News 2/1/12

Top News

McKesson reports Q3 numbers: revenue up 9% to $31 billion, EPS $1.20 vs. $0.60, beating estimates. The company announced that it will buy back an additional $650 million worth of its stock. Shares rose 4% on Tuesday, making MCK the third-best performing S&P 500 stock of the day. Technology Solutions revenue was up 4% with an operating profit of $69 million, although the company took a $42 million pre-tax charge against the termination of development on Horizon Enterprise Revenue Management and the move to Paragon as its go-forward platform. From the conference call:

• The company reiterated that it has no plans to sunset Horizon Clinicals, but also made it clear that customers will probably either choose to move to Paragon at some point or switch vendors.
• McKesson paid $6 million in severance related to the shutdown of HERM.
• The company talked up its payer and transaction businesses (like RelayHealth) in a manner that suggests it likes the steady, predictable revenue they generate compared to the sales-driven revenue swings of the software business.
• The company admitted that “as you know, we’ve had some challenges with the Horizon Clinical implementations.”
• My overall impression is that the company is being fairly open in describing its challenges with HERM and Horizon Clinicals, although in the last couple of quarterly calls they were quite upbeat about both. Publicly traded companies aren’t very good about warning investors of potential bumps in the road.

Reader Comments

From Baystatehockey: “Re: Mark Gorrell, VP/CIO of Baystate Health. Gone and replaced by Heather Nelson as interim CIO.” I think I can safely call this rumor verified based on Mark’s exuberant and obviously recently updated LinkedIn job title, which is darned cool. Here’s his blog with sailing photos and some really interesting thoughts about pursuing something he and his family always wanted to do, even though he says he’s risk-averse and prone to motion sickness.

From Duxelles: “Re: IBM. To acquire [publicly traded vendor name omitted] – any truth to this?” I haven’t heard anything and it doesn’t seem likely. Then again, neither did the rumor at HIMSS time awhile back about this company that turned out to be true, which made me glad that I at least mentioned so I didn’t look clueless. It is likely that quite a few big announcements of various flavors are being embargoed by several companies until the HIMSS conference, so I’m sure we’ll have lots to talk about in three weeks.

From Amish Boy: “Re: Epic’s support teams. At my previous hospital, I got to know our application’s assigned support person very well. I’ve worked with Cerner for years and they don’t have the same personal attachment. We used to joke that Cerner’s Immediate Response Center number was busy because the middle school bus hadn’t dropped the IRC employees off at Cerner HQ yet.”

From Bill Rieger: “Re: Flagler Hospital, St. Augustine, FL. Kicked off its Meditech to Allscripts SCM transition at a well-attended campus event. The IS department broke out in flash mob just before the CIO spoke about how hard it would be to tear down the walls of poor processes that have been built up over the years. We are engaged and involved and want to be dancing when we go live in June 2013.” Bill  is CIO at Flagler Hospital. Nice video.

From The PACS Designer: “Re: FuelBand. A new mobile application from Nike that is worn on the wrist and can track your daily activity with an accelerometer. It tracks calories expended, steps taken, and the time of day, as well as your NikeFuel score viewable on an LED display. Your score is based on an algorithm that assigns points to various movements.”

From BuffaloWings: “Re: Sandlot and Santa Rosa Consulting. To merge?” Santa Rosa already was a partial owner of the HIE technology vendor Sandlot (the other owner is a Texas physician group). I haven’t heard if they are taking that relationship further.

HIStalk Announcements and Requests

Mr. H and I were commiserating last night about our pre-HIMSS overwhelmed-ness. The last few days I have been working on the HIStalk Guide to HIMSS12, which includes an overview of what our sponsors will be featuring this year. We are also including contact information for at least a dozen sponsors who are not exhibiting, but that are available for one-on-one meetings with attendees. Look for the Guide to be published the week before HIMSS. Sponsors, make sure to send your information.

If you are attending HIMSS, you only have about 20 more days to prep. It’s not too soon to go through your old shoes (including your kids’ old shoes) to bring for our Soles4Souls shoe drive. We will have drop-off boxes on the exhibit floor at the DrFirst booth (5456) and possibly one other location. We’ll also accept donations at HIStalkapalooza for those who received invitations (with a free IngaTini for every pair you donate.)

We like highlighting cool vendor events at HIMSS since readers are always looking for fun stuff to do there. Here’s one: CSI Healthcare IT is offering cocktails and dinner at the Canaletto Ristorante at the Venetian on Wednesday evening (February 22) from 6:30 until 9:30. It’s invitation-only and you can RSVP by e-mail.

Speaking of HIMSS events, ours is full. We have a lot of friends and loyal readers, and if we had endless space and money, we would happily invite every one of them to the ESD-powered HIStalkpalooza. Since we don’t, we have no choice but to turn down requests, even for invitees who want to bring a guest (I’d estimate that we have close to 1,000 people who want to come that we don’t have room for.) Maybe next time I should also run a secondary event that’s cheaper to produce so that lots and lots of folks could come as a backup event, like renting some big New Orleans field, hiring a band, setting out pallets full of beer and wine, and passing out hot dogs and marshmallows to roast over a bonfire. That’s my kind of networking event.

Your honey-do list from Inga: (a) search our sponsors in the Resource Center; (b) take five minutes to get your consulting RFI request in front of several companies at once with the RFI Blaster; (c) click on some sponsor ads just to see where you end up; and (d) send us rumors and cool stuff. And while Inga, Dr. Jayne, and I don’t want you to feel like a number, you are, in a good way that we appreciate: one of almost 5 million HIStalk visitors since 2003 and over 110,000 this month; one of 7,861 subscribers to our e-mail updates; one of the 2,165 members of the HIStalk Fan Club that Dann started; or one of our LinkedIn connections or Facebook friends. Unlike HIStalkapalooza, those numbers can scale infinitely, so feel free to increase them. Sometimes we screw up in running an erroneous rumor or being slow in responding to e-mails, but one thing we never do is take readers and sponsors for granted, so thank you for being part of what we do.

On the sponsor-only Job Board: NextGen Training Coordinator, Epic Go-Live Support, Cerner Go-Live Support. On Healthcare IT Jobs: Senior Technical Advisory Consultant, Epic Certified Clinical Analysts, Epic Hospital Billing.

Welcome to new HIStalk Platinum Sponsor Lifepoint Informatics, which offers vendor-neutral data integration solutions, with an emphasis on lab outreach. Its EMRHub  provides fast, easy LIS-to-EMR connectivity (Web-based middleware with only one LIS interface required) for hospitals and any type of labs interested in strengthening physician relationships, developing new revenue streams, and earning Meaningful Use incentives. Its LPI CPOE ensures clean, valid CPOE lab/rad orders that meet medical necessity and ABN requirements. Its LPI Web Provider Portal is a cost-effective way to deliver a complete patient picture to providers, providing a unified clinical inbox, flowcharts, and reports using information from systems such as clinical labs, pathology, micro, AP, cyto, and cardiology via any Web browser, helping hospitals, labs, and groups meet the IT needs of their clients. The company just landed a big deal in providing Sparrow Laboratories, one of the country’s top outreach labs with 15 labs in Michigan, with solutions to extend its reach to current and potential customers. Other customers include Indiana University Health, Continuum Health Partners, Memorial Hermann, and New York-Presbyterian. Drop by Booth 153 at HIMSS for two reasons: (a) to see their tools in action, and (b) to get one step closer to bringing home an iPad 2 in the soon-to-be-announced HIStalk Booth Crawl, of which the company is a sponsor. Thanks to Lifepoint Informatics for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

IT professional services firm NTT DATA Americas announces that its Keane, Intelligroup, MISI Company, The Revere Group, Vertex, and Agile Net organizations will start doing business under the NTT DATA brand.

ADP acquires small-practice revenue cycle management company PhyLogic Healthcare of Springfield, MA and will offer its outsourced billing services to its ADP AdvancedMD customers.

Greenway Medical goes public Thursday, with its $80 million IPO providing a market cap of $330 million.

Sales

BCBS of Kansas City selects InterComponentWare to implement a master patient index to address demands for aggregated patient data in the HIE environment.

Shriners Hospitals for Children selects the MedeAnalytics Clinical Performance Manager solution.

Oswego Hospital (NY) contracts for Wolters Kluwer Health’s ProVation Order Sets.

Acadia Healthcare (TN) selects Healthcare Management Systems Inc.’s (HMS) financial applications for its 25+ facilities.

Banner Health contracts with MEDSEEK solution to deploy its patient, physician, consumer, and employee engagement platform.

Riverside Medical Group (VA) licenses Streamline Health’s physician workflow management solution to manage A/R and denials.

People

PwC US hires Andrew Kemmeling, formerly with Phoenix Health Systems, as a partner in its enterprise resource planning and business transformation practice.

Providence Health & Services, Southern California promotes Elizabeth Petrich-Kennedy to chief nursing informatics officer.

Former CSC and First Consulting CMO David Classen joins patient safety solutions vendor Pascal Metrics as CMIO. Former TheraDoc CEO Stanley Pestotnik also joins the company as a senior advisor.

PerfectServe hires former Krames Healthcare sales executive Michelle Piel as a VP of sales.

iSirona promotes Mary Carr, RN, BSN, CPN to Chief Nursing Officer.

Quantros promotes Gerard Livaudais MD, MPH to chief medical officer and SVP of content and product management.

Alerting vendor Extension hires Tom Berger RN as chief nursing officer. He was previously with Vocera.

Announcements and Implementations

Resource Anesthesia deploys the Shareable Ink Anesthesia Suite across multiple states and facilities.

KishHealth System (IL) implements the Pharmacy Xpert clinical surveillance and intervention solution from Thomson Reuters.

CynergisTek releases Surveyor for Business Associates, a risk management solution for demonstrating HIPAA/HITECH compliance.

The US Patent and Trademark office awards Medicity a patent for locating, indexing, matching, and sharing patient records among healthcare organizations. It’s the company’s third patent issued in two years.

Macadamian will launch its Usability Maturity self-assessment checklist at the HIMSS conference, building on previous work that found that easier-to-use EHRs increase productivity, decrease errors, and provide cognitive support to users.

DrFirst launches its EHR Advisor online tool to help physicians find a solution from those offered by the company’s partners.

HealthStream and Laerdal Medical, through their SimVentures collaboration, offer SimManager, a SaaS-based system for managing simulation-based healthcare training.

Government and Politics

In a Congressional subcommittee hearing, a VA official says its new paperless claims processing system will help reduce the department’s claims backlog and take out months of processing. The current number of pending VA claims is over 854,000, which is 100,000 more than a year ago and 500,000 more than three years ago.

A Congressional Budget Office report predicts that the cost of government healthcare programs will more than double over the next 10 years to $1.8 trillion, or about 7% of the nation’s economy. It predicts that Medicare spending will increase by 90%.

The COO of the West Virginia Health Network is named by a legislative auditor as being one of several retired public employees who are exploiting a loophole that allows them to collect both a pension and  paycheck at the same time.

Conservative group Judicial Watch calls on Newt Gingrich to release the full client list of his Center for Health Transformation.

Innovation and Research

Oracle Health Sciences Institute announces its first group of research projects, including a Brigham and Women’s/Harvard study that will use EMR and claims data to analyze treatment alternatives and a University of Maryland project to visualize longitudinal EMR and claims data to detect adverse events.

Other

The Robert H. Smith School of Business at the University of Maryland announces the “Innovate 4 Healthcare Challenge,” a nationwide contest for college students to develop HIT tools to improve patient engagement with healthcare providers. The challenge is supported by ONC and includes $30,000 in prize money.

I was amused to read that people  lie more when texting than when communicating by other methods, including video chat. I wonder if that carries over to clinical interactions, since I’ve only had one text conversation with a physician and I think we were both pretty honest. However, I’m now wondering  about the text from an old boyfriend who said he couldn’t meet for dinner because he was moving to South America.

Someday there will be a Steve Jobs of the EMR world who will come along and produce a system that listens in on my office visit with the patient, uses voice recognition and AI to produce an extremely accurate summary of the discussion, and schedules all necessary tests and medications based on what I explain to the patient—all without me having to even interact with a computer keyboard.  The note will be instantly dispersed to the patient and all other caregivers.  The program will suggest any useful therapies that I may have missed and provide educational resources to the patient based on the subjects discussed.  And, of course, it’ll hit all the high points needed by the coders and Medicare overlords. When this happens it’ll put every other EMR out of business; because, finally, we’ll have a system that actually helps us rather than hampers us.

A California hospital is fined $100K after a nurse in its long-term care unit replaces a comatose woman’s breathing tube, but forgets to remove the cap, suffocating the 81-year-old woman.

Six employees of the Food and Drug Administration who tipped off Congress about what they claim was the agency’s corrupt push to approve unsafe medical devices file a complaint against their employer, saying that FDA violated whistleblower protections by intercepting their personal e-mails and installing spyware on their PCs.

Sponsor Updates

• Kareo announces the opening of its Indianapolis office and its plans to add 50 new sales and customer service positions.
• Practice Fusion hires Jonathan Malek as SVP of technology and John Hluboky as VP of technical operations.
• OptumInsight announces that its HIE and computer-assisted coding solutions achieved the highest industry standards for interoperability at the IHE North American Connectathon.
• T-System launches Care Continuity, a Web-based patient referrals tool.
• The 37-provider Mendelson/Kornblum Orthopedic and Spine Surgeons (MI) selects the SRS EHR.
• Concerro hosts a webinar on disaster preparedness and emergency management.
• Hayes Management Consulting offers an EMR optimization webinar.
• A PatientKeeper survey finds that preparation for the ICD-10 transition is the highest priority of finance professionals in healthcare provider organizations.
• Allscripts facilitates a meeting with Surgeon General Regina Benjamin MD and 20 North Carolina business leaders.
• Altoona Regional Health System (PA) selects Access Intelligent Forms Suite for its three locations.
• Merge Healthcare adds six practices to its Merge OrthoEMR client base. 

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

Monday Morning Update 1/30/12

From You Know Who: “Re: RelayHealth. Jim Bodenbender out, announced abruptly on phone call. Jeff Felton, who ran the RelayHealth Pharmacy group and was a transplant from McKesson San Francisco, is taking over the entire division.” That appears to be true from the company’s management team page, on which Jeff Felton (above) is now listed as president.

From RAC Frustration: “Re: electronic RAC responses. I see that Medical Electronic Attachment (MEA) has become the latest company to be certified by CMS. I am curious how many HIStalk readers will use the esMD (electronic submission of medical documentation) for RAC and MAC responses?” MEA’s progam uses an NHIN gateway to send electronic responses to CMS’s post-payment audit requests of several flavors (RAC, MAC, CERT, PERM, and ZPIC.) I’m interested in how much transaction volume the average hospital will experience to keep CMS happy once esMD Phase 2 goes live in October and all documentation requests will be sent electronically. Comments welcome.

Surely the calendar is playing a cruel joke: it can’t be just three weeks until the HIMSS conference, can it?

My Time Capsule editorial this week from five years ago: Want Physicians to Use Systems? Standardize Screens Like You Do Back-End Databases. A free sample: “Hospitals never seem to get how illogical it is to physicians that every hospital buys a different system, but expects community-based doctors who cruise in for an hour a day to master all of them without burning up more hours of their self-employed day. They seem puzzled when doctors jeer at their zealous requests to bone up on Cerner when he or she is fuming at Eclipsys across town and McKesson at the university hospital.”

Listening: reader-recommend James, which I would characterize as jangly Britpop with strong vocals. They (it’s a band,  not a guy) remind me of the Smiths. They aren’t totally obscure, having sold 25 million albums in their 30 years. They probably would sell more if they had a more search engine friendly name, although come to think of it, that’s another similarity between them and the Smiths. 

A lot of money and effort is spent putting on the exhibit and educational tracks of HIMSS, but that’s just to provide the backdrop for the real reason people attend: to connect with folks for business and pleasure, two-thirds of respondents said. New poll to your right, as suggested by a reader: what reaction do you have when you hear that a vendor uses offshore programming resources?

Thanks to CSI Healthcare IT, supporting HIStalk as a Platinum Sponsor. The company is a leading national provider of IT and training professionals, both contract and permanent. The company’s team of 75 recruiters can often find local qualified resources, minimizing billable travel expenses to the client. Its pricing model has saved health system customers such as Sutter, Baylor, Texas Health, Clarian, and Sentara up to 60%. The company is vendor neutral, providing resources for projects involving McKesson, GE Healthcare, Allscripts, Epic, Cerner, Meditech, NextGen, and others. It can handle work ranging from providing a single resource to managing the projects of large health systems, also offering a specific package called Epic Community Connect that helps health systems provide Epic’s ambulatory systems to community practices (marketing, contracting, readiness assessments, implementation, and support.) Thanks to CSI Healthcare IT for supporting HIStalk.

Federal CTO Aneesh Chopra resigns and is expected to run for lieutenant governor of Virginia. You aren’t surprised if you read HIStalk on January 13, when my non-anonymous, well-placed informant chose the fantastic phony name of DeepThrowIT to tell us that Chopra was heading out. I think that might have been my first non-healthcare IT big scoop rumor.

I recently quoted some Epic facts provided by Chief Administration Officer Steve Dickmann in a recent talk he gave to a Madison group. The full video is here, from which I pulled a few more:

• The company started in a basement in 1979 doing UW psych department work.
• Epic went from 2.5 employees in 1979 to 30-40 employees in 1994, but then changed direction to focus on the electronic medical record.
• The product was changed from text-based to a graphical GUI in 1994, the same year when the database was scaled up for large enterprises.
• Epic Web came out in 1997; MyChart in 2000.
• The company gained competitive advantage from Y2K because it had minimal remediation to accomplish while its competitors had to redirect resources to work on that problem.
• Epic also gained competitive advantage from being in Wisconsin, which was an early adopter of large integrated delivery systems.
• Epic does not subcontract or acquire software; everything was developed in Wisconsin.
• The original motto was “Do good, have fun.” The “make money” part was added later.
• Epic focuses on large hospitals and clinics, children’s hospitals, and academic hospitals and turns away other prospects. The only exception they will make is for hospitals located in Wisconsin.
• Epic doesn’t do acquisitions because they would have to rewrite the code anyway to keep a truly integrated product.
• Competitors have 20-30% of their employees doing sales and marketing, while Epic has 1%.
• Epic’s culinary team has 70 employees and it also staffs its own horticultural team. It does not contract those functions out.
• All of Epic’s implementers fly out Monday afternoon, which ties up a good bit of the Madison airport’s capacity with 600-700 people all leaving at about the same time.
• Each customer has an assigned tech support team that knows the customer’s people and systems. The team is available 24×7.
• 91% of the HIMSS EMRAM Stage 7 hospitals use Epic.

Supporting HIStalk as a Platinum Sponsor is Versus, which offers real-time location systems for patients, staff, and equipment. Hospitals use that information to automate workflow, improve efficiency, increase patient safety, boost patient satisfaction, and increase revenue. The company provides interesting examples: (a) advancing patients to the next level of care based on events, such as completed labs or EKGs; (b) locating telemetry patients in distress wherever they are; (c) alerting the physician when patients are ready to be seen; (d) reminding staff to wash hands; and (e) alerting housekeeping to clean the room when the patient’s badge is dropped into the discharge bin. The Traverse City, MI company has been around for over 20 years, with its combined infrared/radio frequency system being endorsed by the American Hospital Association. Hospital customers have documented improvements such as cutting equipment losses from $1.5 million to $40,000 year, eliminating the need for clinic waiting rooms, reducing telephone calls by 75%, and increasing bed capacity by 25% with no construction. Interesting stats: the company has over 600 facilities using 500,000 of its components to track more than 1 million patients per year. The big announcement a few weeks back was that The Johns Hopkins Hospital chose Versus to manage staff and assets in real time for some locations after a three-year pilot of several RTLS systems, with additional deployments scheduled. Thanks to Versus for supporting HIStalk.

The Peace Corps has an RFI out for an EMR product, just in case you’d like to sell them one. They’re actually looking to have OpenEMR customized, along with Microsoft Dynamics 2011 and BizTalk for reporting.

In England, Homerton University Hospital allows its original NPfIT contract for Cerner and BT expire and signs its own seven-year extension directly with Cerner, declining to open the opportunity to other vendors because of its working relationship with the company.

The Bipartisan Policy Center releases its recommendations for using healthcare IT to improve care and reduce costs. Quite a few industry names served on the task force and provided their input. Some of its observations and recommendations:

• Even with new delivery models, the healthcare system continues to financially reward procedure and patient volume rather than better care. Recommendations: purchasers and plans should reward care that is higher quality and lower cost, incorporate those models into Medicare physician payments, expand pilots of new care models, and share lessons learned with private sector pilot projects.
• Despite a lot of HIE activity, not much patient information is actually being exchanged. Recommendations: improve the HIE business case by adding more stringent information exchange requirements to Stage 2/3 of Meaningful Use, develop long-term standards that make sense for healthcare delivery, assess the level of information exchange that is occurring, do more work related to two-way data exchange, and clarify the role of health information exchange in the several programs funded by HITECH.
• Consumer engagement with electronic tools is minimal. Recommendations: raise public awareness, help providers engage their patients to use technology, improve the usability of consumer tools and provide easy data import/export for consumer-facing applications, launch an awards program for consumer tools outcomes, share lessons learned, ramp up Meaningful Use requirements to include more consumer tools, and offer incentives to chronic disease patients to use electronic tools to manage their health.
• EHR and Meaningful use adoption is still low. Recommendations: raise awareness of incentive programs and expand RECs and similar programs, clarify Meaningful Use requirements, roll out lessons learned form federal programs to the whole industry and not just government contractors, encourage sharing of best practices, and improve EHR usability.
• Consumers are worried about privacy and security. Recommendations: require all entities that use PHI to comply with policies at least as stringent as HIPAA, clarify government guidance across agencies, development a national strategy for patient identification (a national ID was not specifically mentioned), and issue common sense security practices to providers.

