Monday Morning Update 10/22/12

From MyWay or the HyWay: “Re: Aprima. I hear that Allscripts is upset that Aprima is offering MyWay customers a free conversion to Aprima. I don’t understand the situation there.” Unverified, but that’s surely the case. Here’s some history for the industry newcomers. Misys was a train wreck in 2007, a clueless British company stuck with a bunch of badly aging practice EMRs that could not compete with newer, better, and cheaper competitors that were flooding the small practice market. Instead of developing a new product, Misys took the questionable step of paying iMedica for the source code to its EMR product in a non-exclusive agreement that allowed each company to do its own development going forward, with Misys relabeling its copy as MyWay and selling it through resellers instead of the traditional sales channel. The relationship got ugly, with all kinds of legal actions and maneuvering.

Misys then merged with Allscripts in 2008, its old HealthMatics EMR product was renamed Allscripts Professional, and iMedica changed its name to Aprima in 2009 (for a first-person historical snapshot, see my 2008 interview with Aprima CEO Michael Nissenbaum and my 2010 interview with Glen Tullman and the since-departed Phil Pead from Allscripts.)

Fast-forward to 2012: Allscripts tells customers it won’t enhance MyWay to meet ICD-10 or Meaningful Use Stage 2 requirements, but will support their continued use of their product as-is or convert them to Allscripts Professional for free. Aprima, sensing opportunity, offers those customers a similar deal to move to its product, which is a lot more like MyWay than Allscripts Professional (Aprima’s product isn’t ICD-10 or MU Stage 2 ready either, but the company has said those enhancements are on its roadmap.)

MyWay customers have four options:

1. Keep using MyWay, realizing that while Allscripts support will continue to be available, the product is moving into maintenance mode with no planned ICD-10 or Meaningful Use Stage 2 capabilities. Practices that don’t need those enhancements don’t need to make any change at all right away. Historically, however, vendors usually don’t continue to indefinitely support maintenance mode products, so this option is realistically more of a decision deferral than a long-term strategy.
2. Accept the rather generous Allscripts offer of a free conversion and no-change maintenance cost in moving to the arguably more comprehensive but also more complex Allscripts Professional. That’s a great deal on the surface, but with a caveat: even free EMR conversions to an entirely different product are painful and productivity-sapping, not to mention that the Allscripts conversion schedule is ambitious and they’ve previously struggled with even same-product upgrades (TouchWorks).
3. Convert from MyWay to Aprima at no charge. The Aprima product should look and feel more like MyWay than Allscripts Pro. The switch involves signing up with a different company, which could be good or bad depending on how you feel about Allscripts as a vendor. I don’t know if Aprima has ever done a conversion of that type, but I would suspect they haven’t.
4. Buy a competitor’s product instead of accepting a unwelcome migration to either Allscripts Pro or Aprima. That option makes sense only for a limited subset of customers given the effort and expense required for an on-your-own switch. However, kicking tires doesn’t cost anything, so some customers will probably at least explore competitive products, driving their sales reps crazy since “free” is a tough selling point to beat.

In comparing products, KLAS customer respondents score them about the same:

Aprima beats Allscripts significantly in the all-important “would you buy it again” number from real-life customers, which I consider to be the most important KLAS measure since it summarizes both the product and the company:

I’d want assurances from either vendor:

1. How much productivity will you lose during the switch?
2. Can you talk to reference sites that converted before yours? You don’t want to be the first one.
3. What information will be converted automatically? “Conversion” is not necessarily a generic term.
4. What’s the cost of any required third-party product licenses, hardware upgrades, optional maintenance costs, after-hours support availability, on site training if you think you’ll need it, etc.? Both companies suggest minimal changes, but I’d want that in writing.
5. Will they guaranteed maintenance costs with limited escalation?
6. Will they send you a sample project plan for the conversion?
7. What if something goes wrong? Every factor that’s important to your practice should be covered by a contractual promise from the vendor and a contractual penalty if they fail to meet it.

I’m a cheap-seater on this issue, so comments from Allscripts and Aprima users are welcome.

From Now Seriously: “Re: Paul Levy’s Stockholm syndrome comments about Epic. For some reason in his mind, it’s a bad thing that Epic skated to where the puck was going and got there first with string of solid installs that are successful models for the industry. His poor judgment and lack of clear thinking must have helped him achieve the title of ‘former CEO’ and his blog’s title change to ‘Not Running a Hospital.’” Paul is certainly entitled to his opinion even when it’s uncharacteristically negative, but he (and the pedantic EHR-haters that posts like this one always attract) would carry more credibility with actual experience using Epic or any other commercially available product. It’s the height of arrogance to dismiss the first-hand opinions and experiences of hundreds of hospitals and thousands of actual users of Epic or any other clinical system by writing them off as collectively deluded, like a know-it-all nosebleed-section sports fan shouting out naïve advice to a professional athlete. Paul finishes on a wild tangent in predicting that any Epic error (of which the documented incidence is apparently zero) will cause “a bunch of Congressional committees to come down on the firm like a ton of bricks.” That didn’t happen with Cerner at UPMC Children’s Hospital, the homegrown CPOE system at Cedars-Sinai, or Eclipsys at El Camino Hospital, where IT problems definitely threatened patients. Or for that matter, at Paul’s former employer BIDMC, where a multi-day network outage in 2001 that included its homegrown EMR surely exposed its patients to harm. The crux of his message seems to be that someone should stop Epic’s domination of the hospital systems market (like their competitors, maybe?) and the FDA should regulate clinical software, which always elicits passionate, conflicting opinions about whether government intervention generally improves a given situation.  

From HIPAA Girl: “Re: Blount Memorial Hospital. The Tennessee hospital’s stolen laptop contained information on 27,000 patients.” The laptop stolen from an employee’s home contained only basic demographic information. The hospital says the laptop was password protected, which usually means not encrypted.

From Virtual Virtuosity: “Re: copying and pasting of patient information in EHRs. Is Dr. Mostashari aware that this is how most EHRs work? Does HHS and ONC really expect providers to individually enter every piece of data from a clinic visit? We had a doctor join our practice from the same Kaiser office I used to work at. She had been using Epic for eight years and I asked her how she did it. She said it was initially hard, but she and most of her colleagues finally just made 20 templates and copied them for the vast majority of patients. EHRs from Epic and everybody else were designed to improve efficiency by copying and pasting. If HHS and ONC really expect providers to manually enter every piece of data from every patient visit, we’ll need double or triple the number of primary care providers to keep up with demand. That also brings up another point: as we read the rah-rah press reports about how Kaiser is a shining beacon on a hill for gathering and collecting data to improve healthcare, aren’t they just analyzing the same data constantly if their doctors are just using those 20 templates over and over? How does that reduce costs or improve efficiency?” My opinion is that providers have met every expectation as long as each patient’s EHR information is accurate. If HHS wants providers to craft innovative and individualized prose just for the sake of making every patient record pointlessly different, then they need to set a payment rate for creative writing. First they wanted discrete data, then they decided that what they really want is lots of plain text to assure them that they aren’t being defrauded since they are apparently powerless to determine otherwise. I’ve said it before: the reason that EHRs haven’t improved patient outcomes is because HHS and other payors have forced vendors to focus their development efforts on administrivia enhancements to meet needlessly complex payment requirements that have nothing to do with patients. You could develop a kick-butt EHR if you weren’t required to get bogged down in the Vietnam-like quagmire of billing documentation requirements that allows payors (Uncle Sam included) to avoid writing checks. Unfortunately, that situation is getting worse instead of better as the government insinuates itself even deeper into the practice of medicine. I bet you could design a really cool EMR for cash-only practices, except you’d have few prospects to sell it to.

From Minor Key: “Re: Michigan HIEs. Talk to providers and practices in the state and you’ll hear a different story. They’re realizing benefits now, with little jeopardy or delay in the HIE’s work toward the longer-term goal of interconnection.”

From Jock Ewing: “Re: FDA and biomedical system OS, antivirus, and software patches. This 2005 article says it’s a common ploy for vendors to tell customers that applying software patches would require re-approval by FDA. FDA has clearly said that this is not the case. The bottom line is that manufacturers are supposed to be validating patches and the only issue with getting that done is their willingness to dedicate resources to the task. It’s up to their customers to demand that they validate patches in a timely manner.”

From The PACS Designer: “Re: busy week ahead. Both Apple and Microsoft plan to introduce new hardware and software next week. First, we hear from Apple on the 23rd with the expected offering of new smaller versions of their product line, and on the 26th we will hear from Microsoft on the introduction of Windows 8. Windows 8 is the big deal of the week because it is projected to be the key operating system that will replace Windows XP, and will be used in many upgrade efforts across all of industry, academics, healthcare, and home computing. One of the first apps in healthcare space will be Pariscribe’s Windows EMR Surface (above), which should draw some interest from practitioners.”

From LaRusso: “Re: Fast Company. Several pages on healthcare IT are in the current issue.” It’s mostly the usual oversimplified geek piece on how tiny software startups you’ve never heard of are going to not only disrupt healthcare IT, but healthcare itself because they have brash founders, a few thousand dollars of VC or incubator money, and cool Web pages. I don’t recall many industries that have been disrupted by apps or websites, other than retailers outflanked by competitors who started selling first via the Web, so I’m skeptical that most of these companies will even survive, much less single-handedly transform the highly profitable, political, and parochial healthcare system into a consumer-driven and transparent industry where good defeats evil. Companies get my attention once they hit $5 million in revenue since that’s the point where the concept has been validated, initial development and scaling has been completed, the organizational culture has been defined, and skilled management has been brought in to protect the VC’s investment from the managerial whim of the inexperienced founders. That’s when companies become worth writing about, if for no other reason than the strong possibility that some old-school company will just buy them outright, making the founders as rich as they’d hoped while usually ruining what they created.

Now that I’ve been predictably curmudgeonly in dismissing wide-eyed startups and their naïve faithful who really believe that every David will inevitably rise to defeat his personal Goliath, I’ll take my own counterpoint in reminding myself that I ran a successful series of profiles awhile back called Innovator’s Showcase that introduced several companies to the more traditional side of the industry that most of us work in. I want those small companies to innovate and succeed and that was my way of trying to give them a boost, choosing those that seemed to have predictors of success. Some of them have done quite well since then from all appearances. If your healthcare IT-related company is less than five years old, has sold your offering to real customers, and brings in revenue of less than $2.5 million from selling a truly innovative product or service, e-mail me and tell me why my readers should be interested — I might include it in future posts. Those companies I’ve showcased previously include Aventura, Caristix, Health Care DataWorks, Health Nuts Media, Logical Progression, OptimizeHIT, and Trans World Health Services. There’s work for both of us to do if you’re chosen, so don’t take it lightly.

Widespread interoperability is limited because (a) technology or standards are limited, and (b) because providers have no incentive to share the data they keep. New poll to your right: does your PCP use Twitter for medically related tweets? I don’t really care so I wasn’t sure if mine did, but I’m guessing no since he doesn’t turn up in a Twitter search.

Welcome to new HIStalk Gold Sponsor HealthTronics, which offers a wide portfolio of urology-specific services (mobile lithotripsy, laser prostate treatments, cryotherapy, equipment services) that includes IT solutions such as its market-leading, urology-specific EHR used by over 2,100 providers seeing 18,000 patients daily and who have received more than $12 million in HITECH incentive payments. Its UroChartEHR and MeridianEMR were among the first EHR products to earn certification. Features include hundreds of templates and treatment plans specific to urology, pre-programmed urology terms, an easily understood user interface that requires minimal training and offers a one-screen patient encounter, PQRI, eRX, a sketch pad, device integration, built-in practice analytics and economics analysis, and remote access via iOS and the Web. HealthTronics joined Endo Health Solutions in 2010. Thanks to HealthTronics for supporting HIStalk.

Mrs. HIStalk dragged me to my once-a-year trip to the mall this weekend since I needed some new cooler weather clothes. I noticed that a Microsoft Surface kiosk is scheduled to open there shortly (in the mean time, it was serving as a place to deposit partially consumed cups of coffee and food court trash). The tablet is scheduled to ship on October 26, but pre-orders have sold out. Microsoft is getting killed as iPads have eroded sales of Windows-using PCs (Apple is the #1 PC maker in the world if you consider an iPad a PC as many consumers apparently do) and they need Surface to stop the bleeding. It comes in two versions: one that’s priced similar to the iPad running Windows RT (which has a micro-percentage of the number of apps as the iPad and a questionable apps ecosystem to compete with iTunes) and an expensive Surface Pro running Windows 8. I don’t see it making a dent in consumer iPad sales or even those of Android devices, but Microsoft’s one advantage over Apple is enterprise credibility. I would say their best chance for Surface success is that companies push off employees demanding to use iPads by offering Surface as an less-desirable but acceptable enterprise alternative. Otherwise, I expect few consumers to pony up $499 for a Surface RT tablet (not including the $100 keyboard) with they can get an iPad for the same money. If you can’t beat Apple on price, you’re screwed, because they own the customer experience.

T-System is on a roll with its funny HIT-related e-cards.

John Glaser of Siemens Healthcare wins CHIME’s lifetime achievement award. Above is a photo of the occasion taken by Ed Marx.

Also at CHIME, Ed Martinez, SVP/CIO of Miami Children’s Hospital, is awarded CHIME’s Innovator of the Year award.

A newspaper covering the highly publicized opening of the Massachusetts HIE provides a good reminder of where healthcare stands compared to other industries: “To those in fully automated industries, like banking, the state’s rollout of a new health information network last week must seem sadly behind the times … the experience can leave anyone who has ever used an Internet driven technology like Facebook or even simple email wondering just how exciting it can be to send one file electronically from one organization to another? Very exciting, say those in the health care profession.”

Athenahealth shares took a dive Friday as investors reacted to earnings that were improved, but increased less than expected following its Proxsys acquisition. ATHN closed at $73.31, down more than 8 percent to levels last seen in June. In the earnings call, Jonathan Bush blames Epic for extending the company’s sales cycles and a lowering its close rate:

They go out and sort of do some Bush Doctrine, saying, “In three years, we’re going to be live with this thing, and it’s going to slice and dice and bring world peace. You’re either going to be on it or not allowed in our hospital … you’ll be cut out of our ACO. You’re going to not be clinically integrated with us if you’re not on this thing.” … I believe that all of the banks in America may not be on one instance of one software, and yet all of us can stumble up to any cash machine we want and exchange information. It’s a ludicrous, pre-Internet idea.

El Camino Hospital (CA) provides most of the funding for a group that’s trying to defeat a November 6 ballot measure called Measure M, which would cap ECH’s executive compensation as a tax district-supported hospital. ECH’s CEO makes $700K and can earn a 30 percent bonus. The measure was proposed by the SEIU labor union, which says it’s less interested in that topic now since another bill has earned its undivided attention – one that would limit the ability of unions to raise money for political candidates.

Quite a few readers are fans of snarkmeisters The Onion and feel-good TED talks that tend to be long on inspiration but short on applicability, so here’s what happen when they meet. “I’ll be your visionary, and you do the things I come up with.”

The parents of an 8-year-old boy sue a Chicago hospital for pronouncing their son dead and taking him off life support for five hours until the patients insisted on a cardiac ultrasound that showed he was actually alive. Family members said doctors told them that the boy wasn’t actually opening and closing his eyes – it was just the medications he’d been given that made it look that way. The hospital says he really was dead, but they’re happy that his heart function returned spontaneously.

Sponsor Updates

• Medicomp hosted the two-day MEDCIN U for 32 EHR developers and vendors last week in Reston, VA, teaching attendees about integrating the company’s MEDCIN engine and Quippe into their applications. That’s Medicomp CEO Dave Lareau and Clinical Architecture CEO Charlie Harp above.
• EHR vendor Prowess will use the OrdersAnywhere CPOE product from Ignis Systems for lab orders, results, and lab integration. OrdersAnywhere has been integrated with 120 lab and radiology systems and is being used to satisfy Meaningful Use Stage 2 orders requirements.
• Quest Diagnostics announces that it has certified the first 20 EHRs under its Health IT Quality Solutions program that recognizes EHRs that share data with Quest’s clinical laboratory system. The full list is here.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

News 10/19/12

Top News

AirStrip Technologies wastes no time in filing a lawsuit claiming that clinical mobility vendor mVisum is violating its remote monitoring patent, awarded September 11, 2012. Travis wrote about the patent on HIStalk Mobile at that time, musing about its potential effect on innovation against the backdrop of Apple’s $1 billion patent victory over Samsung. Travis said:

There isn’t an answer yet as to exactly how this patent will protect AirStrip or how it will affect other mobile health vendors developing solutions to enable remote, mobile viewing of physiologic data by providers. As a methodology patent, can AirStrip use it to protect the experience of viewing a EKG, zooming into specific leads, accessing relevant additional data at the at point in time? … It’s interesting to consider the potential of a company’s defining and protecting the experience of mobile patient data viewing. As we start to see more intuitive user experience design for providers, will a standard emerge and can it be protected, enabling a patent holder to require licensing of the its patents to mirror the user experience?

Reader Comments

From Iguana: “Re: MED3OOO leadership conference. I was pleased to hear McKesson exec Pat Leonard suggest that InteGreat may be the go-forward ambulatory EHR product for hospitals implementing Paragon. Another highlight was former Highmark CEO Kenneth Melani, who provided a terrific synopsis of healthcare reform and where it’s heading.” The MED3OOO folks say several hundred clients participated in last week’s National Healthcare Leadership Conference and Users Meeting in St Thomas, USVI.

From Ms. Kravitz “Re: HIStalk’s Must See Vendors for MGMA 12. How do vendors get on this list?” The“Must See Vendors” lists for MGMA and HIMSS includes those HIStalk, HIStalk Practice, and HIStalk Mobile sponsors who chose to be included (there’s no charge) and provided exhibit information. The MGMA list includes over 50 vendors. Most of them will have a booth on the exhibit floor, while a few others aren’t exhibiting but will have people available for one-on-one meetings.

From F. Jackie: “Re: LogiXML fake 1960s TV commercial. Totally cheesy, but I needed a good laugh and it delivered.” I like it.

From Awkward Debates: “Re: degrees. I’m considering a post-grad education and wonder how the industry, particularly the vendor side, views degrees. MBA? Health informatics? Finance?” Vendor side, I’d go with an MBA unless you’re interested in sales or the executive ranks, in which case degrees (advanced or otherwise) matter little and many folks in the job don’t have them. Health informatics is a good advanced degree or certificate program, but less useful if you don’t already have a clinical degree to pair it up with. My experience is that if you have good qualities (ambition, smarts, relevant experience) and make early connections then a degree doesn’t matter all that much, especially the higher you go up the ladder, and there aren’t many cases where the degree itself is going to get you a job that you couldn’t get otherwise except in technical areas. Personally, I’d say an MBA was my best investment, but the one I admire the most in healthcare specifically is an MPH plus a professional degree (physician, nurse, pharmacist, PT, etc.) We’re going to need public health expertise since you can’t fix healthcare while ignoring health.

From Academic CIO: “Re: Allscripts protest of NYHHC’s Epic selection. We had a similar experience with Cerner. After losing on all counts, including price (Cerner’s five-year cost of ownership was twice Epic’s), Cerner had the audacity to aggressively pursue a Freedom of Information Act request for all of our e-mails, notes, meeting minutes, and Epic-supplied documents in an obvious attempt to get competitive information on Epic. At the end of day, we didn’t have to give it them, but it cost us a great of taxpayer-supplied resources to comply with their request. This was one of many attempts they made to circumvent the selection process. I would never do business again with them under any circumstances.” As I wrote previously, it’s a high-reward, high-risk strategy for a vendor to try to force itself on a customer who prefers a competitor’s product. Maybe you get a desperately needed new client and keep Wall Street off your back for one quarter, but who’s going to invite you to bid in the future knowing your history of being a sore loser?

