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Monday Morning Update 4/20/15

April 18, 2015 News 7 Comments

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Kaiser Permanente chooses midtown Atlanta for a $20 million IT campus that will create 900 jobs.

Reader Comments

From Justa CIO: “Re: HIMSS. Do you think it’s becoming irrelevant for people in HIT leadership roles? I find it much less compelling since I can find product information or call someone who has experience with something without being away for a week and spending thousands of dollars of my employer’s hard-earned money while plugging away at real issues. I would like to know what you and others think. Your coverage is excellent – it was enough to make me post this question as I realized that the only things I miss was networking and your choice party.” I’m mixed on the value of attending the conference. Networking can be overrated if you aren’t a vendor selling something – I sometimes think CIOs should stop talking to each other entirely (except to check vendor references) and do creative rather than imitative things since healthcare IT sometimes looks like lemmings following each other off the cliff. HIMSS is efficient in bringing people together so they can schedule time together, but otherwise it’s a horribly inefficient mess of social events, glitzy exhibits, job seeking, and glad-handing and you might be better off just buying the education session recordings (which are included free with conference registration). I’m not convinced that the non-profit health systems that spend fortunes to send people there (often more as a personal reward than a business necessity) show measurable ROI or demonstrate care improvement as a result. Here’s a challenge to health system CIOs that I will report anonymously if you respond: list the immediately actionable items you took away from the conference that you couldn’t have done without attending. Or, the actions you took in the past year that were driven entirely by your 2014 HIMSS attendance. Our HISsies “best CIO” winner John Halamka keeps BIDMC running despite his non-attendance this year.


From Texas Rules: “Re: Next Wave Connect healthcare-specific social collaboration solution. It continues to purge staffers – Drex DeFord and most of the Seattle team are gone.” Drex’s LinkedIn profile indicates that he left the company in February. I asked Chairman Ivo Nelson, who replied,“ It’s pretty common for startups to go through some turnover in the first few years. As you know, I’ve been through this before and getting the right team in place is a sign of health, not illness. Next Wave Connect has steadily grown its staff and will continue to grow this year. We have a good team in place under the leadership of Jim Jacobs and I’ve been very pleased with our progress. Just our March To HIMSS campaign garnered over 15K hits and MyCHIME is has been a huge success.”

From Concerned Tester: “Re: [health system name omitted]. An IT director is under investigation for accepting an Aruba vacation from their [vendor name omitted] rep. That director and his former boss hid a problem with orders that didn’t match after an EHR upgrade. He also pushed out an update that broke the connection to the HIE that caused slowdowns and lost data. The good news that the vendor is being kicked out and Epic will happen in 10 months, but the bad news is that the director was successful in getting them to switch to the previous vendor’s HIE.” I’ve omitted names since I couldn’t verify, but I’m interested in who’s doing the investigation.


From Magnum PI: “Re: Meaningful Use data from Jamie Stockton at Wells Fargo Securities. The numbers don’t seem to match what CMS provides. I also thought CMS stopped including vendor names in their numbers due to ongoing inaccuracies.” Jamie provided this response: “The only hospitals that needed to attest for Stage 2 in 2014 were the ones that originally entered the program in 2011-12. That cohort of hospitals is 2,600 facilities (vs. the 4,800 that have registered for the program through today). If we look at net attestations (adjusting for the fact that sometimes more than one vendor is listed by a hospital when they attest and therefore one hospital occupies multiple rows for the same attestation year in the CMS spreadsheet), then we calculate that 1,800 hospitals have attested for Stage 2, which roughly matches the number your reader quoted. If you just took 1,800 and divided it by 2,600, then you would get about 70 percent of hospitals having successfully attested for Stage 2. I probably need to make that 70 percent number much more clear in the future and we also need to add a line to the bottom of our Stage 2 table that adjusts the gross number of attestations (which was 2,900) down to the 1,800 net. When we look at vendor success rate, we are excluding the hospitals that have switched vendors since 2011-12. If we didn’t, Epic would have a 130 percent success rate because many McKesson, Meditech, and Siemens hospitals that first showed up in 2011-12 with those vendors have subsequently switched to Epic and would not be in the denominator of the calculation for Epic. Excluding all 400 hospitals that have switched vendors, we get to an average vendor success rate of 55 percent. Obviously that penalizes vendors in their success rate if they have lost market share, but I think that is OK. There is a reason that the hospitals moved away from them. At least with the February data set that powered our most recent analysis, CMS continued to publish the vendor names associated with each attestation.”

