News 3/14/14

Top News

Validic, which offers a platform for accessing data from mobile health devices and wearables, secures a $1.25 million convertible note.

Reader Comments

From Professional Zac: “Re: Mat Kendall. Has given ONC exemplary service in leading its workforce, REC. and rural programs as director of the Office of Provider Adoption Support. He is leaving.” Mat is one of those people who gets a lot done, not only running those ONC programs, but before that working for New York’s EHR program and before that leading a FQHC. Like everybody who works for ONC, he sacrificed income and lifestyle for public service since it’s generally true that only low-level government employees fare better than they might in the private sector. I haven’t heard where he’s going.

HIStalk Announcements and Requests

This week on HIStalk Practice: Practice Wise CEO Julie McGovern addresses EHR users who refuse to admit they might be causing their own system problems. Users of drchrono’s free EHR will be rushing to apply for MU hardship exemptions after the company announces that its Stage 2 certified release won’t be ready until  “later this year.” A Rand study finds that physicians recognize the value of EHRs in concept but believe they undermine professional satisfaction and can negatively impact patient care. Between 2011 and 2012, the percentage of EPs participating in  Medicare’s MU program dropped 16 percent and the percentage dropping out of Medicaid’s program fell 61 percent. CareCloud CEO Albert Santalo discusses a possible IPO, company growth, and how its offerings differ from athenahealth’s. While you are checking out the latest in ambulatory HIT news, take a moment to subscribe to the email updates so you’ll never miss a post. Thanks for reading.

This week on HIStalk Connect: Proteus Digital Health announces large-scale trials and plans for a new manufacturing plant in the UK. Nintendo will refocus its strategic direction to capitalize on the growing health and wellness market. Validic raises $1.25 million to expand its mHealth integration engine.

Last chance to help me out plus be entered into a drawing for three $50 Amazon gift certificates: complete my reader survey before I close it Saturday. I appreciate it.

Upcoming Webinars

March 19 (Wednesday), 1:00 p.m. ET. The Top Trends That Matter in 2014. Sponsored by Health Catalyst. Presenters: Bobbi Brown, VP and Paul Horstmeier, SVP, Health Catalyst. Fresh back from HIMSS14, learn about 26 trends that all healthcare executives ought to be tracking. Understand the impact of these trends, be able to summarize them to an executive audience, and learn how they will increase the need for healthcare data analytics.

Acquisitions, Funding, Business, and Stock

Telus Ventures invests $3 million in PatientSafe Solutions and becomes the exclusive reseller of the PatientTouch point-of-care mobile system in Canada.

Covisint announces preliminary Q4 revenue of $24-$25.5 million, short of estimates, and appoints Sam Inman (Comarco Wireless Technologies) as interim CEO.

Accretive Health says it will probably not meet the SEC’s deadline to file restated financial results from the last three years, which will likely cause its stock to be delisted from the NYSE next week. 

General Atlantic is said to be the frontrunner to make a $100 million investment for a 30 percent stake in 1,400-employee healthcare IT services firm CitiusTech, which seeks capital to fund growth in Europe and the Middle East.

People

Validic hires John Turnburke (MedFusion) as SVP of business development, Chris Edwards (Allscripts) as VP of marketing, and Ben Clark (Allscripts) as VP of operations.

Janet Dillione, executive vice president and general manager of Nuance’s healthcare division, will step down on March 21, according to an SEC filing.

Richard Paula, MD (Tampa General Hospital) is named CMIO at Shriners Hospital for Children (FL).

Brian Ahier (Advanced Health Information Exchange Resources) is named director of standards and government affairs for Medicity.

Connance names Michael Puffe (Huron Consulting Group) SVP of sales.

Announcements and Implementations

MMRGlobal announces a confidential patent agreement with Cerner relating to MMR’s MyMedicalRecords PHR portfolio, including the one above submitted in 2005.

OCHIN and Health Choice Network launch Acuere QOL, a data aggregation, analytics, and quality solution powered by the Caradigm Intelligence Platform that will help CHCs and PCAs manage populations and improve quality.

PatientsLikeMe launches a media campaign urging people to share their medical information. How the for-profit PatientsLikeMe makes money: selling the medical information people share to drug and device manufacturers.

Government and Politics

A GAO report recommends that HHS pay more attention to the reliability of EHR data used for quality measures and use them to measure progress.

Other

BIDMC CIO John Halamka reports that the ED has been beta-testing Google Glass since December to view the patient dashboard during examinations. He says its greatest strength is being able to provide real-time updates at the bedside and will become valuable when tied to location services.

Executives of three Madison, WI-area healthcare IT companies were among the 35 invitees who were briefed by White House and HHS officials on healthcare innovation and entrepreneurship last week, including a session with National Coordinator Karen DeSalvo, MD.  The companies were Nordic Consulting, Forward Health Group, and healthfinch.  

Speaking of the White House meeting, HIStalkapalooza winner and Nordic Consulting President Drew Madden broke out socks appropriate to the occasion. It’s apparent that he has worn them before, with the obvious question being, “To where?”

I recently mentioned that I rarely complete a HIMSS member survey because the are so long and poorly designed. I just received one asking for feedback on the annual conference that ran eight online pages and 1,100 words. Needless to say my incompletion record remains intact.

A Fitch Ratings report says hospitals may face weakened credit ratings as a result of their ICD-10 conversion.

The Department of Homeland Security warns users of the now-unsupported Windows XP that they should at least replace Internet Explorer with a more secure browser for which security updates will be issued.

The Society of Thoracic Surgeons will connect its clinical database to CMS claims data, allowing researchers to track readmissions, second procedures, and long-term survival.

Weird News Andy wonders if the hospital gets a commission on tickets as local police install a red light camera near the ED of University Hospital of Tamarac (FL), snaring at least one patient experiencing chest pains. WNA quotes a related story in which most people with chest pain in Northern Utah drive themselves to the ED, slowing their treatment since ambulances can run ECGs during transport and alert the cath lab team to be ready at the door.

Sponsor Updates

• Shareable ink Founder/CTO Steve Hau will run in the Boston Marathon on April 21 and will personally match up to $10,000 in donations for victims and survivors of the 2013 bombing. 
• Capsule Tech will showcase Capsule SmartLinx Medical Device Information System at the American Organization of Nursing Executives annual meeting in Orlando.
• Fujifilm Medical Systems and Fujifilm SonoSite will participate in the National Consortium of Breast Center Meeting in Las Vegas March 15-19.
• Perceptive Software launches v10.3 of its Enterprise and Workgroup Search.
• Holon Solutions and Texas Organization of Rural & Community Hospitals (TORCH) will build a health information exchange (HIE) that will connect North Texas Medical Center (TX) to local clinics.
• HealthCare Anytime offers two-minute video overviews of their enterprise and SaaS portals.
• NTT Data is doubling the size of its US headquarters in Plano, TX.
• Seven healthcare CIOs shared strategies for managing IT cost while maximizing its value at the CIO Summit in Chicago co-sponsored by Impact Advisors.
• NexxRad Teleradiology Partners selects Merge PACS to integrate with its NexxRIS.
• ZirMed partners with Precyce/HealthStream to offer client ICD-10 education to the ambulatory market.
• WiserTogether and Truven Health Analytics partner to help consumers make better healthcare decisions.
• Porter Research President Cynthia Porter shares her thoughts on the Health IT Marketing and PR Conference in Las Vegas April 7-8.
• pMD announces that all of its new mobile charge capture implementations will be ICD-10 compliant.

EPtalk  by Dr. Jayne

I was pleasantly surprised in my personal Yahoo mail account this morning when they returned a feature that was taken away with its redesign last fall. Although I’m glad I can now see my folders and their contents, I still wish they would bring back the tabs across the top that allowed multiple emails to be open at the same time. They also followed up with an email response to my original complaint letting me know. After the original annoyance of the upgrade, I moved most of my real email activity to Gmail, so pretty much all I use Yahoo for anymore is coupons and shopping promotions.

Inga tipped me off to this piece regarding physician professional satisfaction. The study showed multiple factors as having a positive impact on physician professional satisfaction:

• Perception of whether high-quality care is being delivered
• Control over work environment, pace, and content
• Common values shared with leadership
• Respectful professional relationships
• Fair and predictable incomes

Not surprisingly, these have more to do with how practices and physician organizations run rather than with EHR. Although there are problematic EHRs and other IT systems out there, my sense over the last few years is that physicians often use them as a scapegoat. My local colleagues have voiced the thought that they can have some degree of control over EHR (refusing to use the system, demanding de-installation, blaming the vendor) but that some of the other factors (control over work environment, salary issues) are simply untouchable.

Thinking about this from a pure behavioral health standpoint, this is classic behavior. When people experience trauma, they tend to cling to the things they can control even when the rest of their lives are out of control.

Although the timing of the study didn’t allow assessment of the impact of the Affordable Care Act, I see a lot of physicians ready to use it as a scapegoat even though the majority of its changes have not yet impacted anything other than the access issue. I liked the fact that the study had a qualitative portion, which included open-ended interviews rather than just survey-type items. Those types of questions allow respondents to share direct responses without feeling the need to fit them into a predefined response box.

Unfortunately, the responses may also fail to allow full understanding of or exploration of the results. Physicians stated that “their EHRs required them to perform tasks that could be done more efficiently by clerks and transcriptionists.”

Since I spend a lot of time working on efficient clinician workflow, I would have wanted a follow up question. Is it really the software that is requiring the workflow, or is it also impacted by organizational policies that require physician data entry where it is not necessary? Is it impacted by continued administrative cost cutting that forces work onto physicians because they are perceived as “free labor” since the hospital doesn’t bill for their services as community physicians? Of course those would be rather leading questions, but that’s what I see a lot of in our metropolitan area.

Due to my CMIO responsibilities, I cobble together my clinical experience at several different hospitals. Two of them have the same EHR vendor, yet the user experience difference is night and day. One system has been configured to require endless busywork. The order sets are poor, in a confusing order, and missing seemingly key components. Physicians are required (by administrative decision) to key a PIN for each individual order rather than being able to authenticate a cohort of orders at once. That kind of thing is fixable through educating the decision makers and ensuring that physicians are part of that decision-making process.

Don’t get me wrong, there are a lot of bad EHRs out there. It’s hard to sort that out though when poor leadership, incomplete training, and lack of understanding can cripple a perfectly good system. We need to remember that there are plenty of “causal” factors to go around, In order to truly deliver physician usability, we have to address both the hardware/software issues and how the system is implemented and governed.

In addition to EHRs, physicians cited multiple sources of dissatisfaction:

• Obstacles to care, such as unsupportive practice leadership or payers refusing to cover recommended services
• Income instability
• Burdensome regulations, including Meaningful Use

Unfortunately, these aspects of physician practice are mostly outside our control. We can’t control payers and spend countless hours of uncompensated time trying to get care for our patients. We can see more patients, but we can’t control the wide variation in payments for the same service that we see across payers. We certainly can’t control the regulatory environment.

So what do we do? We circle back to the EHR as something we think we can have some control over.

I don’t have any good answers here and wish I did. I’d love to have a magic wand or even a sparkly Band-Aid to make it all better. How do we empower physicians to be part of the solution? How do we help administrators make rational decisions around system selection and implementation? How do we get them to share the reins with providers? Email me.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis, Lorre

More news: HIStalk Practice, HIStalk Connect.

News 3/12/14

Top News

The HIT Policy Committee submits its Meaningful Use Workgroup’s Stage 3 recommendations.

Reader Comments

From Pointy Toes: “Re: CEHRT Hardship Exception Guidance. This is a joke. All you have to say to qualify for the Medicare hardship exemption to avoid the 2015 payment adjustment is say you  had ‘2014 Vendor Issues.’ Tavenner previously said some ‘narrow’ hardship exemptions would be granted. Sounds like anyone wanting an exemption can request it and presumably one will be granted one. Why not just push the deadline back for everyone instead of requiring providers to jump through an extra hoop?” CMS issued guidance Tuesday for EPs and hospitals worried about being hit with penalties, even going so far as to provide instructions to choose “2014 Vendor Issues” no matter what their actual issue. It is ridiculous – setting the bar high officially, then accepting a wink-wink rubber stamp excuse for anyone who can’t make it. Maybe someone should track the vendors whose non-compliant yet certified products forced their users to claim hardship.

From Canuck: “Re: rumore that UHN in Toronto is replacing QuadraMed EHR with Cerner. I believe instead it came down to Cerner and Epic and Epic won.” Unverified.

HIStalk Announcements and Requests

Welcome to new HIStalk Gold Sponsor SyTrue. The Chico, CA-based company offers a business and clinical intelligence platform that tells hospitals how their clinical objectives are being deployed; what physicians are doing; and who in the market is providing services at a given cost and outcome. It integrates and structures disparate EHR information for predictive and clinical analytics used for data analysis, electronic abstraction, outcomes analytics, operations, population management, clinical research, and patient engagement. Thanks to SyTrue for supporting HIStalk.

Here’s one final mug shot featuring Tammi’s office de-stresser, which must have traveled furthest from Orlando while still not leaving the continental US (the UFO on a stick in the background should give a strong hint of her location).

Thanks to the 355 folks who have completed my reader survey so far. That number provides respondents with good odds of being randomly drawn for one of three $50 Amazon gift cards, but represents only around 1 percent of HIStalk’s 30,000+ readers. Spend less than five minutes completing the survey and you’ll help me plan the next year of HIStalk and earn my appreciation besides.

I’m always looking for interesting people to interview. Know someone who would be stimulating, fun, and a straight shooter? Let me know.

Upcoming Webinars

March 19 (Wednesday), 1:00 p.m. ET. The Top Trends That Matter in 2014. Sponsored by Health Catalyst. Presenters: Bobbi Brown, VP and Paul Horstmeier, SVP, Health Catalyst. Fresh back from HIMSS14, learn about 26 trends that all healthcare executives ought to be tracking. Understand the impact of these trends, be able to summarize them to an executive audience, and learn how they will increase the need for healthcare data analytics.

Acquisitions, Funding, Business, and Stock

First-half results from Scotland-based Craneware: revenue up five percent, pre-tax profit up seven percent.

CompuGroup Medical acquires three European HIT providers: lab software provider vision4health Laufenberg & Co and office-based physician software vendors Imagine Editions and Imagine Assistance.

Quest Diagnostics completes its acquisition of Solstas Lab Partners Group and raises its full-year 2014 financial guidance.

Employer benefits platform provider Castlight Health raises the price range of its IPO to $13-15 per share, up from the $9-11 range it set just a week ago. The company, which lost $62 million on $13 million of revenue in 2013, would receive proceeds of $140 million, valuing it at $1.5 billion. The company’s founders are Todd Park (US CTO and co-founder of athenahealth); Bryan Roberts, PhD (chairman and co-founder of venture capital firm Venrock); and Giovanni Colella, MD (founder of RelayHealth).

Sales

The Royal Free London NHS Foundation Trust selects OpenText to manage its scanned legacy case notes.

The Community of Hope (DC) is implementing Forward Health Group’s PopulationManager and The Guideline Advantage.

The VA awards Leidos three contracts worth $16 million to support blood bank software and the MyHealtheVet program.

People

TeleTracking Technologies names Diane Watson (Tilt, Inc.) COO and Joseph Tetzlaff (inVentiv Health) CTO.

Michael Hart is promoted to VP of IT applications at Arkansas Children’s Hospital.

Craig Joseph, MD (Agnesian HealthCare) is named ICD-10 and EHR physician advisor at Texas Children’s Hospital (TX).

Announcements and Implementations

Cox Health (MO) deploys Phytel’s population health and patient engagement platform.

McKesson announces QICS for Cardiology, a CVIS-based workflow and critical results communications platform. OSF Healthcare (IL) is piloting.

QuadraMed announces GA of its QCPR 6.0 enterprise EHR, which includes bar code medication administration, a comprehensive problem list, a Web-based patient portal, the ability to create a CCD, and Canada-specific architecture requirements.

In Canada, Bluewater Health will roll out patient flow software from Oculys.

University of Colorado Physicians goes live on the DocASAP self-scheduling system.

Government and Politics

Office of Civil Rights fines the public health department of Skagit County, WA $215,000 for HIPAA violations involving information on 1,581 people exposed in its public web server, the first time a HIPAA fine has been levied against a local government.

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The White House launches #GeeksGetCovered, encouraging technology entrepreneurs who can now buy their own non-employer health insurance because of the Affordable Care Act to start their own businesses.

President Obama riffs hilariously with comedian Zach Galifianakis, appearing on “Between Two Ferns” to plug Healthcare.gov (“I wouldn’t be with you here today if I didn’t have something to plug … Healthcare.gov works great now.”)

The phrase “healthcare exchange” always seems to be preceded by “troubled,” so add Maryland’s $200 million version to the list.  Like other states, it decided to create its own site, hired a contractor that it later said underperformed, missed its go-live date, and had to create a backup plan to accommodate people who wanted to enroll but couldn’t. HHS announces that it will investigate.

Hillary Clinton’s financial disclosure forms for 2012 reveal that her husband Bill took a $225,000 speaking fee from the struggling, non-profit Washington Hospital Center as it was laying off employees. The hospital also brought in George W. Bush to speak, but since his wife isn’t running for office, his fee remains confidential. Bill made a bunch of money in 2012 for addressing money-losing non-profits. Somewhere in those records is the payment he received from HIMSS if anyone knows how to locate them. I’d bet $400K.

Innovation and Research

A NIST report says that inadequate workflow integration forces users of ambulatory EHRs to develop system workarounds, suggesting that EHR vendors develop these capabilities:

• At-a-glance physician views of patient schedules
• Task reminders from previous patient visits
• Redacting and summarizing lab results
• Draft creation of patients orders in advance
• Conversion of working diagnoses to formal diagnoses
• Skip or defer tasks when workload requires
• Role-based views of progress notes
• Visually differentiate copied-and-pasted progress note text from newly entered documentation
• Manage referral and consultation messages with specialists
• Track scheduled consults and lab results review

The Charlotte, NC newspaper says that Carolinas HealthCare System will use innovative (unnamed) software and the information collected by its multiple EMR systems to identify ED patients who are likely to be readmitted, allowing team-based intervention and remote management. The system’s chief medical officer weighs in on hospitals that don’t use electronic medical records: “You don’t know how bad it is until you actually go back. It was like a time warp. The care is unsafe, it’s uncoordinated. It’s a nightmare…The system was absolutely stupid, and frightening.” I interviewed SVP/CIO Craig Richardville in September 2013. It might be time for a follow-up to talk about analytics.

Technology

Wellocracy provides a well done comparison chart of wearable activity trackers.

Other

A column by InfoWorld’s executor editor says a disconnect exists between complex government EHR requirements and the stubbornness of the healthcare industry to embrace them, summarizing, “We have a mess of proprietary EHR systems with highly customized processes, a set of HIEs that use different standards and protocols to connect them, and a mandate to provide human-readable data from these disparate systems. What could possibly go right?”

In England, University Hospital of North Staffordshire plans to conduct video consultations via Skype, saying the service will reduce outpatient appointments by 35 percent.

The Gainesville, FL newspaper profiles Shadow Health, whose founder licensed avatar technology from the University of Florida to create nursing school education tools that students buy for $89.

A study finds that incorrectly flagging patients as being allergic to penicillin increases overall inpatient days by 10 percent and increases resistance to broad-spectrum antibiotics. Up to 95 percent of patients who say they are allergic to penicillin really aren’t.

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New York-Presbyterian Hospital will host a hospital hackathon this weekend in which teams will design apps for its portal that improve patient access to care. The hospital is offering $85,000 in prizes and has filled all of its slots with 120 participants. Dr. Oz provides the video introduction.

Sponsor Updates

• Kinetic Data names CareTech Solutions “Innovator of the Year” for realizing $4.7 million in cost savings by implementing Kinetic Request.
• Premier enhances its OperationsAdvisor labor management solution to give healthcare organizations the ability to analyze labor efficiency across multiple care settings.
• Ryan Uteg, senior advisor for Impact Advisors, is named to Consulting Magazine’s “35 Under 35.”
• Allscripts Sunrise is selected by Black Book as top inpatient EHR.
• Iatric Systems will deploy integration in the EDIS and vital sign monitors as Southeast Alabama Medical Center (AL) upgrades its McKesson Paragon HIS.
• MedAssets’ National Sourcing Collaborative cumulatively saves providers $135 million over the last three years.
• Wolters Kluwer Health launches Bates’ Visual Guide demonstrating evidence-based physical exam techniques.
• Santa Rosa Consulting’s Fred L. Brown is inducted into Modern Healthcare’s “Health Care Hall of Fame 2014.”
• Kareo announces that its ICD-10 Success Checklist is available on a write-on poster.
• NextGen Healthcare’s CMO Sarah Corley is elected to serve on the EHR Association Executive Committee.
• Medical Economics spotlights e-MDs customer John Bender, MD of Miramont Family Medicine (CO) for expanding his practice while 30 percent of local practices have sold or closed.
• Health Catalyst publishes a free white paper with a candid 12-point review of population health management software vendors.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis, Lorre

More news: HIStalk Practice, HIStalk Connect

Monday Morning Update 3/10/14

Top News

The Wall Street Journal reports that transcription and speech recognition software vendor MModal will file bankruptcy this week, loaded with $750 million in debt as a result of its leveraged buyout in August 2012 and facing declining sales. The company expects to work out a debt restructuring plan in advance that will allow some of its creditors to swap the money they are owed for equity in the reorganized company. UPDATE: MModal provided this statement in response to the HIStalk news item:

MModal is continuing discussions with certain of its lenders and bondholders regarding a range of financial restructuring options to enable the company to reduce its debt and enhance its financial flexibility. We believe these discussions have been constructive and we are working towards a resolution that has the support of our lenders which would provide a positive outcome for all of our stakeholders, including our customers, employees, and suppliers. We fully expect to continue operating in the ordinary course of business and providing our customers the high level of support they have come to expect from MModal. The company has solid revenue, strong operating margins, cash flows consistent with industry norms, a large customer base, and we are continuing to invest in the future. Our operations are strong and we are generating exceptional quality metrics and high customer satisfaction. We are executing on our vision to provide the healthcare industry’s most advanced clinical documentation solutions.