From In the Know: “Re: Arcadia Solutions and the Azara Healthcare spinoff. The Pohlad family will sell them to a private equity firm, with the deal expected to close November 1.” Unverified. Arcadia is a consulting firm, while Azara offers analytics. The Minneapolis-based Pohlad Family Companies, which made its founder one of the richest people in America, bought Arcadia in 2007, adding it to holdings that include the Minnesota Twins, real estate, car dealerships, and banks.

From Oh MyWay – Dust in the Wind: “Re: MyWay. Here’s the Allscripts letter sent to each MyWay client with the grim confirmation. Interesting that the letter wasn’t from Glen, but rather Laurie McGraw. I guess he has bigger issues trying to find a buyer for his company.” It’s a good deal (free) for those MyWay customers who want Pro, but it’s anybody’s guess as to the percentage of MyWay customers in that camp, not to mention that changing systems is always tough. Allscripts says everybody will be upgraded from January to September 2013, which seems ambitious given the tendency of practices to delay until the last minute. I’m curious: if you attended ACE in August, what was said about MyWay then? I assume MyWay clients weren’t forewarned even though Allscripts surely had already planned its strategy. Given that Allscripts says MyWay isn’t ready for Meaningful Use Stage 2 or ICD-10, what were customers led to expect? Still, it’s probably a good decision – Inga asked Glen Tullman an insightful question when she interviewed him on HIStalk Practice in April 2010:

It seems almost as if Allscripts really has two businesses, one that’s focused on the selling the inexpensive MyWay option to small practices through resellers and the other focused on selling to the large, integrated delivery networks and hospitals that subsidize the small practices and offering them the Allscripts EHR products. Explain the strategy and tell me how you avoid channel conflicts.

From Lady Pharmacist: “Re: National Health-System Pharmacy Week next week. It’s time for the annual shout-out to pharmacists and pharmacy technicians, who from an IT perspective are helping their organizations attest for Meaningful Use, closing practicing gaps, and helping with medication-related safety initiatives related to CPOE, medication reconciliation, barcode medication administration, and e-prescribing.” Consider it shouted out.

From Patty Melt: “Re: HIEs. This article from Crain’s Detroit reminds me of the Rodney King line – can’t we all just get along? Do you ever wonder what the cost to society is for lack of consensus and cooperation?” The article says that the state’s two biggest HIEs (Great Lakes HIE and Michigan Health Connect) are competing to become the statewide exchange and aren’t sharing patient information with each other. The CEO of Oakwood Healthcare says they’re happy with Epic and not interested in joining an HIE until there’s just one because they could connect with one that won’t survive. Beaumont, also on Epic, said the state needs to get more involved but healthcare reform will force information exchange in any case.

HIStalk Announcements and Requests

Highlights from HIStalk Practice this week include: Mount Sinai Queens (NY) implements Epic at its ambulatory care locations. MED3OOO and SRS provide updates on their user conferences. Patients who are comfortable accessing and understanding their health information online will use PHRs more willingly. A REC advocacy organization defends the Meaningful Use program. CBS Morning News profiles a pediatrician’s use of social media. Dr. Gregg ponders whether HIT is becoming passé. And as mentioned above, our HIStalk Must See Vendor Guide for MGMA12 is a must-read for anyone heading to MGMA in San Antonio this weekend. Nothing says I love you like a gift of Lucchese cowboy boots (since I am Texas-bound) or your e-mail address for our HIStalk Practice updates. Thanks for reading.

Speaking of MGMA, I will be posting conference updates starting Sunday night or Monday morning (depending, of course, on the quality of the Sunday evening parties.) Our exhibiting HIStalk sponsors will have signs indicating their support of HIStalk, so please take a moment to tell them thanks on our behalf. If you have any suggestions for sessions or exhibits I should peruse, let me know. Please also take a moment to share any conference comments you might have, as well as your photos. See you in San Antonio! E-mail me.

I was initially startled and then pleased to receive this HIStalk sponsorship announcement at my hospital e-mail address. I finally realized that it went out a broad audience, not just me. Inga got one too, and we agreed that it’s nice when a sponsor is publicly proud of supporting our work (as most seem to be). It made our day.

Welcome to Aprima, sponsoring both HIStalk and HIStalk Practice at the Platinum level. The company offers a certified, fully integrated, single application, single database EHR/PM solution along with RCM services. The template-free design is chief complaint-driven with adaptive learning capability. The company, which has a 14-year track record, is offering a timely deal (free license and data migration with a signed support agreement) to users of Allscripts MyWay, for which it provided the original code in 2008. A partial list of the nearly 1,000 enhancements Aprima has made to the product since then is here. MyWay customers and resellers can connect with the Aprima folks at MGMA next week or AAFP this week. Thanks to Aprima for supporting HIStalk and HIStalk Practice.

Welcome to new HIStalk Platinum Sponsor SuccessEHS. The Birmingham, AL-based company offers a Certified Complete EHR and PM that it says can prepare practices for Meaningful Use within 60 days, not to mention that its clients experience an average 11 percent in visit increases and a 19 percent increase in collections in the first six months. The company has been in business for 15 years and is profitable and debt free, with 425 clients and 4,200 providers. Calling support gets you an in-house employee sitting in Birmingham. They’ll be at MGMA next week, also presenting the results of their new practice survey on maximizing revenue. They’re also offering a white paper on healthcare reform (e-Prescribing incentive, Meaningful Use, ICD-10, PQRS). Thanks to SuccessEHS for supporting HIStalk.

I always hit YouTube to see what a new sponsor has out there, so here’s an introductory video from SuccessEHS.

Listening: new from Brooklyn-based Woods, sometimes labeled as folk, but to my ear is more 1970s-influenced trippy, jangly guitar rock with lots of hooks and thoughtful lyrics. I liked it even from the first listen. Best song to me: “Find Them Empty,” featuring wailing psychedelic guitars and keyboard work that could pass for paisley ‘70s bands like Strawberry Alarm Clock or Vanilla Fudge.

On the Jobs Page: Product Manager, Regional Sales Executive.

Acquisitions, Funding, Business, and Stock

Microsoft’s Q1 numbers: revenue down 7.9 percent, EPS $0.53 vs. $0.68, missing earnings estimates on continued weakening in PC demand and a corresponding drop in Windows sales.

Shares in Google dropped precipitously Thursday when the company’s financial printer filed its 8K report in the middle of the trading day instead of after hours as intended. Trading in GOOG was temporarily halted, but shares still ended up down 8 percent at the market’s close because of slowing revenue growth.

Trinity Health and Catholic Health East announce plans to merge, forming a new system with annual operating revenues of about $13.3 billion and 87,000 employees. Trinity’s president and CEO Joseph R. Swedish would head the new organization and Catholic Health East’s president CEO Judith M. Persichilli would be EVP. The organizations anticipate reaching a definitive consolidation agreement in the spring of 2013.

Sales

Australia’s UnitingCare Health will implement Cerner at the recently-opened St. Stephen’s Hospital, which claims it will be the country’s first digital hospital.

The 60-provider Mid Dakota Clinic (ND) selects athenahealth’s EHR, practice management, and care coordination solutions.

Wenatchee Valley Medical Center (WA) chooses Merge’s iConnect Enterprise Archive.

The University of California, Irvine Medical Center, will deploy MModal Fluency Direct and MModal Catalyst integrated with Allscripts Sunrise Clinical Manager.

People

RCM and consulting services provider Cymetrix names Jeffrey Nieman (Accelion) SVP of remote operations.

Alan Fowles, managing director of Cerner Europe and overseer of the first Cerner NHS installations, resigns after 11 years with the company.

RCM provider Office Ally names Daniel Wojta (United Healthcare) director of eSolutions and business development.

Health First (FL) appoints Lori DeLone (PatientKeeper) SVP/CIO.

Mobile PHR provider Cognovant hires Andrew Lambert (Press Ganey) as EVP of business development.

Lynn Danko (Lawson Software) joins Amcom Software as CFO.

Ambulatory surgical center and rehabilitation clinic software vendor SourceMedical announces the resignation of CEO Larry McTavish and the promotion of Ralph Riccardi from EVP/COO to president and CEO. The company announced last month that PE firm ABRY Partners had made a significant investment.

Standard Register promotes John King from VP of sales to president of Standard Register Healthcare. He replaces Brad Cates, who is leaving the company to serve as CEO at another company.

Announcements and Implementations

Omnicell and Cerner will develop interoperability between their products using CareAware iBus,  Cerner’s medical device connectivity solution .

HIMSS names the 91-provider Coastal Medical (RI) the winner of its 2012 Ambulatory HIMSS Davies Award of Excellence.

Kennewick General Hospital (WA) launches McKesson Paragon CPOE.

Baptist Memorial Health Care (TN) deploys EMC VNX and Citrix virtualization technologies in advance of its Epic implementation.

University of Kentucky Healthcare implements Harris Corporation’s Business Intelligence Documentation and Coding dashboard.

MedAptus announces the availability of its ICD-10 software suite.

Government and Politics

National Coordinator Farzad Mostashari, MD says the HIT Policy committee will review whether EHRs are leading doctors to overbill Medicare. He says repeated copying and pasting of patient information is “not good medicine” and wants to determine if EHR functions that prompt doctors to inflate their bills should be made “off limits.”

An Institute of Medicine report finds that the DoD and VA’s failure to create a sequential prescription number system has hindered joint EHR development at the co-managed Captain James A. Lovell Federal Health Center (IL). Because the DoD and VA have both agreed not to charge their respective EHRs, the departments are spending $700,000 a year for pharmacists to manually input prescription data. The IOM recommends that the DoD and VA avoid establishing other combined facilities until an integrated EHR is available.

The VA launches a contest to encourage the development of an appointment scheduling system to work with VistA EHR open source applications.

ONC announces availability of Cypress, an open source certification tool for testing the availability of complete or modular EHR systems to meet Stage 2 MU requirements for clinical quality measures.

As of September, almost 50 percent of all EPs and nearly 81 percent of hospitals have registered for the MU program. CMS also reports total program-to-date payments of $7.7 billion, including $4.8 billion to hospitals and $2.6 billion to eligible providers and healthcare professionals.

Two weeks after House Republicans call for a freeze on all MU payments, four Republican senators request a meeting with HHS Secretary Sebelius to discuss the incentive program. The senators would like CMS and ONC to address four questions, including whether EHRs are increasing the volume of diagnostic tests and Medicare billings. One of those questions (above) indicates a lack of familiarity with the HITECH program, which did not require providers to buy anything at all to qualify for taxpayer-funded incentives.

Technology

eMDs launches its nMotion EHR iPad application.

Medsphere Systems contributes its MSC FileMan database management system to the OSEHRA open source community, which chose it for collaborative development work on VistA.

An article in MIT’s Technology Review says that medical devices in hospitals are regularly infected with viruses because vendors are so scared of the FDA’s requirements that they won’t allow hospitals to keep their operating system patches and antivirus software current. I’ve seen this personally: my former hospital had a nasty worm that was flinging itself with impunity from one networked system to another because our vendors wouldn’t allow us to apply any changes to their FDA-approved configuration (even including applying the latest antivirus update that was known to fix the problem). We had to take the entire imaging network and several systems offline to the extreme displeasure of our physicians, while the vendor said they might get us an answer in a few weeks. I told the network team to ignore everything they had heard and simply do what they knew needed to be done. We were worm-free within a few hours and I have no doubt patients would have suffered had we not ignored our vendor’s advice, albeit at our own risk.

Other

Former Beth Israel Deaconess Medical Center CEO Paul Levy, writing in his Not Running a Hospital blog, equates buying Epic to the Stockholm syndrome, where hostages develop affection for their captors. He concludes that Epic’s market share, driven by HITECH money, makes the company a target for Congressional retribution if a system malfunction harms patients. He also complains, “How did this firm get such a big share of such a critical market with no government review?”

The local paper covers Michigan-based HipaaCat, an image sharing and messaging app developed by a plastic surgeon.

Dan and Colin from Divurgent said Olympic bling-bearers Kerri Walsh Jennings and Misty May-Treanor were “great fun and great sports” in posing with attendees like themselves at CHIME 2012 this week. They (Kerri and Misty, that is) look a lot different with sunglasses off and clothes on.

In England, a healthcare trust that’s in such serious financial straits that it may be dissolved takes heat from the local paper for sending five managers to the Cerner Health Conference. The paper couldn’t find a source to back up its predetermined editorial outrage, so it quoted some guy who whose partner “does not wish to be named who worked as a nurse at Princess Royal Hospital.” It also seems to find a sinister connotation to KC’s power and light district, which it repeatedly places inside quotation marks as though it’s a code word for a hooker-staffed crack house. Must have been a slow news day.

Weird News Andy thinks maybe someone misspelled “birth” as “berth” in this story: a woman delivers her one-month premature baby in a Philadelphia subway car in which she is the only occupant. She calmly walks off the car and finds a police officer, who says the newborn girl “took on her personality” in exhibiting the same calm demeanor as her mother as they were taken to the hospital.

Tweets from CHIME

Heard in the hall – with healthcare consolidation there will be a lot fewer CIO positions available in healthcare. #cio #CHIME12

— Steve Huffman (@SteveHuffmanCIO) October 18, 2012

@farzad_onc shouts out to #CHIME12 for response to the republican letters on #HealthIT

— Nick van Terheyden (@drnic1) October 18, 2012

Magical thinking: National patient ID for under 65 and poof all of our patient matching problems will go away @farzad_onc #CHIME12

— Gienna Shaw (@Gienna) October 18, 2012

#CHIME12 breakout–more organizations today want CIOs with a clinical background.

— Nicole Kerkenbush (@OTSG_CMIO) October 17, 2012

Sponsor Updates

• PatientKeeper employees donate services, goods, and cash to help a Boston-area homeless family move into a furnished apartment.
• GetWellNetwork launches its Transformative Health blog with an introductory post by CEO Michael O’Neill, Jr.
• Intelligent InSites shares best practices for deploying an enterprise-wide RTLS during an October 25 Webinar.
• Infor opens its new headquarters in NYC and unveils updated branding. Also, the Institute for Transfusion Medicine (PA) upgrades its Infor Healthcare Revenue Management solution to integrate with its outpatient records and receivables solution.
• Oregon Medical Association will offer Dr. First’s RcopiaMU e-prescribing services to its members.
• Emdeon releases a white paper on payment collection best practices for small physician offices.
• Teradata will integrate QlikView in-memory data with Teradata’s Integrated Data Warehouse via the QlikView Direct Discovery  utility.
• Physicians in Costa Rica’s public health system use DynaMed’s clinical reference tools to create national breast cancer guidelines.
• Quality IT Partners sponsored last month’s 2012 Hillman Cancer Center Gala in Pittsburgh.
• Imprivata announces 10 additional sponsors of its Imprivata HealthCon 2012 User Conference next month in Boston.
• Cancer Treatment Centers of America and CareTech Solutions present a case study on the need for clinical help desks at this week’s CHIME CIO Forum.
• American Well CEO Roy Schoenberg and Allscripts CMO Douglas A. Gentile discuss the benefits of integrating American Well’s telehealth offer with EHRs offered by Allscripts.
  McKesson integrates RelayHealth’s procedure and test results functionality into its Practice Choice EMR and financial management software.
• T-System announces six winners of its T-System Client Excellence Awards.

EPtalk by Dr. Jayne

Researchers at Duke University create a 3D training application for transesophageal echocardiography for anesthesiology residents. It runs only on the iPad, leading one researcher to state that it would have greater effect if it worked on multiple platforms.

Speaking at the American Academy of Family Physicians annual meeting in Philadelphia, Farzad Mostashari encourages physicians to “turn the tables” on vendors that aren’t addressing interoperability issues. He reportedly advised users to report vendors to certification bodies. Considering the rank-and-file primary care physicians I work with every day, I’m not sure many of them are savvy enough to understand the certification requirements, let alone to become whistle-blowers. I’d rather see physicians spending their time learning to use their EHRs efficiently to deliver quality care. I invite my family physician readers who may have heard the speech in its entirety to weigh in – don’t worry, I’ll keep you anonymous.

The Breast Tissue Screening Bra from First Warning Systems has been designed to detect minute temperature changes in breast tissue that may indicate cancer via sensing the growth of new blood vessels. Temperature data is uploaded to the Internet and algorithms provide a reading to the patient. FDA approval is pending, but release in Europe is anticipated next year.

An impending change in the ranks of Medicare administrative contractors prompts concerns from providers that payments could be delayed. CMS is in the process of re-bidding contracts for claims processing, program enrollment, and other administrative functions in several regions. During a 2008 change, some payments were delayed for six to 12 months. Given the rigor with which CMS audits providers and the narrow tolerances in which we must perform to get paid, it would sure be nice if they held their contractors to the same standards. If we don’t file promptly, we don’t get paid – maybe if they don’t pay promptly, they should be fined.

I have to admit that I’ve been jealous reading about Inga’s plans to attend the MGMA meeting in San Antonio next week. I’m trying to find a way to sneak away for a day so the two of us can make a pilgrimage to the source of some of the hottest boots known to (wo)man. I had a chance to buy these beauties last year and flinched. Cross your fingers!

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

Wolters Kluwer To Acquire Health Language, Inc.

Wolters Kluwer Health announced this morning that it will acquire medical terminology content and mapping vendor Health Language, Inc.

Arvind Subramanian, president and CEO of Wollters Kluwer Health Clinical Solutions, was quoted in the announcement as saying, “Medical terminology management is quickly emerging as a core point-of-care market as hospitals, EMRs, and payers are increasingly focused on interoperability of systems to realize the advantages of healthcare information technology. Health Language has built a leadership position in meeting this important interoperability need. This acquisition allows Wolters Kluwer Health to enhance its current market leading point-of-care solutions and better position its customers to fully leverage existing and emerging healthcare quality and reimbursement initiatives. The acquisition also provides Wolters Kluwer Health with greater access to payers, key customers for various Health Language offerings.”

The Denver-based Health Language has 85 employees. Terms were not disclosed.

News 10/17/12

Top News

Massachusetts Governor Deval Patrick and other state officials celebrate the launching of the Massachusetts state HIE as the first medical record is transmitted from Massachusetts General Hospital to Baystate Medical Center. The Massachusetts HIway was funded by a $17 million federal grant. John Halamka writes about the significance, professional and personal, on his blog (his photo of the “Golden Spike” is above).

Reader Comments

From FirstHand: “Re: MModal changes. SVP of strategic business development Taras Silecky has left the company. Not sure if it is a one-off personnel change or a sign of restructuring following several acquisitions.” Unverified. MModal declined to comment, citing policies prohibiting disclosure of personnel information. His LinkedIn page says he’s still there, but those are notoriously unreliable.

From Allagash: “Re: Aprima. Aprima gave indication that they would have a direct migration from MyWay to Aprima. Not the case. Aprima says that the client needs to contact Allscripts and beg for the database, which won’t come easy since they’re trying to sell us Pro. I get the impression there’s a large fee as well.” Aprima President and CEO Michael Nissenbaum responded as follows: “Aprima offers a free software license and upgrade for MyWay customers with the purchase of an annual support and maintenance agreement. MyWay customers have a multitude of environments in which they reside, including hosted with Allscripts, hosted with independent hosting entities, as well as practices having their own servers. Aprima’s statements regarding our offer are based on the practice having access to their database and an ability to move it to a server / hosting location of their choosing. In most scenarios hosting is a service offering, and as long as the practice is in compliance with the hosting contract, they should have access to their database. Most companies do not hold the practice’s data hostage.” Specific details of Aprima’s migration offer are here.

From Scrooge: “Re: CIO cost pressures. Reports say that CIOs in all industries are having a hard time justifying the long-term operating costs for advanced systems. Hospitals are under pressure to cut staff and other costs due to Medicare cuts. Maybe a topic for a survey?” I would be interested in hearing from hospital IT executives on this issue in a bit more detail than a poll allows. Send me your thoughts and I’ll run them, anonymously if you so indicate.

From Cool School: “Re: Pulse. I received an e-mail indicating that Basil Hourani (director, president, and CEO) and Alif Hourani (executive chairman and CTO) are ‘retiring,’ leaving former CFO Jeff Burton as CEO. Lots of blah about amazing journey, innovation, vision, etc. Recall that they were bought out by Cegedim two years ago. Significance?” Unverified, but reported by several readers. The PM/EMR vendor’s web page has no news. I’ll defer to readers to comment.