I’ve previously mentioned the MIAA EHR mobile viewer app developed by a three-person Palomar Pomerado Health development team for its own use with its Cerner systems. A preview at a Toronto mobile healthcare conference generates interest, with the app going to pilot in March. The hospital hopes to commercialize it. Said a Canadian hospital IT director at the conference, “We need to look seriously at how a publicly-funded hospital in the States has been able to advance their technology like this when we seem to stumble on things like policy and rules.”

The Pennsylvania Health Department finds that nurses at St. Luke’s Hospital overdosed three patients in the past two years by incorrectly programming their PCA pumps. Hospital employees said the hospital did not require training on the devices.

An article covering successful businesses that did not use outside financing provides an example in eClinicalWorks CEO and co-founder Girish Kumar Navani, quoting him:

I don’t foresee leaving the company for at least 10 years. I would like to leave it a private company with no external investors and absolutely no thoughts whatsoever about Wall Street. I am having fun and take great pride in my freedom. There is no reason I would give that up. We are a cash flow positive company. We have recurring revenues and no debt. We have a large customer base that is growing exponentially.

Compuware says it will take its Covisint subsidiary public in its next fiscal year, which starts in April. Covisint, which has $74 million in annual revenue, offers an exchange platform that connects hospitals and practices, including services for identity management, collaboration, master patient index, and record location.

Vince’s latest HIS-tory: Part 2 of Health Micro Data Systems.

A column in The Atlantic revisits a 1995 article it published about Newt Gingrich, saying that some of his goofy, overly dramatic “we are at a crossroads” ideas (like colonizing the moon) prove that he can’t separate something that sounds cool if given little thought from pushing the government into spending huge amounts of money just to find out how cool it is or isn’t, even though the free market is better equipped to make that call. Healthcare technology was mentioned in that 1995 article:

Gingrich also thinks health care technology is cool. Serious students of this subject worry that insurance insulates patients from the cost of technology, thus yielding lots of high-cost, low-benefit use and in turn steering too much of society’s resources to the further development of such machinery. But Gingrich wants more. In 1984 he wanted more cat-scan machines, and he wanted the government to provide a $100 million incentive for the development of user-friendly dialysis machines–even though "there are already companies and researchers interested in this problem." The point here isn’t that Gingrich will now waste tons on technology. The current political climate will restrain this tendency. The point is that–in case you hadn’t noticed–there is little careful thought underpinning his enthusiasms, nothing solid beneath his unshakable self-assurance and his intense disdain for disagreement.

E-mail Mr. H.

More news: HIStalk Practice, HIStalk Mobile.

News 1/27/12

Top News

CPSI announces Q4 numbers: revenue down 2%, EPS $0.59 vs. $0.61, raising questions about the state of the hospital clinical systems market.

Reader Comments

From Vegas Question: “Re: HIStalkapalooza invitations. Will the e-mail come from your usual address or a new one? My spam folder is pretty large and I don’t want to miss it.” Invitations and regrets will be sent from histalkapalooza@contactESD.com this week. The walk-up plan will be described for those we couldn’t invite because of capacity. Check at the registration table at 8:00 and if we have room due to no-shows, we’ll let more folks in.

From Rick: “Re: GE Healthcare. Restructuring of its IT division continued Tuesday with an announcement that it will terminate the Centricity Advance hosted EMR/PM solution immediately. Customers will have to make arrangements to move their data out of the cloud before the system is taken offline. All development in its Hospital and Large Practice division has been halted and products placed in maintenance-only mode, including Centricity Business revenue cycle solution. The Centricity EMR product will be sunset with no Version 10 release, replaced by the Centricity Practice Solutions combined EMR/PM system.” I asked GE Healthcare for a response Tuesday evening and agreed not to run the rumor then since the spokesperson indicated that it contained inaccuracies. Here are the main points from GE Healthcare:

• The company will shut down its hosted PM/EMR solution Centricity Advance (the former MedPlexus product that GE Healthcare acquired in March 2010) on June 30, 2012.
• The decision was made because of market overlap between the Centricity Advance product and Centricity Practice Solution.
• Customers can retrieve their data in read-only form until December 31, 2012.
• Customers will be offered an upgrade to the Centricity Practice Solution PM/EMR, with data migration, training, and implementation costs covered by GE.
• The company will eliminate an unspecified number of jobs related to the announcement.
• The Centricity Business revenue cycle product is unaffected by the announcement.

From Expat Consultant: “Re: Dubai Health Authority embezzlement. These people own the company representing Epic in the current bid for DHA business.” Two men are charged with embezzling $250K from a company providing services to the DHA.

From Rebecca: “Re: HIMSS presenters. Have you thought about listing sessions that will be presented by HIStalk’s loyal followers and contributors? You have so many followers attending and it would be nice to encourage them to attend educational sessions.” I’m a sucker for doing good deeds even though I’m already overwhelmed, so if you’re speaking at a session that’s on the regular HIMSS educational track (not in the exhibitor’s theater, on the show floor, etc.) you can enter your information here and I’ll try to put out a list.

From Ileus: “Re: links to HIStalk Practice and HIStalk Mobile. I can never find them. Why not put them at the top of the page?” That’s a good idea that we’ll take one step further by placing tiny links at the bottom of each news post, starting today. That way, readers using mobile devices and RSS feeds can click them. I hadn’t thought about the ease of finding the links, to be honest.

HIStalk Announcements and Requests

Highlights from this week’s HIStalk Practice: eClinicalWorks CEO Girish Navani highlights his company’s 2011 achievements and 2012 goals. SBA loans to doctors have surged in the last 10 years. Seven states have still not initiated Medicaid EHR incentive programs.  Julie McGovern of Practice Wise discusses New Year’s resolutions, vendor relationships, and setting realistic and appropriate expectations.  The ever-irreverent Dr. Joel Diamond explains the history of ICD-10 (it’s a must read.) Actually, I think everything on HIStalk Practice is a must read, so make sure you are signed up for e-mail updates.

On the Jobs Board: Senior Product Manager of Healthcare Solutions, SCM Go-Live Support, Epic Credentialed Trainers. On Healthcare IT Jobs: Director of Technical Operations, Allscripts Application Analyst, IT Director and IT Leader.

Inga, Dr. Jayne, and I do our HIStalk work in a bubble of lonely anonymity, so we always enjoy connecting with readers, even if only by electronic means. We enjoy seeing the names of the 2,128 folks who have signed up for Dann’s LinkedIn-based HIStalk Fan Club, which is almost four years old now (hello to the new folks there from Citizens Memorial Healthcare, American College of Cardiology, McKesson, Cornerstone Advisors, Vitera Healthcare, DrFirst, Medibis, Medicity, GE Healthcare, and Lehigh University). We accept all friend/connection requests from Facebook and LinkedIn, connecting you to a pretty big web of people that might come in handy someday. We like it when you send us news and rumors, subscribe to the e-mail list, click the ads of our sponsors, and use the Resource Guide and Consulting RFI Blaster. And of course thanks for reading, and thank goodness you do since we would be wasting our time here otherwise.

I forgot to give a proper introduction and welcome to Dr. Rick, whose first EHR Design Talk has earned a great response from the Twitterverse and from reader comments. He chose where to start his series, but you get to decide where it goes from there through your interaction with him. You will no doubt appreciate his active (and sometimes almost immediate) response to your comments, indicating his keen interest in usability and your thoughts on what it means to EHR users. It takes a lot of effort to research and write posts like his, so thanks to Dr. Rick for sharing his time and expertise with us.

Acquisitions, Funding, Business, and Stock

drchrono closes a $2.8 million funding round. The company says 15,000 users have registered.

EHR and PM provider Image MD (formerly eHealth Made EASY) announces it has increased its invested capital from $15 million to $25 million over the last year.

Quality Systems, the parent company of NextGen, reports Q3 earnings: revenue up 23% to $112.8 million; net income up 20% to $21.1 million. The company’s $0.36 EPS missed analysts’ estimates by $0.02.

Sales

Masonicare (CT) selects the Summit Express Connect interface engine to provide interface integration between Masonicare’s MEDITECH HIS and ancillary systems.

People

Former Clinecta President Jeffrey A. Pfund joins JEMS Technology as COO.|

Brian Mitchell, formerly of GE Healthcare, joins ClearDATA Networks as vice president of sales.

M*Modal (MedQuist) promotes Michael Clark to EVP of global sales.

University of Chicago Medical Center promotes Sameer Badlani, MD from associate CMIO to CMIO.

Healthcare data analytics and consulting firm Sg2 appoints Eric Louie MD, MBA as chief medical officer.

Former Microsoft Health Solutions Group VP Peter Neupert joins venture capital firm Health Evolution Partners as an operating partner, joining former ONC head David Brailer MD.

Healthcare Data Solutions, a provider of healthcare databases and intelligence services, names Scott Thompson (InfoGroup) its CTO.

Drexel DeFord, VP/CIO of Seattle Children’s Hospital, will serve as 2012 chair of CHIME’s board of trustees.

Rick Schooler, VP/CIO of Orlando Health (FL) is named CHIME-HIMSS John E. Gall Jr. CIO of the Year.

Leigh Ann Myers RN joins PerfectServe as VP and chief clinical officer. She was previously with PatientSafe Solutions.

Announcements and Implementations

Virtua (NJ) goes live with the first phase of its enterprise-wide device infrastructure using Nuvon’s VEGA System to connect to its Picis perioperative solution.

Upstate University Hospital (NY) introduces Upstate MyChart, giving patients online access to their medical records. The hospital is part of SUNY Upstate Medical University, which is in the midst of $40 million Epic implementation.

API Healthcare announces that 20 hospitals have recently gone live with its workforce management solutions.

M*Modal Inc and Merge Healthcare partner to integrate M*Modal’s speech and natural language understanding technology into Merge solutions.

Siemens HSB CEO John Glaser and Texas Health Resources SVP/CIO Ed Marx are among the presenters of a January 31 webinar, Can Healthcare Providers Afford to Ignore Social Media?

MedAssets announces general availability of its Access Integrity suite for front-end RCM processes.

Greenville Hospital System University Medical Center (SC) goes live on Holon’s CPOE Medication Order Management solution at all of its facilities.

Government and Politics

ONC head Farzad Mostahari MD predicts that at least 100,000 providers will receive EHR incentive payments by the end of 2012. In a blog posting that discusses his forecast for HIT in the coming year, he says:

I see 2012 as the year in which health IT truly comes of age. While much work still needs to be done, the groundwork is firmly in place for what promises to be a breakthrough year in the adoption and widespread use of health IT in ways that improve care for individuals, improve health outcomes for populations, and increase the value we get from our health care dollars.

A just-published article in The Center for Public Integrity’s iWatch News covers the special interest advocacy activities (or political influence peddling, according to rival Mitt Romney) of Newt Gingrich’s for-profit Center for Health Transformation. It lists some examples of Gingrich pitching his clients in various government hearings for projects requiring major government expenditures, among them GE Healthcare, Siemens, Allscripts, and HealthTrio. The center’s project director is mentioned as testifying that the Department of Labor should require healthcare providers to use electronic medical records, which it implies morphed into HITECH. Gingrich also appeared at a press conference in the Senate Office Building to promote a bill requiring e-prescribing, in which at least 20 of his paying clients had a financial interest.

The government says that an upgrade to Symantec’s Veritas Storage Foundation caused the significant downtime experienced by the Military Health System’s AHLTA clinical system last week.

ONC’s Office of the Chief Privacy Officer announces a project to identify best practices for mobile device privacy and security. They will convene a public roundtable in the spring.

Other

Affiliated Computer Services (ACS) officially adopts the Xerox name, two years after its acquisition by that company.

Server problems at a clinic in Canada cause month-long issues, including the inability to access patient records and the complete shutdown of the telephone system for a day.

Healthcare Growth Partners releases its latest healthcare IT industry review, covering Q4 and reviewing 2011’s activities. It’s a very well done review of macroeconomic and healthcare IT industry factors that will affect merger and acquisition activities and share performance of publicly traded companies. I really liked the chart above that describes why some companies command high revenue multiples when acquired, while others don’t. What it’s showing is that recent acquisitions aren’t following the typical trend, with more premium-priced acquisitions than usual. I would attribute to the fifth factor listed in the rightmost section – deep-pockets outsider companies are making it rain to snap up available players so they can scratch their itch to get into healthcare quickly, even if irresponsibly. Whether they’ll stay in is another question (most don’t.)

Weird News Andy declares that bacon is the new duct tape, noting a report from Michigan doctors who stopped a four-year-old girl’s platelet-related nosebleed by shoving raw bacon up her nose. One of the doctors said he got the idea from his military days, when pork was recommended as an antihemorrhagic. WNA postulates that the story was sponsored by the ThinkGeek product above.

An Oklahoma hospital that took a $500K donation from country singer Garth Brooks to build a women’s center to be named after his mother but then used the money for other projects is ordered to give Brooks his money back plus another $500K as punitive damages. The hospital argued that the gift from Brooks was originally made anonymously and without restrictions and that he was fuzzy on details about the meeting when asked later.

Sponsor Updates

• Fulcrum Methods launches its ICD-10 assessment, remediation, and program management tools.
• T-System’s T SystemEV EDIS successfully completes the highest level of interoperability tests at IHE’s Connectathon.
• Sunrise Health System (NV) becomes the first health system in Nevada to use AirStrip CARDIOLOGY.
• MEDecision’s January 31 Webinar will feature a discussion on the use of coordination solutions and EHRs to lower costs and improve care. 
• Concerro announces the keynote speakers for its April 2012 Concerro Client Conference.
• Southeast Alabama Medical Center selects PatientKeeper Mobile CPOE to compliment its McKesson HIS.
• MedAptus announces that its Professional Intelligent Charge Capture solution was named Mobile Data Systems Category Leader in KLAS’s annual report.
• Medicity validates its interoperability capabilities at the IHE North American Connectathon 2012.

EPtalk by Dr. Jayne

The media have been all over reports about physicians distracted by their electronic devices. I laughed out loud at this headline, though: Paperwork causes unintended distractions for physicians and nurses. This quick little piece on KevinMD.com is worth the read. I think sometimes we’re so aggravated by our technology that we forget what it was like before.

As a physician, I’m annoyed by lawmakers’ attempts to control how I practice or how patients care for self-limited illnesses. The recent spike in state and municipal laws that restrict purchasing of over-the-counter cold remedies is an example. Communities typically decide (often in patchwork fashion) that these will now be available only by prescription. This drives me crazy, because although I can purchase it over the counter without a prescription, if I prescribe it for a patient it is considered a controlled substance and requires the use of my DEA number and the use of special prescription paper as it cannot be electronically prescribed (at least not now in the state where I practice.)

In turn, this causes patients to spend a co-pay to come see me, plus the insurance company to fund the rest of the cost for an office visit, all so that the patient can purchase a drug that should have cost $4.99 at the local discount store. An article I recently ran across  lets us know that not only have the meth makers outsmarted the restrictions on pseudoephedrine purchase, they’re also driving up healthcare costs in unintended ways. Users have turned to small-batch techniques (the “one pot” or “shake and bake” approach) to make their own meth rather than relying on the large batches typically produced by dealers. This has caused a spike in burn patients when the experiment literally blows up in the user’s face. An Associated Press survey reports that up to a third of burn patients were injured making meth. These patients are often uninsured and their care is more costly than that of other burn patients. The ultimate cost could be in the hundreds of millions of dollars. Definitely something to think about.

Insurers are moving into the mobile health game. Aetna, WellPoint, and UnitedHealth Group are among payers who have jumped into the fray in a big way. I enjoy following HIStalk Mobile and am supportive of things that help patients get more in tune with their health care and personal wellness. I’m a bit skeptical, though, about in-car health. I’d rather encourage people to get out of their cars instead of convincing them that time sitting in them is terribly worthwhile.|

Speaking of personal fitness: for some, obesity continues to cause issues even in death. Due to the potential for decreased learning when working with obese cadavers as well as the difficulties in preparing and storing them, some medical schools are rejecting donations based on size. Scientific donation of a body is a true gift and I am grateful to those individuals and families who choose this route. I’m sad for those who want to make this gift but are unable to do so.

One of my closest friends is gridlocked with his employer over the use of the CMIO title. He’s been doing the job for years but they refuse to recognize him. It may be just a name, but to bolster his spirits I want to share some unusual executive titles. Hang in there, and remember that in your head, you can have whatever title you want. Personally, I think I’ll choose Imperatrix. Now I just need to figure out something equally important-sounding for Inga.

I’ve been trying to get into Twitter, but it seems to be conspiring against me. Since I haven’t been wasting any time tweeting, I’ve been able to continue my pre-HIMSS shoe shopping. Although I’m not eligible for the “Inga Loves My Shoes” contest, I don’t want her to think I’m a slouch, so I’ve been texting her with my finds. So far I seem to be meeting her standards, but I’m not convinced I have the perfect pair just yet.

In response to Monday’s Curbside Consult, readers are continuing to send some great suggestions. I’m looking forward to hitting some of them soon. Please keep them coming!

Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

News 1/25/12

Top News

MedQuist Holdings changes its name to M*Modal, which is the business MedQuist acquired last year for $130 million in cash. CEO Vern Davenport rang the Nasdaq opening bell to commemorate the company’s rebranding and new MODL trading symbol. The company also confirms that most of its executives will work from an office to be opened in Raleigh, NC while company headquarters will remain in Franklin, TN.

Reader Comments

From Lourde: “Re: Party attire. I finally found my shoes for the party last night. Super excited that that is off my plate!! Choosing the perfect shoe – so ‘stressful.’” I feel your pain. I will admit to no one how many pairs of shoes I have bought in the last month because I keep finding what I think are the “perfect” pair. Since we are talking shoes, it’s a good time to mention that this year’s Inga Loves My Shoes contest during HIStalkapalooza will include special shoe categories. Our judges (Lindsay Miller of RelayHealth and Timur Tugberk of DrFirst) have not yet revealed the categories, but I promise to share more soon. Meanwhile, if you are seeking fame in the overall best dressed contest, keep in mind you’ll have an opportunity to be crowned HIStalk King and HIStalk Queen, as well as Best Elvis Impersonator and Best Attire Left in Vegas. Ladies and gentleman, start your shopping.

From Party Central: “Re: invite from DIVURGENT. We are hosting our Kingpin Bowling Social event Monday night during HIMSS. It’s at 8:00 pm at the Palms Casino and Resort Kingpin Suite and we’d love HIStalk readers to join us.” Sounds fun and gives me an excuse to wear my bowling shoes! Here’s the invite and RSVP information.

From Number Cruncher: “Re: Practice Fusion. Their latest press release indicates 130,000 users. Are those all doctors?” The Practice Fusion folks tell me that about 40% (about 52,000) are physicians. I asked for clarification to understand if the 52,000 physicians were all considered “active” users, but not yet received a reply. Regardless, assuming the US has 600,000 office-based physicians, the 52,000 figure would give Practice Fusion about 8.5% of the market.

From GilaMonster: “Re: Awarepoint. Has laid off 10% of its workforce.” We asked the company, with this response from Merrie Wallace, EVP of product solutions and marketing:

Awarepoint has seen a record-setting year for sales contracts and hospital implementations in 2011. Along with its steady growth last year, Awarepoint strategically acquired Patient Care Technology Systems (PCTS) in order to become the only complete RTLS solution optimizing healthcare workflow. After the acquisition, an analysis of the workforce revealed duplicate positions and a decision was made to restructure the workforce. Around 10 positions have been consolidated, though Awarepoint continues to hire strategic positions to support growth and customer support.

From RS: “Re: Catholic Healthcare West. Just changed their name to Dignity Health.” The 40-hospital CHW also drops its Catholic Church affiliation and opens up its governing board to non-Catholics, although its 25 Catholic hospitals will retain the sponsorship of local congregations. The press release mentions the $1.8 billion it is investing in electronic health records. The organization announced plans to triple its revenue, so the change allows it to acquire and partner with hospitals without running afoul of church policies.

HIStalk Announcements and Requests

Our own Travis Good MD of HIStalk Mobile will serve as a guest speaker of a January 31 Kony Solutions webinar, Mobile Strategy for Pharma – Opportunities and Challenges.

Acquisitions, Funding, Business, and Stock

The Advisory Board expects to realize a $3.5 million gain on its recent sale of its OptiLink business to Kronos. Also, Texas Governor Rick Perry announces that his state will invest $500,000 in The Advisory Board, which plans to create more than 200 jobs and invest $8.1 million to expand its Texas operations.

