Monday Morning Update 9/2/13

From The PACS Designer: “Re: TPD’s back. Since development efforts on a cloud based ICD-10 solution are winding, down it allows TPD the time to post again. A significant event took place concerning Apple this week which could be of interest to HIStalkers, and that is Apple’s acquisition of software company AlgoTrim. Their software improves access speeds to large file sizes typical  and larger diagnostic imaging studies that are more prevalent than ever in today’s practices. The AlgoTrim Fast Compression Library is the fastest lossless codec (compression) on the market, with speeds four times faster than similar codecs.”

I’ve been saying for years that companies need to override their lead-happy sales and marketing people and make their advertising material (like white papers and case studies) freely available on the Web without requiring completion of a sign-up form. My survey results back that up all the way. Half of a company’s prospects run for the hills when faced with a form, and another quarter provide phony information to avoid the dreaded follow-up call. Add in the number of people who sign up but don’t return calls and you’ll see the futility of trying to drum up product interest via an intrusive data collection form. New poll to your right: if you routinely attend the HIMSS annual conference, what’s your primary reason?

Just a reminder: a couple of folks with outstanding credentials will present a free HIStalk Webinar, “The HIPAA Omnibus Rule: What You Should Know and Do as Enforcement Begins” next Tuesday, September 10 at 2:00 p.m. EDT. Their presentation is not sponsored – they just stepped up when I asked for volunteers to go over the changes for readers now that the enforcement date is upon us. Thanks to our presenters from The Advisory Board Company: Rebecca Fayed, associate general counsel and privacy officer; and Eric Banks, information security officer. I watched their practice session and it’s meaty and fluff-free in the admirable Advisory Board fashion.

Financially struggling 68-bed Gila Regional Medical Center (NM), a Stage 6 EMRAM hospital and Meditech customer, eliminates its CIO position after the departure of David Furnas (and most of the executive team) earlier this month.

Joe Miccio (Divurgent) joins ESD as regional sales VP.

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.

I’m constantly annoyed by websites (including healthcare IT ones) that tart up worthless “news” stories with catchy headlines, gratuitous graphics, annoying slide shows, and shameless ploys to get more clicks to impress potential advertisers. That’s all I’ll say since I can’t outdo The Onion’s eloquent criticism of CNN’s decision that Miley Cyrus is the most important news in the world, packaged as a phony confession from CNN’s editor, which is summarized as, “All you are to us, and all you will ever be to us, are eyeballs. The more eyeballs on our content, the more cash we can ask for. Period. And if we’re able to get more eyeballs, that means I’ve done my job, which gets me congratulations from my bosses, which encourages me to put up even more stupid bullshit on the homepage … Advertisers, along with you idiots, love videos.” Right now on CNN as some of its top stories: “The best cat video of all time is …”, “What Miley’s saying now”, “Twin baby pandas now fuzzy, cute,” and “Hear painful beauty pageant blunder.” You won’t find any of those stories on the BBC, although it probably gets a lot less traffic in not pandering to the average American reader. In healthcare IT, you get the added bonus of writers who have never worked in healthcare IT trying to explain it to experts or even editorializing about it, which would be like an unathletic sportswriter telling Peyton Manning how to throw a football.

The non-profit Medical Identity Fraud Alliance launches with founding members that include AARP and the Blue Cross Blue Shield Association. The group says its goals include driving policies, laws, and technology to reduce medical identify fraud.

Wake Forest Baptist Medical Center’s botched Epic implementation caused it to lose $55 million in the fiscal year on the operations side, according to its preliminary financial report. The hospital says the Epic implementation “did have a substantial negative impact on fiscal 2013 operating performance through both direct implementation expenses and associated indirect expenses,” causing a $54 million hit due to go-live disruption, deferred operational improvements, and billing problems.

The US Army is preparing for a major upgrade to its MC4 battlefield EMR that will include a move to Windows 7, replacing Micromedex with Lexicomp, adding a graphical user interface to TC2, and requiring a PKI-E certificate for security.

In England, NHS expects up to 50,000 clinicians to learn the basics of programming under its Code4Health initiative, which hopes to encourage them to develop prototypes that NHS can turn into open source tools. The program is based on the US Code for America program, which encourages government employees to learn programming. Code for America is described above in a TED talk by its founder and CEO.  

A North Carolina comprehensive clinic for the uninsured closes, blaming a loss of funding, the state’s decision not to expand Medicaid coverage, and a loss of productivity caused by its new EHR.

The Federal Trade Commission files a complaint against  Atlanta-based LabMD, claiming that a patient-specific billing worksheet with information on 9,000 of its lab test patients was found on a file-sharing network and later in the hands of identity thieves.

Vince continues his HIS-tory of Cerner, from which I learned where the name originated and how the IPO came about.

Happy Labor Day, especially to those actually laboring on healthcare’s front lines. It may seem like the end of summer, but officially you still have three more weeks to wear those snazzy white shoes and seersucker suits.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

News 8/30/13

Top News

HHS and the Illinois attorney general announce that they will investigate the July 15 theft of four unencrypted Advocate Medical Group desktop computers that contained the medical information of 4 million patients, announced last week. An HHS spokesperson signaled the financial exposure the medical group is facing in describing the “high-profile actions that have sent clear messages to the industry that we expect full compliance with privacy and security rules.” Advocate admits that the information should never have been stored on the hard drives. Obviously encryption technology would be throwing off some impressive ROI right about now, which might be something to consider if your organization hasn’t implemented it.

Reader Comments

HIStalk Announcements and Requests

Highlights from HIStalk Practice this week include: Physicians are split when it comes to publicly sharing Medicare payment data. New York physicians are required to consult an electronic prescription database before writing scripts for controlled substances. The benefits of a practice’s ACO participation reach beyond the patients covered by the ACO. MGMA offers online scheduling tools for its annual conference. More than 90 percent of office-based physicians accept new Medicare patients, which is about the same percentage that accept new privately insured patients. The AMA urges CMS to prohibit insurers from paying physicians less than contracted amounts when reimbursing providers with plastic or virtual credit cards. Doximity says it has more physician members than Sermo. I look at the Stage 2 dilemma, highlighting the recommendations of various professional organizations and offering my opinions, namely that CMS should keep the January 2, 12014 start date but extend the deadline for meeting Stage 2 requirements. You won’t find any of these stories – and others – on HIStalk so keep reading HIStalk Practice if you like staying current with happenings in the ambulatory HIT world. Thanks for reading.

Welcome to new HIStalk Platinum Sponsor InterSystems. The company is a global leader in software for connected care. Its products empower healthcare professionals with the information they need to make the best clinical and business decisions. HealthShare is a strategic platform for healthcare informatics, enabling information exchange and active analytics across a hospital network, community, region or nation. Cáche is the world’s most widely used database system in healthcare applications. Ensemble is a platform for rapid integration and the development of connectable applications. InterSystems has more than 35 years of experience as a trusted partner serving thousands of physicians, hospitals, and health systems around the world, including Johns Hopkins, Kaiser Permanente and Memorial Care; five statewide HIEs; and the national health systems of Sweden and Scotland. The company’s technology is also used by over 100 leading healthcare software vendors in their solutions, including 3M Health Information Systems, Epic, and GE Healthcare. Thanks to InterSystems for supporting HIStalk.

A YouTube cruise turned up this video about InterSystems. I thought I knew the company pretty well, but I learned a lot about them.

On the Jobs Board: Staff Engineer (Java), Clinical Applications Consultant, Project Manager.

HIStalk Webinars

CareTech Solutions will present “Using Infrastructure and Application Monitoring to Assure an Optimal User Experience” on Thursday, September 19, 2013 at 1:00 p.m. Eastern. The presenter will be John Kaiser, senior director of the Pulse IT monitoring service. The abstract:

It’s time for hospital IT monitoring to mature – from reactive to predictive. Supporting the highly-complex healthcare technology environment with only individual monitoring tools or relying on an application vendor to identify system degradation is not the most effective means to providing users with a reliable, optimal IT experience. A comprehensive monitoring solution includes eyes on servers, network, application performance, and real user monitoring. CareTech Solutions will discuss an integrated approach to comprehensive monitoring of both the infrastructure and applications, with an emphasis on delivering a consistent solution based the hospital’s IT maturity level. The target audience is CIOs, CMIOs, CNO, IT directors, and IT analysts.

Acquisitions, Funding, Business, and Stock

The healthcare IT business unit of Tennessee-based Parallon Business Solutions, itself a subsidiary of Hospital Corporation of America (HCA), merges with Vision Consulting to form Parallon Technology Solutions, with Vision President Tim Unger taking the CEO role. Parallon Business Solutions has 24,000 employees and provides services to 1,400 hospitals and 11,000 non-acute care providers.

Carl Icahn boosts his stake in Nuance to 16.9 percent of the outstanding shares, according to an SEC filing Tuesday, saying he may want to talk to the company about adding his slate of nominees to the board. Above is the one-year NUAN share price in blue vs. the Nasdaq in red.

Sales

Blessing Physician Services will deploy Phytel’s population health management suite.

Rideout Health (CA) will roll out Perceptive Software’s Enterprise Content Management solution integrated with its McKesson Paragon HIS.

People

McKesson Specialty Health and the US Oncology Network appoints Michael V. Seiden, MD (Fox Chase Cancer Center) CMO.

Physician RCM provider MedData promotes Ann Barnes from president to CEO.

Announcements and Implementations

Australia’s Noarlunga Hospital activates Allscripts Sunrise Clinical Manager.

Novant Health (NC) reports that 343 of its physician clinics are now live on Epic’s PM platform and 316 are live on EHR. The five-year project was completed three years ahead of schedule and under budget.

Humana and Centene join Verisk Health as founding members of its pooled data initiative, which uses Verisk’s database of cross-payer information and analytics to identify illicit billing practices.

Hawaii Advanced Imaging Institute upgrades to RamSoft’s PowerServer RIS/PACS/MU radiology workflow application.

Home device manufacturer Bosch Healthcare and health content vendor Remedy Health Media announce a partnership to develop and sell products for remote patient monitoring.

Government and Politics

ONC opens the Behavioral Health Patient Empowerment Challenge to highlight existing technologies to help patients manage their mental health or substance use disorders.

A Washington Post article says that the Department of Veterans Affairs was paying bonuses to its disability claims employees despite a mammoth backlog, thereby encouraging them to game the system by pushing the tough claims aside to boost their numbers. It does point out that employees were handling high claims volumes even though the number of claims made the backlog grow.

Other

Skyline Exhibits provides trade show stats that vendors might use to justify for exhibiting: (a) 81 percent of trade show attendees have buying authority; (b) the top reason for attending is to see new products; and (c) building brand awareness is the highest marketing priority for most exhibitors. Marketing execs may very well need to look for justification considering that a 10×10 booth at HIMSS costs about $4,000. Tack on drayage, shipping, travel, trinkets, and personnel and you’re at $20K in no time.

Coming to a baby shower near you: a smart sock from Owlet Baby Care that monitors a baby’s vitals and sleep position and includes a four-sensors pulse oximeter, an accelerometer, a thermometer, and a transmitter to send data to a smartphone or computer. The company’s cofounder says the device does not require FDA clearance, though a version that includes an alarm system for oxygen levels will. Owlet is seeking $100K in crowdfunding.

Here’s a story of interest to anyone in charge of their organization’s encryption efforts. UT Physicians (TX), the medical group practice of the UTHealth Medical School, notifies 600 patients of a potential data breach after the theft of an unencrypted laptop. Unlike similar thefts at other organizations, UTHealth has a comprehensive encryption policy that covers more than 5,000 laptops. The stolen laptop was overlooked, however, possibly because it was attached to an electromyography machine in the orthopedics department and is considered more of a medical device than a standard computer. The laptop included patient names, birth dates, and medical record numbers, but no financial information.

Researchers in Canada find that the use of RFID badges raised the handwashing compliance of nurses from 33 percent to 69 percent. Their study appears in the current issue of CIN (Computers, Informatics, Nursing). I wasn’t familiar with that journal even though it’s been around in various forms since 1983, but it looks decent.

Fourteen-hospital Baptist Memorial Health Care Corp. lays off 61 employees, including pharmacists and nurses, but urges them to reapply for 500 open positions, many of those newly created to support its Epic rollout.

If you’re a fan of evidence-based medicine or Coldplay, you’ll like this video, which was tweeted by Farzad Mostashari.

Spectrum Health (MI) fires several employees after one of them takes a picture of an ED patient’s rear and posts it to Facebook with a caption of, “I like what I like.” The health system fired the employee who took the picture and all of those who gave it a Facebook Like, including an ED doctor.

Marin General Hospital (CA) asks the FBI to investigate a possible scam that shut down the phones in labor and delivery and the ED last week.

Liviam announces its Facebook-like site for long-term hospital patients, which offers the CareStream timeline, a dashboard from which the patient can request help, a blogging tool, and an events calendar.

New York prescribers issuing prescriptions for pain meds must first check an online registry of pharmacy-reported filled narcotics prescriptions as of this past Tuesday, implemented to help curb the abuse of addictive drugs.

Sponsor Updates

• Truven Health Analytics offers free access to Micromedex iPhone apps for customers outside the US and Canada. Truven also announces enhancements to its Unify Population Health Management solution, which is deployed in partnership with CareEvolution.
• Iatric Systems announces that its Meaningful Use Manager and Public Health Syndromic Surveillance products have earned 2014 ONC HIT certification.
• IHS names Merge Healthcare the leading provider of vendor-neutral archive solutions in the world and in the Americas.
• iSirona adds Singapore-based telehealth services provider myHealth Sentinel as a reseller.
• The Massachusetts eHealth Institute awards Aprima Medical a $101,000 grant to advance the interoperability of EHRs with the state’s HIE.
• Besler Consulting releases a review of the FY2014 Hospital Inpatient Prospective System final rule.
• InstaMed achieves Phase III CAQH CORE certification.
• EClinicalWorks names HealthNet (IN) the winner of its Improving Healthcare Together video contest. Auburn Medical Group (GA) and Open Door Family Medical Centers (NY) took second and third places.
• Aspen Advisors shares details of the ICD-10 preparation services it delivered to East Jefferson General Hospital (LA).
• Dearborn Advisors discusses the need for healthcare organizations to optimize their EHRs in order to thrive in today’s regulatory climate.
• API Healthcare highlights the importance of meeting the needs of an aging workforce.
• pMD announces that its mobile charge capture solution will support iOS 7, which has a possible September 10 general availability.
• Visualutions will resell Wellcentive’s Advance to FQHCs.
• RazorInsights will showcase its ONE Enterprise HIS solution at the 15th Annual HIS Pros Buyer’s Seminar next month in Rosemont, IL.
• Medicomp hosts its annual strategy update webinar September 18 and 19 and opens registration for MEDCIN U sessions November 3-5 in Reston, VA.

EPtalk  by Dr. Jayne

It’s quite a challenge to try to keep up with Mr. H and Inga in finding newsworthy items each week for EP talk. Between our day jobs and our staggered publishing schedules, it’s easy to be scooped by another member of the HIStalk crew. In the spirit of mixing things up, we’ll be taking EPtalk in some new directions. I may write up an interesting product, discuss a recent journal article, or respond to something I’ve seen in social media. Since EPtalk runs with the news each week with a slightly different audience than Curbside Consult, I may do some multi-part pieces to allow reader responses to influence the next week’s piece.

Yesterday, @ONC_HealthIT tweeted a recent Wall Street Journal Health Blog piece that asked readers what doctors use as the basis for care decisions: business or financial considerations, fear of lawsuits, or doing what is best for patients. I was gratified that with over 1100 votes, 56 percent of respondents believe we want to do right by patients. The other two options tied at 21 percent.

I’ve spent a good part of my career working in emergency departments and urgent care situations. I have to agree that fear of lawsuits can be an important driver. Financial considerations are also important, but there are many nuances other than what this survey can capture. Case in point: at one of the hospital-owned urgent care centers where I moonlight, the leadership issues a monthly report that looks at our utilization. On the surface, this aims to encourage us to provide more cognitive medicine and perform less defensive medicine.

