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September 17, 2015 News 1 Comment

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Senate HELP Committee Chairman Lamar Alexander (R-TN) calls for Meaningful Use Stage 3 to be pushed back until January 1, 2017, saying that hospitals have told him that they are “terrified” of Stage 3 and patients won’t benefit from a rush job. He also wants the modified requirements for MU Stage 2 adopted to keep Meaningful Use moving.

Reader Comments

From Epic ICD-10er: “Re: Dr. Jayne’s piece on ICD-10 readiness, especially that of smaller vendors. Just to let you know where Epic stands: we’ve supported ICD-10 since 2008 and the entire customer base has been live on the supported software (the 2010 release) for over a year. Ninety-five percent of customers are documenting with ICD-10 clinical terminology today and 92 percent are dual coding accounts (the number doesn’t have to hit 100 percent since some organizations use ICD-10 without impacting coding resources). In early CMS calls, not many vendors were offering documentation using ICD-10 and dual coding. I’m pushing CMS to initiate vendor calls starting October 1 so we can communicate across the entire industry about issues we find and how to resolve them.” I like the idea of CMS opening an ICD-10 conference bridge as a hospital would do for a big IT go-live. Somehow I think the email inbox of its ICD-10 ombudsman is going to fill up quickly.


From Hadoopsie: “Re: unsolicited vendor email. This one wins the award for the silliest buzzwords!”

From Halen Hardy: “Re: NextGen. Little birdy within the company told me they just laid off 19 Austin-based employees.” Unverified. I think that’s the Hospital Solutions office that was formerly Opus Healthcare Solutions until QSI/NextGen acquired that company in 2010.

From Lemmy: “Re: John Halamka of BIDMC. Is having a town hall meeting with all IT staff today (September 17). This is his first one in three years.”


From BKG: “Re: readmissions. Dignity hospitals reduced 30-day readmissions by 25 percent by implementing AHRQ’s RED Toolkit.”

From Grammar Nazi: “Re: health system branding efforts. I’m sick of all the permutations of the word ‘healthcare,’ such as HealthCare and Health Care. It’s about time they got creative – aNytown hEalthcAre!” As a Grammar Nazi sympathizer, I don’t like fusing two words together into one while leaving the second portion capitalized, which passes for innovating thinking among creatively bankrupt marketing people. You see that a lot these days (Partners HealthCare, CommonWell, MedAssets, UnitedHealth Group) as all the good, trademarkable words have been taken, leaving companies to create gibberish. The name HIStalk isn’t far from those examples, so maybe I shouldn’t complain.

HIStalk Announcements and Requests

Deborah Kohn donated $100 to my DonorsChoose project, which I put to work immediately using matching funds from my anonymous vendor executive and from Smarties Candy Company’s “Smarties Think” classroom project. We provided six tablets for Ms. Long’s alternative high school ninth-grade class in West Point, MS. She reports that all of her students come from poor families (some of them get their only meal of the day at school) and they need stimulation to engage in science material. Two-student teams will use the tablets to quiz each other, create flash cards, and play related games. Ms. Long concludes, “I believe that someone taking an interest in them and their education could change their whole attitude about school.” Someone did – DK and her matching donors. Update: Ms. Long emailed to say, “OH MY GOSH! Thank you so much for your donation! You are going to help students know just how much someone cares about their education! You are amazing for doing this and I am sooooo fortunate that you have done this for me! I really appreciate it!”


We bought an iPad Mini for Mrs. Frazier of Memphis, TN, who teaches elementary classes, runs the after-school program, and just earned her library certification. She emailed to say that she is using the tablet to participate in technology webinars and offers it to students in their daily “academic choice” activity, where she says it’s popular because of the apps she has installed and the digital books that are available.


Also checking in was Mr. Schmook from Herminie, PA, whose elementary school class received a large bundle of STEM materials that we donated.