Sales

Rockingham Memorial Hospital (VA) selects Amcom Software’s messaging and communications solutions.

The VA contracts with Decision Simulation’s virtual patient platform for its simulated training and education program for healthcare providers and educators.

Montrose Memorial Hospital (CO) selects PatientKeeper’s application suite.

Unity Health System (NY) chooses dbMotion’s interoperability platform for its 70 locations.

CentraCare Health System (MN) picks iSirona’s device connectivity technology to deliver patient data from its ventilators into its Epic EMR.

Cooley Dickinson Physician Hospital Organization (MA) signs a contract for MedVentive Risk Manager, which it will use to manage its new Alternative Quality Contract with BCBS.

Intermountain Healthcare chooses the mobile application development platform from Kony Solutions to develop its own apps.

The State of New York chooses First Databank and Ernst & Young to survey drug average acquisition costs, a Medicaid reimbursement benchmark authorized by the legislature in 2011.

People

GE Healthcare IT appoints Michael Jackman VP and GM of its specialty solutions business. He was previously with iSoft, Carestream Health, and Kodak.

The Huntzinger Management Group names William C. Reed VP of business development. He’s the former president and CEO of AllOne Health and CIO of Geisinger Health System and Thomas Jefferson University Hospital.

Rubbermaid Medical Solutions names Cheryl D. Parker, PhD, RN-BC, FHIMSS as its chief nursing informatics officer. She was previously with Motion Computing.

Noel Williams, CIO of HCA, announces her retirement, effective at the end of May.

M*Modal names Amy Amick as COO. She was previously GM of worldwide services for Microsoft’s Health Solutions Group.

Mediware promotes VP and Controller Robert W. Watkins to CFO.

Announcements and Implementations

Kaiser Permanente announces that its 9 million patients can access their medical information on a new, free Android app, with an iPhone version to follow in a few months. It offers appointments, secure e-mail, lab results, refills, and a facility locator, all available to both patients and their families acting on their behalf.

UPMC moves all its electronic transactions with suppliers to Toreion’s EDI exchange solution.

Isabel Healthcare and BMJ Group partner to offer Best Practice, which combines Isabel’s diagnostic tools with BMJ’s clinical content. BMJ publishes the British Medical Journal and is a wholly owned subsidiary of the British Medical Association.

Cerner chooses TrustHCS to provide its clients with ICD-10 education.

Innovation and Research

Children’s Hospital Boston offers a $25,000 prize to the researcher who develops the winning best practices for communicating the information found in a patient’s genome to physicians and patients to improve outcomes. The prize carries one of the most contrived and awkward names ever – CLARITY, which they explain stands for “Children’s Leadership Award for the Reliable Interpretation and appropriate Transmission of Your genomic information.” One of the three project leaders is Isaac Kohane MD, PhD of the Children’s Hospital Informatics program. Applications are due March 12.

Technology

Tanking BlackBerry maker Research in Motion continues its unbroken streak of questionable decisions, naming one of its two low-visibility COOs (the one in charge of the RIM’s Playbook tablet, whose sales were so bad even at $99 fire sale prices that the company had to write down $485 million) to replace its two recently department co-CEOs. The new boss says he will mostly follow the path set by his predecessors, except he will hire a chief marketing officer. Shares have dropped 80% from their February 2011 price and took another 4% hit on the CEO announcement.

Apple’s Q1 numbers: revenue up 73%, EPS $13.87 vs. $6.43, crushing estimates with the its highest-ever revenue and profit. In the quarter, the company sold 37 million iPhones (up 128%), 16 million iPads (up 111%), 5.2 million Macs (up 26%), and in the only negative news, 15.4 million iPods (down 21%). The company has $98 billion of cash in the bank. Your $10,000 investment three years ago would be worth more than $50,000 today.

Other

Medical records scanning and document management company EDCO Group will increase the number of employees in its Sioux Falls, SD facility from 40 to 70, helped out with development money from the state’s workforce commission.

Weird News Andy says this isn’t weird, just cool, even though he’ll pass on a spot on the camera recovery team. Researchers in Israel take the “pill cam” intestinal camera system to the next level by developing a version that can be steered by the magnet of an MRI machine.

In a rare public appearance by an Epic executive, COO Steve Dickman provides some company facts to a local technology group:

• 2011 sales exceeded $1.2 billion, up 45% from 2010
• The company expects to add 30 large customers this year
• Construction continues on a new 11,000 seat on-campus auditorium
• 38% of US patients are covered by an Epic product
• The company hires 1,500 new employees a year from 150,000 submitted resumes
• Only five employees work in sales, while 55% do implementation and support
• The average employee age is 29
• The company says it has no interest in buying competitors or being acquired itself

The Wall Street Journal runs a point-counterpoint article on whether the US should implement a national patient identifier. Arguing for: Michael Collins MD, chancellor of the University of Massachusetts Medical School. Arguing against: Deborah Peel MD, psychiatrist and founder of Patient Privacy Rights. Reader votes are running 59% no, 41% yes.

An Ohio hospital’s transparency policy regarding medical errors blows up in its face when the chief medical officer tells the family of a deceased knee surgery patient that his death was caused by malfunctioning lab equipment, which delayed reporting of the high serum potassium level that contributed to his heart attack. Unbeknownst to the hospital, the family had smuggled a tape recorder into the meeting and used the chief medical officer’s recorded admission as evidence in its wrongful death lawsuit against the hospital.

A Florida jury finds that an HCA-owned hospital allowed an uncredentialed surgeon to perform gastric bypass surgery on a patient who suffered brain damage. They award the patient $178 million.

Stanford University researchers find that women report feeling about 20% more pain than men for unknown reasons. Previous studies found that women are more likely to tell doctors about their pain and to delay seeking treatment for it. Here is my theory: men like to be perceived as macho, especially if they happen to be under the care of a cute nurse of the opposite sex. Meanwhile, women feel more cumulative pain between the experience of childbirth and the subsequent carrying of infants, toddlers, kids, and 40-pound bags of dog food. All that, of course, while wearing four-inch heels.

Sponsor Updates

• Humedica and West Health Policy Center announce their collaboration to identify healthcare cost drivers that can be lowered through the use of technology.
• Premier Healthcare Alliance Inc announces a group purchasing agreement with UltraLinq Healthcare Solutions.
• Ingenious Med extends its mobile offerings to Android mobile devices.
• Sparrow Laboratories uses EMRHub from Lifepoint Informatics to send lab results to provider EMRs.
• MEDecision achieves full pass certification for its interoperability tests at the 2012 IHE Connectathon.
• NextGate announces its successful testing of MatchMetrix EMPI at the IHE Connectathon 2012.
• Commonwealth Orthopaedics (VA) selects SRS for its 91 providers.
• McKesson announces an ICD-10 transition service.
• Aspen Advisors publishes a case study on its ICD-10 readiness assessment for East Jefferson General Hospital (LA).
• Jon Phillips of Healthcare Growth Partners discusses his firm’s trade show strategy for HIMSS.
• CHRISTUS Health (TX) selects Compuware’s Gomez Platform to optimize the performance and availability of its EHR.
• AT&T announces communication and infrastructure tools to allow providers to use tablets and messaging more securely.
• Over 10,000 New York State healthcare providers had enrolled in either the NYC Health Department’s NYC REACH program or the NY eHealth Collaborative by the end of 2011.
• Intelligent InSites offers a January 25 Webinar on applying RTLS visibility and lean production principles to healthcare.
• MEDSEEK announces support for the ONC’s “Putting the I in HealthIT” program, which seeks to empower patients to become partners in their own health.
• DrFirst releases a Healthcare Hero video, also offering a HIMSS conference night on the town (limo, dinner, and show) as a prize to one selected person who leaves a comment on the video’s YouTube page.

Contacts

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

Monday Morning Update 1/23/12

From KC HIT BootsOnGround: “Re: Missouri’s statewide health information network. A rumor no more … Cerner will not serve as the technical service provider. Statement attached.” Above are last April’s announcement that negotiations had commenced and Thursday’s announcement that they have ended.

From Al Faretta: “Re: Baptist Montgomery. Just wanted to let you know that our clinical system is not McKesson – it’s Cerner. Thanks for all you do – I start my morning with you!” Thanks. That eliminates McKesson’s sole entry in the Thomson Reuters Top 15 Hospitals list and boost’s Cerner’s presence there.

From Karen Thomas: “Re: Main Line Health. I wanted to clarify the systems used at Jefferson Health System, JHS. JHS is comprised of Main Line Health and Thomas Jefferson University Hospital. TJUH uses GE as their EMR. The Main Line Health System uses Siemens Soarian in four of our hospitals and Cerner in one of our hospitals. I understand that this does not change the point of the author, George, but I thought I should point out that GE is not the EMR for JHS. Also, all the Main Line Health hospitals have recently achieved HIMSS analytics Stage 6 designation.” Thanks for the clarification. Karen is VP/CIO of Main Line Health.

From PharmGuy: “Re: Prognosis Health Information Systems. The CTO, who was the brains behind the company and a co-founder, is gone.” I asked Prognosis President and CEO Ramsey Evans about Isaac Shi. He responded as follows:

Isaac is a co-founder of Prognosis and remains a significant shareholder. He has the gift to see the “big picture” and introduce innovative solutions to the marketplace. His leadership of our ChartAccess EHR has been the foundation of our rapidly growing company. As you realize, our marketplace demands a fully integrated clinical and financial solution. As a result, we’ve broadened our focus and Isaac’s responsibilities changed as our strategy has evolved. With the 2006 vision now becoming a reality and confidence in our path forward, Isaac made a decision to look at some other opportunities to expand on his vision. He remains in good standing with Prognosis and is very supportive of our company’s direction.

From Alzado: “Re: separated at birth? Being an HIT guy and a music connoisseur, I figured you would recognize the resemblance.” I do, but I’ll leave it up to readers to figure out how those categories fit this photo. Hint: two first names, both starting with J.

From Pippy: “Re: HIStalkapalooza. Have the invitations gone out yet?” Everybody who signed up will get a response by the end of the week, hopefully – either an invitation or an apology that we couldn’t invite everyone (it’s about 50-50 since we had over 1,000 requests). As much as I like hearing from readers, I respectfully request (based on experience from previous years) that folks don’t e-mail Inga or me to ask (a) what happened to their e-mail, since we can’t control your spam filters, or (b) if we can slip them an invitation even though they didn’t get one or didn’t register in the first place. I’m already overwhelmed. But here’s some good news – next year’s HIStalkapalooza in New Orleans is already somewhat underway, with a sponsor and venue secured. I’m really lucky that companies volunteer to underwrite not only the cost of putting on the event, but to manage the surprisingly complex logistics required to do it right for readers.

From The PACS Designer: “Re: Blue Button initiative. TPD was first introduced to healthcare blogging by Shahid Shah, a fellow blogger, who started HITSphere to power this whole healthcare phenomenon by highlighting HIStalk and other websites. Now, he has blogged about the VA’s Blue Button Initiative and what he sees as its key benefits. Since it is on the NHIN Watch website, you’ll have to create an account there to read his seven key positives of the project. ”

The level of HITECH payouts is about what most readers expected, although a significant minority thought it would be more. New poll to your right: what do you like best about the HIMSS conference?

My Time Capsule editorial from 2007: Crossing the Cliché Chasm: Banished HIT Words for 2007. It obviously wasn’t effective since most of 2007’s overused words are still being repeated endlessly. A snip: “Thought leaders – people smarter than you and me, at least in their own minds. Companies often present their high-ranking employees as thought leaders when they want to sell you something. Thought leaders don’t have real jobs –they just think and cling to HIMSS podia. Picture that Rodin statue wearing a suit or black turtleneck and bringing Dilbert-laced PowerPoints.”

I just noticed that with increasing readership, we’ll be close to hitting the 5 millionth HIStalk visit right around when the HIMSS conference starts. That’s since I started it, way back in June 2003. I sometimes question whether it’s worth the effort, but I still have a blast doing it every single day, as much or more than I did 8.5 years ago.

Listening: I got several outstanding recommendations from reader Cody, including one I posted here way back in 2007 that deserves a revisit: The Hives, a hard-working Swedish garage rock band that doesn’t take itself too seriously (they wear matching but ever-changing black and white costumes and use old-school corded instruments) playing real, raw rock music with a stage presence and energy that makes them probably the best live band in the world. Proof: the live versions of Tick Tick Boom or Hate to Say I Told You So, which is like a 40-years-ago Mick Jagger without the scowling. They’re playing Coachella in April and my MP3 player starting today. When it comes to music, it’s not about their look, their audience demographic, or their age – it’s about how their music makes you feel. If you can sit immobile while The Hives are playing, then we differ.

Vince’s HIS-tory this week pays tribute to Bill Corum, who passed away earlier this month. Vince will have some fun stuff upcoming – I got an e-mail from Elaine Heusing, whose enjoyed seeing a cover of the magazine her father produced, Healthcare Computing and Communications, on one of Vince’s slides. I suggested to Vince that he cover some of those publications of yesteryear and the people who put them out. Back in the day, you waited anxiously for your mail copy of the magazines (even thought most of them were 70% ads, with mostly harmless and vendor-friendly prose intended to not threaten that ratio) and even faxed copies of newsletters like H.I.S. Insider. The folks who published those magazines and newsletters were highly respected, many of them with healthcare IT experience that went above just writing about it.

Welcome to new HIStalk Platinum Sponsor First Databank. The company requires minimal introduction since its electronic drug databases power a great number of the clinical IT systems out there, but here’s a recap. The San Francisco-based FDB’s team of pharmacists, physicians, and technologists, working with its system developer customers, turn drug information into tools that reduce medication errors by empowering clinicians as they make medication-related decisions: drug information, drug selection, clinical decision support, clinical alerts, and patient education. FDB has developed the first physician-friendly CPOE drug database, the OrderView Med Knowledge Base, that gets clinicians quickly (two clicks, in many cases) to the desired medication without bogging them down with needless details related to dispensing or billing (making prescribers choose a warfarin 5 mg and a warfarin 2 mg to get the desired dose of 7 mg is lame – that’s a dispensing decision that prescribers shouldn’t have to worry about.) The company offers case studies of how developer customers have used its products: Design Clinicals (medication reconciliation), athenahealth (meet Meaningful Use requirements), DMD America (drug pricing analysis), and Personal Caregiver (consumer drug information for mobile devices). FDB, whose vision is “A World Free of Medication Errors,” has been delivering drug knowledge solutions for over 30 years and it was recently ranked #1 among drug database vendors in nearly all key indicators in the just-published KLAS report on clinical decision support. Thanks to First Databank for supporting HIStalk.

The Virgin Islands Health Department conducts an EMR and HIE town meeting with mixed results. An interventional cardiologist talks up how much he likes the EMR, but loses his computer connection while demoing it, leading another doctor in the audience to comment that lost connections are typical in her practice and that the infrastructure may not be up to the challenge. Another doc said computerization slowed them down so much that patients were waiting 2-3 hours to see a doctor and she was thinking about finding a different career purely because of the EMR.

Robert Schwab MD, chief quality officer at a couple of Texas Health hospitals, warbles The Ballad of Go-Live in recounting their Epic go-live week by week.

In England, reliably anti-NPfIT MP Richard Bacon calls for the Cerner Millennium patient scheduling system to be shut down after problems are reported by two NHS trusts. Surgeons complained that their surgery schedules listed incorrect procedures and cases that were not within their specialties. Another trust had so many problems with long call wait times and delayed appointments that they had to stop charging patients for parking.

The VA, fulfilling its data center consolidation plan, will move VistA hosting to Defense Information Systems Agency facilities operated by Verizon subsidiary Terremark Worldwide. In a related story that I missed while taking a break last weekend, the military’s AHLTA system goes down for 10 hours after an upgrade-related problem with its commercial data storage software. An unidentified source says the outage highlights the lack of Military Health System contingency plans for AHLTA, such as a failover data center.

Kronos acquires the OptiLink acuity-based staffing solution from The Advisory Board Company. Kronos will use the system to enhance its healthcare workforce management solutions, saying it will support collaborative cost management efforts between hospital finance and nursing departments.

I like this week’s e-mail from Kaiser’s George Halvorson. He’s throwing down the gauntlet on HIV treatment next week and the CMS Health Care Innovation Summit, challenging organizations to meet KP’s HIV death rate that’s less than half the national average and even 20% better than the VA. KP will also share its tools and strategies. Most interestingly, KP has eliminated HIV treatment disparities, with no outcome differences by race, with a goal of eliminating race-related differences in 16 NCQA HEDIS categories. Well done.

A belated holiday-related charity update: HEI Consulting offered a matching donation challenge to benefit Community Services League, raising $15,000 for the Jackson County, Missouri self-sufficiency organization.

Paul Beckwith, former assistant controller of clinical intelligence vendor TheraDoc (acquired by Hospira in December 2009 for $63 million,) is sentenced to 18 months in federal prison for moving $1.3 million of the company’s money to his stock trading accounts. He initially profited from trading and moved the money back monthly, but like many gamblers and speculators, started losing and got desperate to recoup his losses by betting even more. The company got almost all of its money back.

The Secretary of State of Massachusetts goes public with his spat with Meditech over a proposed construction site, saying of Founder and CEO Neil Pappalardo, “Mr. Pappalardo wants the right to do whatever he wants and not be responsible for anything — including the rights to dispose of skeletal remains if they find them.” A public hearing is scheduled for Tuesday on the construction project, which pits jobs against archaeology.

GE reports Q4 numbers: revenue down 8%, EPS $0.35 vs. $0.42. GE Healthcare reported a revenue increase of 1% to $5.16 billion, but operating income dropped by 5% to $953 million.

GE Healthcare lays off an undisclosed number of employees (“less than 50”) at its South Burlington, VT office, citing “changing market demand and technology needs” in healthcare IT.

Police in Russia investigate whether frequent power outages were responsible for the deaths of eight newborns in 10 days, all of whom were on respirators that apparently had no back-up power source.

Clinical documentation vendor MD-IT names Bard Betz as CEO, replacing former President and CEO Tom Carson. Kevin Shaughnessy is promoted to president.

A baby born 16 weeks prematurely at 9.5 ounces (considerably less than a can of soda) is discharged after a five-month stay at LA County-USC Medical Center. The hospital declined to state who is paying the estimated $500-700K cost.They’re still not sure if the baby, now at 4 pounds 11 ounces, has permanent neurological damage.

Reader James thought maybe Weird News Andy preempted him on this story, but he nailed it. A man building a shed thinks he cut himself with his nail gun, at least until he has X-rays, when doctors told him he had actually shot a nail into his brain. His response: “Did you get that out of the doctor’s joke file?” The response: “No, man, that’s in your head.” While being transported by ambulance to another hospital for surgery, he cheerfully posts his X-ray on Facebook. After surgeons successfully removed the nail and replaced a chunk of the man’s skull with titanium mesh, he said, “We need to get the Discovery Channel up here to tape this. I’m one of those medical miracles.”

E-mail Mr. H.

News 1/20/12

Top News

Minnesota’s attorney general sues revenue cycle vendor Accretive Health for losing a laptop last summer that contained patient information from two hospitals that had contracted with the company. The unencrypted laptop was stolen from an Accretive employee’s rental car. The lawsuit demands that the company inform patients in the state what information it keeps and how it uses it, saying the company “showcases its activities to Wall Street investors but hides them from Minnesota patients.”

Reader Comments

From MountainMan: “Re: Pre-HIMSS insanity. Here is a picture of the first of many to come ridiculous invitations, overnight letters, and expensive marketing crap that will be headed my way. ‘Tis the season to determine the vendors with more money in marketing than in development!”  

From WorkingGirl: “Re: Manager Systems. Love this graphic– makes me think of managers with weird heads in charge of the place. One (red) is totally defeated, head hung. The yellow head is going along to get along (the ‘whatever’ approach,) and the blue head is ‘blue sky thinking’ or ‘head in the cloud.’ I have worked for them all and more!” The logo is for Manager Consultoria em Informatica LTDA EPP, a Brazilian company recently acquired by 7 Medical Systems. The blue one actually looks like a dunce cap, which might be apropos for some managers.

From Otoscope: “Re: Epic. I hear that Epic is competing for a deal in NYC. I wonder if the puff piece in the Times about how cool their campus is and Judy Faulkner giving them a rare interview isn’t an Epic marketing push to win over some decision-makers struggling to find a reason to pay Epic’s exorbitant asking price? Maybe there’s a pattern of newspaper exposure where Epic had other high-profile deals on the table.” The article also claims that Epic steals the best programmers who would otherwise be working for Google or Facebook, which seems a bit of a stretch given Epic’s reputation for hiring new grads with no experience. I doubt many world-class programmers are torn between working with cutting edge technology for Facebook in the Silicon Valley vs. moving to chilly Wisconsin to write MUMPS just because Epic’s campus is cool (not that there’s anything wrong with that, especially if they’re doing it for the satisfaction of helping patients.) The article was a bit fawning, but it was a business feature, not a hard-hitting expose’.

