News 11/7/12

Top News

ECRI Institute’s “2013 Top 10 Health Technology Hazards” report includes several patient issues that are IT-related or potentially IT-solvable: alarm hazards (#1); IV infusion pump errors (#2); data mismatches in clinical IT systems (#4); interoperability failures between IT systems and medical devices (#5); and caregiver distractions due to mobile devices (#9). The nonprofit organization’s report, which contains good assessment tools and recommendations, is available as an immediate and free download with registration.

Reader Comments

From Ron Strachan: “Re: Community Health Network in Indianapolis. I’m happy to report that we’re live on the final wave of Epic sites. Community is an Enterprise customer and now has four hospitals and over 200 sites of care live on EpicCare. The install started in April 2011.” Congratulations to the team there and to the CIO, which happens to be Ron. Epic “waves” of ambulatory go-lives within an organization are like an army’s push into enemy territory – cause for concern beforehand, but worth celebrating after the careful planning pays off.

From Karl: “Re: for Inga and Dr. Jayne. Beware … you are about to lose substantial time and money too.” The Pinterest page is shoe porn for the ladies, or possibly for cash-eager healthcare providers who specialize in treating the foot and leg damage that some of the more bizarre models surely cause. But as they say, it’s better to look good than to feel good.

From Tarheel Ingenue: “Re: UNC Health Care. Named Epic vendor of choice on Friday.” Unverified, but hardly surprising given that not only is Epic getting just about every big-hospital deal, they have several of UNC’s academic hospital neighbors as customers (Duke, Wake Forest Baptist, Pitt County in Greenville, and probably others I’m forgetting.)

From JB: “Re: soft drinks. Mayor Bloomberg isn’t the only one banning the sale of sugary drinks.” Children’s Mercy of Kansas City, MO will stop the sale of all sugar-containing drinks on January 1, including sugar-loaded faux healthy fruit juices. The hospital cafeteria emphasizes healthier food choices, encourages purchase of fruits and vegetables, and plans to trash their deep fryers by 2015. They will also switch all IVs from dextrose to normal saline starting in 2015 (OK, I made that part up). This is an admirable step in trying to lead by example. Outsourced food service departments of hospitals are big-time nutritional offenders in serving whatever is easy and cheap, although in their defense they’re selling what people unfortunately want. It would be interesting to see how many overweight people suck down sugary drinks regularly, which are surely the least-satisfying calories you can take in. Put your finger a third of the way up the side of a soda can – that’s how far the 140 calories’ worth of sugar would pile up if you removed the colored water.

HIStalk Announcements and Requests

I plan to get comfy on the couch tonight in front of the TV to watch the election returns. Hopefully by the week’s end I can unhide a few of my more politically passionate Facebook friends whose various posts have raised my blood pressure in recent weeks. I’ll then be happy to ignore all politics for awhile – at least until Bill Clinton keynotes at HIMSS.

We like reading tweets from conferences, so we’re offering sponsors a free tweet box from their annual user meetings. The one from Imprivata’s HealthCon is running to your right.

Speaking of meetings, AMIA’s seems to be going well judging from the tweets. Your report is welcome since we aren’t there.

Acquisitions, Funding, Business, and Stock

NexJ pays $5.5 million to acquire Broadstreet Data Solutions, a provider of data management, analytics, and mobile solutions.

Shareholders of Streamline Health Solutions vote to convert $5.7 million in convertible notes to preferred stock in order to reduce company debt and reduce interest expense.

Hearst Corporation, whose holdings include Zynx Health and First Databank, will acquire Milliman Care Guidelines LLC, a provider of evidence-based clinical healthcare databases.

Tenet Healthcare subsidiary Conifer Health Solutions, which provides business process management services to 500 hospitals, acquires Dell’s revenue cycle management business for hospitals and healthcare systems.

Vocera reports Q3 results: revenue up 27 percent, EPS $0.07 vs. -$0.25, beating estimates on both and raising earnings guidance.

As we reported earlier, McKesson announces that it will acquire Emendo Ltd., the New Zealand-based vendor of the CapPlan hospital capacity planning solution. Its customers are in New Zealand, Australia, the UK, and Canada, with some US hospitals signed since it began marketing here through partners in 2010.

Sales

Legacy Health (OR) contracts with Explorys for its platform and enterprise performance management applications to power Legacy’s PCMH and ACO initiatives.

Altru Health System (ND) selects Perceptive Software’s content and process management solutions to complement its Epic patient registration, HIM, and patient finance processes.

Baptist Health (AR) chooses the Patient Access Intelligence and Revenue Cycle Intelligence solutions from MedeAnalytics.

First Choice Health Centers (CT) signs with eClinicalWorks for its six-location community health center organization.

Coosa Valley Medical Center (AL) selects Merge Healthcare’s iConnect Enterprise Clinical platform, including Merge PACS, iConnect Access, and iConnect Enterprise Archive.

HomeTown Health buys McKesson’s CareEnhance-Review Manager Enterprise technology to increase the accuracy and efficiency of medical necessity review and documentation among its network of rural hospitals and providers.

People

Kaiser Permanente promotes President and COO Bernard Tyson to chairman and CEO, replacing the retiring George Halvorson.

Stuart Nelson, MD (US National Library of Medicine) joins Apelon as chief innovation officer.

The TriZetto Group hires Jeffrey Rose, MD (Ascension Health) as CMIO.

The Georgia CIO Leadership Association names Emory Healthcare CIO Dee Cantrell its CIO of the Year.

Tony Fonze, CIO of Carondelet Health Network (AZ), is named president and CEO of Carondelet’s St. Joseph’s Hospital of Tucson.

Announcements and Implementations

NYU College of Nursing and Rubbermaid Medical Solutions combine resources to develop and enhance clinical technology solutions for nursing education that will  include scholarship programs, telemedicine projects, and educational initiatives.

The executive director of HealtheConnections reports that about 1.2 million people in central and northern New York are now connected to its HIE.

First Databank releases the ICD-10 code set within its FDB MedKnowledge clinical decision support drug knowledge.

nVoq and Mi-Corporation will collaborate to deliver voice-enabled versions of commonly used templates for the home health and long-term care industries and will develop additional voice-enabled e-Forms for other healthcare settings.

One of my Advisory Panel members mentioned using Vendormate to review the financials and sanction record of prospective vendors. The healthcare-specific company recently announced Medzo, an online service that matches the needs of buyers with seller offerings, potentially eliminating the RFI process. Vendormate’s network covers 70,000 companies, 660,000 provider-vendor relationships, and 48,000 users. Hospitals get free access and vendors get a free basic listing in Medzo.

Government and Politics

A Masachusetts law went into effect this week that prohibits employers from requiring nurses to work overtime.

Innovation and Research

A Rand Corporation study finds that physicians with fewer than 10 years of experience account for 13.2 percent higher overall costs than physicians with 40 or more years of experience.

Other

GE Healthcare issues a field safety notice to physicians warning of a potential defect in its Centricity PACS imaging systems that could result in the loss of images when sending exams from one Centricity PACS to another.

Eleven vendors own 80 percent of the HIE market, according to a new KLAS report. Epic, ICA, and Siemens MobileMD earned the top scores for overall connectivity and satisfaction, though scores for all HIE vendors except Cerner have declined over the past year.

Social workers in British Columbia are startled when their computers display the home page of the US Department of Homeland Security and an entry form labeled “Co-Conspirator.” Their new, problem-plagued software was modified from Homeland Security’s system by a contractor at a cost of $194 million and counting. The government shut down an $89 million student information system last year after giving up that its problems could be fixed.

Strange: a doctor tells a British couple who aren’t having any luck conceiving that the problem might be the husband’s laptop, which he props in his lap for several hours each evening to use Facebook. Three months after the husband starts using a table instead of his lap, his wife becomes pregnant.

Sponsor Updates

• The Sandy Relief Drive of SRS generated almost $5,000 in employee donations, which the company then matched in purchasing supplies for affected employees. The balance of the money will be donated to the Red Cross and Governor Christie’s Relief Fund.
• GetWellNetwork completes its 350th interface in US hospitals.
• CHMB (CA) partners with Ingenious Med to expand its RCM service offerings to hospitalists.
• Intelligent InSites announces that its software platform integrates with the ultra wide band RTLS from PLUS Location Systems.
• iSirona offers a $1,500 prize to the winners of a Code-A-Thon programming challenge at Florida State University.
• ICSA Labs calls for qualified EHR technology developers of both complete EHRs and EHR modules to participate in a pilot program for the 2014 Edition certification criteria.
• Orion Health CEO Ian McCrae discusses the growth of his company and its approach to software integration in a video interview.
• Imprivata is ranked 26th in the medium company category of 2012 Top Places to Work in Massachusetts.
• eClinicalWorks receives full NCQA certification as a CAHPS PCMH survey vendor to conduct NCQA HEDIS surveys.
• Philips SpeechMike Premium earns a perfect score of six dragons on Nuance Communication’s recording accuracy test for assessing compatibility with the latest version of Dragon Naturally Speaking.
• Dawn Mitchell and Kathy Krypel of Aspen Advisors will co-present break-out sessions at next week’s HIMSS Midwest Fall Technology Conference in Des Moines, IA.
• Eye Health Services (MA) selects SRS EHR for its 21 providers and 11 locations.
• Quality IT Partners sponsored the 13th Annual Scott Hamilton CARES Initiative Gala and hosted a patient from the Cleveland Clinic Taussig Cancer Institute last week.

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

McKesson To Acquire NZ-Based Emendo

Mckesson announced this afternoon that it will acquire Emendo Ltd., the New Zealand-based vendor of the CapPlan hospital capacity planning solution. Its customers are in New Zealand, Australia, the UK, and Canada, with some US hospitals signed since it began marketing here through partners in 2010.

