department of Customs & Border Protection records the itineraries of travelers entering the US. if the government authorized access its system, doctors could review the patient’s travel history by entering the patient’s last name, gender, and date of birth. Sounds like a great idea other than the inevitable privacy objections that would arise from having the visit plans of foreign travelers available outside of the government.

A Brigham and Women’s Hospital EHR review finds that doctors experience “experience fatigue” later in the day and are 25 percent more likely to inappropriately prescribe antibiotics late in their shifts. As if that’s not bad enough, the study found that doctors often ordered antibiotics questionably even when they weren’t tired, about 30 percent of the time.



Ochsner Health System (LA) announces that it is the first site to integrate Apple HealthKit with Epic, bringing in weight from wireless scales to monitor home patients for congestive heart failure. I cringed when I typed “weight” since I recall my physics professor adamantly declaring that the correct term is “mass.”

An Exconomy review says there’s not much evidence proving that digital health improves outcomes, but it’s not reasonable to withhold clearly beneficial technologies while waiting for the perfect study to be performed. The best quote is from Joe Kvedar, MD of Partners Healthcare’s Center for Connected Health, who says its tough to get insurance companies to pay for apps for conditions such as smoking cessation where the medical cost benefit won’t be realized for years, possibly after the patient has moved on to another insurer. “That’s why so many companies say they’d rather make a cute thing to put on your wrist, make some money, sell it, and move on to the next thing.”


University of Michigan gets a $1.6 million AHRQ grant to study how clinicians use EHRs, email, and pagers and how those systems can be set up to reduce communications failures.

Several high-end restaurants in Los Angeles are tacking on a 3 percent dinner tab surcharge line item to cover the cost of providing health insurance to their employees. Some patrons are complaining that, like other costs of running a business, the extra fee should be built into menu prices, but the restaurants argue that their leases and insurance are priced based on gross revenue and 3 percent wouldn’t cover it by that method. Some of the restaurants agree that it doesn’t make sense to pay servers nearly nothing and force them to live on tips, so they’re considering adding an all-inclusive service fee. 


Masimo Corporation, which flashily launched a patient safety foundation last year with an on-stage appearance by President Bill Clinton, is found in a ProPublica investigative report to have been reprimanded by the FDA for failing to respond adequately about complaints about the safety of its own medical devices. An expert who reviewed the agency’s findings found it troublesome that the company challenged a complaint about a device’s alarm system involving a patient death, adding, “When a company refuses to respond in any way to the FDA other than to say that the FDA is wrong on every issue, that’s not very credible.”  

Health Catalyst puts out a good video called, “If Restaurants Were Run Like Hospitals.”

Researchers looking at Beth Israel Deaconess Medical Center’s patient portal usage through 2010 found that patients sent an average of about one email every other month per patient, with about a fourth of all patients signing up for the portal and a third of those (8 percent of all patients overall) sending at least one message to their doctor. Physicians received about one email per day. The authors conclude that physicians should be required by their job descriptions to respond to patient emails. That’s interesting, but the information is awfully old and the conclusions are questionable as a result.

Walmart will allow in-store shoppers to compare and select health insurance plans, adding that the company’s goal is “to be the number one healthcare provider in the industry” and that the foot traffic will allow it to sell customers prescriptions, non-prescription medications, optical services, and retail clinic services. The company also announces that it will stop offering health insurance to the 30,000 of its employees who work fewer than 30 hours per week, meaning those employees will lose their 75 percent Walmart premium subsidy.


Weird News Andy is amused by PitPat, a Bluetooth-enabled exercise tracker for dogs. WNA adds that the cat version would be locked on 99 percent sleep.

Sponsor Updates

  • Sanford Health (ND) VP of clinical operations Jeff Hoss describes the use of an RTLS from Intelligent InSites and Sonitor to improve ambulatory patient processes in a video presentation.
  • Medicity earns HISP certification from DirectTrust and EHNAC.
  • Streamline Health will begin work on a $7.5 million, five-year deal for its abstracting solution with a new channel partner.
  • Georgia West Imaging and Outpatient Imaging (GA/AL) select McKesson Business Performance Services for its RCM.
  • Netsmart announces that over 1,000 attendees are participating in its CONNECTIONS2014 client conference through October 9.
  • GetWellNetwork CEO Michael O’Neil, Jr. is speaking at the US News Hospital of Tomorrow summit October 6-8 in Washington, DC.
  • CTG Health Solutions’ Joseph Eberle will share his experience identifying improvement opportunities for chronic kidney disease patients at the National Association of Health Data Organizations Annual Conference October 8.