From The PACS Designer: “Re: medical 3D printing. At the Washington University School of Medicine, cardiothoracic surgeons are using 3D printing to prepare for heart operations. Recently they used the 3D method to prepare for a difficult heart repair for a 20-month-old toddler at St. Louis Children’s Hospital.”

HIStalk Announcements and Requests

I feel sorry for the housekeeping people who had to discard all the junk HIMSS conference attendees left in the overflowing trash cans of their hotel rooms at checkout. Every year most of the booth swag and handouts that seemed worth grabbing in the exhibit hall fail to earn their luggage space back in the hotel, so rather than pack it and haul it home, it’s easier to just chuck it. Somewhere in Chicago there’s a landfill full of Caradigm-provided HIMSS backpacks, although I actually brought mine home since it’s a nice one. I also brought back the pair of insulated coffee mugs that First Databank cheerfully provided.


Arcadia Healthcare Solutions provided the most useful handout ever, a conference essentials pack that included a bottle of water, a coozie, breath mints, ibuprofen, foot bandages, antacid tablets, and vitamin C fizzy drink powder.

The conference reminded me of an observation I had years ago after sitting in on a variety of VC and executive meetings. Mid-level executives and startup CEOs always wear impeccable suits and frown at everything to make sure people take them seriously, while the folks with real money and power wear casual clothes and joke around because they’ve earned the ability to do whatever they want and don’t care what the suited second string thinks. I like that a lot. Big-time VC guy Peter Thiel famously says that his fund will never invest in a technology company whose CEO wears a suit.

Speaking of the conference, I didn’t hear any comments or see any tweets quoting something interesting that was said by the keynote speakers. Did I miss anything by not attending any of them? I’m also interested in more definitive comments about what you liked and didn’t like. Did you go to any educational sessions? Did you meet anyone who was particularly impressive or obnoxious? What vendors raised your interest?

Here’s an odd expression I’ve heard quite a few times over the years: “a piece of software.”

Phrases that need to be expunged from the healthcare vocabulary: mobile health, population health, and patient-centered. All of those be assumed when talking about health. They don’t require being defined as a separate novelty category as they once might have been.

I was annoyed at a video interview with Karen DeSalvo conducted by a young HIMSS Media person with unstated credentials (she includes nothing about education or background in her LinkedIn profile) who repeatedly referred to the national coordinator (and acting assistant secretary for health)  as “Karen.” Even if she’s your BFF, she should be referred to as “Dr. DeSalvo” when interviewing her on video – that shows basic respect for her education, role, and age. 

Thursday beat Wednesday’s HIStalk readership record with 14,658 page views from nearly 11,000 unique visits.


The folks who didn’t attend HIMSS expected their workload to be about the same last week, although a fourth of them admitted that it’s easier when their bosses aren’t around. New poll to your right or here: if you attended the HIMSS conference, how would you grade it?

Lorre has posted some of the interviews DrFirst did at the conference. Here’s one with our HIStalkapalooza host, Forward Health Group’s Barry Wightman.

Here’s another DrFirst HIMSS conference interview, this one with DrFirst CEO Cam Deemer on the one year delay of mandatory electronic prescribing in New York.

For those who attended HIStalkapalooza: what would you do differently? How would you make it more attractive to potential sponsors for a 2016 version? I haven’t decided if I’ll do it again next year, but Lorre has confidently placed a hold on a Las Vegas venue thinking I’ll re-up.

Listening: The Suffers, big-horns Gulf Coast melting pot soul from Houston. This is your chance to tell people about a great band they’ve never heard, but will almost certainly like once they do.

