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Monday Morning Update 3/7/16

March 6, 2016 News 10 Comments

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The VA is reassessing whether VistA has a long-term place as its EHR and has halted some of its VistA modernization steps following a business case analysis ordered by new VA leadership. The VA says it requested $40 million less in 2017 VistA modernization money because it will focus instead on making its existing systems interoperable.

According to Assistant Secretary for Information and Technology LaVerne Council (photo above), “We want to take a step back and look at what we really need an EHR and a healthcare system to do. There are multiple needs that are different than in 2014 around the area of women’s health, the Internet of Things, and how we manage private sector care.”

House Appropriations Chair Hal Rogers (R-KY) wasn’t happy with the VA’s testimony to the committee, saying, “We’ve been at this for 10 years and we’ve given you billions of dollars. I’m hearing muckety-muck here. I don’t know what you’re saying. Apparently, you’ve not made your mind up yet about whether you’re going to replace VistA with something off the shelf. Is that right or wrong? Yes or no?”

Council replied that the VA hasn’t decided yet, blaming her VA predecessors for not developing a sound plan but extolling the virtues of the VA-DoD Joint Legacy Viewer. She joined the VA in July 2015 after retiring as corporate VP/CIO of Johnson & Johnson.

Council also says that a visual overlay to the VA’s 30-year-old patient scheduling system may eliminate the need for its planned $690 million replacement depending on how the VA-wide rollout in April is received.

Reader Comments


From Vegas Blues: “Re: healthy health conventions. Is it a foregone conclusion that we can’t eat healthy at a Las Vegas conference venue?” Plenty of sugary snacks, fatty sandwiches, and coffee were available, but I didn’t see much fruit or unprocessed food. It’s a fine line between providing what attendees want vs. what’s good for them, however. The H in HIMSS stands for healthcare, not health. It’s like McDonald’s, which offers a lot of healthy food that nobody orders, earning it scorn for the choices its customers make.

From Jardin: “Re: delegating computer tasks to non-physicians. The Senate unanimously passed this because, according to the committee chair, ‘hospitals and providers dread EHRs’ and “MD documentation is burdensome.’ After a year-long review that included HIMSS and physician lobbyists, Congress proposes a solution that adds costs, introduces errors, and eliminates many EHR benefits. After spending billions on health IT, we’re regressing back to the e-secretary model, pushing the burdens of the same EHRs to scribes or RNs. Nurses continue to be invisible in the law. Why isn’t there an industry outcry to actually fix the problem instead of just passing it off?”

From Flaming Introvert: “Re: HIMSS conclusions. As a near-entry level vendor employee, this is my second HIMSS and I’m not sure if I love it or hate it. It’s upbeat and our customers provided positive feedback about our changes and their needs. It’s refreshing to connect with patient advocates, even if most conversations end with the defeatist consensus of, ‘It really sucks, but what can we do about it?” Low point was getting to HIStalkapalooza too late for the shoe judging – I don’t normally parade around in six-inch heels without potential ROI. Maybe that same sentiment applies to HIMSS overall – it continues to yield enough return to induce me to participate, but I’m always glad to get home.”


From Bonus Room: “Re: iTriage. Just laid off 33 employees and CTO Patrick Leonard is leaving.” Unverified. I haven’t seen any official announcements from the medical question and doctor finding app vendor that’s owned by Aetna. However, the report came from a non-anonymous iTriage employee.

From Love American Style: “Re: Epic’s 2015 release. I’m a project director for an Epic customer. We are still in the testing phases and the severity and number of patches at this point in the release cycle has been unprecedented. Patient safety problems, patches that break workflows, performance problems all abound. Things I would have expected Epic in prior years to have nipped in the bud long before now.” Unverified.