Although thoughtful practice is a nice goal, I’d be kidding myself if I thought the report was aimed at encouraging us to use our brains rather than tests. The fact of the matter is that our population is largely uninsured, with Medicaid and Medicare closely behind. The hospital has been hemorrhaging money for the last decade despite extremely good management. It’s largely due to payer mix and other external economic factors in the community. Across our department, the Family Medicine physicians have much lower service utilization than do the Emergency Medicine physicians, and I think it’s partly due to the way we see the patient population

As a family doc, I’m used to seeing patients quickly in the office, treating their self-limited problems, and moving on. There’s a relationship between the patient and the physician. We tend to think that if the patient is becoming worse or not improving, they’ll be back. We don’t feel that pressure to try to cover all eventualities while they are in front of us, although it’s become that way with the advent of the Patient-Centered Medical Home, Accountable Care, and other initiatives where every visit has become a preventive/full-service visit as we try to cram as much as humanly possible into each encounter.

I really try not to order tests if I can make the diagnosis based on clinical history and physical examination. Not just for cost reasons, but also because tests are not without risk. Even a simple urinalysis can give false positives that lead to unnecessary follow-up, including not only financial cost but the burden of patient anxiety.

I’m also not afraid to play the bad guy with patients when it’s indicated. I don’t care if your husband’s primary doc gave him antibiotics for his viral illness. Just because you came to the urgent care and have the same symptoms, you’re not going to get them from me. I don’t care if your copay was $50, it’s not the right thing to do. It’s likely you’ll mark me down on your patient satisfaction survey, but I’ve reached a point in my career where I simply care less about satisfaction scores than I do about quality care and antibiotic resistance. You’ll get my empathy, sympathy, and some symptomatic treatment, but no Z-pack for you.

My peers that trained in emergency residency programs tend to order more X-rays for vehicular trauma even if the clinical story isn’t that impressive. Maybe it’s fear of being sued or maybe it’s just the way they’ve been habituated from working in higher acuity and trauma centers rather than the ambulatory office. Maybe because there was that one case where they missed something and it came back at them later. It’s definitely harder to try to help a patient understand why decision support rules say it’s OK to not order an x-ray than it is to just shoot a film, and sometimes I order those films too. None of us is perfect and medicine still has some art to go along with the science.

The most interesting thing about the utilization reports, though, is that over the last year, they have done very little to drive any of physicians at the high end of the test ordering spectrum into a lower bracket. Right now, the only “incentive” provided is seeing your name on the report and where you fall against your peers. Some docs may consider these reports the way I see the physician satisfaction numbers – as something that’s not on the top of their list for the many things we have to worry about when we’re seeing patients. Others may need education or potentially something more tangible before their behavior will change.

The bottom line, though, is that defensive medicine is alive and well regardless of steps towards tort reform, provider education, and other interventions. I’ve been doing some thinking about the other 21 percent as well. I’d liked to have seen the “financial considerations” choice expanded to include other options but you’ll have to tune in to the next post for those thoughts.

I’ll still throw in the occasionally newsy tidbit especially if it involves both shoes and technology. A new CT scan technology by CurveBeam called pedCAT shows what the foot and ankle actually look like when weight bearing. I was fascinated by the YouTube clip from the Royal National Orthopaedic Hospital. Since I was hobbling around this afternoon due to a loose heel on my favorite pair of pointy-toed mules, it’s a sure bet that my scan would have more than one ICD-10 code associated with it. I’m leaning toward “Unspecified soft tissue disorder related to use, overuse and pressure” and “Grief reaction” since I ultimately had to pronounce said mules dead at 6:59 p.m.

Contacts

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

More news: HIStalk Practice, HIStalk Connect

News 8/28/13

Top News

Two Kansas HIEs, one covering Kansas City and the other serving the rest of the state, risk losing their federal grant money if they can’t agree on data exchange terms by the state-imposed deadline of September 30 (already extended from July 30). LACIE and KHIN could be forced to shut down by the end of the year if they haven’t worked out their differences by then. KHIN doesn’t want the network to share data with insurance companies that aren’t KHIN members, while LACIE says the agreement would prohibit organizations that are connected to an ACO from accessing the network’s data. At issue is aggregated information that could be used for non-patient care purposes. The Kansas HIE board voted to shut itself down in September 2012 and let the Kansas Department of Health and Environment take over its duties, which means the state is in charge. Kansas has no secondary data use policy.

Reader Comments

From Joyce: “Re: Mission Hospital, Asheville, NC. Laying off 70 workers, which is big news in a small town where healthcare supports the local economy.” The 730-bed hospital will cut the CEO’s salary by 26 percent, slash management salaries from 13 to 20 percent, eliminate merit increases, implement a three-month PTO freeze where time off is not accrued for worked hours, reduce its 403(b) matching, and reduce the employee wellness incentive. The hospital’s CEO made $480K in 2010, while the CIO was paid $349K. That’s the problem with hospitals – they provide growth to their local economy, but much of that is paid for by federal taxpayers in the form of unsustainably rising national healthcare costs. Building an economy based on healthcare won’t work, which politicians seem reluctant to admit since hospitals employ a lot of people and write nice political donation checks.

From HealthPlans: “Re: WellPoint. AJ Lang is no longer with the company, an internal employee tells me.” A WellPoint spokesperson confirms that Andrew J. Lang, senior VP of application development since December 2008, is no longer with the company.

From Mennonite Rockstar: “Re: BIDMC IT security after the Boston bombing. I had the impression they rearranged the setup of their homegrown application’s security from reading the Fast Company article. Perhaps Mr. HIStalk can get Halamka to clarify?” John says that his IT shop made no changes to their applications, but did tweak their audit log reports to allow the hospital’s compliance department to monitor the specific situation.

Acquisitions, Funding, Business, and Stock

Group purchasing organization Premier Inc., owned by 181 hospitals, health systems, and other healthcare organizations, files plans for an IPO of up to $100 million in common stock. Premier had $869 million in net revenue for the fiscal year that ended June 30, up 13 percent from the prior year.

Merge Healthcare Chairman Michael Ferro, Jr. resigns and is replaced by board member Dennis Bell. Ferro, Merge’s top shareholder, has indicated that he may eventually explore ways to boost shareholder value, including taking the company private. MRGE shares were unchanged on the news.

Federal HIT provider Systems Made Simple projects 2013 income of $260 million, up from $167 million in 2012.

The strategic venture arm of Canada’s TELUS makes an unspecified investment in Rockville, MD-based Get Real Health, which offers the InstantPHR personal health record. Three of the company’s seven executives came from US Web, while two were Microsoft HealthVault developers.

Sales

Southern Prairie Community Care ACO (MN) will deploy technology from Sandlot Solutions to manage patient health information and give providers access to data  at the point of care.

HealthproMed (PR) selects eClinicalWorks EHR for its two-location FQHC.

Greenway Medical will develop an HIE for more than 500 physician members of the Denver-area Rose Medical Group, Rose Medical Center, and their patients.

Grady Health System (GA) selects Strata Decision Technology’s StrataJazz for cost accounting, operating budgeting, and capital planning.

PinnacleHealth will use Care Team Connect’s integration and rules engine to integrate biometric data from Honeywell monitoring devices with other patient health data.

Palmetto Health (SC) chooses 3M 360 Encompass System for automated coding, clinical documentation improvement, and performance monitoring.

The National Football League signs a 10-year agreement for the ININITT Smart-NET PACS, which will allow the medical images of players to be viewed remotely or from mobile devices on the sidelines.

People

QHR Corporation, a Canada-based HIT company, names Owen Haley (Allscripts) chief commercial officer.

Tony Scott (Microsoft) joins VMware as CIO.

Cumberland Consulting Group adds Joseph Serpente (McKesson) as director of business development.

Announcements and Implementations

PeaceHealth’s Peace Island Medical Center (WA) goes live on Epic September 1.

Emdeon launches a self-service testing exchange solution for ICD-10, allowing providers and channel partners to submit ICD-10 test claims and receive claim status feedback. The Emdeon Testing Exchange for ICD-10, which Emdeon purports is the first of its kind in the industry, requires no additional software and is a free service to Emdeon providers, channel partners, and payer customers. Sounds like a great service that would be even more valuable if more payers were ready and if providers already had ICD-10-ready software updates from their vendors.

Greenway presents Innovation Awards to Boulder Community Hospital Physician Clinics (CO), Regional Obstetrical Consultants (TN), and Albuquerque Health Care for the Homeless (NM) at its PrimeLEADER user conference in Washington, DC.

Sonora Regional Medical Center (CA) goes live on Cerner September 4.

Vocera announces enhancements to its secure messaging platform that include on-call scheduling, new smartphone clients, an improved Web console, and server enhancements.

I came across this tweet today. Ah, athenahealth, I don’t think you can convince me that switching EHRs is as easy as switching from Time Warner to AT&T U-verse.

Innovation and Research

University of Florida researchers are developing a scoring model that will use hospital EHR information to identify inpatients most likely to experience an adverse drug event, allowing those patients to be more aggressively monitored. The result will be rolled out to 13 hospitals for validation in the study’s second year.

Technology

An Ohio surgeon wearing Google Glass during a surgery broadcasts the procedure over the campus network, also using it to consult with a colleague.

Other

Apple is rumored to be planning a trade-in program for iPhones in an attempt to increase the percentage of units it sells directly. What Apple is really trying to do is get  more people like me to walk into their retail stores and spontaneously drop $50 on the latest, greatest cool Apple accessory. The speculation is that Apple will tie the trade-in value to the cost of an upgraded iPhone and offer an amount less than the open market value or what third-party companies like Gazelle would pay. I’m not due for a discounted upgrade any time soon, but my 16GB iPhone 5 is almost filled up. Maybe I’ll be one of the nerdy folks queuing up in line at the Apple store the first day the newest iPhone is released, supposedly in late September.

Cerner and Epic are winning three-fourths of all new large-hospital EMR deals, according to a new KLAS report on clinical market share. Cerner and Epic dominate in community hospitals, though McKesson Paragon and Meditech are gaining some traction. Biggest net customer losers for 2012 were McKesson and Siemens, while Epic was the only vendor that didn’t lose any customers. Allscripts, GE Healthcare, and QuadraMed had no wins at all.

HIMSS opens registration for its annual conference February 23-27 in Orlando. Aetna CEO Mark Bertolini will deliver the keynote address bright and early Monday, while Wednesday afternoon’s keynote speaker is still TBA. The Thursday afternoon keynote is “world class blind adventurer” Erik Weihenmayer, who unfortunately may not be enough of a draw to prevent weary crowds from making a mass exodus Thursday morning.

A California Nurses Association press release claims that Sutter Health’s Epic system went down Monday at its Northern California hospitals following an eight-hour upgrade-related downtime on Friday. A union spokesperson was quoted as saying, “This incident is especially worrisome. It is a reminder of the false promise of information technology in medical care. No access to medication orders, patient allergies and other information puts patients at serious risk. These systems should never be relied upon for protecting patients or assuring the delivery of the safest care.” While the union did not issue an equally passionate press release extolling the virtues of paper charts, it did throw in unrelated shots at management for urging nurses to enter patient charges correctly, apparently preferring that Sutter not bill what it’s owed even though those funds allow it to generously pay unionized nurses.

The Gainesville, FL newspaper profiles 12-employee RegisterPatient (now using the name Ingage Patient)and its CEO Jana Jones, who was formerly CEO of BCBS of Tennessee subsidiary Shared Health. According to the company’s site, the product offers appointment scheduling, alerts, registration, secure messaging, check-in, health education, a PHR, care plan integration, renewal requests, and electronic referrals.

This photo by @Nurse_Rachel_ is surely embarrassing Sinai Hospital of Baltimore as it lights up Twitter. Nobody should be surprised that hospitals and doctors do whatever pays them the most; to expect otherwise is naive.

Weird News Andy says, “Nurse, doctor, what’s the difference?” A draft VA policy would eliminate the requirement that advanced practice nurses, including nurse anesthetists, be supervised by physicians. Take a wild guess at how the American Society of Anesthesiologists feels about that.

WNA also notes an AARP report warning  that 20 years from now, aging baby boomers won’t have enough family members to take care of them because of increased longevity, fewer children, and a high divorce rate. Family care is worth an unpaid $450 billion per year

Technical problems with the site Sunday and early Monday forced me (for reasons too hard to explain) to remove Vince’s HIS-tory of Cerner in the Monday Morning Update and simply link to it instead. Here it is again. Meanwhile, the site is now running on a supercharged new server that will better handle the readership growth. I’ll probably appreciate that more after I’ve caught up for all the sleep I lost over the weekend as the web hosting people fixed the inevitable problems.

Sponsor Updates

• Imprivata introduces OneSign ProveID Embedded for use within virtual desktop environments.
• GetWellNetwork announces the call for presentations for its seventh annual user conference June 3-5, 2014 in Chicago.
• Frost & Sullivan recognizes Merge Healthcare with the 2013 North America Award for Product Leadership in Interoperability Solutions for its iConnect Enterprise Clinical platform.
• Wakely Consulting Group will process data from Truven Health MarketScan Research Databases through its Wakely Risk Assessment Model to help health plans meet HHS requirements for risk adjustment and reinsurance.
• Jason Fortin, senior advisor at Impact Advisors, discusses MU deadlines.
• The HCI Group is named to the Inc. 5000, coming in at #3 with 24,545 percent revenue growth in the past three years.

Contacts

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

More news: HIStalk Practice, HIStalk Connect

Morning Headlines 8/26/13

The CIO: Healthcare’s New Million Dollar Man

SSi Search surveys 178 healthcare CIOs on changes to their roles and responsibilities post-HITECH and compares that with associated salary increases. 23 percent of respondents reported a 50 – 75 percent increase in responsibility since HITECH was passed, but reported receiving less a 10 percent salary increase over the same period.

Kaiser Permanente Opens New Information Technology Center in Greenwood Village

Kaiser Permanente opens a five-story, 350-person IT office in Greenwood Village, CO which it estimates will house 700 employees by 2015.

NYC Macroscope Puts Data at the Fingertips of City Officials

New York City public health workers are developing a big-data surveillance program that promises real-time population health monitoring of the city. The program will rely on EHR data aggregated into a surveillance tool that will drive public health decisions.

Class 2 Recall Picis EDIS PulseCheck

Picis recalls its PulseCheck EDIS due to problems with prescription comments being dropped from electronic prescriptions when filed or printed.

Monday Morning Update 8/26/13

From Todd: “Re: FDA security guidance. FDA has published radio frequency guidance for wireless medical devices that includes information about authentication and encryption to prevent hackers from gaining control. FDA has a draft out for comment that includes a requirement that vendors develop a plan to apply operating system updates and patches to address security flaws.” It’s strange (or typical government efficiency) that a document that went to draft in January 2007 finally gets published years afterward. The cybersecurity draft came out in June.

From Digital Bean Counter: “Re: Optimity Advisors. Anyone have experience working with them?”

From Keith: “Re: EHRs. If they aren’t medical devices, why is the vendor reporting to the FDA and recalling its care controlling system?” Picis announces a Class 2 recall of its ED PulseCheck emergency department information system due to a problem printing entered notes along with prescriptions. My guess is that Picis (part of OptumInsight) commendably reports through FDA even though they aren’t required to since I’ve seen their entries in the MAUDE database over the years. Demands for FDA oversight would be reduced to almost nothing if vendors reported and tracked software defects with the same enthusiasm as they do unpaid invoices.

Most poll respondents don’t think the FDASIA report will improve IT-related patient safety since it limits its scope to a user reporting mechanism and other forms of post-marketing surveillance. New poll to your right: when a vendor requires you to register before downloading a white paper you want to see, what do you do? I will, as the poll maker, unprofessionally expose my bias in stating that I think hiding advertising material behind a lead-gathering signup form is both stupid and insulting. We hospital people are smart enough to figure out how to contact you if your material inspires us to further action; we aren’t fans of being cold called as punishment for being willing to give your material a look. Do the sales and marketing people a favor and ignore their faulty advice. I always sign up with phony information, inserting the vendor’s own phone number in the required slot.