Reader Comments

From Caterwaul: “Re: readers during HIMSS. How many do you get?” Around 8,000 visits daily during the conference, peaking this year at 9,000 visits and 17,000 page views on Wednesday, February 26. For the month, it was 125,000 visits and 207,000 page views. The graph above covers the last 30 days.

From The PACS Designer: “Re: iPhone 6. Excitement is starting to build for the next generation of the iPhone, will feature for the first time a quad-core 64 bit processor along with iOS 8. Also expected at  launch is a heart rate monitor along with the much anticipated iWatch. It looks like Apple’s going for a big splash of new products in 2014.” Sometimes it feels as though the iPhone is like the iPod – a mature, somewhat commoditized market in which minor feature differentiation passes for innovation. Apple and competitors can do only so much in screwing around with the screen size and construction materials, so the real improvements have to come from the OS.

From Jeff: “Re: headlines. Is is possible to get the morning headlines and any M&A news in a daily email?” I hadn’t thought of doing that since I assume most readers just go to the site, but it’s possible. Weigh in on the reader survey if you’d like since that’s where my to-do list will come from.

From Olga: “Re: reader comments. I get the feeling that comments are filtered since controversial topics don’t always have many.” Comments are not filtered. I approve every one except these: (a) unverifiable claims that a specific person is quitting or being fired; b) repetitive, annoying diatribes posted by the same person using different names, as in the multiple anti-EMR identities of Not Tired of Suzy, RN; (c) comments trying to publicize a company or site. I should add that the Akismet spam filter automatically deletes comments that come from known spammer IP addresses or that contain questionable content, like a bunch of links. You might be surprised at some of the comments that I’ve rejected: claims that a specifically named CEO forced a female VP to attend an orgy, assertions of deviant behavior by well-known industry figures, and full-out personal attacks on people named in given post.

HIStalk Announcements and Requests

Half of the HIMSS conference attendees who responded to my poll said it was a good overall experience, with the remaining 25 percent each declaring it to have been either poor or great. New poll to your right, just for (anonymous) fun: how much money did you make from your primary job in 2013?

Here are more mug shots. Theo, 18 months old, doesn’t seem to mind Dad’s mishap traveling home from HIMSS that will require Mom to fix the handle. To the right, Colleen says she has one wish for Christmas since nurses need high-capacity mugs.

Every year right after the HIMSS conference I ask readers to complete my survey telling me what they like, don’t like, and recommend for HIStalk. It only takes a few minutes and I plan my entire year from the feedback. You will make a difference, earn my gratitude, and be entered in a drawing for three $50 Amazon gift cards. Thank you.

I won’t overdo the DonorsChoose project updates, but I wanted to share an example of the student letters you receive when you fund a classroom project. This one from a second grader says, “Thank you for the nonfiction books. We use them for learning and reading stations. We love them.” Lots of charities do good work but spend too much of their donations on fundraising and salaries. DonorsChoose has amazing stats: 94.4 percent of donations go toward programs and services instead of overhead, the CEO is paid only $240K, and it earns an amazing score of 67.83 out of a possible 70 on Charity Navigator. I was jaded about charities having worked in wasteful hospitals until I did my homework and came up with DonorsChoose and Salvation Army. I don’t donate a penny until I check Charity Navigator because marketing overhead can be up to 90 percent for some causes that run TV ads.

Thanks to the following sponsors, new and renewing, that recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.

Upcoming Webinars

March 19 (Wednesday), 1:00 p.m. ET. The Top Trends That Matter in 2014. Sponsored by Health Catalyst. Presenters: Bobbi Brown, VP and Paul Horstmeier, SVP, Health Catalyst. Fresh back from HIMSS14, learn about 26 trends that all healthcare executives ought to be tracking. Understand the impact of these trends, be able to summarize them to an executive audience, and learn how they will increase the need for healthcare data analytics.

Acquisitions, Funding, Business, and Stock

The private equity owners of payer-provider connectivity vendor Ability Network are seeking a buyer for the company, expected to fetch up to $500 million.

Government and Politics

Former White House advisor and oncologist Ezekiel Emanuel, MD, PhD (Rahm’s brother) writes a Wall Street Journal piece on the infighting involved in creating the Affordable Care Act. Everybody knows that HHS on one hand declares itself technologically innovative and its ONC organization demands that healthcare providers advance their technology prowess, while the CMS side of HHS’s house spends vast taxpayer fortunes on its primitive systems and the marginally competent bureaucracy required to maintain them. On bundled payments:

We presented the idea of phasing in bundled payments, especially for chronic conditions, to the rest of the White House reform team, where we found some strong support. But then we hit a brick wall. Many of our colleagues who worked for Medicare feared that creating the bundles would be too hard and warned that Medicare didn’t have the computer infrastructure to handle it. The arguments went back and forth, but the Medicare bureaucracy wouldn’t budge. Ultimately, the ACA authorized 10 demonstration projects that could be expanded if they worked—a good start, but a far cry from the more ambitious bundling plan many of us had hoped to see.

Delaware’s health department wants $87 million in FY2015 capital to upgrade its eligibility systems to meet Affordable Care Act requirements, adding that it’s too good of a deal to pass up since federal tax dollars will cover 90 percent of the cost. A Republican state representative isn’t impressed with the department’s plans. “We could have started our own endowment. It’s just staggering. This math is out of control. It’s extremely, extremely disingenuous to say this (Affordable Care Act) is saving us money.”

Innovation and Research

Engineering cadets from the United States Air Force Academy develop Neumimic as their capstone project, working with a local hospital to design a stroke recovery application based on Microsoft Xbox Kinect. The system allows patients to exercise specific muscle groups at home without a physical therapist.

Other

It’s spring-forward time as I write this on Saturday morning. Thanks if you are one of the folks who will be babysitting hospital systems tonight to make sure everything works with the change to Daylight Saving Time.

The folks at SIS put together a hilarious video that parodies vendors preparing for the HIMSS conference. It contains quite a few inside references from HIStalk (like companies that claim “HIPPA” expertise). Leave a comment with those you notice since I’m sure I didn’t catch them all.

An interesting and scary use of big data: auto repossession companies are using vehicle-mounted recognition technologies to cruise the parking lots of malls and stadiums, capturing the license plate numbers, location, and timestamp of every car they pass. The information goes to a company in Texas whose database contains 1.8 billion scans that include the majority of American vehicles. The company is just beginning to realize the value of that information, planning to sell it to private investigators, insurance companies, and banks, who only need to match up the plate numbers to other state databases to know where any given person has been.

Somehow this local newspaper’s headline seems Onion-like.

Family members of deceased patients in China, like those in India, are increasingly turning violent toward the doctor or hospital involved, with 17,000 recorded incidents in 2010. An ED doctor in Guangdong province was forced last week to march with 100 friends and family members of a patient who died, accusing the doctor of malpractice. The hospital called police and he was released 30 minutes later.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis, Lorre.

More news: HIStalk Practice, HIStalk Connect.

News 3/7/14

Top News

The Defense Health Agency, established in October 2013 as a successor to TRICARE, requests $1.6 billion to support its health IT systems in 2015. It also wants $91 million for R&D to develop a new EHR by 2017 and $68 million to integrate its systems with those of the VA. Meanwhile, the VA’s 2015 budget requests include $269 million for EHR development.

Reader Comments

From TooMuch Coffee: “Re: WA state healthcare insurance exchange. You mention that 15k applications are stuck in limbo. I agree that’s not great, but they have signed up around 500k successfully. The site basically works, unlike OR and HI sites.” I’ve written about Oregon’s struggling exchange, so here’s the story on Hawaii’s: it received $204 million in federal funding, went live two weeks late due to software problems, has enrolled fewer than 5,000 people (at a cost of about $46,000 each), and has already been declared unsustainable without ACA rule changes since few potential customers and insurers are interested and it’s supposed to be self-funding its $15 million annual operating budget with 2 percent of the take. Meanwhile, the US Government Accountability Office says it will audit Oregon’s exchange, which cost $304 million and hasn’t enrolled a single person without manual help.

From Concerned: “Re: UHN in Toronto. Can anyone confirm that they are replacing QuadraMed EHR with Cerner?”

From Nobody Knows: “Re: value-based risk contracts. Is there a resources that details which payers and providers are engaging in them vs. those doing fee-for-service? I’ve tried AIS, HIMSS Analytics, and Billian’s and so far, no dice. Even a high-level report would be nice.”

HIStalk Announcements and Requests

This week on HIStalk Practice: You won’t want to miss the summary of my chat with eClinicalWorks CEO Girish Navani, who shares his thoughts on the MU program, population health, and health information exchange, plus provides an estimate of the company’s valuation if it were to go public. Despite the growing number of  employed physicians, work still needs to be done to integrate physicians and develop performance-based reward programs. The pay gap between primary care providers and specialists narrowed in 2013. I recap some vendor announcements from last week and muse on various HIMSS sights and sounds, including the future of Practice Fusion; Allscripts and its new tag line; what’s driving Aprima’s recent growth; and, the hot topic of ICD-10. Thanks for reading.

This week on HIStalk Connect: Samsung unveils the Galaxy S5, which integrates with both its two new smart watches and its new activity tracker. Basis, the maker of the B1 activity tracker, is acquired by Intel for a rumored $100 million. The FDA is looking for a vendor to develop social media analytics tools.

On the Jobs Board: Chief Market Strategist – Healthcare, EHR Tester, Epic Activation Consultant.

Welcome to new HIStalk Platinum Sponsor CompuGroup Medical. You see the count of big global customer numbers in their graphic above and the owner-led and publicly traded company is expanding its US sales. Offerings include CGM Clinical (integrated PM/EHR), CGM DAQbilling (PM), CGM webEHR (EHR), CGM webPRACTICE (PM), and CGM Enterprise (PM/EHR for community health centers); LIS, outreach, and reference lab solutions; the eSERVICES Patient Portal, EMEDIX Reimbursement Solutions, and the SAM disease management platform. The new CEO of CGM US is Norbert Fischl, who has an interesting background as leader of the company’s Northern European region, managing director of a software company, McKinsey consultant, and an Internet entrepreneur. Thanks to CompuGroup Medical for supporting HIStalk.

Here’s another update on one of our DonorsChoose projects that was paid for by the top-of-the-page ads. The 35 freshman girls in the Illinois high school taught by Teach for America teacher Ms. Schwartz are using the notebooks and colored pencils we provided to create College Bound Journals. They will fill them with goals, thoughts about their futures, and information they gather about college campuses and majors. You can see in the photo sent by the teacher that they’ve already started.

More remote mug sightings.

Anne-Marie wasn’t able to get way from the family medicine practice she manages to attend the HIMSS conference, so she made her own mug. She says it’s not nearly as cool as the original, but I disagree.

It’s time for the once-yearly HIStalk Reader Survey. It’s quick and I use the results to plan the entire next year of HIStalk, so I would really appreciate your taking five minutes or less to give me some guidance. I’ll sweeten the pot by randomly drawing three responses to receive $50 Amazon gift cards. Thanks in advance – most of the good ideas I’ve put in place came from responses to this survey.

Upcoming Webinars

March 19 (Wednesday), 1:00 p.m. ET. The Top Trends That Matter in 2014. Sponsored by Health Catalyst. Presenters: Bobbi Brown, VP and Paul Horstmeier, SVP, Health Catalyst. Fresh back from HIMSS14, learn about 26 trends that all healthcare executives ought to be tracking. Understand the impact of these trends, be able to summarize them to an executive audience, and learn how they will increase the need for healthcare data analytics.

Acquisitions, Funding, Business, and Stock

MedAssets reports Q4 results: revenue up 4.1 percent, adjusted EPS $0.28 vs. $0.25, beating estimates on both.

Clinical prediction software vendor Health Outcomes Services completes a $5 million financing round. CEO Jim Wilson has worked for McAuto, EDS, and Cerner and was president of Craneware before joining HOS.

People

ArborMetrix appoints former CMS administrator and FDA commissioner Mark McClellan, MD, PhD (Brookings Institution) to its board.

Idea Couture hires James Aita (Medicomp) as head of healthcare solutions.

Bart Foster, founder and CEO of self-service medical kiosk maker SoloHealth, is replaced by Chairman Larry Gerdes (both above.) The company’s CFO has also resigned and an undisclosed number of employees have been laid off. Gerdes sold transcription vendor Transcend Services to Nuance for $300 million in 2012. One of SoloHealth’s investors is healthcare IT long-timer Walt Huff, the “H” in HBOC, where Gerdes was an executive from 1977 to 1991.

Tamyra Hyatt (McKesson) joins Azalea Health as VP of marketing.

Announcements and Implementations

The New York eHealth Collaborative and the Partnership Fund for NY call for applications for participation in the second class of the  NY Digital Health Accelerator, where 10 early- and growth-stage companies will each receive mentoring and $100,000 of investment capital.

North Dakota officials announce the official rollout of the state’s HIN, which will connect all of North Dakota’s hospitals by the end of the year.

The US Army deploys a software upgrade to its battlefield Medical Communications for Combat Casualty Care EMR, also known as the MC4 system, that includes an upgraded operating system, enhanced security, and patient safety improvements related to allergies and medication history.

Government and Politics

HHS includes $75 million in its 2015 budget for ONC, a $14 million increase over last year.

ONC updates its Health IT Dashboard to include a Rand Corporation-prepared review of literature on the impacts of HIT, with a focus on MU functionalities.

Analysis of full-year 2013 MU attestation data by Wells Fargo Securities finds that 92 percent of hospitals stuck with the same vendor for at least two years. Meditech, Allscripts, and Siemens topped the list of hospitals that stayed the vendor course, Cerner and CPSI were average, and Healthland, McKesson, and HMS lagged. It also finds that small hospitals seem to be dropping out in big numbers by the third year, perhaps because they’ve paid their EHR costs in the first two years and don’t want to deal further with MU complexity.

Innovation and Research

Hospitalization rates declined at nursing homes that used after-hours telemedicine services, according to a Commonweath Fund-sponsored study. Researchers estimate that the use of telemedicine services could net Medicare a $120,000 savings annually per nursing home.

Technology

Azoi announces Wello, a $199 case that turns an iPhone into a monitor for blood pressure, ECG, heart rate, blood oxygen, temperature, and lung functions.

Other

Epic, Orion, and Siemens earn the highest customer satisfaction scores in a KLAS survey on HIE solutions. Overall provider satisfaction with HIE solutions has dropped an average of eight percent since last year.

Becker’s Hospital CFO looks back at hospitals whose bond ratings have been downgraded by Moody’s Investors Services because of EHR-related budget problems: (1) Health East Care System (MN), which is spending $145 million on Epic; (2) Community Medical Center (MT), which is having cash flow problems after installing Cerner and NextGen; (3) Saint Luke’s Health System (MO), implementing Epic for $200 million; (4) Scott & White Healthcare (TX), seeing increasing costs with Epic; (5) Washington Hospital Healthcare (CA), having increased costs and a negative margin after implementing Epic; (6) Robinson Memorial Hospital (OH), with losses partially attributed to its Allscripts Sunrise implementation.

Bloomberg News calls Mount Sinai Hospital (NY) “a heart surgery factory with obscene levels of pay,” claiming the hospital coaches patients to feign heart attack symptoms in the ED to get their stents covered by insurance, earns referrals from doctors with financial ties to the hospital, and pays its head of interventional cardiology $4.8 million per year. The head of another New York interventional cardiology program summarizes, “You essentially have physicians combing the streets of Staten Island, Queens, Brooklyn, and Bronx looking for patients they can screen on a treadmill to feed into the cath lab, where the big reimbursement comes.”

In Canada, Pierre Le Gardeur Hospital cancels all elective procedures after experiencing an unspecified computer system problem.

Weird News Andy has his ear to the UK ground in noticing this story, in which the British public reacts to news that a marketing company used a 47 million-record hospital data extract to target Facebook and Twitter ad campaigns. Another company was found to have loaded the entire database to Google’s servers to create interactive maps. The Hospital Episodes Statistics database had been made available by the government to researchers and approved private companies. The government has a PR nightmare on its hands because de-identification is hard to describe to laypeople who react to “my hospital records are on the Internet.”

Sponsor Updates

• Vonlay concludes an Epic engagement with Aspirus (WI).
• Physicians Interactive and McKesson Patient Relationship Solutions will jointly deliver Coupons on Demand, which will provide clinicians access to online cost-saving offers for medications.
• Kinston Pulmonary Associates (NC) will implement NextGen PM and EMR from TSI Healthcare.
• InterSystems joins the Global Alliance for Genomics and Health.
• Gastroenterology-specific EHR provider gMed will add medical content from Health Language to its system.
• E-MDs releases details on its June 5-7, 2014 User Conference and Symposium in Austin, TX.
• CIO profiles ICSA Labs, which is now the largest government-approved EHR testing and certification body.
• Hardin Memorial Hospital (KY) reports improved clinical response times since integrating telemetry alarms with Voalte smartphones.
• Divurgent raises $5,000 during HIMSS for the Florida Hospital for Children.
• RazorInsights ONE-Electronic Health Record achieves Stage 2 ONC certification.
• Daniel Flanagan, executive consultant for Beacon Partners, discusses in the company’s blog his recommendations to ensure a clearinghouse is ready for the ICD-10 transition.
• MedAssets estimates that its latest National Sourcing Collaborative event will drive $5 million annually in added value for its participating clients.
• Connance expands its patient-pay solution to include predictive analytics and additional platform reporting and consumer engagement functionality.
• On the company’s blog, MEA | NEA CEO Lindy Benton explains the significance of electronic submission of medical documentation (esMD) and health information handler (HIH).

EPtalk by Dr. Jayne

One of my fondest memories from medical school is working the ER during Mardi Gras. I sewed up more than one reveler who didn’t really need anesthesia because they were already feeling no pain. I chuckled when one of my former classmates sent me this story about the germs residing on Mardi Gras beads. Who would have thought that beads that have been thrown around in the midst of public drunkenness might have germs? I wonder if there’s an ICD-10 code for that? Maybe there’s one for choking on the baby in the King Cake as well.

One thing I found lacking at HIMSS was the presence of wearable devices (other than on attendees). I didn’t see much vendor promotion or anything cool enough that I’d consider it (although watching people try to interact with Google Glass was pretty funny). I don’t have any experience with Fitbit, but after reading this article I heard about on Twitter, I might consider one just to have this app. The Sleep Tracker Hack, which emerged from the recent Netflix Hack Day, helps a viewer find her place after sleeping through streaming media. I just might know someone who has fallen asleep in the middle of re-watching “Grey’s Anatomy” for the last several weeks. Unfortunately the hack was part of an internal hackathon, so it may never see the light of day.

I believe in patient engagement and making health-related technology accessible to patients, but there’s such a thing as going too far. I was reading a piece about the Bellabeat Connected System that turns a smart phone into a fetal heart monitor. It also mentioned the Huggies “TweetPee” that sends a tweet when the baby wets its diaper. Seriously? Unless your infant has a urologic problem, I’m not sure tracking urination on social media will do much more than drive followers crazy.

One of my favorite HIMSS connections reached out earlier this week to ask if I would be willing to help mentor a physician who would like to join the CMIO ranks. When I first started out, I had no one to look to for advice, so I was happy to oblige. One of his questions was what I think is the most important CMIO function. I’m not sure I can pin down a single one, but one of the most important in my book is being able to be the peacemaker among IT, the operations folks, and the physicians. Certainly there are other constituencies, but those are the three that tend to be the most contentious.

I’m still surprised that nearly a third of health systems still don’t have a CMIO. The organization where my mentee works falls into that category, but at least they understand that they need to work towards filling that role even if they aren’t ready to admit they need an honest to goodness CMIO. Whether we’re called Medical Directors or Directors of Informatics or Physician Champions, we can still help organizations move forward.

His hospital is currently struggling with physician engagement and clinical oversight, so it makes sense that a physician would be uniquely positioned to assist. He’s not highly techy, but I think that’s OK – if we can master anatomy and pathophysiology, we can learn enough about networks and software to be meaningful participants. The key is knowing who our experts are and being willing and able to leverage them appropriately.

He’s worried that his hospital isn’t really ready to formalize physician leadership in the IT space. There have been comments made about fears that the CMIO “will come in and boss IT around because he’s a physician” or that he will preferentially take the physicians’ side in arguments. I’m encouraging him that even though his role is emerging,  he should ensure that  it’s well defined and that leadership is prepared to support him. Without those elements, the risk of frustration will be fairly high for all involved.