From Delled: “Re: Michael Dell at HIMSS. He’s my hero, but I was stuck in the overflow room for his keynote. The moderator was so bad that people left in droves like the session was over. At one point Dell had to remind the moderator that he was supposed to ask a specific question. Finally I worked my way to the front against the crowd streaming for the exits, and at the end when he was leaving the stage, I asked to shake his hand (photo attached). He ignored me.” Michael Dell would have been an awful choice to keynote even if he wasn’t trying to sell out Dell’s pitiful healthcare offerings so he can finance his $67 billion passion for computer storage in acquiring EMC. EMC owns VMware, which has watched its shares drop 40 percent and has laid off 800 people since Dell came sniffing. Other than funding Dell Medical School, his healthcare accomplishments are zero or less, hoping desperately to sell Perot Systems for the same price he paid in 2009, backpedaling on the the idea that the future is in services rather than hardware.

Here’s my formula for becoming a highly-paid, well-received HIMSS keynote speaker, not inspired by Michael Dell since I didn’t attend any HIMSS keynotes:

  1. Be famous for any reason. Healthcare relevance is unnecessary and even detrimental – the goal is to raise the spirits of attendees by making them think they are as cool, rich, good-looking, or smart as the celebrity podium-gripper.
  2. Negotiate a speaking fee of several hundred thousand dollars, making sure to insert contractual clauses requiring approval of the introduction and the freedom to sell whatever product or service the speaker offers on the side.
  3. Arrange travel to minimize the time hanging out with the insufferably fawning organization people who hired you and who therefore think they’re entitled to face time or the privilege of escorting you through the exhibit hall that makes you glaze over.
  4. Announce to the worshipful masses how utterly delighted you are to be in their midst, carefully omitting the fact that you could have attended any time you wanted in previous years if your delight didn’t carry a price tag.
  5. Begrudgingly allow a high-ranking executive of the group running the conference to (a) hug you before or after your speech; (b) ask carefully scripted softball questions after the stage is reset into a fireside chat type configuration; and (c) annoy the audience by prattling on instead of letting you talk as you’re being paid to do. At least moderator verbosity prevents audience members from asking their own pointed questions that might result in an unfortunate, life-ruining off-the-cuff answer. After the friendly chat, allow the executive to magnanimously present your foundation with a big check above and beyond your personal speaking fee.
  6. Have your hired copywriter modify the harmless, standard speech you’ve given dozens of times to conventions ranging from car dealers too the Bowling Proprietors’ Association of America, penciling in four seemingly insightful anecdotes as provided by the people writing the check that are sure to make the audience feel that you understand them even though you have no idea what they actually do. You don’t  have to review the scripted comments in advance – they will be right there in front of you on the Teleprompter per your contractual requirement.
  7. Include a handful of humorous, self-deprecating, name-dropping insider anecdotes to allow geeky non-profit IT people to live your celebrity life vicariously and to brag afterward that they briefly shared your aura.
  8. Be vaguely motivating in a boilerplate-type way that won’t require actually thinking up something new, extolling the generic virtues of teamwork, leadership, doing what you love, and being true to oneself.
  9. Close with over-the-top accolades that defer glorification to whatever the audience members do for a living, telling them that they are the real heroes even though (a) they’re paying to see you and not vice versa, and (b) you just made more money in 60 minutes than they make in a year.
  10. Go straight offstage to a limo with the engine running to minimize unpaid downtime before the next cookie-cutter speaking gig.

HIStalk Announcements and Requests


A little more than half of poll respondents doubt that Athenahealth and eClinicalWorks will become major inpatient systems vendors. Skeptical says that if eCW’s entry into inpatient is like its interoperability solutions, “we should expect major-league hype and minor-league results.” Vote Early and Often says eCW employees stuffed the ballot box and the company can’t service enterprise customers that expect project discipline and management maturity. Frank Poggio says it’s too late – the market has been sewn up by Cerner and Epic with Meditech, the only small-hospital vendor, losing ground. It’s All Good says there’s a long history of companies aspiring to be what they aren’t (Allscripts) and that eCW should stick to ambulatory.

New poll to your right or here: HIMSS attendees, will the hard-dollar benefit of your attendance cover your employer’s cost to send you within one year? Click the Comments link after voting to explain.


Here’s an extra, reader-requested poll for HIMSS15 exhibitors: in the year that has elapsed since, did you make a sale that you wouldn’t have made had you not exhibited?