A note to non-experts trying to create hysteria over so-called vendor “gag clauses.” Those customer-signed terms that prohibit disclosing intellectual property such as source code, documentation, prices, and screen shots are not gag clauses – they don’t bar users from going public with patient-endangering problems, they only restrict them from exposing proprietary information that would be of little interest to anyone other than competitors. I don’t agree with including screenshots in that contractual definition since that prohibits sharing even user-designed screens with each other or in presentations (a clause that Epic is adamant about enforcing, which is what stirs up people the most), but none of that precludes going public with software problems. That limitation would be covered in a different part of the contract. I would also be interested at how often vendors actually threaten or undertake legal action against their customer, which would seem to send the wrong message to those who might want to become customers. It’s probably an indication of the three-vendor EHR market that customers sign those agreements without a peep, apparently happy to be allowed to fork over millions under whatever terms their vendor among limited choices demands.

Listening: Wolflight, new progressive music from former Genesis guitarist Steve Hackett. Since his former bandmates don’t seem interested in a reunion, I’m thankful he skillfully covered some of their songs on Genesis Revisited, including my favorite, Supper’s Ready. It’s not quite as good as the original Genesis (watch the previously omnipresent Phil Collins if you think he was only good for crooning lame pop tunes), but it’s the only live option other than cover bands like The Musical Box. 

This week on HIStalk Practice: Ian Crozier, MD tells a riveting tale of post-Ebola complications. Vermont physicians agree that administration and documentation burdens are taking away from patient care. ProEx Physical Therapy gets into the consulting business. Brad Boyd evaluates the financial return of clinical alignment tactics. HHS releases $500 million for primary care expansion. Boson Health goes with paging and answering service tech from TelmedIQ. Teladoc gets the green light to move forward with its case against American Well. Google moves into the fake body parts business to sell more wearables (no joke!).


September 22 (Tuesday) noon ET. “Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements Using Simple but Predictive Adoption Metrics.” Sponsored by The Breakaway Group. Presenters:  Heather Haugen, PhD, CEO and managing director, The Breakaway Group; Gene Thomas, VP/CIO, Memorial Hospital at Gulfport. Simple performance metrics such as those measuring end-user proficiency and clinical leadership engagement can accurately assess EHR adoption. This presentation will describe how Memorial Hospital at Gulfport used an EHR adoption assessment to quickly target priorities in gaining value from its large Cerner implementation, with real-life results proving the need for a disciplined approach to set and measure key success factors. Commit to taking that scary first step and step onto the scale, knowing that it will get measurably better every day.

September 22 (Tuesday) 5 p.m. ET. “Laying the Groundwork for an Effective CDS Strategy: Prepare for CMS’s Mandate for Advanced Imaging, Reduce Costs, and  Improve Care.” Sponsored by Stanson Health. Presenters: Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai; Anne Wellington, VP of informatics, Stanson Health. Medicare will soon penalize physicians in specific settings who do not certify that they consulted "appropriate use" criteria before ordering advanced imaging services such as CT, MRI, nuclear medicine, and PET. This webinar will provide an overview of how this critical payment change is evolving, how it will likely be expanded, and how to begin preparations now. A key part of the CMS proposal is clinical decision support, which will help meet the new requirements while immediately unlocking EHR return on investment. Cedars-Sinai will discuss how they decreased inappropriate utilization of diagnostic tests and treatments, including imaging.

Acquisitions, Funding, Business, and Stock


Kyruus raises $25 million in funding to expand adoption of its ProviderMatch health system patient scheduling and referral management system. Investors include one of its customers, Providence Health & Services, as well as McKesson Ventures.

HIMSS Media buys the oddly named MobiHealthNews. I don’t read it, but HIMSS claims it’s the “leading source of digital health news and analysis” and says “our sales team is looking forward to driving growth.” It covers topics that don’t interest me as an average health system reader (fitness trackers and uncritical digital health cheerleading). Still, I would rather have seen it remain independent than to be absorbed into the vendor-friendly, sales-focused HIMSS fold. HIMSS already publishes mHealth News, which it describes as “the only news publication completely focused on mobile innovation within healthcare,” which seems to have intentionally marginalized MobiHealthNews before the acquisition. Both sites are edited by people with zero health or IT experience other than writing about it, which to me is OK when they’re wordsmithing or quoting an expert, but not OK when they try to editorialize or analyze for an expert audience.