From George: “Re: your question about the systems used by the Thomson Reuters Top 15 hospitals. Check this out.” It’s almost all Cerner and Meditech, with only one Epic customer in the bunch. Only a third of the Top 15 are at EMRAM Stage 6 or 7, and of those, Cerner has three customers and Meditech has two. I like to think these facts prove my oft-stated points: (a) it’s not the IT you have, but how you use it; (b) IT can make good hospitals a little bit better, but it’s not going to transform low-performing hospitals into stars; and (c) your mileage will assuredly vary, so just as buying a toupee and a flashy Corvette won’t make you as popular with young ladies as your 20-something nephew, don’t put all of your organizational eggs in the IT basket in hopes of a miracle. And to cap it off with my most annoyingly repeated tagline, plenty of incompetent carpenters own great hammers.

HIStalk Announcements and Requests

Some goodies you might have missed this week on HIStalk Practice: Greenway Medical sets the target price of shares for its upcoming IPO at $11 to $13 per share. Physicians who have an ownership interest in their practice are more likely to think their EHR implementation is difficult. Telemedicine enhances dermatology care. Upcoming Meaningful Use deadlines for eligible providers. Smaller practices may have more difficulty with the 5010 transition than their larger counterparts. Dr. Gregg explains why he isn’t satisfied with the market’s EHR options.  Thanks for reading.

We’re sponsoring something new for HIMSS conference attendees: the First Annual HIStalk Booth Crawl. We’ll be sharing more details as the conference gets closer, but here’s the big one: we will be giving away over 40 iPads generously donated by sponsors. We’ve canned the silly stamp cards, eliminated the reviled “must be present at the very end of the conference to win” restriction, and improved the chances of winning by offering dozens of cool iPads instead of one motorcycle or set of steak knives. Contestants just need to visit some booths or Web sites to be in the running for one. It will be fun, especially for the winners. It’s fun for our sponsors as well, considering that some companies have charged vendors up to $20,000 to participate in similar events and we’re charging nothing just because we like seeing readers get iPads.

Another super HIStalk-sponsored event: a shoe drive benefiting Soul4Souls, a charity dedicated to the distribution of new or gently worn shoes to people in need across the world. A couple of HIStalk sponsors will have drop off boxes in the HIMSS exhibit hall and we’ll also accept shoes at our HIStalkapalooza event (sorry, you still need an invitation.) The terrifically creative folks at Friedman Marketing Group presented the idea a few months ago and of course I fell in love with it. The curmudgeon Mr. H doubts that people will be willing to lug an extra pair of old sneakers all the way to Las Vegas to donate; however, I seek to prove him wrong. I know there are enough shoe-loving HIStalk fans that appreciate the joy of a newish pair of shoes and who would find some room in their suitcase in order to assure the world is a more joyful place. I might even wager Mr. H on this since I so sure he’s wrong.

Welcome to new HIStalk Platinum Sponsor Fulcrum Methods. The Oakland, CA company provides tools and expertise that help providers manage projects, programs, and change initiatives: work plans, guidebooks, and electronic document and worksheet templates. For hospitals or EPs interested in Meaningful Use, the company offers a structured approach and SaaS-based tools for evaluating EHR capabilities, tracking met and unmet requirements, and assessing resource needs for compliance (notable users include Lucile Packard Children’s Hospital and Maine Health, to name a couple.) It’s EP Tracker allows easy MU oversight of affiliated EPs, making sure they are ready to attest, tracking their attestation, and managing the result flow of funds. An interesting service is Pre-Attestation Compliance Services, providing a defensible, documented review that proves to potential CMS auditors that the attestation was legitimate. Other tools and services cover Program Management Office methodologies, change management, long-range planning, and vendor selection and system implementation methodologies. Good IT departments often need nothing more than proven tools, processes, and structure to boost their own proficiency and that’s what Fulcrum Methods offers. Thanks to the folks there for supporting HIStalk.

If you agree that mobile health in its various forms is important, you might want to drop by HIStalk Mobile and sign up for the e-mail updates there. Travis is really good at understanding that market and he’s not shy about saying which products he likes and which ones he doesn’t (and as a doctor and a mobile health startup guy, he’s plenty qualified to offer his opinion.) Read his latest post and I bet you’ll find at least a handful of items that are interesting and useful.

On the Jobs Board: NextGen Go-Live Support, SCM Go-Live Support, and Cerner and Epic Resources. On Healthcare IT Jobs: Implementation Consultant, Epic Willow Consultant, IT Interface Analyst, Epic Certified ASAP Builders, and Senior Applications Programmer/Analyst.

Want to support what we do and make Inga happy? Here are some ideas: (a) stick your e-mail address in the Subscribe to Updates box to your right so you get the news before everybody else, at least everybody other than the 7,800 readers who preceded you in signing up; (b) support our delusions of popularity by connecting with us on LinkedIn and Facebook; (c) while you’re on LinkedIn, sign up for the HIStalk Fan Club that Dann started long ago that now has 2,089 members – when people ask me for something, that’s the first place I look to see if they really are fans; (d) send me news, rumors, pictures, music recommendations, or anything else that might tickle my fancy; (e) peruse with ill-concealed wonderment the roster of fine companies who support HIStalk, perhaps clicking an ad or two, checking them out on the Resource Center, or using the Consulting RFI Blaster if you need consulting help; and (f) look squarely into the mirror and give a world-weary nod to the person who makes it easier for someone who’s already worked a long hospital day to come home to another five hours’ worth of HIStalk work – that would be you, thanks. 

Acquisitions, Funding, Business, and Stock

Private equity firm LLR Partners acquires Paragon Technology Group, a provider of strategy technology solutions to the public sector, including HIT. LLR appointed former Xerox and GTSI executive Scott Friedlander as president and CEO.

The healthcare merger and acquisition market generated 980 deals worth $227.4 billion last year, of which 435 involved the technology segment.

Release of information vendor HealthPort has retained Credit Suisse to find a buyer for the company, reports suggest.

UnitedHealth Group reports Q4 numbers: revenue up 7.9%, EPS $1.17 vs. $0.94, beating consensus expectations by $0.13. Its Optum unit was credited for contributing to the insurer’s $1.26 billion in quarterly profit.

Sales

Arnot Ogden Medical Center (NY) expands its relationship with Surgical Information Systems (SIS) by selecting its anesthesia module.

Nationwide Children’s Hospital (OH) renews and expands its five-year licensing agreement with Streamline Health Solutions, adding additional document management and workflow solutions.

People

HealthGrades announces that its founder and CEO Kerry R. Hicks will assume the chairmanship of the company’s board of directors. The current chairman, Roger C. Holstein, will assume the CEO role.

The Federation of American Hospitals promotes Samantha Burch from director of healthcare policy and research to VP of quality and health information technology.

CollaborateMD, a provider of PM and billing software, hires former Lockheed Martin executive Stephen Hightower as chief strategy and technology officer.

Mobile app provider Happtique names Ben Chodor CEO. He was formerly with InterCall.

Peter Longo has joined Predixion Software as global sales leader. He was previously VP of sales with Allscripts.

Netsmart Technologies hires Dennis Morrison PhD as chief clinical officer. He was previously with Centerstone Research Institute.

Announcements and Implementations

Sharon Regional Health System (PA) unveils its new $3 million, 5,000 square foot IT department that will connect to the health system’s 18 facilities.

QuadMed, which operates 22 on-site primary care clinics in 12 states for large employers, adds telemedicine to its slate of services.

Westchester Medical Center (NY) selects QuadraMed’s identity management solutions.

TELUS Health Solutions launches MyHealthReference.com, a health reference portal for Canada.

Government and Politics

The GAO reports that the National Quality Forum (NQF) failed to complete five of its eight projects promoting EHR on time. The GAO blames both NQF and HHS for “overly ambitious deadlines, given the scope and complexity of the work.”

Other

Titus Regional Medical Center (TX) fires a nurse looking at medical records she was not authorized to view. The nurse claimed she only looked at the 108 charts because she was “curious.”

The teen who made headlines last year for impersonating a doctor in a Central Florida hospital is arrested again, this time for pretending to be a police officer. The 18-year-old was driving with a sheriff’s badge, a pistol loaded with hollow-point rounds, a Taser, handcuffs, a police radio, police lights, and a dash-mounted laptop. He got caught after advising a motorist stopped at a traffic light to fasten his seatbelt, unaware that the driver was coincidentally an undercover detective.

Sponsor Updates

• Picis releases a case study profiling Winter Haven Hospital’s (FL) use of Picis ED PulseCheck to drive patient satisfaction.
• World Wide Technology Inc. ranks #50 on the Fortune 100 Best Companies to Work For list for 2012.
• Bloomberg Business profiles Digital Prospectors Corp.
• CynergisTek CEO Mac McMillan will lead several IT security discussions and workshops during next month’s HIMSS conference.
• DIVURGENT Managing Partner Colin Konschak discusses the future of healthcare and the viability of ACOs in a company blog post.
• SIS successfully demonstrates its perioperative interoperability at the IHE North American Connectathon.
• Quest Diagnostics announces a grant program to provide eligible providers with an 85% discount off the retail price of its Care 360 EHR, including fees for licensing, hosting, support, training, and implementation.
• Craig Hospital (CO) deploys Access Intelligent Forms Suite as part of its patient safety initiative.
• A Beacon Partners survey finds that most hospitals understand the value of HIEs and plan to participate in them, but the hospitals don’t have an adequate budget to participate and are concerned about HIE costs and governance issues.

EPtalk by Dr. Jayne

I’m excited to report that the pre-HIMSS advertising schmooze-fest has started. I was getting a little worried since I hadn’t seen anything yet – not even a post card. The first e-mail came from Hyland Software, which will again be at HIMSS with their OnBase Sports Bar & Grille, offering three daily happy hours. As for other exhibitors, they’re still pretty quiet. One thing is for sure though – I’m hoping that the always-delightful IngaTini will return.

The first CCHIT eNews blast of the year highlights Mr. H’s recent interview with Bobbie Byrne MD MBA, VP/CIO of Edward Hospital and a CCHIT commissioner.

American Medical News advises small practices to guard against security breaches amid concerns that basic security is taking a back seat to the focus on Meaningful Use. I’ve experienced data breaches personally: the Veteran’s Administration; my bank; and now Zappos has notified me of “illegal and unauthorized access” to my account. I’m sure they were after credit card information, but I hope they find humor in the sheer variety of shoes in my account history.

Speaking of credit card information, a recent article spotlights physician offices that require patients to provide credit card information, calling the practice “jarring.” One reader comment states:

When I sit and wait past my appointment time, I always send the doctor a bill by registered mail. I charge $100 an hour for wait time. If I have to wait a half hour, I send him a bill for $50. I have done this three times in California. Each time, they refused to pay the bill. It cost me, but I take them to small claims court. In California, no attorney can represent you — the doctor has to defend himself. They always pay the $50 or $100. They won’t take a day away from the practice to go to court. I had to find another doctor, of course. There are more doctors than attorneys. But I cured them of sucking eggs.

I hope this guy doesn’t show up in my practice. I also hope he never has an emergency medical problem or crisis that causes his physician to run late for the next patient.

E-mail of the day from the AMA: last fall, physicians had the opportunity to seek hardship exemptions and avoid penalties for failing to successfully participate in Medicare’s e-prescribing program. The Centers for Medicare & Medicaid Services (CMS) is reviewing each hardship exemption request on an individual basis and has not yet completed its analysis. Therefore, it is possible that some physicians will be subjected to a 1 percent Medicare payment penalty inappropriately until the backlog of exemption requests is reviewed. Ultimately, CMS will reprocess the claims. No mention of how long it will take or how much CMS is spending on the review.

USA Today reports that 1% of Americans are responsible for 22% of healthcare costs in 2009. Nearly half of health care spending can be attributed to just 5% of patients. The data is from the Agency for Healthcare Research and Quality, but most primary care physicians could tell you that just from gut feelings.

I was initially sad at hearing that a researcher at UConn who has published several articles on the health benefits of red wine apparently falsified his data. It’s unclear whether the data manipulations affected study outcomes. Reviewers have been combing through his research since an anonymous complaint in 2008. The list of deceptions found in the research are almost unbelievable – I’ve judged elementary science fairs with more integrity. My spirits were bolstered, however, by a recent article in the Journal of Women’s Health sharing a recent study finding that red wine has activity similar to a group of medications called aromatase inhibitors which are used to fight breast cancer. White wine drinkers take note – this is strictly an attribute of the reds.

Contacts

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

News 1/18/12

Top News

Thomson Reuters names its Top 15 Health Systems that have achieved superior clinical outcomes based on quality, patient perception of care, and efficiency. If anyone knows how many are Epic, that would be interesting given all the lofty ambitions expressed by customers trying to justify their expensive projects. Or for that matter, how many are HIMSS EMRAM Stage 6/7 since HIT cheerleaders are always trying to make the connection between HIT and outcomes.

Reader Comments

From Barefoot in Vegas: “Re: Trade show shoes. AMAZING TOPIC!!!!!!! Please send me your show list.” I love people who don’t chinch on exclamation points, so I was happy to share my shoe brand tip with Barefoot. I admit I was amazed (!!!) how many people were interested in my footwear insights. It made me feel a little like Oprah.

From Social Profiteer: “Re: pimping HIT tweets. Apparently so-called news organizations, especially those owned by HIMSS, are willing to sell out their readers.“ I can’t decide which is more interesting: (a) charging vendors $10,000 for a couple of tweets,  or (b) vendors thinking that barraging a news site’s readers with unwanted Twittermercials is actually hip, progressive marketing that will benefit those companies. It seems kind of unsavory and reader-insulting for a company with “news” in its name to be doing this kind of revenue augmentation without regard to the potential damage to whatever reputation it has, but it’s really none of my business – that’s between the publication and its readers.

From Harcourt: “Re: inpatient MU attestation. Please post this graph. I believe the huge gap between Cerner, Meditech (including its contribution of HCA’s attestation), and Epic would create interesting discussion.” The graph is here. As with EP attestation numbers, I would be cautious about trying to apply client MU figures to the likelihood of a given customer earning MU money. Meditech has more live hospitals than anyone, so I’d expect its numbers to beat those of other vendors. In fact, I’m slightly surprised that it doesn’t have a wider lead over Cerner and especially Epic (Epic’s number suggests that 50% of the hospitals it has ever sold to have attested, which I would think trounces both Cerner and Meditech if you’re calculating odds). I can’t say I’m really interested in any of this information, since any vendor with even one successfully attesting client has proven that its software has the capabilities needed. Beyond that, much of the required effort belongs to the customer.

From HITEsq: “Re: Girard Medical Center (KS). Really doesn’t like Cerner – suing them for breach of contract. Among the interesting tidbits, Cerner staff apparently though that Cerner was able to get the hospital to agree to an agreement as a result of ‘concert tickets and booze’ and that the Cerner staff was only there ‘because [they] drew the short straw.’ Apparently, Girard feels like it paid $1.3M for nothing.” The 21-bed hospital says it has paid $1.3 million of the $2.9 million total without receiving “any tangible work product” and that the time and attendance system that it thought it was getting wasn’t included (they claim Cerner helpfully suggested using an Excel worksheet instead.) The hospital also claims that Cerner assigned “incompetent staff” to implement the system. That’s all fun to read, but (a) this is one side of an argument that has two; and (b) some of the claims fall between irrelevant and desperate. There’s a good lesson here for customers: don’t let your buddy-buddy salesperson talk you out of getting an expert in contract law to insert protection into the agreement that covers whatever you are (or should be) afraid of as a customer. Once it gets to the lawsuit stage, there’s a good chance that nobody will be happy with the result except the hourly-billing lawyers.

HIStalk Announcements and Requests

Listening: reader-recommended Turisas, epic pagan battle metal from Finland, like a band of Vikings hit Kerry Livgren over the head with a mace in 1975 and took over prog band Kansas, then merged it with Green Carnation and Muse. While I acknowledge that most folks won’t like it, I definitely do. 

I’m really behind after taking some time off, just in case I seem unresponsive. I don’t think that situation will change until well into the weekend since I’ll be working all of it.

Acquisitions, Funding, Business, and Stock

7 Medical Systems, a provider of on-demand digital imaging, EMR, and RCM solutions, acquires Manager Consultoria em Informatica LTDA EPP, a Brazilian company  that offers similar services to hospitals and clinics in Brazil.

Elsevier purchases QUOSA, a provider of life sciences content management and workflow productivity solutions.

VeriTeQ Acquisition Corporation completes its acquisition of PositiveID Corporation’s VeriChip implantable microchip  and Health Link PHR.

Sales

The DOD’s Military Health System awards Planned Systems International a five-year, $96 million contract to provide code maintenance services.

Putnam County Hospital (IN) announces plans to implement CPSI.

Prevost Memorial Hospital (LA) selects CMR EDIS version 3.3 for its emergency department.

Home health provider RBA Texas selects Axxess’ Agencycore home health software.

Nashville General Hospital signs a multi-year agreement with Sectra for its integrated RIS/PAC solutions.

Baylor Health Care System (TX) adopts technology from strategicplanningMD, a provider of strategic planning software for the healthcare industry.

IASIS Healthcare LLC (TN) selects NextGen Practice Management and RCM for its 19 hospitals across seven states.

Ellenville Regional Hospital (NY) selects Healthcare Management Systems (HMS) EHR and financial applications.

The Premier Healthcare Alliance awards a contract to UltraLinq Healthcare Solutions for its Web-based imaging system.

Mercy Medical Center (IA) selects MedVentive’s Population Manager and Risk Manager products to facilitate management of its accountable care contracts.

Massachusetts General Hospital chooses Voalté’s consolidated voice, alarm, and text communication system for nursing communication.

People

Aria Health (PA) appoints Brian A. Hannah MD as CMIO.

OB fetal monitoring software vendor PeriGen names former Allscripts SVP Matthew Sappern as its CEO. He replaces Donald Deieso, who retired at the end of December to join Arsenal Capital Partners.

St. Joseph’s Hospital Health Center (NY) appoints Michael A. Spurchise director of enterprise and ambulatory systems.

Chris Caramanico joins SCI Solutions as SVP of marketing and business integration. He was previously SVP of new business enterprise applications for Allscripts.

Cornerstone Advisors names Gregg Fajkus as VP and Epic practice director. He was previously with Encore Health Resources.

Pamela Lane, formerly VP of health informatics with the California Hospital Association, is appointed deputy secretary of the health information exchange at California’s HHS.

Steven Arnold MD is named chief medical officer of surgical implant management solutions vendor MediQuip.

Announcements and Implementations

Human capital management software vendor API Healthcare announces strong growth for 2011, including the best quarter in its history.

Stockell Healthcare Systems announces GA of its InsightCS Business Intelligence Suite 2.0, which expands its revenue cycle management system with executive dashboards that include days in AR, cash receipts, collector productivity, denial rates, clean claim rates, and coder productivity.

In England, six hospital trusts say they’re saving $12 million per year by operating a telestroke program based on Polycom’s RealPresence video collaboration solution.

Misys Open Source Solutions grants exclusive Swiss distribution rights for its Misys Connect XDS registry and repository to Switzerland-based enterprise content management vendor Uptime Services AG.

Other

A data entry error creates grossly inflated bills for hundreds of Bronx-Lebanon Hospital (NY) patients. The hospital blames its billing company for inserting invoice numbers in the space designated for the amount owed.

The local paper profiles Beacom Health, one of six practices that have taken advantage of subsidies from Fremont Area Medical Center to implement eClinicalWorks.

Cerner donates $10,000 to its First Hand Foundation to celebrate hitting the 10,000-employee milestone. The company has now employs 10,062 associates, including 6,575 in the Kansas City area.

I couldn’t help think of Mr. H when I read this since I know he enjoys both his music and his exercise. Between 2010 and 2011, 47 people were killed or seriously injured while walking and wearing ear buds or headphones. I predict a few lawsuits against Apple for allowing the music to play so loud. 

Weird News Andy says he’s excited at the news that a pill may replace the need to exercise, but he’d be happy with one that helps him remember where he put his car keys.

Strange: unknown criminals steal a computer and paper records from a South Carolina doctor’s office, then drill a hold in the roof, insert a garden hose, and turn it on to run all weekend.

Commissioners of Bay County, FL discuss a settlement with chiropractic office management software vendor Redpine, which relocated to the area to take advantage of $750K in incentives and then closed its doors. The company has offered to sell its software rights to repay the incentives and claims it has several prospective buyers.

Sponsor Updates

• Health Language Inc. releases a new version of its provider-friendly terminology  to include clinician friendly synonyms and more than 100,000 attributes for ICD-10-CM.
• The Health Training Network, a service of Inland Northwest Health Services, opens a new training facility to house medical classes, including a paramedic program.
• IMDsoft reports strong growth in 2011, including first-time installations in three countries and involvement with  45 critical care and anesthesia projects.
• SCI Solutions announces HITECH certification of its Schedule Maximizer V34.
• Awarepoint reports that 10 of its newly-live customers were interviewed by KLAS, with all of them reporting high satisfaction.
• McKesson customers share keys to successfully attesting for Stage 1 Meaningful Use.
• The New Zealand Trade and Enterprise names Orion Health one of nine finalists in the “Best Business Operating Internationally” category in the New Zealand International Business Awards.
• Aspen Advisors announces that in 2011 the company grew revenue 40%, expanded its leadership team, and added 23 clients.
• ICA Informatics signs a memorandum of understanding with the New York eHealth Collaborative to join its workgroup for developing connectivity standards.
• Princeton Orthopaedic Associates (NJ) selects the SRS EHR.
• Canon and Nuance Communications successfully  complete interoperability testing of Nuance’s eCopy ShareScan v5 software for converting and passing scanned documents from Canon ImageRUNNER ADVANCE MFPs into EHR applications.