At this point, I think he’s wise to negotiate for a formal position, but I’d recommend going for something part time that lets him dip his toes in the waters of clinical informatics without locking in at an organization that might not be as ready to move forward as he thinks they might be. That will buy him some time to work on professional development and to build the skills he’ll ultimately need if he wants to make a career of this. I’ll keep you posted as I hear from him. I’m looking forward to remembering what it was like to be young and idealistic before the CMIO life started beating me down.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis, Lorre.

More news: HIStalk Practice, HIStalk Connect.

Lorre’s HIMSS Conference Summary

Last week as I was staring into the House of Blues stage lights at HIStalkapalooza wearing a gown, high heels, and a sash reading, “HIStalk To Me,” I was struck by how different it was from any other job I have had. I had to pause for a moment to remember how it all happened. Twenty years ago I was a mining industry accountant and usually wore steel-toed boots and a hard hat. That seems like another lifetime now.

A seemingly random opportunity landed me in healthcare IT, where I have been for 18 years. I worked for vendors in operations leadership and business development. I have an MBA and I am an LSS Black Belt. I thrived on the never-ending challenges, non-stop travel, and endless demands for my time.

Finding myself on stage with this dream job was the culmination of a whirlwind of recent events, too many to list. I love working with the HIStalk team and I know I am in an enviable position.

HIMSS14 started for me at the beginning of September. I had just joined the HIStalk team when I met with Mr. H and Inga to discuss my role. We already agreed I was going to be responsible for the webinar program and HIStalkU, but we knew that I as the only non-anonymous member of the team could do more.

We talked about trade shows in that September meeting, but it wasn’t until the mHealth Summit offered HIStalk a free booth as a media partner that we decided to try it since we had nothing to lose other than time and travel expenses. I have been to HIMSS and AABB many times and worked in the exhibit hall. I showed up at our impressive vendor booth and stood around talking with customers and prospects all day. How hard could it be to create a micro version of that for HIStalk?

We considered mHealth Summit a trial run for HIMSS and decided to go with the bare minimum. I had never furnished a booth and the logistics are daunting. I learned that nothing comes with the booth. Mr. H and I debated about whether there would be a table at the front of our booth and decided to wait and see. We didn’t have any giveaways.

When I finally found our booth the morning before the exhibit hall opened on a snowy December day outside of Washington, DC, there was only a tiny patch of green carpet holding a chair and a trash can. There was no table or separation wall. Fortunately I was able to rent a table with a skirt and it was delivered in plenty of time. I had amazing booth neighbors who helped me hang our banner and they even let me use one of their power outlets.

There were 400 exhibitors and 5,500 attendees at mHealth. I was pleasantly surprised by how much booth traffic we generated. We weren’t selling anything or giving anything away. I was there to say thank you for reading and thank you for sponsoring, nothing more. There was a steady stream of people each day even though the conference doesn’t draw our core reader demographic. I met writers who later contributed to HIStalk and a few people interested in sponsoring. The best part was how much people just wanted to say hi and express their dedication to HIStalk. I was convinced a booth at HIMSS was a must-do.

HIMSS is a much bigger deal when compared with mHealth with 1,230 exhibitors and 37,000 attendees. It was painful trying to choose one of the available booth locations, all on the fringe and all seemingly uninteresting, but we did. We learned a lot from the mHealth Summit and acted on some great ideas for inexpensive booth signage.

Our giveaways were simple but fun. We designed two lanyard pins, one to commemorate the 10-year anniversary of HIStalk this past June and the other representative of our first HIMSS conference as an exhibitor. We had coffee mugs printed with the top HIT news stories of 2013 according to HIStalk. They turned out to be a hit, and even readers who didn’t attend the conference have asked for the pins and the mugs.

When I visited the exhibit hall Sunday afternoon, I was shocked to find it far from ready for the next day. Some of the giant booths looked only half built, debris was everywhere, and forklifts raced dangerously back and forth. I couldn’t imagine everything being ready in time to open the hall at noon on Monday. I wanted to deliver the HIStalk sponsor booth signs, but the hall was such a mess and the odds of being struck by a forklift were so high that I decided to wait.

I hosted a cocktail reception for our sponsors Sunday evening. It went smoothly and everyone said they had a great time. I met a lot of interesting and energetic people and I was impressed by their obvious affinity for HIStalk. Dr. Gregg was on hand to assist me and Inga and Dr. Jayne spent some time there (anonymously, of course.) Even Mr. H made a quiet appearance, after which he left just as quietly.

Monday morning I arrived at the exhibit hall early and raring to go. I had to hustle to cover every square foot of the exhibit hall, my arms loaded with signs. Thankfully Dr. Gregg was there, too, and when we realized I was running out of time, he helped me get it done. According to my Fitbit, I exceeded my 10,000 steps/five miles goal before 10 a.m.

Our little booth was quite a way from the major thoroughfares, so I was surprised by the immediate flow of visitors when the exhibit hall opened. It was consistent throughout the show. Countless readers and sponsors stopped by to say hello and to tell me how much they love HIStalk. We had even heavier traffic when one of our VIP guests (Ed Marx, Vince Ciotti, and Robert Murphy, MD) greeted their fans in our booth.

Once again, Dr. Gregg was a life saver. Not only did he help me with the booth setup and delivering the signs, he gave me breaks throughout each day so the non-stop visitors wouldn’t be disappointed to find an empty booth. Mike Cannavo (“The PACSman”) was also a blessing. He covered the booth, brought me lunch, and kept our swag collection current. The number of people visiting our booth was so remarkable that someone in the booth next to ours asked, “What are you selling?” I smiled when I replied that we are selling nothing — we are just saying hello and thank you.

There was so much fun on and off each day that it would be impossible to mention it all. My top 10 are:

1. Working with the people in the Epic booth to stage a picture of them looking at their cell phones
2. Watching people apply temporary tattoos to the strangest places (Ed Marx takes the prize for his lower back tramp stamp)
3. Arriving at the booth one morning to find a box of warm scones from MedData
4. Handing out the HIStalk sponsor booth signs and seeing how everyone lit up
5. Chatting with Ed Marx, Vince, and Dr. Murphy
6. Seeing the women who stopped by to show me their shoes
7. Having Inga, Dr. Jayne, and even Mr. H stop by the booth without anyone realizing it except me
8. Receiving my own copy of Struck by Orca
9. Trying on a Super Bowl ring
10. Receiving countless comments and compliments and passing them along to the team

I reconnected with many colleagues and customers from the past. I receive e-mails regularly from people who see my LinkedIn profile and wonder if working for HIStalk is a real job. Talking with them wasn’t any different. Yes, it is a real job, although it is fun and exciting and it doesn’t usually feel like work. I love to chat with readers and sponsors and work on webinars. I get a lot of satisfaction from helping them develop and deliver interesting and educational productions.

The event that was a personal stretch for me came when Mr. H asked me to accept HIStalk’s “Sunquest Industry Pioneer Award.” In my 16 years working for Sunquest, I received many opportunities to learn and grow and I almost always loved it. The same team presenting the award fired me two years ago. I can almost hear the collective gasp — why would I admit something like that publicly, and in writing no less? Let’s face it — we are all one merger, acquisition, unattainable goal, or difference of opinion away from being redundant or no longer a fit for the position. It isn’t personal. I showed up at the booth and everyone was friendly and warm. The HIStalk team stood within earshot and watched proudly. I thanked Sunquest not only for the award, but for their support and sponsorship of HIStalk. It was closure and it felt good.

Participating in the planning of an event like HIStalkapalooza was a whole new experience for me. Since the sponsor is responsible for it, it should be easy for the HIStalk team, right? No way! There is constant back and forth interaction and negotiation. It isn’t easy to strike a balance between what our readers and sponsors expect and what the sponsors of the event think they should get out of it. It was both frustrating and fun to be part of it. I learned a lot, along with everyone else, and I’m sure next year will be better because of it. The event itself was a huge success. The HISsies were entertaining and Farzad, Carl, and Ed all made an appearance to accept their awards. The food was terrific and people raved about the band for days afterward. Imprivata and all of the co-sponsors did a great job.

HIMSS14 was great for me. I met a lot of terrific people, I gained a whole new appreciation for those responsible for planning events, and I had fun. I am already thinking about what to do next year in Chicago.

Email Lorre or follow her on Twitter.

News 3/5/14

Top News

FCC Chairman Tom Wheeler announces the formation of a task force that will seek ways to increase use of broadband to deliver telehealth, mobile apps, and telemedicine. Heading up CONNECT2HEALTHFCC will be Michele Ellison, a lawyer who runs the agency’s enforcement bureau. Wheeler said in the announcement, “We must leverage all available technologies to ensure that advanced health care solutions are readily accessible to all Americans, from rural and remote areas to underserved inner cities. By identifying regulatory barriers and incentives and building stronger partnerships with stakeholders in the areas of telehealth, mobile applications, and telemedicine, we can expedite this vital shift.”

Reader Comments

From Just Tim: “Re: MU stages beyond stimulus payments. What is the legislative basis to extend the MU program? MU requirements were supposed to run in conjunction with years in which payments were made, not years after penalties kick in. I’d certainly agree that if someone never got to Stage 3, they could reasonably be penalized on an ongoing basis. Otherwise, we’ve just created a large bureaucracy with the power to continue to push unfunded mandates.” Legal scholars and political junkies, the less legislative among us are calling.

From Dim-Sum: “Re: military EHR replacement. Word on the street is that the vendors of choice and partners are as follows. Six service integration (SI) firms will bid Epic. The team that is getting the most news is Leidos/Accenture/Harris. Cerner has a single exclusive SI partner (still doing research to see who that SI is). Allscripts cannot find a partner for their Sunrise. Meditech has the incumbent Northrop Grumman. McKesson walked away from GDIT/Vangent. Siemens has a yet to be named DoD giant. Competitive bids will require an investment by prime and sub software solution firm of about 1.5-2 percent of the total contract value. That means that to win a $5B deal with the DoD, the investment for resources, capabilities, compliance, and regulatory wherewithal (see FISMA, FedRAMP, DIACAP, 508, JITC etc) is $50 million USD. Good Luck beltway bandits and COTS EHR dreamers.” Unverified.

From Brenda: “Re: Washington’s insurance exchange. Add it to the list of those having issues. By the way, I’ve recommended HIStalk to countless people and I’m glad our company has been a sponsor for about a year now.” The Healthplanfinder exchange has 15,000 applications that are stuck because the user-entered information can’t be matched to the state’s Medicaid benefits database or contain incomplete information (hello, programmer edits?) I speculate that the state incurred the wrath of the grammatical gods when it combined “health plan finder” into a single word.  

From Charger: “Terrific correspondence from Orlando; much appreciated since I could not attend! I’m sure you have been deluged with coffee mug requests and are out of stock, but may I place an order for one upon receipt of any new inventory? I will gladly swap you one of my local Karl Strauss Brewery pint glasses in return.” Thanks for the generous offer, but sadly all the coveted coffee mugs are gone. Lorre and I are trying to convince Mr. H that the timing is perfect for the opening of an online store featuring HIStalk swag. Beauty queen sash, anyone?

More mug sightings: Investor’s Chair contributor Ben Rooks, who obviously works standing up while looking at green ivy outside his San Francisco office; and Mike Jefferies of Longmont United Hospital, whose Spotify-HIStalk two-monitor setup looks a lot like mine. I still have a few more photos to run next time.

From Dr. Travis: “Re: Nordic’s new office. Thought this was very cool.” I had to clarify with Travis since this is a Midwestern, tailgating, and college thing that much of the country won’t understand: it’s a cornhole platform.  

From Ion Exchanger: “Re: HIMSS booth. You had traffic in your booth back in the hall. You should get another exhibitor to give you space free in return for drawing people.” That idea has come up on occasion, although not usually from people offering space. Our first-time exhibitor experience was good, especially since it was a low-rent, homebrew operation designed solely to give Lorre a way to say hello to interested readers and sponsors. I think I’ve decided to do it again in Chicago.

From Dr. Matt: “Re: QlikView. First there’s an Epic partnership and now I find at HIMSS that Health Catalyst offers QlikView on top of their data warehouse. Why are these big players using it?” I’ll let those organizations speak for themselves.

From Doctor N: “Re: HIMSS conference. It was my first one. Only the HIStalk people made me feel valued as a practicing physician. The insults, lack of humility, time away from my clinic, and the lack of vendor understanding of how medicine really works will keep me from returning soon. The sessions could have been done online and the networking conversations were shortened because everyone was in a hurry to get somewhere else. I believe I have seen the American medical industrial complex at its worst. I was surprised at the number of vendor folks who are physicians and how little they know about how we pay for healthcare: SGR (which will worsen matters for providers) and $156 billion being cut from Medicare Advantage plans. They have no clue that I’m not paid for population health and most docs in my community hardly even know the meaning of the term. It is like we are buying the horseshoe, barn, and saddle in the hope that we’ll get a horse for a present. HIStalkapalooza, however, did not disappoint!”

From Spelling CMIO: “Re: a tech solution to HIT spelling problems. As technology professionals, we ought to be able to bring our expertise to bear on the current plague of spelling confusion. I suggest we start to use regular expressions, like: HIM*S* and HIP*A* so that all variants can be brought under the welcoming umbrella of mediocrity. Heck, we could even bust out CM*S to obscure the failure to include ‘and Medicaid’ in the name of our favorite bureaucracy. We could even try E[Pp][Ii][Cc] to free the caps-lock crowd from their yoke of humiliation.” Scanning for “HIMMS” news stories turns up 56, which is pretty sloppy.

From Frank Poggio: “Re: ONC. Issued new 2015 test criteria while at HIMSS last week. They kept repeating that this new (and extensive at 242 pages) test criteria is ‘voluntary’ for vendors. Here comes another wolf in sheep’s clothing. Do you really think the 2015 Criteria will be ‘voluntary’? How can they generate a revised list of criteria that fixes bugs and not make it required? How can they add something critical to patient safety such as UDI and not make it required? Breaking out CPOE components has been something niche vendors have been asking for since the start. So will those vendors ignore it and stick with 2014 criteria? I have worked through dozens of tests with clients since the inception of ONC and every time they expand or make a test update it soon becomes mandatory by the authorizing testing labs … and with some ATLs sooner than others. I give the 2015 version at most four months before it becomes mandatory.”

HIStalk Announcements and Requests

Listening: new from the all-female, LA-based spacey rock quartet Warpaint, which sounds a bit like Cocteau Twins (and that’s a good thing). I’m also enjoying defunct, brilliant Irish pop band The Thrills.

Some random thoughts I had regarding the HIMSS conference:

• I was surprised and happy that the vendors of much-hyped analytics and population health management products were restrained in their pitch. Many companies talked about those products, but I didn’t hear a lot of wild claims.
• The terms “big data” and “cloud” weren’t repeated reverentially and annoyingly to the extent that might have been expected.
• What is population health management, exactly? It will be whatever payers say it is, no different than “quality.”
• I’m not impressed with “big data” when healthcare is woefully indifferent to “little data.” We ignore evidence-based medicine, warnings for inappropriate or duplicate tests and drugs, and quality measures. We are sloppy about monitoring our supply chain and controlling our labor and materials costs. We pay little attention to the free exchange of information we hold about patients. We don’t like the idea that patients themselves should see our digital secrets. We should be using the information we have to its fullest before trying to tackle giant databases containing even more insights that we’ll ignore. Speak up if your hospital is different.
• I’m not sure if patient engagement was just a token HIMSS nod or a real movement. I don’t see stretched providers getting excited about engaging patients unless government or competitive pressures force them to. It was nice to see patient advocates at the podium, even if only sporadically.
• People are beginning to realize that EHRs aren’t necessarily the center of the universe. Small vendors are creating specific applications that use the EHR, which makes them easier to develop, cheaper, easier to use, and easier to buy since any buyer’s remorse will be several zeroes cheaper than the EHR itself. A question to ask of the dwindling number of EHR vendors might not be what their system does, but what does it allow to have done by other sources? Those companies were in the hall.
• The government has taken a lot of innovation out of the system with Meaningful Use and ICD-10. I said from the beginning that taking MU money means making the federal government your incessantly nagging partner, but with penalties following rewards it wouldn’t have mattered anyway. I got the sense that attendees were more interested in what HHS and ONC say than what vendors were telling them.
• Financial uncertainty as well as a big implementation and optimization ramp-up business has increased the willingness of providers to pay a premium to use consultants since they don’t want to get locked into salaried employees for specific short-life tasks. Consulting companies seemed to be generating a lot of interest.
• Hospitals, like every swollen, inefficient, and political bureaucracy, will do whatever it takes to protect their own interests. They have money and clout and they aren’t just going to happily reduce their profits, headcount, or ambitions to reduce overall healthcare spending. Integrating their acquisitions will be a target market.
• HIMSS is always like a boat show, but this year I’m not sure many boats were sold.

Acquisitions, Funding, Business, and Stock

Telus Health acquires Med Access, a British Columbia-based vendor that claims its EMR is #1 in Canada with 4,000 users.

Clinicient, a provider of RCM and clinical solutions for rehabilitation therapy, raises $15 million in Series C funding from Catalyst Investors and names Rick Jung (Medsphere) chairman and CEO.

Castlight’s IPO could raise up to $140 million based on a revised filing made this week.

Sales

PatientPoint awards Xerox a $28 million contract to work with hospitals and physician practices to introduce PatientPoint’s digital check-in and population health management software and to provide training and support.

Denver Health selects Besler Consulting to assist in the identification of Medicare and Medicare Advantage Transfer DRG underpayments.

UCSF Medical Center will implement Oneview Healthcare’s patient empowerment program at three Mission Bay hospitals.

The University of Miami Health System selects Lockheed Martin to manage its healthcare data, develop predictive models for risk identification, and build automated systems to give providers data at the point of care.

Florida International University’s faculty practice chooses PatientKeeper Charge Capture.

Citizens Medical Center (TX) selects MModal for transcription services and front-end speech recognition.

West Florida ACO will implement eClinicalWorks Care Coordination Medical Record.

Forbes names Epic’s Judy Faulkner as #520 on its list of “The Richest People on the Planet,” estimating her net worth at $3.1 billion.

People

Accretive Health appoints Patrick Funck (Segwick) SVP/CIO.

HCI Group names Bill Bria, MD (Shriners Hospital for Children) as CMIO and Robert Steele (Sterling Healthcare Initiatives) as SVP of delivery operations.

Greater Houston Healthconnect CEO Jim Langabeer, PhD resigns to return to his previous employer UT Health Science Center, with CTO Phil Beckett, MD named acting CEO.

Carolinas HealthCare System hires Nancy Olson, RN-C, MBA, PhD (Providence Health & Services) as its first chief nurse informatics officer.

Announcements and Implementations

WEDI, in partnership with EHNAC, will create a Practice Management Accreditation Program to review PM vendors in the areas of privacy, security, mandated standards and operating rules, and operational functions. While I am all for having minimum performance standards, is this really the best time to ask vendors to jump through one more hoop to remain competitive in the marketplace? It’s no surprise that we are seeing limited advances in product usability and innovation.

The local business journal profiles St. Francis Hospital (CT), which goes live on Epic next month following a two-year, $120 million transition. Above is VP/CIO Linda Shanley.

Summit Health (PA) implements Wellcentive’s population health management solutions and services.

Ontario’s Group Health Centre goes live on Epic.

Wellmont Health System (TN) transitions to Epic in its physician offices and hospitals.

North Oaks Medical Center (LA) goes live with a two-way interface between Epic and the Masimo Patient SafetyNet remote monitoring and clinician notification system.

GetWellNetwork debuts GetWellNetwork Ambulatory, which is available on mobile and stationary devices and integrates with EHRs to provide personalized information, healthcare tools, and patient pathways.

CoverMyMeds launches an API that enables providers of EHRs, e-prescribing systems, and PM systems to offer an NCPDP standards-compliant electronic prior authorization solution.

John Gomez launches Sensato, which will offer healthcare privacy and security assessments, guidance, and tools.

UC Irvine Health deploys WANdisco and Hortonworks Hadoop data technology to provide real-time information for patient care. They run Allscripts Sunrise, I believe, and an unnamed data warehouse technology described in the announcement as one that “struggles with availability issues as well as the volume and variety of data it can handle.”

Government and Politics

The FDA is seeking a contractor to monitor social media chatter about drugs, medical devices, and other regulated products in order to track conversation shifts following FDA warnings. I found this move especially interesting in light of the heavy Twitter traffic during HIMSS and my realization of  the potential value of mined Twitter data. Now I’m wondering if anyone has figured out a way to combine data from social media chatter with old-school opinion polls from phone and mail surveys. That could be powerful.

ONC releases additional draft electronic clinical quality measures for review and testing for the possible inclusion in the MU and other federal programs.

The front-page story of the March 10 issue of Time says that Healthcare.gov had so many problems that the White House was ready to shut it down and start over right after its launch. It says that it’s not clear even now who was supposed to be in charge of the launch and that people knew upfront that the site’s design was flawed.

Speaking of Healthcare.gov, HHS says it will need $1.8 billion in FY2015 to run the federal health insurance exchange.

Other

A three-year study finds that patient-centered medical homes do little to reduce costs, decrease utilization, or improve care, leading researchers to conclude, “Medical home interventions may need further refinement.”