I  ran a reader’s question in Friday’s news asking for hospitals that have switched from Cerner to Epic. Readers provided these: Aurora, Legacy Health Portland, Children’s Dallas, University of Utah (underway), Rex Healthcare, Loma Linda, and Lucile Packard (underway). I appreciate the information, which then led me to another question as it often does: have any hospitals voluntarily switched from Epic to Cerner?

XIFIN, which offers revenue cycle solutions for laboratories, radiology,  and pain management, acquires PathCentral, a vendor of cloud-based digital anatomic pathology vendor with big-name customers such as Johns Hopkins, Mass General, and University of Southern California.

A medical assistant / IT administrator at an orthopedics practice is arrested for stealing a pre-signed blank prescription form from the the practice’s EMR and writing himself a prescription for Percocet.

The Washington Post profiles Altruista Health, a 75-employee Reston, VA company that offers predictive algorithms that identify a provider’s highest-risk patients. I ran a Readers Write article by CEO Ashish Kachru in December 2012.

URAC and the Leapfrog Group announce the second annual Hospital Website Transparency Awards, which recognizes websites that portray quality measures honestly and contain information that’s actually useful instead of the far more common marketing BS (stock photo photogenic doctors, community chest-puffing, and unsubstantiated claims that locals are incredibly lucky to have a world-renowned medical facility in a town too small to even have a mall.)

Wisconsin Statewide Health Information Network says it will go live soon, running on the Medicity platform.

A 178-respondent CIO survey performed by SSi-SEARCH finds that the average CIO makes $286K, but despite greatly increasing workload and responsibility, receives single-digit annual salary increases. Still, almost 60 percent of respondents say their pay is satisfactory. They report that people- and team-related issues are both their biggest challenge and their biggest accomplishment. Only 11 percent of the CIOs aspire to a non-IT role, but those who do are interested in a COO position despite responses indicating that it’s tough for a CIO to be recognized as a strategic leader outside the IT realm.

An Allscripts promotional video filmed at Sarasota Memorial Hospital (FL) celebrates the hospital’s 15 years on Sunrise and features VP/CIO Denis Baker.

New York City is piloting NYC Macroscope, which aggregates EHR data into a public health surveillance database that will allow city officials to monitor the health of the population in near real time. Their only concern is that its data is, by definition, limited to those patients who receive medical care, so the city will still need to conduct traditional survey-based surveillance. Data exchange has been established with 3,200 providers in the NYC Primary Care Information Project, which uses eClinicalWorks and distributes queries through the Hub Population Health System.

Advocate Medical Group (IL) announces that four unencrypted desktop computers were stolen in a July 15 burglary that contained basic patient information and Social Security numbers on 4 million patients.

Bats Global Markets, the nation’s third-largest stock exchange with $101 million in 2012 earnings, is discussing a merger with another exchange that would make it larger than Nasdaq. Bats was started by former Cerner employee Dave Cummings in 2005 as an electronic trading company. The company was supposed to go public in 2012 by being listed on its own exchange, but a software bug froze its systems seconds after its executives rang the trading bell, causing Bats to cancel its IPO as the word spread and underwriters feared a steep share selloff. Cummings may have learned email etiquette from his former boss Neal Patterson as he immediately sent a scathing ready-fire-aim internal email cancelling all bonuses.

Texas Health Resources names Luis Saldaña, MD as CMIO of the 25-hospital system.

Two executives of Eastern Connecticut Health Network, including VP/CIO Charlie Covin, leave the organization abruptly as it prepares to sell itself to for-profit Vanguard Health Systems.

Kaiser Permanente opens an IT center in Greenwood Village, CO, with the current 350 employees working there expected to double by 2015.

The accounting department of University of Mississippi Medical Center accidentally sends an email to 190 students Wednesday evening with an attached worksheet containing the Social Security numbers, GPAs, and other personal information of all 2,300 of its students. It frantically tried to recall and then purge the message, but 115 of the students had already opened it and three had forwarded it to an external email address.

The Roanoke newspaper reports that the former president and CEO of Carilion Clinic (VA) received $6.2 million in final compensation when he left in 2011.  Another Carilion CEO who retired in 2001 received a $7.4 million lump sum payout that was only one of two installments he earned for honoring his non-compete agreement.

A former employee of MedCentral Health System (OH) files a lawsuit against his former employer, claiming that he was unjustly fired after complaining that Open Systems, a Cleveland-based technology vendor, was bribing the hospital’s IT department to buy its overpriced computer equipment with travel, sports tickets, and food. The employee says he complained to the former IT director, who told him he would be running the department some day and should just mind his own business.

Microsoft CEO Steve Ballmer announces his retirement as CEO, causing shares to jump 7 percent Friday, ironically raising Ballmer’s personal fortune of $15 billion by another $800 million by his own departure. A Reuters article summarizes his many mistakes with a quote: “That is the most expensive phone in the world and it doesn’t appeal to business customers,” Ballmer laughed in a TV interview after the launch of Apple’s iPhone in 2007. Five years later, iPhone sales alone were greater than Microsoft’s overall revenue.” The article also mentioned the infamous “Monkey Boy” video, in which Ballmer leaps and screams all over a sales meeting stage hoping to generate enthusiasm that the company’s performance couldn’t.

Vince Ciotti says this device might entice older doctors to use an EMR.

Robert Wood Johnson Foundation says the use of patient-shared medical visit notes (OpenNotes) is spreading, with Beth Israel Deaconess Medical Center rolling it out now with similar plans by the VA, Group Health Cooperative, Geisinger, Cleveland Clinic, and Mayo Clinic. RWJF will issue a $2.1 million grant to share lessons learned and to help health systems implement it.

Weird News Andy perhaps inevitably title this article “Sh*t for Brains.” California’s Department of Public Health fines three UC Davis Medical Center doctors who injected fecal bacteria into the brains of three cancer patients as an experiment, hoping to kill tumor cells. Instead, the resulting infections trigger septicemia-induced seizures, with one patient dying shortly after. The doctors admitted that they had no plan to address problems that might have developed and couldn’t explain why they chose those particular patients.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

News 8/23/13

Top News

Steve Malik, the Cary, NC entrepreneur who sold his Medfusion patient portal startup to Intuit in 2010 for $91 million, acknowledges that he has bought the business back from Intuit, which had announced its intention to divest Intuit Health Group to focus on its core tax and financial software business. Intuit wrote down $46 million earlier this year when partner Allscripts decided to look elsewhere for a portal solution. Revenue was down to $16 million in 2013. Malik says he looked at healthcare IT startups before realizing that his former company held the highest potential. Malik, the sole owner of the company, says he hasn’t decided whether he will revive the Medfusion name (my vote and expectation would be yes even thought the name isn’t descriptive.)

Reader Comments

From Boy Wonder: “Cerner and Epic. Are you aware of any health systems that have switched or are in the process of switching from Cerner to Epic? Just wondering.” I was thinking that Aurora had done so. I assume the specific interest would be those that switched voluntarily rather than being forced by acquisition. Readers?

From Vendor Venting: “Re: McKesson Horizon. As a customer, we have noticed that support and services have steadily declined since the ‘Better Health 2020’ announcement in December 2012. The average tenure of support employees supporting us has dropped severely with resignations. We have to run a gauntlet of triage and bottom-tier support before most of our issues are escalated to a rare senior resource. They are exerting pressure for us to migrate to Paragon while failing in their commitment to support us on Horizon. In the BH 2020 announcement, we were assured that there would continue to be a commitment to Horizon customers, but the executives who made those commitments have moved on. Actions speak louder than words and customers have been left to deal with the fallout.” Unverified. I would be interested in speaking to a customer that has moved from Horizon to Paragon since those mentioned by the company seem to be happy.

From CDiff: “Re: ICD-10 codes for High Life in the ER. Wondering if Weird News Andy has reported the need for five ICD-10 codes for beer?” A Johns Hopkins Hospital study of the one-third of ED visits that are alcohol-related finds that the beer brands most often involved are those most appropriately consumed from a paper bag koozie rather than a tulip glass: Budweiser, Steel Reserve, Colt 45, Bud Ice, and Bud Light. They’re planning to extend the study to see if it’s just a Bal’more thing.

From Pacific Girl: “Re: CIO Unplugged 8/12/13. Mr. HIStalk, that is by far the most moving post I’ve read from your site, and it couldn’t have come at a better time. Thank you, thank you, thank you.” I think people sometimes underestimate how hard it must be for Ed Marx to write soul-baring articles like “Falling from Grace” and post them publicly for his peers with his name on them, opening himself up to criticism from folks who enjoy the benefit of anonymity. Ed doesn’t seem to mind as long as he makes them think.

From Boston Beans: “Re: John Halamka. Why do people feel the need to run him down? He’s doing his job at BIDMC or they wouldn’t keep him.” Long-time readers may recall that I was unflaggingly cynical about him years ago given his ubiquity, but that changed when I met people who know him and then met him myself (as me, not Mr. H) He’s the real deal and I detected no self-serving agenda at all. He won’t take money for doing work external to BIDMC because he considers his time paid for by them, he is patient in explaining what he knows when I’m sure I wouldn’t be, and I think he really cares about patients more than anything else. I interviewed him in 2010 and was impressed at his lack of pretension or ego. I may or may not agree with every IT decision he’s made and he’s got some biases unique to Harvard and Boston, but he’s a good guy. Folks who say he isn’t usually haven’t actually met him. If you’re looking for egotistical douchebag CIOs or executives, you have many more deserving choices.

HIStalk Announcements and Requests

Some HIStalk Practice highlights from the last week include: MGMA urges HHS to not penalize physicians who have met Stage 1 MU requirements but may miss the Stage 2 deadline. The Air Force’s 62nd Air Division highlights its use of RelayHealth’s secure messaging platform. An AHRQ report concludes that the use of HIT in ambulatory care settings has a positive impact on care delivery and provider satisfaction. Physicians can expect an average salary increase of 2.4 percent in 2014. Thanks for reading.

Inga needed a new laptop and asked me if this one from Office Depot was OK (Toshiba Satellite C55-A5286). I was shocked that an Intel-powered 8GB memory Windows 8 laptop with a memory card reader, USB 3.0, a decent screen, and a DVD drive could be bought for $380 after rebate, to the point that I joined Inga in buying one and so did our newest HIStalk colleague. I’m extremely happy with it after doing the usual setup tasks: opening Internet Explorer long enough to download Firefox and Chrome, de-installing all of the bloatware that the manufacturer gets paid to include, and installing a utility that bypasses the new (and confusing) Metro interface in favor of the old Win 7 start menu.

Listening: the entire catalog of Portland-based indie band The Thermals. Also, new Superchunk.

Ed has updated his CIO Unplugged “Falling from Grace” post with a response to the comments left by readers.

Acquisitions, Funding, Business, and Stock

Bottomline Technologies reports Q4 earnings: revenue up 5.86 percent, adjusted EPS $0.32 vs. $0.26, beating analyst estimates of $0.29.

Nuance adopts a poison pill defense, hoping to prevent investor Carl Icahn from taking control of the company and selling it off in pieces.

Orange Health acquires the software assets of ExtendMD, which offers patient-physician communications technology.

Connecticut Innovations, which provides funding for Connecticut technology startups, extends a $200,000 follow-on funding commitment to tablet computer sterilizer manufacturer ReadyDock.

Sales

The Lott AQ Group, a healthcare IT quality assurance and consulting firm, will use VitalWare’s VitalSigns auditing and financial risk assessment tool for ICD-10 testing.

People

Jim Jirjis, MD (Vanderbilt University Medical Center ) is named chief health information officer for HCA.

St. John’s Riverside Hospital (NY) appoints Daniel Morreale (Kingsbrook Health System) VP/CIO.

Denis Connaghan (etrials) joins clinical trials network provider Clinverse as CEO.

The San Francisco Department of Public Health names Bill Kim (Dignity Health) to the newly created position of CIO.

Announcements and Implementations

EHNAC releases updated and final 2013 criteria for the electronic exchange of clinical data.

The Southeast Michigan Beacon Community names Quest Diagnostics its first provider of diagnostic information services for its HIE, BeaconLink2Health.

Allscripts names healthfinch the grand prize winner of its Open Apps Challenge for its automated prescription renewal request app. We interviewed healthfinch CEO and Co-Founder Jonathan Baran on HIStalk Connect last year.

AirStrip and Vivify Health will develop a remote care platform for the AT&T mHealth Platform.

Innovation and Research

Robert Wood Johnson Foundation offers $100,000 in prizes for entrants who combine healthcare with public health data to improve community health.

Other

The CVS drugstore chain notifies 36 prescribers that it will no longer fill their controlled substances prescriptions after an analysis of its million-prescriber database indicates a high likelihood of improper prescribing.

In England, the final tab for the failed NPfIT project is tallied at nearly $16 billion, having delivered an estimated $4 billion in benefits.

Meditech announced to employees this week that it has acquired a six-story, 108,500-square-foot office building from Adobe Systems in Waltham, MA on Route 128. The company will fully occupy the 400-seat, three-year-old LEED Certified Platinum building when existing tenant leases expire in late 2015.

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Peer60, which offers customer intelligence tools, has put together a pretty funny downloadable e-book called “Executives Are Idiots,” which pokes fun at getting executive feedback.

A major national health system work group studying copy-and-paste issues in EMRs recommends monitoring the practice within existing documentation audits, according to an internal PowerPoint presentation forwarded by a reader.

Dubai Health Authority orders 3,000 Android tablets, vowing to provide one for every patient bed toward its plan to use “the latest IT technology to enhance customer service experience.” The hospitals will roll out their EMR in the next 2-3 years.

UMass Memorial Medical Center (MA) pays $66,000 to settle fraud charges in which it was accused by a whistleblower of intentionally mailing bills to a homeless shelter so it could then bill the state for the unpaid amounts.

Weird News Andy says of the story headlined German Doctors Remove Tumours From Liver Using an iPad that he would have used a scalpel instead since it’s sharper.

WNA also likes this story, which he titles “Herniating Money.” A man is told by a hospital that his hernia surgery will cost $20,000 upfront with his insurance company covering the rest. Instead, he heads over to another hospital and has the surgery done the next day for a total price of $3,000 without using his insurance at all. The surgeon who penned the article concludes, “It was clear to both of us that the only way to make health care more affordable is to diminish the role of third-party payers. Let consumers and providers interact through market forces to drive down prices and drive up quality, like we do when we buy groceries, clothing, cars, computers, etc. Drop the focus on prepaid health plans and return to the days of real health insurance—that covers major, unforeseen events, leaving the everyday expenses to the consumer—just like auto and homeowners’ insurance.”

In England, a patient dies after employees omit the an apostrophe in her last name while looking up her electronic records, causing them to miss her history of depression. She was discharged and killed herself with a sleeping pill overdose shortly after.

Sponsor Updates

• Sunquest held its annual Executive Summit last week in Scottsdale, AZ at the beginning of its SUG annual user group conference.
• Emdat releases a video highlighting the advantages of using its medical documentation system within an EHR.
• LG Electronics will integrate Imprivata’s OneSign authentication solution into its V-Series zero client systems.
• Zirmed partners with Catch Data Systems to provide GE Centricity customers integration with ZirMed’s RCM, clinical communications, and analytics solutions.
• The Washington State Hospital Association endorses Besler’s Transfer DRG and IME revenue recovery services.
• Vitera Healthcare Solutions announces details of its VIBE 2013 user conference, to be held September 10-13 in Orlando.
• Forbes features Xerox in an article about 3-D printing in healthcare.
• Two KishHealth System hospitals advance their EHR initiatives with the implementation of Access’s e-form on demand solution.
• Care Team Connect hosts an October 8 Webinar highlighting the implications of Medicaid expansion on care management.
• Greenway Medical adds Krames Staywell’s Integrated Patient Education solution to its online Marketplace as a certified API.
• T-System CMIO Robert Hitchcock, MD discusses an all-in enterprise model for data needs.
• Sunrise Women’s Medical Group (CA) shares how its use of ADP AdvancedMD PM/EHR improved workflow and coding and billing.
• Cornerstone Advisors is named to Inc. 500’s 2103 Fastest Growing Companies in America. Also on the list is Intellect Resources.
• Direct Recruiters made the Inc. 5000 list announced this week.