From Shock & Awe: “Re: Will Showalter, VP/CIO @ Sisters of Mercy Health System in St. Louis. Left last week. Can you find out why? Everyone loved and adored him!” As mentioned below, Mercy (as the former Sisters of Mercy now calls itself) has replaced him with no explanation. I’ll update if he checks in.

From Magenta: “Re: Cerner Health Conference. The tagline was ‘because it’s personal,’ which I thought was a little ridiculous on all the signs and displays. I didn’t realize how much until I saw this sign.”

From Buffalo Tom: “Re: Health 2.0 and Stanford MedX conferences. Free recorded streams are available from a company called Learn it Live that’s trying to disrupt the learning market. The interview with Lumeris CEO Mike Long was especially inspiring – he said mercenary companies look for where to make the most money, while missionary companies want to solve big problems and hope to make money. Sign up for free, choose the ‘three CEOs’ session, and go to the 31.25 mark.” He’s fun to watch. He gives his e-mail address and invites people creating cool things to contact him because he doesn’t think the big companies are moving fast enough.  

From PC Doc: “Re: pharmacy chains encroaching on the practice of medicine. Walgreens has walk-in clinics whose mission is to sell what’s on their shelves, give vaccine injections, and now deliver meds to hospital bedsides to ‘curb readmissions!!’ I smell a coordination nightmare as patients get mammograms at the local retail pharmacies and pharmacists manage diabetes, not to mention that Walgreens is smelling profit while physicians are again asleep at the wheel.” It is interesting that just as we see EMRs taking a firm hold and interoperability taking a shaky one, now you’ve got disconnected non-EPs out there whose corporate parents may lack the interest or ability to share the medical information they’re creating. I don’t know how they’ll play in the ACO world, though – maybe they’ll just pick up the cash-paying business. Those with long memories may recall that the difference between EMRs and EHRs was that the latter were supposed to collect information from every potential point of healthcare service, but here we are years later still thrilled when docs working for the same health system can exchange information with the hospital and each other. That’s a problem with the proprietary EHR-centric model in which neither providers nor vendors have much reason to push their data out in a way that everybody can use it, and the further away you get from the traditional office practice, the less likely those providers are going to be on the grid. In other countries, patients are expected to keep their own medical records and bring them in – sounds primitive, but with all the technology investments we’re not too far beyond that here with our printout and faxes. Not to mention that at least in those countries, the patients are in control of their own information.

HIStalk Announcements and Requests

Going to MGMA next week in San Antonio? Here is our annual list of Must See Vendors. Inga will be there to pick up trinkets, make stealth observations, and post daily updates.

Welcome to new HIStalk Gold Sponsor Direct Consulting Associates and its sister organization Direct Recruiters Inc., both of Solon, OH. DCA offers IT consulting and staffing solutions (staff augmentation, temp to perm, and permanent placement), providing individuals or entire teams to help with Epic, Allscripts, Cerner, Meditech, McKesson, and other healthcare IT systems for short- or long-term contracts. DRI is an executive search firm with a healthcare IT practice that places top professionals (CXO, VP sales, sales rep, product manager, applications engineer, IT director, CMIO, etc.) The company’s site has a nice testimonial from Medicity that calls Director of Healthcare IT Mike Silverstein a “trusted resource” who doesn’t push candidates, but rather listens to understand the talent needs first and makes sure to present only the most qualified candidates. Thanks to DCA and DRI for supporting HIStalk.

Also supporting HIStalk is new Platinum Sponsor PatientPay of Durham, NC. PatientPay is an innovative, patented, Web-based service that addresses the physician practice challenge of managing patient balances. Practices can be up and running within 30 minutes of signing up online, with no IT help required to instantly integrate PatientPay into the practice management system. Patients review their balances and pay online by credit card, while the cost of managing paper is reduced by half. No upfront or monthly costs are involved, just a small, flat per-transaction fee that means they get paid only when the practice gets paid. The company’s goal is to be the most attractive patient payment solution for their ambulatory PM/RCM vendor partners. They’ve been around since 2008, and you may recall hearing a couple of months ago that David Bond (A4, Medic, Allscripts) has joined the company as EVP of sales and marketing. They’ll be at MGMA, so drop by and tell them you saw them mentioned on HIStalk. Thanks to PatientPay for supporting my work.

Speaking of my (endless) work, I’ve reluctantly reached the conclusion that I need more help to make HIStalk, HIStalk Practice, and HIStalk Mobile the best they can be while not getting fired from my hospital job. I’m interested in hiring someone, but I’m picky about capabilities: a stellar and fast writer, lots of energy, an enviable sense of humor, skill with social media, and knowledge about healthcare IT. Sometime with a full-time job probably won’t work since I need more hours. I’m looking for a self-starter who probably doesn’t need to be prompted about what to do next, but here’s a hint since it worked for Inga and Dr. Jayne: tell me why I should hire you while demonstrating the qualities I mentioned.

Acquisitions, Funding, Business, and Stock

The UK-based Wellcome Trust secures an equity stake in AirStrip Technologies.

Healthrageous, a developer of Web and mobile health apps for consumers,  raises $6.5 million in Series B financing.

Nuance discloses that it paid $230 million in cash for QuadraMed’s Quantim HIM division and another $265 million for JA Thomas and Associates, raising its 10-year acquisition total to 34 companies at a cost of $3.6 billion (Nuance’s market cap today is $7.2 billion). Maybe its best deal was paying $400 million for eScription in 2008 to get a strong healthcare foothold. Historians (hello, Vince?) may recall Nuance’s origins as a vendor of scanners under the ScanSoft and Visioneer names  — the PaperPort was all the rage in the mid-1990s.

UnitedHealth Group’s Q3 numbers: revenue up  8%, EPS $1.50 vs. $1.17, beating expectations of $1.34. Growth of its Optum division contributed to the $1.56 billion of quarterly profit, although the company warned of uncertainty about competition and the November election. Analysts say the company always sets conservative expectations, with one saying, “There’s nothing there that reform is going to hurt.”

Sales

Regional Medical Center at Memphis (TN) replaces its Cisco wireless network with Aruba.

Sigmund Software will embed OrdersAnywhere from Ignis Systems into its behavioral health EHR to manage lab orders and results.

Emergency Medicine Specialists of Orange County (CA) selects McKesson Revenue Management Solutions to provide billing and RCM for its 40-physician practice.

The Military Health System’s TRICARE Management Activity segment awards Four Points Technology a multi-year contract to facilitate an expanded rollout of RelayHealth’s Medical Home Support Package.

People

Richard Poulton (AAR Corp) joins Allscripts as CFO. An SEC filing discloses that Poulton will earn an annual salary of $450,000, a $450,000 annual bonus target, a one-time cash payment of $750,000, and stock grants worth up to $2 million. He’s also guaranteed double his salary and target bonus plus full equity vesting if terminated due to a change of control, which could be relevant if the company goes private as has been rumored.

Clinithink names Phil Davies (NHS Connecting for Health) CIO.

Mercy (MO) names Gilbert Hoffman (Maritz) VP and CIO, replacing Will Showalter.

Kathy Ebbert (Achieve CCA) joins Clearwater Compliance as EVP and COO.

Delta Health Technologies names Ben Clay (Prognosis Health Information Systems) VP of product development.

Announcements and Implementations

InterSystems Corporation and eHealth Technologies will offer offer single-click access to diagnostic quality images via the InterSystems HealthShare platform.

EXTENSION added 22 customers of its critical alerting and HIPAA-compliant texting solutions during the third quarter.

VersaSuite announces that its certified ambulatory EHR is the first to earn CCHIT’s certification for Clinical Research, with the capability to automatically determine if a patient is eligible for an open clinical trial.

UMass Memorial Health Care is working with with Informatica and MedCPU on a readmissions reduction project.

AHRQ awards the Oregon Health & Science University a $1 million grant to create smarter and better organized EHR systems.

NYeC and Partnership for New York City Fund select eight early- and growth-stage companies for its inaugural class of the NY Digital Health Accelerator. The winning companies, which were selected from 250 applicants, were each awarded up to $300,000, plus mentoring opportunities from senior-level hospital executives. The Accelerator program is expected to create 1,500 jobs over five years and attract $150 to $200 million in VC investment post-program.

North American Partners in Anesthesia partners with SIS to offer a combined AIMS and managed anesthesia services solution.

Electronic patient payment processor BillingTree announces a new partner program for solution providers interested in integrating a payment portal into their products.

Nuance Communications announces that its voice recognition technology is now integrated into Epic’s Haiku for iPhone and Canto for iPad applications.

Industry long-timers Bill Spooner, Bert Reese, and Colin Konschak are the editors of a newly published book called Accountable Care: Bridging the Health Information Technology Divide. It’s on Amazon for $89.99.

DrFirst launches Patient Advisor, a medication adherence solution designed to work with DrFirst’s Rcopia e-prescribing platform or any EMR or HIT solution.

DSS releases its Patient Search Tool Extension and Launcher to the Open Source EHR Agent via the Apache 2.0 Open Source license, enabling VistA EHR users to search for free text data within a chart.

Government and Politics

ONC names iBlueButton from Humetrix the winner of its Blue Button Mash Up Challenge to make personal health information for usable and meaningful for consumers. ONC also awards Apollo’s Pinaxis top honors in the EHR Accessibility Module Challenge for creating an Internet portal to allow patients to interact with any provider’s existing EHR system over the Web.

Other

Akron General Medical Center (OH) fires several employees for unauthorized access of computerized patient records following the fatal shooting of an ICU patient.

Epic will install six 262-foot wind turbines on its Verona campus that, along with its geothermal and solar systems, will allow it to generate 85 percent of its energy needs by 2014.

I haven’t watched Saturday Night Live for years, but this week’s skewering of the iPhone 5 and self-obsessed Americans in general was savagely funny. It’s slightly mHealth related, at least if you watch through to around the 5:00 mark for the punch line.

The Methodist Hospitals (IN) settles its 2011 lawsuit against FTI Cambio, HealthNET, and Meditech. The hospital hired Cambio to review its entire operation, part of which involved bringing in HealthNET to review its Epic implementation that had already cost $26 million. The lawsuit says HealthNet recommending dumping Epic and buying Meditech for $16 million because of lower maintenance costs. The hospital says the consultants lied in saying it would cost $25 million to finish the Epic project when in fact it would have been only $11 million. It also claims that Meditech never worked and caused a host of problems to the point that the implementation was abandoned in 2009.

The Italian hacker who turned to the Web for help with his brain cancer diagnosis has received 200,000 responses in a month from his Open Source Cure plea. The Italian government is interested in his project as an example of opening up medical records since he struggled to obtain his records and images in an easily read electronic format. He has decided to have surgery, but is talking to 40 doctors about which procedure to have, and will also follow a crowd-sourced diet in the hospital.

Sponsor Updates

• A study by Truven Health Analytics finds that hospital employees are less healthy and more likely to be hospitalized compared to the general workface, with their healthcare costs also running nine percent above average.
• Versus customer Northwest Michigan Surgery Center discusses its use of RTLS to maximize patient flow during an AHA Solutions Webinar.
• Liaison Healthcare launches its Healthcare Information as a Service solution suite.
• GetWellNetwork and Treatment Diaries partner to provide additional resources for patients during and after their hospital stay.
• ZirMed showcases its RCM solution at this month’s MedTrade, MGMA, NAHC and APTA conferences.
• Ninety percent of anesthesia providers believe that perioperative solutions increase success rates, according to a Surgical Information Systems-commissioned study.
• HIStalk sponsors earning a spot on Modern Healthcare’s Healthcare’s Hottest 2012 based on revenue growth include: ESD (1,455%), Allscripts (533%), Cumberland Consulting Group (328%), Merge Healthcare (213%), Beacon Partners (172%), and The Advisory Board Company (92%).
• MEDSEEK moves to new office space in Fitchburg, WI after almost doubling its Wisconsin operations over the last year.
• Two teams of Craneware employees spend a week Peru volunteering with medical staff at the Villa la Paz Center for Destitute and Sick Children.
• Aspen Advisors principal Guy Scalzi discusses HIT governance at this week’s CHIME Fall CIO Forum.
• Digital Prospectors Corp wins a subcontractor role as part of a $15 billion Alliant Small Business Governmentwide Acquisition Contract.
• MModal partners with the BigHand Group for next month’s BigHand Healthcare user conference on digital dictation, speech recognition, and clinical correspondence system .
• A SuccessEHS survey of MGMA registrants finds that the majority are losing revenue due to four problems: clean claims, same-day collections, preventable denials, and underpayments.
• Klinikum Weis-Grieskirchen Hospital (AU) reports saving 10-20 seconds per login session with Imprivata’s OneSign single sign-on solution.
• NextGen adds Logi Info from LogiXML as its embedded actionable analytics tools within the NextGen Dashboard product.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

Monday Morning Update 10/15/12

From mmm: “Re: Allscripts vs. HHC. The whole $1.4 billion is set out in the board agenda. A very small portion of that is Epic software, training, and implementation itself, which came in LESS than Allscripts. Some of it is the maintenance of the software (Epic + InterSystems) over 15 (yes, 15) years. Another huge chunk must be allocated for conversion/interfacing with legacy systems and adding staff.” The September HHC board minutes explain the decision to drop QuadraMed CPR (executive turnover, minimal sales, low R&D, and insufficient functionality) with Epic. The 15-year cost analysis has Epic at $303 million vs. Allscripts at $299 million, with the complete Epic project expected to cost $1.4 billion over 15 years, including significant labor costs that include internal staff and keeping existing systems running during the transition. According to the HHC total cost of ownership analysis, it would have cost $1.278 billion just to keep 135 existing systems and implement 15 required new ones (Epic replaces 90 of those), so if HHC’s numbers are accurate, the switching cost is minimal. From the same document, the five original vendors being considered were Allscripts, Cerner, Epic, McKesson, and Siemens, with McKesson and Siemens voted out early. The minutes suggest that Epic was chosen because of a single inpatient-outpatient record, its track record as a financially strong and stable privately held company, and the percentage of its clients represented on the HIMSS EMRAM Stage 7 list.

From Limber Lob: “Re: extensibility of Epic. IT organizations need to develop software to gain competitive advantage. Academic health centers who are the first to figure out how to do this efficiently and safely with Epic will eat everyone else’s lunch.” Limber Lob is an informaticist – physician at one of those big medical centers and points out that Vonlay is offering services that include development on Cache’, Epic’s Web Services, and probably (but not stated) using Epic’s programming points to extend the applications. It’s early in the game since many of Epic’s customers are relatively new and working within the basic implementation, but it will be interesting to see whether Epic follows some of its competitors in declaring that it’s a platform upon which vendors are welcome to build value-added applications.

From The PACS Designer: “Re: network cleanup. Just as there’s spring cleanup each year at home, there needs to be a regular check and cleanup of network infrastructure wherever it may reside. With the FCC approving a new frequency spectrum for wireless patient monitoring systems, the time is right to make this the effort to improve network speeds and traffic management. The file sizes are also getting larger with each new system release from vendors, so networks can quickly be slowed during busy hours of the day. Also, if network equipment closets haven’t been check for several years, now is the time to upgrade those still working systems with the latest technology offerings for maximum possible throughput of data streams.”

From Radio Silence: “Re: IBM’s protest of the VA’s RTLS award. They probably wouldn’t have spent the entire $540 million anyway, but the options would be (a) reissue the bid, possibly after rewriting the RFP; (b) put the entire project on hold; or (c) split the pie differently so that all the parties agree not to fight the new decision. I would have bet on Option C, but with the political and budget variables they may invoke at least a modest delay.” The GAO accepted IBM’s protest of the award to HP Enterprise Services, saying that the VA’s assessment of the proposals relied on erroneous conclusions.

Thanks to Inga for covering during my vacation. She was one-for-two in her “exotic beach sipping umbrella drinks” guess as to my whereabouts. Correct about the beach, but not the umbrellas  — they tend to poke your eye when you’re trying to sip from a bottle of local Central American beer, although Mrs. HIStalk seems to like them in the wildly colored concoctions she favors. I both enjoy and detest being forced to disconnect from the real world due to poor Internet connectivity. My inbox is bulging (some of those being of the impatient “Why haven’t you responded to the e-mail I sent you yesterday?” variety) and my HIT situational awareness is a week behind, so my priority is to catch back up on both. You can help by e-mailing all those rumors, news items, and fun items that I missed last week.

Three-fourths of poll respondents believe that those four Republican Congressmen who called for an immediate end to HITECH payments were motivated by politics rather than fiscal responsibility. New poll to your right: what’s the holdup on the widespread exchange of patient information? Feel free to use the poll’s comment function to argue your position or to choose a different answer.

Listening: the final album from the recently deceased blue-collar electric bluesman Michael “Iron Man” Burks, recommended by a reader. I’m usually indifferent to blues unless I’m listening to it live in a smoky bar with cheap beer, but he had a 70s-sounding gritty vocal, some wicked growling organ, and a searing rock-style guitar reminiscent of Robin Trower or Eric Clapton. He out-Hendrixes Hey, Joe on this live video. I’m playing him hard on Spotify given my appreciation for honest, non-computer enhanced musical craftsmanship.

I was intrigued by Inga’s mention that the Nashville Medical Mart project has been killed by its developer due to lack of leasing interest, apparently not salvageable even with its partner HIMSS cheerleading and announcing grandiose plans for its involvement going back to the heady HITECH days of 2010. HIMSS planned to place its Interoperability Showcase there, run special exhibits and conventions starting with the center’s grand opening in 2013, and create a “world showcase” for “one-stop procurement market for health information technology, equipment, and software” with up to 600 vendor showrooms on site. The developer blames the sluggish economy for their failure to sign tenants, a lame excuse given that the healthcare IT economy is booming even more than back in 2010. A similar project in Cleveland that’s struggling with the same problems (construction delays, few interested tenants) can at least say it has now no competition, which is similar to being the last front-line soldier who hasn’t surrendered or retreated. All that’s left in Nashville other than cancelled lease agreements is the overpromising vaporware video above.

The other big news item that caught my eye last week was Allscripts protesting New York HHC’s selection of Epic. Usually the protesting vendor at least claims some kind of procedural error or violation of rules, but Allscripts apparently is protesting only that Epic shouldn’t have been chosen because the bid from Allscripts was lower. That’s not exactly the case, according the the board meeting minutes I quoted above (Epic’s software cost was actually less, and the 15-year analysis was performed only for Epic, so there’s no good way to make an apples-to-apples comparison unless you work for HHC, as did the people who chose Epic for presumably sound reasons). Not to mention that software isn’t such a commodity that the lowest bidder automatically wins. The positive outcome for Allscripts would be that the decision is overturned and the bidding opened back up to give them a second chance. I can see quite a few negatives in the “lose the selection, file a protest” strategy:

• Winning the protest would require implementing a complex system in a notoriously problematic client who liked your competitor’s product better, which is a nice short-term boost but a long-term nightmare.
• Going to the press with the protest invites the hospital to do the same with their rebuttal, which HHC’s president has done (he said in the New York Times that Allscripts’ cost analysis is false, HHC’s choice of Epic turned out to be wise given the financial and management problems Allscripts has had since the decision was made, and Allscripts is just trying to buy time as they “scramble to get private equity firms to take them over,” not exactly the kind of PR you want from a prospect that has evaluated your company carefully over many months.)
• If the protest is denied, the protesting company risks losing quite a bit of credibility along with the deal.
• Most importantly, future prospects may balk at inviting a vendor to the table who has previously tried to go over the heads of hospitals that chose a competitor. I’ve only ever banned one company (SMS, now Siemens) from my hospital’s premises and it was for that reason – the rep whined to the board chair that the IT department was incompetent in choosing their competitor, which at the board chair’s insistence got both the rep and the company banned permanently from setting foot on hospital property.

Imprivata has assembled a nice collection of cartoons under the Funny Bones banner. Here’s the latest one.