The use of patient portals for secure messaging does not significantly change the frequency of face-to-face visits, according to a Mayo Clinic study. Weakness of the study are that portal messages were studied in a vacuum rather than in the context of all provider communication, it looked only at the number of visits rather than patient outcomes, and most of the study subjects were Mayo Clinic employees.

Baylor Regional Medical Center announces that it will not accept the Malcolm Baldridge National Quality Award following allegations that it improperly managed a neurosurgeon who is accused of botching surgeries while under the influence of drugs. An extensive profile in the Dallas Morning News paints a disturbing picture of a physician who was labeled a sociopath and serial killer by colleagues. We featured the story in September 2013 with this summary:

A Dallas news magazine recounts the fascinating tale of a newly licensed MD-PhD neurosurgeon whose incompetence left several patients maimed or dead while the state’s medical board couldn’t stop him from practicing. Colleagues called the doctor the worst they had every seen and said his skill level was no higher than a first-year resident as he kept inadvertently slicing arteries causing patients to bleed to death, and in one case the OR team had to forcibly remove him from the OR to prevent him from killing his patient. His marketing team and his 4.5 star Healthgrades.com rating brought in plenty of new patients to his loftily named practice, Texas Neurosurgical Institute. Surgeon readers will be horrified by this recap by a peer who had to clean up one of his messes: “He had amputated a nerve root. It was just gone. And in its place is where he had placed the fusion. He’d made multiple screw holes on the left everywhere but where he had needed to be. On the right side, there was a screw through a portion of the S1 nerve root. I couldn’t believe a trained surgeon could do this. He just had no recognition of the proper anatomy. He had no idea what he was doing.” The article blames the situation on malpractice caps, laws that hold hospitals liable for damages only if their intentions are provably malicious, and a nearly powerless medical board charged more with keeping licensure records and counting CE hours than watch-guarding patient safety.

Mike “PACSMan” Cannavo summarizes HIMSS14 from the imaging perspective in an Aunt Minnie article (simple registration is required.) He tells me that HIMSS rules even though RSNA is a bigger conference because, “The balance of power has definitely shifted from departmental solutions to facility-wide ones and IT and the CIO/CTOs make those decisions here.” Another of his observations:

HIMSS may, and probably will, command the lion’s share of the trade show budgets for VNA and cloud companies from now on. Considering there were more than two dozen vendors playing in this arena alone, plus the majors who showed various central data repository (CDR) solutions, this can affect other trade shows in terms of booth size and revenue. Given that attendance at most radiology-specific shows has been flat or declining and time spent at the shows has declined each year, HIMSS poses even more of a threat.

A group of former senators (Tom Daschle, Trent Lott, John Breaux) forms the noble-sounding Alliance for Connected Care, which will lobby Congress to protect the interests of its big-company members (Verizon, WellPoint, CVS, and Walgreens) as well as patients who benefit from telehealth services. In addition to seeking friendly governmental consideration, the group wants to lift geographic treatment limitations and build the case for telehealth as an effective care delivery mechanism. Surprisingly, HIMSS isn’t among its lengthy list of advisory board organizations. I’m always suspicious of the motivations of retired politicians anxious to make up for the income they lost while holding office, but in this case their announced intentions seem appropriate.

Brian Ahier got a one-on-one interview with National Coordinator Karen DeSalvo at the HIMSS conference. She says everybody has been focused on collecting information via EHRs, but now it’s time to allow patients to participate and acknowledge that “health is more than getting people to a doctor” since only 10-20 percent of outcomes can be attributed to the healthcare system. She clearly has a public health mindset as did her predecessor and she gets a “bravo” for that.

The CFO of Wake Forest Baptist Medical Center (NC) lists reduced Epic expenses as one element of its improved financial performance in which six-month operational losses were reduced from $49.8 million to $23.5 million. The hospital still has high expectations for Epic, saying in a bond ratings agency report, “Management believes that future financial performance must be improved from current levels, and continues to aggressively pursue both short- and long-term strategies to drive growth, reduce cost and leverage our investment in Epic.”

In England, a three-year-old cardiac surgery patient dies when the scheduling system of the hospital to which he was transferred fails to generate his follow-up appointments. According to the hospital’s pediatrics manager, “Samuel’s appointment request must have fallen through the cracks between the old and new system. The new system is now up and running as best as it can be, but as long as there is still humans entering the information there will always be room for error.”

Weird News Andy notes that Banner Health didn’t have a banner day when it inadvertently printed subscriber Social Security numbers on its health magazine’s mailing labels.

Sponsor Updates

• Greenway Medical names Phreesia its Marketplace Partner of the Year.
• Aprima Medical announces that over 1,500 former Allscripts MyWay customers have migrated to its platform.
• PerfectServe introduces automatic electronic PHI filtering capabilities that remove ePHI from the body of messages sent to non-secure mobile devices.
• Lisa Reichard, director of community healthcare relations for Billian’s HealthDATA, writes a fun blog post that includes her top 10 tales and takeaways from HIMSS14.
• Extension Healthcare will participate in the AONE 2014 Annual Conference in Orlando March 12-15.
• The Tennessean interviews Cumberland Consulting Group CEO Jim Lewis about the company.
• Boston Software Systems offers a white paper that examines three steps to a successful migration. 
• An HCS case study highlights Christian Health Care Center (NJ) and the benefits it realized following the implementation of HCS Interactant.
• TriZetto Provider Solutions advises customers that it will continue to accept claims in print image, NSF, and legacy formats even after the ICD-10 implementation deadline.
• E-MDs publishes video testimonials from multiple providers.
• Clinithink’s VP of solutions Russ Anderson suggests leveraging the use of Clinical Natural Language Processing to control patient leakage.
• Health Catalyst offers a white paper with keys to a successful data warehouse and analytics implementation.
• Vital Images experiences significant growth across Europe, the Middle East, and Europe.
• CommVault achieves certified integration with its Simpana 10 software and the SAP HANA platform.
• TeleTracking Technologies, Hill-Rom, and GOJO will co-market integrations with the Hill-Rom Hand Hygiene Compliance solution.
• Cornerstone Advisors reports that its staff has grown to 39, a 25 percent increase in the past year.
• Divurgent will provide support to Medsphere clients in their MU, ICD-10, and value-based purchasing initiatives.
• Gartner positions Qlik in the Leaders Quadrant of the 2014 BI and Analytics Platform Magic Quadrant report.
• HIMSS Analytics names Allscripts its first Certified Educator of the EMR Adoption Model.
• The Cleveland Clinic and Dell will offer Epic EMR consulting and implementation services to other health systems and practices.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Dr. Travis, Lt. Dan, Lorre.

More news: HIStalk Practice, HIStalk Connect

Monday Morning Update 3/3/14

From Elizabeth: “Re: HIStalk mug. Thanks so much for the HIMSS coverage this year, as always. It was great that you had a booth because I’m pretty sure others would agree that the HIStalk gang are celebrities, albeit anonymous, in this space. I am sending you a little pic of my coveted HIStalk mug in its new home in snowy, cold NY. I think it fits in very well. It was by far my favorite takeaway from the conference, so much so that I wrapped it in a t-shirt from another vendor so it wouldn’t break on the flight home. I am happy to report that it remained safe and intact.” I can’t explain why I like seeing pictures of reader workspaces, but I do.

From Sipper: “Re: HIStalk mug. Big fan of HIStalk for many years, read it every day, loving my new mug!”

From Posit: “Re: HIMSS thoughts. Educational sessions were strayed, put together in silos, and not given by industry leaders but more by committee members trying to get placed on the HIMSS board. Educational content had nothing new. Hillary was dry, useless, and added nothing to the conversation of healthcare. The CIO Forum was the usual boy’s club, mostly just CIO wannabes as the majority of CIOs were out sunning themselves. The attendance count seemed to include anyone walking in the door. The HIMSS14 handbooks had many typos – sloppy work.”

From Dr. Info: “Re: HIMSS video. I saw this gem out of the corner of my eye and then had to endure many painful minutes of this insipid self-promotional video before it came around again for a quick photo for your blog. I’m probably the only person who watched the whole thing, including the producers and editors! Maybe they should just change the acronym already.” You would think HIMSS could spell its own name, especially when it was shilling its HIMSS14 TV informercials (“one-third of air time will be dedicated to our sponsors,” which puts even network TV to shame.)

From Eager Cleaver: “Re: cost of exhibiting at HIMSS. You should get someone with a modest-sized booth to anonymously provide all line-item costs to exhibit. Readers would be shocked.” I did this a few years ago and would be happy to do so again if a company would be willing to share. I would do it for the HIStalk booth, but it was tiny and we did everything on the cheap, so it’s not really representative. Meanwhile, money alone won’t buy you prime hall space, as booth selection is driven by HIMSS points, which is like your grocery store loyalty card with a lot more zeroes. The annual conference brought HIMSS $25 million in revenue, half its total take. Dues made up only 18 percent of its total revenue. According to its 2011 tax forms, Steve Lieber was paid $925K, so he’s surely well over the million-dollar mark by now. Also in the footnotes of the form: HIMSS owns 81 percent of MedTech Publishing (book value $8 million), which means if you get your industry news from Healthcare IT News, mHealth News, or Government Health IT, you’re getting it from the vendor-friendly, HIT-cheerleading HIMSS.

From GreenFlamed: “Re: Dragon Medical Network. v12.50.200.089 is not ready for prime time, especially in Virtual Desktop environments. It takes a crazy amount of support to sustain and keep your end users happy. The new service pack is riddled with bugs and the dictation box transparency feature is broken. We are facing a major Dragon buy-in and adoption crisis currently because it keeps crashing. Are there any other Dragon360 Network users out there using Dragon on a Virtual Desktop environment?”

Only 20 percent of respondents say their business card titles include a certification. New poll to your right: if you attended the HIMSS conference, how was it overall?

Some of the classrooms we helped via HIStalk’s donation of proceeds from the big ad at the top of the page to DonorsChoose projects are already benefitting. Mr. Delperdang reports (and sends the photo above left) that his Mississippi high school students are using the inexpensive supplies we donated (remanufactured printer cartridges and a file cabinet, which he calls “a blessing”) to print and file assignments and college applications. Ms. Vega’s Illinois second graders have created a reading station from the set of non-fiction books we purchased, which she says is the most popular learning station in the classroom and that “even my students whom were afraid to speak and share ideas are now sharing their background knowledge with us.” Ms. Opatz’s Utah fourth graders have formed reading groups around the books we purchased for them (photo above right.) We funded a bunch of projects from the ad revenue and will be doing more, so stay tuned.

Oracle – like its CEO, Larry Ellison – rarely passes on the opportunity to exhibit boorish behavior. The company’s sloppy technical work reportedly assured the failure of Cover Oregon’s health insurance exchange, with the resulting outcry shaming Oracle into making a public promise to fix the problems it caused at no charge beyond the $90 million it was already being paid. The still-dysfunctional site isn’t likely to get better – Oracle has decided without explanation to pull 60 percent of its employees assigned to the project.

California’s health insurance exchange, fresh off a five-day system outage, says 14,500 people whose applications were partially completed in the days before the unplanned downtime will need to start over.

The General Accounting Office reviews the progress of the VA and Department of Defense in deciding to pursue their independent EHR plans and make them interoperable. They aren’t impressed: GAO says those organizations don’t have proof that it will be cheaper to run their separate systems than to create a single one. It also points out that despite the VA’s plan to pilot its system by September 2014 and the DoD’s intention to take its system live by the end of FY2016, neither have said what their systems will consist of, when they will be finished, or what they will cost. The report also says the VA and DoD are still fighting over control, with the federally mandated Interagency Program Office (IPO) having no power over funding and staffing. Both the VA and DoD, strangely enough, agreed with GAO’s recommendations that they perform a cost analysis, justify choosing the more expensive choice if that’s the case, create interoperability plans, and strengthen the control of IPO.

McKesson, bowing to shareholder pressure, reduces the pension of Chairman, President, and CEO John Hammergren from $159 million to $114 million, although one analyst says the company’s executive pension plan is still “the richest in corporate America.” Perhaps an earlier announcement of his forced impoverishment would have allowed him to escape the indignity of winning his second consecutive HISsie award last week for “Industry Figure In Whose Face You’d Most Like to Throw a Pie.”

It occurred to me while Mark Bertolini was delivering the HIMSS conference’s opening keynote address, his Aetna employees were setting up the company’s booth in the exhibit hall. Somehow that seems wrong. If it weren’t for HIMSS trying desperately (and unsuccessfully) to get people to stick around later into the week, they would have put the second consecutive keynoting Clinton (Chelsea next year?) in that spot as they have done with politicians in the past.

People have asked what my favorite conference giveaway was. I’ll go with the iPhone 5 cover from zCover. I wasn’t initially impressed because they had a tableful of them and they were packaged in plastic bags, to the point I was about to just toss it in the trash when I got home. It’s a really nice case that fits the phone perfectly (including little covers for each port) and a clip-on back that ties the package together. It has its own buttons that cover the ringer volume and home buttons that make them easier and more satisfying to use. I’m really glad I picked it up – it has replaced my rubber bumper cover.

It’s hardly news since Intermountain Healthcare announced that it was choosing Cerner as a partner last fall partly because it wasn’t confident about hitting Meaningful Use dates, but CIO Marc Probst says Intermountain will forego incentives and accept penalties for not being ready for MU2 in 2014.

Streamline Health Solutions promotes Richard Nelli to COO.

Greenway acquires PeopleLynk, which sends patient relationship messages based on EHR events.

Infor signs a letter of intent to acquire assets of GRASP Systems, including patient acuity, workload management, and patient assignment systems.

Ingenious Med launches its patient encounter platform One by Ingenious Med (IM1), providing care coordination and patient management to acute and sub-acute spaces.

Strata Decision Technology announces sales of its StrataJazz financial platform to Yale New Haven Health System (CT), Northwestern Medical Center (VT), and Southern Illinois Healthcare (IL).  

ONC and ANA will present a free one-day summit for nurses on March 21 at The Baltimore Washington Medical Center in Glen Burnie, MD. The agenda includes a keynote by Deputy National Coordinator Judy Murphy, a panel discussion about using health IT to exchange information, afternoon breakout sessions, and a town hall discussion. I recommend as a counterpoint to all of that healthy discussion a side trip to my favorite place in Glen Burnie, Ann’s Dari-Creme.

In Canada, New Brunswick doctors question their medical society for striking a deal that allows only one EHR – the one sold by a for-profit company co-owned by the medical society — to access the province’s databases. Only 240 of 950 eligible physicians have signed up ahead of the March 31 deadline to earn a 50 percent government subsidy, with only 34 of those actually using the mandatory Velante software. Doctors question whether the medical society’s motivation is business success rather than patients, while the province’s health minister says it may have to take over the system if too few doctors sign up. A similar situation exists in Nova Scotia, where the province gave Nightingale exclusive rights to provide a subsidized EHR that connects to the government’s information.

The VA creates a development portal that explains how to create mobile apps for its use.

CareSync wins the most promising startup contest at the HIMSS conference.

”How the Medical Establishment Got the Treasury’s Keys,” an interesting article by economics professor Uwe Reinhardt, recounts irrational and naturally inflationary creation of Medicare in the 1960s as flawed grand plan to reduce poverty:

To help implement that vision, these proponents reluctantly paid the price the providers of health care extracted in return for accepting the legislation: Congress surrendered to the providers the keys to the United States Treasury, full well knowing that this social contract could have only a short shelf life. One would assume that physicians and hospital leaders knew that as well. In other words, the proponents of Medicare who signed on to the deal were anything but stupid. When confronted by the health care sector with a harsh trade-off between their cherished vision for health care, on the one hand, and a sensible payment policy, on the other, they let their vision override economically sound payment policy. Millions upon millions of America’s senior citizens are indebted to them for a program that remains highly popular to this day.

Weird News Andy wonders, “Does the noise in my head bother you?” in reading of a British tourist hearing scratching noises inside her head that turned out to be a happy family of eight flesh-eating maggots. WNA also likes this story, in which stethoscopes were found to carry more bacteria (especially MRSA) than anything other than the fingertips of doctors. It’s probably not realistic that doctors who can’t be convinced to wash their hands would sterilize their stethoscopes. 

HISsies 2014 Winners

Sponsor Updates from Last Week

• Sagacious Consultants launches Sagacious Dispatch for Epic customers with short-term projects for optimizing their EMR.
• Orion Health launches Collaborative Care for ACOs.
• MEDHOST joins CommonWell Health Alliance.
• Shore Medical Centers (NJ) selects CareTech Solutions Clinical Service Desk for night, weekend and holiday support.
• Truven Health Analytics introduces Micromedex Pharmacy Intervention and Micromedex Infection Prevention.
• CynergisTek expands its collaboration with Iatric Systems to offer support and management of Iatric’s Security Audit Manager.
• Premier reports 90 percent of respondents experienced at least one drug shortage in the last six months that may have caused a medication safety issue or error in patient care.
• Aventura releases Roaming Aware Desktop Version 5.0.
• Kaleida Health (NY) selects Orion Health’s Rhapsody integration engine.
• Covisint receives full accreditation with the Direct Trusted Agent Accreditation Program from DirectTrust.com and the EHNAC.
• iMDsoft announces its MetaVision for NICUs will be featured at the 20th annual Cool Topics in Neonatology conference.
• DrFirst’s controlled substance e-prescribing software will be integrated into Greenway’s EHRs.
• ADP AdvancedMD offers an ICD-10 transition program with preparation resources, product enhancements, and a revenue cycle financing program.
• UnitedHealthcare announces that InstaMed’s online bill payment service myClaims Managers has grown to 50,000 participating care providers with $20 million in payments processed since July 2013.
• Emdeon publishes an ICD-10 transition white paper.
• API Healthcare, a GE Healthcare Company, launches Patient Classification, which matches provider skills to patients.
• Nuance announces that eCopy ShareScan is integrated with NextGen Ambulatory EMR.
• First Databank releases FDB AlertSpace for Siemens Soarian.
• NextGen Healthcare and Cerner announce bilateral integration.
• Infor offers a promotion package for eGate customers interested in migrating its Cloverleaf product.
• Infor introduces PeopleAnswers Talent Science to assist healthcare organization to select, retain, and develop clinicians.
• DrFirst’s Patient Advisor delivers $21 million in prescription savings opportunities for uninsured patients during its first three months.
• Imprivata will integrate its two-factor authentication management capabilities with DrFirst’s EPCS Gold solution to securely prescribe controlled substances electronically.
• Physician First ACO (FL) selects eClinicalWorks Care Coordination Medical Record.
• ADP AdvancedMD announces general availability of its reporting suite AdvancedInsight for physician practices.
• Central Valley HIE (CA) joins Inland Empire HIE expanding the reach of the Orion Health Collaborative Care within California to 48 central and southern California organizations.
• Wolters Kluwer Health announces the beta launch of its integrated clinical decision support and workflow management platform POC Advisor.
• Northeast Georgia Physicians Group achieves Stage 7 of HIMSS EMRAM with Allscripts TouchWorks.
• Covisint offers three reasons to physicians to avoid PQRS penalties.
• Etransmedia expands its RCM services with the acquisition of Medigistics.
• Intel-GE Care Innovations and Caradigm partner to integrate remote patient monitoring and smart sensor technologies to improve care plans.
• E-MDs launches a SaaS-based RCM service.
• AT&T announces plans to expand Digital Life into the healthcare market.
• Predixion Software announces availability of its predictive analytics software on the Windows Azure cloud platform.
• Baylor Scott & White Health (TX) expands its use of AtHoc Critical Communications platform for IT outages, emergency preparedness, and clinical alerts.
• Optum launches Optum One analytics platform.
• Advocate Health Care (IL) selects PerfectServe as its enterprise-wide clinical communications platform.
• Healthy Catalyst reports that 76 percent of organizations lack basic analytics for Meaningful Use measures in a recently published white paper.
• Imprivata will integrate HIT Application Solutions’ Notifi platform with Imprivata Cortext, enabling secure communications for continuum of care.
• The Health Centers of Family Health Care join The Guideline Advantage, which uses Forward Health Group’s PopulationManager platform.
• Siemens Healthcare launches CareXcell a subscription based solution for population health management.
• Memorial Hospital at Gulfport (MS) selects Health Catalyst’s Late-Binding Data Warehouse and Analytics platform to provide a unified view of clinical and performance data from their McKesson and Allscripts EHR applications.
• Capsule Tech reports a 24 percent increase in revenue for 2013, with 1,650 healthcare facility clients worldwide.
• University Hospitals (OH) will deploy PeriGen’s PeriCALM at UH MacDonald Women’s Hospital and UH Geauga Medical Center, which will include sending OB content into its Allscripts EHR.
• NantHealth introduces NantHealth Clinical Operating System, developed after consolidating of several healthcare IT companies including iSirona.
• Capsule Tech introduces SmartLinx Medical Device Information System for point-of-care data delivery.
• North Memorial Health Care (MN) is awarded joint second place in the annual Healthcare Informatics Innovator Awards after incorporating Health Catalyst’s EDW platform and analytics solution.
• EClinicalWorks, Greenway, ICA, InterSystems, Medfusion, Medicity, Optum, and Orion Health found Carequality, which will focus on interoperability between existing and emerging HIE networks.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Travis, Lt. Dan, Lorre.

More news: HIStalk Practice, HIStalk Connect.