Guest Article: Hurricane Sandy Report from a Disaster Recovery Firm

Note: I offered to run an article from a disaster recovery vendor because I thought their perspective on Hurricane Sandy would be interesting. This is not an endorsement of that company, but I appreciate their article.

Extreme power outages and widespread flooding may wind up making Superstorm Sandy the second most expensive storm in US history, according to the forecasting firm Eqecat. Losses from the storm could total up to $50 billion, and according to Moody Analytics, an estimated $30 billion will come from physical storm damage split evenly among households, businesses, and public infrastructure. The remaining loss comes from lost business activity.

In addition to the financial challenges, several hospitals, nursing homes, and assisted living facilities failed a fundamental test of preparedness during Superstorm Sandy: they lost power. Their backup generators failed or proved inadequate, forcing thousands of patients to evacuate. Doctors, nurses, and medical practitioners were unable to access electronic health records and communication lines were down with no backup plan in place to redirect or re-establish phone lines.

Days after the storm, many businesses were up and running despite infrastructure failures because of disaster recovery and business continuity plans provided by Agility Recovery. Agility Recovery, a former division of General Electric that has been rescuing businesses impacted by disasters for over 23 years, offers a disaster recovery solution endorsed by the American Hospital Association.

In the aftermath of Sandy, Agility is responding to over 1,300 businesses, including several healthcare organizations. Agility is currently delivering assets to 95 businesses. Another 1,210 businesses are on alert, meaning Agility is pulling down assets, waiting for the go-ahead from the business to ship them.

The main Sandy-related response activities include:

• Power loss. The company has shipped out generators to dozens of members and provided electricians to connect the generators and fuel to keep them running.
• Downed phone lines. We have conducted over a dozen telephone and voice mail redirects so businesses can continue to communicate with employees and clients.
• Computer or server failure. Agility has shipped out computers and servers to several clients who have experienced damage to their existing technology or need extra technology for employees working from alternate locations.
• Structural damage. We have completed several full office recoveries, shipping out a mobile office, a generator to power the office, satellite to establish phone and Internet connectivity, phones, computers, servers, printers and faxes, desks, and chairs.

Although significant gains have been made in healthcare industry with regards to preparedness post 9/11, Georges Benjamin, executive director of the American Public Health Association, warns that austerity budgeting threatens these gains. “People presume that we have greater capacity than we have. When we get the big ones, we throw everything at it. We need to make sure we have the same capacity on the shelf at all times,” Benjamin continued, "I remain worried about the infrastructure.”

Most Common Recovery Plan Vulnerabilities

• Access to generators in the absence of a predefined relationship.
• Failure of backup generators due to poor location or lack of testing.
• Access to generator fuel.
• Establishing communications, as employees and clients left in the lurch as they receive busy signals.
• Incomplete planning for alternate facilities, where those locations are either impacted by the same disaster or have inadequate technology.
• Inadequate business insurance coverage. Of the estimated $50 billion in Hurricane Sandy damage, $10-20 billion is predicted to be insured losses.

Having a flexible and executable plan that accounts for many eventualities is critical to resuming operations following a disaster. Of course, revenue is an issue. A healthcare industry study found that one in 20 hospitals is unprepared for power disruptions, and a power outage may result in more than $1 million in lost revenue and other costs. Another study of a 16-hour power failure in New York in 2003 found that of 120 hospitals impacted, one was forced into bankruptcy and 10 others suffered significant revenue loss.

But more importantly beyond revenue is the need to provide high quality, continuous patient care. Patient safety is always the biggest concern hospitals and healthcare organizations face. Following the high-profile failure of several hospitals hit by Sandy, it is time for everyone to take another look at their disaster response and recovery plans.

Bob Boyd is CEO of Agility Recovery of Charlotte, NC.

Humana Acquires Certify Data Systems

Health insurer Humana Inc. announced this morning that it has acquired HIE technology vendor Certify Data Systems. The San Jose, CA company, which offers the HealthLogix HIE platform, will operate as a subsidiary of Humana.

Humana VP/CIO Brian LeClaire was quoted in the announcement as saying, “Humana remains focused on leveraging the power of technology to provide a more coordinated patient experience for our members that will enable quality, affordable health care. With the health information exchange platform from Certify we can move closer to creating a virtual integrated delivery health care system that can help us deliver this value-added, simplistic [sic] experience to our members.”

Terms of the transaction were not disclosed.

I interviewed Certify CEO Marc Willard in February 2012. He reported at that time that the company had 70 health system customers.

Monday Morning Update 11/5/12

From The PACS Designer: “Re: iPad Mini. TPD told you about the iPad Mini awhile ago, but didn’’t expect its arrival until early next year. Now that it’s here, you will see a rapid deployment in the healthcare field. Healthcare IT departments need to be on alert as the expansion of iPad mini users will could quickly overload already busy networks.”  

From Japandroid: “Re: MMRGlobal. I spent 30 minutes reading their press releases after your item and was floored. They crank out what seems like one per day, like the one mentioning that they shipped 25 more PHR licenses to a reseller (congratulations!) Check out their YouTube video – the company’s spokesperson is a former Playboy model, soft porn movie star, TV producer, and the trophy wife of company founder Robert Lorsch, who has a long list of business and philanthropic accomplishments.” Looks aside, Kira Reed is polished and engaging in the video, although not enough to make PHRs interesting (she says PHRs are “exploding,” which I would agree by my definition of “exploding.”) Vendors: is anybody planning to reward the company’s patent trolling by licensing its EHR-related intellectual property, which will be celebrating its one-week birthday in just a few days?

From Epic Pawn: “Re: Epic. The contract they sent me for the privilege of consulting with one of their clients will require me to end my HIT career!” Interesting points:

• Apparently a hospital can’t hire a consultant to help with Epic until that person signs a lengthy contract with Epic.
• If the consultant develops any kind of enhancement to Epic software and doesn’t sign over the rights to the hospital, the enhancement is automatically owned by Epic.
• You are obligated to report anyone you know who has accessed anything related to Epic without authorization, even if you didn’t have anything to do with their access.
• You can’t hire or contract with a former Epic employee until they’ve sat out a one-year waiting period.
• You can hire an Epic customer’s project team employee only if you don’t assign them any Epic-related work for two years, and they are considered to be a project team employee until three months after go-live.
• Your employees can’t perform any activities that compete with Epic – design, sales, consulting — for two years after they leave your employment.
• You agree that Epic is a third-party beneficiary of the agreement your employees must sign, which gives Epic a right to enforce the agreement even though those people don’t work for Epic.
• You agree that any legal actions will be heard in Wisconsin courts.
• I’m sure there’s more, but it’s a long read and I’m getting numb.

From Lambrusco: “Re: Allscripts. I think they’ll get a private equity deal announced by the earnings announcement on Thursday. Otherwise, they will have to put out an ‘exploring strategic alternatives’ addendum to the announcement if they miss on revenue or earnings (which is likely) to cushion any fall. Worse than allowing word of the PE deal to leak out was the MyWay announcement, which clued every potential PE buyer to dig more closely into attrition rates, which are sure to rise. They could have waited a month or two before putting a bullet in MyWay. The company is incredibly inefficient and the CEO was given carte blanche by the board to do M&A himself to buy his way out of trouble after avoiding tough product decisions in 2008 and 2010, so the cash flow and margins are probably understated and the PE guys can put in a management team that can execute. This week will be interesting.” Indeed it will.

From Coolmaker: “Re: vaccine refrigeration. They can make a zeer pot refrigerator that only requires water to function.” That might be an interesting project – a couple of flower pots and some sand and you can make a rudimentary refrigerator, although I don’t know if it will get cool enough to keep vaccines.

From Tarheel Ingenue: “Re: UNC Health Care CIO. Leaving.” Verified, apparently, based on an internal e-mail sent my way. Rose Ann Laureto, who’s been on the North Carolina job just a year, is moving to Promedica as CIO of the 11-hospital system that’s closer to her original home.

It’s pretty much all KLAS when providers use paid information sources to evaluate vendors according to my poll, although Gartner and “none of the above” had minimally respectable showings. New poll to your right: how much will patient empowerment and mobile apps change the healthcare system? After you’ve voted, click the Comments link on the poll to try to sway the undecided voters.

Instead of doing a “Listening” recommendation, Lt. Dan of HIStalk Mobile and I put together a Spotify playlist with some new and old stuff we’ve been following (our musical tastes overlap quite a bit). Spotify offers high-quality free streaming, so download it and you can play through the 39 tracks and three hours. Examples: new Neil Young, Wild Belle, Seapony, and older stuff from Frank Black, the BellRays, Public Enemy, and Operator. Feel free to create your own playlist and send me the link – if I like it, I’ll run it. If anyone seems to care, I’ll put out a new playlist every week or two, maybe focusing on specific genres.

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

A colonoscopy is not only an unpleasant procedure — a fact the voice failed to mention — but an expensive one. Hospitals don’t list their prices — no, that would make way too much sense — but independent cost-comparison websites suggest you can count on paying an average of $2,025 for a colonoscopy in St. Louis. The anesthesiologist will bill you separately. Why? Because he can. The facility may bill you separately. Why? Because it can. Also, if the colonoscopy actually finds a polyp or some other anomaly, it becomes a “diagnostic” procedure and not a “screening” procedure and it will cost you more. Why? Because it can. That $2,025 price applies if you have insurance. The voice was happy to suggest a colonoscopy because (a) voices don’t have colons to be scoped and (b) the insurance company would rather pay its share of the discounted price of the procedure than pay out hundreds of thousands of dollars for colon cancer treatment. Insurance companies have many faults, but stupidity is not one of them.

