News 2/16/11

From Wombat: “Re: Blumenthal replacement at ONC. Stephen L. Ondra, MD is the frontrunner.” Unverified. He’s a veteran, neurosurgeon, and senior policy advisor for health affairs at the VA. I doubt he’s a heavy EMR user, but I guess at ONC level that will always be the case. Maybe that should be a pre-requisite.

From CIO or CPA: “Re: Allscripts. Am I the only one that wonders about the Allscripts balance sheet? Nearly $1.6B out of a total of $2.4B assets is either intangibles or goodwill. There is also $460M of long term debt. This is a total of about 85 % of total assets. This compares to Cerner’s totals at about 21%. Seems like a large hole. What am I missing?”

From WildcatWell: “Re: Verizon Health Information Exchange. May offer its own MU-certified EMR to physicians who subscribe, use Verizon Business, FiOS, whatever. Info could then be pushed right into a doc’s home. Game changer, baby!”

From PureSpam: “Re: McKesson. Not a rumor – big layoff happening now (Tuesday morning).” Nasty Parts sent this on Monday: “Wholesale slaughter of the McKesson sales force on 2/15. Over 450 folks being let go.” Monday’s rumor from Doolittle specifically named McKesson, although I didn’t until I gave the company time to respond to my inquiry (they didn’t). I don’t have firm confirmation, but one insider places the number at 84% of the sales organization, or about 200 people. Supposedly a consulting firm convinced MCK that the client executive role was not worth keeping. I’ll let you know if they provide a statement.

From IKnowPlenty: “Re: vendor parties. Any insight about what they’re doing for entertainment? Keep up the good work – I enjoy every issue.” I haven’t followed the events too closely since I never have time to go. I think I signed up for the Allscripts party on Tuesday evening at Hard Rock Live with the hopes they’ll have name entertainment just in case I have time to attend, but in Orlando you usually end up with white-bread Disney day-jobbers doing an imitation of a band.

Just a brief note on HIStalkapalooza: it’s more than completely full from those who signed up during the designated period, so I can’t add more folks – sorry. I wish everybody could be there, but we just don’t have the room.

Kaiser’s George Halvorson extols the virtues of its new computerized clinical library in his organization-wide e-mail this week. It’s available everywhere to users, is being used 10,000 times per day, and in addition to references, also includes includes best practices, protocols, and links for using Kaiser services.

I feel odd mentioning new HIStalk Platinum Sponsor GE Healthcare since I don’t always have nice things to say about the company and they know their sponsorship won’t change that. Still, I was encouraged (and said so) a few weeks back when they were quick to reply honestly to a rumor I asked them about (true, as it turned out) and I admire them for supporting a somewhat loose cannon. Everybody knows GEHC, so let’s talk about what they’ll show you if you head over to that block-long booth they always have (#2401) at HIMSS: Centricity EMR solutions (Advance for small practices, Practice Solution for mid-sized ones, Centricity EMR for the big boys, and Enterprise for hospitals); eHealth Solutions (HIE, image exchange, and community desktop portal); digital pathology from its UPMC partnership; the Qualibria Clinical Knowledge Platform; and other tools (wireless devices, patient monitors, etc.) You can schedule a demo here (if it were me, I’d check out the HIE and Qualibria products since those are new, I think, and I don’t know a thing about either product) or head over to a theater presentation. Thanks to GE Healthcare for supporting an honest and opinionated HIStalk instead of some fawning publication or site.

Allscripts announces Q4 numbers: revenue up 87%, EPS –$0.03 vs. $0.10. The costs of the Eclipsys acquisition took MDRX into the red; otherwise, it would have beaten estimates at $0.20.

Valley Regional Hospital (NH) chooses the HMS hospital information system.

Orlando Health is partnering with Rothman Healthcare to evaluate the Rothman Index as an admissions patient surveillance tool and to enhance the effectiveness of the health system’s Rapid Response Team. I interviewed Michael Rothman in October and it was one of my better ones, if I do say so myself, because it’s an interesting product they’re creating and they’re doing it for passion, not money.

Quite a few of you filled out my reader survey – thanks. I only run it once a year, so this is your last chance to weigh in. I read every response and try to find time to run with a few of the ideas offered every year.

An ABC News piece covers a project by a former Stanford student to improve healthcare in Africa by setting up a telemedicine network based on text messages sent via discarded cell phones. I mentioned it last June when it was called FrontlineSMS:Medic. The new name is Medic Mobile.