From HIMSS 2/27/14

From Spelling Recognition: “Re: ‘documention.’ Is this a misspelling or or marketing gone wrong?” I suspect the former and dread the possibility of the latter.

From Born Free: “Re: HIMSS opening session. It was nice of the HIMSS chair to recognize physicians in the audience, but as soon as the recognized physicians sat down, the speaker then dissed them through sarcasm about their ego and the 6,500 physicians in his organization that think they know best. It was a little uncomfortable and not very wise considering HIMSS’s desire to add physicians to their membership rolls.” I missed the presentation since I was protesting having an insurance company millionaire talking about how healthcare should work. I don’t like having vendors as keynoters.

From IT Director: “Re: HIMSS. It was a pleasure to meet Lorre in the booth on Tuesday. If you are going to have a public face I can’t think of a better one! She was engaging and knowledgeable and fun to talk with even if just for a few minutes. I love the fact that you had a booth — that was a cool thing to do.” HIMSS booths are breathtakingly expensive, but it was worth it to be able to meet readers, sponsors, and passers-by (most of them on their way to bathrooms right by our booth given our tiny HIMSS clout and budget). It was great having Lorre there since as the only non-anonymous HIStalk team member since she kept me updated with who dropped by, what they had to say, and what it was like being on the show floor with the other exhibitors. That was all new to me – my only view of HIStalk is sitting alone in front of a PC all day and night. It was cool that other exhibitors brought celebrities to our booth, sent Lorre scones and fun giveaway items, and helped us figure out the exhibit process since we were clueless. I’ve asked Lorre to do a writeup on what it was like for her to meet readers, work the booth, attend the events, and accept our Sunquest Industry Pioneer Award.

From Brian Ahier: “Re: Ed Park of athenahealth at HIMSS. Gave the best presentation at HIMSS.”

I’m glad the HIMSS conference is over. I’ll be catching up over the next few HIStalk posts. Your comments about the conference, exhibits, companies, and educational sessions are welcome.

I have to say I’m already dreading going to Chicago for the conference next year. All I remember from last time is snow, surly unionized conference center staff, outdated hotels that cost at least double what they were worth, endless cab lines because of the weather, and wearing winter clothes. I like Chicago as a tourist, but not as a conference attendee. HIMSS loves it, of course, because the travel is easier for their people and they get to deal their home city some payola.

Here’s Lorre’s new BFF Bob Murphy, MD, CMIO of Memorial Hermann Healthcare System (TX), meeting people in our booth.

Orlando attendance set a record at an announced 38,828, although I don’t know how that number was derived. I assume all registrations were counted, including exhibitors and press, but I don’t know if HIMSS counted people sitting at home who paid $49 to watch streamed sessions on the Web. I know this: all event promoters like to provide optimistic attendance statistics and there’s no good way to audit their claims.

PeriGen was a booth neighbor and CEO Matt Sappern dropped by to say that “HIStalk is the only thing to read each day.”

This week on HIStalk Connect: Epic and Walgreens launch a wide-reaching interoperability partnership to rival CommonWell. HIMSS publishes the findings of its mHealth Technology Survey. Glooko unveils a population health tracker focused on improving care within the diabetic population.

Jennifer Dennard (@SmyrnaGirl) tweeted out this photo, saying she’s reading up on HIStalk while sipping from our mug now that she’s home from the conference. Our mug supply is exhausted other than a few we set aside for loyal readers who asked us to mail them one since they weren’t at the conference. I like Jennifer’s photo – if you took a mug home, send a picture of it in its new home.

I didn’t hear much about Hillary’s Wednesday keynote other than (a) it was extremely short; (b) like any skilled politician, she didn’t really say anything other than predictably lauding the work of the crowd that brought her there and kissing up to HIMSS. I would have been mad about waiting an hour or two to squeeze into the huge room for her talk given its lack of substance. Hillary’s rumored minimum speaking fee is $200K plus expenses, so she took home a big paycheck in addition to potentially impressing would-be Presidential voters who were apparently happy just to bask in her celebrity.

Hillary mentioned in her speech that corporations don’t have enough females on their boards. She didn’t define “enough” quantitatively.

HHS confirmed during the conference that neither ICD-10 nor Meaningful Use Stage 2 deadlines will change.

Hearst Health’s newly formed venture unit invests in Tonic Health, which offers an iPad-based data collection tool that counts Partners HealthCare and UCLA Health among its customers.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Travis, Lt. Dan, Lorre.

More news: HIStalk Practice, HIStalk Connect.

From HIMSS 2/27/14 – Inga’s Update

It’s early afternoon on Thursday and I just returned home. My feet look like little sausages from all the walking and the flight, so I am putting my feet up and getting out a quick summary of random impressions from Wednesday. I’ll provide a wrap-up by the end of the weekend.

A couple of folks advised me that the guy in the red suit I noticed in the CareCloud booth was not an attendee but Stelle Smith from CareCloud. Maybe it’s the Miami influence? I had a chat with CareCloud CEO Albert Santolo, by the way, and will share more details on that later.

A word of advice: don’t walk around in public, especially at a place like HIMSS, and carry on a cell phone conversation that includes confidential information. As I was walking to the convention center I overheard a gentleman talking about “John Smith” who is over-compensated in his role, especially compared to the hardworking “Joe Brown”. Just so happens I know Joe Brown (who has a much less common name than Joe Brown) so it took me about two minutes to figure out the name of the company and the probable manager who is about to axe poor John.

I love, love, love this photo that the GetWellHealth folks sent over. I considered asking them if they had an extra  pair in a size 8 but then realized I’d probably never have the right occasion to wear them. Well, maybe they would be fun for Mardi Gras.

As I walked by the Surescripts booth there was a representative standing out in the aisle who looked directly at my badge before saying hello. I was wearing an exhibitor badge and she immediately apologized and said she was told they were really only interested in marketing to providers so she was trying to see where I was from (before she wasted her time engaging me). I proceeded to tell her that that didn’t make much sense since they partnered with vendors (maybe she has never heard of “Surescripts certified products.”) I am pretty sure she was an employee and not a hired gun and she was clearly not some 22 year-old marketing intern. Odd.

I went 45 minutes early and snagged a seat for Hillary Clinton’s keynote address. I happen to be sitting next to a guy from one of the better known HIT publications and he was telling me about the insanity of the whole “no press allowed” situation. His publisher was also exhibiting so he was able to use an exhibitor badge to get in. I laughed out loud when Clinton mentioned something about the “anti-journalist” mentality in Russia, wondering how many people caught the irony. Aside from that drama, I found Clinton to be very smart and a seasoned speaker. If she was reading from a teleprompter then she concealed it quite well. During the Q&A session she was just as quick on her feet as during her 20 minute prepared speech and she managed to throw in a little humor now and again. While she of course discussed the importance of HIT, I was fascinated with her comments on Russia, Ukraine, and the tracking of Bin Laden.

Nuance had a huge booth but I thought the lighting was odd. It was as if someone forgot to turn on the lights at the demo stations.

I played Pac Man at the Medseek booth. It took me 15 seconds to lose.

What was with the dead bushes decorating the NantHealth booth? I just realized that NantHealth is the new name for iSirona, which might explain why I found next to no signage with the company’s name.

I felt sorry for the exhibitors that were in the section past Cerner (7000s and above) because there was definitely less traffic than in the other section of the hall. There are probably a lot of people like me that make a conscious decision to start in the 100s and work their way through the hall, only to be fatigued before completing the journey.

API Healthcare was proudly displaying its four KLAS trophies.

I met Brian Ahier who is a big Tweeter (@ahier) and HIT writer who often sounds good stuff to Mr. H and me. I get so excited when I get to meet HIT superstars.

3M’s booth was much larger than I recall in recent years and all the signage was about getting to ICD-10. Strike when the iron is hot, I guess.

Speaking of ICD-10, I saw some Tweets that CMS Administrator Marilyn Tavenner said in her Thursday morning keynote that the ICD-10 transition would not be delayed.

A few folks that didn’t get an invite to HIStalkapalooza decided to have their own party, which they called “HIStalk-a-Pa-Losers. They tell me they spent at least 10 minutes creating their banner and ended up having a fabulous time.

Several exhibitors told me that they were staying a few miles away from the convention center because there were not enough rooms in walking distance, especially if you wanted a large block of rooms. Unfortunately that’s probably going to be the case again next year in Chicago.

Holly sent me this picture of the guy I loved from SIS who was aggressively handing out goodies to folks passing by and even to  the people on trams. I incorrectly said he was asking, “Would you like gum, mints, or analytics for your EHR.” Actually SIS offers analytics for the “OR.”

Dr. Jayne and I passed by the Greythorn booth and actually caressed the winning pair of shoes from the Inga Loves My Shoes contest. Apparently we were not the only ones so I am glad they had fun with the sash.

Ross Martin, who co-emceed the HISsies and provided some musical entertainment to start the evening, posted the above note on Facebook Sunday. He told me that at least a dozen people had asked him to find them a HIStalkapalooza invite.

The CareTech Solutions folks wanted to make sure we knew they were proud of their sign.

The Versus folks put out this Tweet on Tuesday. I definitely took advantage of their hospitality.

The T-System ladies were decked out in fun red shoes.

PeriGen had adorable baby Uggs as pen holders and baby flip flops right by their sponsorship sign. They were also giving out USB drives, which they had arranged to create the letters, “OB.” Very clever.

Mr. H had commented that people in the exhibit hall were “zombies” Wednesday and I was definitely one of them. Inga may perpetually be a 28 year-old party girl but unfortunately she has taken residence in body that is a little more mature. I think I’ll spend the rest of my day and evening on my couch wading through 2,000 emails and hoping my feet return to normal.

Email Inga.

From HIMSS 2/26/14

From SoreThroat: “Why did CCHIT leave the ONC Testing & Certification program? Why were they really losing money? What was the ‘exit plan’ and who benefited? Who will be left to turn off the lights on CCHIT once the relationship with HIMSS is consummated? CCHIT rolls down hill: vendors, hospitals and others don’t like the feel or the smell.”

From Soft Skills Are Key: “Re: consultants. When will vendors learn that consultants are not the enemy? We approached the SCC Soft booth at HIMSS, introduced ourselves to the booth sales rep, and asked if we could see a quick glimpse of his product. We explained to him that we we’re consultants and wanted to familiarize ourselves with their product at the interest of our clients. The sales guy’s response, along with the stone-cold stare, was, ‘I don’t see the point,’, and then walked away. Soft Lab, ‘Yes’, but Soft Skills, ‘No.’”

The lessened enthusiasm of the throng of attendees and exhibitors was palpable Wednesday. The coat check stations were full of bags of folks taking flights out Wednesday, the exhibit hall energy level was a fraction of that Monday and Tuesday, and most of the big social events were over.

I started my day noticing that every single men’s restroom on the main level was closed. Two had signs saying the conference center was being improved, while another just had a barrier stuck in front of it.

SIS was demoing their analytics application.

Health Catalyst had big booth crowds Wednesday morning.

Optum had a disturbingly large display that was like being at a drive-in movie with men in suits milling about in front of the screen.

I noticed multiple occurrences of odd grammar usage that’s as common as uptalking in young folks: saying “yeah, no,” usually expressed when agreeing with someone making a negative point.

Someone forwarded me a HIMSS email intended for working press saying that because of the contract HIMSS signed with Hillary Clinton for her keynote, reporters not only couldn’t cover her speech, they weren’t even allowed inside the hall to see it. I verified that HIMSS people were indeed turning away reporters at the door, although checking every badge must have slowed down the entry process. I say “must have” because having arrived early last year to see Bill, I still ended up sitting on the floor in front of a TV monitor and decided I would rather just beat the crowds out the door instead of in, so I left the conference early.

Athenahealth wasted no time in printing up big booth signs proclaiming themselves as the top-rated software vendor in KLAS. A reporter asked Judy directly what she thought of it and she said it was a scoring anomaly that won’t happen again. The reporter followed up with KLAS and found that she is technically correct because KLAS is getting rid of the category.

We’re first-time HIMSS exhibitors working on the cheap, so Lorre got a lot of help from many folks, including our booth neighbors and readers. She would especially like to thank Dr. Gregg and Mike “PACSMan” Cannavo, who covered the booth when she needed to step away, brought her lunch, and otherwise made her day a lot better.

Speaking of Lorre, I have received a ton of positive comments about how well she represented HIStalk at our events and in the booth. I had little doubt when I brought her on board, so I’m not surprised. I’m gratified that after spending time at Sunquest and Mediware, she is loving her HIStalk role in running Webinars, supporting our sponsors and readers, and managing all the details that I wasn’t handling well because of time constraints. Above is Dr. Lyle Berkowitz, James Aita, Lorre, and Amy Gleason at HIStalkapalooza.

Here’s Lorre wearing the Super Bowl ring of Stephen Baker the Touchdown Maker while he visited our booth, also showing her HIStalk party nail. Note that SB isn’t just trading on his former athletic glories: he is a substitute teacher and supports several charitable causes related to children.

Lorre and I now know that we have a lot of readers from Epic because several of them dropped by our tiny booth to say hello. Lorre says the taxi-themed shoes were her favorite of the entire conference.

Epic people were great about being attentive to their customers and not staring at their phones until we tweeted my desire to capture at least four booth reps doing so at once. They helpfully staged a photo shoot in the Epic booth just for Lorre. They are a fun group.

We have around 1,200 professional photos from HIStalkapalooza. These will provide good memories for those who where there until I can go through the entire set.

Dr. Jayne’s HIMSS Report – Tuesday and Wednesday

More hours in the exhibit hall means more interesting things to see. I must say I like the HIMSS decision to not close the hall during lunch. It may make it more challenging for exhibitors but it made it easier for me to see more booths. Unfortunately, I also forgot to eat on Tuesday, so maybe the forced break was a good thing.

Inga and I spotted this walking carrot earlier in the week but couldn’t catch a photo fast enough. I finally found her at the Phytel booth. She was there to promote their service project where attendees could stuff backpacks with food for Second Harvest, which provides it to children who may not have meals when they’re not able to receive a free or reduced price lunch at school. I wish I had known about it earlier and would have made time on my schedule to participate if I hadn’t already been double-booked.

I had the opportunity to cruise the hall Tuesday afternoon with Dr. Ross Martin, who not only sings fabulous songs about HIStalk by night, but is part of the leadership team at AMIA by day. I always like to visit the first-time exhibitors and we were over in the low numbers when the staff of Nobl engaged us with cookies. They were also kind enough to allow Ross to charge his dying cell phone while they showed us their Vigilance product. It’s a proactive nurse rounding program designed to improve patient satisfaction (and therefore HCAHPS scores). They also have the ability to notify family members about the activities of their loved one – whether he or she is sleeping, eating, taking their medications, etc. I’ll be interested to see how they fare over time.

Ross also granted me a provisional degree of Fellow for ACMImimi, the American College of Medical Informatimusicology. He assures me the board will formally approve my candidacy at their next meeting, but I better brush up on the show tunes in case they ask for an audition tape.

I attended a nice presentation at Aventura about their instant-on and roaming solutions. I particularly liked the fact that they had actual clients delivering the presentations rather than sales reps. They were also very interested in feedback from attendees and prospects which was a nice change. The lovely Bonny Roberts also had her HIStalk beauty queen sash on display.

I stopped by to watch Inga play Quipstar at the Medicomp booth. Although she didn’t win, she did score a $1,000 donation to her favorite charity. Thanks to Medicomp for allowing us to be their celebrity contestants and for their support of worthy causes. Of course Inga had her usual security detail – two handsome men in black who made sure Inga’s many admirers kept a safe distance. Although they didn’t have the shoe-cam this year, she was sporting some sassy heels with bows on the toes.

Inga and I sampled some of the Tuesday afternoon cocktail hours including Aventura, FormFast, and Sunquest. Tuesday night I hit a couple of parties including PatientSafe Solutions and the Athena Cloud Party. I had several others on my dance card, but the distance between Universal CityWalk, Downtown Disney, and Pointe Orlando was pretty daunting. Roving reporters let me know that the band at Greenway was good and the NextGen clients were having a great time at Pub Orlando.

Orchard had a large tree in their booth. I liked the crates as well. After so much walking around, I needed a break, so I went back to find the quiet sofa on the fourth floor that I had spotted on Monday. Unfortunately today there were several screens blaring a HIMSS14TV broadcast that no one was watching. It was kind of annoying.

I missed the #HITchicks tweetup, but Lorre brought me some swag from the event, which was much appreciated. I’m a little jealous of her non-anonymity because she’s had some great networking opportunities at the booth. Inga and I stopped by several times over the last few days and there seemed to be a lot of others passing by as well.

Imprivata had various different people presenting in its booth with its realistic care setting. On one pass through the area, they had these folks dressed as care team members. I generally don’t like people trying to act like doctors and nurses even if it is in the name of marketing. At least if you’re going to do it, make it more realistic. Their scrubs should be rumpled, they should have overstuffed pockets, and they should look much more haggard.

Siemens had an awesome presentation using a dynamic array of tablets to display content. One attendee commented that he didn’t know anything about their products but the presentation was amazing.

CMS had a relatively large booth with virtually no one in it. Your tax dollars at work, folks. Speaking of tax dollars, on Tuesday ONC released a new Data Brief reporting results from the 2012 ONC Consumer Survey on Privacy and Security. The data was gathered from a telephone survey of 2,000 adults conducted in 2012. That’s not a tremendous sample size and the writeup makes it look like there were only four questions asked, so I wonder why it took so long to release the data? If anyone has insight, let me know.

Wednesday was a short day for me due to an early flight home. I really wanted to stay through Thursday to hear keynote speaker Erik Weihenmayer, but work responsibilities and the lack of a hotel room for Wednesday night conspired against me. I’ve heard him before, and if you can spare the time, he delivers an extremely compelling story. Although I do enjoy HIMSS it’s just exhausting and I can’t wait to get home to my own bed.

Dr. Gregg’s HIMSS Report

HIMSS this year was a short, fast blur. Well, for me anyway. I made a fairly late decision to go when Lorre wrote to ask if I might be able to help out at the sponsor dinner and the all-new HIStalk HIMSS booth. It’s a tough thing for a solo doc to take time away from practice, so I was thinking of skipping it. But I like being able to connect in live mode with old friends, see the latest HIT tech, hear new and fresh (or sometimes even old and stale) vendor pitches, but mostly I enjoy supporting the HIStalk efforts.

Flying in later Sunday afternoon, I made it in time for the 2014 HIStalk Sponsor Dinner. It was held at the same place as last time HIMSS was in Orlando, Maggiano’s. There’s a good reason for the repeat booking: Maggiano’s does a great job. They have a lovely place and make spectacular dishes. (The stuffed mushroom caps were divine.) Despite Mr. H’s less-than-happy take on the turnout, it was a very enjoyable event.

By the way, Mr. H, I had several vendor folks tell me later that they regretted not making it, but they had legit reasons such as booth set up issues that kept them tied up until the dinner was over or they had out-of-their-hands air travel delays. Lorre did a very nice job arranging the dinner and her HIStalk mugs were a real hit, both there and at the booth.

I hope Mr. H rethinks not holding it. It’s a nice gesture of appreciation for the generous HIStalk sponsors (and saying “thanks” isn’t about getting a “you’re welcome,” right?) Maybe it gets arranged a little differently, perhaps more casually next time, but I’d offer one suggestion more: Mr. H, Inga, and Dr. Jayne should make an appearance as they did last time we were at Maggiano’s. Their anonymous allure is certainly a special draw.

The HIStalk booth was an undeniable hit. For a small, first-time booth back in the uncharted regions of the HIMSS exhibit hall hinterlands, it had a slew of traffic. Lots of folks made a point to hike back just to say “Hi” and “Thanks for what you guys do.” Lorre did such a great job. The HIStalk swag including buttons and mugs and tattoos and magnets were snatched up by many/most who visited. The traffic was so remarkable that nearby vendors eyed the booth covetously. Lorre told me one looked over after a while and said, “Who are you guys? Why do you get such great traffic?” Booth envy.

Speaking of Lorre – what a gem! I had not met her before Sunday’s dinner, but I gotta tell you, she is a real delight. If you haven’t had the honor, you’ve a treat in store. Smart, pleasant, and just plain nice. Her one flaw may be that she’s too humble. (Wait… that’s not a flaw; that’s refreshing!) Mr. H found a real keeper.

As I mentioned, my time was very limited, but I got to know the vendor landscape early on helping Lorre deliver the HIStalk sponsor signs. (Shame on those who neglected to display them!) The exhibits are overwhelming at first. It takes a trip or three before you can really discern wheat from chaff. I can’t honestly say that I saw anything that really knocked my socks off. Lots of (too much) chatter about data analytics and population health. Minimal, if any, Meaningful Use hubbub. (thank goodness.) A dearth of “wow” overall, though there were some cool things to see.

I took another look at CareCloud. Got a great demo (thanks, Brian) and spoke with Brad and John (big CC wigs) about some of the cool stuff they’re developing. I also got a view at the next phase for athenahealth. It’s definitely a good direction for them. Thanks to Pierre and Maria and the nice Athena folks who showed me their new UI (and for the new Kindle!) Jonathan Bush was not around, off in Sochi at last spotting.