An interesting demonstration of PEBMAC (Problem Exists Between Monitor And Chair): a physician classifies 90% of his patients as Albanian in his new EMR. Reason: it’s the first country listed alphabetically in the EMR’s Ethnicity pull-down menu.

Health Nuts Media has raised $19,000 of its $90,000 goal to develop The Best Asthma Education App in the World … Period. You get swell prizes if you chip in as little as $5 by October 31.

In Canada, hospitals in Saskatoon and Regina go live on bed tracking software from Allscripts, which I assume is the former Premise although it’s not specifically named.

In England, poor employee training is blamed for quality problems in several areas after the recent Cerner implementation at Royal Berkshire Hospital, including increased wait time for cancer diagnostic results and reduced venous thromboembolism performance.

Henry Schein, which offers the Dentrix dental practice management system, acquires a majority interest in Vancouver-based Exan, which sells software for dental schools and dental practices.

A San Francisco business publication names Kaiser EVP/CIO Phil Fasano as a potential candidate to replace retiring Chairman and CEO George Halvorson.

Former Concerro CEO Graham Barnes is named CEO of care coordination systems vendor HealthyCircles.

The entrepreneur who launched Epocrates and Doximity advises companies developing software for physicians to focus on solutions that, in order, (a) save them time; (b) make them money; and (c) improve the quality of care.

Vince wraps up the HIS-tory of QuadraMed with a timely piece on HDS Ulticare, then Per Se Patient1, then Misys CPR, and finally QuadraMed QCPR. A timely story as it turns out: QCPR is the system that New York HHC is replacing with Epic, at least assuming that the protest by Allscripts does not change the plan.

Cerner Health Conference Tweets and Photos

The official recap is here. There were very few attendee tweets and minimal comments from HIStalk readers, so here’s what I could find that was interesting.

thanks everybody #CHC12 for your incredible kindness & passion “@tgrdd: @farzad_onc Great message @chc 2012.You touched many lives today"

— Farzad Mostashari (@Farzad_ONC) October 11, 2012

Neal Patterson: Clients aren’t implementing St John sepsis program because they’re busy with other things which won’t save lives. #CHC12

— Craig Joseph (@CraigJoseph) October 9, 2012

It is not about the technology doing something that impacts quality, cost and speed, it is how you use the technology @farzad_onc #chc12

— Joe Bush (@joebush1) October 10, 2012

It’s not what you do that matters, it’s why you do it. -Simon Sinek. That’s why it’s not about IT, it’s about improving health care. #CHC12

— Brice Jewell (@bricejewell) October 7, 2012

Sponsor Updates

• Dodge Communications offers an October 16 Webinar on leveraging social media tools in conjunction with trade shows, with panelists Brian Ahier (Mid-Columbia Medical Center), Jennifer Dennard (Billian), and Cari McLean (HIMSS).
• An HCI article covers the Top Three Tips for a Successful Go-Live.
• Streamline Health adds Netsmart CEO Michael Valentine to its board.

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

10/12/12

Top News

Allscripts files a protest against New York City’s hospital system after losing a $303 million contract to Epic. Allscripts claims that its solution would be $700 million cheaper over 15 years than the $1.4 billion total cost to implement Epic. The president of the Health and Hospitals Corporation, which runs the city’s 11 public hospitals, said Allscripts’ coast analysis was false and unrealistic and the selection of Epic came after four years of consideration and analysis of nine different vendors.

Reader Comments

From Straight Arrow: “Re: Allscripts NYC protest. Allscripts comes across as a sore loser, and trying to invoke ‘teachers and doctors’ smacks of desperation. Instead of asking the health system why they chose Epic (they mention Allscripts’ history of management and financial problems) they should have left well enough alone. Nobody ever wins these challenges and cooler PR heads should have prevailed; now the market smells Allscripts’ fear.”

From HitTheRoad: “Re: Allscripts missteps. In the New York Times article, Glen Tullman is quoted as saying Epic’s ‘language is more expensive to maintain.’ That is perhaps the least-informed comment ever uttered by a vendor CEO. That comment, their bizarre bid, the MyWay announcement, and the baiting of a former prospect in a public debate that they are bound to lose in an embarrassing fashion could easily mark the beginning of the end of Allscripts.”

From MDRX Knows: “Rumor: Re: MyWay Rescue Program and Allscripts Buyout. Good for Aprima to step in and try to capitalize on a poor move by Allscripts to shut down MyWay. Converting MyWay clients to Professional is laughable. Professional is embroiled in enough trouble of its own without taking on more clients, including a lack of product functionality and overall application inefficiency. Perhaps if the buyout is successful, Glen and company can take the opportunity to clean the Professional house and actually make it the product they claim it to be, not the one they are currently selling.”

From Nasty Parts: “Costco. Word on street is that Costco is going to file a lawsuit against Allscripts over the whole MyWay fiasco. Costco is sitting on a good number of licenses that are not moving, especially with the recent news.” eTransmedia, the Allscripts reseller that owns the Costco relationship, declined to comment.

From Tracker: “Re: VA RTLS The previously announced VA RTLS award of ‘up to’ $540M to HP Enterprise Services has been vacated based IBM’s successful appeal. The entire project on hold until they decide to either re-issue after rewriting the RFP; re-examine the previously submitted responses with a possible different outcome award based on that reexamination (read – work it out so more of the pie is split and the parties agree not to fight the new decision); or, put the entire project on hold. Given the political and budget variables now present I predict there will be a modest delay for now.” Last week the GAO issued the decision stating that “the VA had made several prejudicial errors in its evaluation of the offerors’ proposals. Those errors led to a source selection decision that GAO found was unreasonable since it relied on the erroneous evaluation conclusions to support the award decision.”

From CDiff: “Re: Advice. Asking you and the readers for help in avoiding a slippery slope. Could buying a shoe ornament be considered contributing to a shoe fetish and therefore to be avoided or one of those things that we just wink at and go ahead in the spirit of gift giving with best wishes?” How could gifting a loved one with something as amazing as these shoe ornaments be wrong? Not to mention the cost is a fraction of the cost of a new pair of Christian Louboutins (size 8, in case anyone is doing some early Christmas shopping.)

HIStalk Announcements and Requests

Many thanks to all the readers who sent notes or Facebook posts wishing me a happy birthday. All the greetings were lovely, but I particularly liked the sentiment expressed here:

May you have the ability to happily wear your shoes high, proud and with padded insoles where necessary!

The best gift will be Mr. H’s return, since this job is not nearly as fun without him. Though not necessarily birthday related, I will note that several readers asked for that perfect margarita recipe. Alas, I am still waiting for the cabana boy applications.

This week on HIStalk Practice: athenahealth integrates Entrada voice services into its EHR. Women’s preventative healthcare improves when providers use EHRs. Doximity grows to 100,000 verified members. Miami Children’s Hospital selects CareCloud for RCM. BetterDoctor launches its doctor-connect app nationwide. If you are still looking to give me the perfect birthday, let me make it easy on you: take a moment to sign up for the HIStalk Practice email updates and click on a few of the sponsors’ ads to learn more about their offerings. Thanks for reading.

Acquisitions, Funding, Business, and Stock

TELUS Health acquires KinLogix, a cloud-based EMR provider headquartered in Quebec.

HealthTech Holdings acquires perioperative solutions provider Acuitec. HealthTech will integrate Acuitec’s VPIMS solution into the HMS EMR.

Investment bank Berkery Noyes reports a year-to-date 19 percent increase in healthcare and pharma IT M&A activity compared to 2011.

Sales

The Norwegian Directorate of Health awards Accenture a five-year contract to build and implement Norway’s EHR system.

OhioHealth contracts with Health Care DataWorks, Inc. for its KnowledgeEdge Enterprise Data Warehouse.

Partners HealthCare (MA) extends its contract for MedeAnalytics’ Revenue Cycle Intelligence solution for an additional three years.

Day Kimball Healthcare (CT) will implement SCI Solutions’ Schedule Maximizer and Order Facilitator for it employed and affiliated physicians.

University Physician Associates of New Jersey signs a five-year contract renewal with MedAptus for its Professional Charge Capture software.

People

Tenet Healthcare names Paul T. Browne (Trinity Health) CIO, succeeding the retiring Stephen F. Brown.

Announcements and Implementations

Country Villa Health Services (CA) will be the first organization to implement the AHRQ On-Time Avoidable Nursing Home Transfer Module from HealthMEDX.

Mt. Ascutney Hospital and Health Center (VT) implements Cerner Millennium EMR under the management of The Huntzinger Management Group.

Continuum Health Partners deploys Caradigm eHealth solutions, including the eHealth Community Desktop clinical portal and the eHealth Information Exchange.

The EHR/HIE Interoperability Workgroup, the NYeC, and Healtheway establish a testing program to certify EHRs and other HIT for the reliable transfer of data within and across organizations and state boundaries.  CCHIT will perform the testing.

Government and Politics

Kinergy Health’s MyKinergy wins the Patient Engagement Blue Button Challenge, sponsored by the ONC and The Advisory Board Company, and is awarded the $25,000 grand prize. Other finalists winning $5,000 each include Humetrix, TrialX, Jardogs, and mHealthCoach.

About 284,000 Medicare patients who are potential victims of identity theft are facing difficulties getting healthcare benefits because the government won’t issue new IDs. Medicare officials claim it’s too expensive and too many agencies are involved to reissue the cards.

Innovation and Research

Medicare’s policy to block hospital reimbursements for certain preventable, hospital-acquired infections has not significantly changed the rates of two types of infection.

Technology

Cerner will embed Nuance’s cloud-based medical voice recognition technology into its mobile EHR products including PowerChart Touch. Cerner is also integrating Nuance’s PowerScribe 360 radiology reporting product with Cerner’s RadNet RIS.

Other

The development company overseeing the conversion of the Nashville Convention Center to a medical mart suspends the project, saying that the “leases signed to date do not yet enable the project to be financially feasible.”

Meditech purchases a 26-acre office and conference center in Foxboro, MA for $19.8 million. The site, which will undergo renovations over the next year, will eventually employ 500 workers.

Sponsor Updates

• Impact Advisors releases its 2014 ONC EHR Standards and Certification Criteria primer.
• EBSCO Publishing announces the availability of the Health Economic Evaluation Database, which provides comparative analysis of of medicines for health economists.
• HIStalk sponsors earning a spot on the 2012 Best Places to Work in Healthcare list include: Aspen Advisors, Divurgent, Encore Health Resources, ESD, Hayes Management Consulting, Iatric Systems, Impact Advisors, Imprivata, Intellect Resources, Intelligent InSites, maxIT Healthcare, Santa Rosa Consulting, and The Advisory Board.
• Surgical Information Systems releases its SIS Surgery Dashboard, which displays real-time current case statuses on mobile devices.
• Elsevier recognizes four “Superheroes of Nursing” at this week’s ANCC Magnet Conference.
• University Physician Associates of New Jersey renews its charge capture contract with MedAptus.
• EBSCO Publishing releases its Applied Science & Technology Source resource to facilitate the research needs applied sciences and computing users.
• CommVault announces the integration of its Simpana 9 data and information management platform with Microsoft’s Cloud OS, including Windows Server 2012, Hyper-V, and Windows Azure.
• MedHOK is named a finalist for the Tampa Bay Technology Forum Emerging Technology Company of the Year Award.
• TeleTracking Technologies offers a three-part Webinar on reducing hospital costs through automated asset management.

EPtalk by Dr. Jayne

Another acronym bites the dust: ONC announces that the Nationwide Health Information Network (NwHIN) Exchange is now eHealth Exchange. Nonprofit Healtheway assumes operational support.

Now that 2012 is almost over, CMS has announced distribution of ePrescribing program incentives and PQRS payments from 2011. Accompanying feedback reports, manuals for interpreting the data, and guides for understanding incentive payments are available on CMS’s Quality Net portal. Don’t spend all that money in one place, folks.

An apple a day: Inga shared this article that suggests doctors practice healthy behaviors more often than other workers in the US. I’m glad they didn’t report on doctors who have become administrators or IT staffers. I was definitely healthier when I was running around a practice as opposed to sitting in endless meetings. I think I’m going to have to start adding “stand and stretch” to my time-boxed agendas if I want to avoid getting a blood clot from immobility.

Speaking of health, I went for my physical today so I can scuba dive again. As I sat in the waiting room, my phone buzzed and it was an email from the receptionist inviting me to enroll in the practice’s patient portal and fill out my introductory health questionnaire. It’s always fun to see these things actually work in a practice. Now we’ll just have to see how long it takes before my clinical summary is available.

Jeers to Anthem BlueCross BlueShield who continues to recycle tired old jokes about physician handwriting. If they want something fresh and modern to pick on, let’s try poor typing skills.

I wasn’t able to attend Health 2.0 although I enjoyed reading the reflections by Dr. Travis on HIStalk Mobile. I was glad to hear that Extormity made a with their strategic plan to acquire every application developer in attendance.

Today is my BFF’s birthday, so if you haven’t done so already please take a moment to send Inga your congratulations. I hope her day is full of sassy shoes and adoring fans.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

News 10/10/12

Top News

Bloomberg reports that Allscripts has received first-round bids for a leveraged buyout from PE firms Blackstone Group LP and Carlyle Group LP and expects additional offers within three to four weeks. Allscripts closed Tuesday at $13.57 per share.

Reader Comments

From Master Yoda: “Re: Cerner Health Conference. I doubt you will be able to make it to the conference, but if any of your readers are going, I’ll be the one in the guayabera with the hair that says ‘he really isn’t trying to impress anyone.’ I hope to see Farzad speak and I wonder how long it will take before I hear someone say ‘Epic’?” Cerner provides its own Day One Recap here.

From Innovator: “Re: Cerner conference. The vibe here is cautiously optimistic. Cerner has put a significant emphasis on mobility. PowerChart Touch (Cerner iPad app) and Cerner Careaware Connect (nurse iPhone app). Both are very impressive and the immediate reaction from the customer base seems very positive. However, you can sense a bit of hesitation, as if customers are cautious about getting too excited about new technology because they have been burned in the past.”

From Motown Nurse: “Re: HCA and Beaumont. A couple of my CRNA colleagues who work for Beaumont state that they were informed that HCA has purchased their health system. I had not read this as confirmed anywhere yet though I may have missed it.” The local Detroit business news mentioned a rumored sale last month but I could not find confirmation. Meanwhile Beaumont’s Physician Organization and United Physicians announce plans to combine operations by the end of the year.

From Future Perfect: “Re: Cerner. Have you heard about Cerner trying to sell a single patient accounting system for both hospitals and physician offices? Usually Cerner sells ProFit for hospital billing and Powerchart for physician billing but now they are trying to sell ProFit for both and compete head-to-head with Epic’s combined billing solution. Does it really work and is it tested?” Do any readers have an answer?

From Retired Barkeep: “Inspiration by drink. I have a great single-serving margarita recipe for you.” Thanks for the recipe, which I am happy to share with interested readers. I am pretty sure I will need at least a double by the time Mr. H return at week’s end. Retired Barkeep was unable to offer cabana boy services to accompany the beverage(s) so I will continue to accept applications.

From Amarba: “Stan Opstad. Stan was the product SVP at Healthland but is no longer there.” Healthland confirmed that the company’s product management and development operations were consolidated under SVP Michael Karaman in 2011 and that Opstad left the company in August.

HIStalk Announcements and Requests

Mr. H has yet to check in with me, other than to report a typo, so I suspect he is in total relaxation mode. Feel free to send me your burning HIT news until he returns this weekend.

Acquisitions, Funding, Business, and Stock

Orion Health’s managing director and majority owner says the company is “strongly considering” going public.

Health Tech Hatch, a crowd-funding site, launches to provide early funding and mentoring to HIT innovators that are developing new companies and products.

Volate secures $6 million in new funding from an unnamed HIT leader and a major healthcare system. The company plans to triple its staff to almost 150 over the next 18 months.

Sales

Massachusetts Eye and Ear Infirmary selects MedeAnalytics’ Clinical Performance Intelligence and Revenue Cycle Intelligence solutions to analyze physician utilization and quality metrics. MedeAnalytics also secures a five-year contract extension with West Tennessee Healthcare for its Compliance and Revenue Integrity and Revenue Cycle Intelligence solutions.

People

MediRevv appoints Patrick Tierney (above – University of Iowa Hospital and Clinics) managing director of consulting services and Matthew Reat and Diana Moore (CSC) senior consultants.

Medecision names Jerry Baker (Halfpenny Technologies) SVP and GM of its value-based healthcare solutions business for care delivery systems.

Consulting services firm SISU Medical Solutions names Scott Lee (Lee Advisory Services, KPMG) CEO.

RegisterPatient, which just raised $4.1 million in series A funding, hires Jana Skewes (Shared Health) as CEO.

CHIME elects Pamela Arora (Children’s Medical Center Dallas), Charles Christian (Good Samaritan Hospital), and George McCullock (Vanderbilt University Medical Center) to its board of trustees.

Announcements and Implementations

Awarepoint announces 226% deployment growth, including new activations at Kaiser Permanente, Yale New Haven Health System (CT), Monongahela Valley Hospital (PA) and Vidant Medical Center (NC).

The town of New Canaan, CT pilots a teleheath program that provides 10 seniors iwith Pad or Acer tablets to communicate with nurses two to three times per week. The participants, who range in age from 70 to 85, will also be provided medical equipment to monitor and report vital signs.

Hillcrest Medical Center (OK) goes live on Forerun’s FlexChart physician documentation in its ED.

AT&T and IBM will begin selling private cloud computing services next year over a mutually owned network.

Southern Tier HealthLink (NY) joins the New York eHealth Collaborative’s Health Information Network.

Allscripts announces its Open App Challenge, which offers $750,000 in rewards for developers that create and integrate applications that build upon Allscripts Open EHR platform.

Aprima reminds MyWay customers that the software is based on Aprima’s PRM 2008 version and offers a no-charge license migration, as long as practices sign up for maintenance and support. Aprima also says that MyWay resellers can join Aprima’s reseller network and offer their customers an upgrade option.

Innovation and Research

Physicians using EHR scored significantly higher on quality of care for four screening measures for diabetes, breast cancer, chlamydia, and colorectal cancer, according to a study published in the Journal of General Internal Medicine.

Technology

Imprivata releases Cortext, a free HIPAA-compliant text messaging solution for iPhones and Android devices and Web-based chat solution for nurses without smartphone access.

Anesthesia Business Consultants and iMDsoft launch cloud-based myAnesthesia for the iPad.

Other

Providers need to work together to accelerate interoperability and electronic information sharing across care settings, according to a report from the Bipartisan Policy Center. The Center also recommends a national strategy to improve accuracy of patient matching; an extension of Stark Law exceptions and Anti-Kickback Statute for safe harbors for HIT donations; and improved clarity of federal privacy and security laws.

Doctors are generally healthier than other US workers according Gallup-Healthways report. A physical health index that considers such factors as obesity, colds, the flu, headaches, and sick days gives doctors a score of 86, nurses 80, and other employed adults 81.

The New York Times takes a look at the use of telemedicine on Nantucket Island, MA as a means to increase access to specialists and decrease costs. Nantucket Cottage Hospital’s CEO estimates that the island’s use of tele-dermatology is saving $29,000 per year and provides patients’ access to dermatologists six times a month instead of just four times a year.