Contacts

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

Monday Morning Update 1/16/12

From Barry Goode: “Re: 5010. I’m glad to dish out all the dirt I know as a vendor. Big picture, it’s been a LOT easier and less troublesome than we expected. Most of our payers and intermediaries have been really good. Our clients have a 99+% clean claim rate. The clearinghouses have been far more troublesome than the payers as a rule, which is pathetic because it’s their primary business. A good clearinghouse having trouble with a particular payer should be able to EASILY resubmit claims in the 4010 format in order for the practices to be paid while issues are worked out. The deadline was moved! Although the clearinghouses are to blame for some of the trouble, the real culprits will soon be the state Medicaids. Some of them have yet to even indicate when they will be ready for testing.”

From Rumble: “Re: Partners. Heard they’re making that big decision by April 1. Why use that date? Push it out a day or two, jeez …” 

From HIPAA Hound: “Re: how doctors die. Here’s another article, a tad longish, but interesting. My wife and I are both of this mind, and we have our living wills/advance directives on file and our durable POAs ready if necessary. In my opinion, too much technology in the hands of the uninformed or emotionally involved (that’s not the right word, but I can’t seem to call the correct one to mind) is what runs US healthcare costs out of sight. My two cents.” I’m no expert, but Americans seem to be uniquely culturally incapable of accepting death. We’re so used to endless opportunity (at least until recently), unlimited science, and never-ending self-actualization that to just admit that your number is up never happens. It’s not just the elderly – every hospital I’ve worked in spends millions saving wildly premature babies weighing a pound or two. My conscience hasn’t resolve the question of whether that’s the best use of increasingly limited healthcare resources, especially when you look at some of the families and try to decide what that baby will be going home to after unbelievably expensive months in the NICU.

From The PACS Designer: “Re: iPhone’s 5th. It’s had to believe, but the iPhone just celebrated its 5th anniversary. When it was first released, virtually no one predicted it would dominate the marketplace and outdo other smart phones in popularity. Healthcare has always been a sweet spot for Apple products, so that’s why there’s always a place for almost every new Apple product introduction. The first iPhone was 1.16 cm thick and had a 3.5″ widescreen touchscreen display with multi-touch support, 8GB of RAM, Bluetooth, WiFi, and a 2 megapixel camera.” I couldn’t easily find the link, but an HIStalk poll I ran when the iPhone came out found that readers mostly thought it would have little influence on healthcare. As a vendor, how would you like to have a product that’s in such high demand that Chinese consumers are willing to attack humorless police and criticize their government when the local Apple store doesn’t open on time? Maybe financially irresponsible countries should consider slapping on iPhone tax like the cigarette tax, knowing that people are addicted. I floated a similar to proposal to a slightly interest audience (Mrs. H) while in the airport this weekend – revenue-happy airlines that are even charging passengers for boarding ahead of their assigned zone should charge the idiots that congregate around the boarding lane before their turn, blocking the path of those trying to board as called. You can sit for free, or obstruct for a fee.

I’ve whisked Mrs. HIStalk away for a rare long weekend as I attempt to temporarily recover from the onslaught of HIMSS-related HIStalk work (not to mention work at my hospital) that has been testing my mental and physical capabilities. I’ll keep this post brief rather than just bag it completely or dump it on Inga to write, pecking it out on my small HP laptop on modestly good hotel wireless. Your regularly scheduled verbosity will resume Tuesday evening. In the mean time, Mrs. H and I are tooling around in a really cool Mustang convertible (a rental – something I’ve always wanted to do), eating in good restaurants, working out, and relaxing. Then it’s back for the final assault before the conference.

I’m fascinated with Vince’s HIS-tory this week because he gives some rare and fun background on a couple of industry long-timers: Judy Faulkner and Frank Poggio. His series always reminds me that it’s about the people more than the companies.

Here’s my final thought on CMS’s Meaningful Use numbers. I’m pretty sure ONC’s point was to show what a great job it’s been doing in getting providers to use EHRs, and their information (not surprisingly) seems to support that. I’m not sure why they included vendor information, though. They should have known that everybody would try to over-analyze and massage the skimpy data to gain competitive advantage. That focus has actually caused many folks to miss the point that the adoption curve is moving sharply upward, which is ONC’s real job rather than feeding the competitive EHR market frenzy. As a provider, your mileage will undoubtedly vary no matter what someone else’s numbers show. And the next set of numbers will provide a much-needed data point: does adoption seem to be increasing, or has it peaked?

I was interested to hear that Adventist Health is putting Cerner in its ambulatory locations. I didn’t know that, at least according to one reader, they’re displacing Epic ambulatory. That’s how it should work, of course – the hospital system generally drives the choice of the outpatient system, not vice versa, although Epic has benefited greatly from customers who don’t find that to be an acceptable choice given their incumbent vendors. I was thinking that Loma Linda University Medical Center might be impacted since they announced an Epic inpatient decision not long ago, but I guess they aren’t part of Adventist Health like I thought I remembered.

Thanks to everyone who signed up for HIStalkapalooza invitations. The signups have been closed and invitations will be e-mailed out shortly to the folks we can accommodate (we had around 1,000 invitation requests, so unfortunately we can’t send everybody an invitation.) Thanks, too, to everyone who voted in the HISsies – I’ve closed that voting as well.

It

The economy is looking better to a good number of the folks responding to my most recent poll. New poll to your right: CMS released Meaningful Use numbers. How are attestations running compared to what you expected?

The New York Times writes up Epic in its business section. It’s not a particularly insightful or in-depth piece, but they did apparently interview Judy although the article has few quotes. It does include some interesting statistics: Epic has 260 customers, 35 of which signed on last year. Their software will cover 127 million patients next year. The company has 5,100 employees and will hire another 1,000 this year. Revenue for 2011 is expected to come in at $1.2 billion, up 45% from 2010. It also mentions a retired UW professor of psychiatry who was an original Epic investor and who sits on the company’s board, the first mention I’ve seen that the company has investors or a board. It would be interesting to know what she invested and what that investment is worth now, although obviously private company shares are illiquid, making valuation (and selling) tricky.

Cerner hits the 10,000 employee mark.

This week’s employee e-mail from Kaiser Chairman and CEO George Halvorson talks up walking, with nearly 30,000 of KP’s employees enrolled in its walking programs. KP has developed an EveryBody Walk! app to help people develop a walking plan and find walking routes.

Just in case you’re Googling for old HIStalk posts prior to 2007, they’re gone, at least temporarily. The blog service I used for HIStalk from 2003 until 2007 has gone belly-up, which isn’t surprising since it was really run more like a geek’s electronic bulletin board than a professional service, so WordPress killed it off easily (that threat and a couple of issues I had led me to abandon it years ago). I have an XML backup that can supposedly be imported into WordPress, so if I see benefit to putting the old stuff back online, I’ll hire someone to port it over. I feel some loss – I spent a ton of time and energy crafting those old posts.

Akron Children’s Hospital names Amy Maneker MD as CMIO to oversee its Epic implementation. She previously held a similar role with Rainbow Babies and Children’s Hospital in Cleveland.

Inga ran across this on Facebook. RelayHealth donates its $50,000 prize for winning the VA’s Blue Button for All Americans contest to the Wounded Warrior Project, which helps wounded service members.

E-mail Mr. H.

News 1/13/12

Top News

Adventist Health expands its affiliation with Cerner, announcing plans to implement Cerner Ambulatory EHR across its 130 clinics.

Reader Comments

From Booth Babe: “Re: HIMSS and HIStalkapalooza. Have mercy on the aching feet of worn out tradeshow floor ‘workers’ who have only minutes to spare getting from work to FUN. Do you know how often during aching feet moments we think of the upcoming party and how it drives us through each additional hour until we can cut loose and have some fun?! I would never have time to deck out as some of those fashionistas did last year, though they looked fabulous and were fun to see. Maybe you should add a category for best ‘survivor’ shoes for tradeshow performance. ” Gee, the term “survivor” shoes is right up there with the “straight from the exhibit hall” style company logo shirts. That being said, I have a couple pair of great shoes similar to the ones above that are comfy enough for the trade shoe floor, yet stylish enough for a quick transition to Vegas nightlife. E-mail me if you want details on the brand.

From ThickAndThin: “Re: McKesson. To acquire European firm MACH4 Pharma Systems?” Unverified. The England-based company sells drug packaging and preparation automation for hospital pharmacies.

From DeepThrowIT: “Re: White House CTO Aneesh Chopra. Word on the street is that he will announce in the next few weeks that he will be leaving his job. No word on where he’s going next.” He’s a young guy (39) with a lot of enthusiasm and charisma, so if the rumor is true, we’ll see whether he pursues money (running a private company) or power followed by money (running for office.)

From LeftCoaster: “Re: EDI 5010. Oregon and Washington hospitals are experiencing significant issues with transmission and receipt after mandated January 1 use, but deferred enforcement until April 1. Clearinghouse vendor [vendor name omitted] is a huge problem – they are not responding to support calls and hospitals are considering switching. Both Cigna and Providence Health Plan claim they are unable to transmit payments and organizations are having major cash flow problems, particularly community hospitals. Anyone else having problems?” Unverified, so I removed the vendor’s name. Further reports are welcome.

From Nasty Parts: “Re: [vendor name omitted]. Is moving away from their legacy EHR product and all efforts will be put behind a SaaS product they bought last year. 400+ people will be RIF’d as a result in the near future.” I removed the vendor name while we try to get confirmation (which I don’t expect to be successful), but Nasty Parts has been accurate about this company in the past.

HIStalk Announcements and Requests

Highlights from HIStalk Practice this week include: Dr. Gregg explains why he is skipping the HIMSS soup line this year. Hospitals now employ 20% of physicians. CareCloud grows rapidly. A breakdown of EP attestations by EMR product. Age affects physicians’ perceptions of HIT. A little bit of ambulatory HIT news is like a ray of sunshine of a cloudy day. In other words, by signing up for e-mail updates on HIStalk Practice, you can keep the winter doldrums at bay. Thanks for reading.

Welcome to Humedica, sponsoring both HIStalk and HIStalk Practice at the Platinum level. The Boston informatics company offers SaaS-based clinical business intelligence solutions that create a real-time longitudinal patient care view, giving providers insight into their patient populations, the outcomes of the treatments and procedures, and how those factors impact quality, outcomes, and cost. For physician practices, the company’s MinedShare Ambulatory product supports clinical, operational, and financial benchmarking. Humedica partners with Anceta, the informatics subsidiary of AMGA, to allow its members to collaborate on quality improvement and to share best practices. I interviewed President and CEO Michael Weintraub last month, where he talked about the company’s top-rated performance in KLAS, its partnership with Allscripts, the $50 million in capital investment the company has received, and what’s next for the industry after EMRs. Thanks to Humedica for their support of HIStalk and HIStalk Practice.

Speaking of Humedica, the company announces a predictive analytics tool that analyzes EMR data (not claims information) to identify high-risk CHF patients and intervene before they require hospitalization. Preventable heart failure admissions cost up to $35 billion per year, with 40% of Medicare CHF patients readmitted within 90 days. MinedShare client Community Physician Network (IN) says the tool will help it perform in an Accountable Care Organization model by avoiding unnecessary admissions and providing better patient outcomes.

Reminder: you app and Web developers still have plenty of time to enter Nuance’s 2012 Mobile Clinician Voice Challenge, considering that it takes only a couple of lines of application code to speech-enable your mobile or Web app for clinicians and the deadline isn’t until February 3. Prizes and fame could be yours. Even non-programmers can get a shot at the prize kitty by tweeting about the contest.

Acquisitions, Funding, Business, and Stock

T-System acquires Practice Management Associates, a provider of coding and billing services for EDs.

TriZetto Group, which last week acquired Medical Data Express, acquires Kocsis Consulting Group.

Practice Fusion raises an additional $2 million in funding, raising its total to $38 million from Band of Angels, Felicis Ventures, and other investors.

Columbia University signs an exclusive agreement with Health Fidelity to commercialize its MedLEE text-based natural language processing technology. Fidelity offers its own NLP solution called Fidelity Platform, which uses MedLEE to extract medical data from unstructured text and generate SNOMED codes from it.

In Europe, CompuGroup Medical acquires Netherlands-based ambulatory and pharmacy systems vendor Microbais Werkmaatschappij BV. The transaction also gives CompuGroup a 51% stake in healthcare connectivity startup MediPharma Online.

Sales

Barnabas Health (NJ) adds MedeAnalytics’ Revenue Cycle Intelligence solution to compliment its existing Patient Access Intelligence solution.

El Paso Children’s Hospital (TX), which opens next month, selects RCM provider Cymetrix for business office technology and services.

The DoD awards GE Healthcare a three-year, $43 million extension of its contract for patient monitoring systems.

Illinois Neurological Institute selects JEMS Technology to provide tele-stroke evaluation.

Massachusetts Eye and Ear selects PatientKeeper Charge Capture and PatientKeeper P4P for its 250 clinicians.

Catholic Health East signs a five-year, $40 million contract to implement AUXILIO’s managed print services in its 19 hospitals.

People

Former Google Health exec Missy Krasner joins Morgenthaler Ventures as executive in residence. She was also previously senior communications director at ONC under David Brailer.

Medical appointment booking site ZocDoc adds former Senators Tom Daschle and Bill Frist to its advisory board.

Encore Health Resources promotes Thomas J. Niehaus from EVP of client services to president and COO. Dana Sellers remains as CEO. In case you missed it, Mr. H recently interviewed Joe Boyd, Encore’s chairman of the board.

Lisa Conley, formerly with McKesson, joins Sunquest Information Systems as VP of North American sales and global marketing.

Industry long-timer Kerry de Vallette joins OPTIMA Credentialing as EVP of sales and marketing.

Interactive patient care systems vendor Skylight Healthcare Systems names Scott Johnson as VP of sales. He was previously with A-Life Medical and Philips.

Announcements and Implementations

North Hawaii Community Hospital begins implementation of its HIE, which uses Wellogic’s technical platform

Intelligent Medical Objects announces the successful integration of 2012 ICD-10-CM within its newly released IMO Problem IT 2012 Regulatory 1.3 software.

Nuance Communications expands the availability of Dragon Medical to French-speaking Canadian providers with the delivery of Dragon Medical 11 French.

Yale New Haven Hospital SVP/CIO Daniel Barchi provides an update on its Epic project. Six practices of 27 physicians are live, with e-prescribing at 91% and 80% of encounters closed the same day. Physician productivity for those docs is nearly back to pre-Epic levels. Greenwich Hospital will be the first hospital to go live in April. Daniel is one of few CIOs who has implemented Epic in two large health systems (he came from Carilion) so I asked him how it was the second time. He says Epic’s greatest strength is that they fully believe and trust their own process — developing their own software, rarely partnering with other companies, and creating finely detailed training plans. The benefit for customers, he says, is that if you just follow their plan, you will have a successful go-live.

Innovation and Research

Researchers at the University of Washington develop medical robots that support the open source Robot Operating System, saying it’s time to get away from proprietary, one-off medical robots and allow universities to collaborate in sharing their applications.

Technology

Ford partners with Microsoft, Healthrageous, and BlueMetal Architects to develop “the car that cares,” which would monitor the health and wellness of drivers. Data would be collected biometrically and through voice capture, then uploaded into HealthVault.  And I thought texting while driving was distracting.

A doctor in Canada gets her smart phone PHR app certified by Canada Health Infoway, only the second app to earn that distinction. She named it Mihealth, with the “Mi” referring to her feeling that adopting digital data in Canada was Mission: Impossible.

The Qualcomm Tricorder X Prize offers $10 million to anyone who can create a Star Trek-like tricorder that can diagnose medical conditions non-invasively. The X Prize Foundation chairman helpfully adds, “We don’t have a requirement that it makes the same noise.”

Other

An AHRQ study finds that 5% of Americans account for 50% of the country’s $1.26 trillion in healthcare costs. The top 1% of spenders account for 22% of the costs.

Could there be a connection? Life expectancy is up two years since 2000 and Hostess, maker of Twinkies, DingDongs (my personal fav), and HoHos, files for bankruptcy protection. Experts blame a shift toward healthy foods.

Here’s a point/counterpoint issue to mull over. Inga and I disagree on the value of CMS’s attestation statistics. Inga thinks the percentage of each vendor’s customers that have attested is a good benchmark, so she did lots of spreadsheet work to compare vendors and to assume that varying percentages among them must be reflective of product capabilities and ease of use in meeting Meaningful Use requirements. I said the information is useless for that purpose since it’s more reflective of unmeasured customer demographics and buying criteria than anything else and that it would be wrong (not to mention statistically indefensible) to use the CMS figures to infer that vendors with a higher percentage of successfully attested users have a better product for earning Meaningful Use money. Feel free to take sides. One thing’s for sure: vendors who massage the data into slick marketing collateral won’t be footnoting their handouts with statistical disclaimers.

Weird News Andy says “the eyes have it” in referring to this story, in which researchers are working on a smart contact lens that can continuously and non-invasively monitor glucose levels, electrolytes, and cholesterol, sending the results electronically.

Former Steve Jobs mentor turned nemesis John Sculley, who served as Apple CEO for 10 years, is interviewed at the Consumer Electronics Show, where he was promoting a company he advises and invests in, Audax Health. He describes his interest:

The area I am particularly excited about now is healthcare. Healthcare has been the last major industry that hasn’t been touched by technology in terms of productivity and consumer adoption in the way so many other industries have. While I’m not bringing any technology experience to the healthcare industry, I do see some similarities between what I was asked to do when I came to Apple, which was to bring big brand consumer marketing to Apple and carry it over to the whole Silicon Valley industry – because everybody does that today – well that same opportunity exists today in healthcare. Health innnovation enabled by digital technologies to build big consumer service brands, is an incredibly interesting complex problem to work on. Audax is really the first social health company and it’s focused on consumer engagement in the healthcare space bringing in a lot of the social media technologies and experiences that have been learned from companies like Facebook and Zynga and others.

The federal government adds insurance fraud to the list of charges faced by a Louisiana doctor that also includes possession of child pornography. The doctor was medical director for a company that monitored neurophysiologic surgeries over the Internet, billing insurance companies for their time. He and the company are accused of billing for surgeries in which no Internet connection was established, padding their billed hours, and instructing non-physician employees to log on to the monitoring system and pose as physicians for billing purposes.

An Indiana health insurance plan alerts 2,700 members that their records may have been exposed on the Internet in February 2011, when a server was inadvertently opened up to the Web during an upgrade.

Sponsor Updates

• SRS helps its customer Midwest Ortho (IL) celebrate its successful MU attestation with a tasty-looking cake.
• Pete Rivera of Hayes Management Consulting  discusses building leaders and improving team effectiveness.
• Picis will participate in this month’s 2012 Military Health System Conference in Maryland.
• OnX and MEDSEEK enter into a strategic partnership that allows OnX to distribute all of MEDSEEK’s enterprise patient engagement solutions.
• MED3OOO shares details of InteGreat EHR’s improved KLAS scores.
• Minnesota’s REC recognizes e-MDs customer Christopher Wenner, MD for being one of the state’s first providers to achieve Meaningful Use.
• Gateway EDI and AAPC align to offer ICD-10 training for practices, starting with a January 24 Webinar.
• Orion Health opens its 14th international office in Paris.

EPtalk by Dr. Jayne

It may only be Thursday as I write this, but I’m really wishing it was Friday. This has been a hectic week full of clinical snafus and customer services annoyances.

The first guilty party is HIMSS, whose registration system apparently malfunctioned last month. HIMSS12 registrants were charged a zero dollar amount for their HIMSS renewals. I received an e-mail notice about the registration problem and was told that someone would call me to discuss whether or not I really wanted to renew. They did, while I was seeing patients. I didn’t want to ignore it and risk a snafu in Las Vegas.

I called the customer service number left on my voice mail and the answering staffer had no idea what I was talking about. After more than 15 minutes on the phone and two call transfers, they finally got their act together. I hope the conference itself runs much more smoothly. And to HIMSS, let me introduce you to the concept of service recovery. If you accidentally undercharge people, let it go and use it as a lesson learned. Did that many people really register on those two days that you are going to suffer without the extra $160 per person? Goodwill is invaluable.

The second guilty party was the staff at Well-Known University Medical Center whose performance at the check-in desk gave new meaning to the phrase “epic fail.” Not only did they insist that my insurance information wasn’t in the system (doubtful since it just paid a claim last week on another appointment) but they were also rude about it. As I sat in the waiting room, I was also annoyed by their ham-handed questioning of patients on race and ethnicity. I wanted to jump up and intervene with some better scripting.

If organizations can’t even handle those customer service basics, I have no idea how they’re going to achieve Meaningful Use, let alone be a meaningful participant in an ACO. Not to mention that they didn’t ask everyone about race and ethnicity. I’m not sure if they just “assumed” for the rest of us or if they decided to judge by appearance.