Ms. Livingston says her New Mexico elementary school students “have the idea that they don’t deserve what the schools that have more money enjoy having” and therefore are having great fun with math story books we provided in funding her DonorsChoose grant request.

image image

Also checking in was Mrs. Jochum from Nebraska, who sent photos of her students using the Osmo learning systems we provided.


March 16 (Wednesday) noon ET. “Looking at the Big Picture for Strategic Communications at Children’s Hospital Colorado.” Sponsored by Spok. Presenters: Andrew Blackmon, CTO, Children’s Hospital Colorado; Hemant Goel, president, Spok. Children’s Hospital Colorado enhanced its care delivery by moving patient requests, critical code communications, on-call scheduling, and secure texting to a single mobile device platform. The hospital’s CTO will describe the results, the lessons learned in creating a big-picture communication strategy that improves workflows, and its plans for the future.

March 22 (Tuesday) 2:00 ET. “Six Communication Best Practices for Reducing Readmissions and Capturing TCM Revenue.” Sponsored by West Healthcare Practice. Presenters: Chuck Hayes, VP of product management, West; Fonda Narke, senior director of healthcare product integration, West Healthcare Practice. Medicare payments for Transition Care Management (TCM) can not only reduce your exposure to hospital readmission penalties and improve patient outcomes, but also provide an important source of revenue in an era of shrinking reimbursements. Attendees will learn about the impacts of readmission penalties on the bottom line, how to estimate potential TCM revenue, as well as discover strategies for balancing automated patient communications with the clinical human touch to optimize clinical, financial, and operational outcomes. Don’t be caught on the sidelines as others close gaps in their 30-day post discharge programs.

Contact Lorre about our post-HIMSS webinar sale.



Sixty-nine bed Madison Memorial Hospital (ID) will implement Cerner at a cost of $6 million upfront and $86,000 per month in maintenance fees. They chose Cerner over Epic and their incumbent vendor Meditech.

Virtua Health System (NJ) chooses Epic, which apparently beat Cerner in offering a replacement for Siemens Soarian.

Steward Health System chooses Imprivata Cortext for provider communication across its nine hospitals.


Aurora Health Care (WI) chooses Strata’s StrataJazz as its full financial analytics and performance platform.



Healthgrades hires C.J. Singh (Backcountry.com) as CIO.

Ross Martin, MD assembled video good wishes for Deloitte’s Chris Brancato, who is recovering from unfortunately eventful spine surgery that has left him hospitalized and therefore unable to attend the HIMSS conference. Some of the greetings were recorded at HIStalkapalooza.

Announcements and Implementations

CPSI announces a program by which its revenue cycle customers can apply their additional revenue toward buying its Evident Thrive EHR with no upfront costs. CPSI shares have rallied a bit in the last few months, beating the Nasdaq slightly by increasing 3 percent in the past year.

Health Catalyst arranges its product roadmap around nine subject areas.

Intelligent Medical Objects will work with Northwestern University’s medical school to support pharmacogenomics clinical decision support through creation of terminology to support concepts such as “ultra-rapid metabolizer of clopidogrel.” IMO will make the results available to members of the federally funded eMERGE consortium at no cost.

Vital Images launches an ACO imaging analytics solution and announces a personalized HIE/EMR viewing platform.

Privacy and Security


The personal information of all employees of Main Line Health System (PA) is exposed when one of them replies to a spear phishing email.

Innovation and Research

Mass General’s “Ambulatory Practice of the Future” calls for undergraduate and graduate engineering students to compete for $400,000 in prizes for creating innovations in primary care (technology, instrumentation devices, etc.) Pre-proposals are due April 18, 2016. Ten finalist teams will be awarded $10,000 and the top three winners will receive $150,000, $100,000, and $50,000. Last year’s winner was Hemechip, a point-of-care diagnosis device for sickle cell disease.


The HIMSS16 final attendance count was 41,885, down 3 percent from last year’s 43,129. This is the first time I can recall attendance going down year over year unless maybe it was in 2000 due to the Y2K scare. Possible reasons I came up with:

  • Industry hangover from MU and ICD-10.
  • Fatigue with the novelty of having the federal government drive so much of the conference agenda.
  • Lame keynote choices.
  • Election year uncertainty.
  • A move to immediately valuable vendor user group meetings instead of a massively broad conference that is more useful to providers who are shopping products.
  • A cutback in travel funds from vendors anticipating a market slowdown.
  • Questionable return on investment for both providers and vendors.
  • An increasingly less-useful education track that favors just pushing attendees into the exhibit hall nonstop.