EPtalk by Dr. Jayne

I’ve heard a lot of complaining recently about the Medicare Physician Compare website. The AMA and other physician advocacy organizations have complained about the redesigned site and its errors, which include problems identifying physician location, hospital affiliations, board certification, and other practice information. I searched for myself and even broadened the criteria to a 100-mile radius around my hospital but still can’t get myself to display, so yes, I would agree it’s inaccurate.

I seem to be running into more and more physicians who are integrating scribes into their practices. Some cite EHR as the reason, feeling like it has turned them into data entry clerks. Others see the scribe as a key partner in team care, freeing up the physician to perform cognitive work rather than data gathering and results tracking. I found this nice document from the American Academy of Family Physicians that outlines the potential duties of a scribe (which they expand on using the concept of a clinical assistant) during a routine office visit.

Having implemented EHR with several hundred physicians, I know the importance of helping physicians realize that the support staff is a great asset in prepping both the chart and the patient for the office visit. The document points out the staff role in collecting any recent lab/diagnostic test results and updating preventive care information before the physician ever sees the patient. Whether you use scribes or not, seeing patients in the age of Accountable Care, Pay for Performance, and Meaningful Use definitely takes a village.

AAFP also offers its Family Practice Management Toolbox, which was one of my favorite sites when I was in traditional primary care. Check out their section on practice improvement tools for some interesting practice assessment and improvement worksheets.

The American College of Emergency Physicians will be hosting its annual Scientific Assembly this October in Seattle. I had hoped to attend, but I have an unavoidable conflict that week. I don’t see a huge number of ED physicians in the informatics realm, but I am interested in what products ED docs think are hot and which are not. Ever thought of seeking fame and fortune as a roving reporter? If you’re a HIStalk reader and planning to attend, I’d love to hear from you.

Speaking of the emergency department, quite a few of you reached out to offer your condolences after I wrote about the closing of the quick care unit at one of the facilities where I was seeing patients. I’m happy to report that another facility has offered me a part-time position, although I’m not sure how much inspiration it will provide for writing since its physicians document on paper. Going electronic isn’t an impossible dream, however, as our paper system is provided by HIStalk sponsor T-System. I was happy to see the smoking doc logo on their website.

My email inbox is always deluged with invitations to various webinars, symposia, and conference calls. Some are from vendors and others are from professional organizations, but nearly all suffer from lack of lead time. Some arrive less than two days before the event being promoted. Word to the wise, marketing people — if you’re really trying to reach CMIOs or other C-levels, you should allow at least two weeks notice. Happily Mr. H advertises our HIStalk webinars well in advance – I’ll be listening in on the ICD-10 webinar on September 12. Hope to see you there!

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

News 8/21/13

Top News

From Left Tackle: “Re: Intuit Health Group. Was bought back Monday by Stephen Malik, who founded Medfusion and sold it to Intuit in the first place.” Verified. He was saying just a few weeks ago that he had no interest in buying back the Cary, NC-based company he sold to Intuit for $91 million in 2010. That probably means the asking price and/or the number of interested suitors dropped since then.

Reader Comments

From MoJo: “Re: Allscripts reorg. Allscripts made an internal announcement of (yet another) reorganize to ‘further improve accountability, performance.’” Some of the changes noted in a company memo: the addition of new business units (international, Sunrise, and enterprise); the hiring of Greg White (Cerner) and Ricker Berner (Caradigm) to head the enterprise and international segments, respectively; the addition of new client sales regions and changes to leadership; and the realignment of the client advocate and solutions management teams.

From Partner: “ACE. Dozens of companies are spending big marketing dollars to exhibit at ACE.” The Allscripts annual conference kicked off Tuesday in Chicago. Attendance hasn’t been announced, but the exhibitor directory includes at least 50 vendors.

From Broadway Joe: “Re: North Shore LIJ. Buying a stake in Allscripts.” Unverified.

From Turk: “Re: Rose Harr. Interesting news about the CEO of BlueWare, a small imaging system that claims to be an EHR.” The former Brevard County, Florida Clerk of Court is arrested on a variety of corruption charges that include approving $8.52 million in county scanning contracts with BlueWare for personal financial gain. State law enforcement agents say that BlueWare didn’t own any scanning equipment at the time and 75 percent of the records they were paid to scan could have been discarded without scanning. BlueWare CEO Harr turned herself in was arrested for bribery and bid tampering, but is out on bond. She has an interesting LinkedIn profile that includes running companies that are flipping properties, making a cartoon about Boston Terriers, and selling big imaging deals to NHS hospitals in England.

From I’m Not Creative: “Re: Siemens Soarian customers. Only getting six weeks to upgrade from version 3.3 to 3.4 due to the number of clients who need to get upgraded to meet MU2 requirements. Talk about feeling the burn.” Unverified.

From TexasHeart: “Re: ONC Blue Button announcements. Is this smoke and mirrors because state HIEs are failing and most docs, include a fourth of them in Epic, don’t want to trade? Why would people use Blue Button as a portal? Will docs even accept records sent by a patient?”

From Escapade: “Re: CIOs. You should do some CIO interviews and leave them anonymous so they can be brutally honest and vent. “ That’s a brilliant idea. I would happily do that, as well as running anonymous blog posts (either one-time or ongoing) by CIOs who want provide uncensored opinion without fear of reprisal.  Contact me if you’re a CIO who likes the idea as much as I do.  The anonymous interview would be a super easy and great fun.

HIStalk Webinars

 

Beacon Partners will present “The Transition to ICD-10: Building the Bridge as You Walk on It” on Thursday, September 12 at 2:00 Eastern. With the transition to ICD-10 only 15 months away, healthcare organizations will have to find inventive ways to create their roadmap and execute on their plans. Rather than taking valuable time to complete a gap analysis and then create the plan, leaders and project managers should consider how to do these tasks concurrently. Examples from healthcare organizations will provide ideas for choosing the right partners, defining program strategies, and incorporating ICD-10 work into already existing teams. Even if you assemble the plane as you fly it – or build the bridge as you walk on it – it’s time to move forward and make the ICD-10 transition a reality. The target audience for this presentation is mid-senior level financial, clinical and IT, CFO, COO, CIO, ICD-10 program manager, and ICD-10 team leads. The speaker will be Chris Kalish, national practice director in the Strategic Advisory Group. One of my reviewers summarized, “With approximately only one year to go and a lot of work still to be done, this Webinar provides hospitals with strategies to prepare for ICD-10 if the hospitals are late starters.”

Speaking of Webinars, there’s a list of those upcoming in the column to your right. Clicking on one brings up the full calendar.

Acquisitions, Funding, Business, and Stock

Summit Partners invests $14 million in specialty EMR provider Modernizing Medicine.

Champion Medical Technologies, which sells tracking software for implanted medical devices, receives an unspecified investment from Jump Capital.

The SSI Group acquires Medtelligence, dba Medibis, a provider of analytic, dashboard, and mobile applications.

Greenway reports Q4 earnings: revenue down 2.34 percent, adjusted EPS -$0.08 vs. $0.10, missing analysts’ estimates of -$0.02. Shares rose 3 percent Tuesday after Monday’s announcement. CEO Tee Green notes that the results reflect the company’s continued transition from a one-time system sales and training model to a recurring revenue model. From the earnings call:

• Greenway is live with CCD exchange at Epic and Cerner sites
• Up to 80 percent of new customers are choosing cloud solutions paid for via the subscription model, which is driving training revenue down
• Only 10 percent of users are using the company’s mobile EHR access app
• The company’s growth is expected to be driven by EDI and services
• Greenway says it expects to lose $5-6 million in FY14, with system sales down 50-60 percent

Above is the one-year GWAY stock chart, with Greenway in blue, Allscripts in red, athenahealth in green, and the Nasdaq composite index in brown.

Teleheath software provider SnapMD raises $600,000 in a seed round led by Shea Venture and Whittier Trust.

First Databank acquires medication reconciliation software vendor Design Clinicals. More information and thoughts from Design Clinicals CEO Dewey Howell, MD, PhD are available in the Tuesday morning announcement on HIStalk.

Sales

Wahiawa General Hospital (HI) will implement MEDHOST’s EDIS.

The Healthcare Access San Antonio HIE will offer consumers access to a portal developed by Intellica Corp.

The Defense Logistics Agency awards McKesson a $29.9 million medical imaging technology contract.

Community Health Information Collaborative (MN) selects Orion Health to power its statewide HIE.

Arcadia Solutions selects the Compuware Application Performance Management platform for EHR infrastructure performance optimization.

People

AHRQ names Richard Kronick (HHS) director, replacing the retiring Carolyn Clancy, MD.

Lisa Stump is promoted to VP/associate CIO of Yale-New Haven Health System.

EBSCO Information Services hires Elizabeth Jones (American Medical News) as VP of medical product management and chief content officer.

Announcements and Implementations

UnitedHealthcare adds online electronic bill payment services to its plan participant portal via the InstaMed payment network.

The Liverpool Heart and Chest Hospital (UK) and Robinson Memorial Hospital (OH) go live with integrated OnBase ECM and Allscripts EMR solutions.

Qstream announces new clients for its mobile healthcare education platform that include Boston Children’s Hospital, Partners HealthCare, Mayo Clinic, and Baylor College of Medicine.

Vivature EHR chooses Liaison Healthcare for connecting its Oracle-based EHR to more than 120 labs and imaging departments via Liaison’s EMR-Link hub.

HCA says in an entrepreneur workshop that it likes doing business with Boston-area companies that have an MIT or other academic connection, including Meditech, PatientKeeper, eClinicalWorks, and EMC.

Government and Politics

Florida Senator Arthenia Joyner introduces a bill that would force insurers to pay for telehealth visits. Critics say the bill is flawed because the state’s Board of Medicine allows telemedicine consultations only when a patient relationship has already been established and it also would require insurers to pay the same amount for a telemedicine visit as an in-office visit. Similar bills have failed previously.

Innovation and Research

Via @cascadia:  Intermountain Healthcare looks at the “Personalized Patient Room,” including an in-room camera; a server to support teleconsultations by pharmacists and interpreters; and video chat for bringing in remote family members to participate in the patient’s care. They’re also considering using touchscreens instead of pillow speakers for pushing educational content, entertainment, and information in languages other than English.

Three entrepreneurs form Oscar, a technology-powered insurance company that hopes to reform healthcare via the PPACA-mandated health insurance exchanges. Users of its application can enter their symptoms and click a button that will let them find nearby providers or speak live to a doctor through a partnership with TeleDoc. Patients can request prescription refills through a Twitter-like timeline. The company is analyzing large data sets to guide patients through rational medical decisions. They’ve raised $40 million in funding and will launch in 2014.

Technology

Greenway Medical launches PrimePATIENT, a patient portal integrated with PrimeSUITE.

Allscripts introduces Population Health Analytics, a real-time chronic disease management solution that provides comparative analytics at the point of care. Allscripts also announces the GA of its native iPad app Wand 2.0 for Enterprise EHR.

Other

Virtual Radiologic and its NightHawk Radiology subsidiary file a lawsuit claiming patent infringement by Tandem Radiology related to its teleradiology and order creation technologies.

Mayo Clinic’s Center for Innovation offers $89 Web stream access to its Rochester, MN-based Transform 2013 conference September 8-10.

An Oracle survey finds that 84 percent of CFOs are working more closely with their CIO peers as technology becomes their second-highest focus area, placing behind only industry knowledge.

A Nebraska woman lands in the ER after a post-baby shower brawl in which another woman stabs her in the face with her own six-inch stiletto heel. Police said the altercation resulted from the stabber’s “relationship with the father of the victim’s child.” Once again I am reminded how mundane my life is.

Weird News Andy urges, “EMT, heal thyself.” A Detroit EMT performing in-transit CPR on a patient has a heart attack himself, ending up recovering three hospital beds over from his patient after both receive identical stents.

Sponsor Updates

• iHT2 releases details of its August 21-22 Health IT Summit in Seattle.
• A Triple Tree report, ACOs: The Accountable Care Opportunity, says the organization was impressed by population management and clinical analytics solutions from Forward Health Group.
• Jennifer Dennard of Billian is appointed to the board of the Technology Association of Georgia.
• The Massachusetts eHealth Institute awards eClinicalWorks a $150,000 grant to advance the use of EHRs with the state’s HIE.
• Helix Health Solutions will distribute Wolters Kluwer Health’s Provation Medical software to healthcare organizations outside of North America.
• Greenway Medical adds Seamless Medical Systems to its online Marketplace as a value-added partner.
• The Truven Health Advantage Suite healthcare data and analytics platform version 5 achieves Oracle Exadata Ready status through Oracle PartnerNetwork.
• Laura Kreofsky, principal advisor with Impact Advisors, discusses Stage 2 MU challenges.
• HIStalk sponsors named to the 2013 Inc. 5000 list of fastest growing companies in America include Beacon Partners, Clinovations, Cornerstone Advisors, CoverMyMeds, CSI, Culbert Healthcare Solutions, Cumberland Consulting Group, DIVURGENT, eClinicalWorks, Enovate, ESD, eTransmedia Technology, Forward Health, Iatric Systems, Impact Advisors, iSirona, Intellect Resources, Kareo, Kony, Santa Rosa Consulting, SRSsoft, Strata Decision Technology, and Virtelligence.
• Clinical Architecture introduces Symedical Content Portal, which acquires and maintains clinical and administrative vocabulary files.
• PatientKeeper hosts a September 24 webinar explaining how to make the ICD-10 transition a non-event for physicians. (sent to us)
• T-System CMO Tom Ward, MD discusses ICD-10 compliance in the ED.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

First Databank Acquires Design Clinicals

First Databank announced this morning that it has acquired Seattle-based Design Clinicals, which offers the MedsTracker clinician-friendly hospital medication reconciliation solution. FDB says the acquisition will support its ability to help hospitals meet the medication reconciliation requirements of Meaningful Use Stages 1 and 2. Terms of the acquisition were not disclosed.

According to Chuck Tuchinda, MD, MBA, executive vice president of FDB, “I am very impressed with the success that Dewey Howell has been able to achieve so quickly with Design Clinicals and MedsTracker. He has helped solve a vexing industry problem. We will now work together to develop an embedded solution so that our health information system partners can more easily integrate this medication reconciliation functionality within their systems.”

Seattle-based Design Clinicals has 40 hospital customers. The company was started by Dewey Howell, MD, PhD in 2005.

FDB will offer MedsTracker beginning immediately.

We spoke with Dewey Howell ahead of the announcement, who says the companies share a vision of reducing medication errors and improving patient safety. Design Clinicals built its modern Web app around FDB’s data capabilities. “The problem with med rec is that it involves nurses, pharmacists, and physicians,” Howell says. “All have important but distinct roles, and if any player doesn’t do their job, it all falls apart. We took three complex workflows and merged them into one so that each person has their role.”

“When medication reconciliation first came out, it was all about documenting lists and looking for drug duplicates and interactions,” Howell told us. “With Meaningful Use Stage 2 and beyond, a hospital might get feeds from an HIE or outpatient EMR and will have to decide what to do with these disparate sources of medication data. How will the meds get reconciled? It will be a much bigger problem a couple of years from now.”

FDB is transforming itself as more than just a data supplier. The company has developed Web services, widgets, and end user applications, with the customizable alerts tool AlertSpace being its first product. I interviewed Gregory Dorn, MD, MPH — now EVP and deputy group head of Hearst Business Media and president of First Databank — in September 2012, who described his vision for FDB and its new focus on raising the company’s visibility with end users.

The five-employee Design Clinicals team will stay on with FDB, with Howell taking a San Francisco-based role as VP of clinical applications. FDB will use the team’s knowledge to develop new tools for medication reconciliation at the point of care.