Deborah Peel, MD of Patient Privacy Rights was scheduled to testify Tuesday before the PCAST work group of the HIT Policy Committee and HIT Standards Committee. Her group’s concerns: (a) universal data exchange formats without privacy consideration will make it easy to violate patient privacy; (b) it takes time to build privacy into systems; and (c) de-identification doesn’t really work very well.

University Hospitals (OH) will expand its deployment of the Allscripts EHR and Sunrise Enterprise.

A Boston Globe article covers patient harm caused by alarm fatigue with hospital patient monitors. It mentions a 15-bed unit at Johns Hopkins that averaged 942 critical alarms per day. It also cites a Mass General case in which a patient slowly died while experiencing a fatal heart attach after his cardiac monitor was turned off and staff did not respond to ongoing alarms triggered by his low heart rate. A nurse was quoted: “We have 17 types of alarms that can go off at any time .. It becomes … background.” Studies also found that up to 85% of the alerts are false alarms.

CSC’s big NPfIT contract is in danger of being cancelled over repeated missed implementation dates, some of the go-lives years overdue. NPfIT has gone through many vendors, some of them big, and I don’t know of any that made any money. It probably wouldn’t break CSC’s heart to be shown the door.

Privacy software developed by a Canadian researcher is being tested by two hospitals. It scores the likelihood of being able to identify a particular patient based on their available information and then selectively de-identifies the records as needed. I see by Googling that he’s already formed a company to sell it.

HHS launches the HealthIndicators.gov portal, opening up the HHS health indicators data vault to developers and researchers.

Billionaire Patrick Soon-Shiong makes another healthcare technology investment, this time in UK-based wireless monitoring device vendor Toumaz. The company will start by developing sports sensors, but will then look at wireless healthcare.

A Virginia hospital, hit by Facebook-posted rumors that patients were dying of sepsis contracted there, strikes back by saying “not true” on its own Facebook page. At least it doesn’t cost anything to argue on Facebook.

E-mail me.

HERtalk by Inga

From Fancy Nancy: “Re: HIStalkapalooza attire. I am so excited about the reception coming up and am wondering how formal people are dressing? I need your guidance and wisdom.” Fancy Nancy, I am so glad you asked. I hope that we see lots of velvet and taffeta and strappy high heels. If you can’t decide whether it’s worth it to pack that special outfit, here is something to consider: the two winners of the Inga Loves My Shoes contest will each receive a $100 gift certificate from Zappo’s, courtesy of Mr. H. Then there is the HIStalk King and Queen event for the the best-dressed attendees. These royal winners each take home iPod Touches (not the cheesy 8GB version, but the new 32GB model, complete with Facetime and HD video recording). Here is a hint, if you want to be in the running: don’t be late. We will have a red carpet entrance, and if you really want to strut your stuff, make sure you take a moment for a photo and chat with our red carpet interviewers. The formal presentation part of the evening will begin at 8:00 p.m. and our finalists will be selected by that time. To give you an idea of how high the bar is set for the shoe contest, our esteemed judge sent me the above photo of what will be adorning her feet. Meanwhile, our head judge for HIStalk King and Queen has been cramming to watch all eight seasons’ worth of “What Not to Wear” and to memorize all of Stacey and Clinton’s rules.

From Pretty in Pink: “Re: Winning party attire. Real men wear pink, so I am hoping that someone from my team will have a shot at HIStalk King.”  While we love you pink-pants-wearing guys, we hope you have time to change before heading to BB King’s. Of course, if you show up in a pink tux, our judges will likely make you a finalist.

A big thank you to everyone who shared with me news of other fun evening events during HIMSS.  Some of the hot parties include Cuba Libre for “music , dancing, food, and fun” and a casino night at one of the big hotels. It seems like I also saw something about an event at the Amway Center with appearances by Orlando Magic players, but I can’t find that e-mail. So much for staying in and ordering room service.

Misys Open Source Solutions will leverage technology from Apixio to improve data search and filter capabilities.

Allina Hospitals & Clinics (MN) deploys Mobility XE, a mobile VPN solution from NetMotion Wireless.

2010 was the second worst year in the last 15 for mass hospital layoffs , affecting a total of 10,490 individuals.

Nuance continues to be the “power player” in the speech recognition market, according to a new KLAS report. Nuance’s eScription was the highest rated back-end system, followed by Dolbey Fusion Speech. Nuance’s PowerScribe and RadWhere led the front-end speech segment, followed by MedQuist’s SpeechQ. KLAS says the speech recognition market is ripe for healthy growth, with only one in four hospitals employing the technology.

