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December 19, 2015 News 7 Comments

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Vanderbilt University Medical Center will implement Epic, replacing the sunsetted McKesson Horizon Expert Orders. VUMC developed WizOrder and sold it to McKesson in 2001, which commercialized it as HEO. VUMC announced in April 2015 that it would choose between Epic and Cerner. It says none of the functionality it self-developed in WizOrder will be lost. I can’t think of any other homegrown systems still in use other than at Beth Israel Deaconess Medical Center and perhaps at Regenstrief.

Reader Comments


From Below the Beltway: “Re: Meaningful Use. A blanket hardship exemption was not included in either the omnibus or the extenders package passed and the matter seemed settled for this year. Surprisingly, the Legislature came to an agreement on a bill with several Medicare reforms, including a change to the hardship exemption on a bill with several other Medicare reforms. The bill, S. 2425, passed the Senate Friday morning and the House Friday afternoon by voice vote and unanimous consent, respectively.” The full text of the bill is here.

From The PACS Designer: “Re: EDWs. TPD isn’t a vendor neutral archive advocate. More VNAs only complicate the storage issues and can result in arguments about what can be put in a VNA. A better idea is the electronic data warehouse (EDW), which encompasses not only using internal data sources, but also can include external ones and can bring more value to the decision-making processes. EDWs are also a better way to communicate with an HIE. What do you think?”

From Spiffy Tie: “Re: Cerner. My organization is a Cerner client and my perception of the company has fluctuated widely over the past 10 years. I’ve been especially disgusted by Cerner’s business plan. Their software has improved in many respects, but to make it functional requires a lot of customization. Cerner will gladly sell consulting time to multiple organizations to make the same changes rather than building it into the base product. Issues that would be bugs or defects in other software is typically said to be WAD (working as designed). If you want it fixed, you can pay for the customization yourself or submit an ‘idea,’ which is almost always rejected as ‘not aligned with current priorities.’ Other new features that are essential (to correct prior defects, safety issues, or gaps in content) are incorporated into new packages that have to be purchased separately rather than being a part of already-purchased upgrades. Despite my disgust with Cerner’s overall approach, I also have very positive feelings about Cerner in terms of their employees. Virtually everyone I’ve worked with is knowledgeable, professional, and willing to go the extra mile to make things work for our staff and our patients. I have very high regard for them and enjoy working with them very much. I think it’s especially egregious that Cerner would turn on its best asset, their employees, with this forced arbitration clause. If other companies and our judicial system have engaged in or supported such abusive extortion of hard-working individuals, then shame on them too.”

HIStalk Announcements and Requests


The vast majority of poll respondents see Cerner’s requirement that employees sign arbitration clauses to continue eligibility for merit increases as negative. Some readers say it’s not just Cerner doing it and perhaps adding the $500 in stock options as a legal “consideration” was required to make the unilateral contract change legal. Several respondents predict that the company will lose good employees who will resent the strong-arm tactics and whose talent gives them career options elsewhere. New poll to your right or here: how was your 2015 compared to 2014? Click the Comments link after voting and explain why.


Readers always enjoy the HCIT Family Tree that shows the acquisition history of all the health IT vendors. Creator Constantine Davides, senior healthcare analyst with AlphaOne Capital Partners, has updated it. Here’s a trivia question I randomly chose from Constantine’s chart: which company owns the former Medifor?


I’ve been using a third-party Rumor Report form for years, never quite getting around to making the easy switch to the form design tool I already own that would have saved me $20 per year. The choice was made for me, which you may have noticed if you tried to use the form recently – the tiny company that hosted it lost their server and didn’t have a backup, so they shut the service down without letting users know. Try the new form instead.

My latest pet peeve: software companies that claim to be “population health management” vendors instead of “population health management software” vendors.

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Mrs. Schmidt’s California fourth graders can’t wait to start using the STEM lab kits and library we provided via her DonorsChoose grant request. Also checking in was Mrs. Marler of Alabama, whose third graders are using their new wireless document camera to explain their thought process to the class.

Not much will be happening over the next couple of weeks, so I’ll have less to write about. Then it will get crazy as it always does between New Year’s Day and the HIMSS conference, a frantic 10 weeks.


It’s time for my annual reader survey. Take a couple of minutes to fill it out and you’ll be: (a) helping me, and (b) entering yourself into a random drawing for a $50 Amazon gift card.