Monday Morning Update 8/19/13

From DanburyWhaler: “Re: Norwalk Hospital. No longer hooking up with Western Connecticut Health Network, now part of Yale-New Haven. Stay tuned for lots more consolidation in Connecticut” That would be interesting since Norwalk just signed up as a WCHN affiliate in January.

From Jon: “Re: HIMSS. They emailed members about the ICD-10 Playbook, and when I click the links, I get the infamous registration form before I can view it. It is sponsored by vendors, which is appropriate, but it should be available to all members with no strings attached for all the money we spend on dues. Now we will be bombarded with sales calls. No, thanks. I think my HIMSS membership days are over. Hopefully others will join me in sending a message.” HIMSS has gotten so commercial and so intertwined with its vendor members that I treat them like any other vendor, i.e. I always assume anything they send is spam. I’m rarely wrong on that. All the resources that require registration are on the site of MedTech Media (Healthcare IT News, Government Health IT, etc.), a private company of which HIMSS bought the majority position of shares in 2011.

The more important debate to me is this: are vendors doing themselves a favor by hiding their promotional material behind a registration form? Vendors think this way: we need leads, and any names we can get, even of people with marginal interest, make us feel more successful. I think this way: why in the world would you make it harder to see your advertisement? Nobody wants to be cold-called just because they took a quick look at a white paper. I would bet people often do as I do in just inserting phony contact information to avoid the dreaded phone call (note to vendors: if you are trying to reach a CIO named Scatman Crothers who used a phony email address, that’s me.) Don’t listen to your marketing and sales people – put your stuff out there where everybody can see it. Do the right thing and the HIMSS problem goes away with it.

Two-thirds of respondents say it’s OK if Farzad Mostashari’s replacement isn’t a physician, although most of the respondents probably aren’t members of Congress who may expect to see an MD in charge. New poll to your right: will the FDASIA report help improve patient safety with healthcare IT? Vote first, then click the Comments link at the bottom of the poll to explain your thoughts because “yes” or “no” votes don’t create rich debate.

Speaking of FDASIA, I made that the lead item in “This Week in HIT,” a partly serious, partly snarky weekly news update that I’ll do on Fridays. It will focus on the most important stories of the week, which admittedly aren’t all that fascinating at the moment given the summer doldrums before the inevitable September pickup (hint to vendors: it’s a great time to make announcements.) Long-time readers will remember the format from the Brev+IT weekly newsletter I used to send out until the volume of work overwhelmed me, much of which went toward coming up with Onion-like headlines. People have asked for a weekly summary of just the major news items, so this is it.

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

Wake Forest Baptist Urgent Care – Clemmons goes live with UrgentQ, a “fastpass for healthcare” that lets patients choose an open visit time and receive text message updates of when to come in. It’s from Lightshed Healthcare Technologies, a new company founded by Dialog Medical Founder Mike Burke.

Cerner will develop the biggest office project in Kansas City history if its plans for the former Bannister Mall are approved. The campus will cover 4.5 million square feet on 251 acres and will be valued at $4.1 billion upon completion. It will house up to 15,000 employees. Cerner wants $1.2 billion in tax incentives to build it, offering to chip in $2.9 billion of its own money.

Readers have asked for an update on the HIPAA Omnibus Rule, for which enforcement begins in just a few weeks. I publicly solicited pro bono volunteers to to review the changes via Webinar. Doing so will be a couple of excellent presenters from The Advisory Board Company: Associate General Counsel / Privacy Officer Rebecca C. Fayed and Information Security Officer Eric Banks. Sign up for The HIPAA Omnibus Rule: What You Should Know and Do as Enforcement Begins, which will be held on September 10, 2013, from 2:00 to 2:45 p.m. Eastern. I reviewed their slides and they are excellent in the usual Advisory Board fashion – very meaty and to the point as they cover changes related to business associates, breach thresholds, and everything else covered entities need to know and do. This is a non-commercial presentation offered strictly to benefit readers by Rebecca and Eric. I appreciate their involvement.

The West Virginia Health Information Network has added several hospitals recently, bringing its total to nine.

Louis Kraml, CEO of Bingham Memorial Hospital (ID) pleads guilty to stalking charges for illegally wiretapping a former hospital physician, aided by three of the hospital’s IT department employees. Charges were dropped against two of the employees because they were following the instructions of IT Director Jack York, who had been accused last year of running a bogus consulting company that was charging the hospital for IT services. The court has issued a warrant for the arrest of York, who didn’t show up in court. The charges aren’t mention on LouisKraml.com, the CEO’s official website.

HIMSS urges HHS to start Meaningful Use Stage 2 as scheduled, but suggests extending the attestation window to 18 months.

The Fort Lauderdale, FL newspaper covers the use by several hospitals, most of them VA facilities, of the GetWellNetwork patient engagement solution.

The National Science Foundation issues a five-year, $10 million cybersecurity grant to Trustworthy Health and Wellness program that will develop tools for authentication and privacy, malware detection, and medical IT auditing. Experts from Dartmouth, Johns Hopkins, University of Illinois at Urbana-Champaign, and University of Michigan are on the team.

Sidney Health Center (MT), a 25-bed critical access hospital, will implement Epic as part of an agreement with Sanford Health (ND).

Vince commences his HIS-tory coverage of Cerner, aided by Neal Patterson (who responded quickly and warmly to Vince’s inquiry) and the archives of Cerner’s April Martin. The details they provided are fascinating.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

News 8/16/13

Top News

CareCloud secures an additional $9 million from Adams Street Partners as part of its Series B financing round, bringing the company’s total funding to $55 million.

Reader Comments

From Frank Poggio: “Re: certification scoreboard. Here we are just six weeks away from the termination of Stage 1 vendor Certifications on 9/30/13 and there are only six Inpatient EHR vendors with 2014 Edition Certified systems (aka Stage 2). They are: Epic, McKesson (Paragon only), Allscripts, Meditech, HMS, and CPSI. No-shows for full EHRs are Cerner, GE, Siemens, Healthland, QuadraMed, and NTT-Data (Keane). If you are running a Stage 1 Certified system on 10/1/13, it will be considered a non-certified product even though you’ve not changed a line of code. As I have said on this blog before, the process and details under 2014 are far more difficult than ONC would admit, and even today the test scripts are still changing. In fact, while working through some test data with several of my clients this week, we came across three situations where the test data is in error. When we brought this to the attention of the test labs they simply said, ‘We’ll notify ONC, but for now just ignore it.’”   

From Dodging a Bullet: “With all the praise and glory for the soon-to-be former ONC head, you have to wonder about the timing of his departure. Does this really mean that MU2 will be pushed back and he doesn’t want to be at the helm when that takes place?” I can’t imagine the timing of Stage 2 would be enough to make Farzad leave. He’s been through Congressional grillings, has taken every kind of criticism there could be, and works for an agency that rarely sticks to dates it sets.

From Potha Cary: “Re: Allscripts tip of the week. Tells you how to look up a zip code on the United States Postal Service website. Asinine.” It would be nice if the app could do the lookup itself, but at least if not, they gave users good instructions that they may or may not need. I don’t see a problem with that.

HIStalk Announcements and Requests

Hot news from HIStalk Practice this week includes: the AAFP urges CMS to add a 12-month extension to the timeframe for Stage 2 MU compliance. MGMA-ACMPE adds almost 600 new members as HCA Physician Services joins the association. The majority of physicians believe EMRs have at least some positive impact on patient care according to an athenahealth / Epocrates survey, though 17 percent believe they worsen care. Thanks for reading.

Facebook reports that 128 million Americans and 24 million UK users access Facebook every day. A mere 278 of those are my friends, which happens to be a few more than Mr. H and Dr. Jayne but far less than the 2,271 who like our HIStalk page. We are collectively of the belief that you can never have too many friends, so send us a request and we’ll be happy to join your inner circle. If you prefer to keep it professional, you can connect with Mr. H and me through LinkedIn.

Welcome to new HIStalk Platinum Sponsor Symantec, which secures the IT systems and health information of medical practices, hospitals, and payers. Symantec Backup Exec simplifies backup and disaster recovery for practices. The company’s healthcare software solutions provide security, data loss prevention, HIPAA compliance automation, business continuity, and storage and infrastructure management (the list of specific products is surprisingly long, and Mobile Management is probably worth a look, as is Endpoint Virtualization for managing applications and standardizing single sign-on). Many of these tools are available as free trial downloads. Thanks to Symantec for supporting HIStalk.

Surescripts Mini-Interview

Surescripts announced Tuesday that it has added 19 state HIEs and health information providers to its clinical interoperability network, allowing them to exchange referrals, discharges lab results, CCD, prior authorization, and notes via the Surescripts network. I spoke to Jeff Miller, SVP/GM of clinical interoperability for Surescripts, who says the company “decided to move out of just electronic prescribing and support a wider set of clinical information on the Surescripts network.”

Surescripts network members have always been able to communicate with each other through the network directory, but Miller says that “communities of networks have significant populations we need to reach.” Now that Greater Rochester RHIO is on the network as one of the 19 new participants, for example, any of its members can communicate with any member of the Surescripts network and vice versa. Surescripts is paid by hospitals and EHR vendors, who may or may not pass along charges to their own users, but there’s no extra charge to use the gateway. 

Miller says the connectivity marketplace consists of HIE applications that poll EHRs to get information and send messages and EHRs that can exchange information within their own vendor-specific network or through partners such as Surescripts. The EHR-based solutions allow that communication to be integrated into user workflow, so that an Epic user discharging a patient can look up a provider in the directory and send a message out without launching another mailbox-type application. Miller says over 600 EHR vendors are connected to its network.

I asked how this type of messaging could support population health management. He says networks need to support three models: (a) a push or message-based model; (b) a pull or query-based model; and (c) a publish model, such as moving data to a repository to support managing populations. The benefit to patients, he says, “is to get rid of that clipboard you get at the practice. Let the doctors become more proactive. Take cost out and improve quality.”

Acquisitions, Funding, Business, and Stock

Imprivata announces that Q2 bookings grew 30 percent and headcount was increased to 250 with the addition of 48 new employees.

A stock analysis firm starting its coverage Quality Systems with lukewarm enthusiasm claims that the company’s customers, and presumably those of other EHR vendors, are being lost to enterprise vendors such as Cerner and Epic as hospitals acquire practices.

Sales

The NY eHealth Collaborative awards Mana Health a contract to build the “Patient Portal for New Yorkers.” 

Orthopaedic Associates of Augusta (GA) selects SRS EHR for its 14 providers.

Charleston Area Medical Center (WV) contracts with Besler Consulting to assist with the identification of Transfer DRG underpayments.

The NFL’s Buffalo Bills will implement medical imaging technology from Carestream at the Bills’ Ralph Wilson Stadium to provide early detection and monitoring of brain injuries.

People

James McDevitt (GE Healthcare) joins API Healthcare as VP of human resources.

The Integrating the Healthcare Enterprise Patient Care Device Domain Technical Committee names Iatric VP Jeff McGeath co-chair.

Jeff Finkelstein, MD, former chief of emergency medicine and CMIO of The Hospital of Central Connecticut (CT), joins Hartford Hospital (CT) as chief of emergency medicine.

Standard Register Healthcare names Kevin Lilly (McKesson) as VP of marketing and product management.

John Halamka,MD is named to the board of Imprivata.

Announcements and Implementations

Hawaii Health System concurrently implements Perioperative Management by SIS and Siemens Soarian.

The Central Illinois HIE launches Direct communication between its members and other HIEs using ICA CareAlign Connect technology.

Prime HealthCare Services will connect its 23 hospitals to the Inland Empire HIE, which is based on the Orion Health HIE platform.

Appalachian Regional Healthcare System (NC) goes live on Allscripts Sunrise Clinical Manager.

Diagnotes launches a mobile clinical communications system for patient information, caregiver communication, and documentation.

Innovation and Research

ShiftyBits, LLC releases ID My Pill, a $4.99 iPhone app that identifies prescription tablets using the phone’s camera.

Other

Weird News Andy concludes about a story he titles “En Fuego” that, “Well, they are part of the fire department.” Two Washington, DC ambulances catch fire in separate incidents on the same day, fortunately with no injuries. WNA also likes this story, in which a surgeon intentionally lied to a patient for reasons unknown in claiming that he had removed her brain tumor, when in fact he had not.

An OIG audit finds that Medicare paid $449 million too much in 2011 to hospitals that shouldn’t be considered critical access hospitals because they aren’t in rural areas and aren’t far from other hospitals. States were allowed to override the location criteria until 2006; OIG says it’s time to take their exemptions away and CMS seems to agree.

Sponsor Updates

• Greenway Medical approves Master Mobility iPad and iPad mini applications as certified API solutions for its PrimeSUITE platform.
• An article by Brad Levin of Visage Imaging covers radiology’s “imaging IT disorders.”
• Intelligent InSites celebrates its 10th anniversary.
• Aprima reports having over 600 participants at annual user group conference earlier this month in Dallas.
• A Santa Rosa Consulting article offers a test to determine whether an organization needs to conduct an IT cost optimization review.
• GetWellNetwork publishes an e-book on transformative health trailblazers.
• Ohio State University’s Wexner Medical Center and GE Healthcare collaborate to find ways to make healthcare more enjoyable for patients.
• HIStalk sponsors earning a spot on “Best Places to Work 2013” are Aspen Advisors, CTG Health Solutions, Cumberland Consulting Group, Divurgent, Encore Health Resources, ESD, Hayes Management Consulting, Health Catalyst, Iatric Systems, Impact Advisors, Imprivata, iSirona, Sagacious Consultants, Santa Rosa Consulting, and The Advisory Board Company.
• ORA Orthopedics (IA/IL) reports that its implementation of Emdat’s clinical documentation technology has yielded operational and administrative advantages.
• Direct Consulting Associates and Direct Recruiters expand their offices, staff, and services. 
• HIMSS Analytics’ James Gaston, senior director of clinical and business intelligence, will participate in a panel discussion on leveraging analytics in clinical operations at next month’s Midwest Hospital Cloud Forum. 
• Wolters Kluwer Health introduces iPad and iPhone apps of Lippincott’s Nursing Drug Handbook.

EPtalk by Dr. Jayne

Now here’s an app I’d use. A group of New York University researchers has developed a mathematical model to help identify which preventive measures would most improve a patient’s life expectancy. Responding to the challenges physicians face when trying to address the mass of preventive recommendations that exist, they hope to integrate the model into EHRs to prioritize guidelines on an individual basis. It’s not ready for prime time, but I’m seriously intrigued.

An app that is actually on the market, “Health through Breath – Pranayama” includes controlled breathing exercises intended to relieve tension and promote relaxation. I wish I could have beamed it to the attendees of a meeting I was in the other day because everyone was keyed up and irritable. Its topic: the cost of ICD-10 readiness.

Speaking of apps, Medical Economics releases its list of the top 10 apps physicians recommend to their patients. Four of the 10 are diabetes related, which parallels the percentage of patients I seem to be seeing.

The National Uniform Claim Committee publishes its transition timeline for the new CMS 1500 claim form. The timeline meshes with Medicare’s and proposes that payers begin accepting the new form in January 2014 with a dual-use period through April 1, 2014 when the new form is required. I may have mentioned this before but it’s worth mentioning again – I don’t know how a lot of providers keep up with this and I’ve gotten quite a few questions on it in the last few weeks.

The American Academy of Family Physicians proposes a revised Stage 2 compliance timeline for Meaningful Use. The proposal actually includes three different revisions depending on whether 2014 is your first, second, or third/fourth payment year.

It’s not just a photocopier any more. Affinity Health Plan settles with the US Department of Health and Human Services over HIPAA violations. A returned leased copies rwas later sold to the CBS television network and investigators checking the hard drive found protected health information belong to over 300,000 patients. According to the documents, Affinity didn’t include photocopier hard drives in its HIPAA risk analysis as required. Show of hands: who is pulling out their risk analysis right now to double check? The FTC’s guidance on copier hard drives is here for your reading pleasure.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

News 8/14/13

Top News

Surescripts adds 19 state HIEs and health information service providers to its national health information network, including Cerner, ICA, and Quest Diagnostics.