California state HIE overseer UC Davis releases HIE Ready, a buyer’s guide for providers interested in the interoperability capabilities of EHRs they are considering. It’s mostly a set of technical specs and an invitation for companies to participate.

Former shareholders of critical test reporting system vendor Vocada file suit against Nuance, which acquired the company and its Veriphy product in 2007, claiming Nuance has failed to make $7 million in earned payments. The shareholders say an arbitration panel has already unanimously ruled that Nuance fraudulently induced Vocada’s board and shareholders to agree to an acquisition whose terms included $20 million in cash or stock for shareholders, $4 million in cash or stock for employee retention and management bonuses, and $21 million in earnout consideration contingent on three-year revenue targets. An earlier Nuance SEC filing states that the financial targets were not met.

Is the iPad mini the killer form factor for medical professionals? #iPadmini #Epocrates

— Epocrates (@Epocrates) October 23, 2012

An Epocrates survey finds that one in three physicians plan to buy an iPad mini since it fits into a lab coat pocket.

The Raleigh, NC newspaper covers local EHR efforts. Tidbits:

• A local doctor who took the Allscripts MyWay plunge two years ago is not happy that it won’t be further enhanced. “We bought what we bought thinking it was a stable company and it was their newest package. You spend all this time transitioning to a program, and they come back and say, ‘Sorry guys, we’re not going to do this after Jan. 1.’” Allscripts has 1,200 employees in Raleigh, the home of the former Misys that it acquired.
• About 50 percent of NC doctors surveyed said EHRs haven’t improved care or aren’t worth the cost.
• WakeMed will spend $100 million on its EHR, while Duke’s Epic implementation will cost $500-700 million and will earn $50 million in HITECH incentive payments. UNC will choose a vendor this month to replace several hundred applications.

News 11/2/12

Top News

AHA and four hospital systems file suit against HHS, claiming Medicare isn’t paying for reasonable and necessary care as required by the Medicare Act. The issue: Recovery Audit Contractors are second-guessing physicians long after an inpatient stay, claiming that patients should have been treated as outpatients and demanding that payment be returned. The RAC gets a nice bounty for denying the hospital’s payment, the hospital gets next to nothing.

Reader Comments

From Lee Shapiro’s Shoe Lifts: “Re: Allscripts General Counsel Jackie Studer. Has she left? Her pic and bio are gone.” She’s gone, sources tell me. Unrelated to her departure, the company announces results next week, and I have this feeling that they’re trying hard to get a PE deal ready to announce before then for reasons you might speculate.

From Michael: “Re: RazorInsights. Thanks for the mention. I wanted to confirm our customer attestation numbers – 83 percent have achieved Stage 1 Meaningful Use as of today and several outstanding filings are being finished up by clients.”

From Bucket Head: “Re: Sandy. We have about 50 clients in private practices on the East Coast without power and/or Internet. In our world, the big deal for them was finding a safe home for vaccines. If you have $50K (or more!) of stock in your fridge, it’s not like the milk. A couple of our customers will be without power for five to 10 days at least, so we’re expecting to turn on virtual servers in our offices for them to access. We have three or four customers on the Jersey shore from whom we’ve heard nothing and haven’t returned a call, text, or e-mail.”

From Evan Steele: “Re: Temporary command center, post-Sandy. We are settled into our ‘MCC’ (Marriott Control Center) and everyone not at the MCC is working virtually from home, a friend or relative’s house, or office with Internet access. We have 42 servers (physical and virtual) in a co-location facility, so everything is available and every SRS’er with an Internet connection has access. We are doing a great job keeping pace with support requests considering our less than ideal circumstances.” Evan, who is CEO of the Montvale, NJ-based SRS, reports that his company’s headquarters remains without power. Access to remote servers and a cloud-based phone system has enabled staff to continue working, either from a local Marriott hotel conference room or from home. Thumbs up to technology and adaptability.

From Millerbarber: “Re: Infinitt. The NJ-based PACS vendor has been down for two days.” Unverified.

From Lead Sinker: “Re: NYU. Servers are down, basically underwater. We have an enormous go-live scheduled for 12/2 – not sure how this will affect that date.”

From Capo Crusader: “Re: NYU Langone admitting that its generator was old and poorly located. I hope everyone is OK, but I smell lawsuits with this admission. With all that has been written about Katrina, how can a hospital this size not be better prepared?” The hospital says it spent millions of dollars after Hurricane Irene on backup power improvements that included a flood-resistant pump house, sealed fuel tanks, and rooftop generators, but they apparently overlooked the fact that the electronic system driving it is located in the basement that flooded. At least the staff behaved admirably: four NICU respirator babies were carried down a nine-flight stairwell in the dark while a nurse manually bagged them to keep them breathing as volunteers and medical students lit their way with flashlights.

From Ex-McK: “Re: McKesson. Moral compass broken at the top. We highlight to the company that employees are breaking the law to ensure that the bottom line is met, renting ambulances to ensure we can sneak our profits through.” A purported e-mail from McKesson Chairman and CEO John Hammergren lauds employees of one of the company’s distribution centers for renting ambulances to make deliveries to New York, which prohibited non-emergency vehicles from using bridges.

HIStalk Announcements and Requests

Wondering what you may have missed on HIStalk Practice over the last week? Highlights: an AHIMA-published article suggests that cloud-based computing and smart mobile platforms are making ambulatory EHRs more affordable and attractive to physicians. CMS names 24 qualified vendors for the 2013 PQRS program year. Digichart’s founder and CEO assumes title of chairman emeritus. An Impact Advisors consultant provides recommendations to measure EHR success. NYeC Executive Director David Whitlinger gives an overview of his organization, its goals, and current success. Dr. Gregg (and his dog) fantasize what the world would be like if HIT had started with a grand plan. All I have to say is that if you aren’t reading HIStalk Practice, your HIT news world is incomplete. Thanks for reading.

We have a new contributor on HIStalk Mobile who I’m calling Lt. Dan since he (like me) works full time in the industry and probably wouldn’t find his employer to be receptive to the idea of his writing potentially controversial material under his own name. Lt. Dan is and industry pro who will be posting several news items each day, adding to the excellent analysis and commentary from Dr. Travis. We’ll also be revamping the site’s design shortly with a more modern look, and most likely renaming it to indicate broader coverage than I originally anticipated (we’re now writing about telehealth, startups, consumer health, and social media). In addition to the expanded coverage, Travis will be on the ground at the mHealth Summit December 3-5 in the DC area, of which HIStalk Mobile is a media partner, so you can expect lots of information from there. How you can get involved with HIStalk Mobile: subscribe to the spam-free e-mail updates, follow our tweets, write a guest post, and tell us who we should interview. Most of all, read HIStalk Mobile and participate by sending us interesting news and rumors.

Speaking of HIStalk Mobile, thanks to new Founding Sponsor Imprivata, which offers Cortext, an easy-to-use mobile app that replaces outdated texting and paging with HIPAA-compliant messaging for smartphones (Android and iOS) and PCs. Imprivata now supports both HIStalk and HIStalk Mobile at the highest levels that I had available, which I appreciate.

On the Jobs Board: Senior Certified Epic Analyst, Healthcare Analyst – Security Tester, Community Health Center Sales Executive, System Software Engineer.

A lot of readers dropped by in October, in fact more than in any month in the almost 10 years HIStalk has been around, for reasons unknown: HIStalk had 130,254 visitors and 241,599 page views.

The weather’s cooling down, leading to the bane of the cubicle dweller: where are you supposed to hang your coat?

Acquisitions, Funding, Business, and Stock

Merge Healthcare announces Q2 results: revenue up five percent, EPS $0.01 vs. $0.06 a year ago, missing analyst estimates by $0.02.

Carestream Health acquires Genesis Digital Imaging, a developer of software for diagnostic imaging systems.

Meditech’s Q3 numbers: revenue up 7.8 percent, net income up 4.6 percent.

Greenway announces Q1 results: revenue up 28 percent, EPS $0.00.

Sales

Intermountain Healthcare (ID) selects SA Ignite’s MU Assistant for EP Meaningful Use automate attestation of EPs using Intermountain’s proprietary EHR.

Medical Mutual of Ohio chooses the mobile application development platform and Mobile Health Plan application from Kony Solutions to provide members with account management, access to physicians, electronic ID cards, and claims information.

Health Fidelity will use the terminology solution of Intelligent Medical Objects in its Reveal natural language processing service for extracting data from unstructured medical narrative information. IMO will use Reveal for its solutions.

Alameda County Medical Center (CA) engages MedAssets to oversee several cost reduction projects involving physician preference items, supply and services sourcing, and workforce management.

People

Cerner appoints Justin Whatling, MBBS (BT Health) senior director of strategic consulting for its European advisory practice.

The US Chamber of Commerce names Peter Tippett, MD, CMO of Verizon and VP of its incubator, as the recipient of its first Leadership in Health Care Award for his efforts to advance health HIT innovation.

As a reader leaked to us a couple weeks ago, Pulse Systems co-founders and brothers Basil and Alif Hourani resign their posts as CEO and CTO, respectively. CFO Jeff Burton takes over as president and CEO. The French technology company Cegedim purchased the company two years ago for $61 million.

PerfectServe names Cary Smith (Allscripts) as VP of sales for the western region.

Avalere Health names Protima Advani (The Advisory Board Company) as VP of its healthcare networks practice.

CHIME President and CEO Rich Correll will move to a COO role with the organization, saying CHIME’s board worked with him to develop an operational management role required by its growth. They’re seeking an experienced CIO to replace Correll as “ambassador to the industry.”

Announcements and Implementations

UPMC expands its telemedicine services to rural hospitals.