Welcome to new HIStalk Platinum Sponsor xG Health Solutions of Columbia, MD. The clinician-led company brings to the national market healthcare transformation tools and knowledge developed by Geisinger Health System. The company offers care management services (including population health analytics) and offers help with transition to a fee-for-value environment. XG Health solutions announced at the HIMSS conference EnrG, a suite of advanced interoperability software modules that use Geisinger-developed care models to improve acute and chronic care management, connecting via SMART on FHIR to work seamlessly with any FHIR-enabled EHR (the initial partners are Athenahealth, Cerner, and Epic). The evidence-based care modules address procedures and conditions such as CABG, hip fracture, COPD, diabetes, and chronic kidney disease. EnrGRheum, which addresses rheumatologic diseases, will be released in Q3 2015 with six additional apps following. Thanks to xG Health Solutions for supporting HIStalk.


April 22 (Wednesday) 1:00 ET. “Microsoft: The Waking Giant in Healthcare Analytics and Big Data.” Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Microsoft has been quietly reengineering its culture and products to offer the best value and most visionary platform for cloud services, big data, and analytics in healthcare. This webinar will cover the Healthcare Analytics Adoption Model, the ongoing transition from relational databases, the role of new Microsoft products such as Azure and Analytic Platform System, the PowerX product line, and geospatial and machine learning visualization tools. Attendees will learn how to incorporate cloud-based analytics services into their healthcare analytics strategies.

Acquisitions, Funding, Business, and Stock


CPSI renames its EHR business line Evident. or at least that’s what the verbose yet uninformative press release suggests. It will continue to run its services business under the TruBridge name. The Evident name seems rather generic, not particularly relevant, and likely to get lost in Google searches. Apparently the CPSI name survives as the parent and in the company’s Nasdaq listing. Vince Ciotti tipped me off with the photo above that he took in the HIMSS exhibit hall.


Streamline Health reports Q4 results: revenue up 1.2 percent, adjusted EPS –$0.04 vs. –$0.13. Shares dropped almost 7 percent Friday on the news. Above is the one-year price chart of STRM (blue, down 49 percent) vs. the Nasdaq (red, up 20 percent).

Announcements and Implementations

Tallksoft launches its Survey+ patient survey app that allows medical practices to benchmark their patient experience and practice performance.

Cerner will offer Healthwise health education content to Millennium users and via its HealthLife Engagement module.


Ernst and Young announces development of its Telemedicine Adoption Model.

Government and Politics


The estimated cost of opening the new Denver VA hospital rises to over $2 billion vs. the original VA estimate of $630 million. It’s also two years behind schedule.

The Atlantic says hospitals are chasing CMS patient satisfaction scores that focus on making people happy rather than making them well, encouraging hospitals (even those with low clinical ratings) to redirect funds toward putting in valet parking, live music, and VIP loyalty lounges. They’re also scripting nurse interactions to troll for higher survey scores and tying clinician pay to the results even though everybody knows that the patient isn’t always right. A previous version of the survey allowed comments, where patients complained that their dying roommate was making too much noise and that their sandwich didn’t contain enough pastrami. Experts worry that hospitals trying to appease patients might avoid talking to them about unpleasant topics such as losing weight, seeking mental health treatment, or stopping smoking. Most amazing is that patients with the highest reported satisfaction had higher hospitalization rates, higher costs, and a higher mortality rate.


Here’s the final installment of Vince Ciotti’s vendor revenue review for 2014, this time covering small-hospital vendors.


I missed that Athenahealth’s Jonathan Bush tweeted this last Tuesday, including a HIStalkapalooza photo taken back stage at the House of Blues.

The latest drug of abuse: amphetamine-based ADHD drugs such as Adderall (aka “mommy crack” or “productivity in a pill”), which mostly young career go-getters are using to increase career competitiveness through short-term improvement in focus and attention. Interestingly, the anonymous executive profiled in the New York Times article is a health IT startup CEO, who says she has no choice but to take the drug because it is “necessary for the survival of the best and the smartest and the highest-achieving people.”