I enjoyed a couple of rounds of Quipstar at the Medicomp booth. FYI: Inga was robbed; she actually would have won on total points, but they missed that she had been first to respond on a question. Nevertheless, she and her charity made out. As did all the charities and those participants who walked away with cash or iPads. The illustrious James Aita (no longer with Medicomp having returned to his Canuck roots working at Idea Couture) flew in for a command performance and yet again gave Alex Trebek a run for the money as a game show emcee. Heck, the whole crew, including Cindy and Shannon at Thomas Wright Partners and Patrice of Bzzz Productions, does a really nice job with that event.

Speaking of Medicomp, their CEO, Dave Lareau, walked me over and introduced me to “Marck and Mark” at Clinical Architecture. They do a middleware mapping and a form of NLP (it isn’t really natural language processing, more a “terminology processing”) thing that is simply amazing. They create more connections than eHarmony. Truly awe-inspiring, cool stuff that will undoubtedly have a huge effect on indexing and connecting all this disparate data we’re now digitizing.

I was really lucky running into the guys (Omar, Rufi, and Asad) from Panacea EHR. They are some of my favorite folks – really nice and trying to things for the right reasons. They didn’t opt for a booth and were just taking meetings and checking the floor – a pretty good, more cost-effective idea for a smaller vendor, in my opinion.

I enjoyed seeing lots of good folks, such as Dr. Travis who was there in the Startup Showcase with his new company, Catalyze, and Amy Gleason, Travis Bond, et al, from CareSync, also in the Startup Showcase. (CareSync won the top honors in contest there, but I’m sorry, I don’t remember the contest’s name.) It was great seeing Dr. Lyle who was even more bubbly than usual since his new company, healthfinch and their RefillWizard are performing magically, by all counts.

Of course, my cohorts from Health Nuts Media were roaming the hall, too. It’s weird; for as often as we speak, HIMSS is one of the few times I get to actually see them live and in person.

There’s a laundry list of friendly folks I won’t have time to mention much – such as Jason from Health Care Dataworks, Andrea and Fred from the Ohio Health Information Partnership, Marcy from Fleisher Communications, and more – with whom I really enjoyed getting a little face time.

For anyone I didn’t mention, please know I still really enjoyed connecting. And, for all the folks who took time to stop by the booth or stop me somewhere else to chat or share kind HIStalk words, thanks!

Though I doubt the Twittersphere noticed, I didn’t get to tweet (or take any pix) as my phone’s battery started dying on Sunday and wouldn’t hold a charge well. It was actually sort of nice not being too plugged in for a bit!

Lastly, as I was getting ready to fly out Tuesday night, I got to enjoy a nice dinner and some super conversation when we held little impromptu pediatric geek get together. CMIOs from Ivy League and top-ranked hospitals sharing with trench grunt peds. Thanks to Drs. Andy Spooner and Allen Hsiao for the great time.

HIMSS for the little guy: too big, too fast… and too fun!

From the trenches…

"Everyone is trying to accomplish something big, not realizing that life is made up of little things.” – Frank A. Clark

From HIMSS 2/26/14 – Inga’s Update

So much to share and not much time nor energy following a very long Tuesday and a very short night’s sleep. Coffee will be my friend today.

Random highlights from my day:

I did pretty good on the swag front, choosing to only pick up items deemed cool enough to lug home. One of my favorites is the stuffed yellow lab from Sunquest, which I intend to give to a special friend who has one of the real versions. I went to the Sunquest booth and asked to have one but was told they had run out. Lorre then went to their booth and told them Inga wanted one and curiously they found an extra. I also love the autographed copy of  Niko Skievaski’s Struck by Orca.

I played Medicomp’s Quipstar game and came in last place. Oh well, the Medicomp folks still cut an $1,100 check to my favorite charity.

How about these booth shoes sported by Patrick from Lightbeam?

Humana was giving away smoothies that were created from a bicycle-powered blender.

More than 100 vendors had requested desktop signs proclaiming their support of HIStalk. They are a bit of a labor of love to create and I was sad (hmm…annoyed) that a few opted not to display their signs after all. However, many thanks to those that I spotted, including Orchestrate, Summit, Bottomline, Forward Health, Awarepoint, Healthwise, GetWell, Imprivata, Infor, MBA, Versus, TeraMedica, Fujifilm, Netsmart, PatientSafe (their folks were also sporting HIStalk label pins), Greythorn (they had their sign displayed in a sparkly frame), TalkSoft, Health Care Software, Perceptive, and SIS. If you see one, please tell the booth folks that Inga sends her love.

Stoltenberg Consulting’s booth always reminds me of camping. Maybe that’s the intent. I guess it’s fun.

I really love most of the art in the Epic booth but this girl was a bit creepy because she looked a little too real.

This bear was a little more my style.

I loved the purple sneakers that the GetWellNetwork folks were wearing.

SAP had a big booth but Derek was out in the middle of the aisle trying to engage people in a very friendly and not too pushy way.

It’s a bit hard to see but this guy getting a demo in CareCloud’s booth was wearing a red suit. Um, you have to be pretty confident or a little color blind to wear a red suit. CareCloud, by the way, has a cool new booth with a balcony.

I liked the looks of the MedeAnalytics booth. This is actually the backside of it.

Every time I walked by IBM’s booth it was packed, but I could never quite figure out why.

Some of my favorite guys of the day were from Headspring, which was promoting a mobile nursing application.They were all in cowboy garb (because they are from Texas) and were standing out in the aisle handing out packages of nuts (which I happen to be eating right now for breakfast.)

TeraRecon has this massive screen as part of their booth. I thought it overpowered their space a bit.

I went by CommonWell and was disappointed that when I asked what they did I was handed a marketing slick that showed the various members but was not given any additional explanation of what they were all about. I let them keep their slick.

McKesson’s coffee bar was quite popular. If you are seeking coffee, however, many of the smaller vendors are also happy to give you a cup and most have shorter lines.

Kyle with INUVIO did a great job getting my attention as I walked by and then provided me a nice concise explanation of their card scanning solution.

I liked the look of ICA’s booth.

Check out the magician at NTT’s booth. He had me intrigued.

I had mentioned previously that Alere’s booth was one of my favorites and they were getting plenty of people walking through their tunnel.

The ladies at Dirvugent were super sweet and I liked that the company is donating money to a local children’s charity if you spin their wheel (and let them scan your badge.)

This is an amazing statistic.

Maybe someone can explain why so many people (all men that I observed) were walking around with Google glasses. Late in the evening I tried on a pair and didn’t see enough to make me feel compelled to buy some.

I had the opportunity to chat with Girish Navani of eClinicalWorks. He’s a really nice, down to earth guy and I will later share more details of our conversation, which ranged from eCW’s growth, to Girish’s intent to keep the company private, to his prediction for what HIT topics will be hot over the next couple of years.

I loved the pitch from the SIS guy as I strolled past their booth. He was sporting a red jacket, standing in the aisle, handing out goodies, and asking folks if they cared for mints, gum, or analytics for EHR.

I have another busy day planned and am very excited to see Hillary Clinton’s keynote this afternoon. Hope my feet survive.

Email Inga.

From HIMSS 2/25/14

Imprivata’s people worked hard overnight to get out video from HIStalkapalooza. They did a great job capturing what the event is all about. Thanks again to the companies that made it possible – Imprivata, Greenway, Nordic, Hill-Rom, RFIDeas, and VMware. If you attended, I’m sure those companies would appreciate your stopping by to say thanks (as would I.) The band rocked the house to the point I was told (having left long before so I could get work done) that they were still playing with people dancing until at least midnight. When we all get some catch-up time, I’ll list the contest and HISsies winners.

Lorre wanted me to make sure to thank three guys from our booth neighbor Park Place International. She asked them if they might have a hand cart that she could borrow to bring in three heavy boxes of our giveaway mugs that were sitting in her vehicle on the top level of the Rosen parking garage (since that was the only place left to park). They insisted on going out in their dark business clothes on a sticky morning and hauling in the boxes by hand, starting off their day sweating. That was a classy and chivalrous thing to do. Their behavior reflects positively on the company and we appreciate them, especially since Park Place is also an HIStalk sponsor (they provide Meditech services.)

Sunquest emailed yesterday asking if we could drop by their booth Tuesday afternoon to accept an award. That was a surprise since we’ve never received an award, so Lorre went over during their booth happy hour. It was a bigger deal than we expected – Sunquest’s executive team, including President Richard Atkin, presented HIStalk with the “Sunquest Industry Pioneer Award.” Richard remarked that some companies keep HIStalk at arm’s length knowing that we’re going to call them out if they do something stupid, but that Sunquest supports what we do and considers us a partner. It was a nice thing to do and an honor, and Lorre reports that lots of people stopped her on her way back to the booth wanting a peek at the award.

Odd: everybody was giving away pens, but notepads and sticky notes were impossible to find. Vendors, if you’re going to go green by not giving out paper, we don’t really need pens. I couldn’t find anything to write notes on.

I was walking in the hall and heard what sounded like a high-pitch voiced fire and brimstone preacher. It was patient advocate Regina Holliday of “The Walking Gallery” fame, almost seeming out of place pushing for patient involvement in a hall full of people and products that aren’t really wired with that in mind.

I’m trying to track down something that supposedly happened during the opening reception. I was told that someone from HIMSS was addressing the audience and said something that was potentially insulting to physicians (something about ego, I was told with no further details). If you were there and can elaborate, please do.

Evena Medical had cool glasses designed for venipuncture that view 16 lines transparently in the center of both lenses. They can also take pictures to send back to the EMR. They were interesting, although the venipuncture app seems to have limited sales potential compared to other possible uses.

The folks from 7 Signals showed me a cool display of their WiFi monitoring tool. They have it set up to report on the exhibit hall’s WiFi, which you might guess from the red indicators and the long list of exhibitor sessions, is pretty much useless. Their tool can not only report problems, but actually fix them with a single click. They couldn’t confirm a rumor I had heard – that vendors can’t avoid paying exhibitor company Freeman hundreds to thousands of dollars per day for Internet access in the hall because they run a program that disconnects all sessions that have been active for more than 15 minutes. Along those lines, Lorre found it amusing that we paid Freeman $185 for a single electrical outlet in the booth and they made sure to tape over the second outlet on the jack so we didn’t dare use it without paying.

I would come to HIMSS just to see the Hyland magician. Not only is he very engaging and fun, he fills up their sports bar booth all day long. I can never figure out if he’s a Hyland-knowledgeable magician or a magic-knowledgeable Hylander, which is a testament to how good he is at his craft(s).

Here’s a shout-out to booth visitor and Meditech employee Ockert Coetzee, who earns recognition for reading HIStalk every day from Dubai.

Lorre got a booth visit from Niko, who put together the fascinating book Struck by Orca: ICD-10 Illustrated that features fun and/or bizarre artistic interpretations of obscure ICD-10 codes. He autographed copies for Inga and me, which we appreciate. Copies of the book would make a fun vendor giveaway if you can strike a deal.

Also visiting our tiny but expensive patch of HIMSS release estate was former New York Giants receiver Stephen “The Touchdown Maker” Baker, who caught a touchdown pass that helped beat the Buffalo Bills in Super Bowl XXV. Thanks to Quest Diagnostics for bringing him by. He let Lorre take a picture of her finger wearing his Super Bowl ring and autographed footballs for Inga and me.

HISsie-nominated CMIO Bob Murphy, MD from Memorial Hermann, who is a really funny guy, will be in our booth #1995 today from 10:00 to 11:00. His co-workers Alan Weiss, MD and Mitch Kwartler will join him. Stop by and say hello.

Also in our booth today will be Vince Ciotti (11:00 until noon), who will bring along his HIS-tory timeline poster showing vendor acquisitions over the years.

Lorre reports that someone from Epic told her that if I see their employees on their phones, they aren’t screwing around (as I always accuse) but instead are religiously watching for HIStalk tweets. He said a lot of Epic people read HIStalk. I suggested inviting Epic’s people to flashmob our tiny booth, to which Lorre counteroffered that we should ask them to pose looking at their phones in Epic’s booth since my conference goal is to snap a photo in which at least four company employees are paying attention to their phones instead of the people standing right in front of them.  

Inga, Lorre, and I are all tweeting quite a bit from the conference, so follow us and you might find out where the good snacks and goodies are.

We have a few more 2013 HIStalk headlines mugs to give away in the booth Wednesday. Karen DeSalvo, your photo is on them if you’d like one as a souvenir. We’ll even mail it to you.

People keep asking if I’ve seen anything particularly noteworthy in the exhibit hall. Not so far. I think the government has taken over the agendas of both vendors and providers with ICD-10 and Meaningful Use requirements. One CIO I talked to said he attended the conference only to get ICD-10 deliverable dates from his vendor – he isn’t even thinking about buying anything new.

Today I started at the low-numbered booths and made it to around the 5000 row before my feet and interest gave out for the day. I’m hoping to check out the rest and also take a deeper dive into anything especially interesting, so if you saw something fresh and exciting, let me know. Meanwhile, here are the notes I surreptitiously made as I prowled the hall. My contrived badge title makes it clear that I’m nobody of influence, so I get to see vendor people as they really are when they aren’t kissing butt hoping to make a sale.

• Pentaho was a company that seemed to get traction a couple of years ago, then went off the radar. They are an Orlando-based commercial open source vendor of data analysis tools, with emphasis on Hadoop. They said they got a CMS contract to figure how how to handle the information from Healthcare.gov because CMS couldn’t figure it out and their processing time was hours instead of minutes.
• Ingenious Med had our “We Power HIStalk” sign out. I appreciate that, so indulge me when I mention that fact because it’s pretty cool that companies will use their space to promote their relationship with HIStalk.
• PDR Network had our sign out. They explained that their customers are vendors that integrate their information into their products, so they were mostly using their booth to meet up and prepare for meetings. That’s something about exhibitors that attendees might not know – B2B type companies might rent space just to connect with potential non-provider partners or customers.
• I saw several exhibits featuring variations of the old “Operation” game (“Remove Funny Bone.”)
• I looked over someone shoulder at an NTT DATA demo. It looked pretty good.
• I saw only a couple of white coats worn by booth people who clearly aren’t clinicians. Thank goodness. They were about as phony as those worn by Clinique makeover people at the mall.
• MEDHOST had an impressive booth that was crowded. They said their patient flow solution is new. Some customers have had a payback period of only nine months from implementing their EDIS (note to vendors: if you quote a time-based result, that’s payback period, not ROI.)
• CTG had our sign out. They were nice guys and made me feel better about sweating like a pig all afternoon Monday – apparently the exhibit hall AC was out and it wasn’t just me perspiring.
• Caradigm had a big crowd in a big booth.
• I saw one of the girls who was serving up frozen yogurt in one vendor’s booth fill up a cup for a waiting attendee, then lick her fingers vigorously before handing it over.
• Clinical Architecture had our sign out.
• The red-white dressed people from Alert were there as they are every year despite never seeming to have made a US sale.
• McKesson had a cool coffee bar.
• TeraRecon had a big booth and some cool display stuff.
• Summit Healthcare had our sign out and was baking cookies in the booth.
• Symantec was emphasizing breach protection and had customer IT people talking on stage. They had an effective booth person engaging passers-by.
• Peer60 had some cool, non-corporate guys who explained that they develop customer surveys that require less than 60 seconds to complete. I suggested that their biggest potential prospect is on site since HIMSS sends out ridiculously long and poorly designed member surveys that I’ve never completed even once.
• The Advisory Board Company had a big booth and a lot of traffic.
• Hitachi was going to offer an Orlando microbrew for happy hour, which would have been a welcome alternative to the lowbrow canned swill (Budweiser, Amstel Light, Heineken, etc.) that everybody else was serving up.
• I chatted with someone from ICA, who explained that hospitals are connection to long-term care providers as a “short putt” to meet Meaningful Use requirements with as little effort as possible. He also said that some small companies are getting traction with specific services that use Direct platform. He pointed out that HIE vendors often require hospitals send them all HL7 transactions, which the always-secretive hospitals don’t want to do, so hospitals are choosing ICA to filter what is sent out.
• I talked for a few minutes with Chris Joyce of Bottomline Technologies, who said that its acquisition of his former company Logical Ink opened up a lot of possibilities because of ECM synergies with Hyland Software.
• Thanks to Winthrop Resources, MediQuant, and Arcadia for putting our sign out.
• Passport had our sign out and was busy.
• ESD and Shareable Ink had our sign out – thanks.
• GetWellNetwork displayed our sign and had an effective person engaging on the perimeter.
• The eClinicalWorks booth was large and busy. The rep said they’re signing 2-3 ACOs each month. They got a great gift with Farzad Mostashari pushed their population health and primary care agenda when he was with New York City Department of Health and Mental Hygiene – they are very well positioned.
• Medicomp was playing the Quipstar game, which is always fun.
• Aprima had our sign out, along with brownies and coffee.
• InterSystems had a huge booth.
• Also displaying our sign: Innovative Healthcare Solutions, Healthwise, Quest Diagnostics, and Infor.
• SSI Group had our sign out along with coffee, drinks, and a cool mobile device charging station.
• Aventura hung out their Bonny’s “Fashion Diva” sash.
• PC Connection was making great-smelling cinnamon almonds and pecans.
• NantHealth had out stuff from the LA Lakers that billionaire founder Patrick Soon-Shiong owns. I tried to figure out what they are selling, but I never did given that all the screens seemed to be lofty PowerPoints and videos of PSS talking rather than anything with specific details about how several dozen recent acquisitions that cost a billion dollars have suddenly transformed into a “Clinical Operating System” as was announced this week. He’s a genius, but the roadside is littered with companies that were long on acquisitive ambition but short on integration.
• I was pretty pleased when I saw three sponsor people seemingly caressing their HIStalk sign in their booth, but then I overhead them complaining bitterly that their bosses got invited to HIStalkapalooza and they didn’t.  I’ve heard that almost constantly over the last few weeks from people who should intellectually be able to understand that no company can afford to thrown a bash for the probably 3,000 people who would want to attend, so I’ll resist the urge to call the company out and instead I just won’t mention them at all. I should have jumped in and opined that the Super Bowl needs to be played in a million-seat stadium so everyone can come.
• Max from Legacy Data Access gave me a good elevator speech on the company’s system retirement services.
• The Qlik booth was packed, our sign was out, they had customer presentations, and they gave me a killer chair massage.
• My award for best use of a small booth goes to CommVault, which had a great design, a fun game run by Katrine, and fun giveaways (syringe pens and ear buds). I’m sitting here hours later and I still remember the company’s selling points as featured in the game – performance, access, and management. I’m really impressed with how polished and fun their booth was given its modest space and furnishings.
• Also displaying our sign: healthfinch, Versus, MBA Health Group, Leidos (they had it front and center in their big booth), ICSA Labs, PatientSafe Solutions, Valence Health, Patientco, Beacon Partners, and Wellsoft.
• Divurgent was raising money for a local children’s hospital. You spin the wheel and whatever dollar about you hit is added to their donation check. Nice job.
• Greythorn not only had our sign on display, they had placed it in a glittery frame and mounted it to the back wall. They get the “most creative” award.
• I talked to Talksoft President Ken Walsh about the company’s phone messaging system.

Dr. Jayne’s HIMSS Report – Monday

If I wasn’t already moving a little slowly, the sheer size of the conference center and exhibit hall has almost done me in. I was a little turned off by the keynote speaker. Although many of his recommendations for transforming healthcare are solid, I would love to see payers help lower costs by doing something about the outrageous bonuses that some of their leaders receive. I understand the bonus is for doing a good job, but we all need to remember that those bonuses are funded through premium dollars in the end. After that, I attended a session on converting the legal medical record. Lots of good information and I’ll write more about that later in the week when I have a chance to go through my notes.

At this point, I’m running a mile a minute trying to make it to all the booths I want to check out and fitting in lots of meetings. Usually convention center food is pretty bad but I did score a grilled portobello mushroom sandwich that very good and even better found a quiet sofa on the fourth floor to eat it. There have been a couple of glitches, though. Some of the entry doors are locked (even the ones they actually want you to use) and there were some audiovisual problems in the sessions I attended. In one presentation, the slides were chopped off on the bottom, so content was missing. I’ve been a presenter at large meetings before and I know there’s a speaker ready room here. HIMSS is the big dance and you need to bring your A-game, so make sure your slides look good before you session starts.

Walking through the crowded lobbies, I remembered the jazz combos they had playing last year in New Orleans. They would have been a good distraction from the ridiculously long coffee lines. At one point there was a crew of concession workers bringing out dividers to rope off the lines from the crowd. I’m surprised with a meeting of this size that they didn’t anticipate the need for that sooner.

I haven’t seen a lot of costumes or scantily clad booth attendants this year, but MEDecision did catch my eye with their morph-suited dancer. One of their other staffers was sporting a knee brace, which she assured us was not due to a dance-related, on-the-job injury.

I spent some time in University Row and the career center area. I was happy to see A Hero’s Welcome (#165) on site to help veterans identify job opportunities. Also in the low numbers was MDI Access (# 279), who not only were nice guys, but were giving out hand sanitizer. Mine keeps getting confiscated by TSA, so they were happy to share a couple.