Sparrow Hospital (MI) rolls out Epic’s MyChart for patient use on mobile devices.

Wellcentive announces the release of Proactive Data Quality, which allows healthcare organizations using its population health management system to detect data delivery and mapping issues.

Siemens Healthcare expands its relationship with TIBCO Software, which provides the business process management technology used by Soarian. Siemens says it will use TIBCO’s next-generation technology to provide Soarian customers with on-the-fly analysis of current and historical data to allow them to become what TIBCO calls the Event-Enabled Enterprise.

Brown & Tolan Physicians (CA), a Medicare Pioneer ACO, goes live with Humedica’s MinedShare analytics platform.

UK sensor vendor Toumaz starts the first US pilot of its disposable, continuous wireless vital signs sensor at St. John’s Health Center (CA). Patients in any location can be monitored with the Sensium system, eliminating the need for them to be kept immobile in the ICU.

In Michigan, Beaumont Health System and Henry Ford Health System announced months ago that they expected to merge in some fashion. They’ve signed the papers to start discussions on the merger details, which would create an organization with $6.4 billion in annual revenue and 42,000 employees. Both use Epic.

MMRGlobal, which always puts out bizarre press releases that make it sound like a big company instead of a minimally known PHR vendor, decides that lawsuits pay better than trying to sell a personal health record. The company was awarded a vague patent for a method of giving patients access to their electronic medical records. That was on Wednesday. By Thursday, the company was sending threatening letters to hundreds of EHR vendors, demanding that they start paying licensing fees.

Innovation and Research

MIT researchers develop a system for disambiguating the senses of words used in physicians’ freeform notes in EHRs. The researchers say their method, which identifies relationships between words while also drawing correlations between words and syntax, is 75 percent accurate and thus markedly better than previous methods.

A study in Ireland finds that 40 percent of handwritten ICU orders contain an error, although “error” was loosely defined to include missing pager numbers and illegible signatures. Articles like this always alarm laypeople who can’t distinguish between “preventing an error” vs. “preventing patient harm.” It’s like saying that 99 percent of drivers make at least one error per day while intentionally not mentioning that most of those are of no consequence whatsoever and are thus not worth a prevention effort.

Technology

Researchers from the engineering and media arts schools of Drexel University design the Belly Band, which contains an antenna that allows remote monitoring of pregnant patients. The band, which does not require batteries or electricity, transmits radio signals to indicate changes in the shape of the uterus and can be picked up with an ultrasound. Maybe once they complete work on all the functional aspects Dr. Jayne and I can advise on the fashion design.

Other

The National Health Information Sharing and Analysis Center (NH-ISAC) activates a 24/7 emergency response system to support healthcare critical infrastructure protection, mitigation, response, and recovery. The response system is intended to address situational awareness, facilitate information system, and provide incident response support.

Lake Health (OH) performs a routine EMR audit and subsequently fires several employees for inappropriately accessing a patient’s health information.

Cleveland Clinic and GE Healthcare join 25 companies that have committed to lease space at Cleveland Medical Mart, raising the building’s committed tenancy to 50,000 of its 95,000 leasable square feet.

Exeter Hospital (NH) is denied a court order that would have prevented the state HHS from accessing the hospital’s electronic medical records as part of an investigation into a hepatitis C outbreak. The hospital argued that such access would violate state and federal laws, but the court said the state proved its need to review the records and has proven it will do so in a professional manner. The cause of the outbreak is suspected to be a contract radiology technician who is accused of stealing fentanyl syringes and replacing them with ones contaminated with his blood. After being fired from UPMC for exactly that offense, he went on to work in 10 hospitals, including Exeter, since UPMC didn’t report him for fear of not being able to prove he did it even though they had caught him red-handed.

Bellevue Hospital Center (NY) evacuated about 500 patients Wednesday after fuel pumps for its backup generators failed. Despite pumping out 17 million gallons of water, the basement remained covered in two and a half feet of water.

British Medical Journal institutes a new policy that require researchers and drug companies who submit drug clinical trials articles to make all patient-specific data used in the study available to individual researchers on request. Drug companies are notorious for shining the most favorable light possible on questionable data, so this change will allow independent researchers to double-check their conclusions. BMJ hopes other journals follow suit.

Weird News Andy captions this article as “Starving for Cash.” Two-thirds of NHS hospitals in the UK have earned bonuses for following the Liverpool Care Pathway, which can require them to stop providing food and water to terminally ill patients. The Department of Health says the protocol ensures that dying patients are treated with dignity, while opponents say the practice is “euthanasia by the back door” that is sometimes employed without involving the patient’s doctor or family.

Sponsor Updates

• Allscripts CMO Toby Samo, MD discusses improving public health with EHRs in a blog post.
• East Bay Eye Specialists (CA) will implement the SRS EHR.
• ICSA Labs seeks qualified candidates to help pilot test the test procedures and test tools for the 2014 Edition Certification.
• Greater Baltimore Medical Center (MD) creates a paperless admission and consent process using Access e-Signature and signature tablets.
• Huron Consulting Group releases a case study that highlights how it helped the University of Arizona Health Network improve its RCM operations.
• OTTR Chronic Care Solutions will participate in the National Marrow Donor Program Council Meeting next week in Minneapolis.
• The Nashville Technology Council recognizes Passport Health Communications as Technology Company of the Year for 2012.
• MedVentive hosts a November 15 Webinar on critical technology needed to support ACOs.
• Intelligent InSites will host the InSites Build 2012 conference on November 14-15 in Fargo, ND. Speakers include President and CEO Margaret Laub and AMIA President Kevin Fickenscher, MD,

EPtalk by Dr. Jayne

The HIMSS/AMDIS Physician Community issues a call for posters for the 3rd annual Physicians’ IT Symposium to be held Sunday, March 3, 2013 at HIMSS in New Orleans. The deadline is November 30. Selected presenters must also submit a 5-7 page technical paper after the conference.

CMS offers a second chance to physicians who missed the June 30 deadline to file for a Medicare ePrescribing hardship exemption to avoid the 2013 penalty. They will now have until January 31, 2013.

I’m always having issues with Medicare patients who don’t want their insurance information on lab requisitions and other key paperwork because CMS still uses the Social Security number as its patient identifier. CMS is seeking provider input on new Medicare ID cards that would remove the SSN to reduce the risk of identity theft. Its survey will be available until November 7.

Nashville-based Entrada raises $1M in new equity. Its products, which integrate with a variety of EHR platforms, allow dictation into the EHR through synchronization to the appointment list. I heard some buzz at MGMA that they also have a fax-related product, but I haven’t seen it yet (hint, hint).

Physician Edward Pullen MD shares his frustration with the Washington State Electronic Death Registry System.

Dr. Travis from HIStalk Mobile shared this story about Walmart boosting domestic medical tourism. As of the New Year, its employees will have access to heart and spine surgeries at health systems like Cleveland Clinic, Geisinger Medical Center, Mayo Clinic, and others. Additional companies that are negotiating bundled rates for employees include Boeing Co., PepsiCo, Lowe’s Companies, and HCR ManorCare. Personally I’d like my employer to negotiate a deal here.

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

News 10/31/12

Top News

From Velveteen Rabbit: “Re: NYU Langone and Sandy. My cousin is a neuro fellow at NYU Langone. Was in the middle of surgery when all power flickers and then goes out. Closed via flashlight and then patient was transferred to another hospital.” Sounds like an episode of MASH. A backup generator failed at the height of the hurricane, forcing NYU Langone Medical Center to evacuate at least 215 patients to other hospitals. Other facilities forced with forced evacuations include Coney Island Hospital (NY) and Palisades Medical Center (NJ). Numerous hospitals relied on backup generators and many facilities reverted to paper systems when EHR access was lost. Billionaire and Home Depot co-founder Kenneth Langone was an inpatient in the hospital bearing his name (courtesy of his $200 million gift) at the time and had to be evacuated with everybody else. A board member says the hospital knew its generators were old and poorly located; they’re planning to spend $3 billion to upgrade the facility.

Reader Comments

From Halsey A. Fredrick: “Re: Allscripts. The Mountain Lakes data center attempted and failed to move to generator power Monday evening. Approximately 50 Sunrise customers were down for at least seven hours, including those hosted at the company’s other data center in New Jersey. Some reportedly came back up overnight, some were still down as of Tuesday morning.” Unverified, but HAF forwarded a purported company e-mail update indicating that power was being restored. As any of us who have run IT during a weather disaster can vouch, backup generators work maybe 50 percent of the time, and that’s assuming you’ve been diligent to test the cutover regularly and have stockpiled an adequate supply of diesel fuel.

From Inspired but Concerned: “Re: Connected Health Symposium in Boston last week. I listened to great speakers and met people with truly great ideas, but few will address the elephants not in the room (i.e., Epic and Cerner). Conferences focusing on eHealth and connected health have a grassroots feel of empowering patients and consumers, but I rarely see big vendors participating unless it’s incognito to get new ideas. Providers are increasingly becoming part of IDNs and ACOs that use those large vendors and their non-open, non-easily integrated systems. Will consumer-based healthcare IT and their innovators suffer against these big vendors and providers?” My cynicism is predictable, but I’ve always said that these conferences and their self-selecting, charged-up evangelists are buying the illusion that patient empowerment is increasing when it’s really not. Few examples exist where customers have convinced big businesses to change their ways, especially when those changes threaten their profits, and I can’t think of even one where it happened when those customers had little buying power discretion and in fact aren’t even paying with their own money. It’s going to take a lot more than some feel-good conferences attended by the same familiar faces and featuring demos of the latest cool app to change healthcare, if in fact it can be changed at all. Healthcare reform may end up making it worse, as the massive consolidation it has triggered means a lot more physicians are now just another cog in a faceless corporate wheel whose bargaining power just went up several notches through market-dominating mergers (Partners Healthcare, which puts on the conference you attended, is a good example of using size and brand name to command high prices). In that regard, their choice of IT systems is way down on my list of concerns.