Sponsor Updates

• Three hundred Encore Health Resources’ employees build and deliver fifty wheelchairs to Houston-area veterans and the disabled during the company’s annual retreat.
• Aspen Advisors’ Fran Turisco and Dan Coate deliver a presentation on patient monitoring technologies and accountable care at next week’s NY eHealth Collaborative Digital Health Conference.
• NTT DATA will integrate Dart Chart Systems’ proactive analytics tools into its NetSolutions POC software.
• A local Eden Prairie (MN) publication profiles Virtelligence, which was recently named as one of the country’s fastest-growing companies.
• Wellcentive’s VP of product strategy Mason Beard discusses six pillars of population health management.
• Mike Reppart, (Hendrick Medical Center TX), and Kelley Blair (Craneware) will speak at the 2012 AAHAM ANI Conference on RCM strategies and performance improvements.
• IDC Health Insights recognizes Harris Corporation as a leader in the packaged HIE segment.
• Beacon Partners offers two Webinars in October on risk management.
• Infor releases its Workforce Management 6.0 solution and announces a private beta availability of its iPaaS stack on the IBM SmartCloud platform.
• EBSCO Publishing and Elsevier will provide access to Elsevier’s Scopus database from within EBSCO’s Discovery Service.
• Imprivata customer Dr Harald Eder joins a panel discussion on improving patient care with cloud-based desktops during VMworld 2012. Imprivata also announces the finalists for its inaugural Healthcare Innovation Awards.
• Visage Imaging will participate at the second annual Imaging Informatics Summit this week in Washington, DC.
• McKesson announces general availability of its Reimbursement Manager to assist with bundled payments and fee-for-service reimbursement models.
• Surgical Information Systems offers integration with abeo’s MedSuite billing software.

Clarification from Allscripts

We asked Allscripts to answer a few additional questions about their MyWay to Professional Suite upgrade option. We appreciate their providing us with these responses.

Could you clarify “free upgrade?” Is that a free license, a free conversion, or both?

This upgrade includes software, implementation and training. It will start in January 2013 and end in September 2013. The implementation will be facilitated by enhanced tools that make data conversion and interface activation seamless. This, coupled with tailored simulation learning and a hands-on weekend learning event, will prepare clients to take advantage of their newly upgraded software.

Does the maintenance fee change for MyWay clients once they’re on Pro?

The maintenance fees will remain the same as what is defined in a MyWay client’s current agreement.

And when you say “converged platform,” how is it different than the current Pro product?

We are launching a converged platform and the first step is to move our MyWay clients to this platform. They will experience many enhancements including mobility with Wand, our native iPad mobility solution, additional content including more specialties, and real time point of care/clinical decision support. In addition, the converged platform will be able to process ICD-10 codes and is planned to be certified for Meaningful Use Stage 2.

More news: HIStalk Practice, HIStalk Mobile.

Monday Morning Update 10/8/12

Allscripts announces free upgrade to improve practice solutions ow.ly/efPow #EHR #HealthIT

— Allscripts (@Allscripts) October 5, 2012

From Factory Girl: “Re: Allscripts. My company is an Allscripts partner and last week they told us they were not planning to make any official announcement about the decision to move customers off the MyWay platform. Yet I see that the day after HIStalk mentioned it, they posted details on their WebSite.” Allscripts also filed an 8-K so they probably figured everyone would know even if they didn’t read HIStalk. Allscripts is taking a $10-$13 million write-down on MyWay so that business apparently won’t be sold as once rumored.

athenahealth CEO Jonathan Bush says his company is considering a move to a larger location or an expansion of its Watertown, MA headquarters from 330,000 to one million square feet.

The local paper profiles Nashville-based Shareable Ink, which has grown from two customers at the beginning of 2011 to almost 100 hospitals and clinics today. CEO Stephen Hau says he expects the company to grow from 40 employees to 80 within the next six months.

The 100+ physician Colorado Springs Health Partners chooses Humedica’s MinedShare clinical intelligence platform.

The use of EHRs isn’t increasing Medicare fraud, say 78 percent of poll respondents. New poll to your right: what is the primary motivation of the House members who are urging cessation of HITECH payments?

Listening: new from reader-recommended The Vaccines, an English indie band that sometimes sounds like the Ramones, but is a good (better) listen even when they don’t. I’m also wistfully listening to YouTube recordings of The Howard Stern Show from the early 1990s when it was actually good (Howard, Robin, Fred, Jackie, and Billy, and especially the Jackie Puppet).

Streamline Health Solutions promotes Matthew S. Seefeld from chief strategist of revenue cycle to SVP of solutions strategy.

Providers rank CareFusion, Omnicell, and McKesson the top providers of anesthesia cabinets based on functionality, implementation, and training, according to KLAS. Half of users that have implemented anesthesia cabinet systems say the main benefit of OR-specific cabinets is having an organized and controlled medication inventory.

Surgical Information Systems integrates its perioperative IT solution with OpenTempo’s surgical and anesthesia workforce scheduling tool.

The T-System folks forwarded this card, which they developed in advance of this week’s ACEP Scientific Assembly in Denver.

The former HIM manager of a small Nevada hospital files a wrongful termination lawsuit against her former employer, claiming she was fired for questioning what she says was ED upcoding.

Just a reminder that Mr. H is taking some R&R this week. If you send him an e-mail and he fails to respond, hopefully that means he is busy reclining on an exotic beach sipping umbrella drinks. Actually I don’t think he is an umbrella drink/exotic beach kind of guy, but since that’s my idea of the perfect vacation, that’s what I am envisioning for him. While he is out of pocket this week, feel free to drop me a note, should you have any burning HIT news to share, want to offer encouragement, or have any umbrella drink recipes worth consideration.

Thankfully Weird News Andy never takes a break and sends over this story about one Florida county’s attempt to have patients waive their privacy rights. The Sarasota County sheriff’s office is encouraging pain physicians to have their patients sign a form authorizing the release of PHI to law enforcement, should a physician believes a criminal violation has occurred. The local paper reports that the medical community is is concerned the move violates “HIPPA law.”

Vince provided a HIS-tory this week after all, continuing his QuadraMed history with a fascinating look at Health Data Sciences, which was the hottest vendor going a couple of decades ago. My favorite trivia: founder Ralph Korpman MD was a computer genius who started medical school at 15.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

News 10/5/12

Top News

From DrLyle: “Re: House committee call to suspend HITECH payments. I’m at this meeting. Farzad is keeping his cool. He says it’s just pre-election rumblings and nothing can change without major legislative work.” Several House Republicans call on HHS Secretary Kathleen Sebelius (copying CMS Administrator Marilyn Tavenner and National Coordinator Farzad Mostashari) in an October 4 letter to immediately suspend HITECH payments because the Meaningful Use bar is set too low, resulting in a program that “squanders taxpayer dollars and does little, if anything, to improve outcomes for Medicare.” It claims that $10 billion has been wasted. It also references increasing payments due to higher levels of provider coding, as well as Stage 2 rules that don’t emphasize interoperability enough, leading to “our health care system trapped in information silos, much like it was before the incentive payments.” The letter also directly challenges the HHS/ONC count of HITECH provider participants, saying that HHS is “trying to pad participation rates.”

Signers of the House letter were Rep. Dave Camp (R-MI, Chairman, Committee on Ways and Means), Rep. Fred Upton (R-MI, Chairman, Committee on Energy and Commerce), Rep. Wally Herger (R-CA, Chairman, Committee on Ways and Means, Subcommittee on Health), and Rep. Joe Pitts (R-PA, Chairman, Committee on Energy and Commerce, Subcommittee on Health). One might presume given the timing and the fact that all four signatories are Republican that there’s a political motive, although that doesn’t change the fact that you either do or don’t agree with their assessment of HITECH. If their arguments are sincere, perhaps they should have made them earlier. Also, note that their objections aren’t to the value of EHRs but rather to the value of taxpayers in subsidizing them, so reciting a list of why EMRs are inherently good is not an appropriate rebuttal, nor would a list of accomplished users like Kaiser who got free money for using something they’d already bought without taxpayer bribes.

From BadgerMom: “Re: Valley Medical Center, Renton, WA. Goes live with Epic inpatient.” Congratulations to them. Thanks for the picture.

From Horshack’s Laugh: “Re: Caradigm. The company was simply a consolidation of two non-performing assets so that GE and MSFT could get them off their respective books and write off their significant losses ($1 billion over seven years for Qualibria alone) and allow Immelt and Ballmer to save face.” Unverified. I asked that question in my interview with CEO Michael Simpson.

From THB: “Re: Epic’s succession plan. What about HIStalk’s succession plan? You have built a great open source forum, but at some point you will be the old curmudgeon (and I mean that in the nicest sense!) Believe me, Judy reads this site, as does Glen T. and the rest of them. You share what you can and keep close to the vest what you cannot (that is a fine display of TRUST).” HIStalk is to me a hobby rather than a business, and given that I do it part time (as do my far-flung co-conspirators Inga, Dr. Jayne, Dr. Travis, etc.) I don’t have a specific plan for it to continue without me, nor am I vain enough to think that the healthcare IT world will stop spinning on its axis when I stop typing. Sometimes I feel guilty that Mrs. HIStalk would get no financial benefit from my years of labor if I flamed out tomorrow, but I don’t have a solution. It’s an inherently and intentionally amateurish operation.

From Jeeves: “Re: Patrick Soon-Shiong. His announcement was a big deal. I want to point out that at the end of last year when all the pundits were doing their predictions, Travis of HIStalk Mobile was the only one that I’m aware of that said this would be the year that Patrick’s stuff becomes real.” Travis is looking good with his predictions for the year so far: (a) smart phones everywhere; (b) more research and pilots on mHealth; (c) AirStrip as the biggest mover in mHealth; (d) price transparency gets a foothold; and several others. Travis has a lot of experience (MD, startup, NGO, etc.) and you’re missing out on his insight if you haven’t signed up for e-mail alerts when he posts something new. Soon-Shiong’s announcement this week that his NantWorks group of companies has developed a package of supercomputing, high-speed networking, and mobile access that will let doctors instantly individualize cancer treatment based on the patient’s genome. I listened to the live webcast for a few minutes while I was at work and heard him taking the usual shots against outdated, MUMPS-based systems that don’t talk to each other, although I’m not sure what that has to do with his project, which in itself sounds fascinating depending on who’s paying for it and who’s making money from it. BPC has posted the full video of the all-day event, although I haven’t had time to watch it. There’s bonus footage of an extremely cool Farzad bow tie in his segment at around the 180-minute mark.

Reader Comments

From Pick Six: “Re: Allscripts. Replacing MyWay with Pro.” An internal Allscripts e-mail says that it will standardize its small physician market offering on Allscripts Professional Product Suite, with free migration of MyWay users starting in January. The company also announced that its VAR network will be reduced from 40 to four resellers and that Pro Suite pricing will be standardized (it’s not clear from the wording whether MyWay users will get a free license or just a free migration once they’ve paid for Pro). Also not mentioned is what happens to MyWay, although the most common rumor we’ve heard is that it will be sold rather than mothballed (which makes more sense than Allscripts taking a write-off of some of its Misys acquisition costs). Allscripts is trying to consolidate platforms because of the development effort required for ICD-10, Meaningful Use Stage 2, and accountable care. The risks are that users of MyWay, rumored to be the most popular product Allscripts sells, could look elsewhere given the decision the company has forced on them. One potential winner is Aprima, which under its former name iMedica built the original version of MyWay that Misys licensed in 2007, followed by ugly disputes between the companies (see my July 2008 interview with Michael Nissenbaum). Since then, Aprima has rewritten the PM app and upgraded their version of both EHR and PM, so the gloves will come off if Aprima decides to offer an easy conversion from MyWay to their similar product, potentially also signing on some of the former Allscripts VARs who will be left scrambling. Also affected will be Etransmedia, an Allscripts partner that sells MyWay for $499 per month through Costco.

HIStalk Announcements and Requests

I noticed that one of my new Twitter followers is a “healthcare visionary,” leading me to ponder how one earns that designation. Self-assigned? Or is it an advanced accreditation available through HIMSS for those over-achieving members who feel the need for additional titles? I’m going with self-assigned, so from here on out I will refer to myself as Inga HIStalk, HV. Maybe I will get Mr. H to make some ribbons for HIMSS so fellow healthcare visionaries can promote themselves. By the way, feel free to follow me and my HIStalk buddies on Twitter, connect with us on LinkedIn, and be our virtual BFFs on Facebook.

This week’s highlights from HIStalk Practice: a rumor and a response from e-MDs. CareCloud gives Florida International University informatics students access to its EHR. Practice owners struggle over how to allocate incentive payments for employed providers.The Ohio AFP pilots a project to transform practices to the PCMH model, train medical students, and recruit physicians to practice in the state. Julie McGovern of Practice Wise offers tips for physicians to train for their EHR training – and don’t miss the comment from MarathonMan. You know what makes me happy: that two-second signup for HIStalk Practice e-mail updates. Thanks for reading. 

  Am I the luckiest gal in HIT or what? That’s Dr. Mostashari and Dr. Lyle Berkowitz holding up an IInga sign at today’s CMIO Leadership Forum. (Eat your heart out, BFF Dr. Jayne.)

Welcome to new HIStalk Platinum Sponsor VMware, which offers dependable, always-on frontline clinical systems access. Connect to your mobile clinical desktop from anywhere, view medical images, use any digital device securely with no clumsy security steps, and save time with a clinical desktop that follows you everywhere with fast logins to patient care systems. VMware offers cost-saving, secure, and IT-friendly solutions for virtualization, non-stop point-of-care desktops, trusted cloud security and compliance, and zero-downtime continuity and recovery. Thanks to VMware for supporting HIStalk.

From my obligatory YouTube cruise, I found the above VMware video wrap-up of HIMSS12. I like that they pictured and thanked their employees who staffed the booth.

Thanks to Philips Healthcare, supporting HIStalk as a Platinum Sponsor. The company’s solutions address interoperability (IntelliBridge Enterprise and Bedside to connect Philips products with others); clinical decision support (sepsis monitoring, vital signs and alert trending, EKG analysis, cardiac decision support); mobility (OB TraceVue for iPad-powered fetal information, HeartStartMRx ECG to smartphone, and IntelliSpace Event Management); and telehealth (eICU, IntelliSpace PACS, and Home Telehealth Solutions). I interviewed CMIO Joe Frassica, MD in August, who not only explained the company’s offerings well, but also got promoted to CMIO/CTO/VP right after the interview ran, according to his LinkedIn profile. Thanks to Philips Healthcare for supporting my work.

Here’s a brand new Philips Healthcare video that seems appropriate for Breast Cancer Awareness Month.

As a change of pace, I’ll refrain this week from urging you to sign up for e-mail updates and Like us and all that. Instead, I will suggest just one course of action: tell your colleagues you get news and opinions from HIStalk. I’ve received many e-mails from new readers and new sponsors who admitted that they hadn’t heard of HIStalk until people whose opinion they valued kept telling them they should read it. I appreciate that a lot.

I’ll be taking a little break next week, although I’m sure I won’t be able to resist the laptop’s siren song. My hiatus is minuscule compared to that of Vince Ciotti, who’s enviably taking his bride of 40 years to Europe for the whole month of October to re-live their honeymoon (and unlike me, he’s vowing to stay off the laptop). That means HIS-tory will return in November, and I can honestly say I will miss it since I enjoy every one of them.

Acquisitions, Funding, Business, and Stock

Homecare Homebase closes $75 million in senior securing financing from CIT Group.

Peak Health Solutions acquires the assets of consulting firm Health Data Essentials.

Sales

Managed care health plan Kern Health Systems selects McKesson’s VITAL Care Management programs to provide members with care management and educational materials.

Scottsdale Healthcare and Scottsdale Physician Organization will implement Harris Corporation’s Clinical Integration Solution to connect its hospitals, physicians, labs, and other providers.

Booz Allen Hamilton Holding announces 35 new federal and private healthcare contracts totaling more than $112 million in August and September.

People

Patient flow software provider Central Logic names Steve Erickson (SageCreek Partners) CFO.

Stephen Lawrence (Southern Illinois Healthcare Foundation) joins the Lincoln Land HIE as executive director.

Kaiser Permanente Chairman and CEO George Halvorson announces his retirement effective December 2013.

Announcements and Implementations

Inova (VA) becomes the first organization to participate in the ConnectVirginia HIE.

The New England Healthcare Exchange Network (NEHEN) selects the Massachusetts eHealth Collaborative to take over its executive management, business development, and operations management.

Mediware Information Systems earns updated 510(k) clearance from the FDA for its core blood management software products.

Penn State Milton S. Hershey Medical Center implements an interconnected CareFusion and Cerner solution that centralizes clinical information between the Pyxis MedStation 4000 system and Cerner Millennium EHR using Cerner’s CareAware iBus integrated device connectivity architecture.

Horm Memorial Hospital (IA) and Faulkton County Memorial Hospital (SC) beta-test Healthland’s Centriq Clinic, an ambulatory care solution for rural physicians.

Iowa Specialty Hospitals, The Gabrielson Clinic, and Orthopedic Specialists go live on EMR Oct. 8. The hospitals and clinics are all part of University of Iowa Healthcare, so that’s probably Epic.

CliniComp commits to meeting ONC Stage 2 MU certification with its Essentris EMR.

AHIMA calls for improved EHR patient documentation standards and principles at its conference this week.

Government and Politics

The Medicare Fraud Strike Force charges 91 individuals — including doctors, nurses, and other medical professionals — for falsely billing the government $492 million, including more than $230 million in home health fraud, $100 million in mental health fraud, and $49 million in ambulance transport fraud. Half the people, not surprisingly, operated out of Miami.

Technology

Qualcomm Foundation awards Scripps Health a three-year, $3.75 million grant to develop wireless medical devices, including biosensors that are inserted into the blood stream for disease detection; a mobile app that captures medical data from biosensors and transmits it to patients’ smart phones; and a handheld device to detect genetic variations that may prevent particular medications from working correctly.

Other

St. Francis Health Center’s (KS) will lay off eight patient accounting employees as a result of the hospital’s November 1 transition to Epic.

A Wall Street Journal article called “Hospital Horrors” covers a newly published book on hospital transparency written by a Hopkins surgeon. He says state medical boards do a poor job of policing doctors, hospitals are pushed by lower reimbursement to increase volumes to unsafe levels, and bad treatments pay better than good ones in many cases. He quotes a recent Hopkins survey of employees of 60 high-quality hospitals, where more than half of the respondents said they would not feel comfortable receiving care in the unit in which they work. I’ve said that many times: those of us working in the healthcare system are a lot more scared of it than laypeople when we become patients.

Friday is the premiere of “Escape Fire: The Fight to Rescue American Healthcare.” Variety gave it a pretty good review from its Sundance screening in January, but said it should have included more about how lobbying keeps the healthcare industry safe from political action.

Weird News Andy says he might believe the woman who blames lupus-triggered delusions for causing her to strip naked and chant religious phrases outside a high school, but that doesn’t explain why she was joined by her two adult daughters and teenage son. The adults got probation after pleading guilty to indecent exposure.

A Utah man is convicted of disorderly conduct and charged a $140 fine after paying a disputed $25 doctor bill in pennies. Apparently the practice did not appreciate having 2,500 pennies dumped onto the receptionist’s desk. Personally, I think his approach was creative, and I bet quite liberating.

Just in time for Breast Cancer Awareness month: a “smart” bra that uses sensors and predictive analytics for early breast cancer detection. Don’t look for it at Victoria’s Secret or anywhere else any time soon: the company does not expect to launch the product in the US until 2014.

Men with shaved heads are perceived to be more masculine, dominant, and in some case have greater leadership potential than those with longer or thinning hair. Thank you, University of Pennsylvania’s Wharton School for confirming what I have known for quite some time.

Bizarre: a man sues a stripper who was performing at his bachelor party, claiming she slid down the stripper pole and landed so hard on his abdomen that she ruptured his bladder.

Sponsor Updates

• CMS names SuccessEHS a 2013 EHR Direct Qualified Vendor.
• CareTech Solutions offers discounted pricing for its BoardNet portal to members of the AHA Center for Healthcare Governance.
• The CliniSync REC (OH) profiles Premier Physician Center and its use of e-MDs.
• API Healthcare celebrates customer service week by honoring its client-facing support staff.
• The Journal of the Medical Library Association ranks DynaMed in the top ten among online clinical resources.
• NextGate joins the partner network of HIT consulting firm Exsede.
• Shareable Ink introduces its Meaningful Use program for anesthesiologists.
• QlikView hosts an October 11 webinar featuring Nationwide Children’s Hospital (OH) and its use of QlikView for data discovery.
• MedHOK announces that its technology platform positions participants in the Comprehensive Primary Care initiative to share in savings and improve patient care.
• T-System showcases its RevCycle+ physician coding and billing solution at next week’s ACEP Scientific Assembly in Denver.
• iSirona sponsors a Code-A-Thon programming challenge at Florida State University’s department of computer science.
• Datapharm Australia Pty selects Merge Healthcare’s eClinical OS solution for enterprise-wide electronic data capture.