Inga and I spent some time cruising the hall together and had a few product demos. We make an excellent “good cop / bad cop” team because she asks a lot of patient-centric questions while I hit the clinical and technical areas. Some tips for those of you doing demos, especially if you will have a physician in your audience:

• Make sure your clinical scenarios are valid and your sample patients have been cleaned up. Nothing turns me off as much as seeing an inappropriate antibiotic prescription or ridiculous diagnosis code on your patient chart.
• Don’t make broad statements about “all physicians think” or how large healthcare organizations run without understanding your audience (especially if it’s a one-on-one demo.) One presenter make several statements that were directly contrary to how my organization works, which made me immediately feel that they would not be a good fit for us.
• If you’re going to hand out information sheets, make sure you don’t inadvertently give an attendee your copy that you wrote notes on (although I did enjoy reading them.)

I attended the first round of Quipstar at the Medicomp booth (#2703). If you haven’t seen it, I’d encourage you to attend. Inga is playing Tuesday afternoon and they have a great product, so be sure to stop by.

First time exhibitor CoverMyMeds (#4495) proudly displayed their HIStalk sponsor sign and also offered a quick recharge for those whose phones were dying. After a couple of hours, my feet were dying as well, so it was time to head back to the hotel and get ready for HIStalkapalooza. Unfortunately Inga and I were on a shuttle that got stuck behind an Aramark truck unloading in an alley, so we ended up in a mad rush to get ready.

Dr. J brought his A-game in these shoes. Although he missed the contest, they were my personal favorite in the men’s division. I was happy to see a physician named the winner of the Stiletto category. It just goes to show we can look good in something other than a white coat and surgical clogs.

The ever-dapper Mike Quinto of PatientSafe Solutions (#3983) sported the “I Could Be Dr. Jayne,” sash, which ended up being worn by several different gentlemen throughout the evening. HIStalkapalooza was rocking, the band was excellent, the drinks were tasty, and I thought the night couldn’t get any better until my not-so-secret crush Dr. Farzad Mostashari showed up. I was able to get a nice pic of the two of us, which really made my day. Thanks to everyone who came out and especially to our sponsors for making the night possible.

From HIMSS 2/25/14 – Inga’s Update

From Amanda: “Re: HIStalkapalooza. I had SO. MUCH. FUN. Thank you for everything! Seriously – best time ever.”

From Erin: “Re: HIStalkapalooza. This is the best HIStalkapalooza! Thank you for allowing us to be a part of it!!”

From Lisa: “HIStalkapalooza. Many thanks to you and the HIStak team for a wonderful party. Everyone I spoke with was having a blast.”

Those are a few of the early HIStalkapalooza reviews. Based on the flood of Tweets I read on the ride back to my hotel last night, a whole of people had a great time.

Before I share more on HIStalkapalooza, I’ll mention a few other details from my day Monday.

Fortunately my hotel is in walking distance to the convention center. I was amused by this gentleman standing at a crosswalk handing out one of the free newspapers. Even more amused that so many people actually take one (do they read it?)

I walked in a bit late for the opening keynote by Aetna CEO Mark Bertolini, who provided his vision for transforming healthcare. Among his recommendations: providing patients with digital tools to help manage their own health, increasing emphasis on wellness, and better managing chronic disease.

Outside the auditorium, by the way, HIMSS had a monitor with a feed of the keynote. Unfortunately 15 feet away was a HIMSS TV monitor, which meant that unless you were in directly in front of the keynote monitor you couldn’t hear the presentation. Hope someone fixes that.

I next headed to the ONC Town Hall. I was amused that Karen DeSalvo jumped right into the session without first introducing herself. All the ONC big-wigs were on the panel and after brief introductions the session proceeded in a Q&A format. Questions ranged from concerns about the exclusion of certain groups from the MU incentive program (pharmacists, for example) to possible requirements for Stage 3. The panelists did a commendable job of taking turns replying to the different questions and comments.

There’s always a crowd standing outside the exhibit hall doors right before it opens and this year was no different. The first thing I did was head to the athenahealth booth and took a look at their new athenaCoordinator Enterprise, which provides hospitals with tools and services to coordinate care. The differentiator from other care coordination platforms is that athena also provides much of the behind-the-scenes services, such as contacting patients in need of visits and checking prior authorizations. I think there will definitely be health systems interested in an option to out-source these tasks, though I can also see many that would fear giving up that much control to a third party. The product looked quite intuitive and easy to navigate. The athena folks also gave me a peak at the new user interface they are working on. I remember first seeing athenaClinicals about five years ago and was not impressed with how the product looked visually. However, I think they are on the right track with the changes that provide a much more current and sort of  Facebook-like look and feel.

A quick shout-out to Maria at athenahealth. Her shoe wardrobe never fails to impress me.

I then did a bit of cruising around the exhibit hall and came across the handsome Dr. Travis who is hanging out with his new company Catalyze at the Startup Showcase. The Startup Showcase was actually hopping, to the point that the everyone looked uncomfortably crowded. Vendors with kiosks in the center were at a disadvantage because you pretty much would need to elbow your way in to chat with anyone. Guess that’s a better problem than twiddling your thumbs because of a lack of traffic.

Vendors participating in the showcase also have an opportunity to provide 30 minute company and product overviews. I predict the whole showcase will be much bigger next year, based on its early popularity.

I stopped by the Siemens booth just long enough to see this big game board. I didn’t stay long enough to learn what they were talking about but the way the panel tiles were displayed was pretty fascinating. I am going back today.

I spinned the wheel at Actuate’s booth and am now in the running for a Fitbit force. I am not 100 percent sure what a Fitbit will do for me but I am sure I need one.

If you are going to ask folks to spin your wheel, I think you need to offer prizes that are worth the effort. Dr. Jayne and I kind of giggled at these folks that were offering not-so-amazing trinkets like earplugs, pens, and TSA zip lock bags. We liked her shoes, though.

I don’t recall seeing this guy before at Epic’s booth. I plan to tour the art a big more closely today.

I was intrigued by SAP’s bus, which they had in addition to a regular booth. Inside it was set up like a booth with demo stations. Kind of cool.

I ran into two HIT superstars on the floor. That’s Dr. Mostashari being photo-bombed by Dr. Lyle Berkowitz. It’s my favorite picture of the day.

My first stop this morning will be to MedData which is offering freshly baked scones.

I headed back to my hotel before the exhibit hall closed so I could get spiffed up for HIStalkapalooza.  Many thanks to Imprivata, VMware, Greenway, Nordic Consulting, Hill-Rom, and RFIDeas for sponsoring.

The Inga-Tini – Mr. HIStalk was my drink of choice for the evening, though some of the other options looked quite fun as well.

I thought Lorre looked stunning at the official HIStalk ambassador. If she weren’t hosting I am sure she could have won both HIStalk Queen and the Inga Loves My Shoes contests.

Speaking of the contests, I’d love to know the names of all the winners, so if you were sashed, please drop me a note and/or a photo.

Jennifer Lyle of STS Healthcare did an amazing job as the official emcee for the evening. She was beautiful and funny, as always.

I loved the little decorating touches, including the HIStalkapalooza lamp shades. I think I need one.

I absolutely loved the band. I wasn’t the only one since when I left at 11 there was still quite a crowd that appeared they’d keep dancing until they were kicked out. Who knew HIT had so many great dancers? Ross and Kym Martin, Ed and Julie Marx, and Matthew Holt and any and everyone he could get to dance with him were all non-stop on the dance floor.

Our esteemed shoe and fashion judges, all of whom could have been winners themselves.

I almost missed the whole back room area which had a photo booth and Dance Head recordings. Great keepsakes and hilariously funny.

As a whole, I was only disappointed about a couple of things. First, it was difficult to hear the quite funny Missy Krasner and Ross Martin as they presented the HISsie awards. I also wish more folks could not have been added to the guest list. I hope we have the opportunity to change these imperfections next year.

I actually have so much more to share but I must get moving to the convention center. On today’s agenda: a couple of meetings, possibly the #HITsm Tweet-up, and at 3:00 p.m. I’ll be playing Quipstar at the Medicomp booth (2703). Please come cheer me on as I play for charity.

Email Inga.

From HIMSS 2/24/14

It’s late and I’m tired after a long day and then HIStalkapalooza, plus I have to get up early in the morning, so I will keep it short and catch up later.

Note to self: don’t drive the rental car to the convention center to drop off stuff for the booth. I got stuck in traffic mid-morning, the parking lot lots were all full, and I was happy to finally get a spot in the Rosen Plaza deck maybe 30-40 minutes later. Thanks to our friends from Nuance who helped bring in some of our heavy items. The hall is not the least bit cooperative about helping with carts since it’s all about the Freeman trade show monopoly and you have to pay them for anything you need, so we didn’t have any easy way to bring in heavy boxes of mugs.

The only session I attended  today was one that was supposed to feature several politicians talking about federal legislation. It turned to be their staffers instead. They were unintelligible for the first several minutes because of an audio problem, correction of which made it even less interesting, so I was out of there within ten minutes.

The exhibit area is, of course, sprawling. I mostly just cruised around today getting the lay of the land, tweeting out interesting giveaways and food (MedData’s passionfruit scones were easily the best). I don’t know that I saw any particular trends other than an uptick in privacy and security offerings and of course more vendors touting analytics.

Our little booth got respectable traffic as Lorre hosted her celebrity guests, applied HIStalk temporary tattoos, gave away buttons, and denied that she is either Inga or Mr. H. We didn’t get the 2013 headlines mugs into the hall because of the traffic problems I mentioned, but she will have some on hand Tuesday. Several people asked for a mug and one person said his was stolen, which I suppose is a good problem for us to have.

I was frustrated at the HIMSS people over CEUs. Individual sessions may offer CEUs for physicians, nurses, pharmacists, etc. If you’re a doctor, let’s say, you then need a list of sessions that offer your CEUs. You won’t get it from HIMSS, apparently: the lady in the CE booth says HIMSS has a 20-page PDF print of an Excel worksheet that lists all the sessions and which CEUs if offers, but it’s not available to attendees to print anywhere in the hall (and darn it, this time I didn’t pack my laser printer). This is one of the dumber things I’ve seen HIMSS do, but it’s certainly not unprecedented since they always seem to struggle with the simple idea of providing some indication of which sessions are approved for which CEUs.

The VA will implement the cloud-based version of Nuance’s Dragon Medical.  

Here’s an interesting Epic booth graphic showing how handily they beat their competitors, also pointing out that they’ve never lost a hospital EHR customer.

HIStalkapalooza

Thanks to the event sponsors: Imprivata, RFIDeas, Greenway, Nordic, VMware, and Hill-Rom. I thought the venue, food, and music were excellent. Also thanks to the several folks who presented on stage, including opening music by Ross Martin, MD, Jennifer Lyle as our emcee, and Ross and Missy Krasner as HISsies presenters.

I noticed one error in the final HISsies award as presented on stage. Farzad Mostashari won the “Industry Figure of the Year” award (as well as the “When ___ Talks, People List” one earlier) and the slide was correct, but it was read as though Judy Faulkner was the winner. She won in 2013, not this year. Also accepting their awards in person were Ed Marx, SVP/CIO, Texas Health Resources (best provider IT executive) and Carl Dvorak, President, Epic (HIStalk Lifetime Achievement Award).

Imprivata had still and video photographers on hand and I’ll have high quality images as soon as tomorrow, but here are a few snapshots until then. I’m sure I’ll also have reports from Inga and Dr. Jayne tomorrow. You can also give me some crowdsourcing backup by adding your comments about HIStalkapalooza, the conference, and anything else of broad interest.

From HIMSS 2/24/14 – Inga’s Update

I arrived in Orlando late Saturday afternoon and was able to hop right into a cab – unlike folks who arrived Sunday afternoon. A friend sent me this picture and told me he waiting more than 20 minutes for a ride, but I also heard stories of 40 minute waits.

I was up early Sunday morning and walked through the fog to the convention center. About the only people I ran into along the way were joggers and jet-lagged Europeans. Once I arrived there were a few different hubs of activities, primarily from the pre-conference sessions.

It’s too bad that all these Sunday sessions come with an additional price tag of about $300 because I understand that most are quite good. I did sneak into the Innovation session long enough to hear Dr. Lyle Berkowitz’s presentation, which was informative, nicely paced, and full of interesting anecdotes from the “real world.”

The other hub of activity was in the exhibit hall. I am always amazed at the transformation that occurs in a relatively short amount of time. Here’s how it look about 24 hours before the doors opened.

This year a friend hooked me up with a “back-stage pass,” aka an exhibitor badge so I could actually walk amidst the chaos. Looks like Judy will be back in front of the fireplace again this year.

Alere gets my early vote for coolest booth. This picture doesn’t do it justice but it basically looks like a tunnel. As the worker vacuuming the carpet in the next booth commented, you can’t help but want to walk through it.

CareTech’s booth was also unique. I like the glass walls surrounding it but I wonder if the design will detract people from actually walking in.

This sad little space is where you will find Lorre holding court on behalf of HIStalk this week. Be sure to pick up your HIStalk swag and tell Lorre hello at booth 1995.

Here’s Medicomp’s booth, which was getting prepped for its Quipstar game show. I’ll be playing Tuesday at 3:00 p.m. so please come cheer me on.

Apparently I am not the only person who loves to check out the transformation in progress. That’s HIMSS executive director Steve Lieber taking in the details at one of the learning galleries.

The Startup Showcase looks like it will be a good stop. I look forward to investigating a few of the 44 vendors that have kiosks.

I met up with my BFF Dr. Jayne at the opening reception (no, that is not her.) Mr. H gave the event a big thumbs down, but Dr. Jayne managed to have some fun. Okay, there was minimal decoration or signage or entertainment (no live band this year) but we liked our free drinks and the opportunity to people watch.

There were a few “party pits” with comfy red couches which offered a nice alternative to high top tables.

Yep, some folks brought their fashion A game to the party.

The Voalte guys were making their own fashion statement. I love that they always come decked out in the signature pink pants, which has to be a great conversation starter.

My agenda for Monday: keynote session, ONC Town Hall, a walk through the Interoperability Showcase, the exhibit hall, and some big party tonight. Oh yeah, HIStalkapalooza. Can’t wait.

Email Inga.

From HIMSS 2/23/14

For those planning to visit the HIStalk booth (#1995), here’s a celebrity addition: Vince Ciotti will be on hand Tuesday and Wednesday from 11 until noon.

3M announces that it will acquire analytics and BI vendor Treo Solutions.

Vonlay is doing some cool social media coverage of the HIMSS conference as they always do. Check out their page.

CVS MinuteClinic announces that it will replace its homegrown EMR with Epic.

The HIMSS opening reception was a disaster in my book, rivaling the Chicago one as the worst one ever. HIMSS decided for some reason to hold it in the Hyatt Regency across the street rather than the convention center itself as has always been the case, and International Drive was full of people who were lost since that hotel complex is almost as big as the convention center. Someone told me that HIMSS screwed up and had some of the directional signs reversed, which probably didn’t help, and I saw one HIMSS person running around with “follow me” hand-held signs to try to herd the puzzled  crowds through the bowels of the endless building to its southernmost point that seemed like a mile from the main entrance. The room was the usual cheerless airplane hangar, so the impetus to move from the convention center is unclear. HIMSS went back to the much-hated drink ticket concept that was a welcome deletion a few years back, but it didn’t really matter since the bar lines were at least 40 people deep at every location and the incessant din that could have been a band, recorded music, or a plane passing overheard made it impossible to think, much less hold even a shouted conversation. I lasted about two minutes and left without eating, drinking, or talking to anyone since it was about as pleasant as as dental surgery. There’s a lot to dislike about how HIMSS conducts business, but clearly botched conference logistics isn’t usually one of them.

We had a nice reception for HIStalk sponsors Sunday evening. Thanks to the really cool people who actually showed up, which unfortunately was only about 40 percent of the total who RSPV’ed. Because of the thousands of dollars I spent to guarantee the 60 percent who were no-shows whom I suspect were registered by their clueless admins, I’m pretty sure I won’t do another one, especially thinking of the time and effort required to manage all of their never-ending requests to bring extra people who joined them in going elsewhere. Thanks to Dr. Gregg and Lorre for running the event. Those who attended had nothing but compliments about it.

We gave out some really cool mugs with healthcare IT news headlines from the past year at the sponsor event, and because of all the folks who blew it off, we’ll have some to give away at our booth. Stop by and Lorre will hook you up. One of our longest-tenured sponsors proclaimed the mugs as, “The best favors I have ever seen.”

Monday will be the usual crazy day with the opening keynote (an insurance vendor CEO, which makes no sense), the exhibits, and the rare educational sessions that are actually worth discussing. Inga, Dr. Jayne, and I will use Lorre’s Twitter throughout the day to tell you about what we’re seeing out on the show floor. Then we move right into HIStalkapalooza, which always generates discussion and hopefully some fun pictures and videos.

Dr. Gregg has a brilliant booth idea that he describes as follows.

HIStalk Reverse Giveaway

Laaaaadies aaaand gentlemen! Announcing, the HIMSS 2014 HIStalk Reverse Giveaway!!!

You don’t want to miss this one. Stop by the HIStalk booth out in the hinterlands of the HIMSS 2014 Exhibit Hall on Monday, February 24th, from 1:00 to 2:00 PM and be part of our completely unique Reverse Giveaway. (A first for ANY exhibitor at HIMSS… we’re pretty sure.) Dr. Gregg will be there at that time and has promised to accept any and all gifts you want to unload.

Reverse Giveaway items include:

• Tokens
• Tchotchkes
• Swag
• Bling
• Freebies
• Trinkets
• Baubles
• Doodads
• Lagniappe
• And any general largesse or pure graft (larger denominations preferable.)

Dump that heavy load you’re carting around and make room for more. Enjoy the show (and hope to see you at HIStalkapalooza!)

From the trenches…

"If it wasn’t for graft, you’d get a very low type of people in politics.” – Preston Sturges

Dr. Jayne’s HIMSS Report – Sunday

I’m moving a little slower at HIMSS this year thanks to the half marathon on Sunday morning. It was muggy, hot, and crowded, so on some level was good preparation for the upcoming week of slogging through the exhibit hall, trying to find my way to sessions, and looking for the next great thing in healthcare IT.

The opening reception seemed a little more upscale this year. Inga and I didn’t see as many people in vendor logo polo shirts, but we did see lots of sassy shoes and some pretty high heels. It’s only day one, though, so I’m looking for those heels to get shorter as the week progresses if they’re not retired after the “Inga Loves My Shoes” contest Monday night.

Registration was a breeze and I spent most of the day catching up with old friends that I only see at HIMSS. One good friend works in the public sector and was happy to report that not a lot has been changing in her world. Hospitals in her area are largely focused on meeting Meaningful Use Stage 2 requirements and preparing for ICD-10 with little else on the horizon due to budget and staffing constraints.

I managed to catch up with both Dr. Gregg and Dr. Lyle which was a nice surprise since I know how busy everyone’s schedules are. I also had a chance to expand my network with introductions to other CMIO types. At least two of them are in the vendor space, so I’m looking forward to getting their take on events from the vendors’ chairs. Inga and I also hit a couple of social events – the Divurgent-SummHIT party at the Funky Monkey was definitely hopping.

Last but not least, I heard one juicy rumor although I’m sworn to secrecy until it’s announced later this week. I’ve got a packed day of sessions and meetings tomorrow and a couple of calls to deal with issues back home so I’m turning in early. Looking forward to HIStalkapalooza and definitely need the rest!

News 2/21/14

Top News

Allscripts announces Q4 results: revenue flat, adjusted EPS $0.08 vs. $0.16, beating revenue expectations and meeting consensus earnings estimates.

Reader Comments

From Dr. Detroit: “Re: misspelling HIMSS. Once a vendor does it in four separate emails as this one did, they should be granted credentials as a certified ‘HIPPA’ consultant.”

From Stool Pigeon: “Re: fecal transplants. You’ve grossed out readers before, so you might find this interesting.” MIT launches OpenBiome, the country’s first stool bank, to collect samples to treat patients with C. difficile intestinal infections. At least it eliminates that awkward moment of asking friends and loved ones to sit and be counted.  

From Pathology MD: “Re: HIStalk pins. I am a loyal reader but can’t get to Orlando. I collect pins and really would like the 10-year HIStalk pin or both for my collection. I’ll pay.” Lorre and I were touched by this request for this request for the inexpensive giveaway that was her idea, so she’s sending the pins to this reader as well as another with a similar request (obviously I’m happy to pay the postage.) We have a limited number of these to give away in Booth #1995, so maybe they really will become collectible.

From Dr. J: “Re: men’s wear for HIStalkapalooza. My $99 boots arrived just yesterday.” I love these, especially because they have a big toe box unlike some of those pointed boots that surely cause digital damage. They are from Dude’s Boutique Online, which I see has a really cool crocodile and ostrich boot in cognac for only $198 on sale as long as you don’t mind leaving a trail of dead animals behind your purposeful stride. I’ve asked Dr. J which ones these are because I need a pair to make me look more rock and roll.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Netsmart of Overland Park, KS. Netsmart is the leader in coordinating care among behavioral health, physical health, and acute care hospitals. That’s important because severely mentally ill people die 25 years younger than the rest of the population and drive up Medicaid costs and other loss ratios. Netsmart links primary care initiatives with broader, coordinated care for the body and mind to reduce readmissions. Netsmart CareFabric offers clinical solutions (EHR, eRX, CPOE, consumer engagement, analytics, care coordination) and business solutions (PM, client banking, RCM.) The company’s products are used by 23,000 clients, including 450,000 providers and 40 state systems, to improve the quality of life for 25 million people each day. Its clients include mental health and addiction services agencies, health homes, psychiatric hospitals, private and group mental health practices, public health departments, social services and child and family health agencies, managed care organizations, and vital records offices. Thanks to Netsmart for supporting HIStalk.