From BK: “Re: hospice-specific EMRs. What’s a good source of information? Most seem to be focused on the in-home aspect and we’re a 50-bed inpatient unit not affiliated with any major hospital or health system.” I know the names of a few companies that offer hospice EMRs but I’m not familiar with any of them, so I’ll ask readers to jump in.

Acquisitions, Funding, Business, and Stock

Online physician communication platform vendor QuantiaMD closes a $12 million expansion round.

Hospice and home health software provider Homecare Homebase lands a $75 million senior secured credit facility to refinance debt and fund a dividend payment to shareholders.

Deloitte Consulting acquires Recombinant Data Corp., a provider of data warehousing and clinical intelligence solutions.

CommVault Systems reports Q2 results: revenue up 21 percent, EPS $0.29 vs. $0.17.

McKesson announces Q2 numbers: revenue up

Relexion Health, developer of interactive software that uses Microsoft’s Kinect system to help physical therapy patients, raises $4.25 million in seed funding.

McKesson says in its earnings conference call that Technology Solutions had flat revenue in Q2, but performed a bit better than expected. The MedVentive acquisition provides a technology asset that will bring other McKesson products together to manage populations, the company says, while its MED3OOO acquisition will allow the company to add capabilities to its market-leading revenue cycle management business. CEO John Hammergren hinted that McKesson might work with athenahealth given that a third recent McKesson acquisition, PSS World Medical, sells athenahealth’s products and appears to still hold some portion of the $96 million worth of ATHN IPO shares (at today’s price) that it acquired in 2007 and partially sold in 2008-2009. Hammergren also said that McKesson has experienced some attrition of its Horizon customers who declined to migrate to Paragon because of functionality shortfalls, but the company is on track to deliver the ambulatory capabilities Paragon users need.

Sales

The American Association of Endocrine Surgeons selects ArborMetrix to provide clinical performance analytics for its national clinical outcomes registry.

The hospital board of governors for Fulton County Hospital (MO) approves a $1 million contract for Healthland’s EMR.

Eastern Connecticut Health Network signs a multi-year agreement with MedAssets for its RCM solutions and process improvement consulting services. Also contracting with MedAssets is Sharp HealthCare, which will implement its Spend and Clinical Resource Management solutions, including group purchasing services.

Mountain States Health Alliance (TN) selects Streamline Health Solutions and its OpportunityAnyWare solution for business analytics and automated workflow.

Resurgens Orthopaedics (GA) chooses Merge Honeycomb as its patient image archiving and long-term disaster recovery solution.

The Ohio State University Wexner Medical Center chooses lifeIMAGE for medical imaging sharing.

People

InTouch Health, an acute care telemedicine provider, elects Siemens Healthcare exec John Glaser to its board.

AirStrip Technologies adds Todd Cozzens (Sequoia Capital, Picis) and Keith Pitts (Vanguard Health Systems) to its board, with Cozzens named as chairman.

CommVault Systems promotes Brian Carolan to VP/CFO. He replaces Louis Meceli, who was named SVP of finance.

The Dallas Business Journal names T-System CFO Steven J. Armond as CFO of the Year in the technology segment.

SPi Healthcare appoints Brian Mitchell (GE Healthcare) as SVP of sales.

Announcements and Implementations

The Asian Centre for Liver Diseases & Transplantation announces an agreement with UPMC to develop a transplant center in Singapore. The facilities already share medical and technological expertise, including telemedicine and EMR.

Saint Agnes Medical Center (CA) goes live on Cerner.

Document Storage Systems and GetWellNetwork bring two VA hospitals live on GetWellNetwork’s interactive patient system integrated with the VA’s VistA.

IBM partners with the Cleveland Clinic (OH) to enhance the medical knowledge of its Watson supercomputer.

Government and Politics

The Indian Health Service is building a PHR populated with data from existing IHS clinical, administrative, and billing systems.

CMS publishes the final 2014 clinical quality measures for MU reporting.

AHRQ will conduct a 14-month, $800,000 observational study at six Vanderbilt University Medical Center clinics to look at how EHRs affect workflow at various phases of implementation. The work might have had more applicability had AHRQ chosen a more typical site than Vanderbilt, which developed its own ambulatory care model and EHR.

Wells Fargo Securities has updated its list of hospital EHR attestations by vendor. Small-hospital vendors CPSI and Healthland, along with Cerner, top the list of attestations as a percentage of customers. Trailing the pack are GE Healthcare, QuadraMed, NextGen, and McKesson (interestingly, three of those four are publicly traded companies, and QuadraMed was too until it was taken private in 2009). Also interesting: we’ve talked recently about upstart RazorInsights and I see they’re right in mid-pack with 30 percent.

Innovation and Research

A study finds that whole-genome sequencing will cost the US healthcare system $25 billion annually by 2021 even with steadily dropping prices, with the virtual certainty that the cost of those tests and the patient demand for treatment of conditions they suggest will dwarf the relatively small savings they create from earlier treatment of a few specific conditions.

Other

Dale Sanders (SVP of Healthcare Quality Catalyst and also holding senior roles with The Advisory Board Company and Cayman Islands National Health System) develops a HIMSS EMRAM-type model for measuring a hospital’s analytics capabilities. The Healthcare Analytic Adoption Model, he says, is the key to delivering value from the country’s big EMR investments.

Robert Schwab, MD, chief quality officer for two Texas Health Resources hospitals, adds a new Meaningful Use-related verse to his “Go-Live Ballad,” recorded live at the National CXO Summit last week in Dallas.

Cerner CEO Neal Patterson and his wife celebrate his company’s record quarter by buying the $100,000 grand champion market steer at the Junior Premium Livestock Auction in Kansas City.

A Colorado hospital’s lawsuit claims that it hired WebMD Health to evaluate its wellness programs, only to find that the company used its confidential information to launch a competing service.

A Texas woman is charged with aggravated assault with a deadly weapon after striking a man in the eye with her high-heeled shoe in a fight among 17 female employees of the Hot Body strip club. The man may lose his eye; the deadly weapon’s condition is unknown.

Sponsor Updates

• Steven Waldren, MD MS, director of the AAFP Center for Health, explores the HIT environment during Care360’s Nov. 14 webinar.
• Access releases case study videos featuring employees from Texas Regional Medical Center (TX) and Henry Mayo Newhall Hospital (CA).
• Billian’s HealthDATA introduces its healthcare sales and marketing portal, which includes over 3,900 data points on more than 40,000 US healthcare facilities.
• Emdeon launches its EDGE solution to detect inaccurate healthcare claims and prevent inaccurate payments.
• TELUS Health Solutions reviews the financial and strategic implications of attestation timing for Stage 2 MU in its fall newsletter.
• The Phoenix Business Journal profiles Desert Ridge Family Practice (AZ) and its effective use of NextGen’s EHR.
• InterSystems recognizes 3M Health Information Systems with its Breakthrough Applications award for the 3M 360 Encompass system.
• Kony Solutions announces that its KonyOne mobile application development platform now supports Microsoft’s Windows 8 operating system.
• CIC Advisory launches its new website.
• T-System CEO Sunny Sanyal discusses overcoding and upcoding in the ED in a guest article in a Dallas healthcare publication.

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

Monday Morning Update 10/29/12

From The PACS Designer: “Re: iPod’s 11th anniversary on November 10. The four versions of iPod are Shuffle, Nano, Classic, and Touch. While primarily a storage device for music, they can be used as a storage device for other data elements. Can there be a use in healthcare for the iPod? Let’s have some discussion on the subject.” My Touch is like an iPhone without the calling capability provided you’re in WiFi range, so I would say yes. You would think that a hospital might look at the Touch as a pager replacement for nurses for in-hospital use – it’s cheap and portable, it doesn’t require a cell contract since it works on WiFi, it comes with a camera and Facetime, and it runs most iPhone apps.

From Fertile Imagination: “Re: clinical raffles. I’m speechless that providers would turn this into a contest.” A New York in vitro fertilization clinic runs a contest offering IVF free services to contestants who submit the winning emotional or entertaining essay or video explaining why they deserve the prize. One winner was notified on the day after Labor Day in a scene worthy of a Publisher’s Clearing House commercial: a doctor carrying balloons knocked on her door. Another winner earned her prize by running in a 5K race, where each registration came with one raffle entry. CDC says 1 percent of American-born babies are conceived by IVF. A Harvard Medical School ethics professor concludes, “I think it’s a good parody of the unfair system in which important medical services are only available to those who can afford them. Nevertheless, sometimes these raffles exploit the despair of couples or their misunderstanding of statistics to extract money from them.”

From HITEsq: “Re: Craneware. Being sued by the American Hospital Association for copyright infringement regarding its unlicensed use of the UB-04 codes. My personal take: none of these codes, as codes, should be the subject of copyright, especially when they are used only for functional purposes for which they were created which the AHA helpfully explains in paragraph 7. What’s more, they go on about all the work in maintaining them. Of course, in copyright law, ‘sweat of brow’ does not make something copyrightable.”

Listening: Real Estate, gentle and summery pop music featuring jangly, liquid guitars with a lot of nice vocals and instrumental work hiding behind the obvious hooks so that you can play it repeatedly without getting tired of it.

Only one survey respondent reported that his or her PCP uses Twitter for medical purposes. New poll to your right, for providers: which sources do you find valuable when evaluating vendors? Feel free to choose more than one or check “none” of you don’t find any of them useful. Your comments are welcome as well – after you vote, you’ll see a Comments link.