A reader sent a link to the Sands Expo’s brochure describing its “green “ practices conference planning tool that should relieve HIMSS attendees worried about the lack of obvious recycling efforts. Interesting facts from it:

  • The Sands Expo facility earned LEED Gold certification for existing buildings.
  • Meeting rooms are equipped with sensors that control energy-efficient lighting.
  • Onsite solar panels address some of the energy requirements.
  • The convention center recycling rate is 80 percent, with waste sorted at both on-site and off-site recycling stations.
  • Leftover food is made available in the employee dining room with the unused amount composted and sent to a local pig farm.
  • Carry-out and concession serviceware is compostable.
  • The entire property is smoke free except for the casino and 6 percent of guest rooms.
  • The facility offers volunteer opportunities to conferences exhibiting that include helping with soap and shampoo recycling, creating Clean the World hygiene kits from recycled materials for locals in need, helping sort donated products for the local food bank, packaging nutrition bags for senior citizens in poverty, packing food in backpacks for local children, boxing meals for after-school programs, and volunteering with Opportunity Village to support those with severe intellectual disabilities.


HIMSS barely missed what would have been a huge PR scoop as the Denver Broncos announce that Peyton Manning will retire, just two days after his HIMSS conference keynote.

An 86-year-old woman accidentally strangles herself to death when her medical alert bracelet, which did not have a breakaway clasp, gets tangled in her walker.

Weird News Andy advises people to “Don’t Worry, Don’t Be Happy.” A study finds that joy – along with anger, grief, and fear – can cause emotional stress that contributes to takotsubo (aka broken heart) syndrome. 

Sponsor Updates

  • Huron Consulting Group and Strata Decision Technology announce a partnership to create a value-based care transition solution.
  • NextGen Healthcare integrates CareSync CCM into NextGen Ambulatory EHR and will offer the product to its customers who want to perform and bill chronic care management services.
  • Aventura chooses HealthCast as its single sign-on partner.
  • Catalyze will add support for Microsoft Azure to its HIPAA compliance platform as a service.
  • The Advisory Board Company offers case studies from four health systems that saved $4 million using its Crimson performance analytics program.
  • Nordic will offer its customers visual analytics from Qlik Sense.
  • NextGen Health integrates inMediata’s inBanking payment reconciliation solution with its practice management system, allowing payments to be electronically reconciled against banking deposits.
  • VMware integrates Imprivata’s user credentialing and messaging products into its Workspace One provider digital workspace.

Blog Posts


Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
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Currently there are "10 comments" on this Article:

  1. Do you think the location for HIMSS16 had any effect on attendance? I loathe Las Vegas and will not return in 2018 if I have a choice. The absolute low point for me was watching people pushing their baby strollers through the smoke-filled casinos – the same casinos I had to navigate to go anywhere in the complex. Knowing that that sort of thing goes on is one thing. Seeing it was quite another.

    [From Mr H] Attendance at HIMSS12 in Las Vegas jumped 18 percent over HIMSS11 in Orlando, although the effect of location isn’t obvious. I still remember the constant “snap, snap, snap” sound at HIMSS12 as I ran the sidewalk gauntlet of seedy men trying to flip the business cards of strippers to attendees navigating between Harrah’s and Sands Expo.

  2. Beyond the number of attendees, I’d like HIMSS to release the RATIO of providers to vendors over the past 15 years because – while completely subjective – I am pretty positive that at my first HIMSS is was probably 1:4 while my Spidey sense now feels like it is more like 1:8 meaning. Consequently, I am not sure how worth HIMSS is from the direct sales perspective. I do think branding, partner meetings and customer relationship maintenance make participation worthwhile however, e.g. we all remember when Cerner pulled out awhile back.