GE’s philanthropic organization, the GE Foundation, awards $500,000 to two Erie, PA-based community health centers to support increased access to quality healthcare. Meanwhile, GE Healthcare enters into a joint development and marketing agreement with SAS to use SAS Analytics in GE’s Patient Safety Organization to mine data on patient safety adverse or near-miss events.

Siemens Healthcare announces that five healthcare systems have contracted for Soarian systems, including Baptist St. Anthony’s Health System (TX), Peconic Bay Medical Center (NY), Children’s Hospital (LA), Touro Infirmary (LA), and MaineGeneral Health.

Ken Graham, the newly unemployed CEO of El Camino Hospital (CA), will receive almost $1 million in severance pay. El Camino’s board of directors fired Graham last week “without cause.” Nothing like a million bucks to ease the pain.

Did you have a chance to look through Mr. H’s Must See Vendors for HIMSS11? Here are two reasons it’s worth your time: 1) you will be amazed at the variety of products and services that encompass the HIT world; and  2) there are some pretty nifty giveaways. I have printed my PDF version so I know which booths to hit. If you are short on time, here are a few tips, starting with the offerings exclusively for HIStalk readers:

• Vitalize Consulting (3070) – if you connect a “link” on their Chain of Hope, they will donate $5 plus an additional $5 if you say you are a HIStalk reader.
• Virtelligence (2131), MED3OOO (917), Emdeon (2201), and Cumberland Consulting (6943) are each hosting special HIStalk reader-only drawings for iPads.
• Iatric Systems (3601) – (3) $50 iTunes gift cards for readers.
• Enterprise Software Deployment (2777) – special drawing for a Sonos Music System.
• Billian’s HealthDATA/Porter Research (4579) – snack packs to the first 100 HIStalk readers.
• API Healthcare (3463) – HIStalk reader-only drawing for a Dell Inspiron Mini Netbook.

For the HIStalk-exclusive goodies, you pretty much just need to mention you are a reader – no secret handshakes required. While you are touring the exhibit floor, here are a few other recommended stops:

• CareTech (1831) – raffling off a $1,000 donation to a recipient’s hospital foundation.
• Enovate (2738) – iPad giveaway.
• Enterprise Software Deployment (2777) – in addition to the HIStalk-only drawing, they are giving out cozy flip flops and a chance to win a FLIP camcorder.
• HT Systems/PatientSecure (218-10) – if you register to meet with them in advance, you have a chance to win an Android-based tablet PC.
• Keane (1548) – iPad giveaway.
• MEDecision (2563) – Starbucks coffee (!)
• Microsoft (3101) – Microsoft Arc Mouse giveaway.
• NCR (2805) – a singed copy of Paper Kills 2.0 by Next Gingrich to the first 25 people to schedule a booth appointment.
• NextGen (2163) – chances to win a smart phone or iPad. NextGen will also have “splash” artists creating works that will be given away.
• Sage (1713) – sign their Red by Sage Wall of Inspiration to commemorate someone’s life that’s been touched by heart disease, then get a chair massage.
• Wolters Kluwer (6162) – chance to win a trip for four to the US Masters in Augusta.

E-mail Inga.

Sponsor Updates by DigitalBeanCounter

• Design Clinicals now supports integration with GetWellNework, allowing hospital patients to use the in-room TV to request bedside delivery of prescribed meds.
• Clairvia says sales of its Care Value Management software grew 85% during the last six months of 2010.
• MEDecision is launching a mobile application that enables providers to access its Clinical Summaries through smart phones and electronic tablets.
• GetWellNetwork announces a record number of new contracts, upgrades, and expansions with new hospitals.
• The Boston Globe cites Nuance’s Dragon Medical software in an article titled, “Writing exactly what they say.”
• Riverside HealthCare (IL) selects the eClinicalWorks EHR.
• Five CareTech Solutions clients will share their experiences at HIMSS11.
• Colleen Hittle, managing partner at Anson Group, will be a featured panelist at Indiana University’s Life Sciences conference on February 25 in Indianapolis. Shout out to DigitalBeanCounter’s alma mater!
• Imprivata partners with Thales, an information systems security leader, to deliver high level SSO cryptographic security.
• Stan Cassidy Centre for Rehabilitation (SCCR) chooses Orion Health’s Patient Portal to improve communication between patients and providers.
• Access will demonstrate the new version of its electronic forms offering at HIMSS, which includes an iPad version.
• Siemens will conduct on-the-spot interviews of experienced talent  at their HIMSS booth, with a specific interest in candidates for product line management and enterprise services positions.
• Phelps County Regional Medical (MO) will replace its document management system with Perceptive Software’s ImageNow document management, imaging, and workflow solution, integrated with Meditech.