I’m healthy and fortunately get few chances to evaluate healthcare IT as a patient, but my annual physical last week provided an opportunity. Thinking about it afterward, I was surprised at how many positive technology elements have crept in. I had changed my appointment online a couple of times using the practice’s online portal instead of wasting time on the telephone. I pre-paid my co-pay online and printed a barcoded itinerary. I scanned that paper at the kiosk when I arrived and didn’t need to wait in line since that checked me in. My doc pulled up the EMR screen after the usual chit-chat (the practice just switched to Epic a few months ago) and noticed my weight was the lowest in the seven years I’ve been going to him, so the EMR information allowed him to reinforce that behavior effectively. He did medication reconciliation and reviewed my history over the past year while we looked at the EMR’s screen together. My one and only maintenance med (hydrochlorothiazide, since I used to have high blood pressure) went out to the pharmacy by e-prescribing. I received an e-mail this weekend saying my lab results were available on the practice’s portal, where I could review them in printable PDF format along with a reassuring note from my doc (“Wow, these all look great!”) Also on the portal was a printable visit summary for future reference. We IT types may argue incessantly about the clinical value value of technology in care delivery, but as a patient, I’m sold on the convenience factor. Not to mention that my doctor knows exactly how to use technology to support the way he practices medicine instead of allowing it to dominate either the encounter or our relationship.

I don’t know of many hospitals that developed their own clinical systems, and the cost and torrid development pace required to keep up with Meaningful Use and changing care models have led most of those to cry uncle and replace their old stuff with commercial products. Vanderbilt is apparently hanging in there according to an article in the VUMC newsletter that says they’ve made some nursing documentation enhancements to StarChart/StarPanel, VUMC’s clinical data repository that holds electronic and scanned paper patient documentation. Vandy offsets some of the expense by licensing its creations to vendors: McKesson bought WizOrders (relabeled as the marginally successful but dying Horizon Expert Orders) and Informatics Corporation of America commercialized StarChart/StarPanel.

I’ve read several articles lately about the rapidly increasing cost of the bipartisan-supported, pseudo-socialist American government in which fewer and fewer workers subsidize those who aren’t contributing (either because they can’t or because they choose not to). I don’t always agree with George Will, but his editorial on disability payments mirrors what I’ve read elsewhere. Disability payments are now going to 8.6 million people, more than half of them claiming unprovable mood disorders or back pain. The ratio of workers to those receiving government disability checks has gone from 134:1 in 1960 to 16:1 today even as the number of physically strenuous jobs dropped significantly. The healthcare connection, according to George: “The radiating corruption of this entitlement involves the collaboration of doctors and health care professionals who certify dubious disability claims. The judicial system, too, is compromised in the process of setting disability standards that enable all this.” I’ll take a broader societal view: there’s no longer any shame or embarrassment involved in cashing the many forms of automated government checks that career politicians and indifferent bureaucrats dole out like vote-seeking lollipops, so the only thing standing between unmotivated or unprepared Americans and the government food trough is ever-dwindling personal responsibility. Check the federal deficit and entitlement spending if you want to see how that’s working for us.

Cerner shares jumped 13 percent on Friday following a good earnings report. The company said in the earnings call that its clients acquired 75 hospitals in the past 18 months, potentially expanding Cerner’s customer base with minimal effort required. They also predict an “acceleration in the displacement market” (i.e. replacements of Epic) over 5-7 years as organizations look at “the horse they bet on and make a decision to go in a different direction.” Neal Patterson dropped by at the end to say that Cerner has “reinstated a boldness around here” and declared the company to be “the most significant innovator in healthcare.”

The Detroit business paper says that Henry Ford Health System may be acquiring Beaumont Health System.

Mark Clark (Poudre Valley Health Care) is named CIO of Great Plains Regional Medical Center (NE).

Quality Systems (NextGen) announces Q2 results: revenue up 8 percent, EPS $0.26 vs. $0.35, missing consensus estimates on both. Shares closed Friday at $17.19, down 3 percent and now 60 percent off from their price in April. System sales revenue was down by 15 percent, but was partially offset by implementation revenue (warning sign: reduced sales now means less implementation revenue down the road). The usual obvious reactionary steps were announced: restructure the sales organization and consolidate development efforts (always begging the equally obvious question: if it’s such a good idea, why wasn’t it done before?)  The hospital division sold to six new hospitals, but still lost money. The company will continue paying dividends to shareholders but won’t institute a share buy-back program, saying they would rather use the money to fund possible acquisitions of several companies they’re talking to (they hinted at revenue cycle, hospital products, and ACO-type service offerings). They also say that they expect many of the 462 Stage 1 EHR vendors to fail at achieving Stage 2, leading to a big replacement market. NextGen won’t issue guidance this fiscal year, citing rapidly changing market conditions and the proxy fight it recently endured.

Here’s the five-year Quality Systems share price vs. the Nasdaq in red. QSII was on a nice run, but all that’s been wiped out to the point that performance would have been just as good buying a Nasdaq index fund (“just as good” being relative – you would have done little better than break even either way).

CPSI’s Q3 numbers: revenue up 8 percent, EPS $0.63 vs. $0.54.

A Senate investigation finds that medical device manufacturer Medtronic paid millions to surgeons who put their name as authors on journal articles that were actually written by the company’s marketing team. Medtronic paid $210 million to doctors over 15 years related to its Infuse spine surgery product, including $34 million to University of Wisconsin orthopedic surgeon Thomas Zdeblick (who is himself the editor of a medical journal, Journal of Spinal Disorders & Techniques). Medtronic hired Yale University to review Infuse and his comments don’t sound nearly as pro-Medtronic as the allegedly shilled articles: “This sounds eerily familiar to many of the transgressions we’ve read about from the pharmaceutical industry. It paints a picture of a company very heavily involved in the science; marketing contaminating the science; and the medical profession and researchers being complicit. It’s no wonder the public has lost confidence in the drug and device industries.” My question, as always: Medtronic’s annual sales are $16 billion and its market cap is $42 billion, so how big of a fine would be needed to send a clear message if indeed they’re guilty? I’m thinking $5 billion and some jail time for the scumbag executives who were involved, but that’s just me. And for that matter, why not hit some of those greedy docs with some mega-fines and maybe suspend their medical licenses for producing phony medical research? This business of Uncle Sam settling out of court with mega-corporations for a financial slap on the wrist needs to stop. Medtronic paid a measly $24 million a few months ago to get DOJ off its back over paying kickbacks to doctors and $85 million to settle shareholder suits claiming it made misleading statements about Infuse.

Another argument that paying providers for quality doesn’t really work: the rate of catheter-related infections didn’t go down when Medicare stopped paying for them. That’s great news if you’re a fan of well-intentioned incompetence.

eClinicalWorks held its user group meeting this past weekend at the Gaylord National Hotel and Convention Center in the DC area, with 4,500 attendees and keynote speakers Surgeon General Regina Benjamin, MD and former eCW customer National Coordinator Farzad Mostashari, MD (who used eClinicalWorks, Epic, and NextGen when he worked for NYC’s Department of Health).

Weird News Andy must be brewing over missing this sad story, sent over by a worthy competitor. A new student nurse in Brazil accidentally kills an 80-year-old woman by somehow hooking up her IV to a cup of coffee. She explained on national TV: “As they were next to each other, anyone can get confused. I injected the coffee and I put it in the wrong place."

The Florida office of HHS’s Office of Inspector General says that thieves are stealing claims data from companies that administer Medicare claims. Scammers prefer Medicare records because CMS has balked at the effort required to change its identifier from Social Security number like everybody else has done, which allows the thieves to file fraudulent tax returns and collect refunds since IRS, like CMS, pays first and ask questions later (or never). In other words, one federal agency’s electronic data is used to create another agency’s electronic data for larcenous purposes, like interoperability for crooks. Did you ever get the feeling that government is the only organization where the more technology it uses, the more vulnerable it becomes to fraud because of poor oversight?

Athenahealth is negotiating with Harvard University for the purchase of Arsenal on the Charles, an 11-building office campus and former US Army arsenal in Watertown, MA that includes athena’s headquarters. The company seeks 1 million square feet, while the Arsenal property, estimated to cost about $200 million, has 765,000 square feet.

Vince checks in from Europe with good news about John Sacco (founder of JS Data) and sad news about Ed Meehan (Keane/NTT Data). As always, if you have memories, photos, or ephemera from healthcare IT companies of old (from before 1990 or so, let’s say) then Vince would enjoy hearing from you, especially if you have e-mail addresses or phone numbers for some of the long-lost folks who ran them.

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

News 10/26/12

Top News

Cerner reports an 18 percent increase in Q3 revenues from a year ago, with EPS of $0.56 versus 2011’s $0.45. Net earnings grew 25 percent and the company’s $769.9 million in third quarter bookings represent an 18 percent jump over last year.

Reader Comments

  From Weird News Andy: “Re: MGMA write-ups. This is too good a post not to have a comment.” WNA is referring to one of the four updates posted to HIStalk Practice this week covering the MGMA meeting in San Antonio. If you are interested getting the scoop on the conference, check out the writeups from  Monday, Tuesday morning, Tuesday evening, and Wednesday. I covered an assortment of topics including educational sessions, exhibit hall happenings, and parties. Other publications may offer a more in-depth look at some of the specific sessions, but I bet none published a photo of mariachis with Ronald McDonald.

From Junior Birdman: “Re: MGMA. The athena rep told me that two-thirds of the demos they were doing were for current Allscripts and GE customers.” Unverified.