HIStalk Announcements and Requests

Mr. H has taken a day or two off so I am flying solo tonight. He can never rest for long so be assured he’ll be back at the keyboard later this week.

Reader Comments

From Elsie: “Re: Epic’s new campus. If I were a cow I think I’d want to live in Verona.”  Epic opens its Farm Campus, which includes a white farmhouse with a wraparound porch, a red barn with a silo, a creamery, and a John Deere tractor. The buildings, which have standard offices on the inside, will house up to 1,000 employees and include extra decorative touches that follow the farm motif. Verona city officials have estimated the value of the farm campus and Epic’s new 11,000-seat auditorium at about $400 million.

Acquisitions, Funding, Business, and Stock

Marlin Equity Partners acquires long-term care software vendor 6N Systems, which will be merged with Marlin’s portfolio company SigmaCare.

Emdeon reports Q2 adjusted earnings of $77.2 million, down 3.7 percent from a year ago. Revenues were up almost six percent to $311 million.

Endo Health Solutions subsidiary HealthTronics agrees to sell HealthTronics Laboratory Solutions, its anatomical pathology business, to Metamark Genetics as part of Endo’s announced plan to pursue strategic alternatives for HealthTronics.

Medical device maker Medtronic buys Cardiocom, a provider of telehealth and patient monitoring services, for $200 million.

CareFusion reports Q4 earnings: revenues down six percent, adjusted EPS $0.49 vs. $0.55 and in line with expectations. The company also announced a $750 million share repurchase program.

Sales

East Tennessee HIN selects DataMotion Direct as its secure messaging service.

Apria, a provider of home healthcare products and services, extends its contract with predictive analytics provider Connance.

Brazosport Regional Health System (TX) will implement MEDHOST’s EDIS.

Mercy Health System (ME) selects Allscripts RCM Services for back office processing and patient collections.

The Chain Drug Consortium renews its agreement with Emdeon to provide services through the Emdeon Clinical Exchange eRx Network.

The AHRQ awards ECRI Institute a contract to continue operating, maintaining, and enhancing the AHRQ National Guideline Clearinghouse and the National Quality Measure Clearinghouse.

PinnacleHealth System (PA) and Meridian Health System (NJ) select the SIS perioperative IT platform.

People

Impact Advisors promotes Matt Duncan and Kent Gray from principal advisors to VPs.

Conifer Health Solutions hires James C. Bohnsack (TransUnion Healthcare) as VP of acquisition strategy.

Healthcare analytics provider PTS Physicians names Penn Krause (Treatspace) CEO, replacing the retiring William Bennett.

WebMD names David Schlanger its permanent CEO following three months serving as interim CEO. The company also promoted Steven Zatz from VP of professional services to president.

US HealthCenter hires Paul A. Markham (V3 Healthcare Strategies) as chief strategy officer.

Announcements and Implementations

Cullman Regional Medical Center (AL) deploys the MedSnap ID Enterprise application, which can identify a patient’s pills from a single image and identify the name and strength of each drug. Mr. H mentioned the app several months ago and characterized it as “brilliant.”

Humana agrees to subsidize up to 85 percent of the purchase of Greenway’s PrimeSuite EHR for physicians practicing in the Humana network.

Appalachian Regional Healthcare System (NC) implements Allscripts Sunrise Clinical Manager.

Connections Counseling (WI) installs Forward Health Group’s PopulationManager for analytics.

The Kansas HIN will launch a statewide patient portal next month, which will be free to patients and based on the NoMoreClipboard PHR platform.

The Dallas Business Journal reports that Baylor Health Care System (TX) providers are electronically placing about 94,000 orders each weekday. Orders originate from multiple EHRs but integrate into Baylor’s existing EHR (Allscripts Sunrise, I believe.)

Novant Health (NC) begins implementation of its $1.1 million patient identification iris scanning system from M2SYS Technology.

Nuance Communications announces that in the last three month 100 hospitals and radiology practices, including 50 new customers, have converted to the latest PowerScribe 360 platform,

Government and Politics

The Obama administration reports that the VA backlog of disability claims is now 496,000, a 20 percent reduction since March.

The ONC selects 28 practicing providers and staff from 18 states to serve as the inaugural class of the Health IT Fellows program, which aims to “help other providers overcome challenges faster and more efficiently by sharing key lessons learned.’”

Innovation and Research

The Scripps Translational Science Institute launches Wired for Health, a clinical study to evaluate whether the integration of wireless technologies, online social networks, and medicine have a direct effect on healthcare spending. Half of the study’s 200 participants will use a mobile health device for six months to monitor blood pressure, heart rhythm, or blood glucose and will have the ability to track their conditions through a web portal or mobile device. Researchers will evaluate whether the device-wearing patients have more online interaction with their providers and more success managing their health conditions.

Technology

The FDA extends 510(k) clearance for Verizon’s Converged Health Management remote patient monitoring medical device.

LRS and Siemens Healthcare jointly develop a solution that reduces the number of Windows print servers and printer drivers that need to be defined and maintained within the Siemens Soarian platform.

Other

The Jackson Clinic (TN) reports positive results from the first year of its collaborative accountable care initiative, including better than market measures for annual eye exams and kidney disease screenings for diabetics, breast cancer screenings, and adolescent well-child visits, as well as lower total medical costs compared to the local market.

Sign of the times: The AMA announces it will shut down its print and online news magazine because of its inability to generate a profit over the last 10 years. AM News has a print circulation of about 230,000 but saw an $8.7 million decline in print display advertising last year. Pharma advertising has historically accounted for the bulk of the publication’s advertising revenue.

Only 38 percent of providers participating in an athenahealth/Epocrates survey claim they are at least somewhat confident in their practice’s ability to transition to the ICD-10 code set, while 79 percent express confidence in satisfying the requirements for Stage 2 MU.

Sponsor Updates

• Frost & Sullivan awards Kareo its 2013 North American Physician Practice Management Customer Value Enhancement Award for demonstrating excellence in implementing strategies that create value for its customers.
• Vitera Healthcare offers an August 28 Webinar to help physicians and their staff prepare for MU Stage 2.
• NextGen Healthcare will utilize Clinical Architecture’s Symedical Server for its terminology integration architecture within the NextGen Hospital Solutions suite.
• Allscripts Enterprise 11.4.1 and Professional 13.0 EHRs receive 2014 ONC HIT Certification from the Drummond Group.
• API Healthcare looks at the healthcare system trend of eliminating differential pay in order to reduce costs.
• Impact Advisors identifies three challenges in achieving MU Stage 2.
• Billian’s HealthDATA ranks MedAssets the top healthcare group purchasing organization based on the number of affiliate beds.
• Pro golfer Jason Dufner, who is sponsored by Greenway, wins the 2013 PGA Championship, his first major title since partnering with Greenway two years ago.
• Alere Analytics releases its Electronic Laboratory Reporting solution for hospital reporting of results to state health departments and to improve care coordination between lab personnel and clinicians.
• Ophthalmology EMR provider Medflow will give users access to LDM Group’s healthcare messaging programs for improved patient medication compliance.
• iSirona posts a video featuring its client services team and how it supports hospitals’ medical device integration efforts.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Monday Morning Update 8/12/13

From Ramblin’ Gambler: “Re: HIT Policy Committee’s FDASIA workgroup. They released their draft EHR patient safety guidelines. I don’t think they went far enough.” The draft guidelines call for leaving healthcare IT unregulated by FDA, but encourage reporting,  post-implementation safety testing, and allowing customers to publicly rate their applications. They also call for national standards for quality process and interoperability and encouraging vendors to publicly share patient safety information.

From Leopold: “Re: breach. I had to chuckle at this one. The mixup was caused by a vendor named Infocrossing.” A programing error causes the medical information of 1,300 patients of MO HealthNet to be sent to incorrect addresses. Infocrossing is owned by India-based Wipro.

From Tennessee Dreamer: “Re: Re: Halamka’s view from the bunker. One really has to wonder whom he thinks he is fooling. When a topnotch trainee, who can do his residency at BIDMC, with its cloud-hosted, thin client, mobile friendly, highly interoperable software that is used nowhere beyond a city block from campus, or go to Mass General and use a commercial product that they will very likely use in their academic careers no matter where they wind up, will they decide to contribute to or chip away at BIDMC’s ‘strategic advantage?’ To express the obvious, that the academic, informatics-based HIT development enterprise has been a failure, clearly exemplified by BIDMC being surrounded by Epic in an over-before-it-began war for keyboards and eyeballs in the Boston healthcare market, would be too much to ask of Halamka, half of whose political capital is gained by his ever optimistic view of HIT. Yes, you can build a great suite of software when the only people you have to please are your friends and colleagues in your own neighborhood, when it really gets tough is please hundreds of other institutions at the same time. If Halamka was going to have made a real impact on healthcare, he and others in  the informatics community would have stopped living off government grants and taken the plunge to commercialize their products, putting their necks on the line in the marketplace and, if they were good enough, actually winning the war, to the benefit of everyone. But why do that, when even today you can retreat to the ever fewer centers, give each other tenure and Collen awards and cite each others’ JAMIA papers for research on products that hardly anyone uses? There are many useful lessons to be learned, and productive plans to be made in the current situation. Sitting in the last Boston holdout convincing yourself that you’ve fought the competition to a tie, and might yet win, isn’t one of them.”

Nearly 80 percent of poll respondents say they don’t pay any attention to Most Wired-type magazine awards. New poll to your right: is it necessary that the next National Coordinator be a physician?

Welcome to new HIStalk Platinum Sponsor lifeIMAGE. The company provides a network for sharing medical imaging information. Physicians, hospitals, and patients can securely exchange images from any location and integrate the images with EHRs and other systems. Workflows are defined for managing CD-based exams, receiving exams electronically from any source, importing images from outside into local systems, and sharing exams with physicians and patients. The network also includes a secure social component that allows individual users to connect with each other to exchange images. The company was the first to undergo a comprehensive KLAS review, with results that include 94 percent “would buy again” responses, along with 97 percent of clients interviewed saying the company keeps its promises. Notable customers include Boston Children’s Hospital, Mass Genera, and CHOP. Thanks to lifeIMAGE for supporting HIStalk.

I found this YouTube video describing how lifeIMAGE works.  

Private equity firm LLR Partners makes an investment in Philadelphia-area consulting firm HighPoint Solutions, which says it will become the largest life sciences and healthcare IT consulting company in the world by 2017.

HIStalk Webinar

Elsevier will present “Invigorate Order Set Management: Four Essential Steps” on Tuesday, August 27 from 12:00 – 12:45 p.m. Eastern. Presenters will be Jim Nolin, MD, editor in chief for order sets at Elsevier, and Kevin W. Hatton, MD, medical director of clinical decision support at University of Kentucky HealthCare.

University of Michigan researchers develop WattsUpDoc, which detects malware in biomedical devices by looking for changes in the power they consume.

Amendola Communications employees create a fundraising page for a co-worker, hoping to raise $10,000 towards the cost of brain tumor treatments for her newly diagnosed three-year-old son.

Merge Healthcare announces that CEO Jeff Surges has resigned due to poor company sales and will be replaced by Justin Dearborn, president of the company. Shares dropped 46 percent Friday on the news, dropping its market cap to $227 million.

It’s Siemens Part 4 this week in Vince’s HIS-tory.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

News 8/9/13

Top News

Allscripts reports Q2 results: revenue down 7 percent, adjusted EPS $0.05 vs. $0.16, missing earnings expectations of $0.10. Revenue of $345 million missed expectations of $357 million. Shares are down 6 percent in after-hours trading. It’s the third straight quarter that MDRX has fallen short of expected profit. The announcement’s headline is a clear signal of a bad quarter given that neither revenue nor earnings are mentioned, indicating that the company was forced to dive deeper into the financials to find something to brag about. Allscripts is moving its focus (or at least the attention of analysts) to population health management given the minimal mention of its ambulatory solutions. I tried to listen to the conference call, but felt cognitive dissonance as the optimism I heard didn’t match the pessimism the numbers suggest.

Reader Comments

From Fraudbuster: “Re: Farid Fata, MD. Charged with Medicare fraud. He is affiliated with Crittenton Hospital in Rochester, MI and its cancer center. It’s big news in the Detroit metro.” Federal agents arrested the doctor at his practice Tuesday, charging him with a $35 million Medicare fraud scheme that included administering chemotherapy and PET scans to cancer patients who had no chance of survival. He is accused of employing hundreds of unlicensed doctors trained outside the US to see patients first so he could visit with 50-70 patients per day and bill Medicare for his time, which totaled $25 million plus another $24 million in drug infusions, making him #1 in Michigan. He’s also accused of taking home bags of patient records to do billing from his home. The complaint says that in one case, the doctor insisted that a male patient who had fallen and struck his head on the way to the clinic be given his chemo before being taken to the ED, where he later died of the head injury. You might think CMS suspicion might have been raised earlier(and payments frozen) by doctor billing $25 million.

From Bob: “Re: McKesson Horizon. My hospital is looking to migrate to Paragon. Can anyone share insight?” If your hospital has done the conversion or is underway, please leave a comment.

From DCInternRoomate: “Re: ONC-funded HIEs. They are failing, so expect a huge Blue Button push next week.” I’m assuming you are saying that HIEs have had minimal impact, so patients will be reenlisted as the hand-carrying human interfaces between non-interoperable systems. I wouldn’t necessarily disagree. Technology bears some of the blame for mandatory sneakernet, but mostly it’s the screwy US health system that created the problems involved with expecting competitors to freely share information, not to mention to disenfranchise the patient to the point where they are merely the widget that must be processed in order to trigger sending out a bill. Medicare in the 1960s made healthcare a business and not a charitable endeavor or a public health project as it simultaneous drove (short term) and drained (long term) the US economy, so it’s hard to work corporate empathy and compassion in there. Hospitals have generally good intentions but poor execution.

From Velvet Hammer: “Re: HCA. This e-mail should give you an idea about HCA’s EMR plans.” The e-mail describes plans for HCA and Reston Hospital Center to roll out Meditech Advanced Clinicals, which would suggest that perhaps HCA won’t abandon Meditech for Epic or Cerner after all.

From MyFirstTime: “Re: [vendor’s name omitted]. I called them to learn more, but they say they are getting so many calls that they have started a wait list for new customers. Is healthcare IT so popular that it is now mainstream?” I can’t imagine that a lab ordering and results solution is creating such demand no matter how good it is, but readers have reported that it’s the real deal. I’m not mentioning the name again because this comment smells a bit like a company planted item, having originated in the same location as the company’s headquarters.  

From Gordian Knot: “Re: Halamka’s recent self-indulgent blog post about benefits of keeping his organization homegrown. First, I really, really wonder what the cost analysis is when sites need to meet current regs. Second, I do find it humorous how other bloggers and semi-news sources immediately linked his comments with Maine Med having issues with an install of Epic. It all sounded like voices that have been waiting to jump on anything negative about Epic. How many people in leadership got ejected because of an install gone bad with Allscripts or Cerner or Siemens any other system? Look at Lahey and UCSF as extremes of installs gone bad. Since Epic is just about the only one installing anything,  a few missteps gonna happen.” I used to advocate homegrown software, but those days were gone once the federal government started setting the development agenda. It’s ironic that hospitals that outsource activities such as food service, ED coverage, and even clinical departments assume that they are better enterprise software developers than companies whose own core mission is exactly that. Sometimes organizations really do have expertise and processes that preclude using commercial software effectively, but usually they just overestimate their wonderfulness. Those big hospital systems that like developing their own systems (not BIDMC specifically – I ‘m generalizing now) often have the money to run huge IT departments because they’ve created a lofty-brand pricing monopoly rather than because they have the highest efficiency or best outcomes, and with reimbursement changes, they will just keep buying up practices and hospitals and spreading mediocrity.