EPtalk by Dr. Jayne

I’m mourning the loss of a colleague today – one of my favorite partners is leaving our group. Patients adore him and I’d trust him to care for my loved ones. The reason: he’s fed up with insurance, bureaucracy, and paperwork and is launching a cash-only practice.

He will be sorely missed, but he’s not the only one. Increasing numbers of physicians are dropping participation in insurance plans. It doesn’t do much good to have patients insured when few will accept low-paying insurance plans (see: Medicaid). A New York Times piece this week shares some additional stories. More interesting than the feature itself are the reader comments.

Sponsored by ONC, the Blue Button Video Challenge runs through November 13. This is your chance to create an “engaging and entertaining” two-minute video to advocate use of the Blue Button to access health information online. Judging criteria include submissions being “fun, edgy, and memorable.” First prize is $3,000 to help motivate you creative types.

In the medical staff lounge this week, there has been a fair amount of discussion around the Annals of Internal Medicine article covering patient access to physician notes. The authors concluded that patients felt the practice was beneficial and that providers experienced “no more than a modest effect on their work lives.”

So many of my colleagues think the sky will fall if their patients have access to visit documentation. Not a week goes by that one of my peers doesn’t corner me about making parts of the patient plan documentation “hidden” or “non-patient-facing.” Although they profess concern that patients can’t handle the truth or that phone calls to explain the notes will be a burden, I really think they’re afraid that patients will discover their poor written communication skills.

Reading the notes of some of my peers is exhausting even when they’re dictated, so one can’t always blame the EHR. I wonder if some of them know how pompous they sound or that they simply ramble with no concept of sentence structure? In order to make sure our patients (and sometimes our colleagues) understand us, we need to be communicating clearly and often at an elementary-school reading level.

Even if your organization doesn’t have an open notes policy, I strongly encourage providers to start documenting as if patients will read the notes. Chances are they’ll be reading them in a few years whether you like it or not. Better to prepare now.

For those that are worried that patients can’t handle the truth (aka, “She’s not going to like it if I say she’s obese”) it’s time to be direct with patients. Tiptoeing around the edge of major national health problems like obesity, diabetes, hypertension, and coronary artery disease because we’re worried about hurting a patient’s feelings isn’t good for the patient or for society. I’m not saying we need to be unfeeling or unkind, but sometimes we need to just call it what it is and work to help patients address their health needs.

Being able to communicate well is a learned skill and needs to be taught in medical school and reinforced in residency and continuing professional activities. Last time I checked, online translator software doesn’t offer “Doctor” as a language choice (although I did find a pirate translator), so it’s time for healthcare providers to get with the program.

What do you think about patient-facing documentation? Do you use it in your practice? E-mail me.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

Healthcare IT from the Investor’s Chair 10/3/12

Whither Venture Financing? Or, Where Have All the Cowboys Gone?

I was delighted when Mr. H mentioned he’d gotten some feedback from readers that they would enjoy more columns from the Investor’s Chair. I really enjoy writing them, and even more, I enjoy the responses they generate.

Readers might recall my post two years ago that discussed several ways to capitalize a new venture. I’d like to use today’s post to discuss some of the root challenges in one of those options: venture financing.

While raising capital isn’t what I do at ST Advisors (though we do occasionally advise on aspects of it), from time to time I speak with entrepreneurs who need investors for their business. They tell me that raising venture dollars, especially for companies in earlier stages of development, has become increasingly difficult over the past few years. I attribute this to three major factors:

Funds have gotten larger … There are two main reasons for this fund size growth. Pensions and endowments have grown, so they have been looking to deploy larger amounts of capital. And, VCs are typically paid using a formula known as “2 and 20.” What that means is that 2 percent of the amount of the fund is used for a management fee, i.e., office space, support, travel, reporting, salaries (of both partners and associates), etc. The “20” refers to the carried interest, meaning the venture team gets 20 percent of the fund’s profits.

As a matter of historical curiosity, I recently learned (but have not been able to substantiate) that this virtually sacrosanct ratio was selected by one of the first venture funds and replicated the percentage of a clipper ship’s profits the captain and crew received. Of course, they were risking their lives…

At any rate, the 20 percent carried interest gets divided among the general partners and other fund employees as each fund sees fit. Simple math suggests 2/20 on a $500 million or $1 billion fund is much more appealing than 2/20 on a $100 million fund.

Whichever reason, it’s as much work for a venture fund to write a large check as a smaller one, and both the $2 million and the $10 million investment require similar time and effort for due diligence, negotiation, governance, management, and oversight. It’s only logical that investors are seeking to write bigger checks, as those will have a bigger impact on their funds’ (and their own) financial performance.

… but returns have been lacking … Further challenging the traditional venture investor is the fact that venture funds as an overall asset class, or type of investment (as opposed to real estate, public stocks and bonds, private equity) have underperformed the other asset classes over the past decade. A good overview of returns relative to public markets can be found in this excellent article. Some say that only $0.25 of every invested dollar has been returned. Even if you’re the best VC in the pack, raising money for a new fund in light of this performance has to be a challenge.

I’d postulate two primary reasons other than the most recent recession. First is the law of supply and demand. When venture was hot, too many funds were started and, in 1999, raising a fund was just too easy. With too many dollars chasing too few quality companies, too many bad (or even marginal) companies got funded at valuations that were simply unrealistic as investors were seeking to put money to work in a timely fashion. The chickens ultimately came home to roost, and so there’s been a shake up.

Second, cashing out has become orders of magnitude more difficult, even for investments in high quality companies. When I started my career as a research analyst in the mid-90s, $35 million IPOs were common. Today, as public equity funds (pensions and mutual funds) have gotten larger, a deal under $200 million is challenging to accomplish. Just as above, it’s harder to move the needle on a larger fund. It takes as much work to oversee a small position in a microcap company where you can only invest 0.01 percent of your holdings, as a more liquid stock where you can make a 5 or even 10 percent bet in your fund.

Not only is the stock market demanding larger IPOs, it’s also harder even for companies whose valuations can support an IPO to be public as a result of the Sarbanes–Oxley Act of 2002. Hastily passed as part of the backlash associated with Enron (overdue, but too long after the horses had left the barn, IMO), it contained needed laws and regulations for public companies. But it also undeniably increased the costs, risks, and difficulties of being public as well. An unintended consequence was that it further slowed the IPO market, especially for smaller, typically venture-backed companies.

Virtually by definition, fewer liquidity options will impact returns. Previously, smaller companies could contemplate an IPO for liquidity. Now M&A is often more attainable, and the buyers realize that. The more recently passed JOBS Act of 2012 may make IPOs easier, but I doubt it will prove to be a good thing for the investing public. See noted investor Dogbert for a common view of retail IPO investors (or simply check Facebook’s aftermarket performance).

…and so, there are fewer venture funds. The typical investors in venture funds — entities like pensions and endowments — typically follow a guideline on their asset allocation. They invest set percentages of their portfolio into different types of investments such as public equities (US and foreign), real estate, private equity, venture, etc. With the US stock market’s lackluster performance of late, the denominator has dropped. The total amount they’d seek to invest in venture, even if it performed well, has decreased. Given the poor asset class performance (and a certain degree of herd mentality), these investors have been piling into private equity rather than venture, further exacerbating the trend.

Furthermore, as readers of this blog know all too well, healthcare is complex and difficult to work in. Rooks’ First Rule of Healthcare Investing therefore states, “If you want buyers who make rapid and rational decisions, you shouldn’t target physicians or hospitals.” This means healthcare-focused venture has been hit particularly hard. The broader technology funds which seem to prefer to roll the dice on the next Instagram or gaming app are managing to raise billion-dollar funds despite the challenges of asset allocation, while some of the best venture-stage healthcare investors I know are struggling to raise their next fund, even though they have backed companies that are household names to the readers of this blog (and include current and former HIStalk sponsors.)

So, we have fewer venture investors out there, and they both need and want to want to write larger checks. What are they seeking? That’s likely another post, but in my mind, the top criteria tend to be:

• Scale. Investors seek to maximize returns while minimizing risks. For many, that means they want to back a business that has already shown a lower adoption risk. In other words, does the business have a sales track record, and will the product or service sell? The proxy for this seems to be at least $5 million in revenues. One-time revenues such as licenses are often acceptable, but recurring (i.e., subscription) is obviously preferable. Investors love SaaS for a reason.
• Barriers. What is proprietary about the offering? Can it be easily replicated by competitors with time and capital?
• Market. What is the size of the addressable market? I find most of these statistics are pulled from thin air, but at least some attempt to quantify should be made, and please avoid what my entrepreneurship professor called The China Syndrome: “There’s a billion people in China, if they each buy one …” When a sector approaches 20 percent of the US GDP, this is an easy road to go down, but without an earnest attempt at quantifying the market for the specific product, it will lead to, “Interesting story, love the idea, call me back when …”
• Team. “Bet the jockey, not the horse” is a truism that proves out repeatedly. Investors would typically prefer to back a failed entrepreneur than someone who’s never been one. Track record is why I believe Humedica has raised over $60 million and Castlight raised $100 million in one recent round alone. Whether they will prove to be good investments can’t be known, but the fact that Michael Weintraub and Giovanni Collella both ran successful businesses with good exits (Pharmetrics and Relay Health, respectively) is as good a predictor as one can find.

Filling the so-called “venture gap,” groups such as super angels have arisen, typically offering not only checkbooks, but also expertise and relationships similar to what VCs can provide. Exploring this topic will be a post for another day.

In the mean time, please keep those questions and notes coming. While I’m rarely shy about sharing an opinion or sounding off, my biggest challenge is what readers would find interesting. I’ve spent most of my career as an analyst or banker, so what I take for granted (albeit sometimes painfully gained knowledge), might be unfamiliar to readers whose daily lives are more focused on patient care or with a vendor. If there’s a relevant topic you’d like to read about, please let me know!

I’ll be attending Health 2.0 here in my new hometown in a few weeks, which I’m sure will provide the grist for another post. If you’d like to connect there, let me know.

Ben Rooks spent a decade as an equity analyst and six long years as an investment banker. In 2009 he formed ST Advisors to work with companies on issues that don’t solely involve transactions. He loves e-mail.

News 10/3/12

Top News

Patients say they are better equipped to help manage their own medical conditions when physicians give them access to their visit notes, according to the year-long OpenNotes study published in Annals of Internal Medicine. Ninety-nine percent of patients at the three participating hospitals who responded to the survey said they wanted the project to continue. None of the participating physicians elected to end their participation at the study’s conclusion — they were less enthusiastic about the patient benefits, but found that allowing patients to review their notes didn’t require any additional time or effort on their part. Responses to the potential benefits in the graphic above are indicated by circles (patients) and squares (physicians).

Reader Comments

From Jedi Knight: “Re: EHR adoption numbers. Has anyone pointed out that ONC and CDC are tracking very different numbers? They are showing 58 and 39 percent, respectively.”

From Start and Stop Again: “Re: Nuance. How do you think 3M feels with Nuance acquiring QuadraMed’s Quantim and JATA, who clearly compete with 3M? This has to signal the end of Nuance’s Computer-Assisted Physician Documentation announced last February in a partnership with 3M. Does Nuance think it can stitch the pieces of two dusty companies into Frankenstein?” Unverified.

From Familiar with the Transaction: “Re: McKesson acquiring MED3OOO. It’s a good fit. MCK gets the InteGreat EHR, which has a lot of functionality including a data warehouse and integration with Medicomp’s Quippe. They get instant market share in specialty revenue cycle management such as lab, emergency, and ambulance billing. They get a new market in full management of multispecialty groups, and ACO market opportunity from someone further down the path than they were. Not to mention that they take out a competitor and pick up a decent client base.”

From What, Me Worry?: “Re: West Penn Allegheny downtime. Patient care was not affected – we rely on meaningfully used paper.” West Penn’s servers went down Tuesday morning after a power surge, forcing the hospital to use paper backups. Some systems were up eight hours later and others were expected to come online overnight. It’s not much of an EHR pitch when a hospital claims that being without the computer didn’t really make any difference in patient care. That’s probably more of a PR observation rather than a medical one, though.

From THB: “Re: Allscripts. Are the reports that the company is putting itself up for sale accurate? After your hard day at work, here I am asking you to validate more information, i.e. do more work.” Bloomberg News claimed Friday that Allscripts talked to several private equity firms before engaging Citigroup to explore its options, but neither company would confirm. Shares have risen 11 percent since then, which might be meaningless since (a) the original rumor may have been planted by someone anxious to sell their shares, which is always possible; (b) the rumor may be incorrect; or (c) the rumor may be correct, but may not result in any decisive action. Reasons that going private makes sense: (a) the company’s shares tanked and haven’t recovered after an ugly day in April in which the company fired its board chair, saw three other board members quit in protest, announced the departure of its CFO, and reported lower earnings and guidance; (b) the company conceded to demands by a large shareholder to add its three candidates to the Allscripts board, and those new directors may be influencing the discussion of strategic alternatives; (c) the critical Q3 earnings numbers will be announced in November, and if they aren’t looking so good, this would be the time to plan an escape route from the bloodbath that’s likely to follow; and (d) the stock has fared so poorly in a generally good market that any major strategic changes might be better conducted outside of Wall Street’s baleful glare. My answer, then, is that I have no idea if the rumor is true, but I suspect that it is, and even that wouldn’t mean much until Allscripts decides what it wants to do.

HIStalk Announcements and Requests

My new iPhone 5 arrived last Friday and I am happy to report I have successfully made the migration. It’s definitely faster, the camera is better, it’s lighter, and I like the bigger screen. The battery life, however, does not seem any better than the iPhone 4 and actually seems worse, if that is possible. Maybe the battery life is longer in standby mode, but not when you are using all the cool new features. I also checked out the new maps utility and was amused that my “hospitals” search presented me with an option for “The Shoe Hospital” and for an animal hospital, but no traditional hospitals. It did find more choices when I searched “hospital” (singular), however. An “emergency room”  search found a few urgent care centers, but missed the three closest me and didn’t find any ERs attached to a hospital. Good luck with that issue, Mr. Cook.

Acquisitions, Funding, Business, and Stock

Tenet Healthcare subsidiary Conifer Health Solutions will acquire InforMed Health Care Solutions, an information management and services company.

Ontario-based Kallo, Inc. enters into a $2 million stock purchase agreement with Kodiak Capital Group. The company offers EMR, PACS, and medical device connectivity solutions.

Nuance acquires JA Thomas and Associates, which offers clinical documentation improvement programs. Obviously Nuance is interested in clinical documentation and the ICD-10 transition given the September 27 announcement that it had acquired QuadraMed’s HIM solutions (coding, compliance, computer-assisted coding, abstracting, record and document management, workflow, and clinical documentation integrity) and its acquisition earlier this year of Transcend, which offered transcription and clinical documentation (including the documentation and charge capture solutions of Salar, which Transcend acquired last summer).

HIMSS acquires CapSite, which offers a vendor database that includes actual pricing and contract information as well as research services that HIMSS will fold into HIMSS Analytics. It will be interesting to see how HIMSS balances the confidentiality desires of its vendor members against CapSite’s detailed and vendor-specific pricing and contracting information. My speculation is that it will go away, replaced by aggregated non-identifiable vendor information. And as I tweeted when the news was announced, that means that HIMSS is now an inadvertent HIStalk sponsor, which Inga pounced on with great glee.

In one of the oddest healthcare transactions in recent memory, The Washington Post Co. buys a majority stake in a hospice and home health service, obviously desperate for further non-media diversification as its Kaplan education cash cow dries up after the government reins in for-profit colleges.

Healthcare billionaire Patrick Soon-Shiong announces a deal between his NantHealth company and Blue Shield of California, which will work with St. John’s Health Center in Santa Monica, CA to roll out healthcare breakthroughs and personalized medicine. He will present the news to a Bipartisan Policy Center conference in Washington, DC on Wednesday, starting with an invitation-only 8:00 a.m. small-group breakfast session and then a larger session later in the morning. He’ll be joined in the session covering the use of supercomputer-powered genomic medicine by Senator Bill Frist; J. Michael McGinnis of the IOM; the president of Blue Shield of California; the top medical executives from AT&T, Verizon, and Caremark; and several academics.

Sales

The board of New York City Health and Hospitals Corporation approves execution of a ten-year, $303 million contract to implement Epic throughout the entire corporation. I believe the incumbent was QuadraMed Affinity, although it’s been a long time since I’ve thought about HHC. Cerner and Allscripts were the losing bidders and Allscripts has formally protested the award to Epic, which I would assume means HHC passed on the lower bid by Allscripts, which isn’t at all unusual when prospects get Epic fever. I assume the only difference from the usual hospital decision is that HHC is a government entity, so there’s someone to complain to. UPDATE: readers tell me the product HHC is running is QuadraMed CPR, the former HDS Ulticare / Per Se Patient1 / Misys CPR that they bought from HDS in the early 1990s and used in all inpatient, outpatient, and ancillary areas. It won them a Davies Award in 2006.

Baton Rouge General Medical Center (LA) chooses RelayHealth for its enterprise HIE.

The 77-physician Optimal Radiology selects McKesson Revenue Management Solutions for billing, reporting, and collections.

Faxton St. Luke’s Healthcare (NY) adds the Surgical Information System anesthesia information management system to its Allscripts Sunrise Surgery perioperative system.

The US Coast Guard awards Lockheed Martin a $2.3 million contract to develop a mobile interface to its Epic-powered EHR.

People

Device integration provider Nuvon appoints Christopher Gatti (Living Strategies) CEO and Stephen Spencer (Advantis Medical) VP of sales and marketing. Cathleen Asch will transition from CEO to EVP of strategic initiatives and remain on Nuvon’s board.

Jo Ann Rooney (DoD – above) and Robert Mills (ACS/Xerox) join Huron Consulting Group’s healthcare practice as managing directors.

The Military Health System names David Bowen (FAA) CIO.

University of Buffalo School of Medicine names Peter Winkelstein, MD as executive director of the school’s Institute for Healthcare Informatics. He is also CMIO of UB/MD.

Impact Advisors hires C. Lydon Neumann (Accenture) as VP.

Health Care DataWorks names founder Jyoti Kamal, PhD as president. She was previously deputy CIO and director for the information warehouse at The Ohio State University Wexner Medical Center.

Aspirus names Todd Richardson (Deaconess Health System) as CIO.

Jonathan Grau (AMIA) joins National Quality Forum as senior director of stakeholder collaboration.

Florence Chang is promoted to EVP of MultiCare Health System (WA). She was previously SVP of clinical support services and CIO.

Announcements and Implementations

WakeMed Health & Hospitals (NC) implements the Philips eICU remote critical care monitoring technology.

AHIMA awards the University of Wisconsin Hospital and Clinics the Grace Award for demonstrating effective and innovative approaches in using health information to deliver high quality healthcare.

Healthland will integrate Health Language’s terminology platform to support ICD-10 readiness and terminology standardization.

UnitedHealthcare commits $20 million to help 11 critical access hospitals in California improve their technology, including the addition of EHRs.

Partners HealthCare pledges to award Massachusetts community health centers $90 million over the next 15 years to upgrade technology and make other infrastructure improvements.

CORHIO announces that all six northern Colorado hospitals are connected to the HIE.

UPMC, Oracle, IBM, Informatica, and dbMotion will create a $100 million data warehouse that combines clinical, financial, administrative, and genomic information for analytics and predictive modeling applications.

Orion Health awards Cognosante a contract to provide integration and identity management for the first stage of the Massachusetts Statewide HIE program.

MModal makes available its Catalyst for Quality solution for clinical documentation.

North Carolina Healthcare Information & Communications Alliance offers a Vendor Management Policy Template that addresses HITECH requirements for business associate agreements. It’s free to NCHICA members, $50 otherwise.