American Messaging Services will offer its 1,400 hospital customers real-time care coordination and communication from Cureatr.


HP will lay off up to 30,000 employees when it splits the company later this year into HP Enterprise (enterprise services) and HP Inc. (hardware), with the personnel cuts coming from the Enterprise business. HP had already laid off 55,000 people since Meg Whitman took the CEO job following disastrous decisions that followed no obvious strategy except to get bigger – overpaying for acquisitions, hiring and then firing Leo Apotheker as CEO, and dumping its PC business with hopes of making more money selling data center hardware and services. Its aspirations to be IBM were admirable except IBM had long since abandoned that same strategy by the time HP put its own into place.


The Nashville business paper digs up an SEC filing in which Emdeon says it will spend $126 million to “rebrand” itself to Change Healthcare.


Wellness Council of America chooses Validic to power its “On the Move” employee wellness challenge. Companies that sign up by February 2016 receive behavior programming, outcomes reporting, device integration, coordinator training, personalized assessments and coaching, and educational material.

Announcements and Implementations


Aprima expands its “Rescue Plan” that offers licensing discounts of up to 65 percent to users of an expanded list of EHRS that originally included only Allscripts MyWay.

McKesson wins the 2015 C. Everett Koop National Health Award for its employee health and wellness program that is powered by the Vitality, a South Africa-owned wellness program whose hallmarks are Know, Improve, Reward, and Support.

Imprivata integrates its Cortext secure communications platform with Forward Advantage’s Communication Director, allowing Meditech customers to automatically deliver patient alerts (transitions of care, consult requests, and critical test results)  to mobile devices and desktops.

Government and Politics

The health services of Scotland and Wales form the Health Informatics Service Alliance to collaborate on digital services, with Northern Ireland possibly becoming a third member down the road.


ONC fixes its Health IT Complaint Form, or as Modern Healthcare describes in an absurdly attention-seeking headline, “ONC wants to know what health IT issues grind your gears.” Now that the form is visible, I noticed that it offers submitters an option to remain anonymous. It doesn’t say if it will publish the issues it receives.

Privacy and Security


The Tampa VA hospital gets hit with ransomware, taking down the employee shared drive for five days.

Innovation and Research


A report by IMS Institute for Healthcare Informatics finds that the rapidly increasing number of apps that might be considered “mHealth” is at 165,000, but most simply provide advice related to wellness, diet, and exercise. A fourth of them focus on chronic disease. Only one in 10 connects to a device or sensor and just 2 percent exchange information with provider systems, but two-thirds have social media connections. Nearly half of all downloads are represented by just 36 apps. The authors suggest that providers prescribe health apps to increase adoption and ongoing use, but those providers hesitate because EHR connectivity is uncommon, technologies are ever-changing, providers are paid for volume and not quality, and studies that prove app effectiveness are lacking.


An interesting perspective on the addition of ad-blocking to iOS9 says Apple is threatening Google’s main source of revenue (advertising) as more users use mobile devices and Apple develops search capabilities that bypass Google. It says web content will suffer as small publishers lose advertising revenue, summarizing,

What you want is the content, hot sticky content … Unfortunately, the ads pay for all that content, an uneasy compromise between the real cost of media production and the prices consumers are willing to pay that has existed since the first human scratched the first antelope on a wall somewhere. Media has always compromised user experience for advertising: that’s why magazine stories are abruptly continued on page 96, and why 30-minute sitcoms are really just 22 minutes long. Media companies put advertising in the path of your attention, and those interruptions are a valuable product. Your attention is a valuable product.


A Harvard Business Review article written by the dean of Boston University’s School of Public Health says it’s hard to measure population health success, but it’s tempting for organizations to cherry-pick the most cooperative of their patients and ignore the rest, which will leave marginalized communities (by race, income, and ethnicity) behind. He uses as an example apps that help people quit smoking, which even if they work, still leave out patients who lack the technology and the discipline to use them. The US smoking rate is stuck at 20 percent because it’s harder and more expensive to get poorer patients into cessation programs, which might redirect resources such that the overall smoking rate might increase even as equity is reached. It’s always fascinating to see the dramatic contrast between the beliefs of health system people and those whose world view is based on public health. I’d trust the latter far more than the former in reducing costs and providing the most good for the most people.