HIStalk Announcements and Requests

From HIStalk Practice this week: 80 percent of clinicians use smartphones and almost half of physicians use a combination of smartphones, tablets, and laptops / desktops for professional work. Patients using EMRs through online portals express significantly higher satisfaction with their physicians and believe they are receiving better care. The AMA says CMS still has more work to do on the Medicare Physician Compare website. A reader reports on Aprima’s national user conference. A Colorado orthopedic clinic fires an employee who emailed PHI to her personal email in order to do some work from home. August is “Admit You’re Happy Month” which seems like the perfect reason to admit you’d love to make me happy by signing up for HIStalk Practice email updates. Thanks for reading.

Some recent HIStalk Connect posts worth your time:

Epocrates Mobile Trends 2013
HIStalk Connect Interviews Joe Reinardy, Founder and CEO, CenterX
Battle of the App Stores: athena vs. Greenway

Listening: Built to Spill, Idaho-based catchy guitar indie rockers that hit their popularity peak in the late 1990s that I’ve somehow missed until now. They’re on tour and I’m likely to check them out.

Welcome to new HIStalk Platinum Sponsor Valence Health, which offers providers turnkey solutions for delivering value-based care. The Chicago-based company has been doing that for 20 years and serves 35,000 physicians, 115 hospitals, and 15 million patients. Customers include Cleveland Clinic, Scott & White, OhioHealth, and half of the country’s freestanding children’s hospitals. Hospital solutions include clinical integration, population health, care management, analytics, managed services, physician network development, and financial analysis of value-based arrangements. Its Vision platform combines data from practice-based PM/EMRs, standardizes it with other data (hospital bills, labs, PBMs, LTC, payer), runs it through a proprietary EMPI, and then generates reports and analytics that measure quality, cost, and utilization and provides risk scores, identification of high-risk patients, and information to establish programs for specific populations and conditions. Its vMine technology obtains daily data from all certified PM/EMR systems and takes only 30 minutes to install remotely. Thanks to Valence Health for supporting HIStalk.

Elsevier will present “Invigorate Order Set Management: Four Essential Steps” on Tuesday, August 27 from 12:00 – 12:45 p.m. Eastern. Presenters will be Jim Nolin, MD, editor in chief for order sets at Elsevier, and Kevin W. Hatton, MD, medical director of clinical decision support at University of Kentucky HealthCare.

Acquisitions, Funding, Business, and Stock

LifeNexus, which offers a personalized health information smart card, raises $3.7 million from unnamed investors. Smart cards have been a solution looking for a healthcare problem for at least 20 years and almost always fail miserably, even when packaged as a hospital loyalty card.

Could computing vendor ClearDATA secures $7 million in second-round funding from Excel Venture Management and Norwest Venture Partners.

SEC filings indicate that activist investor Carl Icahn has increased his stake in Nuance from the 9.3 percent of the company’s shares he reported in April to 16 percent now.

Sales

Geisinger Health System selects VisiQuate to develop predictive revenue cycle analytics to increase efficiencies and lower collection costs.

Boulder Community Hospital Physician Clinics select Wellcentive’s Advance platform to facilitate care coordination in support of its PCMH implementation and as part of its comprehensive primary care initiative.

Twenty-four bed Cozby-Germany Hospital (TX) will implement RazorInsights ONE-Enterprise Edition.

People

Chris Belmont (Ochsner Health System) will be named as VP/CIO of The University of Texas MD Anderson Cancer Center (TX). I interviewed him in February.

Announcements and Implementations

St. Louis Children’s Hospital (MO) goes live on iMDsoft’s MetaVision for perioperative.

The Medical Center of Central Georgia (GA) implements Cerner CPOE with assistance from HCI Group.

The Baylor Quality Alliance ACO (TX) will expand its private HIE into a community HIE using technology from Sandlot Solutions.

Quantros will announce Friday that more than 1,500 Target stores and 50 Target clinics will implement its Safety Rx medication incident reporting system.

Texas Health Harris Methodist Hospital Hurst-Euless-Bedford, which surely must possess the longest and least-pronounceable hospital name in America, goes live on PCCI’s Pieces EMR-driven clinical surveillance and risk scoring system. PCCI is Parkland Center for Clinical Innovation, launched by Dallas-based Parkland Health & Hospital System in October 2012. Meanwhile, Parkland Memorial Hospital was finally deemed safe by CMS on Wednesday, which threatened in 2011 to cut off the hospital’s Medicare and Medicaid funding because of patient safety issues. The federal government said then that Parkland’s problems posed “an immediate and serious threat to patient health and safety,” forcing the hospital to spend $75 million on changes in the past two years.

Lubbock, TX hospitals launch the Llano Estacado Access Partners HIE, with the $80K startup costs underwritten by University Medical Center and Covenant Health System. 

Government and Politics

HHS releases a strategy for accelerating HIE in support of delivery and payment reform. Specific strategies and policies include:

• Developing regulations and guidance on existing programs to enable the secure portability of health information
• Advancing HIE among long-term, post-acute, behavioral health, and laboratory providers
• Developing standards, including an interoperability and certification road map and HIT standards for quality measurement and improvement
• Implementing incentive and reward-based policies to encourage providers to incrementally incremental adopt electronic HIE.

Innovation and Research

The Inova Translational Medicine Institute at Inova Fairfax Hospital (VA) and GNS Healthcare will develop and commercialize computer models for predicting risk of preterm live birth using next generation sequencing and EMR data.

Other

Seventy-nine percent of providers using clinical decision support surveillance software report that utilizing the technology has a moderate to significant impact on clinical outcomes, according to a KLAS report. Nearly all Epic, Hospira, and Wolters Kluwer users reported a moderate to significant impact on clinical outcomes, including reductions in length of stay, antibiotic usage, medication costs, and adverse reactions as well as better IV-to-PO conversions.

Highly rated with preliminary data in the KLAS report is PeraHealth, formerly Rothman Healthcare Corporation. I interviewed co-founder Michael Rothman in 2010 about what was then known as the Rothman Index, a real-time patient assessment and clinical decision support tool that readers found promising.

Genesis Health (IA) alerts several hundred patients that the transcription company used by Cogent Healthcare, its contract hospitalist provider, had exposed their information. It turns out it wasn’t just Genesis: Cogent now says India-based M2ComSys exposed information on 32,000 patients due to an incorrectly secured Web server. Cogent has since fired M2ComSys, which might have triggered confidence concerns initially given that all the photos on its home page still bear the stock photography watermark indicating that they apparently just stole the pictures instead of licensing them.

GlaxoSmithKline announces that packages of its vaccines will include two-dimension bar codes, which are smaller and can contain more information that linear bar codes. GSK will include lot number and expiration date so that hospitals and practices can log the information automatically in their EMRs.

Weird News Andy says he isn’t Captain Renault, but he is shocked – shocked – to read that CMS is months behind in testing data security for the health insurance exchanges that are supposed to be operational on October 1. CMS, having missed two June test dates, says it will instead test security on September 30, the day before the PPACA-mandated insurance exchanges are scheduled to be open for business.

Sponsor Updates

• Encore Health Resources announces that its Activation Support Services has supported 28 go-lives in 22 hospitals involving more than 10,000 physicians in the past 18 months. Chief Medical Officer Judi Binderman, MD will present EHR go-live challenges in an August 15 HIStalk Webinar, “Full Speed Ahead: Creating Go-Live Success.”
• Sharp HealthCare (CA) reports that its use of Caradigm’s Identity and Access Management suite has allowed it to grant system access requests in an average of one day compared to 21 days previously.
  NextGen Healthcare reseller ITelagen introduces UroWorx, a series of urology-focused templates for use with NextGen Ambulatory EHR.
• Imprivata announces that its OneSign solution is the most widely deployed SSO product at hospitals using Siemens Soarian Clinicals.
• CTG Health Solutions posts a white paper outlining the potential impact of big data on healthcare organizations.
• TrustHCS joins Greenway Medical’s online marketplace to offer PrimeSUITE customers access to its coding and ICD-10-readiness solutions.
• StrataRx releases details of its annual conference September 25-27 in Boston.
• iHT2 interviews Rick MacCornack, chief systems integration office for Northwest Physicians Networks (WA), who will be a featured speaker at iHT2’s August 21-22 HIT Summit in Seattle.
• Emdeon simplifies the new ACA operating rules and guidelines in its August newsletter.

EPtalk by Dr. Jayne

I can’t count the number of emails and text messages I received this week asking what I thought about Dr. Farzad Mostashari’s impending departure from ONC. Of all the names that are being thrown around as possible successors, none of them happen to share his impeccable taste in neckwear. I’m going to continue to appreciate each day that he remains on the job, although I suspect I will likely have to go into mourning when he leaves. I have a feeling we haven’t seen the end of his influence on health IT regardless of where he lands.

CMS issues a clarification on how multiple eligible professionals contributing to a patient portal may count a patient who views information. I’m glad they clarified that the patient does not have to specifically view information contributed by a particular provider for him/her to receive credit. Trying to track that level of data would truly be a chore.

Registration for ONC’s Third Annual Consumer Health IT Summit will begin on August 12. The event is September 16 and will include an announcement about a new eHealth campaign. How’s that for a teaser? The email from ONC was quite mysterious, and although it included a sentence missing the object of a preposition, it didn’t include a link to register or a specific website.

It may be old news, but I didn’t want to fail to mention the planned partnership to link LOINC and SNOMED. It should help with interoperability and hopefully will make things a little less difficult for those of us who have to hook everything up behind the scenes for hospitals and health systems.

Earlier this week one of my good friends mentioned he was frustrated with my health system’s lack of a patient portal. He can access the competitor’s portal but not ours and wanted to let me know. I was surprised since I helped install it almost four years ago. Turns out his physician is merely on staff at one of our hospitals rather than being employed by us, therefore uses a different EHR that may or may not have a portal live. We had a nice chat about the different kinds of community physicians and that their choice of EHR is largely determined by their employment status. It reminded me how obtuse the architecture of our healthcare delivery system is and how ridiculous it must seem to people working in more reasonably structured industries.

Pressure ulcers are a major problem in debilitated patients and ONC announced the winners of their mobile app challenge aimed at assisting nurses in documenting assessments and interventions for ulcer risk and prevention. The winning solution was WoundMAP PUMP from MobileHealthWare. It includes automatic graphing of wound size and time-lapse review of photos. The app is currently in beta testing.

I always like to hear about low-tech solutions and this story got my goat. Eco-Goats provides “environmentally friendly vegetation control,” which will be used at Washington’s Congressional Cemetery. Maybe I can get them to assist with my kudzu problem.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

News 8/7/13

Top News

It’s true “@Cascadia: New era coming as @Farzad_ONC announces he is leaving @ONC_HealthIT”

— Farzad Mostashari (@Farzad_ONC) August 6, 2013

Farzad Mostashari, MD, MSc announces via Twitter that he has resigned his position as National Coordinator for Health Information Technology, a post he has held for two years and will vacate in the fall. The internal announcements are here.  Who would you choose to replace him, either the individual or the ideal background? Leave a comment with your thoughts – you never know who might be listening.

Reader Comments

From BowTie No More: “Re: ONC. Big announcement coming out tomorrow …” I received this anonymous rumor report Monday. I asked the official ONC press contact as well as an insider if Farzad was resigning and received no response from either, which I told Inga seemed suspicious. The tiebreaker was that Inga’s contact didn’t know anything about it, so I decided to wait and see. I should have direct messaged Farzad, although he probably would not have confirmed.

From Piker: “Re: Farzad. Where’s he going?” He claims he doesn’t know. I would do what he’s doing: announce my availability well before my last day at ONC and see what offers roll in during the interim. He’s not making a mint working for Uncle Sam and therefore probably can’t undertake a lengthy job hunt after his federal checks stop, but he certainly can cash in big time afterward if that’s his ambition. A reader sent a rumor that he described as “weak” that perhaps Farzad is going to Siemens, playing off an earlier rumor that the company was about to hire an unnamed notable. Other than Farzad’s relationship with Siemens Medical Solutions CEO John Glaser, I don’t know why he would go there, so I would put those odds as low.

From Lazlo Hollyfeld: “Re: Farzad. Vendor – no way.  He’ll join a policy / consulting shop (maybe a K Street firm or not), get a few director positions on various boards (10-20k/year for each director position that is almost free), and reevaluate what he wants to do. It’s time for him to go make some easy cash, stop getting grilled on the Hill, and kick back.” That’s more along the lines of what I would expect him to do. His conscience would be clear that he didn’t sell out completely since he would still involved with healthcare IT at a high level, he wouldn’t have to deal with ugly vendor issues like profitability and product lines, and his value would be highest in offering his cache to the highest bidders. 

From InfoDoc: “Re: HIMSS board. I am considering running for a position. Will it be worth my time? Will HIMSS be gaining or losing power in the next four years?” The general consensus is that HIMSS has become increasing vendor-focused in recent years, as opposed to provider-focused. With that shift, I am sure there are plenty of providers and provider organizations who believe HIMSS is not the unbiased advocate it may have been 10 or 15 years ago. On the other hand, you don’t have to look further than the increasingly crowded exhibition floor at the annual conference to recognize the importance that vendors place on HIMSS. As to whether a board position is worth your time, I’d say it in part depends on whether you are hoping to be a voice of providers or of vendors. Readers?

From Boy Lee: “Re: recruiter. This recruiter needs 20 analysts per Cerner module. Is a large nation-state converting to Cerner?” That’s a lot of analysts, suggesting a fast rollout by a big organization. I thought first of HCA, which at one time was looking at Cerner and Epic as an alternative to Meditech 6.0. If you know who it is, tell me. I started to call the recruiter, but dreaded getting locked into a lengthy conversation that probably wouldn’t have resulted in my getting the employer’s name anyway.

From Larry: “Re: Practice Fusion HL7 ORU laboratory specs. The tech writer forgot to take the spec doc out of Word’s Track Changes mode before saving it as a PDF. Perhaps you can drop a hint to accept all changes, turn off the balloon display option, and convert it to a clean PDF with working hyperlinks? Just trying to help on the long slog to interoperability.” Hopefully this will provide the hint.

HIStalk Announcements and Requests

Forget MU and all of Farzad’s accomplishments at the ONC. The real bummer is that Dr. Jayne and I will have to seek a new HIT crush. This is my favorite picture of Dr. Jayne, by the way, who photo-bombed an intense conversation between Farzad and Jonathan Bush at this year’s HIStalkapalooza.

Lt. Dan not only writes  the daily HIStalk news headlines and articles on HIStalk Connect, he’s also a veteran and healthcare IT guy. I ran his comments about how he would approach the never-ending (and always expensive) VA-DoD EHR issues. He got a response from an Army Medicine physician who’s working on project similar to what Lt. Dan proposed. We may have updates, depending on what can be said publicly at this point since it’s more of a concept than a finished project.

Welcome to new HIStalk Gold Sponsor Talksoft, which offers HIPAA-compliant patient reminder systems (phone, email, mobile, and SMS) for appointments, recall reminders, broadcast messages such as last-minute practice closings, payment reminders, notification of new lab results, and outreach calls to help meet Meaningful Use requirements. Practices can estimate their ROI with the on-screen calculator. Orthopedic Associates of Rochester felt pretty good about its 9.4 percent no-show rate vs. the national average of 16 percent, but using Talksoft dropped it to 5.6 percent. Setup took a week (some customers are up and running within a day), one hour of office time, and no phone line or computer hardware, plus Talksoft charges only for usage with no subscription commitment required. I enjoyed playing around with the sample messages and looking at the audit report, and thought it was cool that the practice’s brand is protected because caller ID shows the practice’s number, all aspects are customizable, and the practice records its own messages so the patient hears a familiar voice. Thanks to Talksoft for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

The SSI Group acquires the Dallas-based Claimsnet.com, a provider of claims processing solutions and payer connections.

Hospital billing provider HealthTech Solutions acquires RCM provider Gaffey.

Vocera reports Q2 results: revenue up 12.9 percent, adjusted EPS $0.01 vs. $0.09, beating earnings expectations of –$0.03. Shares are up 18 percent in after-hours trading.

Nuance announces Q3 results: revenue up 9.5 percent, adjusted EPS $0.34 vs. $0.45. CEO Paul Ricci warned that a shift to a subscription-based revenue model will hurt revenue and margins of its mobile offerings in the short term. The company’s healthcare unit was the star, with sales up 29 percent.