A study published in the Journal of Clinical Epidemiology finds that DynaMed is ranked highest of 10 online clinical resources based on timeliness, breadth of coverage, and quality of supporting evidence.

CTG signs an Epic implementation contract with an unnamed five-hospital IDN.

The city of Billings, MT goes live with an ONC-funded and Dossia-powered pilot project to give its employees the ability to view and manage their electronic health information.

Dolbey announces the VoiceBox recording system that tags physician dictation so that the completed transcription can be inserted into the correct location of the EMR.

Verizon announces a cloud and data center infrastructure for storing and sharing PHI. Unlike non-healthcare cloud providers, Verizon will sign a business associate agreement that meets HIPAA requirements.

VersaSuite announces that its 8.0 product has earned pre-market CCHIT ED certification. VersaSuite is certified for both inpatient and ambulatory use, a distinction it says only two companies have achieved.

Government and Politics

Medicare initiates two ACA-legislated programs that target quality of care and readmission rates in hospitals. The Hospital Value-Based Purchasing Program allows the government to pay hospitals bonuses if they meet high performance standards on certain quality measures, while the Hospital Readmissions Reduction Program enables Medicare to reduce reimbursements up to one percent for hospitals with high readmission rates.

ONC announces a goal of helping 1,000 critical access hospitals achieve Meaningful Use by the end of 2014.

ONC releases a consumer-focused video on the benefits of electronic medical records, with cameos by Todd Park, Don Berwick, Farzad Mostashari, David Blumenthal, and others.

Innovation and Research

Kaiser Permanente researchers find that the use of an EHR improved drug therapy and follow-up monitoring of Type 2 diabetics, as well as improved the patients’ glycemic and lipid control.

Health Nuts Media launches a crowdfunding campaign, hoping to raise $90,000 to develop an asthma education app for children. Rewards are offered for various donation levels, with a $50 contribution earning a copy of the app, a “Wall of Fame” credit, coloring pages, a poster, recognition in the app, and a tote bag.

Technology

CalHealth prepares to launch MD Mouse, a device that measures pressure information when a finger is slid inside a cuff that folds out from the middle section of the mouse.

Other

The Census Bureau says adults under age 65 made an average of 3.9 visits to physicians in 2010, down from 4.8 visits in 2001. Possible explanations: more uninsured, fewer physicians, higher patient costs, innovation that allows providers to accomplish more in a single visits, and more meds available without a prescription.

Cerner expects over 10,000 attendees from 21 countries at its 27th annual Cerner Health Conference next week in Kansas City.

An Irish pediatric surgeon is found guilty of poor professional performance after a 2010 error in which the wrong mouth surgery was performed on a baby. The doctor correctly ordered an upper lingual frenulectomy in his patient notes, but an administrator entering the procedure into the hospital’s computer system said the only option it gave him was “tongue-tie.” He chose that option, it printed on the OR list, and the surgeons performed that operation. They chairman of the inquiry committee said he was satisfied with the decision even though the committee had concerns about the OR scheduling and coding systems.

Weird News Andy is amused that a study finds that tickling rats after inducing a stroke appears to prevent paralysis and sensory deficits, possibly by forcing a rerouting of blood through unblocked veins. Playing music seems to work equally well, leading to the “it may not help, but it can’t hurt” recommendation that when someone is suspected of having a stroke, squeeze their hand and talk to them. WNA is also amused at the prospect of giving the rats warfarin as a stroke treatment, which usually is dosed in much larger quantities in the form of rat poison.

WNA cheers this story with a hearty “Hear, hear.” Doctors at Johns Hopkins successfully create a new ear for a woman who lost the original to cancer. They grew the new ear under the skin of her arm until it was ready to be attached.

Strange: a veteran sues the VA for $10 million, claiming that a nurse packed his groin with ice for 19 hours following his genital surgery, causing frostbite that required reconstructive surgery.

Sponsor Updates

• Elsevier launches its nationwide ClinicalKey Experience Tour, an all-day outdoor event at hospitals and academic centers to promote its ClinicalKey clinical reference tool.
• Iatric Systems offers an October 11 webcast on Meaningful Use Stage 2 featuring Beth Israel Deaconess Medical Center CIO John Halamka, MD.
• Michigan Orthopaedic Institute (MI) selects the SRS EHR for its 17 providers.
• Intelligent InSites announces members of its Healthcare Advisory Board.
• Collom and Carney Clinic Association (TX) selects MModal Fluency Direct to voice-enable its EHR.
• Cynergis Tek CEO Mac McMillan achieves the Fellow of HIMSS designation in recognition of his advancement of privacy and security within healthcare.
• Balsam Healthcare Corporation (Saudi Arabia) licenses First Databank’s Middle East Drug Knowledge solution for integration with the OASIS HMIS system. FDB also releases new customizable alert categories within its FCB AlertSpace alert management system.
• Delta Health Technologies selects ZirMed as a preferred business partner to provide RCM solutions to homecare providers.
• McKesson hosts its 25th Health Solutions Conference next week in Orlando.
• Gregg Mohrmann and Mark Van Kooy, MD of Aspen Advisors will lead sessions at this week’s New Jersey HIMSS/Delaware Valley HIMSS joint annual conference.

A Report from athenahealth’s “More Disruption Please: The CEO Retreat”
By Jonathan Baran, Co-Founder and CEO, Healthfinch

Athenahealth’s recent "More Disruption Please" event brought together 50 CEOs of health IT companies and their investors to the Point Lookout Resort in Maine (a resort that athenahealth bought for $7.7M… a steal!). Each CEO was given their own private log cabin to stay in (or to sleep off late nights with Jonathan Bush). The purpose of the meeting was for athenahealth and these newer, innovative HIT companies to get to know and learn from each other.

Any time you get to spend time with Jonathan Bush, you never know what to expect. He did not disappoint, as he began at eight in the morning by impersonating Ali G, telling everyone how athenahealth gets "ka-ching and da bling for doing the right thing!" A couple of more presentations followed, including one by Marty Anderson, who asked how innovation can come from the top-down when "the healthcare industry is a giant cartel."

Then the fun began as 30 CEOs gave two-minute pitches, with five finalists promised a ten-minute presentation to 2,500 of athenahealth’s users. We (Healthfinch) were selected as one of the five finalists, along with iTriage, Entrada, Epion, and Wellframe. In a smart market research move, athenahealth then asked their customers to vote on which company’s product they would most like to see integrated with athenahealth. Ultimately, our scrappy startup from Madison, Wisconsin took second place to Aetna’s iTriage.

Jonathan Bush’s final display of how to "keep it real even when you’re CEO of a publicly traded company" began when he gave us a lesson on how to build a successful business model. Jonathan, like every other EMR CEO, drew inspiration from the “Saturday Night Live” skit, "D— in a Box." He gave us all the following instructions:

1. Get a box (find a pile of work that users hate and suck at).
2. Cut a hole in the box (figure out how to break into the market).
3. Put your junk in the box (bring your secret sauce to the market).

I couldn’t say it any better myself.

Athenahealth also discussed more of their plans for their entire "More Disruption Please" program, the smartest move being their recognition that the biggest challenge in bringing innovation to market (and thus allowing small companies to flourish) is in the distribution channel. That’s why athenahealth is promising to bring the top innovations to their customers by rapidly scaling interesting products and innovations to their entire user base.

Time will tell if athenahealth can live up to its grand plans to become the information backbone of the health system, but their program (and their conference) seem to indicate they are on the right track.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

HIMSS Acquires CapSite

HIMSS announced this morning that it has acquired CapSite, which publishes the CapSite healthcare technology database that includes vendor pricing and contracting information, including 5,000 actual vendor proposals and contracts representing 1,600 vendors.

HIMSS will incorporate CapSite’s offerings into its HIMSS Analytics services, which has not included pricing information. HIMSS says it will also add voice of the customer consulting services through customized research, including analysis of vendor market position that includes product gaps.

According to HIMSS President and CEO Steve Lieber, “The investment in CapSite follows our overall strategy for HIMSS Analytics to provide the best market intelligence on the hardware, software, and services selected by chief information officers and other users of information technology. We will maintain the CapSite office in Burlington, VT with CapSite employees joining the HIMSS roster as part of the HIMSS Analytics team.”

McKesson to Acquire MED3OOO

McKesson announced this morning that it will acquire MED3OOO, which offers physician practice administration services, revenue cycle management, and software. The Pittsburgh-based company employs 2,800, has 10,000 physician users, and has stated annual revenue of $200 million.

McKesson will incorporate MED3OOO’s products and services into its McKesson Revenue Management Solutions business. The announcement quotes its general manager, SVP Pat Leonard, as saying, “McKesson and MED3OOO share a commitment to help customers navigate growing healthcare complexity and achieve their full potential. We are excited about the opportunity to combine best practices and superior technologies to help providers and other customers improve their operations and achieve better business health as part of our Better Health 2020 strategy.”

We mentioned the acquisition several times over the past few weeks in HIStalk, although without specifically naming MED3OOO since McKesson is a publicly traded company. Our November 2011 interview with MED3OOO Chairman and CEO Pat Hampson provides more detailed information about the company.

Monday Morning Update 10/1/12

From DanburyWhaler: “Re: Western Connecticut Health Network. The manager we thought was being groomed to take over as CIO is gone after three months. They are laying off people left and right. The major construction budget is way over.” The hospital recently laid off 28 employees, citing economic conditions, state taxes, and general healthcare trends. The $150 million expansion is pictured above.

From Boomer: “Re: Patrick Soon-Shiong. The billionaire’s healthcare coming out event is this Wednesday, when he will announce the results of an oncology-focused application of his supercomputer / high-speed fiber / middleware / mobile platform that he has been building for years. He claims that 8,000 oncologists using his decision support tools lowered the patients receiving the wrong treatment from 32% to 0%.” He’s presenting at the Bipartisan Policy Center’s October 3 conference in Washington DC, Accelerating Electronic Information Sharing to Improve Health Care.

From At Northwestern: “Re: Epic. No commitment from Northwestern Memorial Hospital to move to Epic.” Like the original rumor saying they were making that move, this one is unverified.

From Bean Multiplier: “Re: Allscripts. I hear from a good source that the company would be willing to take a private equity deal for $15 per share.” Unverified. Shares closed Friday at $12.42, up 14% on rumors that the company is exploring a possible sale to private equity. Shares were last above $15 on April 26, the day before the company fired Chairman Phil Pead, after which three of the company’s board members quit in protest. Even now the P/E ratio is at 40, about the same as Cerner’s. I assume the P/E ratio takes into account the $200 million of repurchased shares, which would have raised earnings per share by reducing the share count rather than reflecting increased profits. Bloomberg did not cite the source of the “possible sale” rumors, which could either be an informed, unbiased source or a pump-and-dumper trying to unload some shares on the market’s reaction to the non-news.

From The PACS Designer: “Re: RIS/PACS integration. There’s been some fresh looks at how a RIS fits into the flow of information between radiology presents, and the submission for and completion of a radiology study. Since most configurations between the RIS and PACS are customized at each institution, it leaves many opportunities for a future RIS/PACS upgrade to be a more robust information source. This upgrade should provide two-way information flow so everyone can plan their activities each day more efficiently. One way to achieve the better information flow goal is to insist that the new system of a combined RIS/PACS come from the same vendor.”

From Miraculous Miler: “Re: John Landis of Cerner. Rumor is that he’s gone.” Cerner’s media relations department confirms that John Landis, SVP of ClientWorks, has left the company.  

From MumpsInToronto: “Re: University Health Network, Toronto. Going to RFP. They are running QuadraMed now, which is MUMPS based. From the volume of data that will need to be converted, you can bet they will be looking at Epic.” Unverified.

McKesson announced Better Health 2020 and an investment of $1 billion in R&D in last December. Three-quarters of poll respondents said the company’s healthcare IT position is worse now than then. New poll to your right: has the use of EHRs increased Medicare fraud?

Welcome to new HIStalk Gold Sponsor Agilum Healthcare Intelligence of Franklin, TN, which describes its offerings as “Business intelligence in a box.” Modules include Service Line Costing and Profitability (margins by service line and payer, case mix trends, length of stay and volume trends, DRG mix, margin by physician, etc.); Revenue Cycle Performance (dashboards, A/R performance indicators, ageing reports, net revenue modeling, and denials by reason); Operational Performance (executive view with KPI line item indicators, facilities operations and department dashboards, daily volume dashboards and forecast, and operating ratios); and Productivity Manager (departmental dashboard, pay period reports, daily reports, overtime ratio reports, and skill mix reports). One of the most technologically astute hospitals in the world, Bumrungrad International Hospital in Thailand, recently signed up for Agilum’s business intelligence solutions to improve its operational, managerial, and financial decision making. Thanks to Agilum Healthcare Intelligence for supporting HIStalk.

I headed over to YouTube to see what I could find on Agilum Healthcare Intelligence. Above is an overview.

I had heard reports that HCA signed a big contract with Epic to replace its Meditech system, but two HCA sources told me off the record that it’s still just one HCA site piloting Epic so far. HCA is still rolling out Meditech CPOE.

Epic consulting firm Nordic Consulting announces that it has raised growth capital from SV Life Sciences, Health Enterprise Partners, and HLM Venture Partners. All three backers focus on healthcare, with the one catching my eye being SV Life Science since Bruce Cerullo is a venture partner there in addition to being the CEO of Vitalize Consulting Solutions that was sold to SAIC a year ago.

CapSite releases its 2012 Ambulatory EHR & PM Study. It finds that 40 percent of organizations are still in the market for an ambulatory EHR, with most of them planning to buy within the next two years. The practice management market offers less opportunity, with only 27 percent of responding organizations indicating their interest in buying or upgrading and just 21 percent saying they would replace their current practice management system to move to an integrated PM/EHR.

Pearson and Cerner announce RealEHRPrep, an EHR learning tool for nursing students.

The UK’s Department of Health admits that the failure of its NPfIT project means it no longer owns rights to the software developed for it by CSC using billions of dollars of public funds. The original contract called for software ownership as one of four terms that were to protect the government’s interests if the project failed, which it did, but either the contract was incorrectly drafted or the government negotiated the rights away in trying to avoid a CSC termination lawsuit. The Department of Health and vendors involved (CSC and BT) are ignoring information requests, according to the ComputerWeekly.com article.

Also in the UK, and external review finds that the rate of clinical errors increased after NHS turned over operation of its pathology laboratories to the multinational corporation Serco. The report by a non-profit watchdog also found that the money-losing JV required hospitals to chip in cash to keep it afloat, and even then the company will pull out of certain markets. Computer problems caused some of the patient-related problems: a patient received the wrong blood type after the software failed to issue a warning, an incorrect creatinine clearance calculation was highlighted as a near miss, and the company’s blood analyzers were shut down for four days after becoming infected with a computer virus.

And also in the UK, a report commissioned by Imperial College Healthcare Trust concludes that 3,000 of its cancer patients have not been seen promptly because the hospital uses 17 different computer systems, some of them requiring manual data entry. The trust says they’re looking for a single system, but the report warns them of the risks involved.

A Wall Street Journal article listing the top 50 startups says that healthcare has fallen out of VC favor based on its somewhat subjective criteria, with last year’s top-ranked Castlight Health dropping off the list entirely.

The VA was expected to award a contract for mobile device management software by Sunday, September 30, the end of its fiscal year.

Weird News Andy likes this story, in which police used fingerprints to locate the former owner of a human finger that was found inside a fish caught from an Idaho lake. When the sheriff called a wakeboarder who had lost four fingers in a towline accident in June, he immediately responded, “Let me guess – they found my fingers in a fish.” The sheriff offered to return the well-preserved digits, but the man declined, saying, “Uh, I’m good.”

Another WNA find: pathology researchers at Georgetown Lombardi Comprehensive Cancer Center (DC) develop a method of testing the susceptibility of a patient’s specific cancer cells to various chemotherapy drugs, much like the routine culture and sensitivity tests that help doctors choose an appropriate antibiotic for a given infection.

Here’s Vince’s HIS-tory on QuadraMed, Part 3, which purely coincidentally provides a history of the Quantim product line that the company just announced that it’s selling to Nuance.

Sponsor Updates

• Vitera Healthcare’s VIBE user group meeting was held September 12-14 at Disney’s Grand Floridian Resort & Spa in Lake Buena Vista, FL.
• Optum announces an ICD-10 education program for hospitals.

E-mail Mr. H.

News 9/28/12

Top News

The American Hospital association agrees in a letter to HHS Secretary Kathleen Sebelius and the Attorney General Eric Holder that EMR-assisted cloning and upcoding should not be tolerated, but retorts that CMS has ignored its repeated recommendations to expand E/M (evaluation and management) codes to create a national standard for hospital ED and clinic services. My opinion: the election-sensitive, administration-friendly HHS’ers got blindsided by a Center for Public Integrity article that insinuated but didn’t prove that a shift to higher complexity codes means that EDs and physician practices are gaming the system to the tune of $11 billion, so given too little time between now and the November 6 election to actually do something useful (like identify and prosecute someone who’s actually guilty), HHS just went public with meaningless finger-wagging to make it appear that they’re on top of the situation. HHS keeps bragging on how great their fraud detection systems are (which they should be, given the hundreds of millions paid to fat cat contractors to develop them), yet they apparently trust journalists more than their own armies of bureaucrats to tell them they have a problem. The reimbursement system is even worse than the tax laws in being a confusing hodgepodge of rules that nobody, even CMS, really understands or can interpret consistently. Some providers are undoubtedly committing fraud and the 99% honest ones would love to see them shut down and punished. However, as with tax loopholes, there’s nothing illegal or immoral about taking the maximum benefit that the law allows. There’s a reason that crime syndicates are moving from drug dealing to Medicare fraud: payment is quick and rarely questioned, the money is great, and the risk of actually going to jail is almost zero.

Reader Comments

From High Roller: “Re: QuadraMed. Quantum is just the first QuadraMed domino to fall. Franciscan Partners isn’t interested in holding on to the rest of the company forever, so it won’t be long before the other pieces are sold off. QuadraMed has a large enough client base, so they could milk their revenue stream for awhile. More likely, Franciscan will look to sell what’s left to someone like Allscripts who’d be interested in having a larger client base to sell into.”

HIStalk Announcements and Requests

Highlights from the last week on HIStalk Practice: patients want more online access to their health records but most doctors don’t offer the option. Lack of staff impacts EHR adoption, especially in smaller practices. Tips for using an EHR as a marketing tool and to increase patient satisfaction. Parents are more likely to fill children’s e-prescribed prescriptions than paper ones. Physicians are working fewer hours and seeing fewer patients than they were four years ago. I am looking for some MGMA picks. Thanks for reading.

Welcome to new HIStalk Platinum Sponsor Emdat, which offers hybrid clinical documentation and transcription solutions that improve the productivity and satisfaction of EHR-using physicians. Instead of pointing and clicking, physicians continue to use the most efficient method of documenting patient encounters – dictation. Emdat’s DaRT system automatically tags sections of transcription content (chief complaint, medical history, etc.) and then seamlessly auto-populates discrete information directly into the EHR just as though the physician entered it directly using structured documentation. Its Emdat Mobile solution not only allows physicians to document encounters on the go, but provides a more patient-friendly way to document during an encounter. Loyola University Health System uses it with Epic and says the setup was simple, reducing transcription turnaround time by 50% and allowed doctors to continue dictation, which they say is faster and better for patient care. Thanks to Emdat for supporting HIStalk.

Mr. H took off a little early to treat Mrs. H to some fun, so today’s post is a bit shorter than usual.  He’ll be back to serve up a full course of the Monday Morning Update over the weekend.

Acquisitions, Funding, Business, and Stock

As reported earlier today, Nuance will acquire QuadraMed’s Quantim product line. You have to wonder if Nuance didn’t rush the announcement a bit following our Wednesday mention of the deal on Twitter and HIStalk: early Thursday morning Nuance posted these (now corrected) announcements referring to “QuadaMed” and “Quantrim.”