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

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Currently there are "14 comments" on this Article:

  1. As Deval Patrick always does, he ignores the facts and spins it his way. He does not include the thousands of people who’s income was not verified and put on the Medicaid rolls. He ignores the total cost of the debacle to Massachusetts taxpayers. Deval, the Harvard grad ignores the total development cost, the cost of the extra Medicaid to the taxpayers and the costs of those who should be on the program and can’t get on because the web site does not work. If most of us did our work and had outcomes like Deval we would be out of work, pronto.

    He did the same with the lab scandal, EBT card scandal, state police problems, the Dept of Children problem. Everything to smirky Deval is anecdotal. He and Obama should get together and write a book of excuses.

  2. If you want to ‘confirm’ the idea of an Epic/Ebola call:

    (Right from the Epic Userweb)

    Kelly Dolan • EpicCare-Inpatient Orders Implementation • Epic
    We’re hosting a conference call to provide an avenue for the Epic community to collaborate and share their strategies for screening, notification and management of communicable diseases on Wednesday, October 8th from 2:00-4:00pm CST.

    Register using this link: https://attendee.gotowebinar.com/register/3316330840586533889

    After registering, you will receive a confirmation email containing information about joining the webinar.

    Future call date and times will be posted soon. This is just the first opportunity.

  3. Restaurants that charge a health tax: I like it as it lets me know which restaurants not to eat at given the ones that do it are trying to make a statement that they shouldn’t have to and in my opinion clearly don’t value their workers. I think it should be required to notify you beforehand though, it’s very controversial if it just shows up on your bill.

    Similarly, Walmart will never become the country’s premier health provider by cutting benefits from its employees.

  4. Where’s Ed Marx now??? Your patient just died in Texas with your 200 million dollar EMR.

    Quick to publish your blog, drop knowledge on us and a post different picture of yourself, but quite as a church mouse when the heat is on.

    No props at all….

  5. Epic conference call? The link posted goes to some generic webinar page – is this a scam? My guess is that the Epic “Userweb” is for their customers only, makes me wonder why would a link be posted here…

  6. To blame this on Ed, THR, or any software system is pathetic. This blog is turning into a tabloid where all motivations are suspect.

  7. @runforthehills, very classy of you to use a person’s death as an opportunity to take cheap shots at Ed Marx.

    I imagine he has more pressing matters to attend to during this difficult time than to feed trolls like you. Once the dust settles, I expect he will be able to share his thoughts with us (provided THR’s lawyers allow it). But for now we are in the midst of rapidly developing events. I doubt his colleagues would take kindly to him stepping away to blog for histalk.

    My point is: spare us your misplaced indignation.

  8. Re:Eddie

    Actually epic updated the conference number about an hour after I posted it. If you’d like I could post the info for the 10/10 call but they’ll change it again…

  9. The fact that a 400 million dollar piece of overpriced software doesnt automatically flag a patient chart for something as critical as whats happened in Texas is just flat out sad.

    So Sam, who do you blame? The patient? Me? Obama?

    EPIC and THR clearly didnt have the software tuned it…you can bury your head if it feels better.

  10. I’m simply not blaming anyone yet. It’s clear that all ‘facts’ that have been reported in the media should be treated with caution. Al Sharpton is involved, which should show you how much of a circus this has become.

    Was the information really available? Was it perhaps just never seen but still available, like most system alerts? Did the patient have contact with known infected Ebola patients in Africa but never offer up more than just “traveling from Liberia”? Was he asked about potential contact, and what was his answer?

    Everyone is chasing for a juicy story. They will be forced to confront it with honesty at some point. Like most after action reports, it will probably find many contributors including both humans and machines. Fortunately it looks like this was a wake up call to both.

    Can we just all agree that this never would have happened in the cloud?

  11. It would be up to the hospital to implement any alerting or workflows for ebola or any other disease…no system can just magically come up with workflows for new “flavor of the day” panics. It’s very possible that THR was looking to address ebola (although I wouldn’t blame them if they weren’t since it’s not exactly an epidemic unless you’re in Africa) but with all the change management and testing processes that are inevitably in place, it’s not going to happen overnight. In my organization, even in the best of situations, a change like that would require months to make it into prod. Ultimately, medicine is the physician’s responsibility. That said, if any system or vendor could address this concern, it would be Epic. I certainly wouldn’t hold my breath waiting for a certain “cloud” vendor with an inflexible EHR which expects all clinicians to rearrange their workflow around their product to provide any help. Oh, and what did Ed do to deserve that hostility?

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