From Empire Statesman: “Re: Allscripts. A totally unverified rumor is that they filed the HHC protest just in case a New York-based private equity company turns out to be their buyer and can then exert local influence on HHC to change its mind. The slim hope they will prevail may also delay the market’s reaction long enough to get them sold before the decision is announced.” Unverified. Another reader’s unverified rumor is that Allscripts had a big meeting with a PE firm on Thursday.

From CIO Reader: “Re: CIOs reading HIStalk. You’ve taken a good first step in running the excellent work of Ed Marx and Bill Rieger. Perhaps include other writing from insightful and innovate CIOs and/or CMIOs?” I’m happy to do that. If you’re both interested and interesting, there’s a place for you here.

From King Biscuit: “Re: RazorInsights. I’m telling you, these guys are going to leapfrog everyone … so cool!  Best engineered software, by far.  Blows Epic and Cerner away.” Unverified, but KB is a non-anonymous expert whose name you’d instantly recognize and who has no horse in this particular race, so I respect that opinion. Some company communication I intercepted says they are #2 in KLAS (behind Epic) and #1 in the community hospitals category, with 64 hospitals in the pipeline.

From HITesq: “Re: Allscripts. You can confirm the unhappy Allscripts issue. Allscripts sued Aprima in the Northern District of Illinois.  Complaint attached. Alleges trademark infringement and unfair competition.” Allscripts demands that Aprima stop using the MyWay name in its advertising and stop insinuating that Allscripts is sunsetting the product. I’ll side with Allscripts. I’m not a lawyer like HITesq, but I assume Aprima can continue to target its advertising to MyWay customers as long as it doesn’t imply that Allscripts is forcing those customers to change and perhaps adds the common disclaimer that MyWay is an Allscripts trademark and product. Kudos, by the way, to HITesq for always finding these interesting legal nuggets from sources the rest us don’t have access to.

From AnotherOneBitesTheDust: “Re: GE. Will be sunsetting it Oracle-based Centricity product – the old Logician – after upgrading it for MU 2 next year.” Unverified. 

HIStalk Announcements and Requests

I get several e-mails each week imploring me to take advantage of the many ways I could make more money from HIStalk (recent ones: drastically raise the admittedly low sponsorship costs, rent the mailing list, make it a pay site, sell consulting services to vendors). I’ll be honest in saying that I have no plans for any of those since I do it for fun, not money, and the more it would become a real business, the less I’d like it. All I need is the satisfaction, and that’s where you come in: (a) sign up for the e-mail updates since Inga loves seeing that number increase; (b) connect with us on Facebook, Twitter, LinkedIn, and Dann’s 2,821-member HIStalk Fan Club; (c) cruise the ads of our loyal sponsors, check out their listings in the Resource Center, and shoot out your consulting RFIs to several companies at once via the RFI Blaster; (d) send us news, rumors, guest posts, or ideas of how we can help the industry and patients; and (e) tell your colleagues you read here since the only way we get new readers is via word of mouth and Google. Thank you for spending time with us.

Acquisitions, Funding, Business, and Stock

McKesson will acquire PSS World Medicine Inc. for about $2.1 billion. PSS is primarily a medical products distributor, but is also an athenahealth reseller. Analysts estimate that PSS’s athenahealth sales represent less than five percent of athena’s new customers per year.

AdvantEdge Healthcare Solutions, a provider of billing, practice management, and coding services for specialty physicians and hospitals, acquires Medrium, a Delaware-based billing and PM company.

HIT raised $194 million in VC funds from 37 deals during the third quarter, according to Mercom Capital Group.

Compuware reports fiscal year 2013 Q2 financials: revenues down 15.4 percent, net income down 53.3 percent, and EPS of $0.05 versus $0.10. Analysts were expecting $0.06/share. Compuware’s Covisint division reported a 17 percent increase in revenues from a year ago.

Sales

In Australia, Queensland Health expands its use of iMDsoft’s MetaVision ICU system by purchasing a statewide enterprise license.

University Physicians Group (NY) will implement the PatientPoint Care Coordination platform and its electronic Check-In/Check out process.

Johns Hopkins Medicine expands its relationship with MModal by rolling out its Natural Language Understanding to all facilities.

Hi-Desert Medical Center (CA) selects iDoc from CareTech Solutions for document imaging and management with Meditech’s EHR and health information management systems.

Partners Healthcare (MA) renews its contract with Omnicell for pharmacy automation.

MedVirginia signs a multi-year contract extension with Alere Wellogic, the creator of the HIE’s technology infrastructure.

The Defense Health Services Systems awards an $11 million prime contract to SAIC for support of the TRICARE Online system and expansion of Blue Button capability.

Holston Medical Group (TN/VA) selects Performance Clinical Systems and the Symphony platform for care coordination.

Queens Long Island Medical Group (NY) chooses MU Assistant from SA Ignite to automate MU reporting and enable one-click electronic attestation to CMS.

Rochester General Health System (NY) purchases Carestream Vue for Cardiology PACS.

Prime Healthcare Services (CA) selects FairWarning Patient Privacy Monitoring for privacy auditing with its Meditech system.

People

Phreesia appoints Ralph Gonzales, MD (UC San Francisco) as chief medical advisor.

Convergent Revenue Cycle Management names Mark Schanck (HBCS) SVP of sales and marketing.

David Bates, MD, the SVP for quality and safety at Brigham and Women’s Hospital, joins the EarlySense medical advisory board.

Announcements and Implementations

Family Healthcare (ND/MN) goes live with RTLS from Intelligent InSites to track patients, staff, and equipment.

Van Buren County Hospital, an affiliate of Iowa Hospital and Clinics,  goes live on Epic.

Government and Politics

OIG says in the video above that among its planned 2013 work is to “identify fraud and abuse vulnerabilities in electronic health records (EHR) systems.” I assume the HHS/OIG survey I ran earlier this week was the first step in that effort.

The VA announces plans to get its VistA system Meaningful Use certified, but says that probably won’t be completed until 2014.

CMS publishes a document containing minor corrections to the Stage 2 MU Final Rule.

Innovation and Research

KLAS finds that 70 percent of providers are using mobile devices to access clinical applications. Physicians using McKesson and Epic applications are more likely to view data on a mobile device than providers running other EMRs. Providers and healthcare organizations say their biggest concerns with mobile devices are preserving the security of patient data and managing and tracking devices.

Other

Most healthcare data breaches occur in facilities with less than 100 employees, according to a Verizon study. The majority of attacks on healthcare systems are financially motivated and target personal and payment data.

The Australian federal government terminates a $23 million contract with IBM to build the National Authentication Service for Health, citing missed deadlines and delays.

Sponsor Updates

• Informatica introduces PowerCenter Big Data Edition, which allows organizations to leverage data for advanced analytics.
• Eugene Gastroenterology Consultants (OR) selects ProVation MD for GI from Wolters Kluwer Health.
• Surgical Information Systems renews its HFMA Peer Reviewed designation for its rules-based charging product.
• Tigermed Consulting Co selects Merge eClinical’s CTMS solution to streamline clinical trial management.
• ROI is not the primary measurement used by organizations to gauge the success of their EMR systems, according to a Beacon Partners survey. The report also finds that quality management and IT departments are the ones most often responsible for EMR performance measures. Beacon also hosts a Webinar featuring a discussion of navigating unknown risk in a practice.

EPtalk by Dr. Jayne

Inga and I are back from MGMA. She is drowning in e-mails I am drowning in the sea of humanity that is a double shift in the ER. I recently started watching Doc Martin on Netflix and sometimes wish I could channel his bedside manner to those folks that think that every ER visit comes with a meal tray and a complimentary can of Sierra Mist.

Like Inga, I was underwhelmed by the lack of buzz both in the meetings and in the exhibit hall. I’m chalking it up to the fact that practices are simply beaten down. Those that have already gone to EHR have spent their available cash and are focused on optimizing what they have. It might have been a good sales opportunity for consulting groups to peddle their skills.

I only saw a handful with booths, but I did run into several consultant colleagues who were there as attendees. There were a lot of complaints about sessions being too full and one Central Business Office Director told me she was skimping on the exhibit hall to make sure she had a seat in sessions.

As you can see, Inga and I were not the only celebrities in town.

San Antonio Banderas responded to my comment about the bottles and trash I saw on the Riverwalk during my morning jog. “I have attended many conventions in San Antonio in my last career, and always referred to the Riverwalk as the Sewerwalk. And Inga said she was walking barefoot back to the hotel? Ick! Have you experienced having a snack or drink at one of the nasty riverside restaurants or bars and have the pigeons land on your table, only to shed feathers and dander all over you when you shooed them away? Ick, ick!” Luckily I haven’t had the pigeon experience, and I’m happy to relay that most of Inga’s shoeless wandering was in hotel lobbies and the occasional restaurant. As her personal physician, I do try to look after her health and welfare, offering the above cowboy-style galoshes as a potential solution.

I wanted to get a better photo of these guys and their sassy purple paisley pants, but I could never find their booth. I assume they were exhibitors rather than two friends who share a stylist. The “Cushiest Carpet” award goes to Pulse. Although they wouldn’t give Inga a pair of green sneakers, they did try to buy our love with coffee at a time when we sorely needed a pick-me-up.

We spent some time cruising the hall together. I admit that I still have to stifle a giggle every time I see my signature on the HIStalk placards. I had the chance to get to know some of our sponsors better and to hear more about the plans for the upcoming HIStalkapalooza. Let me just say it’s going to be something to remember, and based on the theme, I have the perfect wardrobe for the event.

I’m looking forward to next year’s MGMA in San Diego and hope to be joined by Bianca Biller for even better perspective. I seriously doubt, however, that I will find any pastry in the shape of California in 2013. God Bless Texas!