Last Week’s Most Interesting News

  • Cerner requires its employees to sign away their rights to sue the company in return for remaining eligible for merit increases.
  • Robert Wood Johnson Foundation releases a dataset containing details of all marketplace-offered insurance plans for 2015 and 2015.
  • CMS gives doctor selection website Amino access to provider-level quality and cost data.
  • Five foundations donate $10 million to the OpenNotes initiative.
  • National Coordinator Karen DeSalvo, MD, MPH calls for health IT stakeholders to commit to providing consumer access, avoiding information blocking, and following standards
  • Dell is again rumored to be trying to sell the former Perot Systems for $5 billion to help pay for its EMC acquisition.


None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel

Here’s the video of Wednesday’s webinar, “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support,” sponsored by Wolters Kluwer Health and featuring guest presenter Rick Corn, VP/CIO of Huntsville Hospital (AL).

Acquisitions, Funding, Business, and Stock


Columbus, OH-based Aver, which offers software that allows providers to calculate bundled prices based on past claims, raises $11 million, increasing its total to $22 million.

New York’s Capital Region loses its bid for $500 million in state money that would have supported an investment of $100 million to $200 million to create a population health technology hub, but IBM Watson Health and other participants say they will continue their efforts without the state funds.


China-based Luye Medical Group chooses the InterSystems TrakCare EMR.

University Hospital Southampton NHS Foundation Trust chooses Hyland OnBase for enterprise content management.



Pharma bad boy Martin Shkreli, who was arrested Thursday on securities fraud charges and then resigned (or was fired) as CEO of Turing Pharmaceuticals on Friday, spent Friday just like any other day: vainly live-streaming himself on YouTube as he exchanged messages with fans and critics, played his electric guitar, looked for women on dating sites, and played online chess. Magazines such as Vanity Fair are digging deeper beyond his cartoonish villain personality to acknowledge his brilliance, bluntness, and seldom-mentioned charitable side. Meanwhile, shares in biotech company KaloBios Pharmaceuticals, which Shkreli acquired a few weeks back via shrewd Wall Street betting, were halted on the news of his arrest, having shed half their value in pre-market trading. They had jumped from under $1.00 per share to as high as $40 after Shkreli’s involvement was revealed, all in less than four weeks. His stake in the company, once worth $80 million, is now valued at around $50 million, at least until trading resumes. He is apparently still serving as CEO of KaloBios. A UCSF medical school professor and author reminds those who expressed glee at seeing Shkreli perp walked that his infamous Daraprim price hike wasn’t illegal and in fact still stands:

It easy to demonize him. But if you’re going to let the market drive the pharmaceutical industry, it shouldn’t surprise anyone that he wants to maximize profits. There’s no law that he has to be ethical. His job is not to make drugs available and save patients. His responsibility is to make a profit for his shareholders.

Colorado puts single-payer coverage on the ballot, where the state would pay the medical bills of all citizens not covered by Medicare or military programs. Wage earners would pay 3 percent of their net income with their employers kicking in another 7 percent, with the new taxes covering the program’s estimated cost of $25 billion per year. Critics point out that Vermont already abandoned a similar plan because the state couldn’t afford it.

A California nursing home with a history of quality problems stops the IV antibiotic of a patient transferred from a local hospital after three days instead of the ordered four weeks due to a nurse’s order entry error.

France tackles anorexia head on by requiring models to obtain a doctor’s certification that their weight is healthy. The new law also requires magazines to clearly indicate when photos of a model have been Photoshopped to suggest a larger or smaller waistline, with fines of up to $40,000 for failing to do so.

Sponsor Updates


  • Forward Health Group’s PopulationManager earns the highest preliminary rating scores in the KLAS population health management technology report.
  • KLAS names Wellcentive among its top five population health management platform vendors.

Blog Posts


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

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Currently there are "7 comments" on this Article:

  1. Health Systems still using home grown EMRs. Mayo, University of MI are two both going Epic in the case of Mayo the system started as IDX but at this point with all the work they did it’s pretty much home grown.

  2. Pretty sure that Marshfield Clinic also still uses internally-developed Cattails (the old school version, not the stuff that MCIS has been trying to bring to market)

  3. Wouldn’t VistA be classified as “homegrown”? It seems clear that, as talented as the informaticists at all of the cited places are, they do not have the reinvestment potential that the major vendors have. As critical as people are of Epic and Cerner, they have made substantial enhancements to their products over the years, both in terms of functionality and usability. the pace of their evolution is much faster than any single academic medical center can afford.

  4. I will mourn the passing of WizOrder. I never worked on that application, but did provide pharmacy informatics support while our hospital was on HEO. The iForm functionality born out of WizOrders was before its time and to this day is the most robust decision support tool I have seen used in any EMR. We were only limited by imagination and our ability to code in HTML and JavaScript.

  5. I had a bit of an advantage on knowing that. I worked at MC for almost 10 years and know the current CIO at VUMC (who happens to also be a former CIO at Marshfield Clinic\CEO at MCIS).

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