The Kentucky Economic Development Finance Authority approves a $150,000 grant for Health Catalyst, a business accelerator for companies creating health-related software, including life-sciences and HIT companies. Health Catalyst will nurture five startups a year by providing work space, mentoring, and seed funding.

Sales

Evergreen Health (WA) selects MEDSEEK’s ecoSmart Patient Precisioning solution for predictive analytics.

Adventist Health selects MedeAnalytics’ Patient Access Intelligence solution for point-of-service cash collection across its 16 hospitals.

People

Mark Burgess (Cerner) joins Allscripts as director of solutions management.

Fletcher Allen Health Care (VT) hires Adam P. Buckley, MD (Beth Israel Medical Center) to be the organization’s first CMIO.

Announcements and Implementations

Wake Forest Baptist Health (NC) goes live on Epic.

Wellcentive announces Advance Risk Manager, a predictive risk modeling system for population health management that allows providers to focus on patients with specific risk profiles.

The three largest health systems in St. Louis join the Missouri Health Connection HIE.

Government and Politics

Rep. Mike Honda (D-CA) will introduce a bill to set up an Office of Mobile Health at the FDA to provide recommendations on mobile health issues. The legislation also calls for the creation of a support program at the HHS to advise app developers on privacy regulations and for a low-interest loan program for physician offices to purchase new technology.

Technology

The West Health Institute is developing Sense4Baby, a wireless and portable fetal monitor for high-risk pregnancies in remote clinics. The system, which is being piloted in Mexico, sends the captured data over a cellular network to the patient’s physician.

Other

The Seattle Times covers Caradigm, the Microsoft-GE joint venture whose headquarters opened this week in Bellevue,WA. Positive comments from Providence about Amalga are included, along with less enthusiastic ones from Swedish CMIO Tom Wood, who says he’s not sure how they can add a layer on top of EMRs without a lot of cooperation.

UMass Memorial Health Care (MA) will eliminate 140 positions, some of them in IT, in seeking $80 million in cost reductions.

John Reynolds, the former CEO of Hospital for Special Surgery (NY), is arrested for racketeering, charged with soliciting kickbacks from prospective vendors and extorting $300,000 from a hospital employee in return for arranging an annual bonus.

Weird News Andy wonders how this is possible. A women who is “internally decapitated” when her skull is torn from her spine in a car accident not only survives, but is basically back to normal.

Here’s a new video from St. Jude Children’s Research Hospital, featuring patients, employees, and celebrities singing “Hey, Jude” to highlight National Childhood Cancer Awareness Month. Some of those featured are Jennifer Aniston, Betty White, Robin Williams, and Michael Jordan.

Two-thirds of CHIME members report staff shortages and are in most need of more specialists to implement and support clinical applications.

A study published in the Journal of the American Medical Informatics Association concludes that CPOE was the main challenge among hospitals failing to achieve MU in the program’s first year.

Sponsor Updates

• TELUS Health brings its TELUSHealth.com portal live to showcase its solutions that link Canadian patients to their providers.
• Elsevier unveils its EduCode Clinical Documentation Improvement eLearning curriculum for ICD-10 at next week’s AHIMA meeting.
• New York eHealth Collaborative spotlights five health IT champions at the NYeC gala October 15.
• Muhannad Samaan, MD of Aultman Inpatient Medicine discusses how Ingenious Med’s charge capture software improved patient hand-off and communications.
• Software Magazine ranks Macadamian #435 on its Software 500 list, which is based on revenues of the world’s largest software and services suppliers.
• Sandlot Solutions releases a report on using data and analytics to improve healthcare delivery.
• Skylight Healthcare Systems integrates its Service Recovery process with Vocera’s communication devices.
• Optum launches its Optum ICD-10 Core Education program.
• TI combines its DM8148 system on-a-chip with Imprivata OneSign to provide out-of-the-box strong user authentication into any software application.
• McKesson expands its Intelligent Coding portfolio to include observation services.
• First Databank executives Keith Fisher, MS and Patrick Lupinetti, JD  will present educational sessions at next month’s AMCP 2012 Educational Conference.
• Vitera Healthcare Solutions reports record attendance at this month’s VIBE conference in Orlando.
• 3M Health Information Systems adds 18 physician education modules to its Web-based curriculum to address ICD-10 readiness.

EPtalk by Dr. Jayne

Don’t forget — October 3 is the last day for Eligible Professionals to begin their 90-day reporting period for the Medicare EHR Incentive Program, aka Meaningful Use. One of my buddies in the consulting business has been sharing e-mails he is receiving from providers. Today’s special: “I would like to be Meaningful Use but do not know to begin. I need the money. Please send tips for me to start?” I guess that’s someone’s idea of a consulting RFP.

An American Medical News article lists common EHR blunders. I’ve seen all of these in various forms across practices from small to large. Topping the list: lack of infrastructure, lack of workflow assessment, lack of training, lack of buy-in, failure to communicate with patients about delays during the transition, and failure to appropriately integrate the computer into the patient-physician relationship.

News flash: Nearly one-third of US medical school students who initially planned to enter primary care ended up switching to a more lucrative specialty. Surveys of students in New York show that “medical students who anticipated high levels of debt upon graduation and placed a premium on high income were more likely to enter a high-paying medical specialty.” Really.

In similar news, the US medical schools that still don’t have Family Medicine departments are starting to get with the program. Some of these schools are big name and I know all too well what it’s like to attend one. Now we just need to get all medical schools to incorporate informatics into their programs. Let’s teach budding doctors (and nurses, and everyone else) how to leverage technology to better care for patients rather than fighting it or trying to undermine it. Although the new generation seems tech savvy, I see too many students trying to short-cut their documentation.

Mashable lists “10 Office Technologies on Their Way Out.” The list of items they predict will vanish in the next five years includes obvious items like fax machines, tape recorders, and the Rolodex. I’m not sure about desktop computers, cubicles, and standard working hours. There are a lot of entrenched management types out there who will resist. Although I won’t miss formal business attire, which includes pantyhose (#7), I’d like to lobby to keep fashionable shoes part of the equation. If I see one more pair of flip-flops in the office, I just might scream.

The Greater Atlanta area is a hotbed of health IT vendors, so I hope that none of you were recipients of the free kittens given away in the parking lot of the McDonough Walmart. Apparently they were rabid.

As Mr. H mentioned earlier this week, HIMSS registration is open and the room supplies are dwindling. I’m glad he gave me a reminder. I booked tonight, yet wasn’t able to get my preferred hotel or even my preferred dates. I’m leaving a day early, but that’s probably OK since I have to take vacation to attend this year. My hospital no longer has a conference budget or paid professional development days, so I’m not complaining about spending one less night in an overpriced hotel. Plus, I was able to snag a super-cheap plane ticket so I can afford some hot new shoes for Histalkapalooza.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.

Nuance To Acquire QuadraMed’s Quantim HIM Line

Nuance Communications announced this morning that it will acquire QuadraMed’s Quantim product line for health information management. Quantim includes applications for coding, compliance, computer-assisted coding, abstracting, clinical documentation integrity, record and document management, and workflow.

HIStalk reported Nuance as the buyer Wednesday on Twitter and on HIStalk following the filing of Federal Trade Commission documents. The announcement was reportedly originally scheduled for October 1, the first day of the AHIMA conference.

News 9/26/12

Top News

HHS Secretary Kathleen Sebelius and US Attorney General Eric Holder warn AHA and other hospital organizations that the government will take appropriate steps to pursue healthcare providers who misuse EHRs to defraud Medicare, specifically calling out upcoding and cloning of medical records.

Reader Comments

From Wicked Fun: “Re: HIStalkapalooza planning. I just moved from the vendor side to a provider organization. As much as I am loving my brand new job, I miss the ‘fray’ of the world of HIT. The first comment from one of my MD friends  was, ‘What if you don’t go to HIMSS? We always go to the HIStalk party together!’’” The lesson here for the HIStalkapalooza faithful is to add our annual event as a mandatory condition of employment in your contract negotiations. If you like planning ahead, the 2013 version of HIStalkapalooza is scheduled for Monday, March 4, with registration opening sometime in January.

From Plinker: “Re: Northwestern in Chicago. Going Epic.” I don’t recall if I’ve mentioned that previously.

From Squint Eastwood: “Re: Vermont. Not a rumor, but interesting.” Fletcher Allen Health Care and Dartmouth-Hitchcock Medical Center submit an ACO plan that would create the for-profit OneCare Vermont LLC, which would include 13 of the state’s 14 hospitals (Porter Medical Center passed), 58 medical practices, two FQHCs, and other organizations. If approved in October, OneCare would be up and running by January 1, serving most of the state’s 105,000 Medicare beneficiaries. Fletcher Allen SVP Todd Moore, who will be CEO of OneCare if it’s approved, says access to data was a driver. “This is really an access to information revolution as much as it is anything else for us. This gives us access to the full claims set for the first time to Medicare beneficiaries that we treat … to understand how they seek care, how often they go to (the doctor) — whether it be at Fletcher Allen or at Northwestern Medical Center or in Florida.”

From Adam: “Re: Tampa General Hospital. Saw they’re going with RelayHealth for HIE. Aren’t they an Epic shop?” They are indeed.

From HereWeGo: “Re: MCK acquisition of MedVentive. The fat, spoiled kitty found a new toy to bat around and destroy until the next shiny object captures its attention.” Usually the fat cat in a given deal is the seller, so at least some of MCK’s cash trickled down to the MedVentive owners. I should clarify that the rumored MCK acquisition that I mentioned last week isn’t MedVentive, so another announcement could be coming if the rumor turns out to be accurate.

From Bobby D: “Re: MCK acquisition of MedVentive. This is the second company that Nancy Brown has been involved with that McKesson bought, the first being Abaton.com. She has two to go to catch Mike Myers of CliniCom history, who has sold them four companies.” Mike’s at QuadraMed now, I’m told, so he could bag “one for the thumb” if MCK happens to buy QuadraMed’s Quantim line, if indeed the rumor is true that it’s about to be sold (and even if it is, MCK hasn’t been mentioned as a player.) UPDATE: per Federal Trade Commission filings, Nuance will be the acquirer of Quantim.

From Moak: “Re: upcoding. How did you miss this one?” I get at least one e-mail per day (including this one) with a link to a big news story that I’ve already covered, so skimmers are missing out. Still, I appreciate the notice just in case I really did miss something, and Moak brings up an interesting point: the feds gave Faxton St. Luke’s Healthcare (NY) as an example of an ED whose higher levels of treatment jumped 43 percent in 2009, the same year it implemented EHRs. He says the hospital only has 22 days’ cash on hand and therefore is not stealing from anyone. I wouldn’t necessary make that assumption since poverty usually encourages rather than discourages criminality, but I think his point is that the hospital was struggling financially and may have simply cracked down on sloppy billing practices. One might assume that the feds would do some audits before slamming the entire healthcare provider universe with unproven fraud innuendo, but given its poor track record in uncovering even widespread fraud (see: South Florida), maybe the only arrow in its quiver is to bluff. If they have found even one case of EHR-abetted fraud and wanted to deliver an effective message, they should have had a photo op with someone in handcuffs.

HIStalk Announcements and Requests

A big thanks to all the readers who sent me notes bragging that they had already gotten their iPhone 5s after little or no wait at their local Apple store. My phone will arrive from China on Thursday. I loved the lightweight feel of a friend’s iPhone and had fun taking a few panoramic photos. My friend claims it is much faster than the iPhone 4, but she is not yet convinced the battery life is dramatically improved.

Welcome to new HIStalk Platinum Sponsor VersaSuite. The Austin, TX company offers an integrated system for medical enterprises (hospitals, clinics, surgery centers) that includes a hospital information system (including CPOE and eMAR), inventory management, RIS/PACS, laboratory information system, pharmacy management system, accounting, and HR. It’s all built on a single Windows-based stack running on a single database, standardizing the user experience across inpatient, outpatient, and ED. The company says it holds the largest number of CCHIT certifications of any single product, including CCHIT’s enterprise certification, giving healthcare systems one product that is MU certified for both EPs and hospitals. VersaSuite’s EHR includes specialty-specific templates for 24 disciplines, keyboard-free data entry, dashboards, tablet support, and a four-click assessment/plan for outpatients that takes only 5-10 seconds vs. up to two minutes in competing EHRs. The company is a member of IHE and its products support interoperability standards such as HL7 and DICOM and are compliant with HIPAA 5010 and ICD-10. Thanks to VersaSuite for supporting HIStalk.  

I booked my HIMSS room this week and suggest you don’t wait too long. I got my first choice, but the supply for close-in rooms is dwindling. HIMSS usually opens up more hotels later, but they’re usually a long shuttle bus ride to BFE.

Acquisitions, Funding, Business, and Stock

Cancer support site Navigating Cancer raises $2.3 million to hire developers and integrate its patient portal into EMR applications.

McKesson announces that it will acquire MedVentive, which offers population and risk management tools.

Sales

Wentworth-Douglass Hospital (NH) selects the Siemens perioperative management system by SIS.

The Upper Peninsula HIE (MI) will implement ICA’s CareAlign CareExchange platform.

Tampa General Hospital (FL) selects RelayHealth Enterprise HIE for CCD data exchange.

Johns Hopkins Hospital and Health System (MD) selects 3M’s 360 Encompass System for automated coding and clinical documentation.

Health plan service provider Magnacare (NY) will offer online appointment scheduling services from DocASAP, a startup competitor to ZocDoc.

Methodist Dallas Medical Center (TX) selects ProVation Order Sets from Wolters Kluwer Health.

Amcon’s Australian division announces the launch of its Messenger clinical alerting middleware at the 848-bed St. Vincent’s Hospital Melbourne.

People

M*Modal hires Mike Etue (OptumInsight, Allscripts) as EVP of sales, replacing Michael Clark.

Former PatientKeeper VP Michael Bertrand joins home health software provider HealthWyse as VP of development.

RemitDATA appoints John Stanton (Beacon Partners, above) as VP of consulting and Phillip McClure (MedeAnalytics) as VP of sales.

Beacon Partners promotes Christopher Kondrat from principal to VP of professional services.

Phillip Madden (Cerner) is named director of client sales at Orion Health.

Yuma Regional Medical Center names Robert Budman, MD (Catholic Healthcare East) as CMIO.

Besler Consulting appoints Edward J. Niewiadomski, MD (Southern Ocean Medical Center) as senior medical advisor.

Quality Systems, Inc. appoints Daniel J. Morefield (LEADS360) as EVP/COO.

Announcements and Implementations

Munson Healthcare (MI) implements VPLEX Metro virtual storage from EMC and private cloud technology from EMC and VMware.

SCIOinspire Corp. changes its name to SCIO Health Analytics.

Prognosis adds a configurable template engine and a physician rounding tool to its ChartNotes EHR.

In the UK, CSC admits that it will sunset the former iSOFT physician systems, including Synergy, Premiere, and Ganymede, that are used by about six percent of England’s practices. It denied the rumor of the impending retirement until Monday’s announcement.

PerfectServe adds a patient-centered rounding feature to its communications system, allowing clinicians to contact the appropriate physician for each patient.

Cleveland Clinic is implementing software from its new spinoff iVHR, which will present information from its Epic system to doctors in a visual form. The software will create maps patient locations with indicators of patient condition that link to all the background data from Epic, displaying it visually to help doctors see the big picture.

Government and Politics

The FCC’s mHealth Task Force recommends that wireless health and e-Care technologies be incorporated as best practices for medical care by 2017. Example technologies are remote monitoring devices, apps, body sensors, implanted microstimulation devices, medical device data systems, provider apps for remote image viewing, patient portals, clinical decision support tools, and a broadband-enabled HIT infrastructure. Some of its specific recommendations to the FCC include: (a) fill the open position for an FCC healthcare director; (b) provide education and outreach; (c) work more closely with ONC and CMS, specifically helping ONC with secure health messaging and communications standards; and (d) open up more of the communications spectrum for mobile broadband.

UC Davis Health System signs a 16-month, $17.5 million agreement to take over the state’s struggling HIE, formerly run by Cal eConnect. The project has been renamed the California Health eQuality Program (CHeQ) and will be led by Ken Kizer, MD MPH of UC Davis, who was previously CEO of the VA healthcare system, Medsphere, and the National Quality Forum. The project is halfway through its four-year, $39 million grant. They claim they are confident they’ll seamlessly move to a post-grant revenue model when the federal breast runs dry in 2014, which will make them one of almost none if they actually pull it off.

NPR posts the audio and transcript from Tuesday’s “The Diane Rehm Show,” featuring Farzad Mostashari and others on “The Pluses and Minuses of Electronic Medical Records” (but not Diane Rehm, who was on vacation, and not Farzad for the second half because he had to leave). The substitute host led an inordinate amount of the discussion toward upcoding, which made it a lot less interesting. What Farzad said: (a) maybe the EHR just captured the charges correctly; (b) the current system pays doctors more for recording what they actually do, so why wouldn’t they?; (c) EHR or not, fraud is illegal, and in fact the audit trails of EHRs can make it easier to detect. A former healthcare CIO and practice manager named Jim called in to say that his docs always intentionally downcoded with paper records because they were afraid insurance companies would challenge their recordkeeping, but were more confident that electronic records made it safe to bill accurately.

Other

OIG finds that Essentia Health (MN) overbilled Medicare by $865,000, or $3.18 for every $1.00 it was owed. Essentia blames its billing system, which it says it has replaced.

Avado CEO Dave Chase opines in a Forbes article that New York is “the epicenter of healthcare’s reinvention.” He cites as examples health accelerators, Medicaid HMOs, WebMD, the New York eHealth Collaborative, the state HIE, IBM, and Farzad Mostashari.

Weird News Andy finds an article from the physician author of Bad Pharma stating what everybody knows: drug companies selectively publish studies that make their drugs look good, using tricks such as small-numbers studies and statistical tricks that exaggerate questionable benefits. Less-flattering studies get shelved. Industry-funded drug trials were positive 85 percent of the time, while only 50 percent of government-funded studies were. Industry-sponsored studies of statin drugs were 20 times more likely to favor the test drugs. From the book’s description, “We like to imagine that doctors are familiar with the research literature surrounding a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients.”

Another WNA find, which he labels “workaholic”: the New York Post digs through public records to find city-employed psychiatrists who make multiples of their base salaries by claiming extensive overtime for ED coverage. One psychiatrist boosted his $173K base pay to $481K by claiming he worked 80 hours per week. The same doctor made $689K in 2009 by turning in 3,820 hours of overtime, including one non-stop stretch of 96 hours. The physicians are also allowed to operate private practices.

Here’s the latest cartoon from Imprivata.

Sponsor Updates

• eClinicalWorks releases the agenda for its October 25-28 National Users Conference.
• DrFirst creates an infographic called “Key Dates You Need to Know to Maximize Meaningful Use Incentive Payments.”
• Lifepoint Informatics announces its Gold Level sponsorship of the G2 Lab Institute Conference in Alexandria, VA October 10-12.
• MED3OOO VP Steven Stout discusses the risk and rewards of contracting for global risk in an October 3 Webinar.
• McKesson hosts a September 27 Webinar on strategies for driving reimbursement.
• A survey by commissioned by simplifyMD finds that EMR vendors often convince practices to replace their practice management system when implementing their EMR, but practices often experienced problems with cash flow and employee productivity as a result.
• MedVentive offers demos of its Population Manager and Risk Manager products during next week’s AMGA Institute for Quality Leadership Annual Meeting.
• Benefis Health System (MT) realizes a $4.9 million increase in appropriate hospital charges, a $3.5 million increase in reimbursement, and a $2.3 million reduction in uncompensated care within four months of implementing the first phase of its RCM initiative with MedAssets.
• MedAptus releases its Mobile Schedule application for Apple iOS.
• An Imprivata-sponsored survey finds that 72 percent of hospital IT decision makers believe pagers will be replaced by secure text messaging within three years.
• iSirona releases a white paper on device integration.
• Wellsoft will participate in the 2012 ACEP Scientific Assembly next month in Denver.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

More news: HIStalk Practice, HIStalk Mobile.