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

News 10/24/12

Top News

Pam McNutt, SVP/CIO of Methodist Health System of Dallas, tells me that she has received a detailed fraud survey from OIG that covers a lot of territory. She will send it over if the hospital’s legal department gives the OK, but in the mean time, she provided a summary of what’s on OIG’s mind:

• Computer-assisted coding
• HIPAA security practices related to access to the EHR, both remote and internal
• Numerous questions on practices and protections involving allowing patients and non-employees to access EHR data
• Seventeen questions about audit log capabilities and how audit logs are monitored
• Thirteen questions on clinician progress notes, whether cut/paste/copy is allowed, and how record changes are performed
• General HIPAA privacy compliance questions

OIG Survey

UPDATE: Thanks to another reader who provided a copy of the survey, which is specific to hospitals. I found Question #44 involving patient access to their EHR data to be the most interesting given that this is a fraud questionnaire. Not only is allowing patients to see information about them a good thing in general, they can be on the lookout for questionable billing for services on their behalf. Click here for larger, printable version of the survey from my original upload.

Reader Comments

From THB: “Re: Sherman Health in Chicago. I’ll bet a dollar to your favorite charity that they join Cadence since it’s an Epic shop.” Drop a buck into a Salvation Army kettle: Sherman chooses the other suitor, Advocate.

From Back from CHIME: “Re: HIStalk. As a long-time HIStalk follower, I think everyone should know about it for keeping current. Few of my peer group seem to. How can that gap be bridged?” Let’s crowdsource some reader ideas: what should I do to make HIStalk imperative CIO reading or make them more aware of its existence?

From Michael: “Re: EHRs in the NFL. I thought HIStalk would appreciate this.” Indeed I did. A New York Times article talks about NFL teams that use technology to maintain the health of their expensive biological assets (players). Among them: electronic medical records, concussion evaluation apps, sideline video replays so trainers and doctors can quickly figure out the source of a player’s injury, and iPads for viewing player X-rays. The league hopes to move all teams to a cloud-based EHR system soon so that prospects won’t need to be X-rayed by every team that’s considering their services. According to the SVP of medical services for the New York Giants, “Electronic medical records league wide would save a player from a lot of unnecessary radiation. All of this helps on so many levels from before the game to during the game to after the game. It all just makes it easier to help the players stay healthy.” ”

HIStalk Announcements and Requests

Inga and Dr. Jayne are having quite a time for themselves at MGMA, apparently. Inga’s posts (with lots of pictures since she’s determined to wave her iPhone 5 around at every opportunity) are up from Monday,  Tuesday, and Tuesday Part 2. Inga is #4 on the list of Twitter influencers using the #mgma12 hashtag, she told me proudly.

On the Jobs Board: Systems Implementation Engineer, Billing Services Manager, Database Administrator (Oracle).

Welcome to new HIStalk Platinum Sponsor Craneware. The company is all about revenue integrity: charge master management solutions, business intelligence, and revenue cycle management. I was startled to see its growth from the days long ago when my hospital signed up as an early adopter, and now I see that 25 percent of US hospitals are its customers for a variety of products: Chargemaster Toolkit,  Bill Analyzer, Physician Revenue Toolkit, InSight Medical Necessity, Patient Charge Estimator, Pricing Analyzer, and even more solutions for supply management, denials, audits, payment variance analysis, and a broad line of professional services. Thanks to Craneware for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

Health education systems vendor HealthStream acquires provider enrollment and credentialing system vendor Sy.Med Development. Both companies are located in the Nashville area. HealthStream also announces Q3 results: revenue up 28 percent, EPS $0.08 vs. $0.08. 

Perceptive Software saw a 78 percent revenue increase in Q3, according to filings by parent company Lexmark.

Vocera shares were the biggest percentage decliner on the New York Stock Exchange Friday, down 6.7 percent. They regained 2.32 percent Tuesday amidst a big market selloff, however.

Sales

Memorial Hospital (CO) will deploy SIS Analytics across its three facilities.

Beaufort Memorial Hospital (SC) selects Wolters Kluwer Health’s ProVation Order Sets.

Vanguard Health Systems (TN) will deploy AirStrip’s complete mHealth platform throughout its 28 hospitals.

Samaritan Health Services (OR) will use Passport Health’s Patient Access and Payment Certainty solutions throughout its enterprise.

Huntington Medical Foundation (CA) selects Allscripts RCM for its 50 providers to integrate with its Allscripts EMR.

HealthEast Care System (MN) chooses the Wellcentive Advance Outcomes Manager population health management solution.

Carroll County Memorial Hospital (KY) chooses OfficeEMR from iSALUS.

Announcements and Implementations

eClinicalWorks launches an all-inclusive RCM service at MGMA that includes its PM/EHR and services for 2.9 percent of monthly revenue collections.

Vitera announces Intergy Stat, a pre-configured subscription- and cloud-based PM/EHR system for independent physicians. Also announced: Vitera Intergy Mobile, an iPad app that provides mobile providers with read-only access to Vitera Intergy v8.00.

Oncology solutions vendor Prowess will incorporate tools for e-prescribing, medication adherence, and communications from DrFirst.

Government and Politics

Northern Ireland’s health minister is attending a Boston conference to urge healthcare vendors to test their products in his country, touting its single integrated health and social care system. Among the American speakers at the EU-US eHealth Markeplace are Anand Basu (ONC), David Seltz (Massachusetts governor’s office), Dave Whitlinger (New York eHealth Collaborative), Doug Fridsma (ONC), Farzad Mostashari (ONC), Joy Pritts (ONC), Judy Murphy (ONC), Katherine Luzuriaga (UMass), Laura Raimondo (UPMC Italy), and Bill Hersh (OHSU).

The VA hasn’t made much progress on encrypting its computers since a high-profile 2006 data breach, a report investigating an anonymous tip finds. The agency bought 400,000 encryption licenses for almost $6 million, but has installed the software on only 65,000 devices. The VA’s technology office says they had compatibility problems with older computers and stopped the encryption program until the computers were upgraded. The OIG report says they don’t even know if the software meets the VA’s needs and blames poor planning and project management for the outcome.

Technology

Apple announces the slightly smaller iPad mini, pricing it surprisingly high at $329 for a Wi-Fi only model. Concerns are that it still can’t compete with the $199 Kindle Fire (subsidized by the Amazon product sales it generates) or the $199 Google Nexus (sold at cost.) It could, however, take away from sales of its $499 big brother. Also announced: yet another generation of the iPad to make the one(s) you already have obsolete, thinner MacBook Pro laptops featuring the Retina display, and upgrades to the iMac and Mac Mini. Apple shares closed down 3.26 percent.

Diagnotes wins an Indiana innovation contest for its On Call program that connects hospital staff to offsite physicians who can view medical records on their smart phones and send orders back via secure messaging. The company’s CEO is Dave Wortman, who I interviewed many years ago when he was running Mezzia,  the healthcare budgeting company he formed in 1999. It was sold to VFA in 2006.

Other

A University of Wisconsin-Madison biochemistry professor whose research involves the flowering of plants is arrested after police find that the specimens in his lab are actually marijuana. My first reaction: sounds like “Breaking Bad” since I’m watching that on Netflix.

In England, a hospital blames an unspecified technical issue in apologizing to 120 breast cancer patients whose incorrect estrogen receptor biopsy results caused them to miss potentially needed hormonal therapy. The hospital is also on shaky financial ground, saying it could run out of cash in January.

An internist’s Wall Street Journal opinion piece on electronic medical records concludes:

At first I thought EMR sounded like a good idea. Then our practice started using one … checking patients into the office is an odyssey involving scanners and the collection of demographic data—their race, their preferred language, and so much more—required by Medicare to prove that we are achieving "meaningful use" of our EMR … it seems as if this is all about taking care of the chart, as opposed to taking care of the patient … With all the data entry the electronic system requires, my laptop presents a barrier between my patient and me, both physically and metaphorically. It’s hard to be both stenographer and empathetic listener at the same time.

Life Sciences Angel Network will present a November 20 conference, “Healthcare Information Technology: Change, Outlook, and Opportunity,” at Beth Israel Medical Center in New York. Investor Esther Dyson will deliver the keynote; program panelists include representatives from Aetna, Nike, Continuum Health Partners, Castlight Health, and the FDA. Registration is $120.

Medical students from Johns Hopkins University and the University of Maryland who volunteer at Baltimore Rescue Mission develop an EMR system for the free clinic using open source software. They plan to expand it to similar organizations and connect it to Maryland’s CRISP HIE. They’ve formed an organization called Networking Health.

Here’s a music video from the recent CHIME conference. I recognize quite a few of the stars.

Sponsor Updates

• Imprivata announces the agenda of its first annual user conference in Boston.
• Gartner positions Informatica in the leaders quadrant in its 2012 Magic Quadrant for Master Data Management of Customer Data Integration report.
• GetWellNetwork experiences a 125 percent growth surge year over year as patient engagement becomes an imperative component for MU reimbursements.
• First Databank releases its enhanced drug knowledge to support interoperable medication management.
• Iatric Systems receives ONC-ATCB 2011/2012 Certification for its PtAccess V1.0.11.
• QlikView expands its mobile access with QlikView for iOS, available for the iPad.
• NextGate signs 15 new clients during its third quarter for its EMPI and Provider Registry solutions.
• Park Place International introduces its Sustaining Healthcare IT blog to assist Meditech hospitals in achieving sustainability.
• Anesthesia Healthcare Partners chooses to McKesson Revenue Management Services for 30 locations across eight states.
• AdvancedMD releases its survey results at MGMA indicating that only 26 percent of physicians feel they are in control of their finances, while more than half expect their patient load to increase because of the Affordable Care Act.

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

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.