  3. RE: Love American Style: We’ve also seen a deluge of patches in Epic 2015. You can’t go a week without yet another patient safety patch. Epic didn’t even let customers install the base release in production, whoever went with IU1 was urged to patch to IU2 by end of March. I have no idea why they even released the base and IU1 versions if even Epic wants you to go to IU2 ASAP. This release has been a QA disaster. Stick to 2014 for as long as you can if you haven’t upgraded yet.

  4. Re: Healthy Food

    Good morning! I couldn’t help noticing the comment “It’s a fine line between providing what attendees want vs. what’s good for them, however”.

    I hear that a lot, and then from experience, we discover it’s not true.

    In Washington, DC, we’re now going on 2 years of a healthy food policy for our (Kaiser Permanente) Center for Total Health, which is also organization wide, and you know what, what we hear is the opposite – spontaneous gestures of thanks from guests and visitors for respecting their health and dietary requirements.

    Your readers are on to something by pointing this out, and we’re happy to be the example of why it doesn’t have to be this way – it’s a choice that’s made by organizers to pay attention to the learning/collaborating environment or not. More info about our journey here – http://centerfortotalhealth.org/healthy-picks-for-happy-meetings/

    Come by and see us sometime,

    Ted Eytan, MD
    Kaiser Permanente Center for Total Health
    Washington, DC
    @tedeytan | @KPTotalHealth

  5. The small Epic application I oversee had two patient safety alerts in one week recently – due to a previously installed “fix”. The personnel and overhead to keep Epic running (nevermind optimizing) is the greatest I’ve ever experienced after 20+ yrs and 4 other vendor experiences. So I’m working on optimization project and as soon as an alert comes out – all work stops for me and my Epic counterparts because I have to drop all to deal with this patient safety “bug”. Nevermind the change that happened in January after a recent patch was loaded, wiped out user custom settings and our Epic analyst had no information to help out except a shrug and “that patch caused lots of problems”. Yeah, we noticed. My paycheck is the same regardless – I just feel terrible my institution paid so much for the system that users are not happy with and costs a bundle to maintain – and Epic still can’t figure out how to QA their products. Medicare dollars at work folks (because we are all paying for the cool Epic headquarters)!

  6. Last trip to HIMSS for me was in NOLA (2012 or 2013? – and Histalk Palooza was the highlight for me). I actually have talked two employers out of attending with the expense of a booth, and in one case where they went anyway, I positioned so as to not be “selected” to go be a booth person. HIMSS is good for only three things – 1) huge legacy type companies with their city-block long booths to entertain current clients, 2) very small companies looking for partners, investors, or acquisition, and 3) job seekers networking.

    I am not aware of any of my employer companies ever closing a sale due to HIMSS. (and I once was head of marketing for a division of a F100 communications company where I headed our HIMSS $200K+ participation effort). Not to say that some don’t, but when you are in a hall with 100 rows that is a half mile in length, and the attendees are not usually the decision makers, it is a waste of time and money for all.

    But it is a good excuse to get out of the office, spend the company’s money and let your hair down. And it lets marketing departments show they are “doing something” without actually having to get involved in the heavy lifting of “demand and lead generation” activities to support the sales team.

    But then again, I’ve found that all but one conference I’ve attended in the past 5 years actually paid off in measurable revenue or even a decent list of new prospects for my company, so my criticism of HIMSS is similar for most conferences – except that it is just “yuger”.

  7. RE: Publius

    I wouldn’t be so sure that the VA will go Epic enterprise. Yes, I know the VA purchased Epic’s Scheduling solution, but with the DoD going with Cerner Millennium, RFP or Not, there will be alot of pressure to perhaps stay with Cerner Millennium System wide.

    Personally, I would like to see Cerner and Epic play nice together in the sandbox, its a win/win for both. But, don’t count Cerner out of the VA just yet.

    Remember, no many thought they had a chance of winning the DoD…….

  8. The 3% drop in HIMSS attendance could be entirely manufactured – Epic sent 2-3000 folks down last year since it was just a drive away, but didn’t think 3,000 tickets to Vegas was a stellar financial decision. Subtract that from last year’s conference and you have a slight increase.

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Reader Comments

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