Sales

Providence Health & Services contracts with Quantros to provide safety performance improvement advising services across 16 of its facilities.

BCBS of Tennessee will implement Care Team Connect’s population health management platform.

The VA awards CACI International a $14 million contract in to build a data exchange platform that consolidates EHR data and benefits information across the VA, DoD, and other agencies as part of its VLER program.

Rideout Health (CA) chooses the Pavisse incident management solution from RGP Healthcare.

American Medical Software selects Health Language applications from Wolters Kluwer Health to enhance clinical documentation and regulatory compliance in its ambulatory EHR solutions.

The Indian Health Service awards SAIC a $17 million task order to help replace the agency’s electronic dental record system.

HealthSouth signs a five-year deal worth up to $20 million to implement a nurse communications system from Australia-based Austco Marketing and Services.

People

David Furnas, CIO of Gila Regional Medical Center (NM), resigns in the wake of the hospital’s financial crisis that has resulted in the departure of most of the senior leadership team.

TeraRecon names Jeff Sorenson (Hyland Software) SVP of global sales, marketing, and business development.

UltraLinq Healthcare Solutions hires Bao Ho (Canon Healthcare Solutions) as VP of sales.

Announcements and Implementations

The Indiana HIE and Predixion Software will jointly develop predictive health analytics solutions to be offered by IHIE to ACOs and hospitals across Indiana.

Taylor Regional Hospital (GA) integrates its CPSI EHR with PeriGen’s PeriCALM perinatal system.

The Mount Sinai Medical Center launches RateMyHospital, a real-time patient feedback survey tool for patients seen in its cancer treatment center.

Modern Healthcare announces what it calls “Healthcare’s Hottest,” its list of the 40 fastest-growing companies (companies nominate themselves and their own financial information is used to choose the winners). I don’t recognize all the names, but sponsors that were included are Allscripts, Beacon Partners, CTG Health Solutions, Cumberland Consulting Group, ESD, Impact Advisors, Imprivata, Intellect Resources, and The Advisory Board Company.

Government and Politics

ONC’s Consumer Health IT Summit will be held in Washington, DC on September 16, 2013. Admission is free and the morning’s general session will be streamed live. Registration opens next week.

Other

According to a Health Affairs-published study co-authored by the ONC’s Farzad Mostashari, MD, almost six in 10 hospitals actively exchanged electronic health data in 2012., an increase of 41 percent since 2008.

An organization-wide e-mail sent by Kaiser Foundation Hospitals and Health Plan CEO Bernard J. Tyson says the organization needs to focus on affordability and intends to hold per-member, per-month costs flat, reducing the current 3 percent trend to zero, because of “competitors who are enjoying unprecedented success in managing costs.” He wants to see membership growth, care transformation, and standardization of care and service at all locations. HealthConnect wasn’t mentioned, which never would have happened under George Halvorson.

The CEO of Fletcher Allen Health Care (VT) says that despite an expected $200 million in losses over the next 10 years due to Medicare cuts, the health system will add 280 jobs. Many of them will apparently result from its implementation of Epic. According to the CEO, “You do create new jobs. If you’re going to interface new technology, you need people who are savvy about health care and that are savvy at getting into relatively complex software and systems.”

An investigative report finds that six of UCLA’s 17 academic deans claim that their medical conditions require them to fly first class despite a University of California ban prohibiting it. One of them is triathlon competitor and self-professed “cardio junkie.”

Weird News Andy is moved by this story. A man who has been hospitalized and ventilated for 45 years after a bout of polio-caused infantile paralysis teaches himself computer animation and is creating a TV series about his life.  

Trustwave warns that a luxury toilet’s Android app could allow hackers to “cause the unit to unexpectedly open/close the lid, activate bidet or air-dry functions, causing discomfort or distress to user.”

Report from the AHDI Conference
By Jay Vance, CMT, CHP

The Association for Healthcare Documentation Integrity (AHDI) has wrapped up its Annual Conference & Expo held this year at the Buena Vista Palace Resort in Orlando. This is the annual meeting of the professional association for Healthcare Documentation Specialists (formerly referred to as medical transcriptionists).

Unabashed rebranding is underway to portray HDS as true HIM professionals who are important contributors to accurate clinical documentation, quality patient care, and by extension, to improved reimbursement. As part of this rebranding, future annual meetings, beginning next year in Las Vegas, will be known as Healthcare Documentation Integrity Conferences. Additionally, AHDI is working closely with AHIMA, the American Health Information Management Association, to bring greater understanding of the important role of HDS to a wider audience.

Admittedly late out of the starting gate, our association is nevertheless pushing back hard against the perception of HDS as glorified typists who cost money and are easily replaced by technology such as speech recognition technology and, of course, electronic medical records systems. The reality is that SRT still requires thorough review by human editors, while many EMRs are so user-unfriendly that an entire medical scribing industry is springing up to relieve caregivers from the burden of having to use those expensive EMRs which were supposed to reduce costs by eliminating the need for transcription.

Furthermore, it seems more than coincidental to many HDS that costly clinical documentation improvement programs have grown in inverse proportion to our devaluation and outright elimination. Declining physician productivity and satisfaction? Those have also gotten worse as dictation has been eliminated and transcription budgets have been slashed.

Of course we understand that correlation doesn’t necessarily equate to causation, and certainly there are other forces in play. But just because we’re paranoid doesn’t mean they aren’t out to get us. All facetiousness aside, there are a number of research initiatives underway within our industry to quantify in real terms to what degree, if any, removing skilled HDS from the clinical documentation process has adversely affected the quality of documentation, and concomitantly, negatively impacted patient care and provider revenues.

Sponsor Updates

• Stern Cardiovascular Foundation (TN) reports that its use of Emdat for dictation and transcription services has resulted in significant process improvements, reduced costs, and improved provider productivity.
• Orion Health introduces a converged cloud service based on HP’s CloudSystem Matrix, which will support cloud services tailored to individual customers.
• Siemens Healthcare will offer mobile alert, notification, and secure messaging services from EXTENSION to users of Siemens Soarian and legacy Siemens EHR products.
• CCHIT designates eClinicalWorks V10 compliant with the ONC 2014 Edition criteria and certifies it as a complete EHR.
• CIC Advisory releases a report on the challenges and opportunities facing the country’s top healthcare organizations.
• Aprima PRM 2014 EHR/PM v. 14.0 earns Meaningful Use Stage 2 certification as a Complete EHR.
• The FDA grants 510(k) market clearance for Alere MobileLink, a self-testing at home device that connects to Alere’s Connected Health platform.
• Allscripts, McKesson, Medicity, and Sandlot Solutions sponsor a webinar discussing how leading healthcare organizations are using data and analytics.
• Outside Magazine names iSirona to its list of best places to work.
• The Association of Affiliated Plans names CTG Health Solutions a preferred vendor.
• Clinical Architecture CEO Charlie Harp reviews data normalization in a blog post.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Internal Announcements of Farzad Mostashari’s Resignation

HHS provided this information.

From: Sebelius, Kathleen (HHS/OS)
Sent: Tuesday, August 06, 2013 10:51 AM
Subject: Important Staff Announcement

Hello Colleagues,

I am writing to share the news that Dr. Farzad Mostashari has advised me he will be stepping down as National Coordinator for Health Information Technology this fall.

Farzad has been a leader in the Office of the National Coordinator for Health Information Technology (ONC) for the last four years.  Farzad joined the office in 2009 as Principal Deputy National Coordinator and took over as the National Coordinator in 2011.  During his tenure, ONC has been at the forefront of designing and implementing a number of initiatives to promote the adoption of health IT among health care providers.  Farzad has seen through the successful design and implementation of ONC’s HITECH programs, which provide health IT training and guidance to communities and providers; linked the meaningful use of electronic health records to population health goals; and laid a strong foundation for increasing the interoperability of health records—all while ensuring the ultimate focus remains on patients and their families.  This critical work has not only brought about important improvements in the business of health care, but also has helped providers better coordinate care, which can improve patients’ health while saving money at the same time.

During this time of great accomplishment, Farzad has been an important advisor to me and many of us across the Department.  His expertise, enthusiasm and commitment to innovation and health IT will surely be  missed.  In the short term, he will continue to serve in this role while a search is underway for a replacement. Please join me in wishing Farzad all the best in his future endeavors.

Kathleen Sebelius

From: Mostashari, Farzad (HHS/ONC)
Sent: Tuesday, August 06, 2013 10:23 AM
To: OS – ONC Feds
Subject: Announcement

My Dear ONC’ers,

On a pre-dawn morning in June 2009, I paced helplessly outside my Mom’s hospital room as alarms beeped and the monitor showed the most recent run of life-threatening heart arrhythmia. I had screwed up my courage to ask to see the paper chart, but I couldn’t even read the cardiology consult’s name. After her discharge it was also very difficult to get her records; she didn’t get needed follow-up and required emergency surgery. The complications, which weren’t supposed to happen, indecently increased the hospital’s revenue.

I joined ONC a week later.  This office had a daunting task ahead of it. Working backwards from the outcomes we hoped to enable, we had to define “Meaningful Use” of electronic health records, establish a new certification program, endorse national standards, design and set up a slew of new grant programs to assist in health IT adoption, exchange, workforce, research, and privacy.  There were 32 staff members. 

You will remember the successive sprints – to recruit and establish the Regional Extension Centers and collaborate with newly appointed Health IT coordinators in every state.  The “Office of No Christmas” moniker that we earned for yuletide rulemaking. Trudging 4 miles through the blizzard–to a hotel that still had power– for Beacon application reviews.

And then came an intense focus on implementation and integrity of our grant programs. Accelerating consensus around healthcare standards through an innovative new open source community paradigm in the Direct Project and its successor Standards and Interoperability Framework. Coordinating policy with our federal partners.  Adding a new focus on consumer eHealth, and giving consumers access to their own data through the Blue Button. Creating a Health IT safety program.

We gradually assembled within ONC a microcosm of the diverse and passionate Health IT community itself.  Implementers, doctors and nurses, software developers and project managers, privacy experts, proud standards geeks, patient advocates, public health workers, researchers and data analysts. And we added strength, integrity and resilience by recruiting a core of civil servants who are dedicated to lifelong public service.

You each brought to ONC your own personal commitments and your community’s perspectives, and we unified those divisions through our shared goals: A better health system– that truly knows and cares for all of its patients- through application of information and learning. You nurtured a culture of commitment to American innovation, and an essential optimism that healthcare’s best days are ahead of us.

Regional extension centers have assisted 140,000 providers- over 40% of all primary care providers in the country and over 80% of critical access hospitals- the largest medical technical assistance project in history. Nationwide, adoption of health records has tripled in doctor’s offices and increased five-fold or more in hospitals. Over half of prescriptions are now electronic.  New functionalities essential for population health management are increasingly available and used. National standards and protocols for information exchange and interoperability are being implemented throughout the industry. Over the next 12 months we will see a great democratization of health information as individuals become empowered to download their own health information, and venture capital investment in new tools to help us manage our own health and healthcare are skyrocketing. Meanwhile, hospital readmissions are dropping, healthcare cost inflation is at historic lows, and the movement towards payment that rewards quality and value is gaining speed. 

My mom has recovered now. Her hospital is working to implement new systems to provide accountable care. Her prescriptions and health records are electronic and can be shared across the state. Like 37 million other elderly Americans, we can access her medical history with her Medicare Blue Button records on her mobile phone.

There are formidable challenges still ahead for our community, and for ONC. But none more difficult than what we have already accomplished.  In these difficult and challenging times, your work gives us hope that we can still do big things as a country. That government and the private sector working together can do what neither can do alone. We have been pioneers in a new landscape, but that landscape is one changed for ever, and for better.
It is difficult for me to announce that I am leaving. I don’t know what I will be doing after I leave public service, but be assured that I will be by your side as we continue to battle for healthcare transformation, cheering you on.

Best wishes to you all,

Farzad

Mostashari Announces Departure from ONC

It’s true “@Cascadia: New era coming as @Farzad_ONC announces he is leaving @ONC_HealthIT”

— Farzad Mostashari (@Farzad_ONC) August 6, 2013

Farzad Mostashari, MD confirmed via Twitter this morning that he will step down from ONC as National Coordinator. He did not announce his plans and his replacement has not been announced.

HIStalk reader “Bow Tie No More” provided that rumor yesterday, but ONC would not confirm.

Full text of the internal announcements is here.

Monday Morning Update 8/5/13

From DCIntern: “Re: Stage 3 Meaningful Use. Expect ONC to recommend a delay during National Health IT Week.” Unverified.

From Fly on the Wall: “Re: [vendor name omitted]. Having glitches nationally and worldwide in its medication reconciliation programming, causing patient discharge medication lists to be in error. A safety letter was issued on August 1.” I’ve asked the company to confirm, but in fairness I’m leaving their name off until I hear back. A copy of the safety letter would be nice to have.

I needed updated copies of Microsoft Office and wasn’t too thrilled at the price or the limit of installing it on only one PC (it was three PCs in previous versions), so I was happy to have stumbled onto Office 365. The Premium version (Word, Excel, PowerPoint, Outlook, OneNote, Access, and Publisher, all in 2013 version) runs $99.99 year for up to five PCs or Macs and also five mobile devices. I don’t like renting software instead of owning but was about to bite the bullet when I strayed onto Office 365 University. Students, faculty, and staff of approved education institutions (like my hospital) can get a four-year, two-PC subscription that includes 20GB of SkyDrive storage for $79.99, which I did –$20 per year is just fine with me. Installation was slick, fast, and in the background. The new software versions work great, but I haven’t been able to figure out how to use the cloud features, especially with Outlook. It would be a really slick package if Microsoft offered an easy guide on how to use all the file-sharing features it touts. I admit that I didn’t spend much time trying to figure it out, but so far I’m using it just like the old CD version.

Three-fourths of poll respondents don’t see HIMSS as a major player in the debate about healthcare quality and cost. New poll to your right: do you follow the “Most Wired Hospital” type awards? The poll accepts comments once you’ve voted if you would care to elaborate.

Stock picking TV celebrity Jim Cramer, whose lips were perpetually planted on Glen Tullman’s posterior until Cramer finally advised dumping Allscripts shares way too late, is now enamored with Jonathan Bush and athenahealth. Cramer is entertaining, but watching him can be expensive if you take his stock advice. Bush says hospitals are in a decline and struggling ones are being bought up by sharp for-profit operators whose efficiency allows them to make a profit. Cramer says athenahealth “is solving a lot of the healthcare problems in this country.”

Financially struggling MaineHealth will shut down its nine-hospital tele-ICU program that loses $500K annually. One hospital says it pays $150K each year to participate, but, “While the service is fantastic for our patients, it’s not reimbursable … The consequence of this will be that some patients that may have stayed in the local community may have to travel further for care that we won’t be able to offer. MaineHealth signed a splashy deal with VISICU (now Philips) in 2005, with the health system’s president saying then, “The savings in lives and ultimately in dollars make it an important investment. It’s the kind of service that is possible only because we have forward-thinking clinical and administrative leadership.”

The previously insignificant number of physician practices that don’t accept Medicare is growing, according to a Wall Street Journal report that says 9,500 doctors opted out in 2012.

In England, a study of Internet searches for takeout food that originated from a hospital IP address finds that those searches quadrupled in one year.

An Iowa nursing home fires two employees for taking inappropriate photos of a resident and posting them on an unnamed social media site.

A former Health Management Associates hospital CFO files a whistleblower lawsuit claiming that the for-profit HMA and Tenet hospital chains paid kickbacks to two Georgia clinics in return for sending pregnant illegal aliens to their hospitals so they could bill Medicaid for emergency services. The clinics, which advertised, “We care about your health, not your immigration status,” were paid kickbacks disguised as translation service fees, according to the lawsuit. Illegals aren’t eligible for Medicaid, but emergency services, including childbirth, are covered.

Vince covers the HIS-tory of Siemens, Part 3 this week.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.