The final straw was a resident physician who actually was using his BlackBerry to e-mail or text during my visit. Really. Talk about smartphone distractions. He set it on the table between us and typed as he was doing the exam. I know for sure he wasn’t documenting in the EHR because the scribe was tapping away at the PC in the corner.

The resident didn’t think it was funny when I asked him if I was keeping him from something important. He did sheepishly put it in his pocket. Maybe he should have noticed the “faculty” label on my encounter bill. Oops!

Lest you think I’ve just become Angry Jayne, some good things did happen this week. Inga and I strategized on the coveted HIStalkapalooza beauty queen sashes and I have narrowed down the list of candidates who are vying for the chance to escort me to the event.

HIMSS released their list of its 2011 Best Hospital IT Departments. Texas Health Resources, whose IT shop is led by contributor Ed Marx, is listed for large hospitals.

I’m curious about Nemours/Alfred I. DuPont Hospital for Children, which is described on the “medium hospitals” list as having 237 IT staff for its 180 licensed beds. I could certainly do a lot more with 1.3 staffers per patient. I wonder what their nursing ratio is?

Life Technologies Corp. announces that its new Ion Torrent genome sequencer will be able to map an individual human genome in a single day for less than $1,000. Although technically this is HOT, sequencing of a person’s genome brings up lots of controversial ethical and legal issues, not to mention the cost of the human expertise needed to transform the genetic data into something meaningful and to then counsel patients.

The absolute highlight of my week, though, is this delightful video about computers in medicine circa 1964. Thanks to Rockstar HIStalkapalooza correspondent Evan “Velvet Jacket” Frankel for making my day. See you at HIMSS.

Contacts

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

John Gomez 1/11/12

Recently I developed a Leadership Cheat Sheet for clients and friends. The document provided guidance on how to evolve your leadership style and suggestions on avoiding common leadership mistakes. As we move into 2012 (wow,  2012 sounds so Buck Rogers, doesn’t it?) I started thinking about a cheat sheet for HIT executives that helps them evolve their strategies and hopefully avoid technological mistakes in the coming year. By no means is this cheat sheet a comprehensive end-all, be-all, but rather a high-level guide of what to consider in the coming year.

Let me start by saying that not everything in this article is going to be applicable to every organization. You may also find that some of the items in the article are not necessarily new or all that leading edge. In some ways, much of this is a return to the meat and potatoes of HIT. Yet there are some new fancy, out there, Star-Trek gizmos that most of us love to envision included for you mavericks. With that disclaimer, let’s get started.

If I were on the hospital side of the equation (not the vendor side,) I would see 2012 as year to rework foundations and drive strategies that grow revenue and/or margin. I believe these two things go hand in hand. Although it may seem obvious, I find that Meaningful Use has in some ways become a huge distractor to allowing HIT to build an organization’s margin and revenue.

In my eyes, all IT organizations — not just those in healthcare — should be indirect profit centers, able to demonstrate that their strategies are driving organizational growth and financial stability. To do this, many organizations need to consider their foundational systems and begin making bets on what to invest in during the coming year, so that over the next three years, they can demonstrate that IT is a strategic partner to the business, not just a cost center. Sounds rather basic, doesn’t it? Yet it is such as difficult thing to execute upon, and that challenge is the reason for this little cheat sheet.

OK, so first things first. You can’t really get around your continued MU efforts or ICD-10 adoption. Yes it is draining, taxing, distracting, painful, lethargic, and about as exciting and forward thinking as watching wall paper erode. Most of your resources are going to be tired up on MU/ICD-10, yet you need to really think about how you rebuild your technology foundation and drive corporate revenue growth. After all, healthcare is a business.

My first suggestion to you is to establish an “imagineering” team. This can be a small team (depending on your budget) comprised of multi-functional talent, empowered to make decisions, drive change, and most of all, execute upon their decisions. If you want further details on how-to build an imagineering team, let me know, but the key tenets are (a)small team; (b) self-learners; (b) self-starters (c) highly passionate; (d) cross-functional; (e) full-time assignment; and (e) only looking at changes that can be accomplished without the need for board or finance committee approval. The reason for that last item is that you don’t want this team to get bogged down with big, complex changes and projects. Secondly I believe you will see greater returns from smaller strategic investments than big multi-year projects.

The Cheat: Carve out some resources and create an imagineering team. Keep your MU/ICD-10 work moving forward and make progress on the little things that provide big returns.

Recently I had the opportunity to meet with some rather smart and very talented software developers. We were discussing a new product that they are trying to bring to market. The discussion quickly turned to object orientation, software as a service, cloud-based computing, etc. They were pretty shocked when I said that really doesn’t matter – it’s all just drivel. What matters, I said, is getting your product to market and solving the client’s problem, doing those things really, really well, better then anyone else. Why does that matter to you?

I believe in 2012 you need to really consider evolving your departmental systems. Why? Because there is gold hidden in those departments. Want to improve throughput? Lower costs? Drive better ROI? Deal with future challenges related to genomic and personalized medicine? Then you should evaluate your departmental solutions and start thinking about how upgrading or replacing them (yes, replacing) could yield much higher returns. Solving your client’s problems is what matters.

OB/GYN, cardiology, optometry, ED, oncology, pathology, lab, advanced surgical, and other lines of business are highly specific workflows. Although some of the EMR/EHR vendors do a good job at this, you will find that your return is much higher by going with niche vendors who have systems optimized for these areas. The landscape of offerings in these areas is changing and you may find great deals, with short implementation cycles that create huge downstream returns.

The key to improving your revenue and margin is lowering operating costs and seeing more patients (yes, a no-brainer.) Yet to make that happen, you need to consider new systems and consider looking at some of the smaller players in these spaces that are doing some truly amazing things with really new technology. This is the perfect type of project for an imagineering team.

The Cheat: Review your 2012 departmental portfolio to determine if by evolving or upgrading you can improve patient throughput and lower costs.

“You can’t get there from here,” said the farmer along the side of the road.

“Why not?” I asked.

“Because they ain’t built a road, you fool,” he snapped.

Are you building roads in 2012? In my eyes, the next three years will see a tremendous shift in technology within HIT. You can only embrace these changes by laying foundational infrastructure that allows you to not only take advantage of those shifts, but also assure that you can do so at a cost and pace that yields strong ROI.

Throughout 2012, you should come to terms with mobility, patient tracking, resource tracking, analytics, security, and data integration/exchange. I consider this your infrastructure portfolio. Just like you have a departmental portfolio, you should consider developing a portfolio of your infrastructure to better understand how you are positioned for the future. Each of these items in the portfolio should provide a set of “roadways” which allow you to digitally get to anything or anyone in your organization and system.

Key investments in RTLS, HIPAA compliance management, privacy and security management, and the other areas are critical. If you have not deployed directory services and EMPI systems, you need to get that done. Why? Because I believe that over the next three years, we will see more and more focus on the integration of devices and humans. This will drive a tremendous need for an underlying infrastructure that allows you to orchestrate an ecosystem. Evaluating and investing in your infrastructure portfolio is critical to long-term success, reducing costs and driving revenue.

The Cheat: Develop and evaluate your 2012 infrastructure portfolio. Develop key plans for at least RTLS, PRM, HIPAA compliance, and privacy and security. Focus on technologies that improve patient throughput, reduce costs, and drive long-term ROI. If you have not deployed directory services and EMPI, get on it.

Little by little, the world of retail is changing. More and more retailers are evaluating or deploying self-service systems that allow consumers to do more for themselves and get help from a sales associate only when they need or want help. Airlines are also embracing the self-service mentality for passengers and crews, providing access to tools that allow greater access to what was once complicated processes that required human intervention. Developing a “healthcare self-service” strategy in 2012, which puts more power in the hands of the patient, is a key means to drive greater throughput and gain financial upside for the healthcare organization. The self-service strategy should include patient relationship management, patient access, and other tools that allow the patient to take greater control. Although human interaction is vital to patient care, there are a variety of processes that patients can do for themselves and actually would champion to be allowed to do, if they had access to the tools.

The Cheat: Drive higher patient satisfaction, better patient throughput, and ROI through the development of a 2012 self-service strategy. Also consider how self-service can be applied to hospital employees.

“To boldly go where…” you know the rest of the line, I am sure. So what about the cool Star Trek stuff? Well, I do think that you will see subtle shifts in 2012 that have long-term implications, but I am not sure if we are going to remember 2012 as the year that changed the face of healthcare forever. That said, for those leading edge organizations out there, I do think that there are some things you can start evaluating.

Some of my things to watch are DDS (diagnostic decision support), healthcare gaming, robotic aides, and large-scale data analysis, as well as the application of social graphs to patient care and collaboration. Each of these has a backdrop of affecting patient throughput and managing costs. For instance, DDS can help drive better decision-making in shorter amounts of time, freeing up clinicians to see more patients or spend time with patients. Healthcare gaming provides the opportunity to reduce readmissions, improve wellness, and educate patients. Robotic aides will at some point help drive care, though challenges with battery life and size make this a long-term realization. Large-scale data analysis, social graphs, and related technologies are also very much in their infancy, but there is promise and opportunity for those organizations looking for leading-edge game changers.

The Cheat: Pick one or two leading edge technologies that can provide long term differentiation to your organization.

ACO, ACO, ACO. OK, so we are making some progress and little by little, it seems to be coming together. But what is coming together is still a mystery. Developing an ACO strategy is important and probably a good thing to do in 2012, but I would caution you that there are probably other items you can focus on that will drive higher returns. That said, there is some low-hanging fruit an imagineering team can go after in regards to the world of patient financials. That fruit includes asking your current patient financial vendor to outline their strategy to address patient financials over the next three years (not just ACO.) I would not suggest changing vendors unless you are either having serious issues with your current vendor or your current vendor has no strategy for the next three years. If your satisfied with your vendor strategy, then focus elsewhere and monitor the evolution of ACO and its impact to your organization. Wait for the dust to settle, learn from the mistakes of others, and take a crawl-walk-run approach. If you must change vendors or your vendor doesn’t offer a strategy, then this is a project way too big for an imagineering team.

There are a ton of more cheats I can offer and probably some things you might be surprised not to see in the article. My goal, though, isn’t to cover it all. I realize that many of you may find that much of this is already known, which is cool if you are already on it. My goal is to help you think about the little things you could be doing to move your organization forward while you and your team drive greater revenue and, hopefully, margins.

The Last Cheat: If you agree with each of the cheats in this article, you can copy them to a PowerPoint (just the cheats) and present them to your leadership team. You will have an instant outline of your key goals for 2012.

John Gomez is CEO of JGo Labs.

News 1/11/12

Top News

Federal defense contractor ManTech International acquires federal healthcare system integrator Evolvent Technologies. You may remember Evolvent from HIStalkapalooza in Atlanta a couple of years ago, which they co-sponsored with Encore Health Resources and Symantec.

Reader Comments

From Stacy London: “Re: HIStalkapalooza. I have registered and hope to make the official invite list. I haven’t been before, so I am not sure what to wear. Thought it was better to ask you than Mr. H.” Indeed. You will see everything from the dreadful “straight from the exhibit hall” company logo shirts to glitzy gowns and tuxedos (seriously.) However, if you’d like to be in the running for HIStalk King or Queen, I suggest some serious cocktail party attire, complete with great shoes and lots of bling. Because we are in Vegas, we are including two special categories: Best Elvis Impersonator and Best Left in Vegas Attire. Ideally, the winners of the Vegas categories will actually be trying to win. All winners, including those crowned in the Inga Loves My Shoe contest, will be awarded fabulous prizes from the generous Mr. H (who may not know fashion, but who knows this stuff makes me happy so he puts up with it.) Our esteemed judges are pictured above.

From Is It Just Me: “Re: HISsies survey. Of all the silly questions and odd choices, I thought listing John Hammergren as an ‘HIS industry figure’ was the biggest stretch. And shouldn’t ‘guest contributor of the year’ between Vince Ciotti, Ed Marx, Ben Rooks, and Mr. H’s Epic id merit a question?” The silly questions have been the same for years, so there’s nothing new there. Readers chose the nominees, so any quibble about the odd choices should be directed that those who submitted nominations (or more accurately, the vast majority who didn’t despite my exhortation, saving their input until it was too late.) Inga advocated for adding a “best HIStalk contributor” item, but I didn’t want to diminish the accomplishments of those who didn’t win since they’re all good. If you received an e-mail HISsies ballot link, please vote soon since I’ll probably finish it up this weekend. About 1,000 votes are in and there are some surprise leaders so far. We’ll invite some of the winners to join us at HIStalkapalooza, although they usually turn us down.

From Ed Amame’: “Re: UMMC layoffs. Some folks on the right aren’t happy about it. Hot Air, as I understand it, has a pretty big readership. Wonder what waves this will create in HIT policy discussion outside the niche?” Right-wing site Hot Air quotes my mention of University of Mississippi Medical Center layoffs that were implied to be related to its $80 million Epic cost  (a story I just picked up from a newspaper there) and turns it into another vast conspiracy of Obamacare-loving liberals. A few thoughtful comments were left (one basically just pasting in my discussion from the original mention), but many are wildly tunnel-visioned, hysterical, and hateful. It’s no wonder the government is paralyzed by partisanship and an unwillingness to compromise – the politicians are unfortunately representing their intellectually lazy and often ill-informed electorate perfectly, so thoughtful democratic process has turned into a bad reality TV show.

From Spanky: “Re: unions. Why they’re bad for healthcare.” An ambulance technician in Scotland ignores an emergency call because he’s eating lunch. The patient dies. The union last week rejected a salary increase that would have paid paramedics $150 every time an emergency causes their break to be interrupted.

HIStalk Announcements and Requests

HIStalkapalooza invitation signups will be closed Friday evening, so if you have an interest in attending but haven’t filled out the online form, now’s the time.

Acquisitions, Funding, Business, and Stock

Consumer health site WebMD gives up trying to sell itself, its CEO quits, and the company warns of “significantly lower” profits in 2012 because drug companies are moving away from buying its advertising and competition from Facebook is increasing. Shares dropped 29% on Tuesday.

Healthcare apps developer Novarus Mobile Technologies changes its name to Novarus Healthcare. The company also hires Tom Hearn, formerly SVP of ambulatory services with Novant Health (NC), as managing principal.

Shares in Scotland-based charge master software vendor Craneware drop by a third after the company warns that performance of its acquired US revenue cycle software business ClaimTrust will not meet expectations. The company also says it may sue after it lost a large ClaimTrust InSight contract that was being handled by a third party and complains that US hospitals are buying HITECH-subsidized clinical systems instead of its financial ones. 

Ascend Learning acquires Advanced Informatics, a Minneapolis-based vendor of clinical education systems.

UnitedHealth Group forms strategic partnerships with three mobile health companies: CareSpeak Communications (patient medication communication by text message – above,) Lose It! (a weight loss app,) and Fitbit (pedometer and sleep monitor app.)

Sales

Hamad Medical Corporation (HMC) and Cerner sign an agreement to digitize the public health system of Qatar, including all HMC hospitals and primary care centers.

BCBS of North Carolina and Kansas City form Topaz Shared Services and choose TriZetto Group to provide claims, enrollment, and billing services.

People

Sandata Technologies, a provider of IT solutions for the home care industry, names Tom Underwood (Alere Health) CEO.

ApeniMED (formerly MEDNET) elects Charles D. Birmingham, VP of corporate development for CareMore Medical Enterprises, to its board.

Carestream hires Barry Canipe (American Standard Brands) as CFO and promotes Jianqing Bennett to VP of global medical sales and services.

Surgical Information Systems promotes Kermit S. Randa to COO.

Streamline Health Solutions appoints Michael K. Kaplan (Altos Health Management) to its board.

Healthcare consulting firm Equation hires Howard Salmon (Premier, ReHab Care, Phase 2 Consulting) as principal.

Three Kansas hospitals that are affiliates of Sisters of Charity of Leavenworth Health System name Mike Malone as project manager for their Epic implementation. He was previously with the parent organization.  

Capella Healthcare names Magda Osburn BSN, RN as director of medical informatics. She was previously with McKesson Provider Technologies.

RCM company Medistreams hires Marcia McLure Hardy as national director of business development.

Announcements and Implementations

The local paper (which apparently does not use spell-check) highlights the EMR use of Takoma Regional Hospital (TN), which just received a $1.3 million check for its meaningful use of Cerner’s EMR. When I shared this with Mr. H, he got all nostalgic on me, reminiscing about a consulting gig he had at the hospital years ago, the nice people there, and the great grub at Stockyards Cafe.

While I was trying to figure out which EMR Takoma had in place, I found Cerner’s list of clients that have attested for Meaningful Use, which includes 136 hospitals and 238 EPs.

Omaha Imaging (NE) implements Avreo RIS/PACS.

Four Mercy Health (OH) hospitals go live on Epic’s Care Everywhere, allowing hospital staff to view the chart of any patient whose provider is also using Epic and Care Everywhere.

Zynx Health announces a software enhancement that improves integration of ZynxOrder order sets with MEDITECH CPOE.

BryanLGH Medical Center (NE) implements the Pharmacy Xpert clinical surveillance and intervention solution from Thomson Reuters.

Three Ohio hospitals implement InQuicker, software that allows patients to make ED appointments online and “skip the ER waiting room.”

Government and Politics

The latest Meaningful Use numbers, captured in December and presented at Tuesday’s HIT Policy Committee Meeting:

• 172,974 EPs and 3,077 hospitals registered for either the Medicare or Medicaid MU programs.
• Medicare paid $275 million to EPs and $1.1 billion to hospitals.
• 33,515 EPs attested, 355 unsuccessfully.
• 842 hospitals attested, all successfully.

Aaron Berdofe analyzes the November Meaningful Use attestation report using IBM’s Many Eyes tool, finding that (a) Epic has 6,330 attestations, more than triple the #2 vendor; (b) Epic’s strength is concentrated in a few states where it dominates almost totally; and (c) Complete EHR attestations outnumber Modular EHR attestations 21,765 to 1,196.  

  ONC launches its Healthy New Year Video Challenge, offering $5,000 in prizes to consumers who submit a short video explaining their health-related New Year’s resolution and how they will use technology to accomplish it.

  Newt Gingrich, speaking at Dartmouth-Hitchcock Medical Center, says bureaucracy crushes healthcare innovation and that treatment protocols based on statistics interfere with the doctor-patient relationship. Peter Merrill, DHMC IT director, grilled Gingrich on his role in government gridlock, but wasn’t impressed with Gingrich’s answer. “I thought it was an incredibly articulate and well-reasoned defense of his actions in response to my characterization of him as responsible for the current gridlock in government. It was in no way an answer to my question of how to get past the current gridlock. My personal belief is that he is one of the major people responsible.” Merrill says he’ll probably vote for Obama again unless Republicans come up with a better candidate.

Technology

First-year medical students at the NYU School of Medicine use an interactive, virtual 3D cadaver to complement the traditional anatomy instruction, exploring the digital content with projected images, 3D glasses, and iPads. A free online version is here.

Other

  US health spending grew 3.9% in 2010, which was only .01 percentage points faster than the 2009 rate and the second-slowest rate in 51 years. The slower growth is blamed on high unemployment, loss of private health insurance coverage, lower median incomes, and higher patient deductibles and co-pay. Total 2010 spending was $2.6 trillion, or $8,402 per person, of which the federal government paid a record 29% and the combination of federal, state, and local governments paid 45% of all health spending.

The Bureau of Labor Statistics reports that healthcare added 22,600 jobs in December, including 9,800 in hospitals and 11,300 in ambulatory health services. Healthcare employment grew by about 315,000 jobs for the year.

A study finds that nurses using a basic EMR reported better outcomes and were less likely to report adverse patient safety issues, frequent medication errors, and low quality of care.

Cerner, dbMotion, Epic, Medicity, and RelayHealth are the vendors winning the most private HIE deals, according to KLAS, while Axolotl, InterSystems, Medicity, and Orion Health are leading in public HIE selection. Affordability is the top consideration in vendor
selection.

  Fast Company covers mHealth. It’s not particularly conclusive or insightful (at least not compared to HIStalk Mobile,) but does mention some interesting technology work: Best Buy is researching earbuds that can monitor heart rate, J&J has invested in sleep monitoring technology, and AT&T and Qualcomm are working on mHealth projects.

Two English hospitals struggle with error-filled surgical case lists, warning employees to double-check them. The North Bristol NHS Trust blames user error. One surgeon said his case list included patients from outside his specialty.

  Weird News Andy likes this Baby Beyonce’ Lockout story. Beyonce’ and Jay-Z have their daughter (named Blue Ivy) at Lenox Hill Hospital (NY), but at least one other new parent says the hospital locked down the NICU to accommodate Beyonce’s visitors, preventing everybody else from seeing their lesser-pedigreed babies. The hospital denies reports that it was paid $1.3 million to give the celebrities an entire floor to themselves. Gossip sites claim the hospital installed bulletproof glass in the delivery area, taped over security cameras and confiscated employee cell phones to prevent pictures being taken, and kicked people out of nearby waiting rooms. The couple is supposedly worth something like $750 million.

WNA also says he’ll “take a flyer” that the da Vinci medical robot people didn’t count on their robots to be used to make paper airplanes, even in Boeing-centric Seattle.