EPtalk by Dr. Jayne

Barely a week left before HIMSS and I’m still having fun opening the mail every day. However, being in a part of the US that’s been having some weather, I don’t envy my mail carrier dealing with the vendor postcard that was mailed in an 8×10 rigid envelope that required it be carried through the proverbial rain, snow, sleet, and hail to my front porch. Yes, you got my attention with that, but you also could have gotten my attention with a smaller mailing, like the new Rapid Rewards update mailing that Southwest Airlines just sent. The size of a standard CD case, it caught my attention and kept my mail carrier warm and dry in his truck.

Lawson also got my attention (but in a positive way) with their tagline “Top Performers Make the Difficult Look Easy” and photographs of the contortionists they’ll be featuring in their booth. Although fascinating, I have a hard time watching acrobats because it brings back memories of Gross Anatomy class and having to memorize the name of every muscle, bone, and tendon.

Reader Bill, a veteran of the healthcare marketing trenches, emailed Mr. H and me about marketing:

Some folks complain about your HIStalk banner ads; I have embraced them as interesting. Not because I am sold on their offerings – not in the least. But when clustered together and winking at me with their clever little Flash graphics as I scroll, they seem otherworldly, almost anthropomorphic – "look at me!" "No, look at me!”

Mesmerized, I am transported to nearly 100 drab marketing conference rooms where overworked copy and graphic drones are prodded by their regional or national suit to, "Gimme something that ‘pops.’ Stale coffee, half-eaten bagels and doughnuts, pencil sketches, and wads of paper strew the table. Projector images flip through the ridiculous and unrealistic royalty-free stock photos of too-pretty male and female models with stethoscopes posing as healthcare workers. Bright young graphics and PR managers all convinced that they have the next best attention-grabbing gimmick.

With that in mind, my pre-HIMSS Winner of the Week is Aventura, which grabbed my eye with their tag-team Halloween-hued envelopes. The orange envelope held a fairly standard piece, but I enjoyed their promise of fixing all my staff’s roaming profile and VDI issues “in a way that will loosen their hands from your throat.” I’m not so sure though about their promise to “do things that will make clinicians run up and kiss you.” The black envelope held an invite to yet another private hands-on demo where they plan to show “the ultimate technological feat: how to make clinicians think you’re a decent, thoughtful, kind-hearted person.” I give them an A+ for marketing and a gold star for being a vendor that understands my world.

One last thought on marketing: the issue with the RelayHealth Facebook contest to create a welcome gift basket for me has been fixed – it no longer tries to get you to upload a video. I was starting to feel cyber-neglected due to lack of submissions until a reader e-mailed about the issue. The contest ends on February 18th, and if your suggestion gets high votes, you win a prize. Right now the field is wide open, so you’re guaranteed to be a winner! (I did shamelessly seed it with my own entry, though.)

I heard from some readers responding to my challenge to share the one product, add-on, or offering that is indispensable for practice. Several suggested a vendor who is also on Mr. H’s “Must See” list, so I thought I’d share it in advance of HIMSS so those of you who are not familiar can be sure to check them out. Intelligent Medical Objects (also an HIStalk Platinum Sponsor) will be at Booth 3517. I’m already a user and can tell you they saved my sanity as a physician and my life as a CMIO, providing the biggest “win” I’ve ever delivered to my docs. (And no, I’m not on their payroll, before some of you ask. But they did buy me drinks once as my ‘real’ self.)

Enough HIMSS-induced prattle. I have two articles to share this week.

First, from the Journal of Family Practice February 2011 issue, the first published case report in the United States of teenage text-induced tendinitis (although they did get scooped by The Medical Journal of Australia). This fourteen-year-old was texting four hours a day using only one thumb. The authors cite data that shows injury is related to high thumb movement velocities, with females being faster texters than males and thus more symptomatic. Use of a two-thumb style was protective, as was (drum roll) limiting daily texting activities, slowing down, and watching posture.

Second, the Atlanta Journal-Constitution reports that two brand-new members of the Georgia senate have teamed up in an effort to force Medicaid clients (not sure why we can’t call them patients any more) to use an ID card with their photo and PHI on a data chip and to scan their fingerprints at the doctor’s office (at least they didn’t call us providers again).

Although I applaud legitimate efforts to fight fraud, I take issue with this proposed legislation for several reasons. First, doctors are already dealing with the unfunded mandate of Meaningful Use (anyone who believes this is a money-maker, we need to chat) and now you want us scanning fingerprints at $200 a device? Do you two newbie politicians have any idea about health IT or what it would take to implement this?