Welcome to new HIStalk Platinum Sponsor Premier, Inc. of Charlotte, NC.  Premier (NASDAQ:PINC) is a leading healthcare improvement company that unites 2,900 hospitals and 100,000 other providers to transform healthcare. Premier enables better care and outcomes at a lower cost through integrated data and analytics, collaboratives, supply chain solutions, and advisory and other services. A recent offering is PremierConnect Enterprise, a cloud-based data warehousing and business intelligence offering that combines trusted information, collaborative development, and access to expertise to enable information-driven health systems. Premier’s database is among the industry’s most comprehensive with data covering one in four hospital discharges, 2.5 million real-time clinical transactions each day, and $40 billion in annual purchasing information, all used to connect, share best practices, solve important problems, and build new technologies. The company has been named among the world’s most ethical companies for six years in a row. Thanks to Premier for supporting HIStalk.

Ion IT Group is supporting HIStalk as a Platinum Sponsor. The Carthage, TN-based company offers strategic services, consulting, and outsourcing. Specific services include managed IT, security and risk assessment, business solutions, and infrastructure. It also offers the Vital Connect remote vital sign monitoring solution (weight, blood pressure, temperature, pulse oximeter, and blood glucose) that works via a mobile phone data collector. It also provides HealthX secure messaging based on the Direct standard, which enables the exchange of EHR reports, documents, images, and structured data, and Evault services for cloud-based backup, recovery, and end point protection. Thanks to Ion IT Group for supporting HIStalk.

A few highlights from HIStalk Practice this week include: proposed Stage 3 MU objectives that may impact EPs. The Colorado Health Institutes suggests that the use of technology may help mitigate a looming shortage of PCPs. EClinicalWorks CEO Girish Navani predicts it will only be a matter of time before all providers convert to EHRs. Results from teledermatology assessments are found to be nearly identical to results of in-person assessments. Dr. Gregg provides a thorough list of all the JUNK you’ll need to lug with you to HIMSS. Thanks for reading.

On HIStalk Connect: Industry insiders suggest that the Apple iWatch will predict heart attacks in time for wearers to seek help. Surgeons at Washington University in St. Louis test a pair of smartglasses that highlight hard-to-spot cancer tumors during surgery. Partners HealthCare’s bid to acquire South Shore Hospital is rejected because the Massachusetts Health Policy Committee believes that population health-based cost savings are exaggerated. Dr. Travis dives into the world of Big Data in an article that focuses on the patient and the various tools available for capturing and sharing patient-centric data.

HIMSS has been emailing a Groupon-like but even lamer “HIMSS14 Conference Deal” that purports to offer the recipient something of value for opening it. Most of those emails haven’t offered anything at all, only a pitch for a company buying the ad. That doesn’t sound like a a deal for anyone except HIMSS. Those with memories going back more than a couple of years may recall the gentle era when HIMSS didn’t overtly flog the wares of its members to its other members with spam that promotes webinars, white papers, and other promotional stuff that has nothing to do with HIMSS except they’re getting paid to talk it up with little evidence of objectivity or restraint.

I received this by email today, just in case you wonder where all your post-HIMSS conference junk email and cold calls come from. I don’t recall having an opt-out option when registering for the conference as an attendee.

You may be rocking your HIStalk temporary tattoo after stopping by our booth, but you can’t match Lorre, who will let her fingers do the HIStalking.

HIMSS guides for your last-minute perusal: Exhibitor Giveaways, Sponsor Activities, Sponsor Meet-Ups

HIStalkapalooza Timeline

The event will be memorable, with many surprises that I won’t spoil now. The roster of attendees, which unfortunately couldn’t include everyone who wanted to be there, is spectacular and nicely diverse, with a huge number of hospital people enjoying amazing food, lots of drinks including an all-new IngaTini developed by the lady herself, and party music until late. Don’t even think about bailing out for some other event if you have an invitation because you’ll be sorry Tuesday morning when you hear everyone talking about it.

• Transportation to and from the Convention Center will start at 6:30 p.m. on Monday.
• At the House of Blues, we’ll have a red carpet greeting, photographers, and interviews by Jennifer Lyle. Your photos will be available to pick up on your way out as a souvenir.
• The band (Party on the Moon) will play a set starting at 7:00 as the appetizer buffet and bars are open.
• The dinner buffet will start at 7:30.
• We’ll open the stage part of the evening at 7:45 with the music of Ross Martin, MD of AMIA and The American College of Medical Informatimusicology and a welcome from Jennifer, Lorre, and the folks from Imprivata.
• The “Inga Loves My Shoes” contest with Lisa Reichard and Ed Marx will start at just after 8:00.
• We’ll crown the HIStalk King and Queen next with Dave Lareau, Bonny Roberts, and Jennifer Dennard.
• Then come the HISsies awards, with Ross Martin and Missy Krasner of Box.
• We’ll wrap up the stage part of the evening by around 8:45 and the band will play until 11:00.

HIMSS Conference Social Events

Verisk Health is conducting a service project supporting the Second Harvest Food Bank of Central Florida on Tuesday at 6:00 p.m. at the Rosen Centre Hotel. Participants can spend an hour helping to assemble 4,000 food packs for children who do not have access to school cafeterias during the weekend.

ICSA Labs will host an evening of cocktails and hors d’oeuvres from 6:00 to 8:00 p.m. Tuesday at the Hyatt Regency.  RSVP here.

Acquisitions, Funding, Business, and Stock

Merge Healthcare announces Q4 results: revenue down 17.2 percent, EPS $0.00 vs. -$0.19, missing expectations on both. Shares are up 15 percent in after-hours trading.

Vocera reports Q4 results: revenue up 6 percent, adjusted EPS $0.03 vs. $0.03, beating earnings expectations. The company also announces that two New York luxury hotels are implementing its solution for employee communication.

Healthwise and the Informed Medical Decisions Foundation announce their pending merger.

UnitedHealth’s Optum division acquires a majority stake in Audax Health, the developer of a consumer health management platform that was founded four years ago by the now 24-year-old Grant Verstandig.

ISirona retires its name following its January 2014 acquisition by NantHealth.

Sales

Saint Luke’s Health System (MO) selects Solarity technology from EDCO Health Information Solutions for scanning medical records at the point of care and remote indexing services.

Sanford Health (ND)  will spend $30 million to implement Intelligent InSites RTLS at several locations.

People

Farzad Mostashari, MD joins the board of patient engagement company Get Real Health.

CureMD announces the death of  President, CEO, and Co-Founder Kamal Hashmat, MD following a “tragic accident.” Co-founder and CIO Bilal Hashmat will replace him.

The Institute of Medicine names Duke University Health System President and CEO Victor Dzau, MD to a six-year term as president. He will replace Harvey Fineberg, MD, PhD, who has held the role for 12 years.

Bill Spooner, SVP/CIO of Sharp HealthCare, announces his retirement after 32 years in the position. He will be replaced by Ken Lawonn, formerly SVP of strategy and technology at Alegent Health.

Announcements and Implementations

Sixteen health information organizations throughout the Midwest and Rocky Mountain states form The Mid-States Consortium of Health Information Organizations, with the goal of advocating for health information exchange across states and in rural areas.

HIMSS Analytics introduces the Continuity of Care Maturity Model to address the importance of information exchange, care coordination, interoperability, patient engagement, and analytics.

The president of Toshiba says the company will spend billions of dollars on mergers and acquisitions to boost annual sales in its healthcare division to $9.78 billion by March 2018.

Kaiser Permanente Colorado, the largest not-for-profit health plan in Colorado, will join the CORHIO HIE.

Deloitte Consulting launches ConvergeHEALTH by Deloitte, a business unit that supports data-driven transformation of healthcare using analytics, consulting, and collaboration with leading healthcare organizations.

A group of Mayo Clinic physicians launches Ambient Clinical Analytics and raises $1.1 million in funding on top of its original $16 million CMS grant. It will offer Mayo-developed mobile device tools such as surveillance alerts and an analytics-powered EMR viewer. It will be debuted at the HIMSS conference next week.

Government and Politics

CMS announces that it will offer end-to-end ICD-10 testing in summer 2014 to a small group of providers.

ONC selects 15 provider and administrator champions for its HIT Fellows Program.

Other

Carilion Clinic identifies 8,500 patients at risk for developing heart failure using NLP and predictive analytics technology from IBM to analyze clinical data from the health system’s Epic EMR.

A HIMSS survey finds that 19 percent of health systems and physician practices experienced a security breach in the last 12 months and 12 percent had at least one reported case of medical identity theft.

Nashville attorney Michael Dagley, who represented Trinity Medical Center (ND) in its $106 million settlement with Cerner over its ProFit accounting software, indirectly accuses the company of over-promising on ProFit’s capabilities to earn the clinical systems business. He also warns hospitals that limitation-of-liability clauses may prevent hospitals from suing their vendor, saying, “Vendors will have in their contract, almost always, a limitation of liability. Which means you cannot sue us for any consequence of the software being defective, you can only get your money back for the software. The providers, a lot of times, do not understand the significance of that agreement. So now, they’re three months into it, they’ve bought the software, and they’ve lost $100 million. They pull up the contract, and the contract says you can get your money back for the software and they’re going, ‘That’s $300,000, but I lost $100 million!’” He suggests consulting KLAS rankings and talking to clients.

A study finds that few consumers pay attention to online physician reviews even though they’ve gained popularity.

The outgoing CFO of Nevada Regional Medical Center (NV), which is laying off employees and losing $575,000 each month, says, “The biggest expense we’ve had is Cerner’s fees.” Cerner agreed to lower its payments by $31,000 per month for six months and then add $2,000 per month for the remainder of the eight-year agreement (they get paid the same total amount, in other words.)

The local paper says that Epic may reach 10,000 employees by 2018, with much of the growth due to international expansion that will be run from Verona. The article lists “Epic’s 12 Principles” that it says are posted all over its campus:

1. Do not go public.
2. Do not be acquired.
3. Expectations = reality.
4. Keep commitments.
5. Be frugal.
6. Have standards. Don’t do deals.
7. Create innovative and helpful products.
8. Have fun with customers.
9. Follow processes. Find root causes. Fix processes.
10. Don’t take on debt, no matter how good the deal.
11. Focus on competency. Do not tolerate mediocrity.
12. Teach philosophy and culture

St. Vincent Hospital (IN) notifies 1,100 patients that their medical information is in unknown hands after a laptop attached to an EEG machine is stolen. The hospital issues the standard boilerplate in staying it has no reason to think the information is at risk, that it will offer free credit monitoring, and that it just might take a look at encrypting devices one of these days.

All-digital Banner Health (AZ) was all-paper Banner Health Wednesday as its Cerner systems go offline, forcing its hospitals in Arizona, Colorado, and Nevada to go to downtime procedures. The systems came back up Thursday afternoon.

I bragged on buying a cell phone charger to use at HIMSS so I can recharge my iPhone without tethering to a wall jack, but I should have waited: Jay at Lifepoint Informatics saw the mention and said the company will be giving them away at the HIMSS conference. Jay not only says the company is a proud HIStalk sponsor, he even posed the charger with their HIStalk booth sign from last year to demonstrate it. I would get to Booth #6069 early since this is a really nice giveaway.

If you are headed to Orlando, travel safely and I will see you there. If not, thanks for holding down the fort and feel free to take long lunches and leave early because your boss isn’t really working that hard at the HIMSS conference.

Sponsor Updates

• Caristix interfaces the Mirth Connect interface engine to iNTERFACEWARE’s Iguana engine to provide point-and-click migration from one interface to another.
• ScImage announces availability of a universal MPI translator for importing diagnostic images from disparate systems into its  PICOM365 system.
• IMDsoft makes MetaVision AIMS available for anesthesia practices independent of any facility infrastructure and as a subscription-based license.
• DataMotion enables 16 EHR systems to achieve 2014 ONC-ACB certification using its DataMotion Direct secure messaging service as “relied upon software.”
• Ricoh Americas partners with InterSystems to develop new interoperable healthcare solutions, including the Ricoh Healthcare Camera, which allows clinicians to scan barcodes from a patient’s wristband and add information on the injury before taking pictures.
• Surescripts certifies First Databank’s FDB MedsTracker for prescription routing in adherence with the NCPDP SCRIPT 10.7 standard required for MU Stage 2 certification.
• Coastal Healthcare Consulting launches Wave, an implementation solution that encompasses project management, workflow analysis, design, building, testing, training, and go-live support.
• EClinicalWorks deploys Array Network’s APV10650 appliances to consolidate its cloud-based application infrastructure into a smaller number of larger data centers.
• Welch Allyn will use Accelero Connect from Iatric Systems to automate the capture and recording of vital signs into EHRs.
• Bon Secours Medical Group (VA) VP/Chief Clinical Officer Robert Fortin discusses his organization’s move into population health management in an iHT2 article.
• Apelon and Clinical Architecture partner to offer Clinical Architecture’s Symedical with Apelon’s professional services
• Covisint and actuarial Milliman Inc. introduce the Covisint Predictive Analytics solution.
• Liaison Healthcare completes interoperability testing of its Master Person Index and Patient Document Repository offerings with 70 test partners during last month’s 2014 IHE North American Connectathon.
• University Medical Associates (OH) joins the Guideline Advantage quality improvement program, which leverages Forward Health Group’s PopulationManager toolset.
• Orion Health reports that its statewide HIE customer count grew 40 percent in 2013 and its HIE customers increased by 200 percent. The company will open a  development center in Scottsdale, AZ later this year.

Sponsor Speaking Engagements at HIMSS

• Brian Levy, MD, VP of global clinical operations for Wolters Kluwer Health’s Health Language division, will discuss leveraging analytics to capture the benefits of ICD-10 on Wednesday at 11:30 a.m.
• Vital Images will feature VitreaView in a live case study at the Interoperability Showcase on Tuesday at 4:30 p.m.
• Medhost will demonstrate YourCareCommunity in the HIMSS Interoperability Showcase (Hall F).
• Ryan Witt, global manager director for Juniper Networks, will moderate a lunch and learn session Wednesday at 12:30 p.m. that will discussing managing network requirements to support new technologies.
• Intelligent InSites customer Veterans Health Administration will share best practices in implementing RTLS in a Sunday pre-conference symposium.

HIMSS14 in Review
By Vince Ciotti

Since I spend my winters right here in sunny Florida next to Orlando, I thought I’d give readers of HIStalk the advantage of reading the very first report on HIMSS 2014.

• The crowd was huge, way up from last year’s paltry 35,000 to about 40,000 this year. At an average of $800 each for registration fees, that gives HIMSS over $30 million. Maybe next year they’ll lower their annual membership dues.
• Weather was near perfect, although a little on the warm side at about 80 degrees. Interestingly, that was the same temperature inside the hall as well as outside due to the large volume of hot air from all the demo dudes & dollies.
• There were almost 200 booths from vendors new to HIMSS this year, with 195 of them featuring “Big Data” analysis and reporting. Conspicuously absent were major players NSA and Target.
• Vendor booths were absolutely stunning. If you add the out-of-pocket costs for their thousands of marketing mavens and sales reps plus the fees charged for booths and floor space, it was possibly the single largest line item in healthcare costs outside of EHRs.
• The multitudes of speakers had truly impressive PowerPoint files: amazing builds, animation, and other visual effects that must have taken many months of hard work away from providing user service & support.
• 1,275 vendor booths featured banners that claimed they were “Best in KLAS” for one category or another. Indeed, KLAS’s own booth claimed they were rated as the very best source for evaluation of vendors’ true capabilities by… guess who?
• It was hard to count the many new products and releases that were announced, every one of them far better than what clients are suffering with today. All of it was offered at special low pricing for HIMSS attendees who signed up early.
• 417 consulting firms announced new divisions that specialized in Epic implementations, every one of them manned by senior employees (some actually in their 30s) with vast experience of more than one year each.
• Keynote speaker Hillary Clinton surprised everyone when she praised the Affordable Care Act. Her only complaint was that it didn’t go far enough, and whoever becomes the next president really needs to try to improve healthcare even more.

Stay tuned next month — I may have an early report on HIMSS15 in Chicago.

Vince Ciotti is a principal with H.I.S. Professionals LLC.

Ten Tips for Making the Most of Your HIMSS14 Experience
By Jodi Amendola

1. Build your plan around the trends or issues you’re most interested in, then mark the booth and educational sessions that address them.
2. Include networking events in your plans.
3. Building in scheduled breaks throughout the day. Real ones, not check-your-email breaks. Many vendors offer space to sit along with free refreshments.
4. HIMSS14 is not the place to break in a new pair of shoes or to sacrifice comfort for fashion.
5. Take advantage of apps such as the HIMSS14 Mobile Guide; a business card scanner; a personal health monitor; a friend locator; a restaurant and entertainment locator; and apps that let you confirm travel plans for the trip home.
6. Re-invigorate a long-distance relationship over a cup of coffee or a meal and mine your contacts to reconnect with or get to know other colleagues better.
7. Put away the smartphone. Considering how much time and money you’ve invested in being here at the best health IT conference of the year, that email can wait.
8. Connect with the speakers by asking questions during the Q&A, introducing yourself, or connecting via Twitter or LinkedIn.
9. Put a star in the margin of your notes (electronic or handwritten) next to any action item, then distill every session into one or two key takeaways.
10. Share video or audio files of the sessions you found especially valuable with your colleagues and friends or give a talk about something you learned at your next staff meeting.

Jodi Amendola is CEO of Amendola Communications.

EPtalk by Dr. Jayne

I’ll keep it this post relatively short because I am completely overwhelmed by HIMSS preparations and a major calamity at the office. Let’s just say that nothing can prepare you for the chaos that ensues when a provider is arrested in the middle of the work week.

Since it was a solo provider and we had to close the office, I seriously toyed with the idea of using our patient portal to blast a message to the impacted patients, but the risk management department shot me down. I guess it’s better for the patients to sit and wonder what will happen with their care, at least in their eyes.

Inga and I have been hard at work finalizing our social plans for Orlando. We had a reader ask if I would be making a scheduled appearance at the HIStalk booth (#1995 for those of you playing at home.) Although I will definitely be stopping by to pick up my HIStalk tattoo and a Smokin’ Doc pin, I’ll be doing it anonymously. Feel free to swing by, however, and see if there are any sassy blonde physicians lurking about. I’ll probably be there to support some of our scheduled celebrity appearances. I’ll also be at the Medicomp Systems booth (#2703) to support some of my BFFs as they compete in Quipstar.

Most of the events we’re attending are those whose hosts generously agreed to allow us to invite all our readers. Inga and I also have a penchant for hitting the in-booth happy hours, so look for us during the cocktail hour in the exhibit hall as well. I’m trying to fit in some educational sessions in between cruising the booths and taking pictures of ridiculous costumes that the hired booth attendants are forced to wear. Be sure to have your cameras at the ready and feed us pictures of hot shoes, cool giveaways, and the wildest outfits you see.

We’ve also been hard at work identifying the recipients of some of the coveted HIStalk beauty queen sashes. Don’t worry, there is still a chance to win one for yourself by entering Inga’s shoe contest or aiming for the coveted HIStalk King and HIStalk Queen titles.

I look forward to HIMSS each year, but it’s bittersweet on some levels. While many of us are away, we will be depending on the rest of our colleagues in the trenches to keep the infrastructure running and the providers under control. Although a lot of vendor organizations freeze in time around HIMSS, the rest of the health IT world does keep turning.

Case in point: NCQA announces the opening of a public comment period for proposed changes to the HEDIS measures for 2015. Proposed new measures include one on overuse of colorectal and prostate cancer screening and another on appropriate use of antipsychotic measures in children. Those slated for retirement include glaucoma screening in older adults and cholesterol management for patients with cardiovascular conditions.

HHS release a model Notice of Privacy Practices in Spanish. Since over 38 million people in the US speak Spanish, it’s about time. The offerings include fillable forms that can be printed for patients and are designed for both provider organizations and health plans.

The hot topic of conversation in the physician lounge this week has been the publication of the final rule amending the 1988 CLIA regulations to allow patients and their designees to receive lab results directly from laboratories. Physicians are generally resistant to anyone releasing lab or test results directly to the patient. Most of the time they cite concerns that the patient will not be able to interpret the results or that they may be confused or even harmed by results that lack explanation.

Our health system releases results to patients without physician review after 96 hours, so physicians have had to get on the ball and notify patients in a timely manner because the patients are going to receive their results if they are enrolled on the patient portal. There are a couple of tests that are restricted (like HIV and sexually transmitted infection labs) due to state privacy laws, but pretty much everything else in the lab or radiology realms is fair game.

Personally, I think it’s about time that other organizations have to start jumping through all the hoops that providers do with all the different rules that continue to be propagated. In this case, they only require the release of information within 30 days. Let’s make them release within three days like the rest of us and see how they do.

I’m off to pack. Including a half marathon in my weekend plans has definitely added to my fashion worries. If you happen to be at Walt Disney World in the wee hours of Sunday morning, keep an eye out for me as I run through Cinderella’s Castle in bling that even Inga would envy. Otherwise, my next report will be from the HIMSS opening reception.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Travis, Lt. Dan, Lorre.

More news: HIStalk Practice, HIStalk Connect.