Guess which company is looking for a senior sales manager. The candidate must cold-call, hit sales targets, negotiate contracts, create sales campaigns and models, persuade prospects, and “aggressively solicit new customers by telemarketing and formulating follow up plans.” The answer: HIMSS, which needs someone to push corporate memberships and organizational affiliate memberships.

An IT specialist with an Atlanta medical practice is sentenced to 13 months in prison for hacking into the server of his previous employer, a competing practice located in the same building. He download patient information from his former employer’s system, deleted it from their server, and then launched a direct mail campaign touting his current employer.

Sponsor Updates

• Kindred Healthcare Inc. selects MED3OOO’s RCM services and InteGreat PM for its partner physicians.
• PatientKeeper CEO Paul Brient will speak this week at the JP Morgan 30th Annual Healthcare Conference.
• Fred Pennic, a senior advisor with Aspen Advisors, suggests six ways for healthcare organizations to use business intelligence software.
• HealthEdge and Keane announce a strategic partnership to deliver a performance-based business process outsourcing service to the healthcare payor community.
• Imprivata releases a white paper on preparing for a HIPAA audit.
• RelayHealth hosts a live HFMA webinar January 11 on patient consumerism.
• Nuesoft announces its podcast series “2012 Billing Trends: What’s on the Horizon.”
• A Texas hospital selected for the OCR’s pilot HIPAA audits contracts with CynergisTek for preparatory consulting and advisory services.
• McKesson Specialty Health offers a free webinar on the selection and implementation of EMRs in oncology practices.
• eHealth Global Technologies Inc and OptumInsight will deploy a medical image exchange service for HEALTHeLINK, a New York RHIO.
• Idaho Health Data Exchange signs an agreement with Greenway Medical to provide interoperability between Greenway’s PrimeSUITE EHR and the OptumInsight-powered HIE.
• Community Health Network (IN) says consulting services and technology from MedAssets improved its cash position by $26.7 million, reduced denials by 47%, and increased patient access employee productivity by 100%.
• Aspen Advisors ranks third in Planning and Assessment in the Best in KLAS awards.

Contacts

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

Monday Morning Update 1/9/12

From California Girl: “Re: CareFusion. Has done some executive trimming of late and more layoffs may be in the offing.” Unverified.

From Lucitania: “Re: Gerry McCarthy of McKesson. Confirming that he’s leaving for HealthMEDX to work with Pam Pure again. The internal announcement didn’t give his new role.”

From RS: “Re: Kathleen Sebelius. Op-ed in The Washington Post this evening.” One might quibble with her assessment that the Affordable Care Act is “putting consumers back in charge” by (a) requiring insurance companies to provide an explanation when they increase premiums by 10% or more, and (b) also requiring them to spend 80% of premiums on health care services, which of course still lets them make their big money by investing prepaid premiums until services are actually rendered, which allows them to put their signs on tall buildings and to sponsor sporting events. The problem with reducing healthcare costs is that it would require (a) patients who are conscientious about their consumption of healthcare dollars paid by someone else, which hasn’t worked well historically; and (b) politicians with non-partisan political backbone who are willing to rile big organizations that are loaded with lobbyists and campaign donations, which never happens. And in the way of counterpoint, here’s a comment left on the article:

Tired talking points. Where do I start? Funding was shifted from the Medicare program and the doctor SGR fix was intentionally omitted to make this law "bend the cost curve down", but ACA does nothing to lower costs. Savings were based on finding fraud and abuse, which could have been done in the current system. The rising costs of premiums cited by Sebelius are going to insurance companies who squirrel it away in profits hidden as loss reserves. Any increases in payments for the last 9 years to doctors and hospitals have been lower than the same inflation rate. Her state-based "competition" is dependent on states participating. The "80-20" rule doesn’t apply to AARP plans in exchange for their support. For AARP it is really a 65-30. Lastly if it is so great, why has the administration granted so many waivers to unions and large contributors?

It’s HISsies voting time. I’ve placed the most-nominated entries on the final ballot, which I’ll e-mail out Monday evening. I won’t send an e-mail reminder (since I always get a few complaints about wasting 0.5 seconds of someone’s time to read and ignore the e-mail subject line vs. the five minutes it takes to complain about it), so watch your inbox and check your spam filter if you don’t receive yours. Voting is limited to subscribers to the e-mail update as of this past Saturday morning when I had time to create the ballot e-mail list.

Vince’s HIS-tory this week goes micro – it’s all about the early days of PCs in hospitals. Quite interesting as always, and fun to read of the one example where Apple took a hospital beat-down from the old-guard IBM.

Listening: Veruca Salt, mid-90s, unpolished hard-charging chick rock. And while Mrs. HIStalk and I were having lunch today at the local hipster taqueria, I bet I was the only person there who could identify the music playing over the sound sytem – Portishead’s “Glory Box.” Mrs. H applied minimal effort in pretending to be impressed.

Around two-thirds of readers aren’t buying it when a hospital’s post-mortem on computer downtime claims that patients weren’t harmed as a result. New poll to your right: are business conditions better now than a year ago?

Welcome to HEI Consulting, a new Platinum Sponsor of HIStalk. The KCMO-based company provides expertise all over the world in everything related to Cerner Millennium on both the clinical and revenue cycle sides of the house, including assessments, selection, implementation, workflow analysis, revenue cycle, EDI, CCL scripting, Cerner Open Engine integration, data extraction, and optimization. They offer experienced analysts who have been involved with Millennium implementations worldwide, including in the UK, Middle East, Canada, and of course the US. If you need help with Meaningful use, workflow optimization, ICD-10, give them a call. Thanks to HEI Consulting for supporting HIStalk.

My Time Capsule editorial from five years ago: Happy 2007 – Now Get Back to Work! An extract: “Hospitals, too, get busy after months of letting IT projects lie fallow. No wonder ROI is hard to come by — projects come to a screeching halt because of non-IT staff refusal to get involved during (a) the November to January holiday block; (b) summer vacations; (c) school spring breaks; (d) impending JCAHO or state inspection visits; and (e) local, state, or national conferences involving anyone remotely involved in projects. No wonder implementations take forever – they’re on hiatus half the year. ”

The perennial underperforming and unimpressive Yahoo pays $26 million to secure the services of its new CEO for one year, although that’s a pay cut from that of the previous CEO, who made $47 million in one year before being fired over the telephone. I like Yahoo Finance and I use their e-mail because I like it better than Gmail, but otherwise I couldn’t tell you anything they offer and I don’t really want to know.

John Snyder MD of Mayo Health System in Eau Claire, WI is named as a Mayo MacMillan Scholar. He’ll continue his work with workflow and electronic medical records.

A new Vanderbilt study by Josh Denny MD, MS (above) and Dana Crawford PhD links DNA samples with electronic medical records to examine the genetic basis of hypothyroidism.

CMS takes a bold step to curb high levels of Medicare fraud in 11 states (FL, CA, MI, TX, NY, LA, IL, PA, OH, NC, MO) in allowing RACs to review claims before providers are paid instead of the “pay and chase” standard of pay first-ask later. Orthopedics specialists, as you might expect, aren’t thrilled at that policy, suggesting also that CMS should spend some effort cutting back on direct-to-consumer advertising for free motor scooters and sleep apnea machines, which it says only two countries (the US and New Zealand) allow.

National Coordinator Farzad Mostashari lists ONC’s accomplishments for 2011 and invites comments on the biggest health IT trends for 2012. On his list:

1. Launching Meaningful Use
2. Taking the Direct Project live
3. Releasing the National Quality Strategy to use technology to reduce hospital-acquired conditions, heart attacks, and strokes.
4. Running the Standards Summer Camp.
5. Developing software contests.
6. Issuing grants and curricula for healthcare IT education.
7. Implementing breach reporting requirements as part of HITECH.
8. Launching a consumer e-health program that includes regulations making it easy for patients to access their lab results.
9. Exceeding the enrollment goals of RECs.
10. Measuring the growth in EHR adoption.

Rural doctors in Australia, eligible for $6,000 each in telehealth grants but offered minimal assistance and incompatible software modules, are often just giving up and using Skype instead. According to the president of the rural physician’s association, “In many cases, it works much better than some of the more sophisticated things out there. There is a whole range of technologies and, in establishing video-conferencing, [doctors] are not going to go out and buy some extravaganza of a system, they are going to stick with the simple stuff. Inevitably, there will be shonky players coming into something like this. Doctors have concerns about people putting together hardware and software and calling it a video-conferencing solution.”

E-mail Mr. H.

News 1/6/12

Top News

HHS introduces streamlined rules governing electronic fund transfers from health plans to doctors, which it says will cut approximately $4.5 billion in administrative costs over the next 10 years. The new rules require remittances from health plans to include tracking numbers, making it easier for doctors to match payments with bills.

Reader Comments

From NoVegas: “Re: animated ad. When reading yesterday, I noticed that there are still some animated ads up. I thought they were going away?” A handful of well-intentioned sponsors missed the deadline to switch out their banners, but have assured us their new ads are forthcoming. Meanwhile, join me in a collective “thank you” to those who were happy to comply with readers’ requests to retire the flashing ads.

From Swami: “Re: MedPlus. An RFP posted by New Mexico HIC says they’re exiting the HIE market. Are you aware of their plans?” We asked the company, which provided this response:

MedPlus, the healthcare IT subsidiary of Quest Diagnostics, has made the decision that the company will no longer enhance or further develop the product known as the FirstGateways Clinical Portal or Centergy Clinical Portal. MedPlus continues to satisfy its support and contract obligations to each customer of this product. When all such support and contract obligations expire, however, the product will be permanently sun-setted.

From Birdie Little: “Re: McKesson Provider Technologies. [executive’s name omitted], a 20-year veteran SVP of product management and marketing, is leaving, supposedly to take a small company CEO job. The Horizon fallout had influence.” Unverified, with the name omitted for that reason. Another person reported a similar rumor about the same person, but gave the new employer as HealthMEDX, which former McKesson EVP Pam Pure joined as CEO a few weeks ago.

From The PACS Designer: “Re: Apple’s 2012 launches. The rumor mill from the Far East is heating up again, with info circulating that we may see the launch of Apple’s iPad 3 with the LTE communications upgrade. Since Steve Jobs’ birthday was February 24, the launch may happen then. Later this year, we’ll see the launch of Apple’s iTV, not to be confused with the current $99 Apple TV product.” February 24 would be a lousy date since vendors will be giving away bunches of iPad 2s that very week at the HIMSS conference, just in time for them to be rendered obsolete. That happened last year, as the iPad 2 was released on March 2, a week after the conference. As an alternative, how about the above as a giveaway to Apple fanboys (most of us, I suspect): a creepily lifelike 12” Steve Jobs action figure (that’s an actual photo of the doll above). The manufacturer provides free accessories: two pairs of glasses, a chair, two apples (one with a bite taken out of it), and a backdrop that says “One More Thing.” It goes on sale next month as long as Apple’s lawyers can’t figure out how to shut down a company operating in China.

From Rumble:

“Re: Partners HealthCare. The earth shook in 1994 when MGH and Brigham and Women’s joined to form Partners. Rumor has it that they’re definitely going commercial for their clinical systems – the end of home-brewed. They spent $200M for Siemens ADT before Glaser became CEO of Siemens. Several sources, none official, are confident they’re going Epic. I feel the earth moving again.” Unverified, but I would be shocked if they decided otherwise.

From Roots Fan: “Re: Burlington, VT. Men’s Health just listed it as the #1 Best City for Men, with emphasis on the local hospital’s implementing of Epic, especially MyChart.” The real objective is to sell magazines, and junk stories based on a numbered list (often presented via a lame slideshow) to bait intellectually lazy readers. They’re the literary equivalent of fast food restaurants, providing overly processed, nutrition-devoid fat calories (“The 15 Hottest Actresses You Will Never See Naked On Film” “10 Humor Sites to Make You LOL” … notice they always start with a number to make it clear that minimal mental effort is required to skim them.) I’m not sure having MyChart available is that big of an advantage and Burlington is hardly unique in that regard, but the magazine was mightily impressed, suggesting that doctors just needs your encouragement to implement Epic so you can play with MyChart on your iPhone:

“Our major medical center recently introduced electronic medical records, which will hopefully further boost rates of preventive care,” says Dr. Vecchio. Doctors will soon be able to program preventive-care reminders into patients’ e-records so they never miss screenings. Ask your M.D. about switching to digital records, and then download the MyChart app, which lets you use your smartphone to view your medical file and any screening reminders.

From HIPAA Hound: “Re: doctor’s perspective on end-of-life care. Exactly what I’ve often thought, but never heard much like this, especially from a physician. Adherence to this treatment philosophy would surely save the country billions each year.” I’m glad you sent the link since I read and enjoyed the piece, but forgot where I’d seen it. The gist of the article is contained in a quote from it: “… Doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little.” It argues that doctors are expected to recommend care that they themselves wouldn’t want, with procedures that are not only futile, but painful or degrading. It’s restrained in barely mentions the huge cost taxpayers bear as all the stops are pulled out for Medicare patients in their final days of life, with minimal benefit to anyone.

HIStalk Announcements and Requests

  One of our creative sponsors suggested a new and fun event for HIMSS this year: the HIStalk Booth Crawl. More details will be coming soon, but it’s likely that Crawl participants will have a better chance of winning an iPad 2 than they would hitting it big in the $1 slot machines. If you are a sponsor and have not received details on the Crawl, drop me a note ASAP. Potential players, stay tuned.

  After last week’s getaway in the part of the world Mr. H called “The Land Without Broadband,” I am back in full force. If by chance you failed to peruse HIStalk Practice over the last couple of weeks, here are a few gems you missed. Who to contact to appeal 2011 PQRS or e-prescribing payments. A family practice doctor’s use of social media includes posts entitled, “Are You Smarter Than a Medical Student?” My secret indulgence and 2012 predictions and resolutions. CareCloud adds a director of clinical technologies. Don Michaels offers excellent insight into EMR attestation in 2012 (it’s going to be crazy) and ACOs (the jury is still out.) Dr. Gregg and the percolating e-patient revolution. It just takes a few minutes to be enlightened on happenings in the HIT ambulatory world, so come join the fun.

Over 500 people have signed up for HIStalkapalooza invitations in the first couple of days, so if you are contemplating attending, click here or on the graphic in the upper right column. We always get an interesting mix of executives, unsung in-the-trenches grunts, students, investment people, and semi-celebrities, and this year’s event was designed to encourage them to network (lots of conversation-friendly small spaces, for example, not to mention an open bar.) We’ll close down registration in a few days and e-mailed invitations will follow. It’s only a handful of weeks away, shockingly.

I mentioned that I’m not a fan of year-end industry predictions, given that (a) many of the pundits don’t have the credentials and experience to be making them; (b) nobody wants to look stupid in print, so they predict the obvious; and (c) their predictions are often tediously defended with shallow and unconvincing reasons they believe themselves to be right. Not true of our own Travis on HIStalk Mobile, whose 2012 predictions are specific, bold, and concisely convincing. I like his attitude: “I’ve tried to be specific with some of them, not because I necessarily have any inside information, but because I’ll look good if I’m right and people will likely have forgotten if I’m wrong.”

Listening: reader-recommend Arkells, Canadian semi-hard rockers with a blue-eyed soul sound and strong vocals (think Hall & Oates meets Kings of Leon meets Springsteen.) I’ve listened to the album a couple of times and it’s really good. Nice call by the reader. I’ll definitely be giving it several more listens.

Acquisitions, Funding, Business, and Stock

MedAssets announces that is has paid the $120.1 million deferred purchase consideration due to the former owners of the Broadlane Group as part of the acquisition completed in November.

Frontier Capital invests inHealthx, an Indianapolis-based vendor of health plan portals for patients, employees, and physicians.

Sales

Iowa e-Health selects ACS to implement and manage its HIE.

Summit Medical Group (TN) signs a three-year contract renewal with Zix Corporation for its e-mail encryption services.

The Illinois HIE awards InterSystems a $7.25 million contract to implement its HealthShare HIE technology platform.

North Shore LIJ Health System selects Wolters Kluwer Health’s ProVation Order Sets as its electronic order set solution.

Prognosis HIS announces new sales to Colorado-Fayette Medical Center (TX), Biggs-Gridley Memorial Hospital (CA), Plumas District Hospital (CA) and Shamrock General Hospital (TX).

Mammoth Hospital (CA) will deploy Allscripts RCM services and EHR at its 11 outpatient clinics.

Independence Blue Cross (PA) selects Kony Solutions’ Write Once, Run Everywhere as its mobile application platform.

Mental Health Partners (CO) chooses Stockell Healthcare Systems’ InsightCS RCIM to integrate with the MindLinc behavioral EMR.

Pacific Eye Specialists (CA) selects SRS EHR for its 10 providers.

Doctor’s Medical Center (FL) signs up for Vitera Intergy Meaningful Use Edition for its 23-physician practice.

People

Olathe Health System (KS) hires George Dix as CIO. He was previously with Cape Fear Valley Health System (NC).

Andrew Ziskind MD, previously with Accenture, joins Huron Consulting Group as a managing director in the company’s healthcare practice.

Announcements and Implementations

St. Joseph’s Medical Center (CA) implements PerfectServe’s clinical communication and information delivery system.

Continua Health Alliance and some of its member companies will exhibit personal connected solutions at the International Consumer Electronics Show (CES) in Las Vegas next week. That show outdoes HIMSS in terms of celebrity sighting potential, with Dennis Rodman, Justin Bieber, Snooki, and 50 Cent among the glitterati collecting big corporate paychecks for serving as set dressing for booths.

athenahealth announces that it proactively sought and received a favorable Advisory Opinion from HHS’s Office of Inspector General relating to athenaCoordinator, a fee-based offering that would provide order transmission and coordination services to providers. The opinion clears the way for athenahealth to offer a per-transaction pricing model that charges fees to parties that are exchanging clinical data, but steering clear of anti-kickback statutes.

Government and Politics

HHS announces two winners of its contest to create HIT applications using public data for cancer treatment and prevention. The ONC awarded $20,000 each to the developers of  Ask Dory!, submitted by Applied Informatics, and My Cancer Genome, submitted by Mia Levy PhD, MD of Vanderbilt University Medical Center.

Other

Serbia’s health minister says the introduction of an electronic health card system has turned doctors into scribes, forcing them to fill out forms instead of taking care of patients. He offers a solution: “When a doctor finishes examination, he/she enters data into computer and then takes a health card and fills it in manually. I asked them why not printing the findings and attaching them to the health card. That would speed up the process.”

University of Mississippi Medical Center lays off 115 employees and cuts 90 unfilled positions, saying it’s struggling with increased charity care and coming up with the $80 million it needs to implement Epic.

An Iowa public policy analyst discussing the pre-caucus healthcare climate there says the governor accepted $7 million in federal HIE grants while calling it a government takeover of healthcare. “The practical side of that is that many don’t want the government telling them what to do, and the only way that can happen should this continue forward is by setting up your own exchange, otherwise the feds will set up their own.”

Sponsor Updates

• Free EMR vendor Practice Fusion streamlines its e-prescribing workflow.
• Greenway Medical Technologies and NextGen will join MedAllies at the HIMSS12 Interoperability Showcase to demonstrate MedAllies’ Direct HISP patient data exchange solution.
• Computerworld includes Ugo Mattera, VP of information technology operations at McKesson Health Solutions, in its 2012 class of Premier 100 IT Leaders.
• MED3OOO announces a free webinar regarding its PQRIwizard powered by CECity.
• McKesson introduces its cloud-based supply chain solution to support supports multiple materials management information systems.
• Southern Tier HealthLink (NY) expands its use of Lawson Cloverleaf Hosted HIE.

EPtalk by Dr. Jayne

An article in the Journal of the American Board of Family Medicine discusses barriers to use of formulary information by physicians who e-prescribe. It wasn’t a huge study and the authors claimed it looked at eight practices of varying size and specialty, but a closer look finds the practice size to range from one to four physicians, which I would generally consider to be small practices. Each was using a standalone eRx program. Information was gathered both through observation and through interviews.

Some interesting points. The study included the use of a standalone EHR program, which I bet that made it easier for providers to consider a paper-based workaround. I wonder if the results would have been different if the eRx solution were part of a reasonably robust EHR or if larger practices were reviewed. The researchers had backgrounds in medical anthropology and labor relations, which is certainly an interesting combination.

Although few users were using formulary and benefit references prior to the study, there was a central theme of provider distrust of the electronic resources due to inaccurate data. Providers continued to use paper-based workarounds to find information. Three key difficulties were noted: (a) health plans aren’t required to provide a full set of formulary information; (b) some software packages “normalize” the data, creating groups such as preferred, formulary, or off-formulary which really don’t mean anything; and (c) some payer information is group-level rather than plan-level, which can mean a huge difference in insurance coverage information.

In my market, only 70% or so of the patients have valid formulary information accessible through the EHR despite our attempts to make provision of formulary information a part of our contract renewal process with payers. I agree that the coverage groupings are confusing, but they were confusing in the paper world as well. Personally, I’d like to see some realistic ideas of coverage such as “covered and dirt cheap” vs. “covered but crazy expensive” or even “don’t even think about it.” That would certainly help me be a more Meaningful User.