Weird News Andy says this article reads like a Medtronic advertisement, but is still pretty cool. Intervention neurologists use a stent retrieval device to fish out the blood clot that is blocking a woman’s carotid artery, reversing her early stroke symptoms within three hours, allowing her to  recover entirely in just a few days. Most impressive to me is the quick action of the hospital: the patient arrived in the ED at 10:29 a.m., the CT was finished at 10:44, thrombolytics were given at 10:47, a groin puncture was made at 11:10, and reperfusion occurred at 11:40, barely more than an hour after she arrived.

Sponsor Updates

  • Stella Technology co-founder and CEO Lin Wan will participate in the Nationwide Interoperability Pursuit panel at the Central Pennsylvania HIMSS conference on September 18 in Grantville, PA. She has a PhD in physics from Princeton and has held key technology roles at Axolotl and OptumInsight.
  • Forward Health Group posts a video interview with HealthLink CEO Beth Wrobel (I interviewed her this week) and CIO Melissa Mitchell.
  • Health Catalyst wins the 2015 Utah Ethical Leadership Award.
  • ShareCor names Fortified Health Solutions, a Santa Rosa Consulting company, as an endorsed security services vendor.
  • Experian Health is ranked #1 in Modern Healthcare’s 2015 list of largest revenue cycle management firms.
  • MedData will exhibit at the UCAOA Fall Conference September 24-26 in New Orleans.
  • Medicomp Systems releases a new video, “Doctors see 30% More Patients.”
  • Navicure will exhibit at the VMGMA 2015 Fall Conference September 20-22 in Norfolk, VA.
  • NTT Data will exhibit at the BCBS Information Management Symposium September 20-23 in Fernandina Beach, FL.
  • Oneview Healthcare will exhibit at The Beryl Institute Regional Roundtable September 24 in San Francisco.
  • PerfectServe will exhibit at the Maryland MGMA State Conference September 25 in Maryland.

Blog Posts


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

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Currently there is "1 comment" on this Article:

  1. ONC Complaint form….”all anonymous complaints gladly accepted”
    Thoughts /questions..
    1) Why wouldn’t the filed complaints come under the FOIA??
    2) And how will they know if Vendor X is complaining about Vendor Y in an anonymous complaint??

    I can see it now. ONC gets a 100 complaints from anonymous filers. Some are legit end users that can’t ID themselves since the CIO has said we can’t disparage our vendor, since that will make us look bad for buying a bum system, and some are from ‘friendly’ competitors, who I am sure, are just trying to help improve patient care, and some are…well, you get it…

    I think ONC just stepped into Pandora’s box…can’t wait for the sequel.

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Reader Comments

  • SteveS: I’d like to hear more from Ed about his perspective on the current state of “Professional Organizations” – in te...
  • Brian Too: Nice to hear from a small hospital for a change. We hear lots from the large players and consolidation has meant that b...
  • Sam Lawrence: Except in this case, coding = medical billing, not development. Though the same warning may be true...
  • BeenThere: Partners will find the savings from their cuts of coders as fools gold. There are a lot of hidden costs running an outs...
  • JC: If there is not there can be. VistA has a reference lab interface that can create the manifests/labeling and such as we...
  • Tom Cornwell: Great stuff from Dr. Jayne as usual. One small typo, last sentence of second-to-last paragraph: should be 'who's' not 'w...
  • HIT Observer: What I find most interesting here, is people defending their common practices rather than truly taking this as invaluabl...
  • Bob: There's no incentive for the provider to spend time doing a price comparison for the patient. Nor is it a good use of th...
  • Peppermint Patty: Veteran - can you clarify what was "fake "? Was something made up (definition of fake) or did you disagree with Vapo...
  • Pat Wolfram: Such a refreshing article. Thanks -- there really can be a simpler version of an acute HIT implementation. But I do ...

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