Second, they want the patient fingerprinted both on arrival and when they leave the office. Have they never heard of efficiency? Is the patient going to be a victim of identity theft while they are being treated? (Maybe our backless paper gowns can steal more than dignity!)

And third, this is going to be another reason why physicians and other providers are going to stop participating in the Medicaid program (as if low payments, administrative burdens, and medically complex patients with multiple socioeconomic factors influencing their care are not reason enough). The estimated program cost is $26 million. Vendors, start your engines!

Have a question about medical informatics, electronic medical records, or what good has ever come of turning your head and coughing? E-mail Dr. Jayne.

Dr. Gregg Goes to HIMSS
By Gregg Alexander

Amidst the din, nay, cacophony of getting-close-to-HIMSS e-mails from marketers (and Marketeers) and the PR firm mouthpieces for all things HIT, it gets pretty difficult to wean the worthwhile from the worthless … and most appear more -less than -while. Filters are running full bore these day as I try to figure out which pre-HIMSS blasts actually contain any real value.

One made it through a few weeks ago, when the cacophony was more hubbub than holler. Several factors, especially the concise descriptors the e-mailer used, allowed it to reach through my mental blockade (which has become quite the barricade these days out of sheer volume overload necessity). I am happy that it did, because it helps me to honestly say that not all the pre-HIMSS hype is just hype. There’s a few who truly deserve to be noticed. Here’s how:

Today, I had a sneak peak demo of a product that will be rolled out at HIMSS which I am actually thrilled to see coming. VitalHealth Software, which is the result of a collaboration between Noaber (pronounced knob-er) Foundation out of the Netherlands and Minnesota-based Mayo Clinic, is rolling out VitalHealth EHR at HIMMS. I truly think it is an EHR that is going to make a lot of people stand up and take notice. It is Web 2.0 for EHRs, human user interface at the fore, stupid simple on the surface while kick-ass smart below decks, easy on the eyes, workflow-savvy. It is what an EHR should look and act like.

If you’re hitting HIMSS, I highly recommend taking a peek. If you’re a provider looking for an EHR tool that has been turned on a really smart lathe, it should almost be mandatory. It is flat-out cool.

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Pretty much every talking HIT head has had a chance to spout about David Blumenthal’s announced return to academia. (I can’t wait to hear what the buzz around the HIMSS water coolers will be about his replacement.) Sure, he has to head back to keep his spot on the Harvard starting lineup, but who knows what other thoughts may have traversed his mind as he saw the sands running low in the sabbatical hourglass? Here is one possible scenario that I just loved from an author (I only wish I’d written it) who prefers to remain anonymous:

“I think Dr. Blumenthal sees the writing on the wall. Excerpt from his recent internal dialogue:

Government David: ‘CMS says we gotta make ‘em go CCHIT before they NIST and, after that, make ’em achieve MU, build an HIE, become an ACO, and then get NCQA to issue new PCMH regs.’

Human David: ‘OMG, this is wack. AMF.’ (Adios, Mother ——-s.)”

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Another pre-HIMSS marketeering note: maybe it works differently on real reporters, folks who deal with this kind of “Hey, listen to me!” on a regular basis, but in my opinion, the incessant reiteration and second / third / fourth e-mails from PR companies trying to land an interview time for their clients is mostly just off-putting. Especially if the first e-mail blast was poorly drafted, impersonal, insincere, or one of the typical hastily performed cut-n-paste jobs that seem so common. I’ve had a fairly busy inbox for some time, but the pre-HIMSS blasts have probably doubled my Junk…er, Inbox files.

My suggestion: put the effort in the first time and odds would be way better that you won’t need the second, third, fourth, etc.

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Most of you may remember the now-defunct TEPR (Towards the Electronic Patient Record.) I remember how helpful and well-attended it was back in Salt Lake City in 2005. What once was a thriving HIT showcase and helpful place for providers looking to learn more and get hands-on product experience died an ignominious death after the poorly attended 2009 exhibition in Palm Springs. Granted, it supposedly morphed into mHealth, but mHealth doesn’t fill the same bill, not by a long shot.

All the pre-HIMSS blasts have prompted me to consider if there is any way that the thriving, almost bursting at the seams HIMSS conference could one day soon go the way of the once grand-ish TEPR. I mean, once the numbers have reversed and 85% of providers are working electronically and, especially, once the Obama-bucks have run dry, will there really be a need for this digital bacchanalia?

Not sure, but I’ll tell you what: I enjoyed TEPR in ’05 and I’ll betcha HIMSS ’11 is gonna be a ball – especially that HIStalk Reception!! Enjoy ‘em while you got ‘em.

E-mail Gregg.