In addition to immunization and disease surveillance registries, some states are offering registries for Advance Directives, with Virginia being the most recent to head online. I love the idea of patients being able to document what kind of healthcare they want in the event they are no longer able to make their own decisions, and putting it online is a lot more helpful than stashing it in a file cabinet at home or in a bank lockbox. State information exchanges may eventually allow physicians access.

Unfortunate things can happen when patients lose the capacity to indicate their wishes, especially if they haven’t communicated those wishes to family members. Whether you have an online registry in your state or not I, encourage everyone to talk to your loved ones about what you might or might not want done should the situation arise. Some nurses made fun of me when I arrived for an elective procedure (as a sassy 20-something patient) with my advance directive and healthcare power of attorney documents in hand, but I wanted to make sure that in the event of something horrible, it was clear how I wanted my care to proceed.

Speaking of cheery topics, the American College of Physicians recently released its update to its Ethics Manual. The sixth edition features new guidelines that address the issue of cost effectiveness and efficiency in care delivery. Other new or expanded sections include: confidentiality and EHRs; health system catastrophes, social media and online professionalism; pay for performance and professionalism; and patient centered medical home.

Websites like Groupon that offer daily deals are increasingly prone to offer health-care related services. Patients without coverage use the discounts to receive dental care, while others may take advantages of bargains on elective or non-covered services such as Botox or laser vision surgery.

Contacts

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

Acquisitions for Mediware, Cumberland Consulting, and TriZetto

Mediware has announced its acquisition of the assets of Transtem, which sells software for managing adult stem cell collection and transplantation. Mediware President and CEO Thomas Mann said in the announcement, “This is cutting-edge healthcare that is pursuing cures for such large patient population diseases as myocardial infarction (MI), critical limb ischemia (CLI), Parkinson’s disease, diabetes, cancer and many others. Importantly, there is a growing demand for a comprehensive software solution to effectively manage the collection and preparation of the therapeutic cell solutions as well as streamline donor, patient and treatment data management.”

Cumberland Consulting Group has been acquired by members of its management team and private equity firm Tailwind Capital, with participation by investor and former HCA Chairman R. Clayton McWhorter. Tailwind Managing Director Geoffrey Raker said in a statement, “This transaction represents a tremendous opportunity for Tailwind to invest in a proven platform that provides high quality services to a dynamic industry in the midst of an IT transformation. Cumberland has a very experienced management team and is well-positioned for future growth and expansion. We look forward to supporting Cumberland as it pursues future organic initiatives and acquisitions.”

TriZetto announced this morning that is has acquired Medical Data Express, which offers Medicaid and Medicare encounter management software. TriZetto Chairman and CEO Trace Devanny said in a statement, “By acquiring MDE, TriZetto is cementing its ability to offer customers a proven, comprehensive and reliable solution that helps payer organizations meet federal and state requirements for medical encounter data processing. We are committed to continuing to enhance our suite of solutions helping Medicare and Medicaid plans leverage the efficiencies they gain for strategic advantage while maintaining compliance.” 

2012 Mobile Clinician Voice Challenge 1/4/12

The Problem

Clinicians and their mobile devices are everywhere. Doctors, nurses, and other licensed professionals are interpreting clinical information and making clinical decisions right now using smart phones and tablets, often from locations outside the four walls of the hospital, clinic, or medical practice. They need better ways to interact with these systems beyond tiny keyboards.

The Solution

Give mobile clinicians a voice by speech-enabling your applications, both Web-based and mobile, with as few as two lines of code and in as little as a couple of hours. Free them from the limitations of poking at keyboards that are too small for normal fingertips –let them document on the go using their voice.

Link.

The Challenge

The 2012 Mobile Clinician Voice Challenge offers over $25,000 in prizes for most innovative, speech-enabled healthcare application (Web-based or mobile) developed using the HIPAA-secure, cloud-based Nuance Healthcare Development Platform. The contest runs through February 3, 2012, with winners to be announced at the HIMSS conference.

The Prizes

Full Details

Information is available on the contest page. See the text ad in the right column of HIStalk as well, which will run throughout the contest.

Not a Developer?

Tweet about the contest using @NUAN_Healthcare and #2012mobilechallenge and you’ll be entered in a daily giveaway for contest tee shirts and an iPad 2.

Contest Video

Link.

An interview with Jon Dreyer, senior manager of mobile solutions marketing, Nuance Communications, Healthcare Division


Describe Nuance’s philosophy about the mobile clinician.

The “mobile clinician” is quickly becoming synonymous with the modern clinician. In fact, physician smart phone adoption, which is currently at 72%, outpaces the general U.S. adult population by more than 50%.  And by the end of 2012, mobile device adoption among healthcare professionals is expected to reach 85%.

Whether racing from exam room to exam room or working remotely, mobile access to clinical information and mobile collaboration tools are essential for caregivers. This new breed of healthcare professional is in need of better experience-enhancing technologies, such as speech recognition that is available on any device at any time, in order to be completely untethered, yet still be fully plugged in to interact with and contribute to the care delivery process.

With voice-powered applications becoming common, especially on smart phones, do you see that as becoming a standard for systems designed for clinician use?

Absolutely. Voice will continue to grow as a primary form of input into mobile devices for consumer markets as well as within healthcare. Touchscreen devices with small onscreen or physical keyboards will never catch up to the speed of data entry on a desktop environment. Speech recognition overcomes the challenges associated with touch typing and bridges the gap to provide a ubiquitous experience for all users on all devices and platforms.

Keep in mind that speech recognition software designed specifically for healthcare professionals has been in use for more than a decade. On a daily basis, hundreds of thousands of clinical users across all healthcare specialties rely on the technology to reduce turnaround times, cut costs, and improve the overall delivery of patient care.

Given the dramatic rise in mobile device adoption over the past few years, and its projected growth, it’s only natural that the speech recognition experience clinicians have come to appreciate on their desktop is something that they will expect from their mobile and web-based apps as well.

Give me some cool ideas or apps you’ve seen that would be a good choice to speech enable just in case developers out there need some inspiration.

We have more than 100 partners in our evaluation program today. Healthcare app developers are rapidly embedding secure, cloud-based, medical speech recognition in point-of-care documentation/mobile EMRs, reference and content databases, disease management, clinical trial, pharma, and specialty-specific reporting tools. The applications run on a variety of devices and operating systems that are supported by the development platform, including iOS, Android, Web Browser (Internet Explorer, Safari, Firefox, Chrome), and native desktop applications.

Examples of clinical scenarios and apps that use speech recognition powered by Nuance Healthcare include:

• Mobile EMR access. With speech recognition as part of the workflow, physicians can easily voice document findings and clinical notes without having to return to a workstation or office.
• Interactive patient-side care. Specialists using mobile applications can now visit patients post-surgery and retrieve, as well as document using their voice, all relevant information on their mobile devices.
• Trauma communication and coordination. With specialized, speech-enabled mobile apps, clinicians can capture in their own words the patient story without delay. In a trauma scenario where every minute matters, this streamlined mobile approach helps to speed communication across care teams while expediting prep time for surgery.
• Diagnostic image view and reporting. Radiologists can now access patients’ diagnostic images via their mobile device and dictate reports from anywhere and at any time. The time in which patients receive feedback and care can be significantly shortened.

Do you have any words of encouragement for those who are thinking about entering the challenge?

Healthcare app developers should join the challenge because there’s really no reason not to participate.  Not only is it free to evaluate the Nuance Healthcare cloud-based medical speech recognition technology, but it’s also easy to integrate, deploy, and maintain. It requires minimal development effort (most evaluation partners have their integrations up and running within a few hours of registering) and clinical end users will benefit greatly from having access to medical speech recognition from their mobile and web-based apps.

Contest Notes

• The contest is open to any developer who is a legal resident of the US.
• You can submit multiple entries.
• Apps do not need to be live and/or commercially available.
• Apps do not need to be written specifically for the contest – it’s OK to integrate the speech service into an existing app.

Links

• Contest page
• Press release
• Nuance Healthcare’s ‘For the Health of IT’ blog
• Twitter
• Facebook

QuadraMed Acquires NCR Healthcare Solutions

QuadraMed announced this morning that it will acquire the healthcare solutions business of NCR Corporation, whose products include a patient access kiosk, patient and physician portals, and a payment solution. Terms were not disclosed.

NCR acquired the product portfolio when it bought Maitland, FL-based Galvanon in December 2005.

QuadraMed CEO Duncan James was quoted in the announcement as saying, “This addition to QuadraMed’s portfolio is a logical extension of our existing Access and Identity Management offerings. NCR’s healthcare solutions will improve our clients’ ability to meet the increasing demand for patients to control and self-direct their healthcare experience at hospitals, clinics and physician practices.”

NCR’s healthcare workforce in Lake Mary, FL and Hyderabad, India will become QuadraMed employees on January 5, 2012.

News 1/4/12

Top News

The District of Columbia, armed with $1.06 million in ARRA money, issues an RFP for an HIE technology platform. Bids for the one-year contract are due on January 13. The District decided to support the simpler Direct Project rather than a traditional HIE last year, putting the DC RHIO, which was expecting to get the grant money, out of business.

Reader Comments

From Sunshine: “Re: new hire. Mike Mieure from Sunquest and Misys is the director of IS for Vitera Healthcare.” Confirmed via LinkedIn.

  From Tipsy: “Re: tips for meeting with reporters. Joseph Goedert has some great advice for vendors scheduling meetings with the press. My personal favorite: don’t send your marketing manager to talk to the reporter.”  Mr. H does far more interviews than I do, but I am sure that if anyone attempted to give us a lesson on HITECH basics, we’d be making fun of them later. If you handle media relations for a vendor or PR firm, do yourself a favor and give Joe’s blog post a quick read.

From AnotherDave: “Re: Dr. Jayne’s 1/2/12 post, What Gets Measured Gets Managed. To quote Nick D’Onofrio, ‘You can expect when you inspect.’” Dr. Jayne outdid herself with her post this week, which is getting tweeted and mentioned all over the place. It was informative while being fun to read. She enjoys using reader feedback for future posts, so if you have something you’d like her to write about or comment on, e-mail her.

From Pyorrhea, IL: “Re: a second Judy Faulkner article. Does this include any new information, or is it just the same thing over again?” The first article seemed merely politically biased and sloppy with facts, but the second one by the same author ventures into pure nut-job territory, claiming “a de facto alliance between Epic and the Service Employees International Union” because some of Epic’s hospital customers employ SEIU-organized labor, which is hardly shocking given that Epic’s core customer base is academic medical centers in big cities. I have one positive comment about the article: it was short.

HIStalk Announcements and Requests

  Mr. H seems to have survived without my assistance last week. No surprise, of course, but I like saying it so he’ll take a moment to reflect on how much more fun it is to have me around pinging him with e-mails all day. In my absence, I have noticed almost all our sponsors have now replaced their animated ads, giving the site an almost Zen-like peacefulness (thank you, sponsors.) Now that I am back, Mr. H and I are heads down in our HIMSS planning and are excited about a couple of new fun projects in the works. In addition to the more serious stuff, we are addressing details for the annual Inga Loves My Shoes contest, as well as the crowning of the HIStalk King and Queen for the best-dressed HIStalkapalooza party-goers. I predict an exhaustingly good time will be had by all.

It’s the New Year, so it’s time for HIStalkapalooza signups. Our amazingly gracious, creative, and fun event sponsor ESD has been working tirelessly for months in planning a memorable Las Vegas event for you. It’s at First Food & Bar in The Shoppes at the Palazzo (ESD bought the whole place out for the evening) on Tuesday, February 21 at 6:30 p.m. ESD is a consulting firm, so let’s go over the deliverables. Great food – check. An award-winning bar plus specialty drinks such as the IngaTini, the Mr. H Incognito, and the ESD Activation Sensation – check. Fun contests involving shoes and people dressing up – check. A special performance by Elvis – check. And of course, Jonathan Bush and the HISsies – check and mate. Click the graphic above, the button to your right, or here to request an invitation. If we get fewer requests than we have capacity, then beautiful – everybody who signs up will get an e-mailed invitation. If we’re overbooked (which has happened every year so far, and often quickly), we’ll invite the number of folks we can handle. HIStalkapalooza is held in honor of those involved with HIStalk, HIStalk Practice, and HIStalk Mobile in any way (reader, sponsor, contributor, etc.) and we gratefully acknowledge the support of ESD in making it possible. More to come once we get the signups finished.

Here’s some background about ESD (they didn’t ask me to talk them up, but it’s the least I can do considering they’re paying for HIStalkapalooza.) The Toledo, OH consulting firm provides expertise that includes clinical transformation, go-live support, legacy system maintenance, staff augmentation and training, system optimization, and help with ICD-10 and Meaningful Use projects. Clients often (always?) need healthcare experience and workflow expertise that’s way over the head of freshly minted vendor implementers. That’s where ESD’s expert clinical consultants can save the day, helping CIOs sleep at night by reinforcing their front lines to complete projects, generate ROI, and optimize processes. Founder and President Joe Torti started the company as a solo consultancy in 1990 and has grown it to over 400 clinical IT consultants (nurses, physicians, pharmacists, etc.) and 30 corporate employees. If you’ve been around awhile, you’ll no doubt recognize some of the management team names as I did: Joe Mason, David Tucker, and Dan Oberle, to name a few. ESD not only brings you HIStalkapalooza 2012, but is also a Platinum Sponsor of HIStalk. I greatly appreciate the ongoing support of ESD.

Acquisitions, Funding, Business, and Stock

Chicago-based solar products company SoCore Energy LLC raises $3 million in an equity offering. Among its investors is an investment fund run by Michael Ferro (Merge Healthcare). The company’s chairman and co-founder is Allscripts CEO Glen Tullman. I Googled hoping to find that Epic’s mammoth solar installation used solar panels from SoCore, but nothing came up, dashing my hopes for perfect irony.

Sales

San Jacinto Memorial Hospital (TX) selects PerfectServe’s clinical communication and information delivery platform.

The Premier Healthcare Alliance awards a group purchasing agreement to Authentidate for its Electronic House Call Kiosk and Interactive Voice Response solutions.

Stanford Medical Center (CA), HealthEast (MN), Oakwood Healthcare, and McLaren Healthcare (MI) prepare for the ICD-10 deadline by utilizing OptumInsight’s A-Life Medical computer-assisted coding.

Albany Area Primary Health Care (GA) selects eClinicalWorks EHR suite for its 14 locations.

People

MedQuist hires Michael Raymer as SVP of solutions management. He was previously general manager of Microsoft’s Health Solutions Group.

Announcements and Implementations

Tuomey Healthcare System (SC) partners with Advanced ICU Care to deliver remote tele-ICU monitoring by intensivists and critical care specialists.

Regional Health Services of Howard County (IA) launches Cerner at its 25-bed acute care hospital.

Canton-Potsdam Hospital (NY) begins installation of MEDITECH 6.0.

AirStrip Technologies earns CE Mark certification for its FDA-approved mobile patient monitoring applications, allowing them to be sold in Europe and other areas.

Intelligent InSites integrates the TempSys Fetch real-time locating technology into its RTLS system. The InSites RTLS software solution works with several sensing systems, including active and passive RFID, ultrasound, WiFi, and ZigBee.

Pike County Memorial Hospital (MO) goes live on McKesson Paragon, earning the hospital a story in the local paper.

George C. Grape Community Hospital (IA) will hold a Virtual Ribbon Cutting next week to celebrate the completion of its EHR implementation and Meaningful Use attestation. The 25-bed hospital had to deal with Missouri River flooding through the summer as it accelerated its Meaningful Use timelines as a beta site for Healthland’s Centriq small-hospital EHR.

Government and Politics

Washington’s state prescription database goes live, but previously supportive doctors and pharmacists line up against it when the US Department of Justice tells the state not to expect to get federal money for the $530K annual operating costs. State health officials ask lawmakers to remove the portion of the law that bans charging providers for its use, which would entail yearly per-provider charges of $11 to $15.

In Canada, the leader of Ontario’s democratic party calls for a hospital CEO salary cap of $418K – double the premier’s salary — after hospitals release their compensation contracts following a ruling that they are covered by freedom of information laws.

Other

The US Patent and Trademark Office issues a patent to DR Systems for technology that tracks the resolution (or other parameter) for a displayed medical image.

Indiana University Health Physicians misses its 1,200-physician year-end employment target by 350, with some of the slowdown attributed to physician delays in committing to a common EMR and approving common treatment protocols.

Joslin Diabetes Center (MA) partners with Alliance Health Networks to participate in that company’s Diabetic Connect social network.

Sponsor Updates

• Phoenix Children’s Hospital shares how deployment of the Vocera wireless communications solution has improved communication in its NICU.
• NextGate profiles Hartford Hospital (CT)and its use of  NextGate’s matching technology to identify patients in Connecticut’s HIE.
• Besler Consulting announces the general availability of BVerified Transfer DRG and BVerified IME proprietary solutions.
• Concerro adds VLOG, a video blog option, to its Concerro University client learning center.
• Intellect Resources is holding Big Break New Orleans on January 21, a one-day audition for folks who want to help Ochsner Health System implement Epic as trainers.
• Independence Blue Cross chooses Kony Solutions as its mobile application platform.

The Iowa Caucuses and the Stakes for Healthcare
By Donald Trigg

How should we feel about an anonymous force driving US policy? Does it serve our interests to have a beef-loving sovereign dictating our national conversation? Should a single player carry such outsized influence?

We are talking, of course, not about Mr. HIStalk, but the first-in-the-nation caucuses this evening (Tuesday) in Iowa. And in the less harried first days of the New Year, a moment offers itself for a primer on the quadrennial contest and a short exposition on how it might inform the health policy dialogue this fall.

Forty years ago, an obscure McGovernite orchestrated an early start date for the Iowa caucuses. Four years later, a peanut farmer named Jimmy Carter leveraged a “win” (finishing second to uncommitted) to vault to national prominence, a party nomination, and then the White House. Iowa’s outsized role in the nominating process has been set ever since.

The number of delegates at stake in Iowa toward the 1,143 needed for nomination is modest. GOP aspirants are looking, instead, for what George H.W. Bush in 1980 called the “Big Mo.” In our vernacular, Iowa is not a supplier of choice designation. It is a down select.

Indeed, since 1972, the eventual GOP nominee has finished in the top three in Iowa with only one exception. But unlike the definitively predictive South Carolina primary, Iowa does not decide the GOP nominee. It is the “winnower” of the field.

The mechanics of the caucus process are straightforward. Voters gather in roughly 800 locations, typically in a church basement or a high school gym. After electing a temporary chair and a secretary to record the proceedings, Republicans rise to speak on behalf of their preferred candidate. Then, votes are cast. The results are aggregated and a late evening winner is declared.

If the process is fairly unambiguous, the fate of the six candidates contesting Iowa is less clear-cut. Historically, the GOP has nominated by primogeniture — falling in lockstep behind the next person in line. The 2012 race has been marked from the outset by the absence of an overwhelming front-runner.

Instead, the so-called Exhibition Season has seen a series of volatile swings from candidate to candidate in an elusive search for an alternative to former Massachusetts Governor Mitt Romney. Michelle Bachman. Rick Perry. Herman Cain. Newt Gingrich. Now, we are seeing a late “Santorum Surge” that may put the former PA Senator within striking distance this evening.

It has been said that there are only three tickets out of Iowa. Romney, Paul, and Santorum appear to be clutching them, according to the final Des Moines Register poll. But with 41 percent indicating that they could still change their mind, the Register’s Kathie Obradovich rightly characterized the race as “a moving target.”

The stakes for healthcare are large. David Blumenthal wrote last month in the New England Journal of Medicine, “The 2012 election will be the most important in the history of the health care system.” For all the potential implications in 2013 and beyond, however, the topic has featured only modestly, even comically, thus far.

We had, to the chagrin of public health advocates, Herman Cain advisor Mark Block silently smoking into the camera –reminding us that a 20-something staffer, a video camera, and free time are the campaign equivalent of whiskey, car keys, and teenage boys. We had Romney’s Massachusetts bill, and its common features with the Accountable Care Act, as consistent debate fodder. And we had the criticism of Gingrich amid his Q4 rise for his paid advocacy through the Center for Health Transformation to his vocal backing of Part D in 2004. But neither deep policy substance nor deep debate has featured to date.

One reason, beyond the constraints of the modern campaign, is that the US economy looms so large. An NBC/Facebook poll of early state voters out Sunday put the economy at 59 percent as the top voter concern ,with the federal deficit at 19 percent and with healthcare a distant third at just 11 percent. There is little reason to think that mix will shift this autumn.

The impact of that framing for healthcare finance is that the “second phase” debate will be centered almost exclusively around cost and predominately within the context of the current FFS model. We are headed toward a moment akin to the 1997 Budget Act and it may come as soon as 113th Congress.

But first we will need a GOP standard-bearer. Iowa, “the purest of prairie states,” is an opening step in that drama. It is a good and decent place where Winenrenner properly wrote the politics are “clean and competitive” and, just like HIStalk, “the arena is fair and open.”

Donald Trigg is chief revenue officer for CodeRyte. He worked for then-Governor George W. Bush during the 2000 presidential cycle in Austin, TX. He has traveled to all 99 counties in Iowa, suffering chilly winds and an unsettling amount of chicken fried steak.

Contacts

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