Sponsor Updates

  • HCS sponsored the “Arc of Monmouth Walk and 5K” on the Asbury Park Boardwalk in New Jersey last week and raised more money than all other teams for people with intellectual and developmental disabilities.
  • Strata Decision Technology will add Yale-New Haven Health’s quality indicators into its StrataJazz platform to help providers understand the high cost of quality variation.


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

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Currently there are "7 comments" on this Article:

  1. “Our HISsies “best CIO” winner John Halamka keeps BIDMC running despite his non-attendance this year.”

    Yeah, but he more than makes up for the time away with his innumerable self-aggrandizing speaking engagements around the world.

  2. I enjoyed HISapalooza, and thank you for the food, drink, music and good time. I thought having the sponsors in the invite only opera boxes was not the best, i.e. I had interactions with Santa Rosa years ago and would have liked to reconnect, but, they were “up there”. Their loss.

  3. RE: From Magnum PI

    Jamie, “many McKesson, Meditech, and Siemens hospitals that first showed up in 2011-12 with those vendors have subsequently switched to Epic” “Many” is a fairly broad term for securities research. In the case of “many” of the hospitals which showed up with MEDITECH in 2011-2012 switching to Epic it is plain inaccurate.

    On bond ratings though, I would be interested in the data for how many facilities with MEDITECH had their bond ratings downgraded within a year after go live. I have seen this “many” times with Epic facilities but I do not have the full numbers.

  4. Re: Is HIMSS worth it? Easy – NO. I have attended and exhibited at HIMSS for 20 years, with both large Fortune 100 companies that had a HC vertical (none were the mainstream big HIT vendors) accompanied by our 40×40 $250K booth expense, to mid sized companies – one with $50M in annual revenues that spent $1M on Atlanta including renting the GA Aquarium for 2,500 of our closest friends, when our real decision makers were not even the audience who comes to HIMSS – to small 10×10 booths for smaller start ups on the back row in row 8000 (at NOLA where we were literally a 1/2 mile, 20 minute walk from the main entrance) where no one ever came by. NONE of these expenses ever returned their cost in new business, or moved the needle perceptively.

    HIMSS is good for very few business things – seeing and entertaining your good customers who are there for the company paid vacation anyway, thus “bonding”. Or if you are small, looking for potential partners or investors. Everyone already knows who [insert big HIT name here] is, and seeing them at HIMSS provides nothing new. Or snagging a pass to walk around and ask for a job.

    And for the tracks – I have attended dozens on topics of interest where I’m trying to add to my knowledge base. Nearly every one is either very light on real information – or, I could have taught the presentation myself. So I must assume they are for the newbies interested in a certain topic. I would estimate that I actually learn something new, or a new perspective, from only 10% of the presos I have attended.

    I attempt to dissuade whoever my employer is from doing the HIMSS thing. It is a waste of time and money generally, bores the pants off the booth crew (see how many smart phones are active), and does not improve the net revenues at all.

    Just my 2 baht.

  5. Regarding all the swag that’s given away and then tossed and all the left-behind HIMSS backpacks… My colleague Allison and I had a conversation on Wednesday, wishing that next year we could find a way to take all the money spent on the swag and giveaways and turn it into something meaningful. Think about how grateful some schools would be to receive the backpacks that none of us really need. Could HIMSS make it an option at registration next year – YES I want the backpack or NO please donate to a school that needs it more.

  6. Three thoughts:

    1 – I would be interested to know if your observation about casually dressed CEOs holds true (for you and/or your readers) for both genders. Unfortunately, I do not know any women in healthcare-tech leadership that are awesome/confident enough to dress casually, but maybe you do?

    2 – HIStalkapalooza idea: have interested attendees pay a modest fee up-front (PayPal would be a good facilitator), then process refunds for whoever does not attend, and no refund if no show. Just an idea to reduce the financial burden.

    3 – Props for the patient sponsorships to bring a patient presence to the conference. Please refer your readers to this GoFundMe link to help cover the expenses of one patient’s ER visit during the show: http://www.gofundme.com/s76pzdk Although she included bunny health visit costs and I’m terrified of rabbits, I found it in myself to send her something, because it’s simply not enough to cheer patients along without tangible support for the costs associated with their involvement in improving care for everyone.

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